CPR/AED Timing Study

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Aileana

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Not sure whether to put this here or in the BLS thread, but feel free to move it if it's in the wrong place. This was in the Toronto Star today. I find this research to be really interesting, and am excited that it is being pioneered by the service I'm doing my ride-alongs with.

http://www.thestar.com/living/Health/article/262357

Personally, I think that as long as CPR has been started by a bystander/first responder before/right after time of dispatch, AED should be used as soon as possible. Will be interesting to see what the studies conclude.
Opinions anyone?
 
Actually, there has been many previous studies already performed. Don't know why the Doc is so excited and describing it as a "first time". In fact, that is why AHA recommends CPR should be performed up to 1-3 minutes before defibrillation. It causes fine v-fib into course v-fib, a more shockable rhythm.

I think the purpose of AED's are great, however; I have only seen one that actually change the outcome. I believe more effort in effective CPR will be the main key on any prehospital treatment.

It will be interesting on their study results.

R/r 911
 
what makes VF "fine" or "course"?
 
Increasing ATP and increasing irritability by catecholamine levels. This has been know for several decades, as in years of the past CPR has been demonstrated to be the only performance to really change outcome levels. Edison medicine is a good idea, but unless there is something to shock it is wasteless.

R/r 911
 
ahh ok, thanks for the info, I didn't know there were different types of VF. How can one measure the difference between coarse and fine VF?
 
Fine V-fib is small... (hence fine) and course is larger/bigger (hence course) ...

No, not joking.. :)

R/r 911
 
just to claify Rid, you are saying the AHA recommends CPR for 2 minutes if the collapse was unwitnessed, or our arrival is greater than 4-5 minutes...
if we are on scene within a couple of minutes of collapse, the V-Fib will still be course enough to shock... i think the point here is that if we don't know how long someone is down, we have to assume a fine V-Fib, and usually the result of shocking fine V-Fib is asystole...
 
According to the 2005 AHA ACLS standards for an witnessed arrest, immediate electrical cardioversion if V-fib is noted. If one arrives and is unsure or resuscitation is unclear, it is recommended not mandated, that good CPR be performed for 1-2 minutes before attempts to terminate the rhythm.

Most that have been around the business is aware, course V-fib is much more responsive than fine v-fib. Then again, aystole is much more easier rhythm to respond to therapy than V-fib itself. It amazes many to find out, we much rather our patient go into aystole, than to return to fine V-fib (irretractable). Aystole is workable rhythm. Like "re-booting" a computer and clearing the circuits, hoping that the natural pacer will fire on its own. We can assist it once it starts...

R/r 911
 
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