CPR

[Steve M]

I just updated my first aid training last fall. I am sure there is a flaw in this video. At 1 minute and 25 seconds into the vid the reporter says "no need to check for a pulse, just start". The physician that follows states that there is no need to worry about injuring the patient as he is already dead. Now I'm no genius but I'm sure that zimming around and pumping breastplates without checking for lifesigns is not good.  You think?
http://www.youtube.com/watch?v=E5huVSebZpM

[skoker]

I think that if theirs no pulse your still dead.  Even if you can get the pulse back the brain damage would still be to great, even after a few minutes of oxygen loss.  I think its better to check pulse first, or have someone else do it while your pushing.

[Steve M]

[quote]I think that if theirs no pulse your still dead.

[machineman9]

Fat fred?

[DaveSims]

Ok, where to start?  First, I am a firefighter and must re cert in CPR every 6 months, so I do know a little about what is going on.

This is a new form of CPR, designed for non emergency personnel, and has been approved by the American Heart Association.  The reason they removed the breaths is to get more people to perform CPR.  Often most lay people shy away from learning and using CPR because of the mouth to mouth contact.  Plus there have been new studies that show there is sufficient oxygen in the bloodstream and lungs to sustain life for up to 15 minutes after a person goes down, which by then paramedics should be on scene.   


As for injuring the person, as the video states, if you do nothing, the person dies.  Many people are afraid to do CPR, because they don't want to cause more injury, truth is, you can't.  You will break ribs doing CPR, often on the first compression.  The first time you hear that crack, it will freak you out (I did, fortunately the paramedics told me it was ok).  But broken ribs are a lot better than death. 

The entire reason for the emphasis on the compressions is to keep oxygenated blood flowing to the brain.  As I said earlier, there is plenty of oxygen in your bloodstream to keep you alive for 15 minutes, the problem is getting the blood to the brain.  That is why over the years we went from 15/2 to 30/2, and the compressions were sped up. 

As for checking for a pulse, only EMTs are taught to check for pulses, lay people are taught to shake the patient, and listen for breaths.  The average person wouldn't find a pulse on a live patient, or would spend too much time looking for it.

Any other questions?   ;)

[machineman9]

Davy, I mostly just dislike the 'run in and do it' approach (not to mention the strange amount of fingers that you seem to gain through doing CPR as seen in the video)

I can understand people not wanting to make mouth contact, but they still missed the essential checks to make. They seemed to encourage beating anyone in the chest who is lying on their back forgetting to check if they're breathing okay/still alive. I think they got the 'R' and the '.' (responsiveness and emergency number) in DR.ABC but seemed to ignore the rest. They didn't seem to show much reason to what they were doing. That is what makes me think it may cause injury or other complications for when the medics do arrive. It does help to do something rather than do nothing, but causing more problems along the way is not much better.

[DaveSims]

Davy, I mostly just dislike the 'run in and do it' approach (not to mention the strange amount of fingers that you seem to gain through doing CPR as seen in the video)

I can understand people not wanting to make mouth contact, but they still missed the essential checks to make. They seemed to encourage beating anyone in the chest who is lying on their back forgetting to check if they're breathing okay/still alive. I think they got the 'R' and the '.' (responsiveness and emergency number) in DR.ABC but seemed to ignore the rest. They didn't seem to show much reason to what they were doing. That is what makes me think it may cause injury or other complications for when the medics do arrive. It does help to do something rather than do nothing, but causing more problems along the way is not much better.

Watching the video, they do say to attempt to wake the subject by rubbing on the chest first, and making sure 911 is being called.  And believe me, the first time my 200 lbs comes down on your chest, you will be awake.   ;)  That being said, this is not a complete training video, as it didn't show hand location or much else.  As for it being dangerous, I don't think so.  Like it is said, the worse injury you may cause is broken ribs and some bruising.  You can't kill a person with compressions, and truth is, they are technically dead when you get there.  The CPR classes I've helped teach to lay persons has basically been about compressions, and how to do a proper compression, plus AED assistance.  We don't even bother much with breathing, just get your hands between the nipple line, and compress 1 1/2 to 2 inches, at 100 beats per minute, or at a fairly rapid rythm.  Do 5 sets of 30, then hopefully rotate out with someone else, without stopping compressions for long. 

