"New" CPR saves another one!

[Tapout 42]

"Ah ah ah ah Staying Alive! Staying Alive!" Sing it as you thump it... and forget the breathing (which we old timers never wanted to do anyway).

http://www.cnn.com/2009/HEALTH/10/14/cheat....cpr/index.html

[FFFORD 27]

i have been trained with this new type of CPR but have not put it to use as every code i have worked has been with myself and a partner. however when i do chest compressions, i do not pause, i just instruct my partner to keep bagging even if the ventilation might not be going to the lungs. if i do pause it would be to wipe the sweat from my eyes or if the medic is getting a tube. seems like it might be better to just do the compressions. glad to see this woman was saved and kudos to the husband LEO

[ny10570 745]

Ford, make sure you're switching off every two minutes. You may feel like you're going strong but quality really drops off over time. Even with regular rotations 20+ minutes in cpr quality drops off.

[FFFORD 27]

Ford, make sure you're switching off every two minutes. You may feel like you're going strong but quality really drops off over time. Even with regular rotations 20+ minutes in cpr quality drops off.

True that! I always try to make sure to switch off but sometimes I just get in the groove and loose track of time. usually someone is there to bump me off though. Thank you! never bad to hear it again! mini refreshers never hurt!

[Tapout 42]

Ford, make sure you're switching off every two minutes. You may feel like you're going strong but quality really drops off over time. Even with regular rotations 20+ minutes in cpr quality drops off.

20 minutes of compressions will most definitely exhaust you, but it'll give you some seriously big guns, which is never a bad thing!

Kidding. I'm kidding. I'm a kidder. Yes, of course, do rotate out every 2 minutes if you can. But if you can't because you're alone and there's noooooo one coming anytime soon (been there), screw the breaths and just keep up the compressions fast and furious. No 1 and 2 and 3 and... and no Mississippi's either. Just 1-2-3-4-5... 100 a minute. I wasn't kidding- sing the Beegee's song Staying Alive and compress as you sing it.

[SRS131EMTFF 471]

Youtube; "CPR Bee Gees"

Youtube: "?????? espanol"

I used the BeeGees video in a CPR/Cardiovascular system presentation I had to give for an EMT class.

[ny10570 745]

Find a song to fit your taste. http://djbpmstudio.com/bpm-music-index.html

[Guest stephentyler20]

Not to rain on the parade, but this is more a case for *hypothermia* saving another one. Granted, she'd be dead without the husband's CPR (he must have been doing a great job - 18 minutes is a loooong time - props to him!). But that effort would have been in vain if not for the hypothermia. This is the exact reason we're freezing people in the field now - so that if we can get a pulse back (step 1), they can walk out of the hospital (step 247).

[ny10570 745]

Not to rain on the parade, but this is more a case for *hypothermia* saving another one. Granted, she'd be dead without the husband's CPR (he must have been doing a great job - 18 minutes is a loooong time - props to him!). But that effort would have been in vain if not for the hypothermia. This is the exact reason we're freezing people in the field now - so that if we can get a pulse back (step 1), they can walk out of the hospital (step 247).

I completely disagree. Step one is bystander CPR. Everything else is tits on a bull without good quality CPR IMMEDIATELY after sudden cardiac arrest. In fact where hypothermia is having the greatest impact is patients with prolonged down times. Best way to prevent a prolonged down time is early CPR followed by step 2, early defibrillation. Then you can get into the other 244 steps leading up to hypothermia. Without that bystander CPR all you get is another asystole arrest that you run in and out of PEA until you finally pronounce. The new CPR should get more bystanders involved doing better CPR more frequently.

[Guest stephentyler20]

I completely disagree. Step one is bystander CPR. Everything else is tits on a bull without good quality CPR IMMEDIATELY after sudden cardiac arrest. In fact where hypothermia is having the greatest impact is patients with prolonged down times. Best way to prevent a prolonged down time is early CPR followed by step 2, early defibrillation. Then you can get into the other 244 steps leading up to hypothermia. Without that bystander CPR all you get is another asystole arrest that you run in and out of PEA until you finally pronounce. The new CPR should get more bystanders involved doing better CPR more frequently.

Yeah fair enough, but what I'm saying is good CPR (and BLS/ALS) is an obvious necessity (to you and I) in order to have a good outcome from arrest - but the thing that most likely made this woman's life anywhere near worth living is that she received hypothermia. In other words, with good CPR, BLS, and ALS, you may get a "living" patient, but add in hypothermia, and you get a LIVING patient. You think this article would have been printed if she was a vegetable?

Of course, I appreciate that as always, good public education about CPR is important, but don't forget this guy is a cop - he better know CPR in the first place!

