Now I'd like to take a moment to talk to you about something that I've had the honor of
talking and explaining to not just students who are thinking about this situation occurring,
but actually, those rescuers, whether that be professional or even people who were just
helping neighbors or strangers, or in certain cases, even their own family members. And
that is, why didn't CPR work? Why did I do what I thought to be the right thing and the
desired outcome not happen? And I think that's a fair question. It's certainly a question
that I believe finds its roots in a misunderstanding of what CPR is. CPR has always been designed
to be a time buyer. You see, when we do cardiac compressions, we're actually compressing this
hollow organ we call the heart, and its four chambers. And when in cardiac arrest, the
heart is in either a fibrillatory state, which means it's wiggling around in a disordered
fashion, or it's completely asystolic, meaning it's not contracting at all. And when it works
normally, it's beating from top to bottom in an organized fashion with one-way valves.
And it works perfectly to circulate oxygenated blood throughout the whole body, very efficiently.
But when a person suffers cardiac arrest, regardless of really what disorder is happening
with the heart itself, the fact is, the heart is not circulating oxygenated blood, and the
body begins to die biologically. As soon as there's no breathing and no pulse, the person
is in clinical death. They have already died. But it doesn't mean necessarily that they're
going to remain that way. There's the difference between clinical death and biological death.
CPR manually, artificially, tries to do its best to compress that hollow organ between
the sternum and the spinal column. That's why we try to push it at least 2 to 2.4 inches
deep, because we need to maximize that compression to make up for some kind of circulation that
isn't occurring normally. But the reality of it is that even when we do picture-perfect
CPR, I mean textbook, it's only a small percentage of what the body needs to survive. And therefore
CPR has never ever really been equal to what we think of it sometimes to be, and that's
artificial life support. We think, well, as long as we do the cardiac compressions, the
body is alive. And it isn't that it dies until I stop doing compressions. And that's just
not true. The fact of the matter is that CPR compressions are more acting like the brakes
on a downhill freight train. The brakes are not going to stop the train from inevitably
reaching the bottom of the hill, but they may slow it down a little bit. CPR does not
stop the dying process. It simply slows down the biological cell death a little bit, in
hopes that when we activate emergency medical services, 911 or call a code, and we bring
in electrical therapy, automated external defibrillators or manual defibrillators, advanced
life support, oxygenation and drugs, that we can then somehow restore some form of more
efficient and effective circulation of oxygenation, to buy even more time so that we can fix the
underlying reason that the person went into cardiac arrest in the first place. But the
truth and the fact of the matter is that every person who's alive has a day to die. And we
don't know when that is. As a licensed paramedic, I've done numerous cardiac arrests on infants,
children, and adults. I've treated the very young and I've treated the very old. And some
people that should have died survived, and some people that looked like they should have
survived died. As a rescuer, all I knew was that it was their day to live unless they
proved me wrong. But as far as I was concerned, I'm going to give them the best chance of
survival I possibly could until they prove me otherwise. CPR was never meant to save
lives directly. I used to joke around that I would write a book one day: "CPR Does Not
Save Lives, It Just Keeps People Dead Longer." And people would go, "What? That doesn't make
any sense. What are you talking about?" But that's the reality of it. And I think if we
would all approach cardio-pulmonary resuscitation with the understanding of the physiology and
the cardiophysiology of what CPR is versus what we perceive it to be, we would understand
that when a person is in cardiac arrest, and we do our best doing CPR, then the person
remains dead, regardless of who they are. We the rescuer did not fail. The person simply
remained dead for whatever reason. But that doesn't take away from the fact that you still
gave them the best chance of survival if survivability was going to be the outcome. And the one thing
we know for sure is that if you do not try to do CPR, it's almost guaranteed, this side
of a miracle, that one thing and thing only is for sure, and that is that they're rapidly
going to go from clinical death to biological death and remain dead. And I say "remain dead"
because it's important to understand, people in cardiac arrest don't die. They just stay
the way you found them. When you're asking yourself, "Well then, if CPR isn't all that,
when CPR is less than a miracle drug, then is it really worth trying all that hard?"
I can tell you that in my street experience, that though I've never had a person complain
to me that the CPR or the defibrillation hurt them when they were dead, I have had them
come back in with their family and thank us for another holiday with their families. And
as a father of six beautiful children, and a husband, I can tell you that if I was in
cardiac arrest, there is nothing more beautiful than knowing that my loved ones embraced me,
cared for me, risked themselves, and did everything they could to save my life, regardless of
the outcome. Now let's talk about strangers, strangers that don't know the patient from
anybody, and yet they care enough in the family of humanity to say "I don't know who you are,
but you're special to somebody. I'm going to try to save your life." We don't know when
a person can no longer hear, when they go unconscious. We don't know at what point of
unresponsiveness and unconsciousness a person can no longer sense or hear what's going on
around them. There's a lot of research and it's unclear, but we do know that some people
in cardiac arrest have come back out of cardiac arrest and they've actually been able to recount
some aspects of the cardiac arrest protocol. So they were able to hear certain things from
time to time. Could you imagine how beautiful it must be that when either a family member
or a stranger tries to save the life of another, that even if that person remains dead, that
there's a chance that their last impression, their last experience, was that of love, that
someone would care enough to put themselves out there, outside their comfort zone, run
the risk of failure, for the sake of a chance to help you survive. That is the greatest
gift that one human being can give to another. So failure is not in whether a person survives
cardiac arrest or not. Failure is in whether or not we can understand that just trying
is the success. If this has happened to you, I hope that this has brought some peace and
clarity and healing to your life. And if you haven't had this happen, my hope is that it
prevents you from falling into the category of those people I hold so dearly that have
reached out to me that are dealing with pain, agony, and guilt, because CPR didn't seem
to do what it was supposed to do, and they felt guilty for it. Go forth and rescue confidently,
and be at peace.