New CPR Technique!

not only can your breathing rescuer, breath, count compressions and maintain the airway, they can tell you the quality of your compressions. as the breathing rescuer, in between breaths, you can check the pulse to see if the compressing rescuer is delivering deep enough compressions from the quality of the pulse. and there is the view that they are simplflying cpr, and for the general public who take a cpr course on every year or two, i think it is awesome. when i was teaching cpr, half my class would generally be people who had to have this course for workplace, or for home and around your family. how often did they use cpr, i have had three students come back to tell me about there experience. and it wasn't the readings they remembered, it was the simple drills(all three said the same thing, that and i wasn't lying about how sweaty a patient can be) that they got sick of in class, that helped them help another. non-breathing cpr, i'm no expert by any means, but it makes sense that i would move whatever oxygen in a person's system around. personally, i believe the attraction of someone doing compressions on another, will attract more people(look e loos too i'm afraind), but hopefully as well as more/or of higher trained people as well.
 
J Williams: You've got some good medical posts. Nice to see. Pocket masks/barriers are easy enough to come by and very small (for those of us who are not in an ambulance) - I started religiously carrying one after responding to a trauma while going to the store. I'm right there with you on not wanting to share bugs or drink vomit. You've converted people from VT/VF with CPR? That AutoPulse looks pretty cool for field/transport. Can you set it to do continuous compressions if you have an advanced airway?
 
These changes are not only for simplification and it is not just to introduce something new. The changes are a result of studies conducted which show that over ventilation, even when done correctly, and not enough time spent on chest compressions, I mean either or both, can significantly effect your patient's outcome in a bad way.

You do not need to break ribs or separate the sternum from the ribs when conducting CPR. It is a fact that older people and even some younger people have brittle bones, so it may not be preventable, but under normal circumstances you should be able to pull it off without traumatic injuries if you don't compress more than you have to (1 1/2 to 2 inches.)

If these injuries cannot be prevented then so be it but they are not trivial injuries so don't go jackhammer on anyone especially if you are very strong.
 
JohnQTaxpayer said:
J Williams: You've got some good medical posts. Nice to see. Pocket masks/barriers are easy enough to come by and very small (for those of us who are not in an ambulance) - I started religiously carrying one after responding to a trauma while going to the store. I'm right there with you on not wanting to share bugs or drink vomit. You've converted people from VT/VF with CPR? That AutoPulse looks pretty cool for field/transport. Can you set it to do continuous compressions if you have an advanced airway?
Click to expand...

CPR alone does not convert ventricular fibrillation (V fib) or PULSELESS ventricular tachycardia (V tach) to a normal or good enough rhythm, for that you need electricity (defibrillator.) There is a technique called a precordial thump that generates a small 6 joules of charge. It is done by hitting the chest with your hand closed in a hammer like motion. This is no longer allowed as per professional protocol but it has been known to work once in a blue moon. The defibrillator can deliver up to 360 joules so there is quite a difference in charge between it and a potentially injury causing precordial thump.

Not every cardiac arrest is V fib or PULSELESS V tach. There may be no rhythm at all ( a straight line called asystole,) an electrical rhythm to which the heart does not respond (pulseless electrical activity) only V fib or PULSELESS V tach can be defibrillated. Unless a cardiac monitor is connected or a defibrillation device detects it (and the only thing it may tell you is "shock advised") You have no way of telling if that person is in V fib or PULSELESS V tach.

Once you have an advanced airway in place such as an endotracheal tube, compressions do not stop whether a machine is doing it or you are. Ventilations are provided in that case while CPR is in progress. Pausing CPR between ventilations in this case is not needed. The new guidelines for professionals that are NOW in place call for less ventilations every (6 to 8 seconds) even with the advanced airway in place.


Again it has been proven that over ventilation is not a good thing. There is even a device that is now used that help professionals determine whether they are ventilating too much (hyperventilation) or not enough (hypoventilation) it's called a waveform capnography detector it measures the amount of CO2 being produced as a result of your ventilations and compressions. These readings are checked by the head doctors and can help to determine if anyone has been overzealous or under zealous in ventilations.
 
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Greater: I know the guidelines for CPR. I was wondering if the AutoPulse machine (compressions only) could be set to abide by the guidelines for advanced airway. The video only shows it in a 30:2 mode.
 
Some very thoughtful posts here! I am especially pleased to hear from some trained first responders on this topic. A lot of good points are being addressed. Perhaps some misconceptions are being cleared up as well.

I have only had one "event" so far and I count myself lucky that I was near a hospital and received treatment pronto (after being shuffled to a chair in a waiting room!:eek:). The hospital staff went thru a routine with efficient speed, loaded me into a amberlamps for a road trip (15 minutes for a normally 30 minute drive) to a regional hospital with cardiac care specialists. During that trip, the EMTs were also very professional and attentive.

But that one event brought home to me the realization that had something like this happened with no trained people about, the outcome may have been quite different. To me, a person who learned CPR last century, it is encouraging to know that new methods are being explored which increase the odds that I might survive a subsequent event should it occur when no medical help is near.
 
JohnQTaxpayer said:
Greater: I know the guidelines for CPR. I was wondering if the AutoPulse machine (compressions only) could be set to abide by the guidelines for advanced airway. The video only shows it in a 30:2 mode.
Click to expand...


"Continuous compression mode available for software version 3.0 or later" Whatever that means.

I am assuming the thing is software controlled and can be purchased with a variety of pre programed modes that suites the buyers purpose or level of training ?

Interesting
 
The autopulse is set to AHA guidlines. It pauses and beeps when its time to ventilate, then resumes compressions. Software is in development to have it work in conjunction with the heartmonitor to deliver shocks and stop completely if pulse is restored. Cant use it on kids(weight limit), obese people, or trauma codes.

