C6 Tuesday, June 25, 2013
FITNESS & WELL-BEING
Illustration: Corbis
REVIVAL
INSTINCT
After a man collapses from cardiac arrest on a weekend outing, Dr Michael Tse witnesses how the quick thinking of fellow cyclists helped save his life
T
wo weekends ago at Sunny Bay on Lantau Island, a place where many cyclists train and exercise, some fast-acting good Samaritans assisted a fellow cyclist at the side of the road who appeared to have suffered cardiac arrest. While the man, Philip, was not known to them, the actions of those few cyclists that day had an unquestionable impact on the lives of this man, his family and friends. The fact that Philip is alive and well – save for some shortterm memory loss – is a miracle. I know this because I was personally involved in the incident. I had also been cycling in Sunny Bay and saw the state Philip was in when the ambulance arrived. He didn’t look like he would make it. Sudden cardiac arrest kills more than 10,000 people in Hong Kong each year. As we go through our daily lives, rarely do we think about this small “workhorse” of a muscle in our chest that is tasked with pumping blood throughout our bodies ceaselessly from the time we are a few weeks old in the womb until the day we die. Our hearts beat about 100,000 times per day – about 2.5 to three billion times over an average lifespan. When cardiac arrest occurs, blood is not circulated to the brain, resulting in a person falling unconscious in a matter of seconds. If the condition is left untreated, brain damage may occur within a mere four to five minutes due to lack of oxygen. The longer the hypoxic condition, the greater the damage. This is why an immediate – and correct – response is so crucial. That Saturday on Sunny Bay, the first person to arrive on the scene found Philip lying unconscious on the side of the road. The man scanned the area for any immediate dangers to himself or the victim, and then proceeded to check the victim. The victim was motionless and unresponsive. The man quickly called 999 for help, during which another cyclist showed up some 30 seconds later. This man was familiar with cardiopulmonary resuscitation (CPR) and began administering chest compressions to Philip, which kept the blood and oxygen flowing. A third cyclist came on the scene a minute or so later, and declared that he too knew CPR
and could assist. They continued CPR compressions until the ambulance arrived, whereupon it was quickly assessed that Philip’s heart needed immediate defibrillation (an electrical shock to reset the heart rhythm). A shock was administered, the heartbeat was restarted, and Philip was rushed off to hospital in critical condition, still at risk of imminent death. The whole experience was not something out of a CPR course manual – it was real. Philip was most certainly on the brink of death. At this point, many readers might think that they, too, would help someone in need. However, it is actually more common than one might think for people to walk away from such a scene, assuming that someone else can help and even thinking, “It’s not my business” or “I’d like to help, but don’t know how”.
If the first passer-by had thought like this, Philip would have laid there while crucial minutes ticked by as his brain silently screamed for oxygen, until reaching a point of no return. The ambulance also arrived in the nick of time to administer the critical shock to restart Philip’s heart. Had this not happened, Philip would have been
[It is] more common … for people to walk away, assuming that someone else can help
Resuscitation skills elude Hongkongers ............................................. Jeanette Wang jeanette.wang@scmp.com Only about 12 per cent of Hong Kong’s population would know how to revive a person who collapsed in front of them from a heart attack. The number of people who have received some training in cardiopulmonary resuscitation compares to 52 per cent in Australia and is below the ideal level, according to the St John Ambulance Association. Professor Yu Cheuk-man, head of Prince of Wales Hospital’s Division of Cardiology, says the first three minutes after the heart stops beating is the critical period. Most people who die of sudden death fail to get medical support in this window. Says Yu: “If resuscitation and electrical shock are administered to the patient in a timely manner, there’s a 70 per cent survival rate. The survival rate drops by 10 per cent for every minute that passes.” The government website lists a few organisations that provide first aid certificate courses recognised by the government: Hong Kong St John Ambulance,
Heart attack victims need to get treatment within three minutes. Photo: Nora Tam Hong Kong Red Cross, Occupational Safety & Health Council and The Auxiliary Medical Services. The Fire Services Department offers a training course of cardiopulmonary resuscitation for family members and friends of cardiac patients free of charge. For more information, call the Fire Services Ambulance Command Training School at 2640 3708. For people who are certified, remember that you need to take a refresher course every two to three years.
