Doctor sparks debate over CPR

[OBXDIVEGUY]

I am an instructor for Red Cross and American Heart Association and I have unfortunately performed CPR many times as a Coast Guardsman and Fireman.

AHA actually has a class available that does not require the resquer to give breaths. It is believed that the chest compressions alone will pass some air, sufficient amounts or not, I don't know. Red Cross has not adopted this theory yet. These are based on new standards created by an international organization in 2000.

All agencies have now conceded that CPR does not save lives. Resuscitation is actually a misnomer. CPR merely preserves the body until it can be defibrillated. This is why we are now seeing AEDs everywhere. They should be more of a common site than fire extinguishers.

 

[mossym]

yeah, i'm on the MERT team at work, we got trained in AED's. they did a really ggod job designing something that anyone can use, they do nearly everything for you

 

[O2BBubbleFree]

All agencies have now conceded that CPR does not save lives. Resuscitation is actually a misnomer. CPR merely preserves the body until it can be defibrillated.

That's an interesting perspective. I understand where you're coming from, but the only time I have seen CPR 'for real,' the recipient started breathing on his own after a couple of minutes. I doubt he would have started breathing without the CPR.

 

[mossym]

yeah but had his heart stopped or did he just stop breathing?

 

[TheAvatar]

This somewhat recent development has been debated geatly on the EMS forums I frequent. It does appear that the algorithm is going to be changed and there is evidence to back it up.

Personally I see some problem with it for extended periods, but we'll see where it goes.

The standrad remains unchanged once the Pt is intubated.

 

[HammerNoMore]

If nothing else this offers a replacement for situations where it is unsafe to perform rescue breaths. Let's face it, most people, CPR trained or not, do not walk around with a shield in their pocket.

 

[O2BBubbleFree]

yeah but had his heart stopped or did he just stop breathing?

Couldn't tell you for sure. This was at an accident scene along the German autobahn. I was told that the lady performing CPR was an off-duty German nurse.

I didn’t feel that she was doing an overly good job on the CPR. She didn't seem to feel that the 'rhythm’ was all that important. She wasn’t as strict in the routine as I have been trained to be. But what do I know? I’m a non-medical type that has only been trained (fairly regularly over the last 30 years or so), not actually performed.

However, the nurse who was performing the CPR was checking for pulse and continuing to perform chest compressions, so I assume she was not finding a pulse. She stopped only when he started breathing on his own.

 

[Mako Mark]

CCC or 8cvontinious chest compressions) is something that has been discussed for a number of years now, but is nonly now coming to the publics notice

WRT the lack of O2 in the blood, from what I've heard regarding this new method, the theory is that chest compressions circulate sufficient air through the lungs to make breathes unnecessary.
.

This is what I have heard too, and I can see a certain logic to it.

There is also the point that is coming through in inwater rescusitation where it is better to head for a stable platform and initiate CPR rather than waste time with inwater rescue breaths (in the event the platform is less than 3-5 minutes away).

 

[OBXDIVEGUY]

Not only is the breathing changing in the standards, but I teach many classes where the rescuer is not required to check for a pulse. AHA says to check for "signs of circulation." This includes movement or color.

It is extremely rare that someone comes back to life from CPR alone. If they do, chances are they did not need CPR, but rather rescue breathing.

In one of my instructor books, it provides the science behind not checking for a pulse anymore. I don't have it with me, but it was a surprising statistic when a study was done on professional rescuers. They found something ridiculous like an 80 % inaccuracy rate when it came to finding a pulse. Most of the time people were spending far longer than the prescribed 10 seconds to find a pulse, and then after that, many times they just didn't feel one that was really there, or vice versa.

For those that haven't done CPR, you're just going to have to trust the ones that have. You will immediately know, without taking a pulse, if CPR is necessary.

I know DAN provides a program that allows dive operations to get a free AED. There is some type of service or subscription fee involved, but I cannot emphasize enough, get AEDs everywhere. Anyone can use one. They are truely remarkable devices. Literally, the first medical device that the lay rescuer can save a life with.

 

[H2Andy]

My thoughts also. But then, I've done CPR 10-12 times and not a single
one of them survived. Maybe there is room for improvement.

well, when you are giving CPR, the victim is about in as bad shape as they
are going to get -- not breathing, no heartbeat...

i mean... it's hard to recover from that with OR without CPR

good for you for trying. you don't know how close you might have come to
making a difference.

but i also agree with your overall point. you can always improve anything.