New CPR Guidelines...do they work?

[DT4EMS]

I was at ACLS Instructor class the other day and I was involved in a conversation about how evrey couple of years the AHA changes so much.

We started talking about the changes in CPR and if they would "really" make that big of a difference. One of the medics in the class was talking about 4 different "saves" they had since January using the new guidelines. Then I got excited!

The SCIENCE made sense to me. But it was having a person (that I believed) tell me they were seeing results. The part that stood out the most to me was his describing the luck of changing fine VF to course VF and THEN shocking. He told me they were getting perfusing rhythms with the new CPR.

All I can say is if it helps ONE person, it is all worth it.

How about you.... any luck with the new stuff?

 

[akflightmedic]

WOW, the cynic in me has to call BS on 4 saves since January simply by increasing the number of compressions. I understand the science behind the changes and say yeah it may work, but that many saves in that short of time with the addition of 15 compressions is quite "miraculous". Been doing this over a decade and I have yet to have that many "saves". Now if by saves he means he got a pulse back, ok...but to me a save is walking out of the hospital. Very rare event indeed.

But like I said, thats the cynic in me....

 

[DT4EMS]

WOW, the cynic in me has to call BS on 4 saves since January simply by increasing the number of compressions. I understand the science behind the changes and say yeah it may work, but that many saves in that short of time with the addition of 15 compressions is quite "miraculous". Been doing this over a decade and I have yet to have that many "saves". Now if by saves he means he got a pulse back, ok...but to me a save is walking out of the hospital. Very rare event indeed.

But like I said, thats the cynic in me....

Hey I feel ya!! But this is Springfield, MO we are talking about. Big time medical community. The way he talked the "saves" were not just him. He was talking service wide. Their ALS response times are usually less than 5 minutes.

Like you, I haven't had many walk out of the hospital. A point I was getting at was how many times we would joke about the reality..... Hell just shock 'em into a rhythm we know (Asystole) which is what would happen with fine VF.

Now, without meds, IV, ETT etc, he claimed they were getting perfusing rhythms. I guess we will see what the next two years holds. As for me, I am actually pretty stoked.

 

[joemt]

Hmmmm.. I'll have to e-mail the infamous Bob Page on this one and see if he's heard the same kinds of stories. I'm not a fan of the new changes, but I agree... if it saves even one life, I'll gladly admit defeat.....

Actually... on one of these EMS Forums (I think maybe the City) someone posted a column by Bledsoe on this very topic. You might want to check it out over there. If I can find it, I'll repost it.

 

[GaEMT]

The studies and logic behind the changes make sense. I think we al can attest that ventilations were excessive and compressions sucked. Hopefully this will even the see saw out between the 2. We all have to realize that with out ALS intervention in less than 7-8 minutes we are doing you know what in the fan.

 

[Dr.R]

well, around here I haven't heard about increasing "saves" but actually the whole new algorithm makes sense.
especially for BLS, acing without any drugs, first thing is to keep blood fluid, which is done by the increased numer of compressions. if not, ALS-drugs won't be very effective.

haven't had the "chance" to practice new rules in the field but -as wired as it sounds- I'm looking forward to it...

 

[DT4EMS]

Well if there is an actual "Science" behind the new guidelines, then that would mean more saves.

Hey Jo, just call Cox or the John and see what they say. I was at Cox when I got the news.

At least for me it changes my opinion a little. I was hacked at first about the changes, kinda like Vampires and Werewolves....sound scary but don't really exist.......... but when a person is telling you it works........

REMEMBER most medics will jump on a bandwagon when complaining. Here was a guy stating the positive.

 

[Jon]

I tried it 2 weeks ago at an OD... the guy was still dead... we were only working him, I think, becuase he was warm and dead.

ALS gave enough Narcan to cure Kurt Cobain AND the entire Rolling Stones, and enough Epi to get a pulse out of a rock. No luck.

But I did get to try the "new CPR"!

 

[Gents82]

When I took my CPR class it was 15-2 for adults, 5-1 for children and infants, and 3-1 for newborns. What was it changed to? I start my job training in a week, I'm sure they'll tell us then. But can anyone give me the heads up?

Also, since we're on this topic. My class emt book (brady) said that if a newborn has a heart rate lower than 60 that we should compress them to have 120 beats per minute. How is that possible to do when the most you can do is 60, think about it, you can only compress once per second...am I missing something here?

 

[MMiz]

When I took my CPR class it was 15-2 for adults, 5-1 for children and infants, and 3-1 for newborns. What was it changed to? I start my job training in a week, I'm sure they'll tell us then. But can anyone give me the heads up?

Also, since we're on this topic. My class emt book (brady) said that if a newborn has a heart rate lower than 60 that we should compress them to have 120 beats per minute. How is that possible to do when the most you can do is 60, think about it, you can only compress once per second...am I missing something here?

Gents82,

First, you should do CPR as you were trained and certified. They now increased the compressions to 30 for certain patients.

They suggest normal CPR for an adult be 80 BPM. That means you're going to be doing more than one beat per second. How do you do that? Well a second is quite a bit of time when you're doing CPR. You're going to have to speed it up a bit.

Now that's the book, and you'll probably see it done differently in the field. I've seen one compression every two seconds, and I've seen people go to town. When it's all said and done, you'll find a lot of people do CPR differently.

 

[Wingnut]

I haven't heard any feedback from our people on the newguidelines. BUT we use the autopulse on every rig now that I was told gave us some saves that normally we couldn't bring back from regular CPR.

 

[DT4EMS]

I haven't heard any feedback from our people on the newguidelines. BUT we use the autopulse on every rig now that I was told gave us some saves that normally we couldn't bring back from regular CPR.

The Autopulse is supposed to be awesome! I got to see one at a conference. We don't have them here though.

 

[Jon]

Well... there are some differing opinions, and some possibility that some of the studies might not look good.

In theroy - Autopulse, or anything that keeps me from having to do CPR is good.

 

[Jon]

I haven't heard any feedback from our people on the newguidelines. BUT we use the autopulse on every rig now that I was told gave us some saves that normally we couldn't bring back from regular CPR.

Just to throw a wrench in this.... how many of those are being brough back at "100%" and how many are going to spend 15 years eating Ensure through a tube in a nursing home?

 

[MMiz]

Here is an interesting story about the Zoll AutoPulse. One study says it helps, the other one says it doesn't.

 

[Wingnut]

Just to throw a wrench in this.... how many of those are being brough back at "100%" and how many are going to spend 15 years eating Ensure through a tube in a nursing home?

When we talk about "saves" we mean walking out of the hospital on thier own.

 

[bowhkr]

What's so new about it? We still pump and blow.. Still doesn't work. By the time we get tapped, get in the rig, and get to the guy, his six to ten minute "save me" time is GONE. :unsure: Just call the coroner, it's a waste of time unless they code right in front of you.