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Old 04-26-2012, 09:53 AM   #1
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Continuous Chest Compression CPR

Learn Sarver Heart Center’s Continuous Chest Compression CPR

Do you know what to do in the event you see someone collapse or perhaps your own family member has suddenly collapsed? Would you be able to take the proper steps to improve the survivability of the victim?

Continuous Chest Compression Cardio Pulmonary Resuscitation will improve the chances that the person will survive this medical emergency.

I won't go into the mechanics of how the technique and new protocol is applied other than to say, it only involves correctly applied chest compressions at approximately 100 compressions per minute. The first thing that you still need to do regardless of anything else, is to call 911!

Continuous Chest Compressions (instructional video)
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Old 04-26-2012, 12:03 PM   #2
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Quote:
Originally Posted by DriVer View Post
Learn Sarver Heart Center’s Continuous Chest Compression CPR

Do you know what to do in the event you see someone collapse or perhaps your own family member has suddenly collapsed? Would you be able to take the proper steps to improve the survivability of the victim?

Continuous Chest Compression Cardio Pulmonary Resuscitation will improve the chances that the person will survive this medical emergency.

I won't go into the mechanics of how the technique and new protocol is applied other than to say, it only involves correctly applied chest compressions at approximately 100 compressions per minute. The first thing that you still need to do regardless of anything else, is to call 911!

Continuous Chest Compressions (instructional video)
Also read somewhere that they now have a machine that will do the compressions for you. According to the article was instrumental in saving at least one life.
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Old 04-26-2012, 10:33 PM   #3
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It's something everyone should know. I'm a 1st responder for the company I work for and am glad I learned CPR. That is a good video.
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Old 04-27-2012, 07:46 AM   #4
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I'm concerned what they said about not checking for a pulse. When I was trained on CPR (I was Red Cross certified for at least 20 years until I retired until I retired from the company that trained me; we had to recertify every two years), one thing they emphasized in training was NOT to do chest comressions if there was a pulse. It doesn't take more than two or three seconds to check for a carotid pulse.
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Old 04-27-2012, 07:59 AM   #5
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I'm concerned what they said about not checking for a pulse..
They show to apply a knuckle rub to the the sternum to gauge for patient reaction and to say; "Are you OK?". The entire point of the procedure is to be expedient.

Begin compressions immediately and leave the diagnostics to the medics.

Remember, new protocols are constantly being developed.
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Old 04-27-2012, 10:18 AM   #6
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Thanks for posting, everyone should see this video.

Quote:
Originally Posted by LadyFitz... View Post
I'm concerned what they said about not checking for a pulse. When I was trained on CPR (I was Red Cross certified for at least 20 years until I retired until I retired from the company that trained me; we had to recertify every two years), one thing they emphasized in training was NOT to do chest comressions if there was a pulse. It doesn't take more than two or three seconds to check for a carotid pulse.
As an EMT I understand your concern about not checking for a pulse however, this technique allows a lay person to respond without delaying to determine if the collapse was caused by a cardiac event.

If it is a cardiac arrest then they have started blood flowing and increased the patient's chance of survival. If it was not a cardiac arrest there is no danger to the patient from the chest compressions.

By reducing CPR down to just chest compressions they have removed the intimidation significantly. This should equate to more people willing to attempt the procedure.

We discussed this new technique during my last CPR renewal. At that time it was not part of the AHA guidelines for Care Level Providers. Our local protocols have not changed with respect to allow us to adopt this techniques nor do I expect them to in the near future. In our discussions it was agreed that the reduction of the intimidation factor was huge and would lead to positive results.
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Old 04-27-2012, 10:44 AM   #7
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I see, I wondered about the subject line (A tad misleading) they are talking about all compressions, no breaths... I got that last time I renewed my CPR cert.. WHich has since expired. ALAS, chances of a re-cert are slim since the class is in Feb, In S.E. MI and in Feb.. I'm .. 800 miles minimum from there.

By the way folks.. .I do recommend you all take CPR classes.. I have talked to a few folks who, had it not been for someone nearby knowing CPR, I'd not have been talking to. PLUS.

Last OCt, my brother, a (now retired) Over the road semi truck driver, Pulled into a Truck Stop near Indy.. Walked around to the back of his truck and DFO'ed (Done Fell Over) Full cardiac arrest it seems.. Another trucker saw him did the 9-1-1 bit and either he or someone near knew enough to keep him alive till medics arrived and hauled his clinically dead carcus off to the hospital. They were able to re-start the heart and 3 weeks later he came out of the coma.. With 3 weeks in a coma they were very worried about brain damage but from chats I have had with him since. Sounds 100% Still has his sense of humor and everything.

So now you know how much *I* support CPR...
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Old 04-27-2012, 10:57 AM   #8
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CPR is good... but I'm not sure you could say no harm done if no cardiac event was present... as I understand it... chest compressions good enough to get the heart compressed and move the blood result in broken ribs. EMT's Please address? Wouldn't want to get sued over that if I was only trying to help.
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Old 04-27-2012, 12:25 PM   #9
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Quote:
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CPR is good... but I'm not sure you could say no harm done if no cardiac event was present... as I understand it... chest compressions good enough to get the heart compressed and move the blood result in broken ribs. EMT's Please address? Wouldn't want to get sued over that if I was only trying to help.
http://www.azdhs.gov/azshare/documen...hure_Final.pdf

Basically the Good Samaritan law protects you from law suits, as long as your intentions were not malicious. The GS laws vary by state, see the link below. Do not let this fear stop you from providing aid.

