First time doing CPR

As far as CPR itself, medics said I did well. I'm not sure; I was pressing hard and deep and there was much less chest recoil than I expected. Could it be because I pressed to hard, cracked many ribs and that prevented the chest from recoiling?

I'm a pretty big guy and have pressed pretty hard when doing compression and cracked more then my fair share of ribs -- I can't recall a time where I didn't see chest recoil.

Perhaps you are used to the way the manakins pop right back? A person doesn't respond quite the same same way. Just like I've always found it way easier to get a seal on a person then the manakins.
 
I'm a pretty big guy and have pressed pretty hard when doing compression and cracked more then my fair share of ribs -- I can't recall a time where I didn't see chest recoil.

Perhaps you are used to the way the manakins pop right back? A person doesn't respond quite the same same way. Just like I've always found it way easier to get a seal on a person then the manakins.



I'm ringing in usually >85kg. I've been the first responder on CPRs feeling the whole sternum pop... yes every joint. I still to this day do not believe I have broken a rib over > 30 pt's that i've done CPR on.

Yah they pop a little, but i highly doubt people are breaking ribs.
 
Yes, normally it is the cartilage popping.
 
rest assured

You are not the only one.

One of the best emergency physicians I have ever met broke down after her first night of residency. By the time her 3rd year came around she was a goddess among men.

It is all part of the experience.
 
Thank you all for your encouragement. It's nice to hear I'm not the only one who had difficulties first time out.
I did have a stool available and used it but even so, I was still too short to get deep enough compressions. I think that was my problem... But now I know for next time.
Thanks for all your stories! Keep them coming! Especially from those of you who have been in EMS forever.
 
Im a guy and i like being short. I can stand up in the back of the ambulance without having to duck or bend my head =p
 
For my first clinical in my EMT-B class, I signed up for 11p-7a in the ED. After a long quiet night, at 6:59am, a code came in and adrenaline kicked everyone into motion. The tech who was my proctor let me get in on the action. Unfortunately, apparently I wasn't tall enough to do effective CPR and the docs told me to just let the techs do compressions. After 20 min of CPR, the pt was still asystole and they took him up to the OR. Shift changed and I went home in tears.

Anyone else have an unsuccessful first attempt at CPR? What are your stories?

I qualified 15 years ago.. 2 days out of training I got my first arrest Pt. I can still remember exactly what the guy looked like and every intervention (although we called them treatments back then! hehe) I made and I remember how crap I felt when it didn't work.

I still get that feeling when one dies on me.. I've just now come to realise that it's a good feeling, it reminds me that i'm still human. It's not supposed to get any better... it just becomes easier to deal with!

You will get jobs that upset you. There will be jobs that leave you mad as hell and some that have you wondering why you bother, but hang on in there.. it's worth it ;)
 
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You can do picture perfect CPR and still break ribs,but if you don't do it,they're dead anyway.You cringe inside,thank God they can't feel it,and do what you have to do.
 
I had my first CPR experience a couple days ago too. He was a patient from an accident on one of the mountain passes here in Oregon. The patient was talking and LOC X 4 on the way in, unfortunately he coded the second the helicopter landed. I was with the nurses when we did a "hot off-load" on the helicopter pad (the cool part). Like you see them do in the movies one of the nurses hopped on the guy and started compressions while the rest of us wheeled him in the ER. I was determined to get the experience of "real" CPR despite the grim circumstance. I rotated doing compressions with the nurses for 30 minutes before they called it (the sad part). It was a surreal feeling seeing the life pass from somebody, but it's something I have prepared myself for coming into this career field...

It is sad, but good training to do the real thing and experience it first hand. It isn't even similar to the CPR dummies!

And as for the height thing. I'm not a very tall person (or heavy) so I found it slightly tough too, halfway through I just put my knees on the table to get some good leverage. Not so much about comfort but more about the life you're trying to save!
 
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I heard the pooping noise was caused from the bursting of air bubbles betwixt and between moving cartilage and muscle, can anyone confirm?
 
I heard the pooping noise was caused from the bursting of air bubbles betwixt and between moving cartilage and muscle, can anyone confirm?

Of course I meant to say popping noise, not pooping... :blush:
 
Most of the popping heard is the cartilage between the ribs and sternum, seperating.
 
CapnSmurf, wow! you actually witnessed a nurse doing cpr? most of the time it has been my experience that the ems crew, er tech or security usually end up doing compressions
nothing like riding the stretcher while holding on and doing compressions all while worring about dislodging the tube.
 
+1 for the stool.

I'm 6' 2" and while I can do compressions standing on the floor, you can use much more of your upper body if you're really standing over the patient.
 
I heard the pooping noise was caused from the bursting of air bubbles betwixt and between moving cartilage and muscle, can anyone confirm?

Of course I meant to say popping noise, not pooping...


Heh.. No, the pooping noise is the sphincter releasing. ;D But seriously. Two things to remember.

One, our ribcage is designed specifically to give structure to our thoracic cavity, allowing negative pressure caused by the diaphragm to suck air in during inspiration, and then passively push air out during exhalation without collapsing on itself like a beachball. It's also designed for protection of our internal organs... Hence why the heart is protected behind the ribs, deviated to the left, in its own little niche of the chest, in it's own shock-absorbing sac, behind strong chest muscles (and in some people, fat). It's arguably the most important organ, and the body therefore protects it the most. During CPR, your job is to manually squeeze this organ from the outside... If you aren't breaking ribs, you probably aren't going deep enough to effectively cause a compression of the heart to force blood into the system.

Second, as Vene said, it's perfectly natural to be very upset after certain calls, especially the first one. Our job requires us to see the worst (and occasionally, best) that life has to offer, and see it over and over. Everyone else's "worst day ever" becomes our typical work day. There -IS- a learning period where you adjust to this profession, and it can be confusing and eye-opening and emotional. And frankly, it scares me if people -DONT- have these reactions, because it makes me wonder if they truly care about patients or outcomes.

Just remember, you are still a human, and still have human emotions. It's perfectly acceptable to express them and deal with them, so long as it doesn't impact your patient care.
 
MEDIC802, the hospital doesn't have too many staff to utilize. They are really good at getting the students in on the action though. Once we got the patient into Trauma room 1 the helicopter crew came in and started helping with intubation and IV's. It's pretty neat seeing everyone working for the same thing and knowing exactly what to do.
 
It is amazing to watch when everything goes as expected, was not trying to be a smart a** with my comment earlier, just my experience is that the er nurses generally will not jump in and do compressions unless there is no other choice but this is at a larger ER with lots of help.
 
CPR for the first time

Just had my first full arrest pt. I was doing an 8 hour clinical in the ER. I was second to do compressions. The girl didn't make it, but it was a weird experience. Definitely will not be forgetting this experience.
 
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