CPR Board

[CFRBryan347768]

So at a code, with CPR started, at a BLS level, try the OPA first?

Assuming no gag reflex.

And no head injury. I'd go for that first.

 

[skyemt]

for whatever it's worth,
if you guys are running a code, the pt is effectively dead unless you can get ROSC.

what is the point of focusing on head chocks, and potential head injuries? or even airways right off the bat?

there's a head injury alright, the brain isn't getting oxygen because he's DEAD! LOL...

the whole point of the early code is to get effective AED usage (if within the first 4-5 minutes), or to do effective, quality CPR if arrest unwitnessed. yes, ACLS meds will be urgent, as will the advanced airway, but it is not what's done first. even ACLS is based on good quality CPR.

the point of the LSB (or similar) is that without it, you really can't get effective compressions. anything soft, that will absorb some of the energy of the compressions, may well render your aid useless.

 

[MSDeltaFlt]

So at a code, with CPR started, at a BLS level, try the OPA first?

Assuming no gag reflex.

If they're dead, they will have no gag reflex. Do the OPA first then Combi

 

[Jeremy89]

for whatever it's worth,
if you guys are running a code, the pt is effectively dead unless you can get ROSC.

what is the point of focusing on head chocks, and potential head injuries? or even airways right off the bat?

there's a head injury alright, the brain isn't getting oxygen because he's DEAD! LOL...

the whole point of the early code is to get effective AED usage (if within the first 4-5 minutes), or to do effective, quality CPR if arrest unwitnessed. yes, ACLS meds will be urgent, as will the advanced airway, but it is not what's done first. even ACLS is based on good quality CPR.

the point of the LSB (or similar) is that without it, you really can't get effective compressions. anything soft, that will absorb some of the energy of the compressions, may well render your aid useless.

Correct me if I'm wrong, but while doing CPR, aren't you circulating blood and breathing for the pt? So if that was the case, wouldn't the brain still be getting some O2?

 

[skyemt]

Correct me if I'm wrong, but while doing CPR, aren't you circulating blood and breathing for the pt? So if that was the case, wouldn't the brain still be getting some O2?

yes... my point, though, is that when you come upon the arrest, it is getting nothing, there is nothing circulating, and acid building up.

it is a matter of priorities... studies have shown that the percentages are poor anyway for ROSC, but the best chance is to do immediate quality CPR (unless witnesses arrest, then AED), and you need to be on a hard surface...

the other stuff will not mean anything, if the process is not started correctly.

hope that clears things up a bit...

 

[MAC4NH]

Instead of a long board we usually use a reeve's stretcher. The slats give you enough support to do compressions and it's much faster and easier to get the patient down stairs, especially in old multiunit houses with narrow staircases.

 

[Ridryder911]

Here is the traditional CPR board, with the head "scooped" out to allow the head to stay in a head tilt position, as well as a firm surface. They have been out for a couple of decades or more. True most use a LSB or anything firm, so compressions can be effective.

Head blocks or even C-collars is not unusual on arrest (for ALS) to help reduce "pulling or dislodging" the tube.

R/r 911

 

[Jon]

Here is the traditional CPR board, with the head "scooped" out to allow the head to stay in a head tilt position, as well as a firm surface. They have been out for a couple of decades or more. True most use a LSB or anything firm, so compressions can be effective.

Head blocks or even C-collars is not unusual on arrest (for ALS) to help reduce "pulling or dislodging" the tube.

R/r 911

You will sometimes see those boards on rigs... but they are more often found in the supply cabinets because they looked like a good idea, but really aren't.

In the hospitals, I've often seen a 2ftx3ft piece of Plexiglas or thick plastic attached to the side of the hospital's code carts... this works great as a CPR support on a hospital bed.

 

[ErinCooley]

We use the Comb-Tube. The lab instructor in our course says to use the OPA until you get into the truck and then switch to the Combi. I've heard other say go for the Combi ASAP. Which do you do?

EMT-I combitube station on the NR practical not using a OPA/NPA is failing criteria. You preoxygenate the pt with NRB while the adjunct is in place then remove it to insert the tube.

 

[Ridryder911]

EMT-I combitube station on the NR practical not using a OPA/NPA is failing criteria. You preoxygenate the pt with NRB while the adjunct is in place then remove it to insert the tube.

The usual standard to pre-oxygenate the patient for upto three minutes prior to insertion of any Adavanced Airway Device.

R/r 911

 

[Airwaygoddess]

Back boards!

Can't tell you how many times we would get a call for seizures, and they wound up being Code Blues......Long back boards are a great thing! By the way, Santa Barbara's protocol for advanced airway requires c-collar and head beds being placed on the patient, this helps with not losing ET tube placement.

 

[PeteBlair]

Head Bed is a new term for me. What is that? Would that also be known as "head blocks?"

 

[Airwaygoddess]

head beds!

pre made, although not my favorite,

www.boundtree.com

Give me a roll of 2 inch cloth tape and "cheese blocks" you will not move!! ^_^

 

[BossyCow]

I've used the CPR board once and just for that little scoop out for the head. It maintained an airway on rough terrain where it was difficult to get good access to the pt. The board stabilized them nicely.

As for the combi-tube, in practice, the OPA is used until the Combi-tube is ready for insertion. As protocol states the tube is to be lubricated, and both balloons tested prior to insertion, there's time passing with no airway adjunct in place.

 

[Katie]

Head Bed is a new term for me. What is that? Would that also be known as "head blocks?"

yeah pretty much. here's one example.

 

[mikeylikesit]

yeah the lsb is good and all until they code on the cot in the back of the Ambo. are you gonna pull over to get out the LSB? i use the CPR when ever there is one in an AMBO period unless they are already on a LSB.

 

[Grady_emt]

Our protocol states that any code goes on a LBB, and that the pt have a C-collar placed to help maintain a patent airway. The head doesnt have to be "blocked" in place as would be the case for a trauma call. Also, only one strap is "required", but usually ill go ahead and use two just to make sure they dont slide off.

 

[emt357085]

why bother with a short board just use a long board so u could also transport on it

 

[mikeylikesit]

you know those CPR boards double as a nice snack tray in the back of the AMBO. i think mine gets the most use during lunch.^_^J/K

 

[AnthonyM83]

why bother with a short board just use a long board so u could also transport on it

I'd never bring a short board on a cardiac arrest call. It's not going to help carry them out if you're transporting nor help keep airway secure when transferring to the gurney nor help in smooth transition from gurney to ER bed.

Short board is pretty much for patients who code during transport (yet most around here don't keep it at easy access) or maybe for pediatric spinal immobilization. I heard before they days of the KED, they used to be used for extrication.