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New CPR Guidelines. Chest compression first. EMT/Boy Scout comments???

Discussion in 'Off-Topic' started by News Shooter, Oct 18, 2010.

  1. News Shooter

    News Shooter

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    It's official: The American Heart Association says chest compressions come first when performing CPR.

    According to new guidelines issued today, ordinary people and professionals trying to revive people whose hearts have stopped beating should immediately start pushing on the person's chest. That's a departure from previous recommendations to check for breathing and to clear the airway before starting chest compressions. Those two steps should come later, the group said.

    In the first few minutes of cardiac arrest, the Heart Association explains, people still have oxygen in their lungs and bloodstream. Vigorous chest compression can push that oxygen-rich blood to the heart and brain and keep it circulating in the body.

    http://www.boston.com/news/health/blog/2010/10/_its_official_t.html?p1=Upbox_links
     
    Last edited: Oct 18, 2010

  2. whtmtnhiker54

    whtmtnhiker54 NES Member

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    As a respiratory therapist, I agree with the new guidelines. Unless blood is circulating to the brain and organs, there is no way that life can be sustained for very long. Ventilation of the lungs must follow shortly, though, if breathing has ceased, or is less than adequate for the normal transfer of oxygen and carbon dioxide. - Michael M.
     
  3. Garys

    Garys NES Member

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    The brings us into line with what Europe has been doing for a few years. There are a lot of changes in the new guidelines, but most of them are not related to CPR. They are also recommending doing away with pulse checks after defibrillation, but I'm not quite sure how they expect people to determine if there is a pulse. Lay people and BLS providers that is, ALS providers have more tools to work with.
     
  4. blindfire

    blindfire NES Member

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    Geeze, when I took my CPR class back in 2007, it was 15 compressions to 2 breaths. Shortly after that, it went to 30:2.

    Are breaths just completely out now???

    I'm confused.
     
  5. wolf223

    wolf223 Guest

    change no. 15,748
     
  6. Another_David

    Another_David

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    Depends on your level of training and willingness to participate.

    1. Do what you've been trained to do
    2. If you can't remember what you've been trained to do then do chest compressions only. For pacing think of of the disco song "staying alive" and compress on the beat. Keep doing it until you're told to stop, someone else relieves you, or you can't physically continue.
    3. And lastly, if you've been trained to do the breaths and don't want to make mouth to mouth contact just follow step 2.
     
  7. firestorm

    firestorm

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    I literally just did my cert for CPR a month ago for my EMT-B course. As far as I know its still Airway, Breathing then circulation at least for the professional level. Thats one of the state test stations too, starting with checking for breathing, and giving breaths.
     
  8. exodious

    exodious

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    Good advice. But is wearing a white leisure suit required too? [grin]
     
  9. wolf223

    wolf223 Guest

    just like anything else, it's always changing. i.e. the military went away from ABC's as well to B C A.... via C.A.T's and quick clot. [rofl] j/k on the quick clot
     
  10. firestorm

    firestorm

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    Well then I guess my question is how quickly does it take for something like this to filter through? My state practicals are somewhere after the 3rd week in november, do I have to worry about everything changing by then and forcing me to learn a new way?
     
  11. Jasper

    Jasper NES Member

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    I did my cert about 8 months ago. it was still recommended 30:2 compression/breath, but they said specifically if we didnt have a CPR mask available, and werent willing to possibly exchange fluids, that chest compressions alone would be satisfactory for 10-15 minutes (realistically long enough for first-responders to get to the site and take over).


    for the hell of it, anyone got a good link for a decent quality first-aid kit / bag setup for the truck? they seem to either be <$50, and come with absolutely nothing, or >$300+ and be ready for war. ideally looking for something in the middle. (still cheap tho!). i figure i can always add to it later.
     
  12. wolf223

    wolf223 Guest

    good question. i'm NREMT-B (affiliated through Army) and just re-certed CPR / EMT in Feb. funny, we are teaching a CPR re-cert later this month... hopefully is NOT before then [laugh]
     
  13. terraformer

    terraformer NES Member

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    Yup, it will change again in February.
     
  14. WayneWong

    WayneWong

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    There is some speculation that when you push down on the chest, the lungs compress and exhale, and when you let the chest rise, the negative pressure cause air to rush in.

    It doesn't seem possible to me because the compressions are so fast that the breaths can't be adequate. But it makes for an interesting discussion.

    Well, what counts is the research and facts. They're starting off with compressions now, that's easy enough.

    In compression only CPR, at some point during a prolonged effort, the oxygen levels in the blood are going to become too low to do much good. Consider low oxygen levels and compromised ejection during CPR. The success, I think, is closely related to time to defibrillation. They want to reduce the interruptions in CPR to keep the oxygen flowing to the brain and keep the pump primed for that electric shock.

    When I renewed my ACLS just a few months ago, we were told to stop doing pulse checks after defibrillation. We were told that this is because even after a successful shock, there wouldn't be a palpable pulse right away. In my own experience, I recall one guy who came right back from VFIB after a shock, I mean immediately. Twice.

