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(Don't post it off of Tumblr, thank you)

This is the “part two” of an animation I published some time ago. “Claire” went into ventricular fibrillation and fainted. The first thing you have to do if you find someone on the ground is to check if the place is safe and look that there are no things like uncovered electrical cables, fires or armed people (self protection is actually very important). Once you are sure there are no danger you have to verify that the potential victim is really unconscious: you can call her, and say something like: “Hey you! Can you hear me?”; this is always good. If the victim doesn’t react you can apply a slightly painful stimulus like a pinch on the shoulders and if the victim doesn’t react neither to this you have verified the state of unconsciousness. At this point if you are sure that the victim is not a traumatic event victim you place her supine over a rigid surface, with limbs alligned to the body and you have to stay on one of the victim’s side at the level of her chest. You can now start a protocol called “ABC” a sequence of first aid procedures. The “A” stands for “airways”, you have to check if there are no objects that are obstructing her airways, you have to check the nose and expecially the mouth, here because the tongue is the main cause of chocking in an unconscious person you have to turn her head upward considering the victim body’s axe (avoid to move the head if the victim is a traumatic event victim). If you see an obstructing object try to remove it, if there are fluids first turn the head on one side to let it flow outside. The letter “B” refers to “Breathing”. You should first rapidly look at the victim’s chest searching for movements but to be really sure the best method is to place your ear few “fingers” over the victim’s nose and look downwards to her chest, from this angle it will be extremely easyer to see movements and hear the airflow. If you see no movements, hear no airflow or strange noises (agonal breathing) you have to consider as absent the respiration; this is usually enough to consider the victim into cardiac arrest and at this point you have to call for a rescue team but to be even more sure you can pass to the letter “C”. “C” means “Circulation”, with the best way to assess this system consisting of checking the carotid pulse. She has two main carotid arteries that lie on the two sides of her trachea, if the heart is beating it’s quite easy to find them and feel the pulse by touching there with two fingers. In the absence of a carotid pulsation it’s clear that the victim is in cardiac arrest. In the presence of a cardiac arrest the brain will suffer irreversible damages after 3 minutes so you should be as quick as possible. You have to expose the victim’s chest and find with your fingers where the ribs join together with the sternum in the front of the torax, a couple of fingers upwards to that position slightly on the left is where her heart lies, position yourself very close to the victim side arm, and put your hands on the center of her thorax (near the heart), both of them, one over the other and crossing the fingers but keeping both hands OPEN. Your arms have to be straight (elbows blocked) and perfectly perpendicular to the victim. Now you have to do 30 compressions with a linear movement never bouncing on her chest or leaving the position at a pace of 100-120 compressions per minute reaching a “depth” of four fingers (it can be exhausting). After 30 compressions you can blow your air in the victim’s lung closing her nose with the fingers of one of your hands and opening her mouth with your other hand (in some countryes this is not mandatory, the most important part is the compression). You have to check if the victim’s chest expands when you blow in the air, do not try again if you fail, after 2 blows restart the compressions. Keep going on 30+2 till the recue team arrives. The team will take your place, rapidly confirm the status of the victim and applying a defibrillator. There are 3 types of defibs: Authomatic, semi-authomatic and manual with the second one as the most utilized, it will check the heart rhythm and decide if to release a charge if the rescuer press a button. Defib leads can be placed in 3 different ways: anterior-posterior with one lead in the center of the chest and the other on the back; lateral-lateral with one lead on one of the side of the chest and the other one on the other; anterior-lateral, the most utilized, with one lead under the right clavicle and the other one on the left side of the chest. Before releasing the charge the operator will look if no one is touching the victim or is excessively close otherwise the charge will probably create another cardiac arrest victim… The charge released by the defibrillator will restart the heart electrical activity by simply stopping it for some seconds, if there is not an important underlying condition that caused the fibrillation her heart should restart in few attempts.

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Which is the correct frequency for good compressions? If one doesn’t know the answer he could think about the fact that, for an adult, the correct heart rhythm at rest is between 60 to 100 bpm so compressions should have around the same rhythm, right? Wrong! A heart to beat properly needs to realize a series of complex activities, in the case the heart stops, an external compression is not able to mimic its beating completely. The cardiac output realized by a compression is smaller than the one generated by a normal beat. To artificially create a sufficient blood flow toward the brain during compressions, the pace must be higher than a normal resting rate. To be effective you should stay around 100 to 120 compressions each minute (the best on the upper portion of this interval) and it is a really huge physical effort for the rescuer. Just a curiosity: cases are reported in which the compressions were so good that the victim woke up just to faint again instants after the maneuvers were stopped having no pulse at all.

In this situation you and some of your friends are at a pool party. You are running around in the pool playing to create a whirl. One of your friends has an heart condition about which she’ve never said anything. To run around in the water for such a long time is a huge effort and her poor heart suddently gives up. Having no more an heartbeat she just stands still for a couple of seconds saying nothing just looking at the void and then collapses on the ground. You bring her outside of the pool, you start the ABC procedures and when you recognize she’s in cardiac arrest you remove her bra and start CPR.

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Snow White and the Seven Dwarfs - Chest Compression?