Critical lessons for life

MARK NICHOLS March 23 1998

Critical lessons for life

MARK NICHOLS March 23 1998

Critical lessons for life



Seventeen-year-old Kasia Smetny was watching a tennis match in Halifax last summer when she saw another spectator, a white-haired man of 60, fall to the ground. A small crowd gathered around the man’s unconscious body, recalls Smetny, who was visiting friends in Halifax at the time, “but nobody was really doing anything.” So she did something. Drawing on training in cardiopulmonary resuscitation (CPR) that she received in Grade 9 at her Ottawa high school, Smetny checked for a pulse and, when she failed to find any, made sure his airway was clear then blew into his lungs. Still unable to locate a pulse, she placed her hands on his chest and leaned the weight of her body against them. The stricken man responded by gasping— and by the time an ambulance arrived soon after, he was showing definite signs of life. The man she helped was Robert Weatherston, a Halifax businessman who recovered and was soon walking several kilometres a day. Weatherston telephoned Smetny later to thank her for helping to save his life. “I’m happy I was there,” she says. “I just did what seemed natural.”

Only 10 per cent of Canadians know how to use CPR

couver are considering setting up programs, and ACT has had inquiries from scores of schools and boards across the country. “Our goal,” says Sandra Clarke, ACT’s executive director, “is to have CPR training in one grade of every Canadian high school in major centres by the year 2000.”

If that happens, a significant part of an entire generation of Canadians would grow up possessing basic knowledge of CPR—a vast improvement over the current situation that relies on adults volunteering for train| ing by such organizations

0 as the Canadian Heart and

1 Stroke Foundation, the Red £ Cross and St. John Ambu§ lance. About 75,000 Canadi£ ans a year have heart at1 tacks—22,000 of them fatal.

Statistics show that about seven out of 10 cardiac arrests happen at home, and many victims die simply because so few Canadians

In fact, by her quick action Smetny became

the vital first link in a chain of survival that can save someone whose heart has stopped because of organ failure, electrocution, drowning or some other life-threatening event. The key lies in keeping the victim alive until emergency personnel arrive with the equipment needed to electrically shock the victim’s heart back into operation. Yet even though CPR techniques have been around for more than 25 years, experts in emergency care estimate that only about 10 per cent of Canadians know how to use them. Now, an Ottawabased, nonprofit organization called the ACT (for Advanced Coronary Treatment) Foundation is trying to change that by making CPR instruction part of highschool curriculums across the country. So far, ACT has helped to get CPR courses going in secondary schools throughout Ottawa and two nearby Ontario counties. Pilot programs are also under way in 16 high schools in Montreal and 18 in Toronto. As well, school boards in Edmonton and Van-

know how to provide CPR in the crucial first few minutes after the attack. Besides teaching students to recognize heart attacks and provide help, CPR instructors make students aware of the “denial response” common among victims—a refusal to acknowledge their own symptoms, often until it is too late. Most students who have been instructed say they like the CPR courses, which take about four hours of school time. “It was fun,” says Carolyn Chevrier, a 14-year-old who received training at her Montreal high school earlier this year. “I hope it never happens, but if I had to, I could help a family member who had a heart attack.”

One of the features that helps to win over school boards, says Clarke, is that except for the time teachers spend being trained themselves and instructing students, CPR courses in the schools cost virtually nothing. As well as contributing instruction manuals and other educational materials, ACT helps raise money for the training of teachers and canvasses local service clubs, corporations and charitable organizations for the modest funding needed to run the programs. The heaviest outlay is at the start



Once learned, the steps are simple. But experts stress the importance of taking a course in the correct technique for cardiopulmonary resuscitation.

1. When someone has collapsed and is unconscious, immediately call for help by dialling 911.

2. To clear possible airway obstruction by tongue, tilt back victim’s head, lift chin, listen for breathing.

3. If victim is not breathing, pinch nostrils shut and cover victim’s mouth with yours.

Give two full breaths.

4. Check for pulse, by placing fingertips on victim's Adam’s apple, then sliding them sideways into groove next to the windpipe. If there is no pulse, move on to the next step.

5. Place hands on lower part of victim’s breastbone. Push to compress chest 15 times. If there is no sign of recovery, alternate mouth-to-mouth breathing and chest compressions until help arrives.

with the purchase of plastic head-and-torso mannequins that students use to practise CPR (cost per mannequin: about $65).

In launching school-based CPR programs, it also helps to have a dedicated member of the local community to win over school boards and search out funding—someone like Dr.

Justin Maloney, a physician specializing in emergency medicine at Ottawa General Hospital who teamed up with ACT in 1993 and played a key role in persuading Ottawa school boards to introduce CPR training—and the local Kiwanis Club and other organizations to help fund the program. As a result, says Maloney, “we now know that we’re getting 10,000 new CPR providers from the school program each year.”

In the neighboring Ontario counties of Prescott and Russell, east of Ottawa, René Berthiaume, a Hawkesbury, Ont.-based ambulance service operator, played a similar role in convincing school boards to launch CPR training last year. “Part of the challenge,” says Berthiaume,

“was people saying this couldn’t be done in a rural area because of the smaller population spread over a large area—I wanted to prove that it could be.” In Montreal, Shirley Straughton, a nurse at Montreal Children’s Hospital and mother of two teenagers, played a key role in persuading schools to launch CPR training.

ACT’s Clarke, a former Montreal child care worker who specialized in helping handicapped youngsters, got interested in CPR after her younger sister took a course in the late 1970s (the sisters’ father died of a heart attack when he was 51). Clarke decided to take the course as well, went on to become an instructor and gradually became caught up in the idea of encouraging wider knowledge of the techniques. In 1985, she founded ACT, with funding (currently $250,000) provided by four drug companies—Astra Pharma Inc., Hoescht Marion Roussel Canada, Merck Frosst Canada Inc. and Parke-Davis. After mounting a series of national campaigns in an effort to make Canadians more aware of CPR, ACT switched its focus in 1994 to high schools.

One of the advantages of teaching CPR to teenagers, says Clarke, is that it also pro-

vides a natural opportunity for education about “heart health”—how low-fat eating habits and plenty of exercise can benefit Canadians’ cardiovascular systems. Ideally, people trained in CPR should have periodic refresher courses. But even if they don’t, says Clarke, “some training can be better than none. The important thing is giving help—quickly.” With CPR instruction taking root in the school system, more Canadians should soon be able to provide vital assistance to family members, or total strangers, when heart failure strikes.