    IMHO.
     
  15. cekim

    cekim NES Member

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    I'm in MA shouldn't I just dial 911 and wait for someone else to do it?
     
  16. FhvnLT4A

    FhvnLT4A

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    This is why the American Heart Association has a large budget of money and holds conventions every two years. SOMETHING WILL CHANGE every two years so they can have their annual banquet. I have been CPR certified for 20 years, and it has always changed according to the convention , symposium, or whatever the hell the AHA has to spend money and bring all those doctors into the room to talk about how to spend more money on healthcare. I am not religious, but I believe in fate, and I believe we all have a clock. When that clock stops ticking... you will find out what your god is like. Thats all there is to it. If your plan isnt finished, SOMETHING will bring you back. It might be your neighbor doing anything close to jumping up and down on your chest, it might be because someone shocks you with something from a car battery to an AED. It might be epi, atropine, dopamine, or any other host of meds. Or, it might just be you wake up in a black back in a cold room wondering why you have a tag on your toe... Fate baby..... We r just here to tempt it.
     
  17. wolf223

    wolf223 Guest

    spoken like a true para-god [wink]
     
  18. FhvnLT4A

    FhvnLT4A

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    I forgot to add it might be a dark haired dude in a funny blue suit with pink boots and black gloves on... sorry :eek:)
     
  19. Another_David

    Another_David

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    Considering none of the muscles in the body are consuming oxygen what's in the blood stream and wafting in and out of the lungs through chest compression should last a while. If you have to do CPR by yourself for an extended period odds are you'll tire out before the casualty runs out of air.
     
  20. wolf223

    wolf223 Guest

    [rofl]

    ahhh yes, the teletuby suit.

    HAZMAT Tech! HOOAH! [laugh]
     
  21. JohnFH

    JohnFH

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    The released guidelines are just that, guidelines. These guidelines will be implimented in 3-6 months, until then there is no change in current procedure, I just received that information from my AHA Training Center today
     
  22. vellnueve

    vellnueve

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    It makes sense... in a situation where professional help is close by. The AHA site is overloaded but I would guess that there are still many applications for rescue breathing.

    Damnit, I did my BLS for Healthcare Providers like 3 weeks ago... now I need to learn something new.
     
  23. C-pher

    C-pher

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    Funny, we just did something on that here for a meeting yesterday.
     
    Last edited by a moderator: Nov 18, 2017
  24. FhvnLT4A

    FhvnLT4A

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    This video brings up a great qestion I have. The first case, the doctor said you really dont need oxygen for about 10 minutes in a heart attack. I propose that he is speaking of one very specific KIND of heart attack. What about all the other conditions that lead to cardiac arrest that are CAUSED primarily by respiratory distress/ insufficnency. What then are you doing to the patient by circulatiing their already de oxygenated blood? I can think of three cases off the top of my head where unwitnessed cardiac arrest was caused by something other than ventricular fibrilation.

    1. unresolved asthmatic

    2. narcotic overdose

    3. pulmonary embolism

    What do you guys think about the whole concept of getting away from intubation and oxygenation? I personally think they chose these two cases based on data they had on what happened AFTER THE FACT. Just like they did when AEDs were all the rage. You cant swing a dead cat without hitting one now adays, but they only work in ONE kind of medical emergency resulting in a rhythm disturbance.
     
  25. Jason

    Jason

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    I just had my AHA CPR training last week. The insert in the work book mentioned compressions only in the case where an adult suddenly collapsed. It was also talked about in class but we still trained doing the 30:2 compressions to breaths ratio.
     
  26. Serapis

    Serapis Navy Veteran

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    CPR in a professional setting never goes as instructed. It's usually chaotic. That's why they are only guidelines.

    AHA needs to make more money so they come up with new guidelines every year or so. They do this so they can sell the instructor videos for 100 bucks each and workbooks for around 50.
     
  27. cekim

    cekim NES Member

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    Something I've always wondered is that blowing into someone's mouth you are no doubt blowing a lot of CO2 in there...

    Rapid deep chest compressions are going to cause _some_ amount of air exchange in the lungs mechanically by themselves and you won't be adding CO2 to the system... Provided the airway is clear, I've always wondered if perhaps the break-even point for your CO2 air was pretty low... Guess so...
     
  28. MetalgodZ

    MetalgodZ NES Member

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    I've noted the same thing. If you find a good middle-of-the-road bag, I'd be interested.
    I asked the same question during my 1st re-cert (looong since expired) and was told that there's enough oxygen in the air that you don't pull it all out, but your lungs are efficient enough that they can make use of the reduced oxygen. :: shrug ::
     
  29. medic12

    medic12

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    The state practicals are usually very far behind. When the AHA changed to 30:2 the state practical sheets still said 5:1. Ask your instructor, but you will be fine testing with the ratio you have learned. Good luck with the course.
     
  30. KilgoreTrout

    KilgoreTrout

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    I recerted last year. 30:2 makes sense. RBCs are darn efficient at moving O2 around. Just keep that blood circulating.
     

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