A video shared by Railways Minister Ashwini Vaishnaw recently went viral, triggering an intense debate on the proper procedure for performing Cardiopulmonary Resuscitation (CPR). The video showed a Travelling Ticket Examiner (TTE) administering CPR to a 70-year-old passenger who was reportedly conscious during the process while on a moving train. While the minister initially praised the act as a life-saving effort, it quickly drew widespread criticism from medical professionals and the general public alike, sparking questions about the correct application of CPR.
In his defence, the minister followed up with a clarification, stating that CPR should cease once the patient becomes conscious or can follow commands, signalling a return of spontaneous circulation. However, this explanation failed to quell the backlash from doctors, many of whom argued that performing CPR on a conscious individual is not only unnecessary but also potentially harmful. Some went as far as to suggest that the video should be deleted, stressing that CPR should only be administered to an unconscious person.
Our dedicated Indian Railways’ team. pic.twitter.com/BDIEnHTEns
— Ashwini Vaishnaw (@AshwiniVaishnaw) November 24, 2024
The Medical Backlash: Why Was the CPR Incorrect?
Doctors and medical experts quickly pointed out several significant issues with the video. First and foremost, CPR is only meant for individuals who are unconscious or unresponsive due to cardiac arrest. Administering CPR to someone who is conscious could not only be ineffective but might also cause harm. Moreover, the video showed the TTE performing mouth-to-mouth resuscitation, which is only advised in cases where the person is unconscious and not breathing.
Another key point raised was the environment in which the CPR was being administered. Performing CPR on a moving train posed a major safety risk. Medical professionals emphasized that a proper response to a potential cardiac arrest would involve halting the train and ensuring a controlled environment where the patient’s condition could be properly assessed and treated. In an emergency, every second counts, and attempting life-saving techniques in a chaotic setting may delay access to the appropriate medical care the person needs.
Sir, he is harming the patient than helping her. CPR is not offered to patients who are conscious. This only exposes the fact that TTE s aren’t even trained in giving basic life support.
— Dr Rahul Mally (@drrahulmally) November 24, 2024
Understanding CPR: When Is It Really Needed?
CPR is a critical life-saving technique used when a person experiences sudden cardiac arrest. In this state, a person loses consciousness and stops breathing, with their heart no longer functioning. At this point, CPR is performed to manually restore blood circulation and provide oxygen to vital organs until professional medical help arrives.
Also Read: Amitabh Bachchan Swears By Yoga For Health; Discover Key Benefits Of Yoga For Ageing Adults
But how can you determine when CPR is necessary? The first step is recognizing that the individual is unconscious and not breathing. Once this is confirmed, CPR must be initiated immediately to prevent brain damage and organ failure due to the lack of oxygen. The American Heart Association (AHA) provides clear guidelines for CPR administration.
Proper CPR Techniques: Conventional vs. Hands-Only
CPR can be administered in two primary ways: conventional CPR and Hands-Only CPR.
Conventional CPR
This method involves a combination of chest compressions and mouth-to-mouth resuscitation. The standard ratio is 30 chest compressions followed by 2 rescue breaths. For effective chest compressions, the AHA recommends a compression rate of 100-120 per minute, with a compression depth of at least 2 inches (5 cm), but no more than 2.4 inches (6 cm) to avoid injury. This method should only be used when the person is unconscious and not breathing.
Hands-Only CPR
For bystanders witnessing an adult collapse, Hands-Only CPR is often advised. This involves performing chest compressions without mouth-to-mouth breathing. The compression rate remains the same, and the focus is on delivering consistent and effective compressions until emergency medical help arrives. This technique has been shown to be just as effective in saving lives as conventional CPR, especially when performed quickly and with proper technique.
Why CPR Should Be Performed Only on an Unconscious Person
CPR is not intended for use on someone who is awake or aware. The body’s natural reflexes and processes can still function when a person is conscious. If someone is alert, their heart is likely still beating, and they are able to breathe on their own, thus making CPR unnecessary and potentially damaging. Furthermore, chest compressions and mouth-to-mouth resuscitation could cause injury or trauma to the patient, especially when the person is awake and trying to resist the procedure.
In this particular case, the viral video showed a person who appeared to be conscious during CPR, which is a clear violation of the basic principles of life-saving measures. When someone is alert, it’s crucial to reassess the situation, ensure they are breathing properly, and seek medical attention immediately without attempting CPR.
CPR should be stopped when a person becomes conscious or follows commands, which are signs of return of spontaneous circulation.
— Ashwini Vaishnaw (@AshwiniVaishnaw) November 25, 2024
Understanding the Right Time to Act
This incident serves as an important reminder about the critical need for proper CPR education and awareness. It highlights the fact that while the intention to save a life is commendable, administering CPR at the wrong time or in the wrong circumstances can do more harm than good. If you witness someone collapse and suspect cardiac arrest, the first step is to check if the person is unconscious and not breathing. If they are unresponsive and not breathing, initiate CPR immediately. If you are unsure of how to proceed, performing Hands-Only CPR is always better than doing nothing at all.
In cases where the person is conscious or regains consciousness, CPR should be stopped, and the focus should shift to seeking professional medical care. Remember, CPR is a life-saving tool—but it must be used correctly to ensure the safety and well-being of the person in need.
Bottomline
The viral railways video has sparked a much-needed conversation about the proper techniques for CPR, but it also serves as a cautionary tale about the importance of proper training and the right timing when it comes to life-saving procedures.