HeartSafe America - Good Samaritan Laws by State

The risk of a broken rib is very real, in fact, some will say "if you are not breaking ribs you probably not performing CPR correctly".

Remember the person is dead or soon to be dead without CPR. Broken ribs are preferable to dying.

The risk vs. reward is very heavy on the reward side.

A quote from a survivor, talking about the pain from CPR:
"From a new b on this forum. If your pain is anything like mine, I had two broken ribs, you should be coming to the end of it. I must say they were the two most wonderful broken ribs a guy could have. They did not reach me with the paddles for 16 minutes, so without the CPR the outcome would have been much different. Remember pain free days are just around the corner. Stay positive and your new life will blossom."

The other skill I would encourage everyone to learn is the use of an AED. More and more public places now have AEDs available.

My favorite EMS quote:
"Dead is dead it's pretty clear cut...Yea until we show up with drugs and jumper cables and argue about it"
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Old 04-28-2012, 11:52 AM   #10
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AZ's Good Samaritan law has this caveat in it:


This subsection does not apply if the person providing emergency medical aid is guilty of gross negligence or intentional misconduct.

A sharp weasel...er...lawyer could have a field day with gross negligence if one were to start CPR of any kind without making sure first that there was no heart beat, especially since most CPR training to date emphasizes NOT to perform CPR when a heart is beating because of the potential for damaging the heart. While one probably would win such a lawsuit, one would be out legal expenses plus have all the stress that would result from such action. Personally, since I know how, I will check for a pulse.
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Old 04-28-2012, 12:22 PM   #11
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Originally Posted by LadyFitz... View Post
AZ's Good Samaritan law has this caveat in it:


This subsection does not apply if the person providing emergency medical aid is guilty of gross negligence or intentional misconduct.

A sharp weasel...er...lawyer could have a field day with gross negligence if one were to start CPR of any kind without making sure first that there was no heart beat, especially since most CPR training to date emphasizes NOT to perform CPR when a heart is beating because of the potential for damaging the heart. While one probably would win such a lawsuit, one would be out legal expenses plus have all the stress that would result from such action. Personally, since I know how, I will check for a pulse.
From AHA website:

Can I Harm the Patient?

It is not dangerous to perform chest compressions even if the heart is still beating. You cannot make a patient any worse than he or she already is. Yes, you may break ribs, but the alternative is almost certainly death. The patient’s medical history is not important; conditions such as a pacemaker or bypass surgery should not concern you as a bystander.


From RESUS:
The 2005 resus changes were about making things easier and more reliable. The checking for colour, pulse, response etc. was removed and replaced simply by “is the casualty breathing normally – if not do CPR”. This was introduced because the first aider, in the heat of the moment, often incorrect concluded that the heart was beating. It is far better to do chest compressions on a beating heart than not to do chest compressions on a stopped heart.

Keep in mind the most common cause of SAC (sudden cardiac arrest) is ventricular fibrillation (VF), the heart is beating the whole time you are performing CPR on a VF patient. The problem is the heart is quivering and therefore not acting like a pump. CPR alone will not save this patient as VF is an electrical pulse problem, this victim will need to be shocked to correct this rhythm but by providing CPR you are keeping blood flowing to the brain.

Additionally, a lay person has not had any formal training much less any form of certification. Therefore gross negligence would not apply. Remember hands only or continuous chest compression CPR is designed to remove the intimidation factor so that a lay person will attempt CPR. It is not designed for care level providers. Those that are properly trained will continue to perform CPR in the conventional manner. Hard to be negligent when following AHA guidelines of not checking for pulse. Again this is only for the lay person.

The average lay person may attempt to check for a carotid pulse, but if they use the wrong hand or go cross body with their hand their thumb will be in the way and they will feel their own pulse. Giving them the false indication the patient has a pulse.

Lawyers be damned.
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Old 04-28-2012, 06:17 PM   #12
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From AHA website:

Can I Harm the Patient?

It is not dangerous to perform chest compressions even if the heart is still beating...
That is contrary to the training I have received in the past.

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...Additionally, a lay person has not had any formal training much less any form of certification. Therefore gross negligence would not apply...
Therein lies the rub (appologies to Billy Wigglestick). I have had formal training (which says NOT to perform CPR when there is a pulse).

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...The average lay person may attempt to check for a carotid pulse, but if they use the wrong hand or go cross body with their hand their thumb will be in the way and they will feel their own pulse. Giving them the false indication the patient has a pulse...
I can check a carotid with either hand, depending on what is convenient. Going across the body is much easier (same side is extremely unreliable) and the thumb is not used; fingers only.

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...Lawyers be damned.
I'm good with that. Per ol' Billy Wigglestick again, "The first thing we do, let's kill all the lawyers." Either that or employ some beavers.
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Old 04-28-2012, 06:40 PM   #13
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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 '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.
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Old 04-28-2012, 06:58 PM   #14
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I am a Level 1 first aider. My work has me renew when it lapses. Good to have for all reasons.
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