Well ac7ss is kinda right. Unless you witness the cardiac arrest, immediately start CPR, and keep an AED in your back pocket; it's pretty unlikely that you will revive the victim. Even if you do get the person back, most of the time, they have been so oxygen deprived they are a vegetable.
And that's kinda wrong thinking...... There are several studies and recommendations now that show there is significant evidence that their is enough oxygen circulating for several minutes and air exchange may occur passively when compressions are done It has to be a "community" thing, early access to defibrillation and continuous chest compressions are the most significant things to improve SCA survival rates... Hands only compressions are easy to teach, easy to do, and people are less apprehensive about them then dough ventilations, etc. If your community dosen't have AEDs, then you need to ask why.... They should be as prolific as fire extinguishers. Sent from this... Using that...
Right on. Hopefully someday the cost will come down enough so that we all could afford to keep one in our homes or the trunk of our car.
You have me thinking. We should have AEDs in our field trucks. (They are all over our work sites, but I cannot remember where it is on one building.) AED is not just for the collaped patient. A person may have a 'running' heart attack. it still pumps, but part is not getting enough blood moving. You do not 'shock' a stopped heart, it won't do anything. Defib is just that, it 'startles' the fibrilation out of the heart. I have grabbed the 'jumper pack' for an employee that was making the standard complaints. "I don't feel good" "Is there an elephant on my chest" " , my left arm hurts for no reason." He was sitting in a chair and refused aid at the time (aid unit enroute), I just squatted on the floor nearby in case he passed out (at which time I would have started procedure, he wouldn't have been able to stop me then.) EMTs gave me attaboys.
I don't know what kind of field truck you are referring to, but it absolutely makes sense to have them where ever you can get them, fire truck or garbage truck... Dosen't matter who brings it as long as it gets there, and it makes complete sense to take it to anyone who is "ill" or "sick"..... A heart attack can evolve into a Cardiac Arrest very quickly and other complaints can be mistook for such, falls, seizures, etc..... Better to have and not need then need and not have. Firm believer in companies having some sort of standardized response to a medical emergency... Sent from this... Using that...
A field truck here is a Supervisor truck for transit. (Often gets to scenes faster than PD or Fire/Aid)
That's why I said immediate CPR. There is only 3-5 minutes worth of oxygen in the blood, after that the brain is oxygen deprived. I'm not saying you shouldn't do CPR, I'm saying after the first 5-8min. Your likelihood of survival significantly drops.
There is newer research that suggestions that the time is longer, however you have to have the whole system and everyone buy into the plan to see the benefits, Public education, AED placement with early access, rapid notification of EMS, early initation of hypothermia(which decreases oxygen demand) and continuation of it in the hospital.... You have to have all the pieces Sent from this... Using that...
You can turn it into a PR thing... See if you can partner with the local hospitals and EMS agencies... Make it a bit deal.... There are foundations and grants that this is all they do... "Local transit agency purchases new devices to save lives" reads the news headlines.... Sent from this... Using that...
I'm a Red Cross Lifeguarding/CPR instructor in Washington and this is pretty much our standard too (Manual is at work, I'm not ) I have to second the access to AEDs, my staff had to use one about a year ago (4 lifeguards from 15-21 years old rescued a guy from the pool who was having a medical emergency) and by the time EMS arrived they had given the victim 4 minutes of CPR and 2 shocks, the guy was home within 10 days. I am so proud of them.
I've always been lead to believe that compression only CPR is "better than nothing" unless, as noted above, you see an adult collapse in front of you.
This thread has been very informative. My last CPR class has been far too long ago (15+ years) and this helps make it clear why you should re-certify so often. Time to go hunt for a class in my area...
Since this was discussed elsewhere the Resus Congress met in October and the guidelines have stayed the same. So it's still 30-2 for people trained in CPR until at least next October.
I just recerted today (on AHA: CRP / AED / First Aid) out here in Northern California. The ratio (and video) was 30:2 for pretty much everyone. Depth of compressions changed slightly on age bracket, and 2 fingers for infant compressions. Rescue breaths were still covered, but definitely secondary. The emphasis of the training, and videos, was on compressions as the primary.
I work in a teaching hospital. Sometimes 1st year interns need to make a 2nd or 3rd pass to get the patient intubated. In between those attempts, we bag the patient with bag mask valve. Even with the controlled breaths through the ambu bag and oral airway in place, it is stunning how quickly the abdominal area gets distended. With this distention the patient is at high risk for vomiting and aspiration, which can quickly lead to ARDS. Not giving breaths in the field without a ET tube is not just about taking time away from compression, even though that is a very good reason. It is also minimizing the risk for vomiting and aspiration. An unresponsive patient vomiting is a huge medical emergency. It's not just that vomit is messy on them and you. Aspiration is dangerous even life threatening. Using hypothermia protocols minimizes the damage of the patient being hypoxic. Hence the old saying, "they aren't dead until they are warm and dead". The hospital I work at has had amazing success using hypothermic protocols
