CCR - do you use it?

[Mateo_1387]

Why not capture the airway with a non-visualized airway like the King LT-D and deliver asynchronous ventilations with continuous chest compressions?

Tom

The idea is not to increase thoracic pressure with aggressive ventilations. Increased thoracic pressure decreases preload to the heart, and in a sense can cause blood to be stagnant.

[Tom B.]

The idea is not to increase thoracic pressure with aggressive ventilations. Increased thoracic pressure decreases preload to the heart, and in a sense can cause blood to be stagnant.

I definitely agree that ventilations should be given sparingly (every 6-8 seconds which is a long time if you count it out). As for increased intrathoracic pressure, that's where the ResQPod comes in. At least, that's the Wake County EMS approach, and it seems to be working quite well!

Tom

[FL_Medic]

I definitely agree that ventilations should be given sparingly (every 6-8 seconds which is a long time if you count it out). As for increased intrathoracic pressure, that's where the ResQPod comes in. At least, that's the Wake County EMS approach, and it seems to be working quite well!

Tom

Our system is having great results using the ResQPod, as well as Collier Co. EMS.

[hertzvanrental]

<!--quoteo(post=222037:date=Aug 23 2009, 03:00 PM:name=Tom B.)--><div class='quotetop'>QUOTE (Tom B. @ Aug 23 2009, 03:00 PM) <a href="index.php?act=findpost&pid=222037"><{POST_SNAPBACK}></a></div><div class='quotemain'><!--quotec-->I definitely agree that ventilations should be given sparingly (every 6-8 seconds which is a long time if you count it out). As for increased intrathoracic pressure, that's where the ResQPod comes in. At least, that's the Wake County EMS approach, and it seems to be working quite well!

Tom<!--QuoteEnd--></div><!--QuoteEEnd-->

Our system is having great results using the ResQPod, as well as Collier Co. EMS.

In my service (Secamb) in the UK we have been doing this for the last few years. Our version is called Protocol C. At the present time our return of ROSC and survival to discharge figures (over 35%) are among the best in the country. I've certainly noticed a massive different in successful resus cases.

We have a criteria, it's not used on paeds, OD, pregnancy,trauma or witnessed arrests.

For everyone else it goes like this:

100 compressions (a tube and line may be inserted at any time but no inflations until after the 3rd cycle)

check rhythm

100 compressions

shock (if non-shockable rhythm then we revert to UK/ERC resus guidelines-drug/fluid therapy etc)

100 compressions

check rhythm

100 compressions (adding a ventilation every 6 seconds) which is basically 30:2 and carry on.

I had a guy walk out of hospital after receiving 12 minutes of bystander chest compressions prior to our arrival. we turned up and shocked him once and he was GCS 15/15 by the time we got him on the stretcher.

We also stay and play with most cardiac arrests and if we get a ROSC then we will wait for up to 10 minutes prior to moving, just to let them settle. As you all know many will arrest again if you start moving people straight away. Also if you start moving people while trying to carry out CPR it is pointless. You lose all the CPP that you spent ages maintaining and once that's lost you'll never get it back. Moving people will kill them.