I would say yes (but PLEASE keep in mind patient privacy if at all possible!). You need to see the area you're working with, get the correct alignment for hand position, etc)do you cut the PT's upper body clothing away if cpr is required? (bystander, AED hasnt arrived yet)
I hate rules. How about principles?CPR is ALWAYS done on bare skin. No exceptions to this rule.
You and I both know there isn't one out there but if you're really going to nit-pick at me here ya go http://circ.ahajournals.org/content/95/8/2183.fullCitation please that disrobing the pt supersedes early fast and deep CPR for EMT's and paramedics.
Now you're being ridiculous and after 20 12 hour shifts in a row with another one tomorrow I don't have the patience or drive to continue arguing with you.Bare everybody before CPR, then put them on a long board, start high flow oxygen via NRB, start two IV's just in case...did I miss any?
This is essentially correct, except that for most of us this is a TEAM SPORT. Even if you haven't choreographed a specific "pit crew" sequence in your department, it should be clear if you try it both ways that -- starting from recognition of unresponsiveness, pulselessness, and apnea -- one person beginning compressions while another exposes the chest and applies the AED yields shorter hands-off time than one person exposing the chest while the other peels readies the AED and then twiddles his thumbs. (Not much difference here with a manual monitor.) The time to shock may be a few seconds shorter in the latter case, but I would rather have less no-flow time with that delay than the alternative, and that position closely matches current AHA recommendations. Remember that we used to explicitly teach two minutes of CPR before shocking anyway in most arrests, and while it's no longer dogma it hasn't been thrown out either. (Never mind if somebody actually needs to go fetch the defib -- or wait for an AED to cycle through 30 seconds of layperson voice prompts before shocking.)There are times at the sports medicine job where it is conceivably possible that I will be alone for a minute or two before the AED arrives. During that time I am not going to do anything but compression (assuming there are no pads in the way). Those that bring the AED can start cutting the shirt while I continue compressions allowing minimal off chest time during while applying the AED. If I have the AED with me and some suffers cardiac arrest in front of me (lacrosse ball/puck to chest type scenario), the first thing I'm doing is cutting the shirt off and getting the AED on there even if I'm alone.