# CPR on stretcher



## goidf (Jul 11, 2008)

Would compretions be efective, when done to a patient on the strecher, or do you need to have a short board under the mattress?


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## mikeylikesit (Jul 11, 2008)

goidf said:


> Would compretions be efective, when done to a patient on the strecher, or do you need to have a short board under the mattress?


 CPR board otherwise you can do damage to a trauma patient, or you have to work twice as hard. there is another post on this somewhere.


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## Airwaygoddess (Jul 11, 2008)

*Firm surface for effective chest compressions*

If your patient was not packaged on a long spine, ( i.e. code blue) then yes you would need to have that short spine board under the gurney mattress for the firm surface that is needed for effective chest compressions.  Better to have it ready to go.


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## goidf (Jul 11, 2008)

so if a patient I was transporting decided to code on me, in the back of my bus (van) I would have to grab a short board and shove it under them (Or under the mattress) and only then start CPR.
Would I hook up the AED, or go staright for the board?


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## knxemt1983 (Jul 11, 2008)

I would say tell your partner to stop and let him get the board and come give you a quick hand, unless you just have a driver. I wouldn't delay the aed if possible. just my 2 cents though


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## KEVD18 (Jul 11, 2008)

"just a driver" could still help me manhandle a short board under the pt.


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## Nycxice13 (Jul 11, 2008)

The newer stretchers have a metal surface under the mattress for this reason.


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## mikeylikesit (Jul 11, 2008)

AED hook up...don't delay the CPR thoguh thats whats keeping their brain alive...sorta.


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## Ridryder911 (Jul 12, 2008)

goidf said:


> Would compretions be efective, when done to a patient on the strecher, or do you need to have a short board under the mattress?



Personally I have never streched or performed compretion anyone but I have placed them on a 
stre*t*cher and did compressions... 

R/r 911


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## MMiz (Jul 12, 2008)

What's wrong with doing compressions on a stretcher matress?  They're tiny, and there is a solid piece of metal below them.  They don't take a patient off of a trauma gurney to do compressions.

At a nursing home we use a CPR/compression board until we get them on our cot.  I've found that many mattresses are air matresses, and have that quick emergency release valve (I found out the hard way).

Don't delay CPR or shocks.


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## Grady_emt (Jul 12, 2008)

anyone we are pumping on gets a LBB, Medical or Traumatic


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## stupie680 (Jul 16, 2008)

You should be OK getting good compressions on most standard strechers. As for the bed sceniro its always best to quickly place the pt on the floor to ensure good compressions.


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## WuLabsWuTecH (Jul 16, 2008)

If on scene, we'll backboard them, else if hes already on a stretcher well do CPR there.


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## skyemt (Jul 16, 2008)

you need to get at least 1 3/4" to 2" of compression depth for CPR to be effective at all... every bit of energy absorbed by the mattress will ensure that you are wasting your time, unless the air is let out, as mentioned previously.

it helps to understand why you need a solid surface under the patient NOT the mattress... this is why patients are placed on the LSB prior to being moved onto the cot...

in regards to traumatic cardiac arrest, doesn't really matter what you do, as the chances of ROSC have been proven to be almost zero.


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## goidf (Jul 16, 2008)

LSB? not sure what that is.
(I think every new EMT should be givin a 3 month grac period to ask all the quetions that he should allready know the answers to...)
I'm still not sure if I got a clear answer here, let me just clearfy that I am talking about the mattress on the stracher, it aint that soft and giving... the quetion again is if I should take that 30-45 secunds do grab the short board and jam it under the mattress (or patient), I'm talking about when one is in middle of a transport (putting the patient on the floor is not really an option).


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## NC-EMT08 (Jul 16, 2008)

goidf said:


> LSB? not sure what that is.



Pretty sure that LSB = long spine board


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## FireResuce48 (Jul 29, 2008)

Ive found using the reeves stretcher tends to be allot easier then the long boards, ecspecially with the bigger paitents.


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## CFRBryan347768 (Jul 29, 2008)

goidf said:


> LSB? not sure what that is.
> (I think every new EMT should be givin a 3 month grac period to ask all the quetions that he should allready know the answers to...)
> I'm still not sure if I got a clear answer here, let me just clearfy that I am talking about the mattress on the stracher, it aint that soft and giving... the quetion again is if I should take that 30-45 secunds do grab the short board and jam it under the mattress (or patient), I'm talking about when one is in middle of a transport (putting the patient on the floor is not really an option).



I have heard answers from both sides saying you can and can not. But why not it only takes that 30-45 seconds to grab it. So yes I usually grab it and put it under them.


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## Airwaygoddess (Jul 29, 2008)

NC-EMT08 said:


> Pretty sure that LSB = long spine board



Yes you are right!


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## MikeRi24 (Jul 29, 2008)

my company uses this lovely piece of crap, so its never an issue







http://www.youtube.com/watch?v=2rP0CzKXxTw

i hate this thing, and unfortunately its company policy to use it.


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## mycrofft (Jul 29, 2008)

*If God hadn't intended CPR to be done on the floor,*

 He/She'd make victims float, not fall.
As for litters/stretchers, would you pound nails on a trampoline?


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## medic_chick87 (Jul 30, 2008)

MikeRi24 said:


> my company uses this lovely piece of crap, so its never an issue
> 
> 
> 
> ...




