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Published on February 26, 2018

Learn CPR – you may save someone’s life

The first time Cape Cod Hospital emergency medicine physician Jacob Crowell, MD, performed CPR (cardiopulmonary resuscitation), he found himself temporarily stunned.

“Even with the proper training, I was filled with anxiety, and overwhelming emotions,” he said. “I couldn’t immediately process what to do.”

For Dr. Crowell, who had the experience after he came across a car accident as he drove along Route 95 in New Hampshire, the shock of the wreckage – especially the unresponsive passenger – lasted only a moment before he sprang into action.

“Another bystander said, ‘Let’s get this guy out of the car,’” he said. “And that’s when the need to act kicked in.”

The initial reaction he experienced can often happen to people during emergency situations, explained Dr. Crowell, who is also the medical director of Cape & Islands EMS System.

“Bystanders can be left reeling and unsure of what to do,” he said.

Which is why he believes bystander CPR training can help people be better prepared in a crisis situation.


Below, are Dr. Crowell’s answers to a series of questions about CPR.

What is bystander CPR?

Cardiopulmonary resuscitation (CPR) is an emergency procedure, which includes chest compressions. The life-saving technique helps circulate oxygen for a person who is in cardiac arrest. Bystander CPR is when CPR is performed by a person from the community, who isn’t a medical professional. Because most cardiac arrests occur outside hospitals, it’s ideal for as many bystanders as possible to learn CPR.

Have CPR recommendations changed over time?

Yes. Throughout history, the American Heart Association has come out with varying CPR recommendations. In fact, its CPR timeline, published in 2017, illustrates how CPR procedures have changed since the 1700s. In the last five to 10 years, for example, the American Heart Association has begun to delineate between CPR performed by medical professionals and bystanders. The newest recommendation is for bystanders to only perform chest compressions, instead of a combination of chest compressions and rescue breaths. When a person’s heart stops, the body is still filled with oxygen and the chest compressions will help circulate that oxygen and provide a degree of air flow in and out of the lungs, while you wait for help to arrive.

What is the first thing a bystander should do when they witness someone going into cardiac arrest?

The first thing any CPR instructor will teach his or her students, is to make sure help is on the way. Meaning, either you or someone right next to you should be dialing 911 immediately. I can’t emphasize enough how crucial it is to contact trained personnel. It’s literally a matter of survival.

I’ve heard that administering CPR can be physically taxing. Does it take a lot of strength to perform chest compressions?

There is no doubt that administering CPR is an aerobic workout. If you are doing it appropriately, you are using your body weight to do most of the strenuous work, but it’s still vigorous physical exercise.

Because CPR takes so much physical strength, is it okay to rest between compressions?

No. When someone drops to the ground, and is in cardiac arrest, there are only two things that highly promote survival. The first is performing high-quality, early CPR, for as long as it takes without stopping. That will keep oxygen flowing to the brain, and can prevent brain injury. That’s actually another reason why the American Heart Association eliminated the respiratory cycle. It was deemed that the respiratory phase was interrupting chest compressions.

The second thing that shows to be highly advantageous in the reversal of cardiac arrest is early defibrillation. Defibrillation is the use of a carefully controlled electric shock, administered through a device on the exterior of the chest wall or directly to the exposed heart muscle, to normalize the rhythm of the heart or restart it.

On an emotional level, how can a person, who is performing CPR, stay calm?

It’s definitely true that the normal citizen – or bystander – isn’t faced with life and death procedures or emergency situations on a regular basis. So, it’s obviously really easy to become overwhelmed and filled with anxiety and fear. And let’s face it, it’s not easy to move towards danger and trouble, and I don’t think anyone expects to have to do that – especially as a bystander. That’s why it’s always a good idea to seek out training so that if an emergency situation does happen, you at least have some education to go on. Also, I think people need to trust themselves, and understand that it’s human nature to be nervous. But, trust your instincts and try to remember that this person needs your help to stay alive.

Was it a desire to help others that encouraged you to become an emergency medical physician?

One of the biggest draws to this kind of work was that my father was a fire fighter. For as long as I can remember, we were constantly making detours during the course of the day so my dad could attend to fire and EMS (Emergency Medical Services) calls. That’s what really stimulated my interest in this line of work.

I’m trained to work in the ER (Emergency Room) and to deal with initial triage and stabilization. As far as my background goes, even prior to medical school I worked as an EMT (Emergency Medical Technician) and as an ER technician as well. That leaves me currently wearing two hats, in addition to the work I do as a member of the Dennis Fire Department, and as the medical director for 15 of the local ambulance services here on Cape Cod.

As you became more involved in the medical field, what is the most important thing you think you’ve learned?

I think the biggest message that I learned as a young kid and as an adult is that if there’s something wrong and someone needs help, we need to try our best to come to their aid. And, I think it’s that kind of mindset that drives people to serve the community – either as a physician or a bystander who wants to become familiar with lifesaving techniques like CPR. It’s that underlying desire to help those that need it.