Katawa Shoujo Forums

Mirage: Unfortunately it is a reality still, you can get sued for giving CPR. This is unfortunately without citation. This on the other hand is not of CPR but rescue, related nonetheless. This gives a theoretical answer but also (without citation) says that no successful lawsuits against people giving CPR have gone through. If the first link is, even lacking the citation, truthful, then this is put into a questionable light.
However, more or less this cavalcade of links does prove the point: you can be sued and punished for helping someone (not necessarily CPR though) in some countries, mainly USA.

Now that's life for you.

I may be wrong, but I think incorrectly performed CPR might not be "incorrect" simply because it would break a person's ribs, but also because you might not actually be doing anything to help them breathe. Therefore you would in fact be making things worse.

In the US it's illegal for an untrained person to use a defibrillator. It's been mentioned multiple times on this forum that defibrillators are not used in real life the way they are on television dramas, and it may be the same way with CPR -- chances are that someone trying to perform CPR without training would try to push down on the wrong place. (Am I correct in assuming that the correct area to press when performing CPR is under the diaphragm, not the sternum?)

Anyway, I imagine the point of these laws is to encourage people who don't know CPR to not do more damage in their attempt to play hero, and instead 1. immediately call 911 and 2. wait for/seek someone who actually does know CPR.

Chances of someone performing CPR so "incorrectly" that they a) don't do anything to make the patient breath and at the same time b) break their ribs are quite minimal. You'd have to be pressing pretty hard and... I dunno, maybe from on top of their heart or something. And even that would probably cause _some_ breathing.
Personally my opinion is, having CPR training and all that, that there is no serious harm to be done even if a layman who doesn't know shite about CPR doing CPR. There's also the great thing that giving CPR isn't exactly easy and fun. It's tiring and messy. Preferably you'll have a lot of guys doing CPR to save that guy, one at a time of course. If there's one guy who doesn't do a good job, the others can tell him what to do right and even if they don't, it's still only a single person in the chain.

And yeah, defibrillators aren't really for anyone else to use than medical professionals. I've been given basic training (theory level) on how to use a defibrillator and some Finnish First Aid bags even carry those (on trains I think, for instance), but the only point there is that since I know how and what can happen, I know to tell others to not do it.
Basically defibrillators are, well surprisingly, not miracle items. They're not used when someone's heart has stopped (is drawing that straight line). That's when you start CPR again. Defibs are used when someone's heart is in tachycardia, is otherwise out of beat or starts trembling rather than actually pumping. A defib doesn't start a heart, it restarts one. So your heart is beating too fast, too slow, out of rythm or is just trembling? Well give it an electric shock to make it stop and thanks to the heart and the brain being quite a powerful machine, it'll most likely start beating again, most likely with it's rythm back to somewhat normal.
Defibs can also be used to stop a working heart, so that already is quite a strong reason why only medical professionals are allowed to use them.


As to the law part... I think it's rather telling that in USA they have had to create laws to protect helpers, the Good Samaritan laws. In most of Europe it's instead stated in the law that you have to help, when you help you are immune to being charged for any damage and if you don't help you're subject to punishment. Only thing that people who do not know CPR should be encouraged to do is to learn CPR and even if they don't know CPR still go and help out by giving CPR (if nothing else, someone [preferably the nice woman from 911 on the phone] will tell you exactly how to perform CPR) and doing whatever else can be done at a site of "playing hero" situation. Calling for help is good and all, but "wait for / seek someone who does know CPR" is just pretty much the same as twiddling your thumbs, watching the guy / gal become a vegetable right infront of you.

I will point out that if someone seems to not have a pulse but is in fact breathing very faintly, and someone doesnt pick that up (easiest way is to put your cheek up close to the mouth to feel for air) and then uses CPR, it will do more harm then good, and can in fact be fatal.

however, i have yet to hear of anyone being convicted for incorrectly applied CPR, due to the fact that the person was trying to help.

the point of CPR is to keep oxygen circulating the body, or more specifically the brain.

a sad fact remains that on average 8 out of 10 cases of CPR fail, either due to other Injuries, Incorrect application or Emergency Services taking too long.

also note that CPR is only a to attempt to keep the persons brain going until Defib can be used, however, if not applied within 3-5 minutes, its safe to say its too late.

Shades of gray wrote:I will point out that if someone seems to not have a pulse but is in fact breathing very faintly, and someone doesnt pick that up (easiest way is to put your cheek up close to the mouth to feel for air) and then uses CPR, it will do more harm then good, and can in fact be fatal.

That is correct, however:
A person might have a pulse and not be breathing. This can be caused by a variety of conditions like obstruction of airways etc. and would not indicate a CPR.
However the chance of a person's heart stopping while they still breathe is negligible. I've never heard of such a case. If a person still breathes, just assume he has a pulse, no need to check. Examine his airways and put him in recovery position.
If they are not breathing, check their pulse, preferably at the throat left and right, because it is easiest to feel the pulse there even if the patient is in shock. Only if you can feel a pulse on neither side, start giving CPR...
A few years ago this part of training was changed for first aiders to omit the pulse check! The reason was that many first aiders were taking too long for the pulse check, because they weren't sure whether there was pulse or not. Current policy says it's better to do CPR once too many than to omit it completely. That is not my opinion! I'd still advise for doing the pulse check, especially if you are living in a ocountry with a questionable legal system...

a sad fact remains that on average 8 out of 10 cases of CPR fail, either due to other Injuries, Incorrect application or Emergency Services taking too long.

