CPR and Moving Patients

Discussion in 'BLS Discussion' started by Asmo, Aug 30, 2007.

  1. Asmo

    Asmo New Member

    Location:
    SoCal
    EMS Training:
    EMT-Intermediate
    Sorry for the rookie question.. How long can you stop CPR for moving a PT? I know that while moving a PT that requires CPR, you alternate stops with your partner to continue CPR off and on until the PT is loaded. Just wondering how long you can stop CPR for a moving PT.

    Any help would be wonderful, thank you.:unsure:
  2. PArescueEMT

    PArescueEMT Forum Bartender

    Location:
    Mauricetown, NJ
    EMS Training:
    EMT-Basic
    not really a stupid question imho... if you have enough people on scene, once the patient is on the bed, someone can ride the stretcher and you would have <1min anoxic time after CPR is started to transport started. Most agencies do a multiple unit response for a code so that you can have the manpower to run it.
  3. Asmo

    Asmo New Member

    Location:
    SoCal
    EMS Training:
    EMT-Intermediate
    So basically you have <1 min to stop CPR, load the patient, and continue CPR? Sorry, just started my EMT-B course and the question is asking me to "Recall your CPR Class" and my CPR instructor said nothing about stopping CPR to move a patient.
  4. PArescueEMT

    PArescueEMT Forum Bartender

    Location:
    Mauricetown, NJ
    EMS Training:
    EMT-Basic
    it's not you have less than one minute, it's you can minimize it to less than one minute... all you need to do is call for the appropriate manpower
  5. Asmo

    Asmo New Member

    Location:
    SoCal
    EMS Training:
    EMT-Intermediate
    Ok I get it now.

    I greatly appreciate your help.
    Thank you.
  6. PArescueEMT

    PArescueEMT Forum Bartender

    Location:
    Mauricetown, NJ
    EMS Training:
    EMT-Basic
    your first code will not go as smooth as you would like, but you will get the hang of it as you progress.
  7. Markhk

    Markhk New Member

    What is your agency's policy on doing CPR while the cot is in motion? (I.e. ambulance bay to the ER).

    I have seen three variants:
    1) Have someone light actually get into the cot, straddle the patient, and do CPR. Many agencies frown on this for safety reasons.

    2) Lower the cot to the lowest position and do CPR from the side.

    3) Have someone step, with both feet onto the bottom frame at the cot's side, so they can do CPR, while the cot gets pushed by two other people.
  8. ffemt8978

    ffemt8978 Forum Vice-Principal Community Leader

    Location:
    Zip code EIEIO
    EMS Training:
    EMT-Intermediate
    Now that's an understatement :rolleyes:.

    All codes seem to have some fustercluck factor involved, but as you gain experience, you do start to get the hang of them.
  9. I know this isn't "regulation", but if you're short staffed and the second due unit is a while off and you need to do a 2 person move (god-forbid), each of you take one side of the stretcher and move it that way, while one of you does one-hand compressions and the other does one handed bagging while keeping the other hand to move the stretcher. Not ideal, but we had an arrest outdoor in absolute pouring rain in the middle of the road, so we were trying to get into the ambulance and out of the road as quickly as possible.
  10. KEVD18

    KEVD18 New Member

    Location:
    mass
    i think that the real spirit of this question may have been more towards the cardiac arrest in a situation where a stair chair or long board would be needed. if that the case, here is my input:

    THEY'RE SCREWED. if your in arrest and i have to carry you down the stairs to get out of the house, you pissed someone up there off. so before loading you on the chair, we'll get thing going. iv, ett, monitor(listed in no particular order) and if appropriate, we'll start giving drugs. you'll get two, maybe three rounds before we move. then its onto the prefered extrication device for the unresponsive pt. now if you have several flights of stairs with landings in between, by all means we'll stop and do some stuff at the landings but if its a straight shot or otherwise prohibits stopping, your not getting compressed ventliated or medicated from the top to the bottom. depending on the stairs, how well they know you at mcdonalds and at what point in my shift it is(i do get tired and move slower as the day goes on) this might take a few minutes.
  11. Tincanfireman

    Tincanfireman Airfield Operations

    Location:
    Southeastern US
    EMS Training:
    EMT-Intermediate
    Yeah, that pretty much sums it up from my perspective, too...
  12. Ridryder911

    Ridryder911 EMS Guru

    ... my basic opinion is that there more than screwed, their dead. Sorry, with only about < 10% + outcomes, very few if any ever survive and less than that are functional.

