NO CPR is better than moving CPR...true or false?

VFlutter

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What about the one handed CPR shuffle firefighters love to do?

There is a tiny ICU nurse that is know for jumping on the bed and straddling the patient for CPR. One time they wheeled down to the OR with her on top pumping away....That was a sight.
 
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Medic Tim

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What about the one handed CPR shuffle firefighters love to do?

There is a tiny ICU nurse that is know for jumping on the bed and straddling the patient for CPR. One time they wheeled down to the OR with her on top pumping away....That was a sight.

There are studies that show they are just as effective as traditional compressions...... if you are wheeling the stretcher on flat even ground. I am sure I can dig a few up if anyone wanted to see them...............completely different from doing it in a moving ambulance.
 

Handsome Robb

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Or you could work the pt on scene then transport if you get rosc. If it is ineffective and unsafe for providers what is the point?

/thread
 

Medic Tim

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Here is some video of CPR in a moving ambulance in Thailand http://www.youtube.com/watch?v=24Hn3X_pxD0&list=PLV31vpWtnO2HprwoE21xIqyITGkc9xROj&index=18 The person doing the compressions looks to be doing good despite standing in a moveing vehicle. could it be the size of the ambulance that makes the difference?

Unless you are driving like 5 mph on straight, flat , level ground you will not have good compressions .

And to kick a dead horse a little more.. it is not safe at all.
 

KellyBracket

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I've heard this said a few times on this forum, that CPR in an ambulance is not worth it.

I wonder if any hospital people, MD's or medical directors would like to comment?

I wonder if anyone would like to defend doing CPR riding on a gurney down a hospital hallway over doing CPR in a moving ambulance?

OR is this really just a thread about calm smooth safe driving with patients, er, people in the back?

As an ER doctor, I don't think that, in general, it's worth it. There can be extenuating circumstances, but there are numerous challenges to keeping up quality resuscitation during transport, and I don't have to review those here. And despite the appeal of the mechanical CPR devices, I don't believe that these change the bottom line much.

I think you'll find most (all?) EMS-astute physicians see this issue similarly.
 
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mycrofft

mycrofft

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Originally Posted by KellyBracket
And we didn't even bring up the "lights and sirens" issue
!


Until you did. :rofl:

Thanks. Nor the whole "My bus is as good as your ER" thing...;)
 
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mycrofft

mycrofft

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"icwidt"?
 

KellyBracket

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Trying to incorporate the internet "meme" ICWUDT was my attempt to be more relevant to the youngsters, with their Twitter and AOL.
 
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mycrofft

mycrofft

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Just a couple of hep cats, we are...but you're hepper than I.
 

TheLocalMedic

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Here is some video of CPR in a moving ambulance in Thailand http://www.youtube.com/watch?v=24Hn3X_pxD0&list=PLV31vpWtnO2HprwoE21xIqyITGkc9xROj&index=18 The person doing the compressions looks to be doing good despite standing in a moveing vehicle. could it be the size of the ambulance that makes the difference?

Their compressions are terrible in the ambulance. Maybe an inch in depth? All that upper body motion is actually him just bouncing with the dips in the road and if you watch all of their hands closely you'll see that they're actually not pressing straight down but in more of a circular motion so they lose a lot of depth for the effort they're putting in.

Don't transport a working code. Just don't do it. There isn't a point to send them somewhere else that's going to do exactly what you should be doing.
 

kaaatielove

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Their compressions are terrible in the ambulance. Maybe an inch in depth? All that upper body motion is actually him just bouncing with the dips in the road and if you watch all of their hands closely you'll see that they're actually not pressing straight down but in more of a circular motion so they lose a lot of depth for the effort they're putting in.

Don't transport a working code. Just don't do it. There isn't a point to send them somewhere else that's going to do exactly what you should be doing.

:beerchug:
 

med109

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I have never heard of "not transporting a working code" We always load and go, and work the code on the way to the hospital. I see how CPR wouldn't be as good, and the dangers to providers. So can you all enlighten me? It seems like the thing to do is work it on scene for "X" amount of time, and only transport if ROSC. If no ROSC call it on scene. Am I correct?

We are about 50/50 ALS and BLS, our basics can't call on scene. If they arrive and the patient is obviously dead (rigor, lividity ect) then they can call the Dr and he will advise. However, if the patient was witnessed, or CPR is in progress, then they load and do CPR until they meet ALS rig or the ER.

We are obviously a rural department, so I am just curious about the protocols involved in this.
 

RocketMedic

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As long as you keep the switch off within 10 seconds there is no harm done. And it's a lot safer than trying to provide compressions while standing or being half on a seat.

Or you can just buy a mechanical CPR machine and get effective compressions...
 

systemet

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I have never heard of "not transporting a working code" We always load and go, and work the code on the way to the hospital. I see how CPR wouldn't be as good, and the dangers to providers. So can you all enlighten me? It seems like the thing to do is work it on scene for "X" amount of time, and only transport if ROSC. If no ROSC call it on scene. Am I correct?

The factors that are important in surviving an out of hospital cardiac arrest are pretty much: pre-existing health status, cause of the arrest, whether it was witnessed, prompt and effective bystander CPR, and early defibrillation. BLS can do all of this.

The only people who probably should be transported are potential hypothermic arrests, penetrating trauma within about 15 mins of a trauma center and patients with ROSC.
 

ITBITB13

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I'm for CPR during transport. I had my second save this past Wednesday. Worked up and shocked en-route, and we dropped off the patient with a bp of 160/90, and in sinus tach @ 104. :cool::cool:
 
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