NepoZnati
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Or, as I was told, if witnessed arrest one can use a precordial (fist) thump on adults.
CPR and AED
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I don't know of anywhere that still advocates the precordial thump.
Then again, I was told of a job where somebody kept flip flopping between VF and sinus rhythm so the Officer I was speaking with just "kept smashing him in the chest and he reverted back...."
NepoZnati
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That's what I was told... But ONLY if witnessed and only once.
mycrofft
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Learn your protocols and use them. (cough cough)
Her I go gassing off again, but having seen CPR being "perfected" for nearly five decades:
1. Virtually no one survives CPR without quick intervention at least at the AED level. That is, unless the pt really didn't need CPR, or the cause was an electric shock. Instead of trying to get your compressions right on the desired speed, you should be screaming for backup. Even with AED, everyone who gets CPR, rescue breathing or airway clearance ought to be assessed and treated at a higher level of care than an ambulance, school nurse, or nursing home.
2. The precordial thump will never be clinically proven. It may very well work, but there is no way to collect data. I figure I can give her/him a thump as I'm leaving to go find the AED or phone or bystanders, as long as I don't curse at them.
3. The days of doing CPR for prolonged periods is over. (personal record: 49 min, pt of course dead). I could DO it for over 3/4 hr because compressions were 60/min; I recently tried the faster and pauseless style and it will whip your behind in much shorter order.
Her I go gassing off again, but having seen CPR being "perfected" for nearly five decades:
1. Virtually no one survives CPR without quick intervention at least at the AED level. That is, unless the pt really didn't need CPR, or the cause was an electric shock. Instead of trying to get your compressions right on the desired speed, you should be screaming for backup. Even with AED, everyone who gets CPR, rescue breathing or airway clearance ought to be assessed and treated at a higher level of care than an ambulance, school nurse, or nursing home.
2. The precordial thump will never be clinically proven. It may very well work, but there is no way to collect data. I figure I can give her/him a thump as I'm leaving to go find the AED or phone or bystanders, as long as I don't curse at them.
3. The days of doing CPR for prolonged periods is over. (personal record: 49 min, pt of course dead). I could DO it for over 3/4 hr because compressions were 60/min; I recently tried the faster and pauseless style and it will whip your behind in much shorter order.
NepoZnati
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I guess I needed to put there that my instructor did say that fib is something that is not commonly done, it is something we maybe can do when no one is looking and it is not approved by protocol.
By bad, mycrofft. You are 100% right. :blush:
By bad, mycrofft. You are 100% right. :blush:
As was mostly said above if unwitnessed cardiac arrest do CPR first and the reason was explained to me ... we want to prime the pump ... IE we want blood in there before the shock so if the shock works there is something to pump.
I just couldn't keep this all straight until it was explained this way to me. I hope i have helped somebody here ...
I just couldn't keep this all straight until it was explained this way to me. I hope i have helped somebody here ...
Not in a BLS setting.....
I was the lucky one on the receiving end of a thump years ago. It worked but boy, what a thing to do to someone!
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NepoZnati
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Well, I never said it is by the protocol and it is something "when no one is looking"... But, that's what I was told on my EMT, BLS class. By the NYFD EMT, BLS guys.
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