AnthonyM83 Posted April 19, 2008 Share Posted April 19, 2008 Have people started teaching the new AHA standard? I haven't received formal training on teaching it, but I've been told it will now be compressions only for cardiac arrests witnessed by healthcare providers. Unwitnessed will remain the same. Link to comment Share on other sites More sharing options...
spenac Posted April 19, 2008 Share Posted April 19, 2008 My understanding was non healtchcare would be compressions only to buy time till an ambulance arrives. We would still bag them as well as compress them as healthcare providers. Link to comment Share on other sites More sharing options...
vs-eh? Posted April 19, 2008 Share Posted April 19, 2008 Sorry? I think you should extrapolate on this more. So witnessed by HCP = compressions only and ? Unwitnessed = upfront CPR prior to anything and then whatever ACLS dictates... Current ACLS (if I'm not mistaken, we do studies around here) is basically immediate defib on witnessed (CPR while waiting) and upfront CPR on not. EDIT - unless you mean compressions only (no vent) until defib. Then you continue with ACLS. We have been doing that for years. Link to comment Share on other sites More sharing options...
AnthonyM83 Posted April 19, 2008 Author Share Posted April 19, 2008 To clarify, I mean: I believe current teaching has already been civilian CPR is compressions only to increase chance of bystander involvement rather than doing nothing at all. I haven't taught this class, though. The new thing for "BLS for Healthcare Providers" class will be continuous compressions (without ventilations) for witnessed arrest until AED or ALS arrival. Our AHA Liason just mentioned it, but haven't gotten the details. The reasoning is residual O2 is sufficient until AED is applied, so efforts should concentrate on circulation. It's basically implementing info from the studies that came out awhile ago and that some systems already do. I don't know if the entire ACLS code will be run with compressions only regardless of length? I'd have to ask. Link to comment Share on other sites More sharing options...
AZCEP Posted April 20, 2008 Share Posted April 20, 2008 This isn't really new, just since the 2005 guidelines were published before this could be included. Two minutes of uninterrupted compressions prior to ventilation for unwitnessed arrest, or if there is any delay applying the defibrillator. ACLS recommends performing compressions while doing other interventions whenever possible. IVs, medication administration, intubation-if possible, while compressions are underway. Two minutes of compressions, then rhythm check, decision making, and continue. Link to comment Share on other sites More sharing options...
DwayneEMTP Posted April 20, 2008 Share Posted April 20, 2008 The reasoning is residual O2 is sufficient until AED is applied, so efforts should concentrate on circulation. Actually I think I read an abstract on a Canadian study that said that good compressions move a significant amount of air for a body that needs little... As well, pulling this out of my rear as I don't remember who/what/where I may have heard it...before intubation the ventilation of the patient is using up valuable circulation time. Now I'm really reaching...but it was something like 15-20 sec/min of max effective CPR circulation with resps vs a continuous maximum effective CPR circulation without, minus the first 15 second or so of CPR. Intuitively it seems that bagging instead of compressing is obviously foolish...but many things seem foolish on their face... Dwayne Link to comment Share on other sites More sharing options...
AnthonyM83 Posted April 20, 2008 Author Share Posted April 20, 2008 Well the only thing really new about it is that it's now apparently finally being taught by AHA. That's all. We've posted and discussed the original journal articles about it here before, I believe. Current BLS teaching is 30:2 with heavy emphasis on the chest compressions and not stopping compressions for more than 10 seconds at a time if possible. But at least for BLS, the two minutes of compression is new. I can't imagine why AHA ACLS would teach different than its BLS AHA as far as what to do before AED or Monitor. Dwayne, I too heard about the compressions moving air, though I recently had someone tell me it's only "dead air" in the upper airway...not actual new/old air exchange. BUT I haven't seen the actual studies.... Link to comment Share on other sites More sharing options...
rdelisle Posted April 20, 2008 Share Posted April 20, 2008 Hi all. I instruct for St. John Ambulance and their current stand according to a memo I just received is until ILCOR gives a decision they will still teach compressions and ventilations for lay people and health care providers. What I took from the studies I read was that they are looking at dropping the ventilation in an attempt to reduce intrathoracic pressure and increase circulation. IMHO I always understood that by creating negative pressure in the chest with compressions the recoil of the rib cage should be enough to draw in a sufficient amount of air. Link to comment Share on other sites More sharing options...
DwayneEMTP Posted April 20, 2008 Share Posted April 20, 2008 Dwayne, I too heard about the compressions moving air, though I recently had someone tell me it's only "dead air" in the upper airway...not actual new/old air exchange. BUT I haven't seen the actual studies.... Yeah, I can't remember where I saw it, but it seemed to say that most of the air would be moved from the bronchial tree, but over time that air is mixed with that from the alveoli. It is not much, but perhaps enough for the short term until intubation can be initiated. Of course, I'm also just yapping, as I don't remember where I got the info, and haven't seen the studies. Dwayne Link to comment Share on other sites More sharing options...
Mateo_1387 Posted April 21, 2008 Share Posted April 21, 2008 Yeah, I can't remember where I saw it, but it seemed to say that most of the air would be moved from the bronchial tree, but over time that air is mixed with that from the alveoli. It is not much, but perhaps enough for the short term until intubation can be initiated. Of course, I'm also just yapping, as I don't remember where I got the info, and haven't seen the studies. Dwayne Check this link out http://emscapnography.blogspot.com/2006/08...hould-know.html On this link find the LP12 about half way down, and three strips below that is a strip showing the gas exchange with CPR alone. Link to comment Share on other sites More sharing options...
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