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CCB vs CPR


boeingb13

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I may of missed it but i didnt find any past threads on CCP (Cardio Cerebral Resus) as opposed to CPR.

Ive been reading in EMS magazine, and in Fire/Rescue magazine, that there are a few medical directors around the country trying this ( Names werent listed). Does anyone know if AHA has run any trials in any areas as far as this goes. I've read alot of convincing material to back this up, I just havent found any cons to this. I know AHA is the primary standard for the large majority oif the country, and im guessing that why there has been no cons listed, being they dont have to.

Keep priming the pump, the o2 in the blood will be enough.

What are your thoughts on this, do you see pro's or cons?

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Dont know exactly where it stands as of now. It must be making way though seeing as we have the 30:2 ratio and its now starting to be mentioned in magazines. I first heard of it last year by word of mouth and I didnt understand it at first, and it took a while after I heard to to find someone who knew what I was even talking about. The theory makes sense, but Im sure some will trip up once its made a guidline. Hell, I had a hard enough time changing from paper to EPCRs when the state (Connecticut) mandated it for all of its EMS agencies.

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Wouldn't it be Cardiopulmonary Cerebral Resuscitation? Isn't the idea, get oxygenated blood to the heart, tissues and brain? So, no matter what you call it, it's the same goal? I could be wrong.. Throw me a bone, b/c I just woke from a chemically induced nap.

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My understanding to CCR is that is designed to take the delay out of lay-people and bystanders starting chest compressions. Apparent some(a lot) of people were withholding CPR so they would not have to give the two breaths on a stranger (who can really blame them) when no barrier device was available. The theory behind this is that when a person has sudden cardiac arrest they have enough O2 in their bodies to last for several minutes, until the first responders and or EMS can arrive. According to my medical control Dr. it was never meant to replace CPR for health care providers(EMTs, Paramedics, First Responders).

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CCR has been used with (supposedly far as I know no firm numbers or reports have been published by anyone) success in various agencies in Arizona and Wisconsin for around 2 years I believe. Most point to there being much more benefit during the hemodynamic stage of cardiac arrest (8-15 minutes in) versus the electrical phase (first 5 minutes). I haven't looked into it for awhile, but last I checked there still wasn't any real concrete evidence on how it worked, and how it should be integrated into ACLS treatments. That may have changed by now.

The theory behind it is fairly sound; circulate blood that should still be oxygenated before attempted to shock the heart from an abnormal rhythm; kind of like the new CPR standards, they just took it a step farther and completely removed ventilations, at least initially. Stopping compressions causes the pressure built up by those same compressions to vanish, which essentially means that each time you restart you really are starting from scratch...another thing that's being pushed as a benefit.

There's probably more current info about it out there, but these have some good information on what it is and why it works. What they don't have (yet) is how it should be integrated into the rest of the treatments we have.

http://circ.ahajournals.org/cgi/content/full/111/16/2134

http://www.ncbi.nlm.nih.gov/sites/entrez?c...f1000m%2Cisrctn

http://web.kshb.com/kshb/pdf/ACurrentOpini...REwy06MCC58.pdf

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Our EMS chief sent an email to us in regards to this line of treatment a year or so ago. If I remember correct, the article he sent us mentioned a Japanese doctor researching this method of lay person interventions. From what I can recall, it was felt that more people felt comfortable doing the compressions versus the ventilations on a person they may or may not know. The article did mention there was some benefit to the sole application of compressions, due to the fact that there should be enough O2 in the blood to maintain the critical organs during CPR. This was sent to us to inform us that we may see this happen in the street by lay persons, but not to expect to see it as a treatment for prehospital EMS. Have not heard much more about it though.

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Just out of curiosity... when someone has a theory on a new medical treatment, especially one requiring a patient whos clinically dead, near dead or unable to consent to something experiemental (the topic at hand for instance) how do they test it? I realize there are animals with simillar human anatomy. But how does it get to the human testing stage? There are still differences in anatomy and mechanism of how treatments (compresions in this case) would be performed.

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