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April 11, 2008

BehindTheMedspeak: 'What should you do if you come across an unconscious person?'


That was the question posed in Melinda Beck's February 12, 2008 "Health Mailbox" column in the Wall Street Journal.

Ms. Beck — who took over from Tara Parker-Pope, lured across town by the bigger impact factor (and, no doubt, $$$) afforded by the New York Times — has gotten her groove and now offers a consistently interesting and informative read.

Here's the gist of the aforementioned Q. & A.

    Q: What should you do if you come across an unconscious person, as in the case of actor Heath Ledger?

    A: Emergency physicians say the first step is to verify that the person really is unconscious. Shout, shake him or dig your knuckles over his collarbone. That may revive him.

    If it doesn't, call 911. Then check to see if the person is breathing. It may be shallow so put your ear to his face to feel for any movement of air. Also watch to see if his chest is rising. If you don't detect breathing, tilt his chin back, open his mouth and clear out anything that may be blocking his airway. Then check again for breath. Also check for a pulse; the easiest place is under the jawline on either side of the windpipe.

    If the unconscious person is breathing and has a pulse, you probably don't need to do anything else. Just stay by his side until assistance comes.

    If there's no breath or pulse, the 911 dispatchers may ask you to perform cardiopulmonary resuscitation (CPR).


The new CPR eliminates so-called "rescue breathing" and focuses on chest compressions.

Make it hard and deep (try for 2" of up-and-down movement with each compression) and fast — 100 times a minute without interruption.

Don't worry about sharp cracking sounds — those are ribs breaking and all it means is that you're doing it correctly.

Completely acceptable collateral damage, happens all the time.

Keep on with the chest compressions.

CPR performed properly can get very tiring even for experts: I find five minutes of chest compressions is the max I can do before I start to noticeably slack off in terms of power and frequency.

If there's someone else around, draft them to help while you rest.

More on the new CPR here.

CPR training?

You just had it.

April 11, 2008 at 10:01 AM | Permalink


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If the AHA guidelines on how to do CPR are obsolete, perhaps you should omit them from your excerpt. It's not completely obvious what you mean at first glance, and I can imagine that someone skimming won't get the point.

Posted by: k | Apr 11, 2008 1:30:58 PM

As your link shows, mouth to mouth is not necessary. The chest compressions apparently also cause some movement of air in and out of the lungs. Advanced airway techniques when not done properly just squander valuable time. These techniques are best left to those who know how.

Posted by: QuietusLeo | Apr 11, 2008 1:06:10 PM

I heard to perform cpr in NYC you shout, "Get up! You're going to f***ing die!".

Posted by: Nick | Apr 11, 2008 10:20:18 AM

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