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My certification expired a while back. I have some of those keychain sized shields in most of my backpacks and travel bags. And a large shield in my actual first aid bag.
The one time I did have to do CPR was at a house party and an elderly man collapsed and fell into the pool. I went from very black out drunk to doing compressions until EMS arrived. I will never forget the gurgling of the water in the back of his throat when I gave rescue breaths. I didn't have a mask, and it didn't matter because trying to save his life overrode any concerns of him coughing or vomiting.
While waiting for EMS and performing CPR, one drunk guy literally pulled me off him and said "give him some air!" And all I could think was "that's literally what I was doing." When EMS arrived, they took over CPR and I took on keeping the man's daughter away while they tried to resuscitate him. The other people there kept saying things like "he'll be okay" and I kept having to physically hold her back as her dad died right in front of her. I was telling her that we had to let the paramedics do their job and "they're doing everything they can for him." I knew not to say anything that would give her false hope.
Sadly, he passed away. I remember hearing he died the next day, after the family was able to say good bye. So I don't know if they were able to restart his heart or not or get him on life support.
After the paramedics took him away, I overheard the guy that pulled me off him was going to take CPR classes so he'd know what to do in that situation. Well, first of all, don't fuck with the guy that does.
Anyway, I hope you never do have to perform CPR, but it's great that you took the time to get certified and recertified. If you do need it, it's reassuring to know that you'll be prepared. I was prepared for breaking ribs, but not for the gurgling sound during breathes. It's the one thing that's really stuck with me. And even though the man I assisted passed, I never felt any guilt or regret because I knew that I had the knowledge of what to do and that I did everything that I was able to do to give him the best chance at surviving.
Hey mate, Critical care paramedic for almost a quarter of a century here.
You did fucking great. Seriously, tipping my head here.
Why?
You started CPR despite being in a huge crowd. That alone takes some braveness - trias on nurses (!) showed that they had issues with it.
You seemed to done a stellar job despite having alcohol as your situational awareness was still there. Great job.
You continued despite interference. (That is the number 1 reasons my trainees fail their exams - and the drunk know it better is a very common scenario)
You did mouth to nose/mouth to a unknown person post drowning. Honestly? I wouldn't. You did. Mad respect.
The fact that it didn't work out and he died is none of your fault. Even with bystander CPR being present an extremely low percentage of people survive, even less without permanent damage. One reason one must not forget is the fact that it takes a lot for a heart to stop. A fuckton. We have a multitude of redundancies build in. Sinus node is fucked? Take the AV. Etc. So the chances that there was an issue that was uncorrectable is extremely high. And water,well,makes everything twice as hard. (Truth to be told I never resuscitated a person post drowning/immersion successfully)
To boil it down to a single sentence: The patient is the one who started it.
What you are responsible for is the fact that he had a chance and had another day- it means his heart was beating at some point but the damage was done. You have contributed the biggest part to restarting it (seriously, all our ALS paramedic shenanigans are worthless without bystander CPR) and therefore gave him a chance and gave the family time. (And gave a third person a chance for an organ potentially)