# Basic CPR Question



## cfman (Dec 20, 2008)

Here's a very quick CPR question.  I learned to Look, Listen, & Feel, and then feel for pulse.  

In the event that the person if no breathing & there is no pulse, you perform CPR.

What if there is no breathing but the pt has a pulse?  
Do you never perform CPR if a pulse is present?


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## Ridryder911 (Dec 20, 2008)

No breathing, you breathe for them (about 12-16 times a minute) and NO compressions


R/r 911


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## magicman (Dec 20, 2008)

correct me if i am wrong
one rescue breath every 5 seconds

when do you stop and check for pulse every 60 seconds?


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## MMiz (Dec 20, 2008)

One breath every five seconds with a pulse re-check every 12 breaths or 60 seconds.


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## cfman (Dec 20, 2008)

Okay, so let me get this straight:

No breathing, no pulse: CPR with breathing & compressions
No breathing, pulse: Only breathing, NO compressions

How likely are you to encounter a situation where there is no breathing but a pulse?


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## firecoins (Dec 20, 2008)

cfman said:


> Okay, so let me get this straight:
> 
> No breathing, no pulse: CPR with breathing & compressions
> No breathing, pulse: Only breathing, NO compressions
> ...



all the time. Opiate overdoes come to mind.  People with COPD having respiratory failure. I am sure there are more.

And it isn't just the cessation of all breathing but the lack of adequate breathing that sustains life.


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## cfman (Dec 20, 2008)

Aside from pulse rechecks, shouldn't you also Look, Listen, & Feel?


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## tydek07 (Dec 20, 2008)

cfman said:


> Aside from pulse rechecks, shouldn't you also Look, Listen, & Feel?



Yes, if the pt starts to breath adequately on his/her own... then you can stop breathing for them. But keep in mind, that they can stop breathing adequately again if the underlying problem is not fixed... so keep a close eye on the pt until ALS arrives. So even though a person is breathing, they may not be breathing adequately... so you may have to assist a person even tho they are breathing on their own.

Take Care,


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## Tincanfireman (Dec 20, 2008)

cfman said:


> How likely are you to encounter a situation where there is no breathing but a pulse?


 
Don't forget that most pediatric arrests begin with a respiratory event; in addition to the sage advice above, you need to know how to clear obstructed airways as well. All the rescue breathing in the world isn't going to do any good if there's not a patent airway.


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## BEorP (Dec 20, 2008)

cfman said:


> Here's a very quick CPR question.  I learned to Look, Listen, & Feel, and then feel for pulse.
> 
> In the event that the person if no breathing & there is no pulse, you perform CPR.
> 
> ...



Before this question can be appropriately answered, we would need to know if you're referring to lay rescuer or healthcare provider CPR guidelines.


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## cfman (Dec 20, 2008)

lay rescuer...thanks for all the info


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## Jon (Dec 20, 2008)

cfman said:


> lay rescuer...thanks for all the info


That changes the game.

The current guidelines do NOT specify a pulse check for the lay rescuer. So unless you take Healthcare Provider CPR, you aren't taught to check a pulse.

Essentially, the layperson pulse check was too often incorrect, so it got removed. Now, if someone doesn't show "signs of responsiveness" and they aren't breathing, then a LAY PROVIDER is taught to do CPR.


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## cfman (Dec 20, 2008)

Okay, that makes sense.  And two last things here.  

If in the middle of a rescuer's cycles of breathing/compression a pt starts coughing/breathing/etc...does the rescuer stop the CPR and put the pt on his or her side to await EMS?

Also, prior to using the AED, should the rescuer *always* do the 5 cycles of breathing/compression?

Thanks for the help everyone.


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## Jon (Dec 20, 2008)

cfman said:


> Okay, that makes sense. And two last things here.
> 
> If in the middle of a rescuer's cycles of breathing/compression a pt starts coughing/breathing/etc...does the rescuer stop the CPR and put the pt on his or her side to await EMS?
> 
> ...


 
Yes... if the patient shows signs of responsiveness... stop pressing on the chest and put them in the rescue position.


