On November 1, 2022, during the Halloween festival in Itaewon, Yongsan-gu, a large number of people gathered, pushed and fell, and a stampede accident occurred, in which hundreds of people were crushed. Due to the crowds immediately after the accident, it was difficult for rescuers to enter, and the rescue was delayed, and some citizens performed CPR, but there were not enough rescuers. A total of 156 people died and 151 people suffered small or large injuries due to suffocation due to chest compressions, the most common cause of death in stampede accidents.
This incident is quickly exposed nationwide through social media, and everyone must have felt the importance of CPR. It is an important first aid that can increase the survival rate in situations where cardiac arrest occurs not only to strangers passing by, but also to close family and friends. I think that all citizens should know about CPR, which is a decisive help in saving lives, and that periodic education is necessary. It is organized so that the general public can easily understand it, and it is not difficult, so I hope that everyone can learn about CPR.
Let’s start with the basic knowledge for CPR.
1.carotid artery
The carotid artery is a large blood vessel located in the neck. It is an important blood vessel that sends blood from the heart to the cerebrum, supplying energy so that the brain can function smoothly.
When the carotid artery is damaged or in cardiac arrest, the blood supply to the brain is cut off, causing loss of consciousness within 10 seconds or so, and brain damage begins. In case of cardiac arrest, 2 to 3 minutes, if CPR is being performed, up to 30 minutes of irreversible brain damage, but if more time is delayed, irreversible brain damage will be received.
In the case of the carotid artery, you can easily feel the pulse when you press it with your finger, so it is easy to check the state of cardiac arrest. Therefore, if you find a patient who has collapsed, check the carotid artery immediately and if you do not feel a pulse, you must perform CPR.
2.Automated external defibrillator (AED)
For defibrillators, you can find defibrillator locations near your current location by entering the site below.
https://www.e-gen.or.kr/egen/search_aed.do
Instructions for use are as follows (source – Korea Cardiopulmonary Resuscitation Association)
① Power on – The defibrillator should be used only for cardiac arrest patients who do not respond and breathe normally, and should be applied without delay if the defibrillator arrives during CPR. First, place the defibrillator in a location that does not interfere with CPR, then press the power button.
② Attaching two pads – Pad 1 (under the right clavicle) and Pad 2 (on the middle axillary line under the left nipple) are attached after removing any foreign matter at the corresponding location, and if the pads and the defibrillator are separated, connect them.
③ Heart rhythm analysis – When the voice command “Analyzing” comes out, stop CPR and take your hands off the patient. If a heart shock is needed, the defibrillator starts charging with the energy set by itself along with the voice command, “I need a heart shock.” It takes more than a few seconds to charge the defibrillator, so maintain CPR as much as possible. If a heart shock is not needed, a voice instruction “Check the patient’s condition and continue CPR” comes out, and in this case, CPR continues.
④ Conduct a shock – The shock button starts blinking only when a shock is needed. Press the flashing button to deliver a heart shock. Before pressing the shock button, make sure no one else is away from the patient.
⑤ Restart CPR immediately – After delivering the heart shock, resume chest compressions and eye respiration at a rate of 30:2. The defibrillator repeatedly analyzes the heart rhythm every 2 minutes, and the use of the defibrillator and the implementation of CPR should continue until the 119 ambulance arrives on the scene.
Let’s learn more about CPR.
The first guideline for CPR is “If you find a person who has collapsed, judge it as a cardiac arrest and report it to 119.”
Reporting is the first principle because it can be somewhat difficult for the general public to determine whether or not there is a pulse in the carotid artery and whether there is breathing or not.
If there is no one around you, report it first, and if there is someone around you, point out exactly (the person wearing a red T-shirt!) and request a 119 report. And ask someone other than the person you named for the report to bring you an automatic defibrillator.
After notification is given first, “palp the carotid artery and check breathing” will be checked if possible.
It may not be easy to check breathing, but it is better to start chest compressions without delay if breathing check is not possible. Chest compressions should not be delayed because of breathing checks.
Immediately, chest compressions and artificial respiration are performed at a ratio of 30 (times): 2 (times), but it is very important to continue chest compressions without stopping.
The location of chest compression is the lower half of the sternum, the heel of the palm of the hand, and the other hand is overlapped, interlocking and compressing, and the elbow must be straightened to apply force well.
Compression is performed at 100 to 120 times per minute at a depth of 5 cm, and it is as important to release as much as to press during compression. During release after compression, maximal chest relaxation is required so that the next blood flow is filled to the heart so that blood flow can be circulated by chest compression.
Use the automatic defibrillator as soon as it arrives, and continue chest compressions until 119 paramedics arrive.
This is a video for practicing CPR chest compressions.
The response of a cardiac arrest patient in the first 5 minutes of cardiac arrest determines their fate. In an emergency, if CPR is performed by a witness, the resuscitation rate increases more than three times, so please make sure everyone is familiar with CPR.
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