CPR in India: gender greater than life?

It is estimated that 98% of Indians do not know about CPR. For thousands of Indians, cardiopulmonary resuscitation (CPR) is a word hard to pronounce, difficult to spell, and perhaps, even more difficult to ingrain in people’s minds.

Most times, CPR is used as a pretext to introduce mouth-to-mouth breathing, invoking humour or romance in movies. The importance of the act, the context and the technical nature of performing it go for a toss. But that is as much sense that can be expected from celluloid.

In reality, CPR has much to offer. It can not only save a drowning victim but if performed at the right time on a patient having a sudden cardiac arrest, it has the ability to save lives. Despite being the capital of cardiac diseases, diabetes, and obesity, there is a paucity of printed data to estimate the situation in India. A surprising indifference towards cardiac health awareness is simply pushing each of us towards a cardiac epidemic.

Indifference towards this life-saving support has resulted in the appalling lack of campaigns in India. The gap between academic knowledge and implementation is tremendous.

While people willing to perform CPR in public places often resort to guesswork hoping their technique are right, the ones who know how to perform CPR miss out on the golden seconds.

What makes the situation even worse is not evaluating the circumstances right, such as linking fainting with brain and not the heart. While mouth-to-mouth breathing is widely considered to be CPR, in fact, it is not as powerful as hard pressing on the chest.

CPR is an approved medical intervention and can be easily performed with basic training, until medical help arrives. But to avow and support the same, we need to dissociate CPR from its celluloid depiction. In the process, we need to reject mouth-to-mouth as the only form of CPR, rid our mind of hesitations, accept the effectiveness of chest compression and correct procedures of CPR, and know the CPR basic and beyond.

Women’s lives at stake

The differences between the physical bodies of a man and woman make men hesitant to administer CPR on them. A constant apprehension of falling into trouble while helping the opposite gender often stops the men from performing CPR.

Performing a CPR at home is more common than in public spaces. International studies have pointed out that the percentage of men and women receiving CPR is almost the same — 36% and 35%, respectively. Generally, at home, we around family and close relatives. Therefore, the hesitation is less since the people are familiar to us. However, the same cannot be said in the Indian context where many conservative notions envelope people even within families. The levels of physical intimacy and ease are much different than what it is in the West.

To eliminate such unease and apprehension, we must understand that CPR does not necessarily require building pressure on the breasts but on the sternum. This boosts the blood circulation and prevents the pulse from sinking.

These aspects of CPR are not known to people. To tackle this effectively, for starters, various misconceived notions relating to gender must be detached from CPR.

We have to establish CPR as a medical intervention correlated with therapeutic and natural science. Dissociating CPR from the social constructs guided by sexual taboos is the need of the hour. It is an act which prevents the brain from dying due to lack of oxygen and keeps the unconscious person, irrespective of age, sex, caste, class or creed, alive. We have to grow past our misconceptions and reservations and start considering CPR as the means to save a life.

Training in CPR should be made mandatory, especially for the those working in public spheres, such as traffic police and emergency services.

(The writer is Director & Head – Cardiac Electrophysiology, Max Super Speciality Hospital)