Be careful, this kind of rescue "trick" can cost someone's life!

Recently, an enthusiastic reader left a message to the Science Rumor Refutation WeChat public account, providing a piece of hot information, asking us to judge its authenticity. When the editors saw the content, they were furious. What is the purpose of making such a rumor? Are you planning to kill someone? (In order to prevent secondary dissemination, it was specially marked with a "nonsense" watermark).

Message from readers

Let me first state the conclusion: this method is simply harming people! Don’t take it seriously!

What is going on?

To refute this rumor, let us first understand the normal cardiac arrest rescue process, and then talk about leg lifting.

01

What should I do if my heart stops beating?

Everyone knows that if the electrocardiogram becomes a straight line, the person is in danger... Yes, the heart is responsible for pumping blood to all parts of the body. Once it stops working, the blood circulation of the whole body will be interrupted, breathing will stop, and consciousness will be lost in about 10 seconds. However, this fatal situation is not very rare. According to the "2016 Chinese Cardiopulmonary Resuscitation Expert Consensus", about 544,000 people in my country suffer from cardiac arrest every year, and the vast majority of sudden deaths are related to cardiac arrest.

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Once the heart stops beating suddenly, if effective intervention is not given within the golden rescue period of 4-6 minutes, the patient can easily die. This is why rescue must be carried out quickly for such patients.

How to rescue it specifically?

In the case of cardiac arrest, all rescue methods are aimed at first establishing temporary artificial circulation and artificial respiration to ensure the blood and oxygen supply to the vital organs of the person being rescued, and then strive to restore the person's heart's autonomous circulation, autonomous respiration, and consciousness.

CPR training course | Tuchong Creative

The most important method in the medical field for the on-site rescue of patients with cardiac arrest is CPR, or cardiopulmonary resuscitation. The specific method requires professional training, and here is a brief summary (the following is the standard for adults):

1. Determine the patient's consciousness, breathing and pulse. If the patient is unresponsive, unconscious and has no pulse, call 120 for emergency help immediately and ask people around to help find an AED (AED is an automatic external defibrillator, which is often equipped in public facilities such as subways, airports, and shopping malls).

2. Place the patient supinely on a safe, hard surface and perform chest compressions at the midpoint of the line connecting the two nipples, with a frequency of 100 to 120 times/min and a depth of 5 to 6 cm.

3. Give 2 artificial respirations for every 30 compressions.

4. Repeat this process until the patient resumes spontaneous breathing or medical staff arrives.

(Note: The above are brief steps. You need to attend first aid training to master all the details. Don’t think you can do it just by watching...)

If you look at the above, you will find that there is no leg lifting step in these steps? That's right, in fact, there is no mention of leg lifting in the current various CPR guidelines.

So here comes the question…

02

Are leg lifts useful?

Let me first state the conclusion: in case of cardiac arrest, do cardiopulmonary resuscitation first. On this basis, we can discuss the role of leg lifting.

Why do I say that? Because before 1992, raising the legs was part of the CPR guidelines. It was believed that raising the patient's legs could help increase coronary perfusion and improve heart and brain blood flow, which could enhance the effectiveness of CPR. The reason is easy to understand, because as the saying goes, "water flows to the lower place", the same is true for blood. If the legs are raised, more blood will flow into the upper body.

Although effective in theory, this method affects blood flow for a short period of time, less than 1 minute, and its actual impact on blood flow is difficult to monitor. There is a lack of sufficient clinical evidence to prove its effectiveness, so after 1992, this operation was removed from the relevant guidelines for cardiopulmonary resuscitation.

Although in recent years some doctors have begun to consider adding the step of raising the patient's legs during cardiopulmonary resuscitation to help the patient recover as much as possible, this is still in the research and verification stage and is often performed in hospitals with well-equipped facilities. General out-of-hospital emergency guidelines do not recommend doing so.

In fact, if we think about it, we can understand that in an emergency, we should be thankful if we can find a safe, hard and flat place on the scene to quickly let the patient lie down for rescue. Why would we have the time to find something to straighten the patient's legs?

Even if the legs are lifted, CPR itself involves a lot of movement, and it is too much to ask the patient to keep his balance while pressing. If you have to toss the legs there, precious minutes may be wasted, and the patient who originally had hope may lose his life.

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Therefore, when we face cardiac arrest, the best way is to call 120 and start cardiopulmonary resuscitation immediately.

I would like to emphasize again that this section discusses whether leg lifting can add "icing on the cake" under the premise of CPR. If you encounter cardiac arrest without CPR and just lift the legs... this is basically equivalent to waiting for the patient to die.

In short, this rumor is really infuriating.

In fact, if we were just refuting the rumor, we could have ended here, but we might as well use this rumor to discuss how to identify the patterns of such rumors.

03

What are the flaws in this rumor?

First, we should pay attention to those extreme descriptions, which are what we usually call "speaking in a final way". It is unlikely that such a statement as "there is no risk at all" will appear in the statements of regular doctors - doctors have to give instructions for a long time before prescribing medicine or giving injections.

Then, pay attention to those amazingly good statistics. For example, a rescue success rate of over 100%... it makes doctors want to beat people up.

In fact, according to a 2015 Beijing Emergency Center survey, among 505 cases of cardiac arrest outside hospitals, the success rate of cardiopulmonary resuscitation was only 8.12%, and other research statistics are basically of this order of magnitude. So, if there is a 100% effective rescue method, it would definitely be a great paper, and you can find it with a simple search.

But what is the reality? Not to mention that the name of the so-called doctor in the original article is different from the previous one. If you search any name + first aid or cardiopulmonary resuscitation as the keywords on the paper website, you will find nothing.

An example of search results

Search Examples

Therefore, we have figured out the pattern of this kind of rumor. First, they say something life-threatening (such as cardiac arrest), then promise no side effects, make up a famous doctor, and then make up some shocking data, and then they can fool people. This kind of rumor is easy to make up. Today it may be a first aid master, tomorrow it may be a cancer doctor, and the day after tomorrow it may be a sugar-lowering star... In short, when we see this kind of content about "amazing treatments", we might as well pay attention, do a little research, or ask a doctor, so that we won't be fooled easily.

Author | Ding Zong

Review | Wang Qian, Chief Physician, Emergency Department, Third Medical Center, PLA General Hospital

Editor | Ding Zong

References:

[1] Chinese Society of Research Hospitals Cardiopulmonary Resuscitation Committee. 2016 Chinese Cardiopulmonary Resuscitation Expert Consensus[J]. Journal of PLA Medical Journal, 2017, 42(3).

[2] Lu Yanxiu, Lin Jinle, Zhang Wenwu, et al. Application progress of passive straight leg raising test in cardiopulmonary resuscitation[J]. Journal of Clinical Emergency, 2019(8):4.

[3] Wang Xiaogang, Gao Ding. Clinical experience of cardiopulmonary resuscitation in 505 patients with pre-hospital cardiac arrest and analysis of factors affecting success [J]. Chinese Journal of Clinicians, 2015(4):3.

Source: Science Refutes Rumors