FIT & FAB
PLAY LIKE A PRO
Adventure lover pursues opportunities on the run
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................................................. Rachel Jacqueline life@scmp.com Despite having a solid career as an engineer, Wong Ho-fai did what most 24-year-olds only dream of: he quit his job to realise his passion – sports photography. Four years later, the gutsy decision has led to an exciting role spearheading French trail-running brand Salomon’s marketing campaigns in Hong Kong. “My parents always urged me to get a ‘real’ job,” says Wong. “But I told myself I had to find a job where I could combine work and travel.” A self-taught photographer, he did his rookie gig in Nepal in 2009, for the 10-day Yak Attack
mountain bike stage race that cuts across the Himalayas. Over the next couple of years, he travelled on adventure photography jobs, sharing his stories in a column in a local sports magazine. His work caught the eye of the Salomon boss, who offered Wong a job. Although Wong still snaps photos on the side, the job has given him the chance to develop his other passion: sports, in particular, trail running. Work has taken him to some of the most amazing trails in the world. His most recent adventure, in March, was running three ultra-marathons in as many weekends – the Tarawera 100 kilometre and the Northburn Station 100 miler (160 kilometres) in New Zealand, and the Twilight Ultra Challenge
in Singapore (100 kilometres in 16 hours). “I was in the basketball team [in high school], then I transitioned to rock climbing. After that, I was a mountain bike rider and then I got into trail running,” he says. He recently bought a road bike to participate in triathlons – though he doesn’t know how to swim. Yet. But endurance sports seem to come naturally to Wong, so it won’t be long before he excels in this new pursuit. Do you think the body has limits? No. My first big adventure race was a seven-day, non-stop expedition in October 2011 in Tasmania, Australia, where it was very cold and remote. Our team of four had to kayak, mountain bike and hike. We
slept about four hours per night. I learned the body can do anything if your mind is strong. What were you thinking the morning after Tarawera, knowing you had 100 miles to race the following weekend? I was surprised. My legs didn’t feel so bad and I was excited for the 100-miler. I rested for a few days, then did a training run on the Thursday before Northburn, which started on the Saturday. Northburn is hilly. The total elevation gain is 12,000 metres and it took me 31 hours 41 minutes. After I finished, I felt I could run another 50 kilometres.
Trail runner Wong Ho-fai in action at Rotary Park, Tai Mo Shan. Photo: Edward Wong
Do you consider yourself unique for most Hongkongers your age? I’m not unique, but I would say I’m brave enough to step up and do what I’m passionate about. But above all, I’ve been very lucky; I’ve met so many people who have helped me out and given me opportunities in the process.
1. Immediate recognition that a victim’s heart has stopped, he or she is unresponsive and lacks normal breathing. Set the chain of survival in motion by calling 999. It’s the same number for the police, fire services and ambulances in Hong Kong. 2. Early initiation of CPR, focusing on chest compressions at 100 compressions per minute. 3. Early defibrillation with Automated External Defibrillators that are available in ambulances but may also be found in some planes, shopping malls and sports centres. 4. Advanced life support in the ambulance and hospital. 5. Follow up post-cardiac-arrest care. For the sake of family, friends, colleagues or even strangers, everyone should familiarise themselves with CPR. It is easy to learn. In Hong Kong, you can take a simple course from the American Heart Association or Hong Kong St John Ambulance. At the very least, you can find some useful information or educational videos online. An amusing video advertisement by the British Heart Foundation on how to perform compression-only CPR, to the beat of the Bee Gees tune Stayin’ Alive, has attracted a lot of attention and already made an impact on educating people and saving lives. Learn through whatever means you can, but don’t walk away when tragedy strikes. A quick phone call and chest compressions can work miracles. life@scmp.com Dr Michael Tse is a sports science, strength and conditioning professional. He is clinic director of the Active Health Clinic of the Institute of Human Performance (IHP), University of Hong Kong, and was formerly head coach of strength and conditioning at the Hong Kong Sports Institute where he worked with world champions, Asian Games athletes and Olympians.
Lam Zhiqun life@scmp.com Stretching is crucial for golfers because they tend to get injured if they neglect to do it. Professional golfers are constantly on the road. I carry a resistance band that is light and easily transportable in your luggage or golf bag. The beauty of this exercise is that it can be done anywhere. I usually do it before heading to the golf course and doing my routine golf shots.
First step: Tie the rubber band on a door handle or on anything sturdy. Stand up straight with your legs slightly apart. Your elbows must face the ground, and extend your forearms.
What’s your recipe for recovery? Make sure you listen to your body and give it what it needs; eat what you need to eat, rest when you need to rest. If you enjoy your life and your running, rather than pushing yourself into it, the recovery part is easy. What’s your favourite inspirational quote? “Pain is temporary, but quitting lasts forever.” But you have to be honest with yourself; sometimes you can’t carry on. Last year at the [161 kilometre] Ultra Trail Mount Fuji, I did not finish because I hurt my knee and I had more races coming up. There will always be another race.
rendered just another statistic. Thankfully, it didn’t turn out that way due to the right timing and proper actions of the first responders – or maybe because of sheer luck. So what was the process that enabled Philip to get to the hospital with a better chance of survival? According to the American Heart Association, this “chain of survival” involves five steps:
Second step: Move your forearms in a pendulum motion for about one to two minutes. Third step: Lift your shoulders and maintain your forearms in an outstretch position. From the mid-angle, move your forearms upwards and repeat for one to two minutes. Benefits: This exercise helps loosen the arm muscles. When you have loose muscles, you tend to swing more fluidly. More importantly, you hinder any injury.