Hands Only CPR

[DeepSeaDan]

OK...so if this is the way to go, then what is the in-water process to use?

Currently (this is a very simplified version) under 5min to safety provide breaths and move toward safety.

Over 5min give breaths for a minute and move as fast as possible to safety.

If breaths aren't good enough when they change the protocol would we just move asap to safety with no breaths ?

Anyone care to guess on this one

...my FAVOURITE subject!

If you care to do a search on my posts, you'll discover a certain passion I have for this issue.

Essentially, I have advocated the removal of rescue breaths from most in-water scenarios for some time now, primarily due to the narrow window of opportunity available to resucitate a v.s.a. casualty before the onset of cerebral damage. It is also a reality that proper, effective ventillation of a patient is no easy task for professional rescuers in the dry, thus the odds of doing any good in the water are not so good. Better to make all speed for a hard, flat, dry surface before attempting resucitation. There are exceptions to this general idea, but you'll have to read back for my thoughts as I have written & re-written about it ad nauseum.

DSD

 

[scuba70]

There are many medical studies that have been conducted that show that mortality greatly increases for every second that a rescuers hands are off of the chest not doing compressions. It has been demonstrated that compressions only is the way to go. I live in a part of the world that has, if not the highest certainly in the top percentage, of CPR saves. This compressions only type of CPR and also cryo therapy comine to give a patient a better than average chance of survival. Unfortunately, in water compressions are ineffective at best because you have no resistance to build pressure in the chest during compressions. I don't know that any standards for AHA or EFR have changed yet, but it is coming.

 

[Allison Finch]

Quote from DeepSeaDan
...or "Cardio-Cerebral Resucitation" has been in use for several years now by certain 1st responder agencies, in several different countries, with significant improvement in save rates over conventional cpr.

Actually, from the reports I've read, there is little difference in survivability between the two techniques.

As an ex-CPR instructor, I used to be very discouraged by the lack of training given for the emotional reaction to the fact that any save with CPR was rare. Students are often led to believe that they will be performing a life saving technique. However, anyone who has been in the game long knows that "saves" are extremely rare. I have seen many unprepared CPR givers go through horrible self recriminations thinking that their poor performance was the reason for the person not surviving.

Heck, chest compressions only on "VIEWED" collapses may just help cardiovert someone...sometime.

 

[DiverBeth]

I just did my EFR course a few days ago. We were taught that if you have no barrier to use that you can just do chest compressions if you don't want to do breaths.

For a few dollars you can buy a tiny barrier to use for breaths that you can keep on a key chain.

 

[garyfotodiver]

I am taking my AHA CPR renewal tomorrow. Can't wait to see what will be taught...

Just finished American Heart Association Healthcare Provider CPR & AED; 30 compressions & 2 breaths. Except for 2-person CPR on children. Then it is 15 & 2.

 

[Jim Kerr]

Just took my Padi EFR last night and while studying for it they encourage you to do just the commpressions if you are not comfortable doing the mouth to mouth. When doing complete CPR they go with the 30:2 ratio (30 commpressions and 2 rescue breaths)..

 

[donooo]

Couple of things important here. Most important is that it really only applies to an adult suffering cardiac arrest. Still need rescue breaths in all of the other cases. This will just add to the confusion. The changes last go around were to make it simpler for the Lay responder, how they treat this in training will be interesting. The lay responder does not need any more options. Every article that I have read on this topic has had some qualifier in it that compression only was better then nothing, and most lay responders were doing nothing.

To the diver, you need to take the higher level of training so that you can administer rescue breaths alone. Switching to compression only is for the cardiac victim only.

At the pro or caregiver level, training may or may not change, another topic to watch.

I am an Instructor for both the ARC and DAN

don O

 

[covediver]

Just got an advisory on the subject from the Red Cross as I am a lifeguard instructor. It in part states

"The following individuals will still need to take training which includes full CPR (cycles of chest compressions and rescue breaths).

those who take CPR training for certification to meet State and Federal requirements;
lay responders in workplaces who have a duty to respond;
those responsible for infants and children;
Compression-Only CPR does not affect professional rescuer CPR/AED training programs or protocols."

Professional rescuer includes lifeguards...where that leaves divemasters, instructors, etc, I have no idea as I no longer do that kind of work.

 

[dmmike]

Please do not get mad at me.......

I guess I'm trying to understand another "new and improved" method, being an old EMT, and 1st responder instuctor. As long as the results are based on true improvement from the field it's a move in the right direction. If its' just a change because of the possible "bio-hazard" maybe we need to educate people to carry a barrier protector. People can remeber cell phones, PDA's, dayplanners, ect..... Why is it so difficult to just put a barrier on your key chain.

I do not believe people are afraid of the "bio-hazard" I believe people just do not want to get involved.

Case in point......( this may get a little graphic, sorry) the other day a gentleman suffered a major head anorsim on the john, I was informed of the problem by the large stream of people "going to look for help" as they left the the lone EMT alone. So, and this is for all those Responders on the board, over the wall I climb, stand in a puttle of "pee" and "stuff", stablablize the head, bah bah bah........... until the bus comes to transport.

So, as long as there is a shown increase in intervension from the feild and the results are better when they get to the ER, I'm all for it.

Now my only problem is going to be remebering what to do: 5:1 or 15:2 or 30:2 or 100:0.......

I'm getting to old for this......

 

[DeepSeaDan]

Quote from DeepSeaDan
...or "Cardio-Cerebral Resucitation" has been in use for several years now by certain 1st responder agencies, in several different countries, with significant improvement in save rates over conventional cpr.

Actually, from the reports I've read, there is little difference in survivability between the two techniques.

As an ex-CPR instructor, I used to be very discouraged by the lack of training given for the emotional reaction to the fact that any save with CPR was rare. Students are often led to believe that they will be performing a life saving technique. However, anyone who has been in the game long knows that "saves" are extremely rare. I have seen many unprepared CPR givers go through horrible self recriminations thinking that their poor performance was the reason for the person not surviving.

Heck, chest compressions only on "VIEWED" collapses may just help cardiovert someone...sometime.

...in your source material for your opinion. I wholly agree that with either technique we are looking at very limited chances for a successful result, even with all the favoured ducks in a row ( witnessed arrest, quick on the 911, excellent cpr/ccr, early defibrillization/ access to advanced care ). I insure my students understand that folks who arrest are not on the floor without good reason ( usually advanced coronary disease ), and not to get too hopeful for their survival as they do they're very best. But those on the floor for other, less chronic reasons ( eg.: electrocution, near drowning ) may have a better chance, if things are done optimally.

Do your best & pray to ( insert deity of choice here).

And REALLY listen to the "prevention" part of your 1st Aid course. Never having the need to be "fixed" in the first place is a much better option.

DSD