Query on CPR ?

[SteveJ]

I noticed in the OPA newsletter a leaflet enclosed on medical tags,which I think are a good idea and intend to buy one. Reading this leaflet prompted me to think what would happen if a situation arose whereby we who have had an oesophagectomy and the stomach now relocated to the chest cavity had to have CPR administered. Would this be a safe procedure ? Obviously if it was a heart attack they would have to do this.

[DaveChuter]

Hi Steve,

Good question, the answer will be down to the 1st Aider attending, their knowledge of the patients history and the crcumstances leading up to incident, and if CPR is needed, someone must have phoned for medical asistance and should be in contact with control for updating patient condition.

As a 1st Aider, with a non breathing patient, my first action would be to call for medical asistance and then my concern would be blood circulation so I would start CPR in 98% cases.

The other 2% is when advised not to by medical control or for obvious reasons due the circumstances of an accident.

I believe it is a safe procedure in the circumstances, the heart is in front of the stomach, I would be watching for any vomit and checking the airway all the time, just in case.

CPR is the only thing we can do to help preserve life if a patient is not breathing until the medical experts arrive, and it just may help with the final outcome.

These are my views only, as a 1st Aider at work and my surgery was 5 and half years ago.

Iif anyone else has full medical knowledge and can advise, please do as this is question which does need a complete answer, especially if my views are wrong!

Best regards,

Dave C

[SteveJ in reply to DaveChuter]

Hi Dave

Thank you for taking the time to respond with a comprehensive answer.

It will be interesting to see if anyone else comes up with any further information.

Kind Regards

Steve

[moya]

I agree with Dave re CPR, maintaining oxygen to the body is the most important action. My worry is being put into recovery position, with the head low you can get reflux problems. I carry a made up card suggesting something under head. I am a first aid trainer and had my surgery 18 months ago. Moya

[SteveJ in reply to moya]

Hi Moya

Thank you for your comments. That is a very valid point, I hadn't taken into consideration the recovery position. I also think carrying a card is a good idea. There is only so much information you can engrave on a medical tag.

Kind Regards

Steve

[Hidden]

There might be an increased chance of stomach contents being pushed up through the mouth and thereby affecting breathing, but I have referred this question to an Upper GI surgeon to see whether there are any other thoughts.

From a purely personal opinion, I think that the absolute priority is to get the heart going again and to maintain a clear airway, but, subject to that, to keep the patient flat for the minimum necessary period. And having the medical tag might well alert the paramedics to the complications as they would expect a stomach to be in its normal place.

[SteveJ]

Hi Alan

Thank you for that, I would be interested to hear what the surgeon has to say.I agree as all three of you have said getting the heart going and breathing must be a priority. I thought it was a question worth asking.

Kind Regards

Steve

[DaveChuter]

Hi All,

Re: Moya's comment about the recovery position and possible reflux problem, this is similar to treating someone who may vomit while in this positon, it should drain away without blocking the airway and the patient will be monitored by the 1st Aider all the time.

If the patient is unable to communicate, is not carrying obvious tag or wristband and history is unknown, the 1st Aider is not going to look for a card in pockets, wallet or purse so has to treat as best way in the circumstances.

A highly visual tag or wristband is a godsend for 1st Aiders, medical experts and doctors, a card may hold more info but can be missed if hidden away.

A consultants and an A&E Matrons view would be helpfull.

Best regards,

Dave C.

[moya]

Putting people who have had surgery into normal recovery position increases the risk of reflux blocking airway. I have experianced this, as I am diabetic type 1. When I went unconcious my family put me into r. position , my breathing and airway only changed when pillow was placed under head. This stopped anymore reflux.

Re medi tags mine have always been missed , but the cards have been found. Best wishes Moya.

[Mick]

To add to others comments already posted, I recently attended a 1st Aid course I have to do for Scouting (being a cub leader) I raised this question with the tutor.....to her surprised she DIDNT know the answer....reason being it wasnt something she had come across..so explaining my condition and op to her, brought this to her attention so 1 more person is now aware of Cancer of the Oesphogus.

So last week I was back to see my consultant (3 months post op checkup). Being more with it now and I wanted to know more about what had happened and what was involved with cancer of the oesphogus, I asked about CPR and Chocking, his answer was in our cases, CPR could still be done as the stomach was behind the chest wall and it is better to get air into the lungs than doing nothing. Regarding chocking the same has to be said better to try to remove the obstruction than worry about where the stomach is. Still bare in mind what has been said about the possibility of reflux.

Hope this helps, I talk honestly and openly to friends and family making them aware of what we have gone through and the problems associated with it. The more people we talk too the more aware others will become.

Best wishes to all, Mick.

[SteveJ]

Thanks Mick.

Strangely enough, I was talking to my consultant today and he said exactly the same thing. He said if you were to need CPR It is better to be more concerned with getting your heart started again than to worry about reflux.

I'm not surprised your tutor didn't know the answer, I asked a paramedic and he wasn't sure either. I totally agree with your comments about making people aware of this condition.

Kind Regards

Stevej