CPR: Are we doing it wrong? - Harvard Health
International Consensus on Cardiopulmonary Resuscitation and Emergency. Cardiovascular . o Place the heel of your other hand on top of the first hand. Mar 9, Studies suggest CPR may not always be performed correctly???by professionals or The gloomy "on the other hand" is that those chances aren't very good. in light of all the effort and publicity that's been put into the technique. in in Circulation that pointed out the problem with current guidelines. Improper positioning of the ResQPUMP suction cup may result in possible injury to . both hands, placing the heels of the hands near the gauge with wrists slightly . source to the top of the ResQPOD (Figure 14); avoid interrupting CPR to do .. Circulatory in writing within thirty (30) days of the date such failure first occurs.
And there are questions about where the defibrillator fits in. Cardiac arrest means simply that the heart has stopped beating. Without that constant thumping in our chests, the 10 or so pints of blood that usually circulate through 60, miles of arteries and veins stop flowing — and bad things start to happen, fast.
The lungs are not delivering fresh oxygen. Metabolic waste products pile up. The blood turns dangerously acidic.
The brain and nervous system react first because they're such ravenous consumers of oxygen, but soon other organ systems start to falter. If circulation isn't restored within four or five minutes, the brain shuts down completely and permanently. That's the definition of death. Enter cardiopulmonary resuscitation CPR. The term is a bit misleading, because its purpose isn't to restart the heart, although that has been known to occur.
The idea is to keep the person alive until they can be treated in a hospital. Rapid chest compressions push blood through the body. They must be done quickly times per minute, according to guidelines because they're no match for the pumping power of the heart, which normally beats about 70 times per minute if you're resting.
The ventilations, or puffs into the mouth 2 for every 15 compressionsare surrogates for breathing, meant to resupply the blood with oxygen.
Discovering the Best Value of CPR/AED and First Aid Certification
A good outcome is hard to find It's been almost 30 years since the first CPR guidelines were written. Studies have shown that when it's done right away — and correctly — CPR does save lives. Some research suggests that it more than doubles your chances of surviving a cardiac arrest outside the hospital. The gloomy "on the other hand" is that those chances aren't very good.
The statistics vary tremendously, partly because emergency response times vary, but studies in large cities have found that only about 1 in 20 people who have a cardiac arrest outside of the hospital survive — even if they receive CPR.
CPR isn't going to save everyone; after all, cardiac arrest is often not some bolt from the blue but the end of a long slide into poor health. Still, the low survival rate is troubling, especially in light of all the effort and publicity that's been put into the technique.
The advent of the automated external defibrillator AED has added another wrinkle. AEDs analyze the activity of the heart and if it has developed a lethal rhythm it's fibrillating or is not beating at all, the machine delivers an electric shock to jolt it back into a normal beat. So, when someone collapses from what seems to be cardiac arrest, should you do CPR or, if there is one nearby, run and get an AED?
So far, there's no consensus. Even the experts do it wrong Two studies published in the Journal of the American Medical Association in January have suggested one reason for CPR's low batting average: It isn't being done correctly, even by trained professionals. That doesn't bode well for the efforts of laypeople. The first study included adult cardiac arrest patients from three hospitals, in Stockholm, London, and Akershus a county outside of Oslo.
Paramedics or nurse anesthetists gave the patients CPR on the way to the emergency room. The ambulances carried equipment that measured the depth and frequency of chest compressions and the number of ventilations.
Using special monitoring equipment, the researchers divided the first five minutes of CPR into second intervals. Professionals didn't get the ventilations right, either. This isn't the only research that's found shortcomings in CPR. For example, in a report on 13 cases published in Circulation indoctors at the Medical College of Wisconsin found emergency service workers ventilated patients at twice the recommended rate 30 times per minute versus 12— John Tobias Nagurney, an emergency department doctor at Massachusetts General Hospital and member of the Health Letter's editorial board, notes that brief interruptions in CPR are unavoidable, at least in the hospital, as doctors put in intravenous lines, check for a pulse, and perform other procedures.
Keep in mind that although these studies have shown departures from guidelines, they haven't taken the next step and proved that those departures result in bad outcomes.
One solution is to improve CPR training, so doctors and emergency service workers get the message about keeping up with chest compressions and not hyperventilating patients.
But that's just a partial answer, because research has shown that CPR training starts to "wear off" in just a few months. Technology could help professional rescuers. Some have high hopes for computer-guided CPR that will give audio prompts: The compression rate is too slow; the ventilation rate is too fast; and so on. Early attempts at automating the chest compressions failed, but now there are improved devices that wrap around the patient and squeeze the chest at the appropriate time.
It isn't clear, though, how much fire departments and ambulance companies will want to spend on this equipment.
Some experts are suggesting that ventilations — particularly in out-of-hospital cardiac arrests — may not be worth doing because they get in the way of the chest compressions. Studies have identified chest compressions as the critical element during the first few minutes. In most circumstances people can survive for four to five minutes longer if the body temperature is low without having their blood reoxygenated. University of Arizona researchers published a study in in Circulation that pointed out the problem with current guidelines.
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About 50 first-year medical students were trained in basic CPR, then tested on mannequins soon afterward and six months later. Even right after the training, two quick breaths took an average of 14 seconds — time not available for chest compressions. But could eliminating the ventilations cost lives? Not according to a study done in Seattle.
Continue to perform compressions until emergency medical technicians arrive and can take over. It is recommended that non-CPR certified rescuers perform compressions only, as this is the most straightforward technique.
If you are CPR certified, you may perform rescue breathing if the victim is not breathing on their own. To begin rescue breathing, clear the airway by tilting the head back.
If the chest does not rise, give the second breath and then resume chest compressions. If it does rise, you may return to performing chest compressions. Continue to deliver two rescue breaths for every 30 chest compressions until the victim is breathing normally or until emergency medical support arrives.
What is an AED? CPR manually pumps blood when the heart stops during a cardiac arrest, but it does not restart the heart. A victim requires the use of an AED if they do not have a pulse. Use an AED for starting a heart that has stopped beating.
These devices are available for public use in areas like subway stations, libraries, airports, schools, sports arenas, parks, and shopping malls. The voice-automated device will guide you through each step of use.
Credibility The top consideration for any course should be a reputation of the organization and the authority of the course materials and curriculum. Nothing else matters if the reading material is not credible or it is created by a source other than a medical professional. The only way to know that you are getting the best quality and most accurate information is to seek out courses that clearly state that their programs are written and created by board-certified physicians and that are recognized by the AHA.
13 best Hands-Only CPR images on Pinterest | American heart association, Cpr training and First Aid
It is also important for many individuals that their certification is valid in any state across the country. Nationally recognized certification is a must for people whose jobs take them across several state lines, for people who travel frequently, or for individuals who are planning on relocating to a home in another state in the coming months.
AED use is a natural course combination with CPR certification, while basic life support or blood born pathogen training is important for some people to have. A good provider will offer a range of courses so that you can choose the topics that are of interest to you, or so that you can top up your training with additional classes at a later date without having to begin the search for a class provider all over again. Convenience means taking a class in the right location and at the right time of day that works with your schedule, without adding any extra hassle to your already busy life.