What is cough CPR and why do doctors not recommend it?

There are many life-saving procedures that one ought to know during a health emergency. The most crucial among them is CPR, which stands for ‘cardiopulmonary resuscitation‘.

It comprises urgent chest compressions that are also often combined with an artificial ventilation in order to revive a patient who may not have a pulse and is unresponsive. But, can a patient revive themselves via CPR?

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We reached out to some doctors, who explained that it is practically impossible for someone to administer CPR on themselves; resuscitation can only happen when someone else gives them chest compressions when their heart has stopped during a cardiac arrest, while waiting for medical help to arrive on the scene.

Dr Shaarang Sachdev, consultant and head, Department of Emergency Medicine, Aakash Healthcare told this outlet that if someone has expired, they cannot give CPR to themselves. “When the heart shuts down, there will be no blood supply to the brain. And when that happens, how will the patient know what to do?”

Explaining the process of CPR, he said that when someone dies, irrespective of their age, they have enough oxygen in the body for 5-7 minutes. Till the time medical help arrives, a bystander can follow certain rules. “First, check whether you are safe or not, for instance, you cannot administer CPR in the middle of the road. Tap the patient’s shoulders; if they are semi-conscious, they will move; if they are unconscious, perhaps they are dead. Check for their pulse — next to the neck — and breathing. If there is no pulse and no breathing, immediately call an ambulance, because if you start CPR first, you may delay advanced medical help from coming [to the scene].

“Then, you start giving chest compressions. In Covid times, the rules have changed; it is no longer safe to give mouth-to-mouth [breaths], besides, the body has enough oxygen. Press the centre of the chest continuously for at least 100-120 times in a minute, and not more than 5 cm in depth,” Dr Sachdev said.

He added that if the blood vessels around the heart get blocked, it can lead to a heart attack and if a doctor is not able to identify one and treat it, a person’s heart can stop beating, leading to a cardiac arrest. “That is when CPR is required.”

“There is no such thing as self-CPR. If someone has collapsed, they cannot revive themselves. One can follow the steps to administer CPR on others during emergencies,” says a doctor. (Photo: Getty/Thinkstock)

The internet, however, mentions something called ‘cough CPR’, which the patient can do themselves. The American Heart Association (AHA) does not endorse it, and many health experts around the world have called it a myth.

Dr Abhijeet Palshikar, interventional cardiologist, HOD Cardiology at Sahyadri Hospitals told indianexpress.com that ‘cough CPR’ could be used to “prolong the consciousness of a patient in a catheterization laboratory”, but it cannot be used in a “pre-hospital setup”. “If the patient coughs during arrhythmia, it is not as if the cardiac arrhythmia will abort… People [who believe it will help them] spend a lot of time coughing instead of calling a doctor or an ambulance. It is absolutely wrong.”

Adding to this, Prof. Dr G R Kane, head of cardiology at Kokilaben Dhirubhai Ambani Hospital, Navi Mumbai said that if someone is experiencing a heart attack, they must not exert themselves by walking and must immediately sit down.

“One of the solutions is consuming water-soluble aspirin (in a liquid form when mixed with water) or a tablet containing Isosorbide dinitrate, which is helpful for heart failures due to its ability to relax and widen blood vessels so blood can easily flow to the heart. A cardiac ambulance must be called immediately and the patient must be shifted to the hospital,” the doctor said, adding that cough CPR — where the patient is advised to cough repeatedly and vigorously with deep breaths before each cough — is not recommended, because, “when we have a heart attack, tissues in the heart can die, but the heart usually keeps on beating. One must not waste time performing cough CPR, and instead call for an ambulance.”

Dr Vivek Shama, associate consultant cardiologist at BLK Max Super Speciality Hospital, Pusa Road, New Delhi summarised by saying that sudden cardiac events are “momentary”. “You must have seen people collapsing on stage while giving a speech… it all happens within seconds, one does not feel it coming. There is no such thing as self-CPR. If someone has collapsed, they cannot [revive themselves]. One can, however, follow the steps to administer CPR on others during emergencies. It can save lives,” he said.

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