[EVVFCX]

Hi all,

The cpr without first checking for pulse is the current international medical guideline,  when I first did first aid we did some 30 years ago, ended up with trophies for first aid.

As someone has put, we went many years ago from 15/2 to 30/2

[beaky]

I've heard about this "if ribs don't break, you're doing it wrong" concept... but isn't the damage (the source of the cracking or clicking sound) actually to the cartilage where the ribs join the sternum, or where front and back ribs connect? I remember hearing that somewhere once...

[Steve M]

I disagree with the current guidelines for chest compression.
One reason is because they keep changing. The experts on the topic used to be correct. Oh, hold a minute, that was wrong now this is correct. OK, wait, we think we have it this time. Oh, we need to change the guidelines one last time, this time we are right so do it this way now.
The second reason is.. There is a distinct difference between unconcious and dead. Rubbing a chest and shouting at a person only tells you the person is unresponsive. Not dieing. I have given CPR once in the last three years and by the video guidelines it would have been twice. The second person would have gotten compressions because he was unresponsive, needlessly. I checked for any sign of life in both cases and both are fine today.
    

[Steve M]

[quote]I've heard about this "if ribs don't break, you're doing it wrong" concept... but isn't the damage (the source of the cracking or clicking sound) actually to the cartilage where the ribs join the sternum, or where front and back ribs connect? I remember hearing that somewhere once...

[DaveSims]

[quote]I disagree with the current guidelines for chest compression.
One reason is because they keep changing. The experts on the topic used to be correct. Oh, hold a minute, that was wrong now this is correct. OK, wait, we think we have it this time. Oh, we need to change the guidelines one last time, this time we are right so do it this way now.
The second reason is.. There is a distinct difference between unconcious and dead. Rubbing a chest and shouting at a person only tells you the person is unresponsive. Not dieing. I have given CPR once in the last three years and by the video guidelines it would have been twice. The second person would have gotten compressions because he was unresponsive, needlessly. I checked for any sign of life in both cases and both are fine today.

[Steve M]

[quote][quote]I disagree with the current guidelines for chest compression.
One reason is because they keep changing. The experts on the topic used to be correct. Oh, hold a minute, that was wrong now this is correct. OK, wait, we think we have it this time. Oh, we need to change the guidelines one last time, this time we are right so do it this way now.
The second reason is.. There is a distinct difference between unconcious and dead. Rubbing a chest and shouting at a person only tells you the person is unresponsive. Not dieing. I have given CPR once in the last three years and by the video guidelines it would have been twice. The second person would have gotten compressions because he was unresponsive, needlessly. I checked for any sign of life in both cases and both are fine today.

[EVVFCX]

Hi All,

Well lets see what happens in the near future as the current guidelines are the 2005 ones and are due for review, lets see if they change again.

When I redid my first aid for industrial use (and yes, we all do it in the hospital) they asked would we check for pulse first, I said Yes, we all agreed to check for pulse, that was all I knew from the past and they told us we were all wrong.

Regarding the the ribs breaking bit, they didn't teach us where the ribs break but I would expect it to be at the sternum.

regards to all especially our firemen/rescue services wherever you are.

Steve.

[Theis]

I think that if theirs no pulse your still dead.  Even if you can get the pulse back the brain damage would still be to great, even after a few minutes of oxygen loss. I think its better to check pulse first, or have someone else do it while your pushing.

It would be pointless to check for a pulse while someone is doing CPR, because the CPR would create a false pulse because of the compressions.

[quote]Fat fred?