No more mouth to mouth for heart attack?

[rakkis]

Let's remember that this is a one-rescuer scenario. When more than one trained person is helping, you can have one giving dedicated, non-stop compressions while another one does breaths.

Also, be sure to not over extrapolate from what you hear in the news. In the actual study quoted, the rescuers were untrained lay people.

 

[ArcticDiver]

When judging the effectiveness of any particular method of CPR be sure to find out how the Survival Rate is determined.

Defined as arriving at the hospital with vital signs.? Or,
Defined as being discharged from the hospital without significant deficit?

Radically different numbers and long range outcome.

 

[Wildcard]

Let's remember that this is a one-rescuer scenario. When more than one trained person is helping, you can have one giving dedicated, non-stop compressions while another one does breaths.

Also, be sure to not over extrapolate from what you hear in the news. In the actual study quoted, the rescuers were untrained lay people.

Who didn't rember that? I was pointing out that BLS airways are almost impossable to maintain no matter who you are....No one here is talking about the news. These are reports from JAMA and AHA.

 

[rakkis]

I wasn't saying that to anyone in particular. The report in the OP was published in The Lancet.

 

[fisherdvm]

Let's remember that this is a one-rescuer scenario. When more than one trained person is helping, you can have one giving dedicated, non-stop compressions while another one does breaths.

Also, be sure to not over extrapolate from what you hear in the news. In the actual study quoted, the rescuers were untrained lay people.

I don't think you want to do "non-stop compression", unless you want to shoot vomitus into the face of the rescue breather. Even if he had a one way mask, it is kind of disgusting having air forced back at you from the victim.

Non-stop compression is only if you have a secured air-way in place (ie. tracheal tube, or one of the other devices that block off the esophagus).

I don't mean to offend you, just want to clarify for folks who have not done ACLS.

 

[Wildcard]

Non stop is exactly what is coming with the next round of AHA recomendations. Now for two person it's nonstop and "try" to get a breath in every ummm? 10-12 a minute? I think that was what it was. We were all flabergasted by the new standards that it didnt realy sink in. For a change my last ACLS class was mostly MDs, one nures one baby RTand me. We all had the same thoughts on some of the changes...See my "new ACLS" for details.

 

[mdjh51]

I will ahve to talk to one of the docs I know on the AHA panel that reviews/makes recommendations here in Dallas, but I vaugely remember him telling me that the pressures that are needed to move the blood through the vasculature are not developed until several compressions into the cycle. Think of priming a pump. Every time you stop to breath for the patient, you "loose the prime" and have to reestablish it for the compressions to be effective. So (and this is just me speculating for clarity) if it takes 10 proper compressions to develop the proper "prime", then in a 15:2 ratio, you only get 5 effective compressions. Couple this with the reluctance that the general pubic typically has to performing mouth-to-mouth and it makes sense to eliminate ventilations from layman rescue situations. For professional rescuers, continuous compressions with an established and controlled airway (LMA, ET, or combitube) will be most effective. I will call John and ask him about this, and to see if I can get the reference articles.

B

 

[SteveDiver]

Chest compression only CPR may be beneficial for the lay person. I sincerely am not a fan of chest compression only CPR. To avoid vomit (so stated early) it would be a great idea to have a valve mask on your person at all times (they have pocket size masks). As lay persons any help is apreciated until more advanced help arrives. The only way I would do chest only would be if I did not have a bag or mask and the person is not known to me.. I have been in Emergency med. for years and never heard of "priming the pump" for lay persons. I am also a FAR/CPR and ACLS Instructor...however, I am always willing to learn so if one can give me information on "priming the pump" I would like to look into it.

 

[Wildcard]

You only have to look as far as the new ACLS standards. "priming the pump" is refering to the buildup of intrathorasic pressure required for effective chest compressions.

 

[Fish_Whisperer]

I had a patient vomit in my mouth, once. It's not that big a deal. Spit it out and keep going.