45 Minutes of CPR...

[Ayisha]

I believe, at least in the USA, in Oct 2010 the new recommendations for CPR are to focus on chest compressions (getting blood circulating) as opposed to establishing an open airway and assisted breathing (mouth-to-mouth), since it was determined that in many cases the victim's blood was sufficiently oxygenated, and establishing the airway first was taking valuable time.

New CPR Guidelines: Chest Compressions First

In Canada, also. I re-did my EFR in September 2010 and it was all in place, complete with newly revamped book.

 

[Bubbletrubble]

They call it 'Hands Only'. Sometimes 'Breathless CPR'. I'm told it will begin being taught in EFR starting in March. The old guidelines are still in effect. I'll find out more this weekend when I take my EFR Trainer class.

In Canada, also. I re-did my EFR in September 2010 and it was all in place, complete with newly revamped book.

Excerpt from the AHA Hands Only CPR FAQ page:

Q: Are there times when I should use conventional CPR with breaths?
A: Yes. There are many medical emergencies that cause a person to be unresponsive and to stop breathing normally. In those emergencies, CPR that includes mouth-to-mouth breathing may provide more benefit than Hands-Only™ CPR. The American Heart Association (AHA) recommends conventional CPR (CPR with a combination of breaths and compressions) for:

• All infants (up to age 1)
• Children (up to age 8)
• Adult victims who are found already unconscious and not breathing normally
• Any victims of drowning, drug overdose or collapse due to breathing problems.

Q: Is Hands-Only™ CPR as effective as conventional CPR?
A: Any attempt at CPR is better than no attempt. Hands-Only™ CPR performed by a bystander has been shown to be as effective as conventional CPR with mouth-to-mouth breaths in the first few minutes of an out-of-hospital sudden cardiac arrest. Conventional CPR may be better than Hands-Only™ CPR for certain victims, though, such as infants and children, adults who are found in cardiac arrest (whom you did not see collapse) or victims of drowning or collapse due to breathing problems.

Given the above recommendation by the AHA, I'm shocked that the EFR course, geared for scuba divers, would teach Hands-Only™ CPR. Scuba diving is an in-water sport where, in many cases, it's difficult to rule out "drowning or collapse due to breathing problems." I suppose it would be OK to make divers aware of the trend towards Hands-Only™ CPR (particularly in non-scuba-related instances), but the above exclusionary conditions should be emphasized so as not to confuse the diving community.

 

[Ayisha]

Sorry, I shouldn't have said EFR. I should have said that I re-took Standard First Aid and CPR, which was through my employer and not diving related. I just figured they could all be grouped together under EFR.

 

[TSandM]

Not to sound a negative note, but I would be very interested in the victim's neurologic status. Although I have seen people survive after prolonged CPR, many of them sustain significant neurologic damage. Which is not to say that you shouldn't try!

 

[ScubaNurse758]

Many Many kudo's to the rescuers. I wont lie, in my hospital a 45 minute code is rarely heard of. Usually after 20-30 minutes of unsuccessful resuscitation efforts we call it. Great job of not giving up!

Jordan.

 

[Midget]

I would like to know more about this statement:



It means paying closer attention to the standard technique or using a different one?

New American Heart Assoc BLS guidelines focus more on high quality CPR/compressions and less on breaths.

I think a few other countries already had this emphasis before AHA made their's official last fall.

 

[DandyDon]

I don't know if everyone realizes the amount of work it takes to sustain CPR (even compression-only CPR) for 45 minutes. This is a wonderful example of great teamwork which allowed this man to be resuscitated successfully. Great Job!!!

SeaRat

I am afraid I would have been tempted to give up in half the time. I'll keep this in mind if my opportunity ever arises. Follow the training; keep at it until relieved - or you can't.

In general they've decided that doing correct and effective chest compressions means you don't need to do rescue breathing anymore.
The switching back and forth, losing momentum, etc was hurting more than the CPR was helping...

Yes, for many incidences true, but that is an overly general statement that does not apply to in water accidents at all I don't think. Another reason compressions only cpr has been publicized is that too many were afraid to do anything because of the mouth to mouth. Compression only cpr is better than none, but inadequate for diving, snorkeling, swimming, and the like - from what I have read, much of which does conflict these days.

It does look like they did both compressions and rescue breathing, however. While one of the rescuers was performing compressions, another was breathing.

Which may have made a big difference in this case.

Excerpt from the AHA Hands Only CPR FAQ page:

Given the above recommendation by the AHA, I'm shocked that the EFR course, geared for scuba divers, would teach Hands-Only™ CPR. Scuba diving is an in-water sport where, in many cases, it's difficult to rule out "drowning or collapse due to breathing problems." I suppose it would be OK to make divers aware of the trend towards Hands-Only™ CPR (particularly in non-scuba-related instances), but the above exclusionary conditions should be emphasized so as not to confuse the diving community.

Not to sound a negative note, but I would be very interested in the victim's neurologic status. Although I have seen people survive after prolonged CPR, many of them sustain significant neurologic damage. Which is not to say that you shouldn't try!

Many Many kudo's to the rescuers. I wont lie, in my hospital a 45 minute code is rarely heard of. Usually after 20-30 minutes of unsuccessful resuscitation efforts we call it. Great job of not giving up!

Jordan.

I was wondering. Would you medical professionals have kept at it that long?

 

[=C=]

I believe, at least in the USA, in Oct 2010 the new recommendations for CPR are to focus on chest compressions (getting blood circulating) as opposed to establishing an open airway and assisted breathing (mouth-to-mouth), since it was determined that in many cases the victim's blood was sufficiently oxygenated, and establishing the airway first was taking valuable time.

New CPR Guidelines: Chest Compressions First

I'm thinking this is a reference to the changes in the number of compressions versus breaths. The ratio has been gradually increasing in favor of compressions over breaths in recent years (but careful not to under emphasize the need for oxygen or clear airway). I would mention that in my EFR Inst course last month they did emphasize the need to inhale away from the patient to maximize the o2 content and then focus on compressions.

 

[ZenDiver.3D]

I don't know if everyone realizes the amount of work it takes to sustain CPR (even compression-only CPR) for 45 minutes. This is a wonderful example of great teamwork which allowed this man to be resuscitated successfully. Great Job!!!

SeaRat

I do. My husband and I performed cpr for 38 minutes, two years ago. It is monumentally hard.
Great work to those guys!

I would like to know more about this statement:



It means paying closer attention to the standard technique or using a different one?

Compressions to breath ratio have gone to 30 comps to breath, and also the emphasis that compression is vital to breaths. Non-breath compression is effective.

 

[CaptRam]

I just took the Red Cross CPR , First Aid & AID class - this month Jan 2011 and its 30 chest compressions then Mouth to Mouth 2 full breaths- then back to Chest compressions- - every commercial boat would do good to have a defibrillators onboard-they have come way down in price just over $1100USD-used ones can be had for $600USD- I would not run my Dive boat with out one onboard