There's a New CPR

[Yrys]

Did the CF change it's CPR ?

http://www.msnbc.msn.com/id/19762047/site/newsweek/

July 23, 2007 issue - The good news: millions of Americans know how to perform CPR. The bad news: when confronted with an apparent victim of cardiac arrest, most bystanders won't do it because it includes mouth-to-mouth breathing.

Now Dr. Gordon Ewy, director of the University of Arizona's Sarver Heart Center, is championing a new form of CPR called cardio-cerebral resuscitation, or CCR, which focuses on rapid, forceful chest compressions, about 100 per minute, minus the mouth to mouth. "Mouth to mouth inflates the lungs, but it's not the lungs that need oxygen, it's the heart and the brain," says Ewy. "Chest compressions alone will help save those organs."

The Sarver researchers have developed two separate CCR protocols. Bystanders who witness a cardiac arrest are urged to perform chest compressions until help arrives. Paramedics are to attempt CCR for two minutes, before they use a defibrillator. Several Arizona fire departments have adopted the new approach. An analysis of that data shows survival rates have nearly tripled.

Current American Heart Association and American Red Cross guidelines do recommend compression-only CPR for anyone who is unwilling or unable to provide mouth to mouth. The AHA also encourages emergency dispatchers to give instructions for compression-only CPR to bystanders at the scene of a presumed cardiac arrest. "People want to do the right thing," says Ewy, "and we are giving them an easier way to do the right thing."

 

[Bzzliteyr]

well we just did the first aid course and the compressions did change from what I learned a few years ago..it is now 30 compressions to 2 breaths..

 

[PMedMoe]

Yep, 30 hard and fast compressions and two breaths of one second each (changed from two seconds).  Not a lot of time to see if the chest expands, eh?  Another change is not checking the pulse if you are not trained to do so.

 

[Civvymedic]

It was found that CPR providers were over ventilating and under compressing. The focus is now very strong on Compressions for better overall circulation and "priming" the heart to facilitate Defibrillation. In the Civvy world where I work the emphasis is so strong on proper compressions that we have devices that lay over the chest to monitor compression rate and depth and a computer graph as a visual guide on the cardiac monitor with sometimes annoying voice prompts. "Harder"  "Faster" Deeper" etc.  : It makes for some interesting discussion and glances from the public but it actually works very well.

 

[PMedMoe]

"Harder"  "Faster" Deeper" etc.  : It makes for some interesting discussion and glances from the public but it actually works very well.

  I bet you get some comments/glances!! 

 

[Civvymedic]

Oh yes. We have actually been able to turn our voice prompts off and just use the visual graph. The Fire Dept.'s in our area have kept theres though. It can get quite comical at a most inappropriate time, and for whatever reason it's programed very loud.

 

[PMedMoe]

and for whatever reason it's programed very loud.

Probably if it's very noisy and chaotic on scene.  Otherwise, you might not be able to hear it.

 

[Civvymedic]

True. Thats what we figured but it could be a wee bit more discreet. I mean it belts out the statements. Actually some systems have an earpiece for the compressor to use so only that person hears it. Probbably the best way to go.

 

[Bzzliteyr]

We were informed in Quebec that we aren't allowed to use an automatic defibrillator if we are not trained on them.. kind of funny how this province is...

 

[HItorMiss]

Last update I had on CPRit was mentioned that we were no longer to do AR in a cariac arrest situation with a single rescuer. I was a bit taken a back by that but when I did some research on my own I know understand.

 

[Armymedic]

The recommendations came out in 2004 by American Heart and Stroke, but were adopted by Red Cross for FA in 2006.

15,2 vs 30,2...Really, does it matter? Not a whole bunch... as long as air is going in, and blood is going round and round.

 

[X Royal]

As a St. John Ambulance F/A & CPR Instructor we teach the 30 to 2 compressions to ventilation ratio. For those who are uncomfortable with the "mouth to mouth" portion the no ventilation method is an accepted alternative. Compressions without ventilations is still better than no CPR. Many people will be uncomfortable giving "mouth to mouth" to unknown people or people they suspect may not be healthy without barrier devices (pocket masks ect.). Compressions & ventilations are still the best, but self protection is important. Barrier devices are a simple safety measure.

Best Wishes: Rick

 

[Yrys]

kind of funny how this province is...

It may be coming from the laws that we have here, French ones, instead of English ones.

From Wiki :

Quebec law is unique in Canada because Quebec is the only province in Canada to have a civil law system.

 

[Northern Ranger]

Here in NWT we must be trained on a automatic defibrillator, once trained we must be certified by a MD.

 

[ArmyGuy99]

Back in Ontario anyone can use the AED's now, thanks to superb stupid proofing of these devices.  The ont gov't changed the legislation a few years back, and now there is an AED at every school, pool, museum, places of work etc........ Of course unless you know how to do CPR as well, not much is going to happen. Since there are only a few shockable rythyms, and asystole or no heart beat is not one of them. You'd better know how to do Compressions.

as for not doing AR as well.  I agree that the protection of the First Aider is important, and so is getting oxygen to the brain.  I like that the protocol is now up to the first aider IF THEY want to take that risk.  I for one won't, but then again I keep a mask in my F/A Kit.

 

[medaid]

ArmyGuy99 there's only 1 rhythm an AED is programmed to recognize and shock and that's V Fib.

Also, first-aiders always had a choice when it came to vents. To do vents and CPR or NOT to give care. The option has always been there. Also, that's only a St.John's thing with regards to no vents straight compressions. Red Cross doesn't have that at all.

 

[Armymedic]

there's only 1 rhythm an AED is programmed to recognize and shock and that's V Fib.

Interesting. As I do not play AEDs, I did not look into the theory of use for them that much, I did not know that.

Not V Tac?

 

[kratz]

I know the MP's are deploying the Zoll AED Plus in their patrol cars and the CF Fire Trucks are carrying Medtronic's Lifepak 500. I know that AED is now allowed to be used without training in 8/10 Canadian provinces, though yearly recertification is encouraged. The CF policy on AED use has not been updated yet, so retraining an being signed off by a designated MO is still required.

 

[medaid]

Interesting. As I do not play AEDs, I did not look into the theory of use for them that much, I did not know that.

Not V Tac?

Ya apparently it's the only rhythm that it shocks, and it's the one that more closest and I guess easiest to being achieved after compressions. Hence... I guess that's why laymens get a defib for only 1 rhythm.

That's what's been taught to me maybe not the laymen's parts... and that's what I've been teaching my students. 

 

[medic45]

An aed will also recognize and shock ventricular tachycardia.  In theory if you applied to a person in VT who was still perfusing it could and would recognize and shock VT in a pt with a pulse.  That is why aed's are only indicated for pulseless patient's.