New CPR method

[Raider Bill]

http://www.youtube.com/watch?v=E5huVSebZpM

Just in case...............

[RynSmith]

I heard that you're supposed to do it to the beat of 'Staying Alive' by the BeeGees.     :D

[Patty]

This is good to know. The doc is right, your patient is already dead, so you cannot hurt him, but you can keep his brain healthy until medics arrive.

[Warbird]

Man...  CPR is hard on a body.  Seems to me that continuous compressions wold increase damage to ribs and the chest.  Granted, it is better to be damaged than dead.

[Ianab]

It's not unusual for a CPR patient to suffer broken ribs, but that's the least of their problems at that moment in time. Broken ribs heal, stopped hearts dont unless someone can zap them back to life.

CPR hopefully keeps a 'dead' persons brain alive long enough for paramedics to jump start them again. Do your best, the chances of saving some random 'dead' person is anout 2%, but if you dont do CPR it's zero.

What the researchers have found is that just doing chest compression actually pumps the lungs enough to keep the O2 flowing just as well as breathing.

Main thing is WHY their heart stopped beating. Electric shock is the most likely to recover as their heart may not be physically damaged, just mis-firing. CPR can keep the brain alive, and paramedics can jump start you.

Drowning, less likely as the heat stopped due to lack of oxygen, but there is a chance. Same with heart attacks. It's worth a try, and you cant make things worse.

Serious trauma, not so good as all their blood has probably leaked out or brain/spine damage. If their haeart has stopped after a car crash etc, they are usually gone.

Ian

[SwampDonkey]

Yeah, they have changed it to 2 breaths then 30 compressions. Took it last spring.

[Black_Bear]

The video suggests chest compressions only. The CPR course I took last spring taught us the same thing: chest compressions only, no breaths, and the instructor cited the same reasons as this video. The instructor was an experienced Army field medic who gave an excellent course. It was a fairly lighthearted and humorous few hours, but when he needed to he got serious. He had some awesome pics of people all over the world, and he had some rather gruesome pics of accidents. This was through the NH PLP; I suggest anyone working in or around NH to take this course.   

[SwampDonkey]

I took through Saint John Ambulance last spring and it's 2 breaths and 30 compressions. Even shows it in the handbook.

[Reddog]

Donk, they are talking about Compressions only CPR.
http://americanheart.mediaroom.com/index.php?s=43&item=377

[SwampDonkey]

Sure beats doing nothing. But it looks like it for the untrained or unsure crowd.

[Reddog]

While we are discussing CPR, remember it is not everyone's wish to be resuscitated.
Also once CPR and life saving measures have been started you are obligated to continue until re leaved by a medical professional.

[Reddog]

Sure beats doing nothing. But it looks like it for the untrained or unsure crowd.

No it has been proven in the EU to be just as affective as conventional CPR. It is the Red Cross that has been resistant to the change. This debate has been going on for many years here in North America. But because the Red Cross does a vast majority of the training it was never taught or talked about.

[SwampDonkey]

Well I'm not an "expert" on it, I leave that to the experts to determine. ;)

[Black_Bear]

The Army field medic who taught our course was familiar with the logging industry and compared typical logging trauma situations to situations he has encountered during combat. Regardless of whether you are applying pressure to a wound or performing CPR, you do something now or they die.

According to the instructor, the highly trained Armed Forces medics have been using the "compression only" CPR method for years. As others have written, some reputable articles I have read do suggest that the "compressions and 2 breaths" method has comparable results to "compression only" under certain situations.

SwampDonkey is right, doing something is better than nothing, as long as you are being effective. The first thing to do is to get help on the way!

Eric J., I would want Tim in my corner if I was injured. Hopefully he can return to NH this spring.

[Captain]

The answer lies in the question whether the CPR is being done by a first responder who is anticipating more advanced life support to arrive on the scene, or the people such as paramedics that are doing the resuscitation effort and transport to definitive care.

Compressions only CPR has been proven to keep the brain and essential organs oxygenated for a period of minutes if initiated immediately.  It utiizes the oxygen already in the blood stream, and there is a small amount of air exchange in the lungs with every compression cycle.  Not to mention he fact that in this day and age, a person that is unprepared with any sort of body substance isolation is unlikely to initiate mouth to mouth respirations on a "stranger", however strictly chest compressions can be done without any special equipment considerations for bodily fluid protection.

Health care providers get a different CPR class (still AHA).  We still do 30:2 (compressions to breaths) usually with some sort of airway adjunct device and a bag valve mask with 100% oxygen.  However, If I am at the shopping mall and somebody drops nearby and needs CPR and I have no equipment, it is compressions only for the first few minutes until assistance arrives. 

