CPR

One day, or maybe it was night, over the Pacific Ocean a flight attendant leaned over and whispered into my ear, “Can we continue to Japan or not, you have 30 seconds to reply.” It is a peculiar position to be in. Not the flight attendant whispering into my ear, but to be confronted with such a question. I took pride in being decisive when practicing medicine, and here on my knees in the escape door aisle staring at an unconscious middle aged man’s face I needed a quick response. 

I answered a summons on the 747’s intercom system for a doctor. Now I had thirty seconds to decide if 300 souls should take a detour to a South Pacific atoll instead of to Narita Airport outside of Tokyo. 

 

Let’s be clear, not all doctors are created equal. My interest lies in primary care. I disliked the techy misery of the ICU and the commotion of the Emergency Department. For me a good day was when patients kept their appointments and nothing dreadful occurred with those hospitalized. I liked to know, when possible, why I was walking into the exam room. I was comfortable with the fifteen minutes I had to decide on a plan of action. Of course, it did not always work out but then I admitted it and that was a plan in itself. The less drama the better. 

 

So, what to do. I remembered the ABC’s: airway, breathing and circulation. I saw his chest rise and fall. It took ten seconds for my fingertips to feel his carotid artery’s heroic pulsations. His face was pink, and became pinker after I gave him a slap and dug my index finger’s knuckle into his sternum. Now with eyes open wide he moaned and gave a generous cough. Without turning I quietly said, “Keep on course.” and sensed the flight attendant’s quick motion to relay my response to the captain.

 

He sluggishly sat up and apologize for Ambien and alcohol, and I in turn, for the slap. I cleaned the dribble off his chin, closed the enormous first aid kit and escorted his embarrassed self to an aisle seat, hovering until I was sure I would not have to return. It was a walk to get back to my seat and as Charlotte noted, not enough time for my pink cheeks to recede. 

 

This taught me to dread each plane flight. Now that we will soon be traveling to the tip of South America, I felt compelled to refresh my expired Basic Life Support (BLS)/CPR certificate. It is the third renewal since that faithful day. BLS is not for the faint hearted, but then consider the consequences of inaction. 

 

BLS/CPR is an odd formulation of recognition, activation, and compression/ventilation. There are ratios and rates, placements and depths, and age ranges to take into consideration. And then there is the acting out. My wrists and elbows have yet to recover from compressing the plastic adult dummy’s recalcitrant chest.

 

That said, none of this should deter you from becoming proficient at CPR, because one day, or night, you may find yourself on your knees staring into an unconscious face . . .