6 Minutes to Save a Life

Could you do it?

Textbook Response

Linda Jones's two-year-old son, Reilly, was sharing a hot dog on the deck overlooking her friend Lisa Roth's swimming pool. One moment Jones was watching Reilly goof around with the other children at this gathering of moms and kids last July. The next moment he was gone. Jones turned to her friend Maschel Rawlings and asked, "Have you seen Reilly?"

Rawlings stood, scanned the pool and suddenly screamed. Reilly was floating facedown in the deep end. What happened next was a textbook response: As Rawlings dove in the pool, grasped the boy, rolled him over and swam him to the edge, their host, Lisa Roth, rushed into the house and called 911. At the pool's edge, Rawlings handed Reilly up to his mother. His skin was blue, his eyes had rolled back in his head. He wasn't breathing.

Jones laid him next to the pool, and Rawlings, who'd taken a CPR course with Jones just four months earlier, immediately began rescue breathing. Hanging up the phone, Roth, a former flight attendant who'd had seven CPR courses over the years, ran back out to the pool and took over CPR from Rawlings. Three long minutes went by with Roth breathing into Reilly's mouth and performing chest compressions while Rawlings and Jones monitored his condition.

Gradually his color returned, and then, just as paramedics were arriving on the scene, Rawlings looked at Roth. "He's breathing," she said.

The decisiveness with which the women acted saved Reilly's life. Linda Jones finds it hard to express her feelings for her two friends. "I'm eternally grateful," she says simply. "They did everything right."

Would you do everything right? Experts estimate that once the heart stops, there is a crucial window of four to six minutes to restore circulation. Nationwide, fire and rescue operations are having a tough time finding paramedics. A shortage would mean response times could stray beyond that six-minute mark. There's a real possibility that you could face a situation in which a person's life depends on your knowledge and ability.

Keep this guide handy for dealing with summertime emergencies, but also sign up for training in CPR -- something every American should know.

CPR
Cardiopulmonary resuscitation -- CPR -- is the cornerstone of emergency medicine. There are lots of reasons why someone's breathing or heartbeat might stop -- heart attack, stroke, drowning, electrocution, overdose and many others. Whatever the cause, the required action is the same: Put oxygen into the victim's lungs by performing rescue breathing, and circulate it through the body by doing chest compressions. These instructions are for use on unresponsive victims age 8 and older.

1. Have someone call 911 or the number for Emergency Medical Services (EMS) in your area. She should also check to see if an automated external defibrillator (AED) is nearby. These devices can shock the heart back into a normal rhythm and are found in many public locations, from airplanes to restaurants.

2. With victim lying faceup, tilt the head back by lifting the chin up with one hand, pushing down on the forehead with the other hand, to open the airway.

3. Look, listen and feel for signs of normal breathing (chest rising and falling, breath on your face or ear) for about five seconds.

4. If victim is not breathing, pinch the nostrils shut and give two slow full mouth-to-mouth breaths, making sure a good seal is formed and making sure you see the chest rise.

5. Check for normal breathing, moving and coughing -- signs of circulation.

6. If victim begins regular breathing and regains consciousness, monitor until help comes. If he is breathing but unconscious, turn him onto his side and monitor until help arrives.

7. If the victim is still not breathing, moving or coughing within 5 to 10 seconds, give 15 chest compressions at a steady rhythm of about 2 per second: Place the heel of one hand with the other atop it at the center of the breastbone directly between the nipples. Lock your elbows and align your shoulders directly above your hands. Push down just enough to move the breastbone about one and a half to two inches.

8. Repeat rescue breaths and chest compressions. After four cycles, check for signs of breathing and circulation.

9. Until circulation and breathing return or help arrives, continue compressions and rescue breaths at a ratio of 15 to 2. Check for signs of circulation and breathing every few minutes.

Stay Calm

Heart Attack
Last winter, Ruth Carroll was watching her husband, Tom, shooting pool with some buddies at the local bowling alley where he worked part time. The 84-year-old had just finished a shot when he turned toward Ruth.

"He looked at me funny," Ruth says, "and that was that." She and a friend caught Tom before he hit the floor.