Hope this helps clear up the debate.

Captain

[Reddog]

Captain,
If you could please touch on how you where trained for CPR.
Things like what to observe to even decide to start CPR.
Also how to handle Do Not Resuscitate orders, also known as DNR's.

Just because somebody drops on the floor does not give you the right to start life saving measures. I think it would be good if folks had a better understanding of the protocol that should be used to decide.

[SwampDonkey]

It's life or death, if they don't respond to you it's time for CPR. If someone is lying there about dead, whose gonna tell ya they don't want to be resuscitated?  Here in New Brunswick we are protected by law for performing CPR provided you have a training certificate under the "Good Samaritan Act".

[Reddog]

we are protected by law for performing CPR provided you have a training certificate under the "Good Samaritan Act".

What I am trying to point out is,
Don't be surprised if the person and the family are completely and truly mad at you for your decision to ignore the victims wishes.

[bl73]

I guess i would have to live with someone being mad at me, If a person has no pulse and is lying there I'm going to do what i can to save that person, having to get certified every year i couldn't live with myself if i didn't help.

[Captain]

We're trained to AHA standards (American Heart Association) for CPR and ACLS (Advanced Cardiac Life Support).  This is the same governing body the ER docs are trained by, and all of our procedures and medications are exactly the same as the ER Docs.

Any medical emergency basically starts the same way : A,B,C (airway, breathing, circulation)

A) open, clear and secure the airway.  Open using the head tilt chin lift OR jaw thrust where trauma (ex fall from ladder or motor vehicle accident) and cervical spine injury is possible)  Clear the airway (false teeth, food, etc).  Do not attempt a blind finger sweep of the mouth, only remove items visible in the mouth.  Secure the airway refers to an airway adjunct that gets inserted in the mouth (with no gag reflex) or in the nostril(s) to make sure air is going to make it past the tongue, which may tend to block the airway in the back of the mouth.

B) look listen and feel for breathing.  For a good 15 seconds, with one ear close to the mouth/nose of the victim listening and feeling, looking at the chest for rise and fall evaluate if the patient is breathing
*if no breathing iniitate CPR - (there is no pulse check recommended any longer.  if they're not breathing, they're going to be pulselesss within a couple of minutes)
"layperson" CPR or even for trained personnel without equipment is chest compressions at the rate of 100/min. 

At the above step, trained emergency personnel would give 2 quick breaths of oxygen by a bag valve mask, and then evaluate for a pulse.  (Circulation step)   If pulse is not present, CPR with oxygen at at a rate of 30:2 is preformed while a defribrillator is setup.  CPR is to continue for a 2 minute cycle...then defibrillation attempts begin, followed by intervals of CPR @ 2 min in between.  If paramedics are on scene, there are different cardiac medications that are administered based on what the PTs heart is doing (or not doing).  This cycle continues while the PT is transported to definitive care.

DNRs (in some states called "comfort care") are legal documents that express a patient's (or their health care proxy's) wishes for a patient not to be resuscitated in the event of a respiratory and/or cardiac arrest.  Rules in the State of Massachusetts state that the DNR must be presented to the rescuer, must be an original document (not a copy) and must not be expired (some have expiration/renewal dates).  If no valid document is present, the law states resuscitation efforts are started.

Captain

[Reddog]

Thanks Captain.
That has sure changed a lot over the years. 

[Black_Bear]

Yes, that was a very good summary.

What I don't understand is how the DNR will be recognized by a co-worker in the woods. This being a forestry and logging forum, I usually have visions of forests and mills when I read the stories. What happens at the downtown mall is different than when your co-worker is lying there with blood running out his ears because of a falling limb. Is the DNR something a person could present to an employer ahead of time, because it seems awful unlikely any unconscious person will be able to retrieve a DNR certificate, and I'll be damned if I'm going to look for one in that situation. I respect other peoples wishes, but the whole DNR in an emergency situation seems absurd. 

[Captain]

DNRs are usually agreed upon by physicians when the person is terminally ill, or is not expected to have high quality of life after a resuscitation....as in a late stage alzheimer's patient for example.  Healthy people are not typically carrying DNRs.

Captain

[Reddog]

All I am trying to point out is that not everyone agrees with CPR in all cases.
Agree or disagree it is the person's choice on how to live their life. Make sure your family knows your wishes to best steer the health care in the direction you want. If left to the Doc's and first responders, they will be more than happy to put you in a Nursing home as a vegetable.
It's up to you to define what quality of life you want.

[Paul_H]

So,Wally,if I see you at the next pig roast and you clutch you chest and drop,do you want help or should I move along the line and continue filling my plate?  :D

Can I have your trailer?