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## BossyCow (Dec 21, 2008)

Cfman.. think of it this way.. CPR is providing for the pt those life supporting systems that the pt is not providing for themselves. Breathing for those who cannot breathe and a pulse/heartbeat for those who do not have one.

Also.. remember.. you are breathing for them.. not attempting to inflate them


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## vquintessence (Dec 22, 2008)

cfman said:


> Okay, that makes sense.  And two last things here.
> 
> If in the middle of a rescuer's cycles of breathing/compression a pt starts coughing/breathing/etc...does the rescuer stop the CPR and put the pt on his or her side to await EMS?
> 
> ...



In regards to the cycles of CPR prior to AED analyzing/defibrillation, you SHOULD do the cycles UNLESS YOU witnessed the cardiac arrest.  If you should happen to witness the arrest, give the 2 rescue breaths and hook em up and follow the AEDs instructions.


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## cfman (Dec 26, 2008)

Hi everyone, 

I have a few other questions that have arisen.

1. With a conscious choking infant, aside from the back slaps, do you give chest compressions as well?

2. At what point do you administer CPR to a choking victim - once they have lost consciousness?  

3. With an unconscious patient that has an airway obstruction, if you cannot see the object in his/her mouth, do you do any sort of breathing for the patient or just chest compressions?

4. You find an unconscious patient that you’re told has an airway obstruction.  Do you do any sort of thrusts or go right into CPR?

Thanks for any help.  I am looking to hone my CPR skills.


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## Shishkabob (Dec 26, 2008)

> Also, prior to using the AED, should the rescuer always do the 5 cycles of breathing/compression?



If you see them go down, hook up the AED right away.  If the arrest is unwitnessed, do the cycles first, THEN the AED.







> 1. With a conscious choking infant, aside from the back slaps, do you give chest compressions as well?
> 
> 2. At what point do you administer CPR to a choking victim - once they have lost consciousness?
> 
> ...



Going by Healthcare Provider CPR level here;

1.  Back slaps/chest compressions until the object is dislodged of pt becomes unresponsive.

2. When a pt becomes limp and unresponsive, you ease them to the ground and go right into compressions.  After 30 compressions, check the airway, then proceed CPR like normal.

3.  After your first set of compressions, check the airway.  If you don't see an object, attempt to ventilate, hoping to get some bit of air around the object.  Look for chest rise.

4.   One of those iffy ones.  I was always told ABCs when it comes to 3rd party info.  Basically, do CPR like normal... open airway, attempt to ventilate, compressions.


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## BossyCow (Dec 27, 2008)

cfman said:


> Hi everyone,
> 
> I have a few other questions that have arisen.
> 
> ...



You need to sign up for a CPR class. If you are looking at entry into EMS, it should be an AHA Healthcare Provider class or ARC CPR for the professional rescuer. All of these questions are covered in the classes. The answers are slightly different depending on whether you are a bystander or an EMS responder.


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## danguitar12345 (Dec 27, 2008)

*Answer*

No breathing but pulse= no Compressions just breaths if you do compressions you may harm the patient


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## medicdan (Dec 27, 2008)

BossyCow said:


> You need to sign up for a CPR class. If you are looking at entry into EMS, it should be an AHA Healthcare Provider class or ARC CPR for the professional rescuer. All of these questions are covered in the classes. The answers are slightly different depending on whether you are a bystander or an EMS responder.



Agreed. We may be able to give you the right detailed answers, but you dont/wont have the big picture. 

When you take a full CPR class, you will learn such things as how to asses a patient for life-threatening injuries, how to properly protect yourself (re: liability and body fluids), how to perform proper breaths, compressions, back blows, abdominal thrusts, etc, and receive a certification. 

If you are looking to find a class, check out redcross.org or americanheart.org

Good Luck!

Dan


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## vquintessence (Dec 28, 2008)

danguitar12345 said:


> No breathing but pulse= no Compressions just breaths if you do compressions you may harm the patient



I believe he was referring to a complete FBAO with an unresponsive pt.  Which case, there certainly *would be* compressions to ideally dislodge the obstuction, _regardless of pulse or not_ for an *unconscious/unresponsive pt with complete FBAO.*  If you give ventilations and they aren't getting past the oropharynx, what good are the ventilations?

