This month we have another peek into the medical side of fiction. We covered head trauma before, now it’s time to go a step further, by killing a character off and seeing what happens when Gustav tries to revive them. CPR is one of the most crucial first aid techniques and one that always gets used the wrong way. Let’s do it better, shall we?
The short version:
CPR does not bring people back to life. It only makes sure that if they are revived they don’t end up vegetables.
After failing to get rid of the Big Bad last time around, Gustav decides he needs to get a partner. And sure enough, as the plot will have it, there’s technological genius Woodrow, who used to be a gay exotic dancer before turning to the life of hacking into evil people’s accounts and giving all their money to Romanian animal shelters. The two quickly hit it off and form a dream team like the world has never seen before.
But gosh! The Big Bad has returned and, witnessing the world-changing teamwork these two put up, develops a master plan to both break Gustav’s spirit and get rid of that pesky kid Woodrow.
Soon, millions upon millions of nanites flow through Woodrows blood stream and at the push of a single button he drops dead, right before they can blow up the Big Bad’s base in the middle of Hungary.
Gustav is nothing if not a man of action. He drops beside his trusty friend and lays his fingers against his neck to check for a pulse. When none is forthcoming he folds his hands over each other and starts applying CPR, begging Woodrow to come back to him. He gives him mouth-to-mouth, even if he swore never ever to kiss another dude.
„Don’t you die on me. Don’t you dare die on me!“ he shouts and as if the Lord had taken mercy on him, Woodrow’s eyes open with a start. He inhales the breath of life, brought back into this life by Gustav’s quick action and true heart.
Sorry to break the news, but Woodrow’s a goner. Yep, no saving that kid. Dead as a doornail.
To understand why, we need to look at what CPR actually does.
The abbreviation CPR stands for cardiopulmonary resuscitation, meaning the reactivation of heart and lungs. The name itself is misleading, because what’s dead is dead and can not be brought back except with a well aimed intervention from Thor. Or maybe a defibrillator. Whatever’s handy at the moment.
So what are you doing, if not bringing people back to life like a second coming on budget? And why do it at all?
The main problem with dying is the sudden lack of oxygen in your brain. Of course, there’s also long periods of boredom and lack of variety when it comes to afternoon activites. But mostly it’s the oxygen. If your brain doesn’t have oxygen it withers and dies, shriveling like an old raisin. Not all at once of course. Your brain behaves more like holding itself hostage, killing random parts off one by one if you don’t get the damn blood flowing now.
Since, being dead and all, your heart isn’t very much up to the job, you take on an outside source. Meaning Gustav kneeling over Woodwrow and frantically trying to remember what he learned in his mandatory first aid course twenty years ago.
Gustav is now Woodrow’s heart. By putting all his body weight on his chest he compresses the heart, making the stored blood in it flow up to the brain. When he lets up the pressure new oxygen rich blood flows into the heart chamber which are again compressed via bodyweight and pushed up to the brain.
The oxygen itself is provided by mouth-to-mouth, which is about as far from a kiss as anyone can get. If it isn’t for you, then you’ve probably doing kissing wrong for a long time. More to that later.
Nothing during CPR gives the body any incentive to resume living. It just keeps the brain fresh until Thor or the guy with the defibrillator arrives and can attempt to resurrect it.
This is why there is a very specific rhythm to the speed of compressions. Doing it to ‘Highway to Hell’ is often recommended by First Aid teachers, though you are discouraged from actually singing it.
If Gustav were to put pressure on the heart in too short intervals it wouldn’t have time to refill and thus less blood would arrive at Woodrow’s brain, ridding it of oxygen. Too slow and all the nice blood just sits there doing nothing and again, no blood in the brain.
If Gustav doesn’t press hard enough his efforts won’t go through all the ribs and other pesky biology standing between him and the heart.
There is a very real chance of breaking ribs during CPR. You shouldn’t aim for it, but that’s about the amount of pressure Gustav should be using. Consistently. For as long as someone with some electricity comes running. CPR is bloody exhausting.
There is a brief respite for the minute or so Gustav spends taking over Woodrow’s heart function. Let’s look at the kiss of life, shall we?
Homophobes among you, no need to avert your eyes. This is the least gay kiss you will ever witness in your life.
First, no real kiss requires of you to push your intended’s head back to his neck, so the line from mouth to lungs is straight. Second you shouldn’t hold your intended’s nose closed, unless you’re into that sort of thing. And there won’t be much lip contact. In fact you will pull your mouth over the other’s as if it was a condom. Nice and snug around with no chance of air getting by. Then you blow as if you wanted to fill a six liter balloon with air in one go. Because, essentially, that’s what you’re doing. See? Mouth to mouth is closer to a children’s birthday than romantic interaction. (It’s equally stressful and traumatising, too.)
So, no homosexual subtext. But what about that sudden gasp when Woodrow wakes up after a heartfelt plea to the heavens? A myth, sadly. Rule of thumb: If someone wakes up from CPR, he didn’t need it in the first place.
Although, sometimes it can be hard determining if someone is still breathing or not. Looking for a pulse at one of the pulse points like the wrists or the neck (there are seven in total, though at least one is where you don’t want to look for a pulse on a perfect stranger) isn’t a good way to determine heartbeat. Sometimes the heart beats so faintly that you couldn’t find a pulse even if the person was upright and walking. People with low blood pressure often have that. It could also beat so fast that you can’t detect it by pure sensation of touch. Then you have to take into account that you rarely search for a pulse while completely calm and collected. Even trained professionals who spend their career looking for the dead in people sometimes have trouble detecting a pulse. That is why you check for breathing instead and with three methods. By hovering closely over the patients mouth you can listen for breath and feel it should he exhale. Your turned head also allows you to watch the chest and determine if it rises or falls. This is the most sure-fire way but even there is a margin of error.
If in doubt, apply CPR. Except for hurting like a bitch, it won’t harm your potential dead guy, but will save him a world of trouble should he actually need it.
To sum it up, you should apply CPR everytime you think someone’s dead to keep the brain blood saturated until the heart can be jumpstarted. If there is no such help forthcoming, as hard as it may be, don’t bother. There is nothing you can do without an electric shock.
On a side note: When resucitating people via a defibrillator, sometimes adrenaline is adminstered as well. It is believed it also can get a heart beating again or at least help in the process. It’s standard procedure in Emergency Rooms and ambulances, but it’s effectiveness hasn’t been proven. It may help or it may turn out to be the 21st century equivalent of blowing smoke up ones ass.
Three Rules to keep in mind:
Number 1: CPR is only useful when there is further help coming
Number 2: Waking up from CPR is not a result of the technique but of your chest hurting like hell
Number 3: Mouth to mouth is only romantic for a very select people.
The best way to get familiar with CPR and all other forms of First Aid is to do a course. It will help you get the viewpoint of administering CPR much better than if you just read about it. For example, people tend to underestimate the sheer strength and stamina needed to apply CPR for a longer period.
Courses are held practically everywhere and don’t cost much. I would strongly urge you to take one, not just for your writing but for general life as well. You could save a life with that knowledge.
In case some of you wondered why I gave sources for the post about guns but nor for the one before. This is because I am working in the medical field and write mostly from first hand experience. Guns are a topic I was not inherently familiar with, which is why I had to do a lot of manual research. If enough people are interested in the professional literature I used during med school or some of the manuals we use in our daily lives I will post them.