Ran a code yesterday where the fire crew running with us used this thing. I personally think that they are _awesome_! It took one less person out of the way for me to trip over, and it never tired out. 

As far as "To use a board or not to use a board, that is the question" last two codes I've been on one we used a board, one we didnt and both had pulses back by the time we reached the hospital so I personally dont think it matters too awful much.


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## mdkemt (Jul 30, 2008)

*Omg*

Okay I totally need to see if your service will get this.  Looks like a great idea.  As for CPR with or without  board..I prefer a board because it gives more stability and is easier to move patients from bed to bed or if they do start to aspirate you can roll them.

MDKEMT


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## MikeRi24 (Jul 31, 2008)

mdkemt said:


> Okay I totally need to see if your service will get this.  Looks like a great idea.  As for CPR with or without  board..I prefer a board because it gives more stability and is easier to move patients from bed to bed or if they do start to aspirate you can roll them.
> 
> MDKEMT



the things cost like 10 grand each i think. something stupid expensive. personally, I do not like them at all. they look great on paper and in the demo videos, but in the real world, I think they suck. depending on the size of the pt, its sometimes hard to get them positioned right, wires and tubing like to magically get tangled in the system, you pretty much need to get a line and tube before you start using the thing, you've pretty much got to immobilize the pt because this thing zip-ties to a backboard, so if you're in the classic "upstairs on the 5th floor and the stairwells are 2 feet wide and the elevator is broken at 4 in the morning" predicament and you cant get the pt down the stairs, through the door, around the corner, or whatever the thing is useless because they have to be on a backboard. not to mention its heavy as hell and a real pain to carry around. 

Like I said, just my opinion on the thing, and on paper and in demos it looks great (I was sold on it after watching the training video) but once you get out in the real world, it just isn't practical. My partner feels the same way about it, so everytime we work a code, we just say "oh there was possible trauma" so we don't get written up for not using it and just do CPR the conventional way. Since we've had it, I think we are 1 for 3 on code saves and at least double that without using it. I know thats not saying anything really, but we can do without it just fine and things seem to run a lot smoother.


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## reaper (Jul 31, 2008)

They are great if used correctly. I can't see how the 5th floor matters to the autopulse. You would have the pt on a LSB anyways?

Why would you have to do IV's and ETI before hand? Never had a problem with it.


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## MikeRi24 (Jul 31, 2008)

reaper said:


> They are great if used correctly. I can't see how the 5th floor matters to the autopulse. You would have the pt on a LSB anyways?
> 
> Why would you have to do IV's and ETI before hand? Never had a problem with it.



I'm saying if you're in a tight spot where it would be really hard to maneuver a pt on a LSB around corners and down stairs. in my area, we have a lot of really old buildings and houses with extremely narrow staircases that make really tight turns. We use a stairchair a LOT and even then sometimes its hard to maneuver. and if you do it right (manual CPR then stop to do the line and tube) you're ok. if Fire is on scene first or something using it, then its kinda hard to get a line and tube sometimes in the "pause" time the device allows. Also, this thing makes the pt's arms flop around a lot, seems like doing manual CPR if a medic had to get a line when you were doing compressions, it could be easier. I'm not trying to pick a fight or anything, just saying from my experiences with it thus far, it seems very cumbersome and more trouble than its worth. I'm just not a fan of it. if you are educated and do CPR correctly you shouldnt really need it.


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## reaper (Jul 31, 2008)

Mike,

I am not picking a fight. I understand tight areas. For that, just wait till you get them in the truck, before putting on the Autopulse.

I have never had a problem intubating or getting an IV, while it is compressing. It is harder, but can be done. 

I agree that manual CPR is good, but people do get tired after 30-45 seconds. It is shown that compressions fall off in effectiveness, after a short time. The machine does not wear out and gives constant compressions. That is the most important thing that can be done.

It does take time to get used to using it and working around it, but I think it is a great device. Rural areas can really benefit from it. If you are five minutes from the ED, it is not worth the time to put them on it.


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## MikeRi24 (Aug 1, 2008)

reaper said:


> Mike,
> 
> I am not picking a fight. I understand tight areas. For that, just wait till you get them in the truck, before putting on the Autopulse.
> 
> ...




its our companies protocol to get it going before we move the pt. and as I think I said, where I'm at, theres so many hospitals that you can be to one less that 5-10 min from just about anywhere, so like I said, for our particular situation I just think its more of a hassle than its worth.


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## ILemt (Aug 1, 2008)

This can be a great boon to rural areas... 
Even running code three its at least 30 minutes to the ER, normal time is closer to 45 minutes.

Having one in the rig would be great.
Then again, standard practice at my vollie service is to get a FF to drive, a FF to compress, EMT does airway, and medic does the lifepak 11 and the drugs.


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## reaper (Aug 2, 2008)

Mike,

If you have Ed's that close, then yes I think it is a waste of time and money on your dept's behalf!!


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## ride2k (Aug 11, 2008)

mikeylikesit said:


> CPR board otherwise you can do damage to a trauma patient, or you have to work twice as hard. there is another post on this somewhere.



I would hope if it were a trauma patient, they would already be immobilized on a long backboard.

But most people say not to do CPR on a bed especially in a nursing home, or a stretched without something hard underneath. At least log roll them on a backboard is my inital thought.


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