Cardiac Life Support for Aging Folkies

by Mike Richardson

There’s nothing like doing cardiopulmonary resuscitation (CPR) on a friend to make one into an instant poster child for cardiac life support.

The Northwest folk community recently learned this lesson on New Year’s Eve ‘06, when one of our dancers had a cardiac arrest on the dance floor during our Northwest New Year’s (NWNY) Camp. First, I’ll give away the happy ending – our dear friend survived this event, and is now back home and doing well. What remains are more details about what happened, what we learned, and how we are preparing for the next time.

More Details

As I write this eleven days after the event, most of us campers are finally starting to calm down a bit. At the time, I was absolutely eff-ing terrified. I say this even though I am a physician and have done real, live CPR a number of times in the past. However, I have never done it on a friend, and only once before outside a hospital. To up the stakes, we were at Camp Sealth, a rural island retreat in the middle of Puget Sound, down a long, windy dirt road from the nearest EMT station.

At moments like this, it was a great comfort to be surrounded by a group of smart and talented friends, who saw what needed to be done and did it quickly and quietly. Within moments, four physicians and a fire captain/EMT were performing CPR. Other quick-thinking people called 911, ran for the local automatic external defibrillator (AED), and set up a privacy screen of sheets around the resuscitation effort.

When the AED arrived, we connected it, delivered a shock, and successfully restarted our friend’s heart. The island EMTs arrived shortly thereafter, took over care, and quickly transported our friend to Seattle via a helicopter ambulance. Our folk brigade meanwhile mobilized to transport our friend’s spouse to town, to get their car and gear home, and to provide round-the-clock support at the hospital.

An hour or so into 2007, we got our best new year’s present ever, when we heard the news that our friend was waking up.

What We Learned

1. Be prepared.

In some important ways, we were.

Designated Camp Doctors

I give the NWNY Camp Committee high marks for their prescience in recruiting a set of two “camp doctors” for the past few years. These physician campers normally spend the weekend dealing with minor owies and boo-boos, and dancing and playing music the rest of the time. I’m very grateful that we had even more folks around with medical training. It’s difficult to imagine doing real, live CPR by oneself.

CPR Training

A number of campers on-site had CPR training. CPR is supremely useful; with basic CPR, a patient’s chance of making it to the hospital alive following a witnessed cardiac arrest increases dramatically (from 5% to over 60%).

On-site AED

CPR is wonderful, but sometimes it just isn’t enough. However, with AED use, the resuscitation success rate goes way up (to 83%), and the chance of recovering normal neurological status is very high.

Defibrillation works best when done quickly. I can’t tell you how glad we were to see that AED appear at our resuscitation site so quickly – the only better sight was seeing it restart our friend’s heart. We are all extremely grateful to the woman who donated the AED to Camp Sealth.

2. No battle plan survives first contact with the enemy.

A good CPR training program pounds a few simple steps into your brain so that you can recall them even in times of great stress. One version: Call (for help), Pump (cardiac compression), Blow (artificial respiration) ¹. However, every CPR class I’ve ever had has had the same problems: it takes place in a quiet, comfortable room with minimal distractions. There’s time to think and recheck your notes. You know that darned manikin is going to need CPR, and you never have to worry about false alarms or alternative diagnoses.

If I were teaching a CPR class tomorrow, I’d add a few things to make it more realistic: a marching brass band would burst into the room playing the 1812 Overture; the CPR manikin would barf all over you; and some dude dressed like the Grim Reaper would stalk around with a scythe, just to help you remember the stakes you’re playing for. This chaos works like a Dementor, sucking all thoughts and training out of your skull. Your best defense is to have multiple folks with CPR training – a group mind doing CPR chances greatly increases the likelihood that the resuscitation will stay on track and all the right things will get done.

3. We were really, really fortunate.

Even in the best hands in a great hospital, CPR and defibrillation don’t always work. We are humbly grateful that our efforts were sufficient to help our friend.

4. The job’s not over when the ambulance pulls away.

Once our friend was off to the hospital, we were all in a state of shock, depressed, and with no idea of the eventual outcome. Eventually, cooler heads (not mine) realized that having taken care of one patient, we still had over 100 adults and kids huddled together in the main hall needing some attention. Many people still had an incomplete idea of what had just happened, and no one knew what to do next.

Someone pointed out to me that as a caller and one of the camp doctors, I might be an appropriate person to give a medical summary of what had just happened, and possibly get the group moving again. The medical summary was easy enough to give, other than the part about trying to speak with my proverbial heart clenched in my actual throat.

The next part was tougher – what should we do now? I flashed on a caller’s workshop I had attended years ago, led by Fred Park. In a “Gigs from Hell” session, he told us of calling at a dance in which the guest of honor dropped dead early in the evening. After this, Fred’s group stumbled around, as directionless as we were. Should they go home? Should they continue the dance? Fred had the insight that dancing might be the most therapeutic thing they could all do. He posed this dilemma to his crowd, and suggested that they finish the dance in memory of their departed friend. They agreed. Our group also agreed. So, we gathered in a circle, sang and spoke various words from our hearts, and then proceeded to have a hell of a dance in honor of our friend.

How We Are Preparing for Next Time

CPR / AED Classes

Seattle has a reputation of being a good place to be when one needs CPR ². We’re determined to make it an even better place. A number of our NWNY campers have already signed up for CPR/AED courses. IMHO, dance organizers should strongly consider taking these courses, and perhaps noting which of their regular dancers have medical training or CPR skills.

However, you don’t need a class to successfully use an AED. It’s remarkable how many of the patients saved by AEDs are resuscitated by rescuers with no training or experience in AED use ³. This is possible because AEDs are automated and will tell you exactly what to do. All you have to do are these three things:

1. Recognize that cardiac arrest may have occurred

2. Turn the AED on

3. Follow the AED’s instructions

The AED does the rest. It first records and interprets an electrocardiogram (ECG). If this shows a normal cardiac rhythm, no shock is given. However, if the device detects a lethal arrhythmia, it charges itself automatically to a predetermined level and then indicates that a shock should be given. Full instructions are provided by voice prompts and written instructions on a screen. If the arrhythmia persists, the device provides additional shocks and advises you to continue CPR between shock cycles. A short online movie demonstrating AED usage is available online ⁴.

The benefits of AEDs are now so obvious that even politicians are believers. In a rare show of bipartisanship, the U.S. Congress and state lawmakers in all 50 U.S. states have passed Good Samaritan legislation to protect bystander operators of an AED.

Acquiring AEDs for Dance Spaces

I go to folk music and dance camps, in part, to flee the city, its pace, and its technology. However, after NWNY ‘06, there’s one piece of technology I’m no longer willing to do without. Any camp I attend these days will have an AED on-site, even if I have to bring my own. As a precocious geezer of 56, I want to have an AED around for my friends, family, and me. I suspect I’m not the only one.

The Seattle folk community is currently working to place AEDs in all of our local dance venues. At the time of this writing, we have already had sufficient pledges to buy three AEDs. The NWNY committee and campers have already donated $750 to Camp Sealth to replace the AED battery we used and to purchase additional resuscitation gear.

If your hall already has an AED, learn where it is. If not, AEDs are now amazingly affordable (under $1100 at amazon.com).

The Wrap-up

I’m extremely proud of our Northwest folk community and consider them heroes for the way they took care of each other at camp. When I go to Seattle-area dances from now on, I’ll feel a warm glow every time I see an AED at a dance or hear that another person has learned CPR. I hope that other folk communities and camps around the planet will join ours in promoting these effective techniques for taking care of each other.

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