Technology. :D

The reason it pauses to ventilate is because of the nature of the compressions it delivers. The way it compresses the chest you cant get air into the lungs.
 
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greater said:
These changes are not only for simplification and it is not just to introduce something new. The changes are a result of studies conducted which show that over ventilation, even when done correctly, and not enough time spent on chest compressions, I mean either or both, can significantly effect your patient's outcome in a bad way.

You do not need to break ribs or separate the sternum from the ribs when conducting CPR. It is a fact that older people and even some younger people have brittle bones, so it may not be preventable, but under normal circumstances you should be able to pull it off without traumatic injuries if you don't compress more than you have to (1 1/2 to 2 inches.)

If these injuries cannot be prevented then so be it but they are not trivial injuries so don't go jackhammer on anyone especially if you are very strong.
Click to expand...

greater said:
CPR alone does not convert ventricular fibrillation (V fib) or PULSELESS ventricular tachycardia (V tach) to a normal or good enough rhythm, for that you need electricity (defibrillator.) There is a technique called a precordial thump that generates a small 6 joules of charge. It is done by hitting the chest with your hand closed in a hammer like motion. This is no longer allowed as per professional protocol but it has been known to work once in a blue moon. The defibrillator can deliver up to 360 joules so there is quite a difference in charge between it and a potentially injury causing precordial thump.

Not every cardiac arrest is V fib or PULSELESS V tach. There may be no rhythm at all ( a straight line called asystole,) an electrical rhythm to which the heart does not respond (pulseless electrical activity) only V fib or PULSELESS V tach can be defibrillated. Unless a cardiac monitor is connected or a defibrillation device detects it (and the only thing it may tell you is "shock advised") You have no way of telling if that person is in V fib or PULSELESS V tach.

Once you have an advanced airway in place such as an endotracheal tube, compressions do not stop whether a machine is doing it or you are. Ventilations are provided in that case while CPR is in progress. Pausing CPR between ventilations in this case is not needed. The new guidelines for professionals that are NOW in place call for less ventilations every (6 to 8 seconds) even with the advanced airway in place.


Again it has been proven that over ventilation is not a good thing. There is even a device that is now used that help professionals determine whether they are ventilating too much (hyperventilation) or not enough (hypoventilation) it's called a waveform capnography detector it measures the amount of CO2 being produced as a result of your ventilations and compressions. These readings are checked by the head doctors and can help to determine if anyone has been overzealous or under zealous in ventilations.
Click to expand...


:thumbup::thumbup:
 
JohnQTaxpayer said:
J Williams: You've got some good medical posts. Nice to see. Pocket masks/barriers are easy enough to come by and very small (for those of us who are not in an ambulance) - I started religiously carrying one after responding to a trauma while going to the store. I'm right there with you on not wanting to share bugs or drink vomit. You've converted people from VT/VF with CPR? That AutoPulse looks pretty cool for field/transport. Can you set it to do continuous compressions if you have an advanced airway?
Click to expand...

Thanks man. :thumbup:

Like greater said, VT/VF needs defib. The people Ive converted from dead to not dead are people who were witnessed arrests without cardiac monitor in place yet to determine what rythm they were in...:)

Clinical saves in the field from CPR, without defib/drugs are EXTREMELY rare.
 
FYI current CPR guidlines are

30 compressions for 2 breaths for one rescuer CPR. Adults, kids, babies. 15:2 in kids and infants for 2 rescuer CPR.

They doubled the compressions from the last time, and many people were thinking that continious CPR was gonna be the next change.

Also guys, CPR tech is differant for babies and kids and adults.

Babies you use 2-3 fingers under nipple line, and compress 1/2-1in. Also be advised that they require a much smaller breath then adults.

Kids you compress 1-1.5in Ive found that full grown adults of reasonable strength use one hand instead of 2 to avoid trauma. Watch your ventilation volume.
 
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If Im in the wilderness and someone is in cardiac arrest, Im gonna give them a nice chest thump .
 
Codger_64 said:
But that one event brought home to me the realization that had something like this happened with no trained people about, the outcome may have been quite different.

Good or you codger. Glad that worked out

To me, a person who learned CPR last century,

Do you mean 100yrs ago or just pre-2000? :D

it is encouraging to know that new methods are being explored which increase the odds that I might survive a subsequent event should it occur when no medical help is near.
Click to expand...


May you not require such measures again.
 
J williams and greater have the straight dope with one exception. Stop calling it the autopulse and refer to it by its correct name. The geezer skeezer. :D All kidding aside, I agree with everything they have said and have the same experiences doing CPR in the back of the ambulance.

I agree with j williams that continuous CPR is going to be the next change likely for 4 to 8 minutes providing it isn't an arrest from drowning, lightning strike or airway obstruction and likely not for children either. Current CPR guidelines will likely stay the same for those cases. We will see what AHA comes up with but I think it is likely that is what is coming down the pike.

KR
 
Thanks for the info....... :thumbup:
I always had trouble remembering the compression to breath ratio anyway, since they changed it so often. This will be easy to remember.... ;)
 
kr1 said:
J williams and greater have the straight dope with one exception. Stop calling it the autopulse and refer to it by its correct name. The geezer skeezer. :D All kidding aside, I agree with everything they have said and have the same experiences doing CPR in the back of the ambulance.

I agree with j williams that continuous CPR is going to be the next change likely for 4 to 8 minutes providing it isn't an arrest from drowning, lightning strike or airway obstruction and likely not for children either. Current CPR guidelines will likely stay the same for those cases. We will see what AHA comes up with but I think it is likely that is what is coming down the pike.

KR
Click to expand...

Geezer Squeezer. :D

I talked with a AHA instructer yesterday, and he said this is what is next. :thumbup:
 
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