Chiropractic + Naturopathic Doctor • July August 2016 • How To Save A Life

New rule requires Ontario Dcs to update first-aid, CPR certification BY THERESA LISK

Recently, the regulatory body of Ontario passed a new rule that requires chiropractors to maintain a current certification in first aid and CPR (cardiopulmonary resuscitation). As a practicing chiropractor in Ontario, I am confident this life saving information will be of great benefit to our practice.

According to the Heart and Stroke Foundation, a cardiac arrest occurs every seven minutes and a stroke occurs every nine minutes in Canada. Considering the number of people that chiropractors see in their offices – many of them leading unhealthy or less-than-ideal lifestyles – the likelihood of chiropractors being present when one of these emergencies takes place can be higher. Being prepared in these situations can help save a life.

I have been teaching first aid and CPR courses to healthcare professionals for the past decade. From these classes, I have been told numerous stories by attendees who have aided in emergency scenarios.

I also assisted with several emergencies over the years. Two of the most recent events were car accidents that occurred on back-to-back days. In one situation, the driver crashed into a guard rail, head on. In the other scenario, a pedestrian was struck by a car and thrown across the intersection. Although these did not occur specifically in my chiropractic practice, being prepared gave me the confidence to act quickly and assist these individuals in their time of need.

The reason I am confident to assist in these emergency situations, regardless if they occur inside or outside of my office, is because once I was certified, I practiced these life saving skills often. This is the same advice that I want to give my fellow chiropractors – once you are certified in these life-saving skills, practice them often. Remember, these are skills that can help us save a life one day.

The certification that an individual receives for first aid and CPR typically lasts for three years. However, to gain confidence and increase our ability to react effectively in an emergency, these skills need to be practiced and reviewed more frequently than just every three years.

Much like with our own chiropractic skills, the more frequently we practice, the better we become. We should consider conducting quarterly office trainings and completing the certification at least once a year. In my experience, when people complete the certification within this time frame, their memory and ability to perform these skills is much sharper. We know that the more we practice, the more it becomes engrained in our minds. If we ever come across an emergency in our office or out in public, we will be able to react quickly and increase the chances of saving a life.

It is essential to understand that there is a critical period of time between when the patient becomes unresponsive due to an event and the time that it takes for the paramedics to arrive on scene following a 911 phone call. This time frame is typically between five and 10 minutes, but also depends on the area where you are located. In a more rural area, the time for emergency personnel to arrive at scene could be longer.

During this waiting period, it is crucial that CPR be started and an automated external defibrillator (AED), if available, be used. Every minute that passes during a cardiac arrest decreases the chance of survival by seven to 10 per cent. Beyond 10 minutes, CPR is rarely successful, according to the Heart and Stroke Foundation.

This is why it is vital to attach the AED as soon as possible. I always recommend that chiropractic offices be equipped with an AED. An AED can be applied to the individual within minutes, which will drastically increase the chance of survival.

Some practitioners may not have an AED at their clinic, but they have access to one within range of their office when needed. If this is the case, it important to take note of a few challenges that may potentially arise. First, it is the responsibility of the owner to ensure the AED is functioning properly. If you rely on using an AED that you yourself did not check for functionality, you run the risk of having an emergency situation and no working AED. Second, depending on the distance from your clinic, consider how much time it will take to obtain the AED during an emergency. Remember, every minute wasted decreases the chance of survival.

Having an AED in your clinic provides you, your staff and your patients the confidence that you have the necessary equipment to use in an emergency. Your patients will appreciate the extra effort you’ve put in. They are already confident in our ability to help them achieve their optimal health, now they can also be confident that we are ready to respond to an emergency, should one arise.

Now that chiropractors are required to have up-to-date first aid and CPR training, it shouldn’t stop there. It is critical that the office staff are trained as well. Our office staff are the face of our practice. They are the first ones to greet the patient when they come into the office. Typically, the patient will tell them how they are doing that day. What if the patient begins telling the receptionist the signs and symptoms they’re experiencing? What if the emergency doesn’t occur in the treatment room, but occurs in reception area, instead? Is the receptionist ready to deal with an emergency scenario? What if the chiropractor is not in one day but there are other practitioners, such as a massage therapist, treating that day. If an emergency occurs, are these individuals prepared?

This is why I encourage all office staff to be trained, not just the chiropractor. We will have more confidence knowing that if an emergency situation arises when we’re not present, our office staff will be able to effectively handle it.

In one of my recent courses, three independent chiropractors stated that they had to perform CPR one or more times to people in their office. In each of these cases, the chiropractor needed the assistance of their staff.

Imagine this for a moment. A person becomes unconscious and is no longer breathing in either your treatment room or in your reception area. You first have to call 911 and call for an AED. At this point you have approximately ten minutes until the paramedics will arrive. Now, you must start CPR, apply the AED and maintain some crowd control for any patients that may be waiting in the office or crowding around the scene.

In this situation, you require a couple of minutes to call 911 and a couple of minutes to get an AED. This is valuable time that is wasted if you are performing this all by yourself. Having a staff member that you can rely on during an emergency is very important.

Every clinic should have an in-office action plan in case of an emergency situation. In this action plan, we delegate who will call 911 and who will retrieve an AED in order for us to begin CPR immediately. Remember, every minute that passes when a person is unresponsive and not breathing, their chances of survival decreases by up to 10 per cent. Having an office action plan will ensure that every crucial minute is spent efficiently toward saving the life of a person.

Some first-aid and CPR courses would cover how to draft an office emergency action plan. However, you can make a plan for your office now. Determine who will call 911 and who will retrieve the AED. This one simple step can help save a life.

As chiropractors, we play an essential role in our patient’s health and well being by adjusting their spine, positively affecting their nervous system, and providing lifestyle changes where we see necessary.

Research has shown that when we change poor behaviours to healthy ones, we can impede the onset of cardiovascular disease by up to 14 years. For some of our patients, this could mean being around to see their grandchildren grow up or be able to enjoy their retirement.

DR. THERESA LISK, DC, is a graduate of the Canadian Memorial Chiropractic College and owner and operator of Dr. Theresa’s Health Institute in Courtice, Ont. Lisk has been a certified CPR, first aid, and first responder instructor for the past eight years, teaching these life saving techniques to chiropractors and chiropractic students throughout Ontario. You can contact her at [email protected].