And some simply fail, even if the patient keels over right next to a medic. There's no guarantee, that a stopped heart will start beating again, even if you do everything correctly.

Chances of someone performing CPR so "incorrectly" that they a) don't do anything to make the patient breath and at the same time b) break their ribs are quite minimal. You'd have to be pressing pretty hard and... I dunno, maybe from on top of their heart or something. And even that would probably cause _some_ breathing.

Chances of breaking a rib or two are quite high as I mentioned before, but that's not important.
What I maybe should mention is that pushing down on someone's ribcage doesn't magically cause breathing. It's only in combination with mouth to mouth resuscitation that CPR is efficient. MtM gets oxygen into the lungs and the CPR gets it up to the brain. (I do realize that the concept of CPR includes resuscitation, but as it seems that not every country has mandatory first aid courses, I felt this should be mentioned at least once...

And yeah, defibrillators aren't really for anyone else to use than medical professionals. I've been given basic training (theory level) on how to use a defibrillator and some Finnish First Aid bags even carry those (on trains I think, for instance), but the only point there is that since I know how and what can happen, I know to tell others to not do it.

Yes, normal defibrillators should only be used by professionals, but there are so-called Automated External Defibrillators (AEDs) that can be used even by laypersons. An AED automatically does an ECG of the patient and decides whether a shock is necessary or not. AEDs are quite common at airports or other public places. During the last three years, I think two people's lives have been saved at Frankfurt airport due to timely use of an AED by a layperson.

I may be wrong, but I think incorrectly performed CPR might not be "incorrect" simply because it would break a person's ribs, but also because you might not actually be doing anything to help them breathe. Therefore you would in fact be making things worse.

I can only repeat it again: A person in need of CPR is already not breathing and has no pulse. You cannot make them any worse than they are! Even if you perform it incorrectly, it is better than not doing it at all.

Concerning the "omit the pulse checking" part, I was actually going to mention that but forgot. In Finland it's nowadays told not to even try checking the pulse. We were told (on our first aid course) that even professionals have trouble reliably checking the pulse. If there's only a very slight pulse or no pulse, you'll probably feel your own pulse from your fingers anyhow (it's a panicy situation, it's not that easy to be sure) and end up thinking that the patient has a pulse.
In Finland even paramedics nowadays check the pulse usually from the crotch, the blood flow is much stronger there still than in the neck, or at least the vein is bigger. *grin*

On the chances of breaking ribs. Just want to point out (in order to look like an ass, probably) that as I was saying, performing CPR so incorrectly that you don't help the breathing at all and at the same time still manage to break ribs is rather neglegible. You'd have to blunder very badly. That's like rolling three consecutive natural 1's on your First Aid check. On a D20. And at the same time you'd have to roll at least 20 natural 6's on the inevitable 20d6 damage roll.

Oh and about CPR and resuscitation: in some cases only "pushing down on someone's ribcage" can actually be enough. I've actually been in a CPR-situation where only that was done. This was, though, due to the fact that the professionals were capable of arriving ont he scene within 2 minutes of the patient going down. As far as I'm aware he had something caught in his throat, so resuscitation could've pushed the object deeper in, causing damage and problems, but also the body does have some oxygen reservoirs, so if help will be there quickly, even "pushing down" can and will help the blood flow and thus keep brain damage from happening before the rescue arrives.
But of course that's a special case.


Sort of a meta point. This is probably one of the most informative, more or less on-topic and yet completely unrelated to Katawa Shoujo outright discussion ever to be had on these forums.

AED's: Oh yeah, I've heard of those! Actually saw a video of those too, just completely forgot them. I don't think they're widely used in Finland. Can be wrong though.

Aapo, I am half expecting Hisao to need CPR in the final product... maybe...

also note: Yamako probably has classes for this, regardless of the fact there is 24/7 medical staff on hand, especially when you consider that most disabled people rely on each other (game example : emi-rin, shizune-misha)

and while 8 out of 10 cases may fail, the important thing is to keep doing CPR until Emergency Services get there, due to the fact that CPR will prevent brain damage if the person is successfully revived.

Helpful Tip : you know when you are performing CPR correctly when the persons color improves, this is due to the body receiving oxygen.

Aapo, I am half expecting Hisao to need CPR in the final product... maybe...

also note: Yamako probably has classes for this, regardless of the fact there is 24/7 medical staff on hand, especially when you consider that most disabled people rely on each other (game example : emi-rin, shizune-misha)

A most intriguing observation. I wonder how different girls would react, in this sense, if they were put in the same situation or a similar one to the one in the OP. They get it on with Hisao, and suddenly he breaks. Shizune would probably act very professional and all and do it like a pro. So will Emi, I guess, since she would have far more training (being an athlete, and it's also implied that she frequently aids the Nurse). Hanako will freak out (poor Hisao), and Lilly may or may not be able to help effectively due to her blindness (While she may know how to act, she may not be able to do so quickly enough. Blind medics are rather suboptimal ones).
Rin... well... I don't think you can administer first aid with your feet, but I guess it would be funny to try (also deadly, so no).

Get ye old, DISCARDED scenes here.