“Reducing fears and uncertainty through practice”
Check, call, press: Anyone can save lives by lay resuscitation. We spoke with Patricia Niemietz, CARL Support staff member and former nurse in the field of intensive care medicine, about the topic of lay resuscitation, fears about the right technique and establishing lay resuscitation in schools.
Ms. Niemietz, you are a former nurse in the field of intensive care medicine and have witnessed resuscitation emergencies in the internal medicine intensive care unit. What happens when an emergency call comes in?
Patricia Niemietz: I have worked as a nurse in the field of intensive care medicine on an internal intensive care unit, where emergency situations occurred regularly. Unlike an emergency outside the hospital, in a cardiovascular arrest in the hospital, treatment proceeds under controlled conditions. In an intensive care unit, the patient is already connected to various devices and a monitor indicates when, for example, asystole occurs. Then two nurses as well as a physician immediately start the measures to be initiated: One person starts directly chest compressions, then quickly a chest compression system is established.
An emergency cart with prepared emergency medication is brought in and the first emergency drugs are injected. The monitoring as well as the ventilation are permanently monitored, blood gas analyses are performed closely and, depending on the results, measures are adapted as quickly as possible. In such an emergency situation, every minute counts, as within three to five minutes without oxygen supply, the first cell damage can occur.
Cooperation works hand in hand, the team is in constant contact and every step on the patient is communicated so that all processes run smoothly. One person, usually the physician, takes the lead and makes clear announcements to the team. In such nerve-wracking situations, it is very important to remain and stay calm in order to ensure optimal care for the patient.
Heart failure, and in particular sudden cardiac death, occurs predominantly outside the hospital in everyday life. How do you recognize such an emergency situation and what can each of us do in such a situation?
Niemietz: It can happen to anyone at any place; maybe in the supermarket, at the gas station or on the way home. If you find yourself in an emergency situation, you should be prepared for it. It takes around ten minutes for the rescue service to arrive on the scene, and these ten minutes are life-critical for the patient. If you don’t start cardiac massage right away, it can massively endanger the patient’s survival. First you should check, whether the person is conscious or directly responsive. If this is not the case, you should call the emergency directly, or, if another person is nearby, ask him or her to do so. Then immediately start the chest compressions: The upper body should be free. Place the two balls of the hands one above each other on the middle of the chest between the two nipples and push through the elbows so that more power is available for chest compressions. Chest compressions should be given 100 to 120 times a minute until the emergency physician arrives.
In an emergency situation, many people are certainly afraid of doing something wrong or feel overwhelmed by the task of performing lay resuscitation?
Niemietz: There is actually no “doing something wrong” in an emergency situation, everyone can help. If you have dialled the emergency number in an emergency situation, you can have the rescue service give you step-by-step instructions on how to perform lay resuscitation. The best way to do this is to set your phone to hands-free mode. The rescue service is trained, and the appropriate specialists will guide the rescuer every step of the way. On site, you should also try to enlist the help of another rescuer to assist you with lay resuscitation and to take turns with so that cardiac massage stays efficient. By pressing, one establishes an emergency circuit; when the rescue service arrives, the emergency paramedics can perform chest compressions.
What can you recommend to refresh one’s knowledge on the subject of lay resuscitation?
Niemietz: Even if someone doesn’t have that much time, everyone can get information digitally. Personally, I think it makes sense to attend a course where you can actively practice resuscitation on a first aid manikin and share ideas with other people. This also gives you more confidence if you get into such a situation. On site, each participant can also clarify many questions directly and on a personal level, and through the personal contact, perhaps also exchange information afterwards.The topic of lay resuscitation is complex, and such courses also help to train automatisms that can be recalled in an emergency situation as well as to reduce fears and a certain shyness, for example with regard to the risk of infection as in the Covid period.
How important do you think it would be to establish first aid and resuscitation as an educational subject in schools in order to counteract the fear of resuscitation?
Niemietz: Children and young people can also be witnesses in emergency situations and become lifesavers. Therefore, education and practical courses on first aid and lay resuscitation are recommended at school. And it seems important to me in this context that it is not just a one-time introduction, but that continuity and sequential courses are offered. Regularity is crucial. This also applies to adults. Personally, I have reduced many fears and uncertainties through continuous practice and training. and I myself also think it is worthwhile for employers such as companies and public institutions to regularly train their employees in this direction. Because it can affect anyone, regardless of time and place, and then it’s: check, call, press.