# CPR question



## Ediron (Dec 19, 2009)

How would you visualize if the patients condition is improving??
by their skin??

and also
for a pregnant lady who just finished delivering both newborn and placenta and there is vaginal bleeding, how would you take care of that???

by rubbing the fundus ?


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## Shishkabob (Dec 19, 2009)

Typically once a pt has ROSC after successful CPR/AED, it wont be a dramatic "Ok they're better".  They wont have a pulse of 80 and a bp of 120/80.  You'll just have to constantly monitor their vitals, and watch the trend.  Typically if they don't go back into cardiac arrest, they're improving 



A bit of bleeding is normal (ie 500cc).  Fundal massage should relieve that, but if it continues and gets significant, all you can do is cover the opening with bulky dressings.  Do NOT pack the vagina to stop bleeding.


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## lightsandsirens5 (Dec 19, 2009)

Linuss said:


> Typically if they don't go back into cardiac arrest, they're improving


 
Linuss, No! You think? 

~~~~~~~~~~~~~~~

If they start fighting you it is usuall a good sign.

The one consistant thing I have noticed in the few ROSCs I have seen is gagging on the tube. Plus you are suppesed to re-assess for a pulse every what, 5 cycles of CPR?


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## Lifeguards For Life (Dec 20, 2009)

Ediron said:


> How would you visualize if the patients condition is improving??
> by their skin??
> 
> and also
> ...



Letting mom hold the baby, and encouraging her to breastfeed, further stimulates uterine contractions, which further decreases bleeding. When the neonate sucks the breast, the nipple stimulation sends a message to the pituitary gland to release oxytocin. Breastfeeding immediately after delivery encourages oxytocin production and causes uterine contractions, helping the uterus to become firm and close off the blood vessels at the placental detachment site. This process limits the amount of blood lost after childbirth. In some cases, we even may administer Oxytocin to control postpartum hemorrhage.


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## Aidey (Dec 20, 2009)

Ediron said:


> How would you visualize if the patients condition is improving?? by their skin??



Do you mean how can you tell you are doing effective CPR? That is how I'm going to answer this because people have answered it literally. 

If you are doing good CPR and ventilations you may see the pts skin color improving. They probably won't get pink, but you can see a reduction in cyanosis (blue). You may also see a change in what areas are blue, like they will go from all blue to just blue in the hands and feet. 

You can also tell by feeling for a pulse at different spots, like the carotid, radial and femoral. If you have a pulse with each compression it means that blood is being pumped. Blood is still being pumped even if you can't find a pulse, but a pulse with CPR is a good sign. 

If the PT is on an EKG you can watch the CPR on the screen and it will show each compression (unless it is some newer models). If you see waves that are the same size and shape it is a sign the compressions are consistent. An EKG can also show rhythm changes that can mean the pt is improving. 

If the pt is intubated capnography is also an indicator of how well resuscitation efforts are working.


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## Ediron (Dec 20, 2009)

Greeattttttt info.

thanx


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## Jeffrey_169 (Jan 9, 2010)

Lifeguards For Life said:


> Letting mom hold the baby, and encouraging her to breastfeed, further stimulates uterine contractions, which further decreases bleeding. When the neonate sucks the breast, the nipple stimulation sends a message to the pituitary gland to release oxytocin. Breastfeeding immediately after delivery encourages oxytocin production and causes uterine contractions, helping the uterus to become firm and close off the blood vessels at the placental detachment site. This process limits the amount of blood lost after childbirth. In some cases, we even may administer Oxytocin to control postpartum hemorrhage.



Absolutely right.


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