Tom's friend and boss, Don Lebold, came out of the kitchen as a staff member called 911. Knowing that Tom had had two previous heart attacks, Lebold -- who had taken four CPR courses over the years -- checked for a pulse. There was none. Lebold directed a friend to give breaths to Tom. Then Lebold began performing chest compressions. Twice, Tom began breathing again, and twice more he stopped.

Undaunted, the two continued CPR until paramedics arrived and used a defibrillator to restore Tom's heartbeat. "What Don did is the most important part," says Tom Carroll, who has made a full recovery and is grateful to be alive. "Without that, there wasn't much chance for me."

The following are possible signs of a heart attack: pain or pressure in the center of the chest, sometimes radiating down through the left or both arms; tingling in the jaw; cool, clammy skin; shortness of breath; nausea or lightheadedness. The symptoms vary widely: A good rule is to treat any of these unexpected symptoms as a heart attack. If the victim is conscious:

1. Call EMS. Check for an AED.

2. Encourage the victim to sit and stay calm.

3. If the victim has medication to take in the event of a heart attack, she should take it immediately.

4. Stay with the victim, monitoring her until help arrives. Proceed with steps for CPR if needed.

For someone who is unconscious:

1. Call EMS. Check for an AED.

2. Check for breathing and other signs of circulation to see if CPR is needed; if signs are present, lay victim on side and monitor until help arrives.



Burns
Derrick Harris was driving his 18-wheeler down a highway in southern Virginia last fall when he spotted a fireball in a drainage ditch. Curiously, the fire seemed to be moving. To Harris's horror, he realized he was looking at a person on fire. The 36-year-old pulled his truck over, grabbed a blanket, ran to the man and smothered the flames. The victim, a homeless man who had been set on fire, was severely burned over 60 percent of his body.

Harris called 911, keeping the man covered with a blanket and calm until help arrived. "I credit what I did with being in the military," says Harris. The man survived.

Burns are classified as first-, second- and third-degree (most severe). These rules apply to mild to moderate burns:

1. Running cool water over a burn may alleviate some of the pain.

2. Mild burns may be treated with burn creams. Don't use butter.

3. Any burn that encircles a body part (such as a wrist or finger), or any significant burn to the face, should be evaluated by a physician.

4. Cover burns with sterile bandages to keep them clean and dry.

5. If blisters form, don't open them.

For extensive or deep (third-degree) burns, take the following steps:

1. Call EMS.

2. Do not move the victim unless he's still in danger. Don't try to remove victim's clothing.

3. Cover the burns by laying a clean sheet or blanket over the burned area.

4. Raise burned areas above the level of the heart if possible. Monitor victim and proceed with steps for CPR if needed.

5. Protect the victim from drafts and keep the victim dry.

Injured Limb
For first aid, it is not very important to know whether an injury is a break or a sprain. If the body part is swollen and painful, assume the worst.

1. Call EMS. Have the victim lie down or get in a comfortable position.

2. Don't try to straighten or set the bone, or put weight on the limb.

3. Place an ice pack on the injury, with a clean cloth between the skin and the ice pack.

4. Remove the ice pack every 20 minutes for 5 minutes.

Comfort the victim. If you're away from civilization with no help on the way, you can transport the victim by improvising a splint:

1. Use a pillow, foam pad, thick newspaper, wooden slats or other materials to surround the limb, providing support to keep the bones from moving (. If the limb is crooked from the break, splint it that way rather than straightening it.

2. Use rope, twine, duct tape, a belt, T-shirt or other materials to secure the splint. Be sure the splint is held snugly but not too tight: You should be able to slip a finger comfortably between the binding and the splint.

3. Do not allow the victim to put weight on the limb during transport.

Be Prepared

Bleeding
The big news is that the experts no longer recommend that laymen use tourniquets to treat blood loss. Tourniquets can do a lot of harm -- increased bleeding, paralysis -- and are often unnecessary.

1. Call EMS. Place a clean cloth or bandage directly against the source of the bleeding and press firmly.

2. If the bleeding occurs on a limb, raise the body part so that it is higher than the heart.

3. If the bandage becomes saturated, do not remove it. Instead, add bandages on top of each other as needed. If the bandage is saturated, you may need to adjust your pressure more directly onto the source of the bleeding.

