Commotio Cordis and "The New CPR"

[Jon]

Ok... I finally went through "New CPR" this weekend. A question was asked by our squad's resident PA as to why we are doing Chest thrusts on a choking victim... given that they HAVE a pulse. He felt that that increased the risk of Commotio Cordis or similar.

I said that some of the changes had been to increase retention, but that I wasn't sure EXACTLY why.


So - IS this increasing the risk of Commotio Cordis? I understand that they are dead if we do NOTHING, but still.

RidRyder? Anyone else?


Jon

 

[Guardian]

The big reason is to simplify cpr instruction to public. Apparently and sadly, people are too stupid to remember when and when not to use abdominal thrusts. Evidence shows that chest compressions create more pressure for expelling foreign bodies from an airway anyway. Worrying about blunt chest trauma from chest compressions is the last thing on my mind unless someone can show me some evidence that it's detrimental to pts. Likewise, AHA always does what's best for the most amount of people and will continue this practice until evidence proves they shouldn't.

 

[Guardian]

I've heard of the precordial thump causing commotio cordis, but not proper cpr...anyone hear different?

 

[BossyCow]

Part of the AHA's thinking is that first and formost, the pt needs an airway. Potential side effects aside, without the airway patient will absolutely develop DDRD*. This is also why they are setting aside the importance of the jaw thrust maneuver in trauma codes. The priority is get the airway.

AHA has a great site that shows the old standards next to the new standards with the science that backs up the new changes. I don't have the link available but its through the AHA website.

*Dead. Dead. Really Dead.