CPR Certifications

[KEVD18]

What is really the difference between medical provider and lay person? They are both push up and down real fast here, blow there, and you are good to go joe.

yeah, but its sort of nice to understand the physiology behind whats going on. that's the diff between the heartsaver and the healthcare provider courses.

heartsaver is the mechanics of the cpr, with a brief and incredibly dumbed down explanation of the physiology.

healthcare provider goes into more of whats going on and why we do the treatment modalities that we do.

the two courses aren't equal in scope, yet. but as the courses continue to be dumbed down,. they will inevitably meet at the bottom.

 

[Ridryder911]

The layperson does not have to perform ventilation's or how to ventilate using adjuncts such as BVM, pocket mask, oxygen administration, etc. As well, they are not informed on the usage of AED's, pediatric or infant (unless a specialized class).

There is a lot of difference or should be between common laymen and health care provider course.

R/r911

 

[mikie]

healthcare provider goes into more of whats going on and why we do the treatment modalities that we do.

Ya, but how much detail does it really go into? Not much of a difference, at least if you ask me.

 

[zacdav89]

The first are geared towards the lay person who most likely will not see a cardiac arrest frequently in life so it becomes a very scary situation, they set of these classes with more simplicity to them to make it easier to recall the necessary information to do the job before we get there, the bls and pro gear more towards using tools like bvms and AED (though some layperson classes use theses tools in teaching too) but also gear towards working with a partner and taking control of the scene. These also include different ratios when using two person responders’ 15:2 on children and infants that are not included in layperson CPR classes. At least this is the way with the Red Cross and my basic understanding of the AHA system.

 

[Ridryder911]

I wished it was true. Unfortunately that is the propaganda they are feeding us. Many of us remember when CPR was much harder and the common laymen attended 8 hours of CPR training and was tested over the circulation of the heart. In fact much harder than some of the EMT tests now.

Guess what, people took it and passed it. They also performed it as well. Seattle had a 1:4 ratio of people knowing CPR. So "dumbing it down" does not produce better numbers or increased save rates.

R/r 911

 

[zacdav89]

I agree, I may not know how CPR was before some of these newer standard but I do understand that as a nation are cardiac survival rates suck. Something’s got to change and fast.

 

[medicdan]

What is really the difference between medical provider and lay person? They are both push up and down real fast here, blow there, and you are good to go joe.

Actually, a lot.
There are small differences in protocol esp. based on the newest research- i.e. Laypeople are instructed NOT to check a pulse on an unresponsive adult- they are to progress directly to the rescue breaths, etc, HCPs under AHA are taught that for an infant and 2-person CPR to change to 15:2, etc. As well, there is little discussion in the lay-person class as to WHY we make the decesions we do-- what the reasoning is-- and in fact, ARC instructors are told to deflect those questions, even if they can answer them, so as not to confuse the class.

There are minor differences between AHA and ARC. I recently became an ARC instructor, and have strong feelings against what is taught, but still teach it. ARC makes the majority of it's money from these classes (that goes on to fund disaster relief, etc.), so they charge for everything, and its getting expensive. This is turning into a pissing match, and I dont see an end in sight.

 

[medicdan]

JFTR, as a lowly EMT and new CPR instructor, I disagree with the actions of AHA this April in their release of the "push hard and fast" PR campaign. They are telling lay-people that all they need to know is to push hard and fast on the chest of anyone who looks unconscious-- no check for consciousness, pulse, respirations, just push hard and fast "wherever". If not already, we are going to start to see broken ribs, etc. on diabetics and epileptics...
[/rant]

 

[Ridryder911]

nation are cardiac survival rates suck. Something’s got to change and fast.

Can't cure death. Realistically, the focus should be on preventative and not the post or afterwards. Unfortunately, as much research and new methods are developed it has always been shown and demonstrated that they never achieve much more than 6% prehospital and about 4% in hospital save rates.


R/r 911

 

[el Murpharino]

JFTR, as a lowly EMT and new CPR instructor, I disagree with the actions of AHA this April in their release of the "push hard and fast" PR campaign. They are telling lay-people that all they need to know is to push hard and fast on the chest of anyone who looks unconscious-- no check for consciousness, pulse, respirations, just push hard and fast "wherever". If not already, we are going to start to see broken ribs, etc. on diabetics and epileptics...
[/rant]

I believe they're telling "lay rescuers" to look for signs of circulation, not unconsciousness. According to AHA, signs of circulation include "the rise and fall of the chest and abdomen, as well as skin color". The AHA also states you should bare the chest of someone you're going to perform CPR on - of which the AHA also state that "It would be very difficult to visualize these signs of circulation without a bare chest." A proper 5-10 seconds to assess unresponsiveness and signs of circulation should be good enough to prevent unnecessary CPR, however there will be a sliver of patients who may not be dead that receive CPR.

