CPR: You dont know till it happens

[mistermo]

Originally Posted by AngryScientist

awesome. good karma points in the bank for you two. Best Paceline story in a while.

If PL had "Like" button, I'd bang it hard for this story!

Over the last several years, CPR has changed so that there's no more mouth to mouth breathing. Even if you've been trained for CPR, it's good to refresh your knowledge periodically.

[DRietz]

Originally Posted by mistermo

If PL had "Like" button, I'd bang it hard for this story!

Over the last several years, CPR has changed so that there's no more mouth to mouth breathing. Even if you've been trained for CPR, it's good to refresh your knowledge periodically.

It changes every couple of years. I recertified earlier this year and we practiced rescue breathing.

[Heisenberg]

No no on M2M rescue breathing. Open the airway, but don’t do mouth to mouth. Unless you have a BVM handy, don’t bother. We have a fair bit of O2 floating around and can get by without respirations for longer than you think, but if the blood isn’t moving, tissue dies quickly.

Re: pulses, if the person isn’t breathing, there’s a good chance they’re pulseless. Don’t dick around trying to make 100% certain they’re pulseless if apneic - start high-quality compressions. Starting chest squishies immediately is paramount to survival.

Bystander CPR saves lives, full stop. If we get on scene after an arrest and no one has been doing compressions, the chance we’ll get them back with any semblance of brain function is close to zero.

OP, you saved that guy’s life. EVERYONE should be CPR-certified.

source: 911 EMT

[benb]

I thought they'd gotten rid of the breathing too.. but there is so much conflicting information and it seems like they have reversed themselves over and over. It sounds like they have semi-reversed this lately?

Changing it IMO makes it harder for non-professionals to keep it all straight over the years.

If you have constant training & practice that's one thing, but if you're getting it every year or two or five it gets really confusing when they keep reversing what you learned the previous class.

I think it's been about 2 years since I took it and I think they had us do breathing on the dummies AND use the BVM.

Moot point with respect to the workplace course I took because after the class they issued us all BVM devices.

[redir]

IT used to be 15/2 and the PDF that was posted earlier said 30/2 so it is a bit confusing. I thought I had heard there was no more M2M anymore too.

Having said all this... Have you ever read what many doctors say about CPR?

Of course it's deferent if it happens to young people or in the case of the OP someone who might be a bit older but is physically fit.

https://www.utne.com/mind-and-body/d...-zm0z12mjzros/

[mistermo]

Here's the most current Red Cross CPR training video I could find on youtube. No mouth to mouth breathing.

I also watched the AHA training video where they showed CPR with a BVM (bag valve mask). Since most of us don't have a BVM, I think it's safe to assume we should follow the Red Cross method.

https://www.youtube.com/watch?v=6eRwgM2Pa4o

100-120 compressions per minute which is about the rhythm of the Bee Gee's Stayin' Alive song.

[bob_in_pa]

I have to keep my certification current for my part time job and we’re instructed to use rescue breathing in addition to chest compression.

It’s been explained to me that compression only CPR was devised to encourage people who might not otherwise get involved to perform CPR. Unresponsive people can be somewhat gross and the thought is compression only is far better than none. But we’re taught that including rescue breathing (with appropriate PPE) when called for is better yet.

I think the bottom line is get training and do whatever it is you’re trained to do. You just might save a life.

Credit to the OP. You made a difference and contributed to someone getting a second chance.

-Bob

[paredown]

Hats off to the OP--you always wonder if you will have the presence of mind to step up.

My brother (quite some time ago) proved he did. They were applying clear finish below deck on a boat they were renovating next door--stupidly without a fan or masks, and one guy passed out. His workmate came tearing out, yelling...

My brother (who got nicknamed 'The Ox' when we were bike racing) hears the commotion, runs out of the back of our family shop, across the dock, onto the deck of the boat, takes a huge breath, and heads down below deck, grabs the guy and fireman carries him up onto the deck. Not a small guy, IIRC. I think someone else may have done CPR at that point, and the guy recovered pretty quickly...

(We did the old certification as part of our pre-lifeguard swim training, but I have never kept it up. Maybe I should...)

[Heisenberg]

Originally Posted by bob_in_pa

I have to keep my certification current for my part time job and we’re instructed to use rescue breathing in addition to chest compression.

It’s been explained to me that compression only CPR was devised to encourage people who might not otherwise get involved to perform CPR. Unresponsive people can be somewhat gross and the thought is compression only is far better than none. But we’re taught that including rescue breathing (with appropriate PPE) when called for is better yet.

I think the bottom line is get training and do whatever it is you’re trained to do. You just might save a life.

Credit to the OP. You made a difference and contributed to someone getting a second chance.

-Bob

Little of column A, little B. M2M rescue breathing doesn’t deliver a whole lot of O2 to the patient. Research has shown it doesn’t improve outcomes vs compressions alone in bystander settings. That, and doing M2M is a good way to get dead guy puke in your mouth, and then they’ll just aspirate.

