CPR and AED

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EMTBWannabe

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I have read, re-read, and re-re-re-read the "pro" edition of the American Heart Association CPR and AED manual.

I am a EMT-B student with 2 weeks under his belt and will be tested on CPR both written and practical.

I am confused as to when to use the AED (of course provided that I have determined that an AED should be used).

so here's the question:

for Adults - (unwitnessed conscious) i will call 911 and try to get an AED first and then start cpr - before i start CPR i will open the air way using the head tilt chin lift and look, listen, feel for breathing- using no more than 10 secs. then i check his carotid artery to see if he has a pulse. if there is no pulse - i should do 5 cycles of CPR and then hook up the AED for analysis and possible shock. IS THIS CORRECT?
 
here's my email in full:

I have read, re-read, and re-re-re-read the "pro" edition of the American Heart Association CPR and AED manual.

I am a EMT-B student with 2 weeks under his belt and will be tested on CPR both written and practical.

I am confused as to when to use the AED (of course provided that I have determined that an AED should be used).

so here's the question:

for Adults - (unwitnessed conscious) i will call 911 and try to get an AED first and then start cpr - before i start CPR i will open the air way using the head tilt chin lift and look, listen, feel for breathing- using no more than 10 secs. then i check his carotid artery to see if he has a pulse. if there is no pulse - i should do 5 cycles of CPR and then hook up the AED for analysis and possible shock. IS THIS CORRECT?

for adults (witnessed) i will call 911 and get an AED... i will do assessment of breathing and pulse. if there is no pulse or breathing do i go straight to the AED without giving CPR?

for pediatric pts - (unwitnessed) give 5 cycles of cpr... then call 911 and get AED - hook up AED for analysis and shock (if advised)... and resume cpr... is this right?

for pediatric pts - witnessed - call 911 and get AED. do i give 5 cycles of CPR before i hook up the AED? or go straight to the AED for analysis and possible shock... and then perform another 5 cycles of CPR?

please advise.

thanks
m
 
I managed to get 100% on that test so I should know this... I have to run on my class but I tried to type short answer. Hope this helps:

1) Adults: Call for ALS after establishing unresponsiveness and BEFORE you begin CPR.

establish unresponsiveness – call 911 if no response – position Pt – open airway – look, listen & feel for no more than 10 sec. – DELIVER 2 BREATHS – CHECK CAROTID (5-10 sec.) – if no pulse START the CPR

Kids: Call for ALS after establishing unresponsiveness and AFTER 2 minutes of CPR.

2) BEFORE you start with AED you should administer 5 cycles of CPR (2 min.) prior to first shock (that is to "re-prime the pump")

3) If you coming on the scene with the AED and someone else is already doing the CPR, stop them and apply the AED.

4) You do NOT stop CPR on your patient to go look for AED but rather dedicate someone to go and bring it to you... CPR should start right away after initial assessment.

5) Once the AED came on the scene all CPR stops and AED is applied.


Good luck to you.
 
thanks.

sounds like the only difference is - when to call ALS (or 911) - i think we're doing cpr in a sense that we're bystanders.

call 911/ALS for adults immediately then CPR

for Kids start CPR for 5 cycles and then call 911/ALS.

m
 
Basically, unless I'm mistaken (which I shouldn't be :ph34r:), for ANY unwitnessed arrest (without CPR in progress), begin with 5 cycles of CPR (to get "new" blood to the body and to perfuse the organs (blood without wastes, lactic acid, etc.).

For unwitnessed arrests with CPR in progress, if it's good CPR, then ask how long it's been going on. If longer than 2 minutes (or if started immediately after arrest), go straight to the AED. If not, begin CPR.

For any witnessed arrest, go straight to AED.
 
medichopeful said:
Basically, unless I'm mistaken (which I shouldn't be :ph34r:), for ANY unwitnessed arrest (without CPR in progress), begin with 5 cycles of CPR (to get "new" blood to the body and to perfuse the organs (blood without wastes, lactic acid, etc.).

For unwitnessed arrests with CPR in progress, if it's good CPR, then ask how long it's been going on. If longer than 2 minutes (or if started immediately after arrest), go straight to the AED. If not, begin CPR.

For any witnessed arrest, go straight to AED.
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This is correct. We just covered this in class on Saturday. Performing 5 cycles of CPR increases the chances that the AED can knock out V-Fib on the first shock.
 
CA EMT; said:
This is correct. We just covered this in class on Saturday. Performing 5 cycles of CPR increases the chances that the AED can knock out V-Fib on the first shock.
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That's true, but my understanding was that in the last update AHA said that it was up to each medical director if they want to to have 2 minutes of CPR before AED is used, though it is recommended. Also note that this applies to people who have been down for more than 4 minutes before the AED is on scene. If you are in the back of your ambulance, the patient is talking to you and passes out, you check and there is no pulse or breathing you give 2 breaths and then hook up the AED.