There is a strong push toward more compressions in between ventilations. Cardiocerebral resuscitation has been mentioned and used in some services with a higher success rate than CPR. You may want to get used to this hard and fast method of CPR or CCR, it's not stopping now.

 

[medicdan]

I believe they're telling "lay rescuers" to look for signs of circulation, not unconsciousness. According to AHA, signs of circulation include "the rise and fall of the chest and abdomen, as well as skin color". The AHA also states you should bare the chest of someone you're going to perform CPR on - of which the AHA also state that "It would be very difficult to visualize these signs of circulation without a bare chest." A proper 5-10 seconds to assess unresponsiveness and signs of circulation should be good enough to prevent unnecessary CPR, however there will be a sliver of patients who may not be dead that receive CPR.

There is a strong push toward more compressions in between ventilations. Cardiocerebral resuscitation has been mentioned and used in some services with a higher success rate than CPR. You may want to get used to this hard and fast method of CPR or CCR, it's not stopping now.

http://handsonlycpr.eisenberginc.com/
Above is a website written and sustained by the AHA, and is says

When an adult suddenly collapses, trained or untrained bystanders – that means a person near the victim – should:

1) Call 911
2) Push hard and fast in the center of the chest.

Studies of real emergencies that have occurred in homes, at work or in public locations, show that these two steps, called Hands-Only CPR, can be as effective as conventional CPR. Providing Hands-Only CPR to an adult who has collapsed from a sudden cardiac arrest can more than double that person’s chance of survival.
Don’t be afraid. Your actions can only help.

It’s not normal to see an adult suddenly collapse, but if you do, call 911 and push hard and fast in the center of the chest. Don’t be afraid. Your actions can only help.

 

[el Murpharino]

So by viewing this website you're automatically trained in CPR? I'm pretty sure that this would be of use only in conjunction with a CPR class. I'd hope that this website does not serve as a training module for rescuers. In fact, the same website says the following in the FAQ's:

"The AHA continues to recommend that you take a CPR course to practice and learn the skills of CPR, including giving high-quality chest compressions."

"Hands-Only CPR is recommended for use on...adult victims who are found already unconscious and not breathing normally, and for any victims of drowning or collapse due to breathing problems"

 

[BossyCow]

I think part of the 'dumbing down' of the AHA layperson CPR is the supposition that ALS is going to be on scene in a few minutes. Also, with the fear of disease transmission and the likelihood that the person having that MI in front of you is a stranger, the willingness of the bystander to perform something as intimate as mouth to mouth is drastically reduced.

Like most AHA changes, we'll just have to see what the results are after doing it this way. One thing is for certain though.. there will be changes

 

[Sasha]

I think the simplifying is in hopes to increase the likelihood that someone will actually DO something rather than stand and stare because they cant remember the exact compression ratio or dont want to put their mouth on someone elses. Can you blame them? I dont particularly want to put my mouth on someone elses either.

I had heard the compression only CPR was for a witnessed arrest, with the theory that there is enough oxygen on the hemoglobin to sustain life for a minute or so while ALS arrived if it got to be circulated.

I dont particularly believe that would work, after all it is just a theory. And what if ALS is delayed? You can circulate the blood all you want but not breathing is 100% fatal.

 

[redcrossemt]

I had heard the compression only CPR was for a witnessed arrest, with the theory that there is enough oxygen on the hemoglobin to sustain life for a minute or so while ALS arrived if it got to be circulated.

I dont particularly believe that would work, after all it is just a theory. And what if ALS is delayed? You can circulate the blood all you want but not breathing is 100% fatal.

I'm not sure it's just a theory. Gordon A. Ewy had his literature review "Cardiocerebral Resuscitation: The New Cardiopulmonary Resuscitation" published in the April 2005 issue of Circulation. Ewy et al concluded that chest-compression-only CPR is more effective for most sudden cardiac arrest situations in adults. There are cases that demand ventilatory support immediately, such as pediatric arrests (most likely cause of cardiac arrest is respiratory arrest) and drowning victims. They also state that while additional research is needed, they estimate that ventilation is mandatory after about 15 minutes of cardiac arrest without gasping / agonal breaths.