The thought/purpose of the chest compressions in this instance is to create a pressure from within that would dislodge the complete FBAO.

CMFMAN, another piece I don't think has been mentioned is that for a pregnant woman (or a very large person) with an complete FBAO, *INSTEAD* of abdominal thrusts you would do chest thrusts (regardless of being conscious or not).  Ya don't want to be slammin on the fetus.

Check out this link:
http://circ.ahajournals.org/cgi/content/full/112/22_suppl/III-5

You'll find it useful, especially if ya decide to get the healthcare provider CPR course like others mentioned.  _(note the reference it makes to the possible medical complications of abdominal thrusts, just keep it as a reminder NOT to do thrusts UNLESS there is an COMPLETE FBAO.)_

Good luck, Happy New Year.


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## frogtat2 (Dec 30, 2008)

*cpr question*

If you look listen and feel and there are no spontaneous respirations, but there is a pulse, it's called respiratory arrest and you bag them (assist ventilations either with a pocket mask or bag valve mask.)  Adults can go inot respiratory arrest and not cardiac arrest.


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## AMRmedic10 (Jan 11, 2009)

cfman said:


> Here's a very quick CPR question.  I learned to Look, Listen, & Feel, and then feel for pulse.
> 
> In the event that the person if no breathing & there is no pulse, you perform CPR.
> 
> ...



If a pulse is present, but it's not a sufficient pulse, you ABSOLUTELY do compressions. AEDs work because there is a shockable rhythm. 
Your instructor should've stressed this in class:
If they're not breathing, they're not getting oxygen... if their heart isn't beating or isn't beating sufficiently, the oxygen isn't going anywhere - which means the brain isn't getting oxygen. SO, if they're not breathing - breathe for them... if their heart isn't beating - beat it for them.


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## Explorer127 (Jan 11, 2009)

Linuss said:


> If you see them go down, hook up the AED right away.  If the arrest is unwitnessed, do the cycles first, THEN the AED.
> 
> 
> 
> ...



If you have an unresponsive choking victime with a pulse, and you start CPR with the finger sweep, can't they go into traumatic arrest because of the chest compressions?


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## KEVD18 (Jan 11, 2009)

Explorer127 said:


> If you have an unresponsive choking victime with a pulse, and you start CPR with the finger sweep, can't they go into traumatic arrest because of the chest compressions?


 
check your cpr guidelines. no more blind sweeps. you can chase what you can see, but no more fishing.

its also highly unlikely that you'll be thrown into commotio cordis/r on t through cpr. its usually caused by a very sudden, very hard impact in a tiny window of oppurtunity.


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## WFDJustin (Jan 29, 2009)

never perform compressions on a patient with a carotid pulse. u need to ventilate your patient until he/she becomes able to breathe on there own or you are turning the patient over where they will then take of ventilations


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## reaper (Jan 29, 2009)

WFDJustin said:


> never perform compressions on a patient with a carotid pulse. u need to ventilate your patient until he/she becomes able to breathe on there own or you are turning the patient over where they will then take of ventilations




You may want to recheck your AHA guidelines!


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## ps23435 (Jan 29, 2009)

*No Pulse Check for Lay CPR*

Remember, there is no pulse check for Adult CPR for lay responders; pulse check only on child and infant CPR.


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## emtfarva (Feb 3, 2009)

cfman said:


> Okay, so let me get this straight:
> 
> No breathing, no pulse: CPR with breathing & compressions
> No breathing, pulse: Only breathing, NO compressions
> ...




A drug overdose caught in time will cause resp failure but the heart will still beat.

Breath for the PT


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## BossyCow (Feb 4, 2009)

emtfarva said:


> A drug overdose caught in time will cause resp failure but the heart will still beat.
> 
> Breath for the PT



Choking, spinal injury, and anything that affects the respiratory drive.


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