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Phuket Opinion: ‘Reviving’ drowning victims

PHUKET: Since the beginning of the practice of medicine, medical professionals have been trying to “bring people back from the dead”. The treatments and procedures used today are dramatically different than those used decades ago, yet with all our progress, only 45% of victims of sudden cardiac arrest survive until hospital discharge.

opinionmarineSafetyaccidentshealthdeathtourism
By The Phuket News

Sunday 20 January 2019, 09:00AM


Even children can learn the basics of effective CPR. Photo: 2018 Nov 30_Phuket Lifeguard Club

Even children can learn the basics of effective CPR. Photo: 2018 Nov 30_Phuket Lifeguard Club

This statistic applies ONLY to developed countries with a long history of promoting bystander CPR, and ONLY to those that receive prompt (within six minutes of cessation of heartbeat) and effective CPR.

Hypothermia related cardiac arrests are the exception – but a very unlikely occurrence in Phuket.

Cardiac arrest victims who do not receive CPR have a near-zero chance of survival.

Of the 45% who survive until hospital discharge, many have permanent neurologic damage, and fewer still will be alive one year later.

CPR is a skill that can be learned by children as young as five years old. A proper course taught by a certified instructor to lay (non-medical professional) rescuers takes about four-to-six hours. Courses should be repeated every two years to maintain proficiency.

One of the most effective and common sense approaches to reduce snorkelling deaths on Phuket, is a requirement for all Marine Tour Personnel, including boat “captains”, to have current full CPR training.

The Problem With “HANDS Only” CPR

One of the more recent innovations in lay rescuer CPR is the “Hands Only” version.

Studies revealed that many people trained to do CPR were reluctant to perform it when confronted with a real life cardiac arrest situations. When asked why they didn’t do it, many were afraid of the rescue breathing (mouth-to-mouth) component of the procedure, afraid they would contract a communicable disease.

A chest compression only version of CPR, which omits rescue breathing altogether, was tested and proven to be almost as effective as the full version, with a very important exception: Hands Only CPR is NOT effective in asphyxiation and drowning cases.

Boat Crew Reports of ‘Reviving’ Victims

Effective CPR which results in ROSC – Return of Spontaneous Circulation, or “Revival” – in a previously unconscious drowning patient requires full CPR with rescue breathing. Unless marine crews are trained in this full version CPR, reports of patient “revival” after being pulseless for an extended time are unlikely to be accurate.

Properly performed CPR is physically exhausting even for trained, experienced rescuers. It is physically impossible for one or two untrained crew members to perform effective CPR correctly for an extended period of time.

In Phuket’s situation, it can be difficult to verify with a medical professional at the receiving hospital whether or not the initial reports of “revival” were accurate. Ambulance EMT’s do write reports on each incident, but these reports may be considered confidential patient information, and therefore difficult to obtain.

It is likely that many of these reports of “revival” declared by untrained tour crews are inaccurate at best.

Unfortunately, most of these victims are not likely to survive to hospital discharge.


This article was provided to The Phuket News by a reader with more than 40 years' experience in emergency medical services and more than a decade working in surf rescues.

 

 

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Jor12 | 21 January 2019 - 14:31:56

If you didnt help and just stand about watching the person die, you be charged with failing to provide the necessities of life.  No such thing as "Good Samaritan law." Law of negligence applies to anything.

CaptainJack69 | 21 January 2019 - 13:16:40

We have Hollywood to thank for images of people miraculously reviving after CPR. In real life all it does is keep oxygenated blood circulating in the victims body until more effective treatment can be given.

BUT, here in Thailand you take your freedom in your own hands since the victim or their family can sue you for damages if you try and help regardless of the outcome.

Galong | 20 January 2019 - 14:05:33

I'm a first aid instructor, but I would NEVER give CPR to someone in Thailand for one simple fact: Thailand is one of the few countries that doesn't have a Good Samaritan law, meaning if you help someone and they have complications (whether it had anything to do with you trying to help) you are in legal jeopardy! I guess that's why so many people just stand around taking pics instead o...

Kurt | 20 January 2019 - 10:08:13

Great informative article. Every Phuket beach life guard, all tourist boat 'captain's' should be obligated to do once in 2 years a cpr training. No training, no certificate, than not allowed to work as a beach LIFE guard or tourist boat 'captain'.  A great asingment for Phuket marine office  to justify themselves.  Gives them some work to do.

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