# MedStar adopts new CPR Technique (not really)



## Shishkabob (Jul 13, 2010)

http://www.wfaa.com/news/health/MedStar-in-Fort-Worth-adopts-new-CPR-technique-98331254.html



> You've heard it before: learn CPR because it saves lives
> .
> But now a local emergency service is convinced that the way you learn it in a class may do more harm than good.
> 
> Now they're making some changes.




They switched to having their EMDs tell bystanders to do compression-only CPR.


I don't know how legit their 19 percent survival rate is that the article reports... might be 19 percent ROSC.


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## WTEngel (Jul 13, 2010)

Good on them. More often than not the issue with bystander CPR is that people take no action at all, or worry too much about the breathing, because it is the most dramatic and noticeable thing they see on TV...

I think 5 minutes of strong compression only CPR is great, and can set up EMS  really well for a strong save!


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## abckidsmom (Jul 13, 2010)

We started a similar protocol in 2001 at the comm center I worked in.  We found that if we only directed people in compressions after confirming absence of signs of life, they actually did what we told them to.  Then the ambulance or fire first response was on scene most of the time before the 5 minutes of compressions was finished.


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## Foxbat (Jul 13, 2010)

> But now a local emergency service is convinced that the way you learn it in a class may do more harm than good.


I saw it coming. Oxygen, backboards, collars... and now we know that CPR does more harm than good and it may be better to avoid it


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## PotatoMedic (Jul 13, 2010)

I think in my area we have been teaching CPR only for at least a year now.  I am not sure if it is just king county that is doing that or if it is the state or red cross or Heart association.


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## Aprz (Jul 13, 2010)

It's what I tell people, continous chest compression (CCC). Like what WTEngle said, people usually don't do it because they think you have to do the breathing or get the ratio all messed up and don't do enough compressions. I think it's better for people to do CCC before EMTs arrive to start doing CPR because CCC really isn't enough, it's just good for delaying from what I've read and understand. They eventually need some O2 in their blood, haha.


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## Veneficus (Jul 13, 2010)

There is no way I would do mouth to mouth on somebody I didn't really care a lot about, how could you ask a bystnder to do it?

I agree though, the CPR classes are way more complex than they need to be.


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## Meursault (Jul 13, 2010)

I believe it's pretty common for dispatchers to instruct callers in compression-only CPR. It improves compliance, though I'm not sure about intermediate outcomes or survival.


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## DrParasite (Jul 14, 2010)

MrConspiracy said:


> I believe it's pretty common for dispatchers to instruct callers in compression-only CPR. It improves compliance, though I'm not sure about intermediate outcomes or survival.


as an EMD-Instructor, I can say Absolutely not!!!

dispatchers (more accurately, medical directors and coordinators in charge of 911 centers and those who write EMT guide cards) do not deviate from basic standards.  that includes mouth to mouth and compressions.  The order sometimes changes, but no where can the dispatcher arbitrarily waive directing a caller to not do mouth to mouth.

that all being said, if a caller refuses to do MTM, the dispatcher should have rules and scripts on how to proceed if the caller doesn't want to do MTM on the patient.

and current research has shown that compression only CPR has better save rates for layperson CPR.


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## Aprz (Jul 14, 2010)

My CPR class was a part of my First Responder class. The teacher was pretty intense, but to be honest, he drilled it in our heads. I went I went into EMT at Chabot, I was surprised that so much students forgot the ratios, orderings, the AED, etc... In my First Responder class, the teacher was very tough on us, but it definite made EMT a lot easier for me, and since I self learned A&P and the ECG, it was really a breeze for me, or at least I felt like that. Other students were up all night studying the basics when I was studying Pharmacology for my Clinical Tech class, which was harder.


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## berkeman (Jul 14, 2010)

DrParasite said:


> as an EMD-Instructor, I can say Absolutely not!!!
> 
> dispatchers (more accurately, medical directors and coordinators in charge of 911 centers and those who write EMT guide cards) do not deviate from basic standards.  that includes mouth to mouth and compressions.  The order sometimes changes, but no where can the dispatcher arbitrarily waive directing a caller to not do mouth to mouth.
> 
> ...



Are you saying that your standard Dispatcher protocol is to instruct lay responders to do unprotected mouth-to-mouth breaths?  I find that hard to believe.


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## ExpatMedic0 (Jul 14, 2010)

Hey everyone correct me if I am wrong here..... but CPR for non healthcare providers was changed to compression only quite a while ago? I believe AHA did away with MTM at least a year ago or more for lay rescuers?(not healthcare provider level)

http://circ.ahajournals.org/cgi/content/full/117/16/2162
http://www.theheart.org/article/849745.do


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## DrParasite (Jul 14, 2010)

berkeman said:


> Are you saying that your standard Dispatcher protocol is to instruct lay responders to do unprotected mouth-to-mouth breaths?  I find that hard to believe.


yes.  not only that, but dispatchers are not concerned with BSI stuff when we tell people to apply a dressing to a person who is bleeding.  the directions are "apply pressure using a towel or appropriate cloth" not "don a pair of latex gloves, and apply pressure using a towel or appropriate cloth."

go up to your local dispatch and ask to see their dispatch cards.  there is a lot of stuff that can be clarified if you make a visit or a phone call and see for yourself.


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## MrBrown (Jul 14, 2010)

I think this will come out in the next update of AMPDS and the AHA Guidelines.

The new way of teaching CPR here is something like this

1.  Dial 111, ask for Ambulance.  Tell them where, tell them what
2.  Push hard and fast in the centre of the chest

We are still teaching 30:2 with ventilations but that will probably change.

Oh, I almost forgot

3.  Run away very fast when Brown arrives in the big white van


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