[ny10570 745]

Unless his dept participates in EMS the last time he was trained in CPR was probably the academy. Intact arrests were occurring before hypothermia and hopefully will grow as hypothermia spreads

No high quality early CPR means you're not going to get a patient viable for cooling.

Neurologic benefits from the use of early cardiopulmonary resuscitation. Annals of Emergency Medicine, Volume 16, Issue 2

We conducted a study to determine the effect of early CPR versus no CPR on resuscitability, 24-hour survival, and neurologic deficit in an animal model of cardiac arrest. Twenty-two mongrel dogs were subjected to five minutes of electrically induced ventricular fibrillation. In 11 dogs, closed-chest massage and ventilation with room air was begun immediately and was continued for five minutes. The other 11 dogs received no CPR. At five minutes defibrillation was attempted and advanced cardiac life support (ACLS) protocols were followed until the animal was resuscitated or died. No statistical difference in resuscitability or 24-hour survival between the two groups was demonstrated. Eight of 11 “early CPR” animals were resuscitated and survived 24 hours; six of 11 “no CPR” dogs were resuscitated, and five lived for 24 hours. A significant difference was demonstrated by the Student t test in neurologic deficit and ease of resuscitation. “Early CPR” dogs had no neurologic deficit, while “no CPR” dogs had a 41% deficit (P < .01). “Early CPR” dogs were resuscitated in significantly less time once ACLS was started (29 versus 317 seconds), and required less electrical energy (100 versus 560 J), fewer countershocks (1.3 versus 4.0), and less epinephrine (0.1 versus 1.7 mg) than did “no CPR” animals. In this animal model of cardiac arrest, early CPR was shown to be beneficial to neurologic function and ease of resuscitation, even when ACLS was provided within five minutes.

[Tapout 42]

While CPR may have a better outcome when hypothermia is induced, it is still most absolutely effective even without cooling. In other words, CPR minus the breaths (as long as there is no hypoxic event worsening things like drowning, smoke inhalation, etc.) is most definitely effective in saving otherwise dead people.

I'm an RN 18 yrs now, in ED's, ICU's and nursing homes all over NY. I've seen CPR done everywhere, both on-duty and off ---in the field, in my ED, at my bedsides, etc., without breaths. Patients recover their pulse even in the absence of ventilations and meds and most certainly without dropping their core temps. So don't EVER think that only with the latest, fanciest cooling methods will a patient survive asystole. To think that is either naive or just plain ignorant.

Edited October 19, 2009 by Tapout

[Guest Yankee medic]

Had second save last Saturday, which was my second in two months last one 15 yrs ago. 51 y/o male no hx, moving furniture with family went down w/o warning. Family started cpr E-4 (Columbia FD), got on scene con't cpr shocked once with aed we got on scene put pt on monitor V-Fib shocked @ 150J RIGHT INTO Sinus Tach. Attempted tube he gagged wanted nothing to with that. Enroute to er pt became A+Ox3 c/o chest pain. Told him you had cpr done. 12 lead if I remember correctly posterior infarct. Had cath done w/o blockages. Wednesday internal defib installed walks out of hospital Thursday.

Side noted for E-4 Thet did great cpr. When we put our SPO2 on 100% with BVM. Also kuddos to the family. Cpr does work when everything falls into the right place. This one call MAKES ALL THE b.s. WOTH WHILE. eVERYONE KEEP UP THE GREAT WORK AND be safe.

[Tapout 42]

Had second save last Saturday, which was my second in two months last one 15 yrs ago. 51 y/o male no hx, moving furniture with family went down w/o warning. Family started cpr E-4 (Columbia FD), got on scene con't cpr shocked once with aed we got on scene put pt on monitor V-Fib shocked @ 150J RIGHT INTO Sinus Tach. Attempted tube he gagged wanted nothing to with that. Enroute to er pt became A+Ox3 c/o chest pain. Told him you had cpr done. 12 lead if I remember correctly posterior infarct. Had cath done w/o blockages. Wednesday internal defib installed walks out of hospital Thursday.

Side noted for E-4 Thet did great cpr. When we put our SPO2 on 100% with BVM. Also kuddos to the family. Cpr does work when everything falls into the right place. This one call MAKES ALL THE b.s. WORTH WHILE. EVERYONE KEEP UP THE GREAT WORK AND be safe.

THANK YOU, YankeeMedic, 1st for the awesome save and 2nd for making my point. GOOD, effective CPR saves people. Everything else is just gravy or icing (whichever you prefer. wink)

[SRS131EMTFF 471]

Did you have my permission LOL....just kidding.......

This class was a while ago...