Monday, October 8, 2012

CPR Refresher Course for HealthCare Providers, Or "Where I had no business being!"

When I started working as an assistant with Shane, I had to be certified in CPR, in case things went really, really pear-shaped with a patient in the chair.  I never minded the CPR training.  I feel (in theory), like knowledge is power. 

That first CPR training was pretty rough.  I vaguely remembered learning CPR enough to get my First Aid Badge in Girl Scouts in the fourth grade, but let's be honest.  I half-assed that, collected my badge, and fluttered on to the next one, because Girl Scout badges weren't so much a way to reflect on things I learned and would maybe ever have to use in real life, as they were a way to make my green sash look all flashy with sewn-on bling at Girl Scout get-togethers.

And wouldn't you know, because I was going to the CPR class with a bunch of healthcare providers, I wound up in the "CPR Refresher Course for Healthcare Providers."  Shiiiiiiiiiiiiiiiit!  I started out at the bottom of the hill and went down from there.  The whole time, I felt a palpable sensation of pure panic, no two ways about it.  I watched the video with clenched jaw and dry mouth as they the people on the training video bandied about doctor-words like "sternum," and talked about going two finger-widths up from the xiphoid process, to prevent lacerating the liver when you do chest compressions, I full-out freaked.

"Shane!"  I hissed at my husband, Doctor Blake.  "Shane!  Where's the sternum?"

He looked at me like I was crazy.

"Are you serious?" he whispered back.  My eyes bulging out of my head and the visible and throbbing vein in my temple must have made him realize yeah, I was serious.  "Breastbone!"

Sonofabitch, he was right.  I knew that.  I KNEW THAT!!!

Another dentist we worked with was sitting on the other side of him, and I saw her roll her eyes and make a pfffffffft face.  I realized I'd stupidly played my 'English Major' card that day, and made a mental note to just be hyper-vigilant, to figure out on my own what this xiphoid process was, to avoid more rolling eyes and pffffffffffft faces from the Genius Gallery.  I looked around.  I was the only one in the room dutifully taking notes.  Strike that.  Furiously taking notes.  I was writing notes from the training video as fast as my pen would move.  I didn't want to miss anything.  Everyone else in there, all doctors and dentists, and the hygienists from our office, were relaxing in their folding chairs, a collective air of ennui about them.  They all knew where the sternum was, without having to ask my husband.  They didn't have to sit there wondering what a xiphoid process was or what it did, besides lacerating internal organs!

Then out came the dummies.  The big-people dummies were all Annie, and the baby dummies were Baby.  Annie!  I remembered Annie from Girl Scouts!  Geeze Louise, she sure didn't look any better on this day than she did when I was nine.  Man, that was too bad. 

And I watched all the doctors and dentists and hygienists deftly do their chest compressions and simulated rescue-breaths on Annie and Baby.  They all made it look so easy. 

"Yeah," I overheard Dr. Rolly Eyes saying to one of our hygienists, "when I was doing my dental residency at Hershey, I took all the Code Blues I could get."

Good for her, I thought.  I also thought 'One time, at band camp....' and went on watching our boss dentist save Annie's life and her baby's. 

All too soon, it was my turn, but I'd prepared.  I'd been watching the real healthcare providers.  I felt pretty okay with this.  So the instructor turned me loose on Annie, and right off the bat, didn't I start doing chest compressions too low- right on the xiphoid process the instructional video had said NOT to compress!

"Well, aside from a lacerated liver," said the instructor, her voice trailing off in an impatient arc.  I knew my idiocy was keeping her from getting home in time to catch Wheel of Fortune.  Thing was, I wasn't doing it for attention or anything else.  I was outclassed, outsmarted, out of the CPR kiddie pool, where I should have been.

"Sorry," I said to her.  "Sorry, Annie."

Compressing up where you're supposed to compress was a lot harder to compress, and now I was all afraid of hurting Annie, and puncturing her lungs, along with having lacerated her liver by pushing on the xyphoid process and all.  They decided to have me demonstrate knowing how to do CPR on Baby, and come back to Annie.  Great idea.  Let me kill Annie's baby before coming back to finish her off!

Getting me through the practical CPR training was painful for me, painful for the instructor, painful for the healthcare providers unfortunate to have had me thrown in with them in their class, and painful for Annie and Baby, for sure. The written test, everybody else sailed through.  I sat there, staring at my paper, trying to see the questions and multiple choice through the tears in my eyes.  It was getting really late, and another group needed to use the hospital conference room, so my test became an exercise in cooperative test-taking, and I was shooshelled out with my "CPR for HealthCare Providers" in my wallet. 

Did it look impressive as hell to see when I'd open my wallet to pay for after-work Hershey's therapy, and see that CPR for HealthCare Providers certificate?  Yes it did. Did I pray every night that nobody would drop on the floor with a heart spell or a choked-on marshmallow with only me around?  You betcha.

I also went home and Googled everything about CPR I could find on the world wide web.  I dug out Shane's Gross Anatomy Lab Manual (gross in more ways than just one- that thing actually went into cadaver lab with him....), and read up on anatomy in general, and the structures in the chest cavity in particular.  Right there, in illustrated (and messy) glory, was the sternum, the xiphoid process, the lungs, the liver that you don't want to lacerate with the xiphoid process. 

The next time we had to do the CPR training, we weren't in the "Refresher Course for HealthCare Providers."  We were in the CPR course for just anybody.  The rules were simpler.  The instructor was better.  When I started to freeze up, trying to be perfect, the instructor actually smiled kindly and said that mostly, any CPR is better than no CPR to someone who's stopped breathing, and you can't really hurt them by doing CPR.  I wanted to ask if she'd talked to Annie and her lacerated liver, but instead, I absorbed the mantra that any CPR is better than no CPR. 

When the headlights came on, I was not the deer in them, at least as far as the class was concerned.

In theory, I know what to do.  I know that if you sing 'Stayin' Alive' by the BeeGees while you're doing the chest compressions, and do the compressions in time with that song, that's about the number of beats per minute you need for the chest compressions.  I know that most likely, if you have to do CPR, you're going to get puked on, and you're probably going to break some ribs.  All small stuff, when the situation is life or death. 

I still can't be sure I wouldn't be the deer in the headlights, if the headlights were shining on me in a real situation.  I'd like to think that everything that's happened since that day in 2002, when I was placed in the "Refresher Course for HealthCare Providers" has helped me keep a cooler head in emergencies.  I mean, I've gotten sort of lost in an airplane- a couple of times, even, and found my own way back to my home airport without having to call Cleveland Center to vector me home.  I practiced and practiced how to break a stall in that plane.  I practiced and practiced what to do when an engine's out, either partially or wholly, enough so I stopped getting that sick feeling in my gut whenever my flight instructor would pull back the throttle and mixture and cut the engine.  And then the day we really needed to make the landing the first time at the airport, with no option of a go-around, the day my plane's engine decided to crap out.  I knew just exactly what to do, and the rest as all about keeping calm and doing it.  I'm here to tell the tale, so training and being prepared works.

And now that I have a little kid in the house, I want to make sure that in the event of some emergency, I'm able to do something, not be the hysterical mother who's helplessly ringing her hands while waiting for help.  So I have some work to do.  CPR, first aid.  This time, I'm really going to earn that First Aid badge, and not give a rip about a patch on a green sash.


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