First aid: Knowledge of CPR will save life

Some cases have been recounted of women who are transferred to hospitals after delivery but they collapse and lose consciousness on arrival. Dr Bonaventure Uwineza, the head of department anaesthesia and clinical care at University Teaching Hospital, Kigali (CHUK), says this happened because the woman had bled profusely after giving birth. “She needed a cardiopulmonary resuscitation (CPR) to bring back her heart rhythm. When I carried out the procedure her heart was beating again after a couple of minutes and we managed to save her life,” he says. According to Uwineza, a lot of patients die because people around them are not aware of what to do when they collapse. “By the time they are taken to hosipital, there is less that can be done to rescue their lives.” Uwineza says many lives can easily saved if the entire population is educated on how to carry CPR, adding that it doesn’t require one to be a medical expert as basic information is needed for anyone to do it. When CPR is needed Uwineza explains that CPR is a lifesaving technique conducted in case of emergencies such as in case of drowning, an accident, and heart attack, where someone’s breathing or heart beat has stopped. “CPR comprises chest compressions, which generate small but critical amounts of blood to the heart and brain,” he says. Uwineza explains that someone doing CPR should do it until the heart rhythm comes back, adding that it is a very systematic activity which is very demanding in terms of personnel. For instance, he points out that when there is one rescuer, it’s harder than when they are two or more performing the CPR. “Most of the time when people collapse, the only thing people run to do is provide them with fresh air. Unfortunately, it’s not the right way to save the life of someone who needs CPR to bring back the rhythm of the heart,” he says. To identify if someone needs such help, Celestine Karangwa, a physiotherapist at TCM Technology Clinic, Kigali, says in case of a collapse, the rescuer needs to first check the patient’s pulse. “CPR should be done timely and fast to allow blood to reach the brain and other parts of the body fast,” he says. However, he says one should do CPR while calling for help from other people to help because doing it alone is not easy. Karangwa points out that here in Rwanda there are a lot of lives that have been lost following a collapse just because people around them don’t have any information about CPR. In the Ministry of Health, there is a paramedics unit which one can reach by calling 912 for immediate help in case of emergency. Who is at risk? Karangwa points out people with underlying conditions such as diabetes, high blood pressure, heart failure, as well as those with drug abuse problems, are more at risk of heart failure. On the other hand, Yvan Ntwari, a general practitioner in Kigali, says the common signs for someone who has cardiac arrest are sudden collapse, no pulse nor breathing as well as loss of consciousness. He notes that since there is no sure way to know the risk of sudden cardiac arrest, the best way to prevent it is to reduce the risk. Also regular checkups and screening for heart disease and living a heart-healthy lifestyle is as well vital. Ntwari notes that sometimes there can be rib fracture if the CPR procedure is not carried out right. Uwineza, however, suggest that such training (CPR) should be included in the curriculum at high school level, so that students can learn the simple techniques of helping a patient who may need a CPR. He says in busy public places, for example where people do sporting, the people in charge can be given basic information so that in cases of emergencies they are in a position to handle to prevent deaths that can be avoided. Uwineza further advises that after the CPR, the patient should get further checkups and medication to rule out the exact cause of cardiac arrest. He says fainting should not be mistaken for cardiac arrest, as the former occurs when a person is just lacking oxygen in the brain or has low blood pressure, and not that they don’t have pulse as is the case with cardiac arrest.