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Best Tips Cardiopulmonary Resuscitation in Sports

Using chest compressions and rescue breaths with a view of sustaining supply of oxygenated blood to vital organs, in particular brain, is what constitutes cardiopulmonary recovery (CPR); the ultimate aim being to prevent death or everlasting damage to brain tissue due to lack of oxygen.
Paramedics tend to use stipulations such as CPR, basic life support (BLS) or fully developed basic life carry more often while ‘mouth-to-mouth respiration’ is more of a layman’s term.

CPR and endurance Rates in Cardiac Arrest Patients

According to a study accepted out by the University of Amsterdam, the outcomes of out-of-hospital cardiac arrests can be altered favourably by timely administration of CPR1. While studying the effects of CPR on continued existence rates of cardiac arrest patients, Fergusson found that not only does CPR positively influence survival rates but it may be the single most effective conduct to buy time until ‘expert help’ arrives2. Furthermore, research has shown that the probability of survival more than double if CPR is administer during the overriding period before hospitalization3.
With more than three-quarters of cardiac arrests occurring out-of-hospital3 and the proven 
effectiveness of CPR in growing chances of survival, CPR does indeed appear to be the proverbial ‘kiss of life’.

Importance of CPR in Sports

Cases of cardiac arrest important to death in athletes, either due to cardiovascular causes (sudden death) or a blunt trauma to the chest (commotio cordis), have always intrigued sport medicine researchers. Increased adrenergic drive combined with altered anatomical and physiological variables in high power sports can cause abnormal rhythm of the heart4. These cardiac arrhythmias render the heart inefficient (as a pump); passage and oxygenation of brain suffers ensuing in death.
Sudden death in sports is not a rare observable fact by any stretch of imagination. An Italian study spanning 2 decades had reported an frequency of 1 in 100,000 population per year and definitely identified the involvement of sports with cardiac arrest5 (incidence of 2.3 per 100,000 in athletes as compared to 0.9 per 100,000 in non-athletes6).

A more current study carried out in France reports an incidence of 4.6 per million populations per year; 6% of these living being in ready for action athletes7.

In a exposition study of the causes of death and types of injuries in crevasse accidents, Hohlrieder et. al. reported that trauma and asphyxia were mainly responsible for deaths. Of the survivors, the ones who suffered cardiac arrests and were administer CPR continuously during migration responded favourably and had a much better chance of survival then those who suffer other life bullying injuries like critical multisystem disturbance and hypothermia8.

apart the benefits of spectator sport and physical activity, close relation of sudden death with these has tempt Corado et. al. to call physical activity a ‘double-edged sword’9.

Aims of Delivering CPR

As avowed earlier, the immediate goals of delivering CPR is to maintain patent airways and normal blood circulation without the use of (or with barest minimum) utensils until such a time that expert help arrives or the victim is relocate to the hospital.

The above are achieved by delivering ‘chest compressions’ and ‘rescue breaths’.
The purpose of the whole do exercises is twofold:

1. To ensure appropriate oxygenation of blood as it passes all the way through the lungs
2. To preserve pumping of the heart so that oxygenated blood is supplied to the brain (interruption of blood supply to the brain for as little as 10 seconds can cause irretrievable damage)

CPR Procedure: The progression of Events

The acronym ‘DR-ABC’ or ‘Doctors’ ABC’ can be used to remember the steps in delivering CPR.
1. Danger: assess immediate danger to the patient, other players and self. For example, before running on to the field to attend to an sportsperson who has ‘gone down’, it should first be confirmed that the referee has stopped the game.

2. Response: check if the athlete is cognizant; gentle tapping on the shoulder or asking if he/she is OK can do the trick.

If there is retort, put the athlete in recovery position (provided there are no injuries) and check regularly.

If there is no response, call emergency (911/999) and initiate CPR.

3. Airway: tilt head backwards and lift the chin so as to open the mouth; obstructions if any are to be removed gently.

4. Breathing: ‘look, listen and feel’ for respiration: look for chest movements, listen to breath sounds by bringing your ear close to the athlete’s nose and feel the warmth of the athlete’s breath on your cheek.

If breathing, put the athlete in lateral recovery position and dial urgent situation services; keep checking the athlete’s condition sporadically.

If not breathing, call urgent situation and start CPR.

5. Circulation: can be assess by feeling the carotid pulse by the side of the neck. This be supposed to be done for not more than 10 seconds.

If pulse is in attendance, put the patient into recuperation position and monitor.

If pulse is absent (or when in doubt), initiate chest density followed by set free breaths. Send your colleague to get help. If you are alone, get help first and then revisit to initiate CPR.

There are exceptions to these wide-ranging rules: in cases of drown or in children, CPR should be imparted for a minute before departure for help.

Although the succession of events, ‘DR ABC’ in CPR has been followed for years, the new American Heart Association guidelines of 2010 suggest chest compressions to be initiated without assassination valuable time in assessing airway and breathing. Thus, ‘ABC’ is now ‘CAB’.
Chest Compressions and Rescue breath: How To?

Chest Compressions:
1. place your hands on top of each other and interlock fingers
2. place the heel of the bottom hand in the focus of the chest at the level of the sternum (breast bone)
3. take care that your arms are perpendicular to the ground so that you can deliver chest compressions efficiently; this will also ensure that you conserve energy and avert fatigue
4. chest should be compacted a minimum of 4 to 5 cm; a full recoil should be allowed before commencing the next compression
5. rate of chest compressions should be 100 per minute (a total of 30 compressions should be given before delivering 2 breaths and then carrying on with compressions)
Rescue breaths:

1. Titling the head backwards, pinch the patient’s nose and make a seal over the patient’s mouth with yours. If a CPR kit is available, you can make use of a CPR representative.
2. If you have concern over giving a ‘mouth-to-mouth’, bear on giving chest compressions till such a time that lend a hand arrives.

Please note that:
1. CPR involves giving alternating chest compressions and breaths: the ratio being 30:210
2. During trunk compressions, do not worry if ‘crack a few ribs’; a few broken ribs won’t do much harm
3. Breaths should be forceful enough to make the chest rise up; do not go for the second breath till you see the chest deflate finally
4. If concerned about benevolent breaths, carry on with chest compression
5. After every link of minutes, check for recovery; if patient is still not mouthful of air, continue with CPR
6. keep on with the cycle of alternate compressions and breaths till such a time that uncomplaining recovers, expert help arrives or you become done in.

To conclude, there is a very real risk of a cardiac arrest and sudden death in competitive as well as spare time sports. In spite of the proven effectiveness of CPR in growing survival chances in pulse-less and non-breathing athletes and the fact these events are witness by a number of individuals, very few of the victims are administer CPR7.

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