CPR - personal lesson learned

[Bowers]

For non-drowning needs, just remember that rescue breathes are not needed unless the victim is a baby or toddler, and for the latter just take your chances.

I would like to expand on this to say that it is better to give compressions alone than nothing at all.

Caregivers need to protect themselves and that is a large part of the reason resent text is advising not to give breaths for those who do not have the extra equipment. This is partly assuming that ems will show up within minutes and take over (yes we still do ventilations when we get there). However if you have the equipment and training to use it, ventilations are very much so necessary for sustaining life. A prolonged duration of CPR prior to ems arrival such as that of someone on a boat would have zero chance of survival without gas exchange in the lungs.

 

[TMHeimer]

Have to admit my kit, etc. only comes with me in the car when I dive. And 98% of my diving is solo, so I'm trying to figure what's the point of it being there. I keep up my skills in case I have to use them on my wife at some point.
I guess having a pocket mask handy would help with disease transmission, but don't know if it prevents covid 19.
The last of 4 times I took CPR they changed to doing compressions before rescue breaths, so I assume compressions may be a bit more important? That was in 2014. I can't really be bothered to pay for a new course every couple of years since they tend to change such stuff every time I took a course.

 

[wstorms]

I guess having a pocket mask handy would help with disease transmission, but don't know if it prevents covid 19.

Not (enough) according to the Dutch CPR council.

Regardless, I did order a few of those kits suggested earlier.
Each kit contains a pocket mask, gloves, scissors, razor, and towel. They cost about 15 euro and you can fit 2 in a mask box.
Yesterday there was another call out. This time I did grab my bag (including one of those kits) before going out so I guess I did learn something (the call out was cancelled by dispatch before I was well on my way).
It seems they changes the automated message from "go perform CPR at location X!!!" to "Collect AED at location X and hook up at location Y!!!", to be more in line with the current protocol.

 

[jondavies]

Could any of the medical professionals on this thread recommend an ambu bag for a CPR-trained layperson? Would it be worth carrying one on my boat/in my car and if so, are there features to look for? There's a lot available and i am guessing some are junk.

TIA and kudos to the OP.

 

[Ben_3]

Thanks for going to the rescue of a fellow person!!

 

[uncfnp]

Could any of the medical professionals on this thread recommend an ambu bag for a CPR-trained layperson? Would it be worth carrying one on my boat/in my car and if so, are there features to look for? There's a lot available and i am guessing some are junk.

TIA and kudos to the OP.

My EMT days are long past but I can tell you that Ambu is a brand name and you can be fairly certain of quality if you buy Ambu. The generic term is Bag Valve Mask or BVM and I am sure, like most things, there are plenty of chinese knockoffs with uncertain quality.

Prior to covid 19 I would not have recommended a BVM for a lay first responder. They do take some skill and practice to use effectively and I am only aware of use with some form of artificial airway, oropharyngeal, nasopharyngeal or endotracheal.

Hopefully someone with more recent EMS experience with respond.

 

[Bowers]

Could any of the medical professionals on this thread recommend an ambu bag for a CPR-trained layperson? Would it be worth carrying one on my boat/in my car and if so, are there features to look for? There's a lot available and i am guessing some are junk.

TIA and kudos to the OP.

My EMT days are long past but I can tell you that Ambu is a brand name and you can be fairly certain of quality if you buy Ambu. The generic term is Bag Valve Mask or BVM and I am sure, like most things, there are plenty of chinese knockoffs with uncertain quality.

Prior to covid 19 I would not have recommended a BVM for a lay first responder. They do take some skill and practice to use effectively and I am only aware of use with some form of artificial airway, oropharyngeal, nasopharyngeal or endotracheal.

Hopefully someone with more recent EMS experience with respond.

Absolutely worth carrying on boat and in car!
You do not NEED to have an airway adjunct to use a bvm (bag valve mask) if you have good head positioning (to open the airway and pull the tongue forward), and learn to bring the face into the mask rather than smash the mask against the face while obtaining seal. Adjuncts however are nice for extended durations and when moving around a lot because it keeps the airway open even when you let go.

Ambu is a good brand. Most of the knock offs should work fine but avoid to many bells and whistles. Those are designed for fancy attachments that you dont need and are more likely to fail or at least confuse you. The number one thing id look for is one with a supple mask seal. The softer the mask seal the better seal you can make and the better ventilations you can provide.

 

[martincohn]

Performing CPR on a patient is a violent act. It affects rescuers in many different ways. If you need help from a peer NEVER be afraid to reach out. Talk to someone.

You have to remember one very important thing. If you aren't performing CPR and they need it they are dead. You aren't going to make it worse.

You are trying to save their life. That said, you have to accept that the great majority (almost all), aren't going to make it. But you sure as hell can try.

In 12+ years as an EMT on the street and a year in a level 2 trauma center ER I had only 1 save. I was a volunteer firefighter/EMT and the call was literally 2 blocks from my house. He had a pulse and was breathing before EMS got there.

And let me tell you, there is nothing like being able to walk up to a once dead man and shake his hand,

 

[bowlofpetunias]

I agree using a BVM is worthwhile and you don't need to have an oral airway to do it. I used to tech my students the message that if you have an unconscious non breathing person.. you can not make them worse. If you break a rib and get them back.. they get to remember you with every breath for a while but they are better than you found them.

Something I believe needs to be said about unsuccessful CPR or any first aid attempts. We all die sooner or later, dying alone, afraid with nobody around that cares is tragic. We don't know when the last moments of awareness occurr. If the last thing they heard was your voice, it was kind and reassuring and they knew they weren't alone.. easing their fear in that terrible moment is a great service.

When I worked Ambulance the most common question from the loved ones.. Were they alone? Did they suffer? Our answers give peace to the survivors knowing someone was there for their loved one and they didn't die alone.

These situations are not measured in sucess or fail based on the survival of the patient. Sometimes it is just their turn and we can't change that but we can give comfort to so many by our responses.
Kudos for being there!

I see the suggestion of having a small protable kit have been made. I still carry one that is on a clip I can clip to me belt loop.

LOL a few months back the mechanic had our car for repair and we had to ask him to check for a lost item to see if it was in the car. He phoned back and said I found more first aid kits and supplies than I have ever seen in a car but I didn't find the Oxygen System or AED. I said.. oh they are in our cupboard I only put them in the car when we are on a trip or diving... lol.

 

[mattia_v]

Honestly, I don't think using a BVM is going to be particularly useful for an untrained individual (BLS certification), and it isn't a sealed system so not particularly 'safe' against COVID-19 unless you yourself don a FFP2/N95 mask. It does all depend on your location - here in NL, the time until an ambulance arrives is almost always within 10 minutes, and there are a lot of local initiatives (like the OP is involved with) for ensuring early CPR and AED arrival on-site. I'm trained to use BVMs, but I still 'just' have a pocket mask in my car, and I'd be restrictive in its use on the street for non-drowning-related incidents.

The situation in the sticks with a diver or on a dive boat is different, but if you want to buy yourself a BVM, get someone to train you in its use so you don't e.g. cause unnecessary barotrauma by enthusiastically emptying its entire contents into lungs that only want about 300-400ml of ventilation per breath. The other issue is that once used, you probably won't have the means to sterilise it properly (the mouthpieces are usually disposable single use items, the balloon is generally silicone and can be sterilised).