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CPR method questioned?

Discussion in 'General EDC Discussion' started by greenLED, Mar 16, 2007.

  1. greenLED

    greenLED Empty Pockets

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    I found this article stating "cardiac arrest victims are more likely to survive if bystanders use only chest compressions when they perform cardiopulmonary resuscitation".

    As part of the EDC skills that you pack every day, I wonder how this will affect y'all's training in CPR, and/or if these new findings will even be incorporated into training.
     
  2. dowtech

    dowtech Loaded Pockets

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    I heard about that study on the radio this morning.

    My last CPR recert, part of my Wilderness First Aid recert last fall, put much more emphasis on starting compressions and less on extended airway clearing and ventilation than in the past. We also got defibrilator training, and the increasing presence of these may be the most important step toward survival.

    Riding as an EMT with an ambulance squad in Florida years ago, we used to do compressions continuously while simultaneously using an ambu bag for ventilation.
     
  3. Grizzlybear

    Grizzlybear Loaded Pockets

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    I'm sure the next study will find that stun guns should be used as a defibrillator.
     
  4. deeker

    deeker Loaded Pockets

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    For our Search and Rescue team our protocols have been changed again for our latest re-cert. Fewer breaths, more compressions.
    If you are in a first aid situation and know nothing about CPR at all, at least attempt compressions.
    Better yet - learn something about CPR!! :stretcher:
     
  5. pax

    pax Empty Pockets

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    The Learn CPR site at UW has the current CPR guidelines and includes videos. Not a substitute for an actual class, due to the physical skills component.
     
  6. BillCurnow

    BillCurnow Loaded Pockets

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    If I remember the articles and numerous TV news stories, the study was based on the pre-2005 standard of 15:2 (15 chest compressions, 2 rescue breaths). In 2005 that changed to 30:2 and both the AHA and ARC courses were updated last year to reflect this change. Once sufficient data has been collected on the new standards, it would be interesting to see if this study's recommendations change at all.
     
  7. el_diabl0

    el_diabl0 Loaded Pockets

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    I was just re-certified a couple months ago at the ARC and was taught the 30:2 method. Our instructor also told us that the compressions will almost always break ribs. Any experts know about this?
     
  8. Lugsalot

    Lugsalot EDC Junkie!!!!!

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    I learned to do compressions and breaths at the rate of 30:2 when I got certified a few months ago. When I first learned CPR back in high school (GOD that feels like a long time ago!), the subject of broken ribs did come up, especially if one were performing CPR on an elderly person. I don't know if ribs will ALWAYS be broken in the process, but it's something one should be prepared to experience when doing compressions. I can't remember how few compressions we did back in the late 1990's...was it 10:2? Less? Anyone know?

     
  9. deeker

    deeker Loaded Pockets

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    The purpose of the short, quick compressions is to pump blood through the body, not to aid in breathing. There is often the breaking of ribs. That is a side affect to keep the blood moving through the body.
     
  10. dowtech

    dowtech Loaded Pockets

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    Given that most of the people you do CPR on will have a history of heart problems, often involving open heart surgery, their ribs will have already been cut and then stapled back, and thus a lot easier to "break".

    It's a bit disconcerting to hear that "pop pop pop" when you begin compressions if you don't know about this!
     
  11. BillCurnow

    BillCurnow Loaded Pockets

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    Yup, you might break ribs, but ribs heal; death doesn't. Not all of the crunching you'll hear will be bones breaking, however. You'll also be popping cartilage. The bottom line is as long as your chest compressions are deep enough, but not too deep (about 2" for adults, 1.5" for children under 55 pounds or 8 years, and 1" for infants) don't worry about hurting the individual you're performing CPR on.

    /ARC CPR Instructor
     
  12. el_diabl0

    el_diabl0 Loaded Pockets

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    Thanks for the information..if I didn't know about this ahead of time, it really would have freaked me out if I ever had to perform CPR!
     
  13. spiritof76

    spiritof76 Loaded Pockets

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    So I guess the current advice is to give compressions only for the first few minutes (unless it's a drowning) and start rescue breathing only if paramedics don't arrive soon? The only thing I'd be worried about is the pause while I yank the CPR shield out of my wallet.
     
  14. BillCurnow

    BillCurnow Loaded Pockets

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    No, both the American Heart Association and the American Red Cross* continue to recommend cycles of chest compressions and rescue breaths in a ratio of 30:2. A single study based on outdated standards is enough to start a conversation, but not enough to change international consensus.

    If you're a trained lay-responder, follow your training. If you're an untrained lay-responder with your local emergency service on the phone, follow their advice.

    * And anyone else following to 2005 International Consensus on CPR and ECC Science with Treatment Recommendations put forth by the International Liaison Committee on Resuscitation (ILCOR).
     
  15. deeker

    deeker Loaded Pockets

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    I believe St. John Ambulance is on board with this, too.
     
  16. BillCurnow

    BillCurnow Loaded Pockets

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    According to their website, they are. In fact, their site is great because it reminded me of the one detail not mentioned in this thread: you want to do compressions at a rate of 100/minute or about five cycles of 30:2 every two minutes.
     
  17. Lugsalot

    Lugsalot EDC Junkie!!!!!

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    You've raised some excellent points, Bill; if I follow my training, and the victim dies, I can say that I did everything I could according to my training.

    Now, if I go by heresay, or something that "I read somewhere," and the person dies, I could be held liable for their death!

    I'll stick with what training I have, until my company orders us recertified.
     
  18. BillCurnow

    BillCurnow Loaded Pockets

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    Good Samaritan Laws in the U.S. vary by state, but that's the gist of them: stick to your training, do not exceed the scope of your training (no emergency tracheotomies based on last week's ER), and you should be fine. In the U.S. the laws protect those who choose to help but outside the U.S. they often compel citizens to assist people in distress, so its a good idea to become familiar with the your local law.
     
  19. deeker

    deeker Loaded Pockets

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    Also, if a person is injured, choking or whatever, they can refuse your assistance. You can't do anything but stand by and watch. Once they pass out however, their condition is considered to be granting consent for care. In some instances if you leave that person, you are liable.

    Do what you know - and don't forget to call (or have someone else call) 911 and get the EMS on the way to help. Remember you are the First aid, not the only or final aid for the person... hopefully. :heart:
     
  20. bexteck

    bexteck Empty Pockets

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    I am an instructor for the Red Cross in CPR for the Professional Rescuer among other things. We have changed the ratio of chest compressions to breaths from 15/2 to 30/2 starting this year. Commenting on a few things mentioned previously in this thread, when doing compressions correctly, you will almost certainly break ribs, but dealing with broken ribs is much better than death. Giving rescue breaths is also very important, as is clearing any obstruction in the airway.

    As far as legal action is concerned, if you are certified by the Red Cross and you perform rescue skills according to your training, the Red Cross will back you up in court. This should be the same for other certifying organizations such as the American Heart Association. There are many different good samaritan laws, and they pertain to different groups of people with different degrees of training. The overall idea of all of these laws is that if your actions are a result of trying to help, you cannot be prosecuted for what you have done. You should check the specificics of the laws that pertain to you.

    One thing that has not been mentioned is that when CPR is performed on a person, they will most likely vomit. This is usually due to air being forced into the stomach as well as the lungs during rescue breathing. It is not pleasant, but hopefully the rescuer is using a breathing barrier which will shield them this. If this happens, the rescuer should tip the head to the side, clear the airway of material and continue CPR.