Not stopping compressions to ventilate..?

[redundantbassist]

Hello all,
I have another cpr related question, this time pertaining to ventilations with a BVM. I was thinking, and I figured it would be more effective just to squeeze the bag every 5-6 seconds, (like with an endotracheal tube) thus drastically increasing compression output. Why is it that we must stop chest chest compressions to give 2 ventilations with a BVM? Does it increase the risk of gastric inflation or something?

 

[chaz90]

We refer to this as upstroke ventilation when we attempt to time it with recoil of the chest wall during continuous compressions. Many systems, including my own, have transitioned to continuous compressions even prior to placing an advanced airway and don't ever pause for ventilations anymore.

 

[Akulahawk]

I was doing upstroke ventilation 14-15 years ago... because it made sense. We knew even back then that pausing compressions caused a rapid decrease in blood flow, so it just didn't make sense to pause compressions, and it also seemed to make sense to ventilate on the upstroke. It was just an intuitive thing... Unfortunately I couldn't get the rest of the company to switch over to continuous compressions with upstroke ventilation because they were drilled to follow the standard which resulted in a pause every 15th compression to deliver a full breath before they'd begin compressions again. Between then and now, I'd gotten away from field work kind of forgot about that practice and it was only relatively recently that I read that people were trying that... Little did I realize that I was a few years ahead of things.

 

[cprted]

There are studies currently under way. Interestingly, if you look at the top five EMS agencies in North America for best survival to hospital discharge in out-of-hospital cardiac arrest, 3 practice 30:2 and 2 agencies practice continuous chest compressions.

https://roc.uwctc.org/tiki/current-studies

My agency is involved in both the ALPS and CCC study. Will be interesting to see how things shake out once they start publishing data.

 

[Chewy20]

We use an ITD (ResqUpod) attached to the BVM, so it prevents air from entering the lungs during chest wall recoil except when intended during ventilation. It makes the negative pressure greater which pulls more blood (about double) into the heart and lowers intracranial pressure. It also has a light that blinks every time you need to give a breathe at about 10 breathes pm (unless you need to hyperventilate 20-24 breathes pm). We don't stop compressions for anything besides shocking, even when placing King tube. Your body can go without a breathe for about 2-3 minutes. So once you get on scene and not sure how long the pt has been down. IMMIDEATLY start pumping that chest, get a rescue breath in their and set up your other crap. You should have more people on scene shortly so they can help set up the rest of equipment depending on how your system runs arrests.

 

[NPO]

Hello all,
I have another cpr related question, this time pertaining to ventilations with a BVM. I was thinking, and I figured it would be more effective just to squeeze the bag every 5-6 seconds, (like with an endotracheal tube) thus drastically increasing compression output. Why is it that we must stop chest chest compressions to give 2 ventilations with a BVM? Does it increase the risk of gastric inflation or something?

Our protocol is still 30:2, meaning every 30, pause, and ventelate twice. However in actuality, I've never seen this done in the field.

Typically from what I've seen is continuous compressions with ventilations 5-6 seconds. Airways are usually established quickly either with the BLS FD placing a King prior to our arrival, or ET placed on scene by the medic.