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Old 04-28-2012, 08:27 PM   #15
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Continuous Chest Compression CPR has not been adopted by any of the EMS agencies I'm associated with.

My last revert, yes even EMTs must revert every 2 years. Still required ventilating the patient.

The primary reason for pushing this technique is to engage lay people who would otherwise choose not to get involved.

Ventilating a patient (without the use of BVM) is not as easy as they make it seem in class, most lay people are ineffective in this task.

By distilling CPR down to Continuous Chest Compressions it reduces the intimidation factor without increasing any risk to the patient, in fact it will increase the patients chance of surveil if it causes a bystander to get involved that would not have otherwise. Every minute a patient goes without CPR their chance of survival is reduced by approximately 10%.

This doesn't mean those of you with CPR training should abandon that training in favor of this new technique.

Remember back to your very first class in CPR, trying to keep track of is 30:2, 15:2, head/chin tilt or jaw thrust maneuver, etc... Very intimidating in the classroom now imagine your self with out formal training and certification trying to remember all this in an emergency situation.

From AHA:
Why Is Continuous- Chest-Compression CPR Better for Cardiac Arrest?

Presently, only 1 in 4 patients in cardiac arrest receives bystander CPR. Studies have found that bystanders are more willing to start resuscitation efforts if mouth-to-mouth ventilations are not required. In addition, continuous-chest-compression CPR is less complex and therefore easier to learn and remember. It is important to realize that, even when chest compressions are performed continuously and properly on a person in cardiac arrest, the blood flow they generate is so weak that any interruption in chest compressions, even for breathing, lowers the chances of survival.

In my previous post I did not mean cross body in relation to the patient, I meant in relation to the rescuer, should they let their thumb interfere there is a chance they would feel their own pulse and misinterpet that as the patient having a pulse.
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Old 04-28-2012, 08:33 PM   #16
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What prompted this change was that medical research found that during a cardiac event when oxygen is suddenly made available to oxygen starved heart muscle it actually does more damage than almost anything else. Macro-cellular damage was the term used I think. They validated the hypothesis with clinical trials and found that the chest compression only group had better survival statistics and less morbidity overall. Perhaps there's a physician in the house who can explain it better?
I haven't read this study but wonder if it's not related to AMI and ACS vs. SCA??? We'll above my pay grade. As an EMT we would never have a patient long enough to interrupt the hypoxic drive of a patient by administering O2. May be why we haven't looked into this further.

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I 'think' if you pull someone out of water and they're turning blue you're probably OK giving them the old style CPR. I know it's shameful that I have let my CPR cert expire. I've been a full time volunteer for the Red Cross for over 2 years now. They keep me busy.
In drowning conventional CPR is indicated as the patient is likely to be hypoxic and therefore needs the ventilations.
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Old 04-28-2012, 09:01 PM   #17
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Thanks for posting, everyone should see this video..
I was a first responder for 28 years and we were always taught to check for obstructed airway (finger sweep). In the rapid CPR they didn't mention checking the airway at all.

The theory that a vacuum is present and it pulls air into the lungs in fascinating. The important part about this rescue technique is rapid compressions. No more of this one - one thousand cadence. The cadence is for 100 compressions per minute - man that's a lot of work.

This is why they explain that the rescuer needs to be vertical over the patient, lock the elbows and transfer the body weight to the sternum of the victim "yet" lifting before the next compression.

As a first responder and knowing about BSI, I am not going to have gloves etc. so rapid CPR w/o ventilations would be my preference.
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Old 04-28-2012, 09:17 PM   #18
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Never leave home with out gloves, rescue knife, AED, O2, various airways adjuncts, BVM, c-collars, maternity kit, even carry a KED and a couple trauma bags. I keep this gear in every vehicle.
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Old 04-28-2012, 09:33 PM   #19
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Never leave home with out gloves, rescue knife, AED, O2, various airways adjuncts, BVM, c-collars, maternity kit, even carry a KED and a couple trauma bags. I keep this gear in every vehicle.
I'm retired ....
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Old 04-28-2012, 11:39 PM   #20
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Way above my pay grade too

It either came from Reach MD on XM Radio, from one of the physicians reference books that were circulated around the office, or from one of the doctors/nurses I worked with in my last corporate job at a rather large medical device/pharma/consumer products corp. headquartered in NJ.

I found several relevant programs on ReachMD.com but I can't play them because I no longer have a logon.

I found this from 2006: Cell Death Following Blood 'Reflow' Injury Tracked To Natural Toxin

and this at the American Journal of Physiology :
http://ajpcell.physiology.org/content/282/2/C227.full

There's lots more. I didn't make this up!
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