From working in prehospital care, clinical and emergency departments as an EMT, it is clearly evident that the value of quality Basic Life Support skills and knowledge is immeasurable. No matter what field or department of healthcare you choose to work in, emergencies happen and everyone should be trained to some degree. It is not easy to mentally prepare to perform life saving techniques as the pressure of the situation is difficult to simulate. However, the best thing you can do to prepare is to practice. Practice correctly and practice often to create muscle memory, so when the time comes to perform these skills under immense pressure, you will have that muscle memory on your side.
As I have told many EMT students, CPR is one of the skills they will likely use the least in their careers, but it is the most important skill to perform perfectly when the time comes. You never know when you might need to implement these skills, but you need to be ready for whenever that time does come. It will no doubt be a stressful situation, but knowing that you were prepared and did what you could to help this person will be very rewarding.
Another thing I try to reinforce with new EMTs is how important communication is, and to always remember that you are working as a team. Immediate constructive feedback is never as important as when performing CPR. Do not hesitate to identify when a partner is getting tired, slowing down or not delivering effective compressions. This does not have to be an order, you can simply offer to take over after the round. High quality CPR is exhausting and that’s ok. It is important to maintain humility in times like this, and admit when you are getting tired and need to swap out. When a new partner jumps in, it is a good idea to make sure their adrenaline does not take over, and that they are performing high quality compressions with the proper depth and rate, and allowing for full recoil of the chest. Simple, gentle reminders, such as: “Nice job, a little deeper,” or, “Your depth looks great, but slow it down a bit, you got this,” go a long way in saving a life and in strengthening your team. Being open to receiving this feedback is crucial to performing high quality CPR and to fully function as a team.
Something else to keep in mind is that it is hard to predict and anticipate the reaction of family members and bystanders. In a perfect world, there will be someone on scene whose primary role is to control the scene, but especially in prehospital situations, it is important to remain aware of what is going on around you. It is important to ask for help and delegate tasks such as calling for Advanced Life Support or for someone to retrieve an AED, but also to ensure that no one’s reaction will jeopardize the scene or compromise the CPR being performed. This includes keeping an eye on team members, making sure that they are ok with what is happening and able to productively contribute.
In the same respect, it is important to later reflect on the scene. It is genuinely impossible to anticipate your reaction to your first code scene, therefore impossible to predict your actions. It is important, after every high-priority situation, to reflect on your actions, your interactions with your team, and analyze what worked and what didn’t. This does not mean to criticize and beat yourself up about all the things you did wrong, didn’t do, or didn’t do correctly. If you walk away with thoughts of, “My compressions were too fast,” “I got tired too quickly,” “I should’ve given better feedback”…you will drown yourself in regrets and self-blame that can have an affect on your personal well being, but you will also unlikely perform better in the next situation. It is so important to reflect on what you did right just as much as what you didn’t do right, or what you could do better next time. Analyzing the situation and walking away with it with an attitude of how you will do better next time is invaluable. It is a good idea to allow everyone involved to process it on their own, then to partake in a brief discussion of how everyone felt about the scene and how things went. This is not a time for attacks, but a time to provide constructive criticism, strengthen the team by strengthening each other, and to recognize room for self-improvement.
Being confident in yourself, and simply trusting that you have the knowledge and skills to potentially save a life is probably the most important aspect of performing high quality CPR. Having the confidence to act is the first step. The more you practice and review BLS skills, the better you will perform at critical moments. Knowing that you have the proper training will be the biggest factor in having the confidence you need to save a life. Take a moment to tell yourself this when the situation does arise; know that you can make a difference!