CPR 10 TRAINING TO DELHI POLICE PCR FORCE
Dr K K Aggarwal and Dr R P Vashisht
BACKGROUND and RATIONALE
Sudden cardiac arrest is the number one killer in India taking a toll of 25lakhs persons annually. As per Delhi Economical Survey “150 to 250 deaths take place every day out of which 25-45 deaths occur suddenly.”
Over 60% of victims are dying before they reach the hospital. 40 percent of these having cardiac arrest can be revived by a simple technique performed by any person.
The technique is called Hand only Cardio Pulmonary Resuscitation (CPR) or CPR10 (othr names Compression Only CPR, Bystander CPR, first responder CPR).
This technique works amazingly on people dying due to Choking, Heart attack, Electrocution, Chest Blunt Trauma, Sudden emotional burst cardiac arrest Exposure to cold temperatures etc.
Cardiopulmonary Resuscitation (CPR) is a first aid technique to help people who suffer “cardiac arrest” (their heart stops beating). Clinically the person will not respond to painful stimuli and will not be breathing. It si not for an unconscious person.
The CPR 10 training can be imparted to any person. The technique is simple and involves only hands on compression i.e. within 10 minutes of death (earlier the better) for the next at least 10 minutes (longer the better), compress the centre of the chest of the deceased person at least by 1-2 inches at least with a speed of 10X10 per minutes (100 to 125 per minute). till the medical help arrives
The HCFI has created mantra “Marne kedus minute ke under kam se kamdus minute tak 10×10=100 per minute ki speed se apni chhati peetne ke badle mare hue aadmi ki chhati peeto”.
This technique is approved by Heart Care Foundation of India, Indian Medical Association, Indian Red Cross Society, St John Ambulance Delhi , American Heart Association and American College of Cardiology and many more .
The scientific rationale of CPR 10 is that due to heart stoppage (arrest), the blood circulation ceases. In theory, there is unused Oxygen on the arterial side of the system. If adequate circulation is created via compressions, perfusion of oxygen to key organs may be achieved faster.
When the compression is done on the chest of the victim, with the body of the victim, on a hard surface, the heart gets compressed and that starts the activity on the stopped heart. It is similar to kicking a stopped scooter and starting the engine without the keys. Till the brain is alive, and heart can be started, the person can be brought back to life.
The American Heart Association (AHA) in an Advisory Statement of March, 2008 recommends hands-only CPR in circumstances when a non-medic bystander sees a suddenly collapsed adult then he or she should call ambulance service and provide chest compressions by pushing hard and fast at the rate of 100 per minute in the center of the chest keeping Interruptions to a minimum until trained rescuer/s arrive.
CPR 10 or Hands only CPR is not a difficult skill to master. The CPR 10 or Hands only CPR is still beneficial even if it is done imperfectly, one can maximize his chances of helping someone by undergoing a Regular First Aid & CPR Training Course. Even if you break the ribs while doing CPR10, its ok as one life is saved. Ribs can be taken care of by the doctors. Ribs may get broken even in the hands of trained doctors.
90% of the people can be revived if the CPR 10 is attempted in the first minute of cardiac arrest. The percentage of revival goes down with each passing minute and beyond ten minutes, the percentage becomes minimal.
Mouth to mouth breathing is not done in hands only CPR. That may however be required for cases of near drowning or children. In that case chest compression is followed with opening the airways and rescue mouth to mouth breathing.
As on today , it seems improbable that CATS / Delhi Health System may reach the victims in the first few crucial minutes. The PCR van is only facility in the city reaching the victim within five minutes; and almost before the ambulance. Therefore Delhi Police has taken the initiative to get the PCR Force trained cent percent in Hands only CPR or CPR10 in partnership with the Heart Care Foundation of India (HCFI) , Indian Medical Association (IMA) and Indian Red Cross Society (IRCS) Delhi at no cost to the Delhi Police. Delhi Police believes that Even if one person is saved a day from cardiac death by PCR Force, this is a great human service to the community.
TRAINING METHODOLIGY :
The PCR Force will come daily seven days a week to IMA Building at ITO in a batch of 200-300 people. The training will be imparted by Dr K KAggarwal Hon. Secretary General IMA & President HCFI assisted by Dr R P Vashist Hon. Secretary IRCS Delhi .
The training session will last 30 to 45 minutes. Every person will get one to one training opportunity on individual manikin. The target is to achieve cent percent coverage on or before August 14, 2015.
The trained personnel will be given certificates dully certified by the partnership. These certificates have value addition to the individual holders. The cost of certificates will be borne by Delhi Police. In addition, a monthly training session will continue for the follow up. The partnership ( the DP, the HCFI, the IMA, the IRCS) will bring out a mobile phone App on the technique which will also act as a supplementary training tool and a refresher guide to the already trained force. The cost of the development of the App can be decided on mutual consultation.