Railways video showing CPR on conscious patient faces criticism; cardiologist shares dos and don’ts of the life-saving procedure

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A video shared by Ministry of Railways, showcasing a Travelling Ticket Examiner (TTE) performing cardiopulmonary resuscitation (CPR) on a 70-year-old conscious passenger who had suffered a heart attack has attracted criticism on social media, with medical experts pointing out that performing this procedure on a conscious person can be dangerous.

CPR is a life-saving emergency procedure and given its critical nature, it becomes essential to administer it accurately at the correct time. In a conversation with mid-day.com, Dr Pradeep Kumar D, Senior Consultant - Cardiology, Manipal Hospital, Yeshwanthpur, discusses the essentials of performing CPR.

When should CPR be given? When should it be stopped?

Dr Pradeep: CPR should be administered to a patient who is unresponsive, not breathing spontaneously and has no pulse. These are signs of a cardiac arrest, and immediate CPR can help maintain circulation and oxygenation until emergency medical services arrive.

CPR should be stopped when the patient begins to breathe on their own, regains a pulse or when trained emergency responders arrive. If the person regains consciousness or begins breathing, continue monitoring until help arrives.

What is the correct process of administering CPR?

Dr Pradeep: CPR should be performed with chest compressions on the lower half of the chest, with a depth of compression 5-6 cm and a compression rate of 100-120 per minute. After 30 compressions, 2 rescue breaths should be given. The breaths should be delivered only if the person is not breathing on their own and if mouth-to-mouth is appropriate. This process should continue until the person shows signs of life, such as breathing or moving, or until emergency medical personnel take over.

What are some definitive 'Don'ts' of performing CPR?

Dr Pradeep: It is essential to keep the following don'ts in mind while performing CPR:

1. Don't perform CPR on someone who is alert, conscious and talking. If the person is responsive and breathing, CPR is not necessary and could cause harm.

2. Don't give chest compressions if the person has a pulse. Performing chest compressions on someone who has a pulse can cause damage to the heart or other organs. Always check for a pulse before starting compressions.

3. Don't interrupt compressions for more than 10 seconds. Every interruption, such as checking for pulse or giving breaths, should be as brief as possible. Prolonged pauses in chest compressions can reduce the effectiveness of CPR and decrease survival chances.

4. Don't forget to position your hands properly for compressions. Place your hands on the lower half of the breastbone, ensuring the heel of your hand is centered and your fingers are not pressing on the ribs, which can lead to fractures.

5. Don't attempt to administer CPR if the scene is unsafe. Ensure the environment is secure before providing CPR.

Disclaimer: This is for informational purposes only and does not replace professional medical advice or training. Kindly consult a qualified medical expert for personalised guidance.