Renewing CPR and first-aid skills help prepare for emergencies

WASHINGTON -- They're in airports, stadiums, museums and even schools. Wherever you find a lot of people these days you're likely to find a portable heart defibrillator.

The devices deliver an electric shock to people whose hearts are beating erratically or have stopped. They can mean the difference between life and death when someone suffers sudden cardiac arrest, if bystanders know what to do.

"As long as you follow the instructions they are really quite safe," said Connie Harvey, a health and safety specialist for the American Red Cross.

The machines come with instructions in words and pictures, and some also have recorded instructions. But while using the devices is easy, people have to have the confidence to know when to use them, she said.

That's why the Red Cross trains an estimated 6 million people a year in first aid and cardiopulmonary resuscitation (CPR), skills that need to be updated periodically. Many more people take courses at local hospitals, health departments and other facilities.

"One of the big buzzwords is empowerment. What could be more empowering that being able to save a life? And you just never know when the occasion would arise when you will be able to use those skills," said Betty Connal of Inova Healthsource, which offers courses at several hospitals in northern Virginia.

A study published in the New England Journal of Medicine found that even people with no prior training can use defibrillators effectively. The report on defibrillator use in Chicago airports over a two-year period found that of 11 cases where people were rescued, six of the rescuers were untrained passers-by.

Demand for CPR and first aid classes has doubled over the past year, Connal said. It may be a reaction to the terrorist attacks or simply people encouraging friends to take classes or more employers sending their staffs, she said.

In addition, people are spending less time in hospitals these days, with the result that more adults are caring for loved ones at home and taking classes to update their skills, Connal said.

The basic first aid course is likely to be the same everywhere, although more attention may be paid to heat stroke in Phoenix or frostbite in Fairbanks or altitude problems in Denver, said Harvey.

One change from the past is that today's courses emphasize protecting against disease transmission, either from the victim to the rescuer or vice versa. That means the introduction of barriers -- disposable gloves, for example -- when handling someone who is bleeding. Breathing barriers, which allow air but not fluids, to pass through, can be used to give rescue breaths to a victim.

The Red Cross stresses three steps in helping a victim: check, call and care.

Check the area to make sure it's safe for you to help -- no live electrical wires, for example. Call 911 or send someone for help. Then take action to care for the victim.

There are new skills to be learned, such as using defibrillators. There are old skills that need practice, like bandaging and splinting. For people who haven't been taught first aid in some years there may be skills that need to be changed.

"One thing that seems to be instinct in choking is to slap them on the back, and that is something that should be unlearned," said the Red Cross' Harvey. "You're forcing the object down when you want to get it out."

"We have to correct some of those kind of myths," Connal agreed. Instead of a slap on the back the rescuer should use the abdominal thrust -- also known as the Heimlich maneuver -- to dislodge material from a choking victim, she said.