CPR For Dummies

A couple of weeks ago, I wrote about how the mesivta that I teach in recently got wind of a NJ law that five teachers in each school have to be certified in first aid—including CPR, the Heimlich, and the use of an AED. And we needed a course, because some of us, such as myself, had no idea what an AED is. It sounds dangerous.

So the mesivta hired an official instructor, who came in with handouts and dummies of various sizes. The idea of the course was to practice bringing the dummies to life. We were unsuccessful. But as far as I know, we’re all going to receive certification, hopefully sometime before the school year is over and some of the teachers retire.

But we definitely learned a lot. A lot of people assume that they know this stuff. (“What? I breathe and I push! I’ve been breathing my whole life!”) But there’s a lot we don’t even realize we don’t know. We don’t know the science, for example. Like the person’s heart gave out, but you’re pushing on the ribs, not even directly over the heart, and the heart is like, “Oh, right. Okay, I’ll take it from here. Sorry, everybody!”

And even if we do know it, we can always use a review. So here’s a bunch of stuff that I learned. Obviously, this is a very serious matter, but the idea here is that if this inspires you, I urge you to actually look into taking a course yourself and not just rely on a humor column.

“Step away!” you can say, if the need arises. “I am certified via humor column!”

• CPR is not really mouth to mouth anymore, ever since the scientific discovery that if you tell people to do mouth to mouth on a random person they find on the floor, there will be some hesitation.
• Also, science has recently discovered that people mostly breathe in oxygen and breathe out carbon dioxide, so you’re not really breathing out what the victim needs to breathe in. So maybe you’re better off shoving a plant in his face.
• So instead of having us put our mouths on his dummies, the instructor gave us each a resuscitation mask that we’d have to carry around to school every day until the end of time that we could run and grab in an emergency. But that’s not considered hesitation.
• Basically, the resuscitation mask is this triangular thing that fits around the victim’s mouth and nose, provided you create a seal with both hands, leaving you with zero hands free, and you’re putting all of your weight on his face, but he’s not complaining, and then you breathe into this little tube at the top. I don’t know how this solves the carbon dioxide problem.
• When you come across an unconscious victim, you don’t just jump in and start doing CPR. There’s a whole procedure you have to do first, while the person’s not breathing.
• Always defer to the highest-ranked rescuer in the room. So for example, you can say, “I’m certified in CPR via a humor column I read one time,” and if no one else claims anything higher, may Hashem be on your side.
• You also want to make sure the person is not breathing. You can’t just assume people aren’t breathing and start CPR, because there are other reasons a student can be unconscious. There are multiple things that can happen in my classroom, for example, that could cause unconsciousness, like when the students do pullups on the heating pipe that goes across the ceiling. (Apparently, I teach in a prison.) In fact, at any given point while I’m teaching, someone in the room is unconscious. And you can’t start resuscitating every student who’s asleep, or you’ll never get anything done.
• As you approach the victim, the instructor told us, choose someone else in the room and tell them to go call Hatzalah. Make sure to tell the person you send—and this is how we knew that he’s dealt with bochurim before—that he should come back and report to you afterward, as opposed to getting sidetracked at the nosh machine or running outside so he could be the first to see Hatzalah get there.
• CPR is meant to be used when the victim is not breathing and does not have a pulse, and is not responsive. That said, not every victim needs CPR. Sometimes the victim is not breathing but still has a pulse, so he doesn’t need it. But that doesn’t mean you should just walk away. You still have to do breathing stuff. It’s important to check.
• If he does not have a pulse but is breathing, the American Heart Association recommends you check again, because that’s impossible. Except that the instructor then had everyone put two fingers under their jawline to check themselves for a pulse, and the teacher next to me could not find one, thus conclusively proving the instructor wrong.
• That said, it’s very important that you learn how to find a pulse, because otherwise you say, “This guy has no pulse!” and you start CPR, and he’s lying there saying, “But I never have a pulse!” So if you don’t find a pulse, check on yourself to make sure you’re doing it right. Then on him, then on yourself again.
• According to the instructor, all breathing and compressions needs to be done on the floor. That said, if you have knee issues, you may put the person on a table. Unless you have back issues.
• Put your ear to the victim’s mouth and listen for breathing. You also know he is breathing if your glasses fog up. At the same time, while you’re down there, feel for a pulse. Do this for ten seconds.
• A good pulse, the instructor said, is about 80 beats per minute. That said, you cannot spend an entire minute while the victim is not breathing counting to 80. You have to listen for 10 seconds and then whip out a calculator. Divide 80 in your head, and then figure out what a third of a breath sounds like.
• Holding the mask in place, do a full breath out, into the mask. You don’t need to breathe in, as the victim does not need help breathing out. That is never the problem, apparently. Even Tupperware breathes out.
• With adults, you do one breath every 5-6 seconds. With kids, it’s more often. Kids breathe more, apparently, which allows them to cram more movement into every moment of the day.
• There’s also a difference between kids and adults as far as compressions, regarding how many inches you push into their rib cages. I don’t know how to measure any of this, though, because on the dummies there was a hard stopping point. I hope people have that too.
• Every two minutes, stop everything you’re doing and check again for breathing and pulse. By this point, Hatzalah should be there. If they’re not, ask the person if he really called Hatzalah. Or send someone to find the person you sent. Make sure to tell that person to come right back when he finds the first person.
• CPR is simple, once you’ve mastered breathing. All you need to do is push into the chest an estimated 1-2 ½ inches depending on the size of the person, 30 times in a very specific rhythm at 100 compressions per minute—though you’re not doing a minute because you’re stopping after 30, then breathe into the victim twice with 5-6 seconds in between. Do that whole thing five times, then check again for breathing and pulse every two minutes for ten seconds to see if he has a rhythm of 80 beats per minute. I would need six people to help me keep track of all the numbers. In fact, the one thing I learned from practicing on the dummy is that I have no idea when it’s been five times.
• You may (as in might, not as in are allowed to) break some ribs during CPR, and this happens in 30-70% of cases, because there is no stopping point 2 ½ inches in. Keep going with the procedure. If the person starts telling you that his chest hurts, he’s alive and conscious. “That’s what’s important,” is what you can keep in mind later when he sues you.
• After attempting CPR for a few cycles, you can try the AED. An AED is that machine with paddles that delivers shocks that get the heart to say, “Oh, right,” and the A stands for automated, but only to a point. You have to put the paddles on and also know when you should yell, “Clear!” and at whom.
• All schools are required to have an AED in a clear, unlocked location. Meaning that it’s been touched and played with by every bochur in yeshiva, so they can tell you how to use it, by all talking at the same time.
• Our yeshiva keeps it in the beis midrash, which I guess is where the bochurim are most likely to have a cardiac event. It’s good to know where it is, so I can move it to my classroom every time I plan on announcing that there’s going to be a test.
• And all this is if the victim is unconscious. You don’t want to do CPR if the victim is conscious, as he may not be cooperative.

Mordechai Schmutter is a weekly humor columnist for Hamodia and is the author of seven books, published by Israel Book Shop. He also does freelance writing for hire. You can send questions, comments, or ideas to MSchmutter@gmail.com. Read more of Mordechai Schmutter’s articles at 5TJT.com.