Our protocols (Oakland/Alameda County) are 30 compressions/2 breaths via BVM with supplemental O2 if we’re doing manual CPR. If automatic (LUCAS), we just bag once every 5-6 seconds.

[dcama5]

Originally Posted by Heisenberg

Little of column A, little B. M2M rescue breathing doesn’t deliver a whole lot of O2 to the patient. Research has shown it doesn’t improve outcomes vs compressions alone in bystander settings. That, and doing M2M is a good way to get dead guy puke in your mouth, and then they’ll just aspirate.

Our protocols (Oakland/Alameda County) are 30 compressions/2 breaths via BVM with supplemental O2 if we’re doing manual CPR. If automatic (LUCAS), we just bag once every 5-6 seconds.

I've watched this thread. With over 32 years in respiratory care and pulmonary diagnostics in hospitals in 4 states (VT, NY, PA, VA) I have done compressions hundreds of times (literally) some successful, others not. The above by H is exactly true IMO. I am now retired and don't really care about all the changes in protocol, because I know that I will be effective. As H says above, effective compressions are essential. Something like close to 100 compressions/min w/ an effective filling time between compressions.

[Spaghetti Legs]

I’m sure some google fu could turn it up but there is a study somewhere which shows it takes several compressions to get good outflow from the heart/perfusion pressure to brain and when you stop compressions (whether for breathing, checking a pulse, changing hands) outflow goes to zero, and then takes several more to get blood flow back up to the brain, the whole point of chest compressions. That, along with getting more people to do it, is the point of compression only CPR.

Major takeaway is don’t sweat trying to remember the rescue breathing rate or technique and focus on good compressions. Breathing becomes more important after 5-10 minutes but at that point walk out of hospital survival is dropping to the 1% neighborhood.

[AngryScientist]

Good informative thread here with a lot of helpful stuff.

It's also totally awesome that the OP turned out great.

[kiwisimon]

My brother (first aid trained and certified for his job) responded to my mum calling him at home that our dad was unresponsive after his afternoon nap. He was a minute away and started compressions after dragging dad off the bed on to the floor. The ambo was about 10 minutes away but my bro was totally spent after about 5-6 minutes and had to switch out with his son (also qualified for work). Both obviously massive emotionally invested but their training kicked in.
EMTs took over a few minutes later with an AED but sadly Dad had passed in his sleep, which was his wish.
CPR is a physical activity that will be tiring if done correctly. No shame in switching out.

[alessandro]

Originally Posted by dcama5

I've watched this thread. With over 32 years in respiratory care and pulmonary diagnostics in hospitals in 4 states (VT, NY, PA, VA) I have done compressions hundreds of times (literally) some successful, others not. The above by H is exactly true IMO. I am now retired and don't really care about all the changes in protocol, because I know that I will be effective. As H says above, effective compressions are essential. Something like close to 100 compressions/min w/ an effective filling time between compressions.

Originally Posted by Spaghetti Legs

I’m sure some google fu could turn it up but there is a study somewhere which shows it takes several compressions to get good outflow from the heart/perfusion pressure to brain and when you stop compressions (whether for breathing, checking a pulse, changing hands) outflow goes to zero, and then takes several more to get blood flow back up to the brain, the whole point of chest compressions. That, along with getting more people to do it, is the point of compression only CPR.

Major takeaway is don’t sweat trying to remember the rescue breathing rate or technique and focus on good compressions. Breathing becomes more important after 5-10 minutes but at that point walk out of hospital survival is dropping to the 1% neighborhood.

What a great thread! For me, it's been almost exactly 5 years since I had an MI. I was age 56, had no history of heart disease, ate mostly plants, BMI under 25, exercised regularly. It was a beautiful fall day in Vermont, and I was out riding in a charity ride for the nonprofit LBS, the Old Spokes Home. This is a non-competitive ride, the kind that has a pie stop every 20 miles.

At about mile 18, on a flat road, I went down, still holding the bars. (Most likely explanation: A piece of plaque broke off somewhere and lodged in the LAD, causing a 95% blockage.) Fortunately for me, my good friend and riding partner is an EMT, and he started chest compressions, along with two women from Ottawa that we'd befriended on the ride. They kept things circulating until the local rescue squad arrived, with a defbrillator, which they used two or three times while I was on the pavement and another time in the ambulance. Off to the hospital in Burlington, got a couple of stents, and spent 5 days in ICU. I don't remember any of it--not that day, not that whole week. I've recovered and am now riding bikes, skiing, going to the gym, and am really glad to be here.

The only reason I am alive and am the same person as before that day is because some people with CPR training flipped me on my back, ignoring the bystander warnings about possible spinal paralysis, and started chest compressions. Gotta keep blood flowing to the brain. The Richmond Rescue squad told me later that since they'd started high-performance CPR (which is what we're talking about in this thread), their save rate for unwitnessed cardiac arrests had gone from 10% to 65%. I got super-lucky that day--the lights went out, but for me they came back on. Keep the rubber side down, Paceliners, and crank up that CPR playlist!

Photo: That's me in the yellow jacket, about 10 miles before the crash. Camel's Hump on the right.