Curious about CPR guidelines in Arizona

[AVPU]

Hello forum!

I am reading a fascinating book by Dr. Sanjay Gupta called Cheating Death. Among the true accounts he tells about, he mentions that in 2005 the state of AZ got away from doing the breaths during CPR.....laypeople and healthcare providers are taught compressions only. According to the book, it's based on research a Tucson-based doc has been doing......what's most important is the compressions, and interrupting those to do the breaths is dangerous for the patient.

This strikes me as odd b/c, as I understand it, the AHA is what sets the standard for healthcare BLS, and AHA is a national organization, so how can one state stray from the guidelines?

Anyone familiar with this want to comment?? I don't live in AZ, so I'm not familiar with the standards there, but would like to find out more. This book has piqued my interest.

 

[Bloom-IUEMT]

http://circ.ahajournals.org/cgi/content/full/116/25/2894

http://www.jems.com/resources/supplements/eagles2010/reducing_interruptions.html

I see this as becoming the new gold standard in a few years because every article I've read about it seems to sing its praises.

 

[Bloom-IUEMT]

Here is a good video:

http://www.youtube.com/watch?v=E5huVSebZpM

 

[reaper]

Any state or MD can determine if they want to follow the AHA guidelines or not. They are not mandated. The problem lays with the liability of that. If something happened and ended up in court, they would have to explain why they strayed from the national accepted guidelines!

 

[JPINFV]

This strikes me as odd b/c, as I understand it, the AHA is what sets the standard for healthcare BLS, and AHA is a national organization, so how can one state stray from the guidelines?

There is nothing stopping anyone from making up any standards. Of course who ever makes up a standard also faces the liability of doing so, but just because the AHA (or really, any non-government agency) says something doesn't compel you to follow it.

 

[Foxbat]

There is nothing stopping anyone from making up any standards. Of course who ever makes up a standard also faces the liability of doing so, but just because the AHA (or really, any non-government agency) says something doesn't compel you to follow it.

But then again, you still can be sued for not following a "non-mandatory" standard. I heard of cases where fire departments were sued for not following NFPA (aka Not For Practical Application) standards even though those weren't the law in their jurisdiction.

 

[JPINFV]

You're still going to have to show damage caused by non-compliance. If a medical director wants to write a protocol based on studies published after the last update, then they are no longer in compliance, but that doesn't mean that they are negligently so.

 

[TccEMT]

Hello forum!
Anyone familiar with this want to comment?? I don't live in AZ, so I'm not familiar with the standards there, but would like to find out more. This book has piqued my interest.

There are some depts. doing CCR (no breaths). I think Tucson Fire is one of them. It's be no means the whole state and state EMS office is part of the program, so thats how they are "getting away with it" per say.

Some interesting reading
http://www.azdhs.gov/bems/QApres/Ben Bobrow - Prehospital Data - Quality over Quantity.pdf

 

[oc_emt]

It's my understanding the AHA guidlines will formally teach compression only cpr as an option for the lay person but for healthcare providers, it will remain as is. This is what I have been told by several seasoned instructors. We shall see...

 

[dmc2007]

Per my instructor trainer, compression only CPR has been added to AHA guidelines and is advised only for witnessed adult arrests before EMS arrives. When working in a healthcare capacity, however, breaths are still required. IIRC AZ was where the trials for this were conducted, hence Dr. Gupta's reference.

 

[joeshmoe]

The AHA CPR for health professionals book I used in my CPR class stated that lay people are being taught compression only cpr.

I can understand that, compressions are relatively easy to do and dont require anyone to expose themselves to anything wet or yucky, so people are more likely to come forward and do cpr instead of waiting or hoping for someone else to do it.

 

[rescue99]

Per my instructor trainer, compression only CPR has been added to AHA guidelines and is advised only for witnessed adult arrests before EMS arrives. When working in a healthcare capacity, however, breaths are still required. IIRC AZ was where the trials for this were conducted, hence Dr. Gupta's reference.

Breaths are not required in any layperson setting without mask whether we're trained or not. Pulse checks are not something laypersons should attempt since few have the skill to do a pulse well. There is a much greater chance of converting an arrest with immediate compressions.

As for differences between areas;

PC.02.01.11 EP4 requires that an evidence-based training program is used to train staff to recognize the need for and use of resuscitation equipment and techniques. It does not limit organizations to only Red Cross or AHA, although these are two of the better known programs. The specific requirement is that the program chosen is evidence based. Dr. Gupta is testing potential or expected standard changes.