Should blood continue to flow at a high rate, try using one of two major pressure points.

If the wound is on a hand or arm:

1. Seek out the brachial artery between the biceps and triceps on the inside of the upper arm.

2. Use four fingers to press against the artery until you've stopped or noticeably slowed blood flow to the wound. Keep pressure on the artery until EMS arrives. If the wound is on a foot or leg:

1. Unless you suspect a spinal injury, have the victim lie on his back.

2. Seek out the femoral artery in the crease of the groin, where the leg meets the body.

3. Using the heel of your hand, press down against the artery until bleeding stops or noticeably slows. If you're unsuccessful, use two hands to press harder. Keep pressure on the artery until EMS arrives.

Anaphylactic Shock
Don Cota had been stung by a bee before and thought he was mildly allergic. But last summer, when the 54-year-old outdoorsman was showing game warden Scott Martin an illegal bear-baiting site in the Maine woods, he was attacked by hornets and had his first full-blown anaphylactic reaction. Minutes after being stung, Cota had just made it back to his truck when everything began to go black. "I think I'm in trouble," he said before passing out beside the driver's door.

Cota's girlfriend, Rae Moore, had been waiting. She and Martin moved Cota to the passenger seat. Martin ran to his own vehicle and tried to radio for help, but they were out of range. He instructed Moore to follow him, his siren blaring. Cota drifted in and out of consciousness as they sped out of the woods. Martin finally contacted an ambulance, and they met rescuers 22 miles from their starting point. A nurse quickly stabilized Cota. He made a full recovery and now carries an injector kit of epinephrine everywhere he goes. "If Scott hadn't been there, we would have been in trouble," Cota says. "I thought I was history."

Whether caused by bee stings, food, or other allergies, anaphylactic shock can be life-threatening. The signs of a severe allergic reaction are hives, itching or swelling on parts of the body away from the sting site; tingling or itching in the throat or on the tongue; dizziness; difficulty breathing or swallowing; constriction in the chest. This is an urgent emergency.

1. Call EMS.

2. Ask the victim if she has an injector kit (EpiPen) she can use. If the victim is unconscious, you're certain it's an allergic reaction, and you are trained to use the EpiPen, do so.

3. Monitor the victim; proceed with steps for CPR if needed.



Choking
Someone who is truly choking can't make noise or get air. The windpipe is blocked and you'll need to perform the Heimlich maneuver. Call EMS so help will be on the way in case your efforts fail. Remember, if the person can cough, speak or breathe, don't do the maneuver. These instructions are for victims age 1 or older:

1. Step behind the choking victim.

2. Wrap your arms around the victim's midsection.

3. Make a fist with one hand and place the thumb side on the victim's abdomen, between the navel and the bottom of the rib cage. Place the other hand over the top of the fist.

4. Thrust upward into the abdomen with the hands only, avoiding the rib cage, until the object is expelled.

5. It's always a wise precaution for a victim to visit a physician after the maneuver has been performed.



Heat Exhaustion
Heat exhaustion is dehydration due to prolonged heat exposure. Recognized in time, it's easily treated. The victim is thirsty, weak, often pale in color, clammy and sweaty; he may also be dizzy or nauseated.

1. Make sure the victim stops exerting himself.

2. Give the victim fluids (water, a sports drink). Make the victim more comfortable in such ways as moving him to a cooler environment, loosening tight clothing or fanning him.

Heatstroke
Extreme temperatures can cause heatstroke, a serious condition occurring most often among the elderly. A telltale sign is a shift in mental state, such as confusion that's out of the ordinary for the victim. She will have a very high body temperature; may vomit, stop sweating and have red, hot, dry skin; and may have a rapid, weak pulse. Breathing may be shallow and rapid, and the victim can lose consciousness.

1. Call EMS.

2. Get the victim out of the heat.

3. Immediately begin cooling the victim's body by sponging with cool water or applying ice packs.

4. Monitor breathing. Proceed with steps for CPR if needed.