    Technically, you are only supposed to stop CPR for <10 seconds... okay, do not be surprised CPR stopped for undetermined amount of time. This is one of the few areas, that is definitely different from the clinical aspect and text book interpertation.

    R/r 911
  13. Grady_emt

    Grady_emt New Member

    Location:
    Atlanta, where the players play, and we ride on th
    EMS Training:
    EMT-Intermediate
    You are over 18, you started in Asystole, stayed there after two rounds and a tube, congrats, you are now a candidate to futher the education of medical students, ill let the M.E. handle moving you when he gets to it.
  14. sdadam

    sdadam New Member

    Location:
    San Diego, CA
    EMS Training:
    EMT-Paramedic
    Rid got it, per AHA CPR should only be stopped for 5 to 10 seconds. If this is a test question that's most likely the answer they are looking for.

    either that or that you should "minimize hands off time" depends what the options on the test are.
  15. If i had it my way, anyone in excess of 500 pounds overweight who's more than 1 flight of stairs up is considered to have an injury incompatible with life. Don't think the AHA would go for that, though...
  16. Gbro

    Gbro New Member

    Location:
    Northern MN
    I would like to comment on;
    I went through a stage where i thought i could determine if the Pt. had a chance or not, and its a trap you don't want to fall into. After being lacsadasy on one code, pt. was revived at the hospital.
    8 miles to scene + 2-4 min to get wheels moving, 21 miles to hospital.
    No intercept in those days.
    I give them all 150% if not more.
    The longest breaks i have ever seen in CPR is on the intercept. Intubating.
    I like to update the intercept unit prior to intercept on the need for an ET tube, as we use combi tubes and sometimes they are great and other times they are very hard to manage.
    I had an ER Doc that didn't know what a PTL(Pharyngeo-tracheal Lumen) was and tugged it out and through it over his shoulder saying it obvious that thing is no good. That pt. went to ICU but never made it home.
    I do prefer Combo's to Patel's.

    Give it your best, treat every Pt. like they are your family. You WILL sleep better.

    You are right, only we work in that <10% survival rate area for the most part in the rural arena.
    Last edited by a moderator: Sep 2, 2007
  17. KEVD18

    KEVD18 New Member

    Location:
    mass
    yes i approach every call witht he intent to save the pt, but it doesnt always happen. injuries inconsistent with life, comorbidities etc. one of the things generally inconsistent with life is a cardiac arrest involving a heavy pt and stairs. maybe you might win that one, but then again santa might bring you that wii this year. that doesnt mean im not going to work it but it does mean they're not going to get excellent care. its not physically possible. you can do compressions on a pt in a stair chair going down stairs. so you will have excessive hands off time. excessive hands off time has been proven to have a negative outcome.
  18. Airwaygoddess

    Airwaygoddess New Member

    Location:
    The north country in Santa Barbara Ca.
    EMS Training:
    EMT-Basic
    I agree with Gbro, one must do their job with the and treat that patient as we ourselves or our loved ones would want to be treated. I do not believe in "beating a dead horse" as far as Code Blues go. If we are there to do the job do it for all it is worth. My point here is that we have MANY young and new EMT's that need to guided and taught not to get tunnel vision and become jaded even before they get their first job. It is the tunnel vision that causes important things to be missed.....-_-
  19. SC Bird

    SC Bird New Member

    Location:
    South Carolina
    I asked one of my instructors about this exact situation, and this was his view on it.

    There are multiple problems with moving a patient and still providing CPR.
    Problem #1: Compressions given from the side of the stretcher while the provider is walking alongside are rarely "good compressions".

    Problem #2: The center of gravity of the stretcher can be compromised by a decent sized provider who is stradling the patient giving compressions while being transported into the ER, out of the house, etc.


    I share the same P.O.V. as Rid....unfortunately, there chances are greatly decreased.

    -Matt
  20. They may not be effective compressions, but it beats no compressions at all. *shrug*.

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