You don't need the 2 minutes of CPR because the patent just went down, the heart is full of oxygenated blood, and they have to have their electrical problem fixed.
 
i just passed my cpr exam... it was alot easier than i thought and i remembered alot of the skills taught.

i scored 100% on the written but i felt it was too easy.

thanks for all your thoughts.
 
NepoZnati said:
I managed to get 100% on that test so I should know this... I have to run on my class but I tried to type short answer. Hope this helps:

1) Adults: Call for ALS after establishing unresponsiveness and BEFORE you begin CPR.

establish unresponsiveness – call 911 if no response – position Pt – open airway – look, listen & feel for no more than 10 sec. – DELIVER 2 BREATHS – CHECK CAROTID (5-10 sec.) – if no pulse START the CPR

Kids: Call for ALS after establishing unresponsiveness and AFTER 2 minutes of CPR.

2) BEFORE you start with AED you should administer 5 cycles of CPR (2 min.) prior to first shock (that is to "re-prime the pump")

3) If you coming on the scene with the AED and someone else is already doing the CPR, stop them and apply the AED.

4) You do NOT stop CPR on your patient to go look for AED but rather dedicate someone to go and bring it to you... CPR should start right away after initial assessment.

5) Once the AED came on the scene all CPR stops and AED is applied.


Good luck to you.
Click to expand...

i see you are in NYC - where do you train?
 
EMTBWannabe said:
i see you are in NYC - where do you train?
Click to expand...
Hi,

I am in one small school in the Bronx... I am almost done. In two days I am taking my finals and then next week my state exams... Kudos on the 100% score! It was easy and yet some in my class needed to take it 3 times!? And he is also passing the school even that he doesn't know what BLS means... Go figure.
 
NepoZnati said:
Hi,

I am in one small school in the Bronx... I am almost done. In two days I am taking my finals and then next week my state exams... Kudos on the 100% score! It was easy and yet some in my class needed to take it 3 times!? And he is also passing the school even that he doesn't know what BLS means... Go figure.
Click to expand...

I think that is scary.
 
NepoZnati said:
Hi,

I am in one small school in the Bronx... I am almost done. In two days I am taking my finals and then next week my state exams... Kudos on the 100% score! It was easy and yet some in my class needed to take it 3 times!? And he is also passing the school even that he doesn't know what BLS means... Go figure.
Click to expand...

good luck with your finals and exams! pls let me know the outcome.
 
NepoZnati said:
Hi,

I am in one small school in the Bronx... I am almost done. In two days I am taking my finals and then next week my state exams... Kudos on the 100% score! It was easy and yet some in my class needed to take it 3 times!? And he is also passing the school even that he doesn't know what BLS means... Go figure.
Click to expand...

any advice on which stethoscope and blood pressure cuff to get?
 
If you check out www.emtb.com you'll find the review guides are the same checklists that the national registry uses. I print those and use them as a guideline.

Other than that, "what everyone else said"
 
EMTBWannabe said:
good luck with your finals and exams! pls let me know the outcome.
Click to expand...
Thank you. :) Hopefully I would have some good news by the end of the next week.
EMTBWannabe said:
any advice on which stethoscope and blood pressure cuff to get?
Click to expand...
That I do not know. I am sorry. My course is paid by the some organization and books and equipment I got in the package. Therefore, I did not needed to search for them... If you search here you will find posts that they taking about equipment and many more advices. Example:

http://www.emtlife.com/showthread.php?t=6096&highlight=stethoscope

http://www.emtlife.com/showthread.php?t=14626&highlight=stethoscope
 
after you deliver a shock,remember to stay consistent with cpr. if you go checking for a pulse after words,you will fail. just a tip. time is crucial.



cheers.
 
Glad I live in Florida...seriously though, congrats.
 
The book you are using is for lay rescuer wheresas Ambulance Officers should be using something slightly different because of the higher level of care that can provided.

For example; adult witnessed arrest is taught do two minutes of CPR then call the ambo's and hook up the AED. If I am approaching a cardiac arrest as a lay person while I am out-and-about spending my hard earned money in pursuit of the capalist dream that's pretty much what I'd do, however, as an ambo you look to shock first if it's a witnessed arrest.

Not much point doing CPR for two minutes on somebody who just fell down when you have a monitor/defibrillator right there with you. What is the only proven effective treatment for VF or VT, CPR or defibrillation?

Paediatric patients most likely have an airway obstruction or a seizure or some other non-cardiac cause for thier being unconscious.
 
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