CPR timing

[NomadicMedic]

High-performance CPR. It's a bit like ballet, or synchronized swimming. A lot of things have to happen within a tight time frame. And even on the best run codes, unless one provider is specifically detailed as a timekeeper, time has a way of becoming elastic. That two-minute round of CPR may stretch to three or four ... and that 10 second pulse check may stretch to 15, 20 or 30…

There are a lot of very nice applications for your iPhone or android to track events during a cardiac arrest. However, I found them to be a bit of overkill and a simple interval timer would work the best. I use an iPhone app called "Seconds Pro". I built an interval timer with a two-minute CPR unit and a 10 second pulse assessment unit. When you hit GO on the timer, it just starts running, marking off each two minutes, counting down 10 seconds and then restarting a two-minute CPR block. We mark all of our drugs and each defibrillation or other intervention on our lifepak, using event markers. So all I really needed was a big timer that beeped when it was getting close to the end of the segment to help keep things in sync.

Download an interval timer for your phone, and try it at your next cardiac arrest. You'll find your CPR timeline is more consistent, your pulse assessment and peri-shock pauses are shorter and you've got a large visual indicator to show you how much time you have in between shocks/drugs/interventions.

 

[Drax]

High-performance CPR. It's a bit like ballet, or synchronized swimming. A lot of things have to happen within a tight time frame. And even on the best run codes, unless one provider is specifically detailed as a timekeeper, time has a way of becoming elastic. That two-minute round of CPR may stretch to three or four ... and that 10 second pulse check may stretch to 15, 20 or 30…

There are a lot of very nice applications for your iPhone or android to track events during a cardiac arrest. However, I found them to be a bit of overkill and a simple interval timer would work the best. I use an iPhone app called "Seconds Pro". I built an interval timer with a two-minute CPR unit and a 10 second pulse assessment unit. When you hit GO on the timer, it just starts running, marking off each two minutes, counting down 10 seconds and then restarting a two-minute CPR block. We mark all of our drugs and each defibrillation or other intervention on our lifepak, using event markers. So all I really needed was a big timer that beeped when it was getting close to the end of the segment to help keep things in sync.

Download an interval timer for your phone, and try it at your next cardiac arrest. You'll find your CPR timeline is more consistent, your pulse assessment and peri-shock pauses are shorter and you've got a large visual indicator to show you how much time you have in between shocks/drugs/interventions.

Great advice, thanks!

 

[Tigger]

This is great. Currently the best we can do is leaving the AED on for it's metronome.

It be nice to see this sort of thing eventually integrated into the monitor.

 

[NomadicMedic]

I'd love it if physio would build a big timer into the screen. One of the other medics uses the 30:2 metronome on the monitor for timing. He said to me, "when she says 'ventilate' the fifth time, you know you've been doing it for two minutes." Yeah. I got better things to do than count how many times the monitor says "ventilate".

 

[mycrofft]

Nice one.

The pacer/timekeeper can also keep running records and be gofer if needed.
I'd hesitate to rotate a compressor to timekeeper if they're handwriting records, they're likely to have shaky hands for a while. (Truth).

 

[TheLocalMedic]

Someone taught me a great trick a while ago if you have a LP15. Throw it into AED mode and it'll give you a metronome and prompt for ventilations, plus a two minute timer. Sure, it takes a shade longer to analyze, but it's worth it for everything else it provides. And if you're overstocked on medics and can dedicate one to solely the monitor they can add additional information to the data being collected, like when drugs were given, then you can send it all to your laptop with the bluetooth connection for easy retrieval.

 

[rmabrey]

You can turn the metronome on without using AED mode.

 

[Christopher]

Someone taught me a great trick a while ago if you have a LP15. Throw it into AED mode and it'll give you a metronome and prompt for ventilations, plus a two minute timer. Sure, it takes a shade longer to analyze, but it's worth it for everything else it provides. And if you're overstocked on medics and can dedicate one to solely the monitor they can add additional information to the data being collected, like when drugs were given, then you can send it all to your laptop with the bluetooth connection for easy retrieval.

Ack! Negative to AED mode. Worsened survival to discharge due to the increased perishock pause.

 

[NPO]

This is great. Currently the best we can do is leaving the AED on for it's metronome.

It be nice to see this sort of thing eventually integrated into the monitor.

My CCT monitor sort of does it. Its got defib options, but if you leave it in monitor mode and hit analyze it acts like an AED and starts talking to you. On the screen below the rhythm. START CPR appears.

 

[NomadicMedic]

Depending on how quickly your monitor while in AED mode analyzes, you may have a +/- 30 seconds off the chest. Unacceptable by today's standards. Leave the AED for the first responders to get that first shock on board, but after that, use your monitor in manual mode and keep those compression pauses to a bare minimum. Ideally <10 seconds.

Truly, until you start examining cardiac arrest data, using a "real time" source like Physio's CodeStat, you just won't recognize how poorly most codes are run.