One handed compressions

[shorthairedpunk]

As a time saver, I do compressions during CPR one handed, to free my other hand for settin up IVs, mesin with the monitor, radio callins, etc.. THe compressions are good, before anyone asks, strong pulses and good monitor show. The trick is that I dont push, I rock my wrist down (I swing hammers alot so my forearms are strong for this, and I have long hands so I can get up to a 4 inch compression effectively if neccessary). Using this method you can do compressions for over an hour and not break a sweat. Anybody else do this?

 

[emtbuff]

Nope cant say I do. When ever I have to do compressions I use both hands. One reason being that I probley counldn't get deep enough. And the second being we normally have more than enough people on duty.

 

[ffemt8978]

Only in the back of the ambulance doing 90+ mph and hanging on to the overhead bar.

 

[Jon]

Originally posted by ffemt8978@Feb 27 2005, 01:16 AM
Only in the back of the ambulance doing 90+ mph and hanging on to the overhead bar.

Or when I'm trying to do compressions on the pt. on the strecher going into the ED....

Jon

 

[ffemt8978]

Originally posted by MedicStudentJon+Feb 27 2005, 12:01 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Feb 27 2005, 12:01 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-ffemt8978@Feb 27 2005, 01:16 AM
Only in the back of the ambulance doing 90+ mph and hanging on to the overhead bar.

Or when I'm trying to do compressions on the pt. on the strecher going into the ED....

Jon [/b][/quote]
AKA Code Surfing

 

[40sCutest]

I haven't had to do compressions at all yet.... My boyfriend complains about doing compressions and how tired they make him so maybe I will suggest this to him.

 

[Wingnut]

I don't see how that's possible. I had a hard enough time not falling on the patient or into the medic that was working him while I was doing them.

 

[MedicPrincess]

I've seen them done on Scene. But I personally have only done them in the back of the Med Unit on the way to the hospital. Holding onto the "Uh-Oh" bar is a necessity then.

 

[cbdemt]

I'm not saying that its impossible to provide adequate compressions with one hand, especially if its the only option. Something's better than nothing. My only concern is that the vast majority of us probably can't get the job done with one hand. (minds out of the gutter please! ) I'd just watch out who sees you doing this, especially newbies. Just make sure they know the importance of good compressions and that two hands (in most cases) are better than one.

 

[medic03]

Originally posted by ffemt8978@Feb 27 2005, 01:16 AM
Only in the back of the ambulance doing 90+ mph and hanging on to the overhead bar.

what's the point of going +90 down the road? it will only lead to another dead person when someone crashes. no reason to go that fast. take the extra min and get to the ER safely.

 

[ffemt8978]

Originally posted by medic03+Feb 28 2005, 10:29 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (medic03 @ Feb 28 2005, 10:29 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-ffemt8978@Feb 27 2005, 01:16 AM
Only in the back of the ambulance doing 90+ mph and hanging on to the overhead bar.

what's the point of going +90 down the road? it will only lead to another dead person when someone crashes. no reason to go that fast. take the extra min and get to the ER safely. [/b][/quote]
It's sixty miles to the nearest ED from where we're at. At that distance, every minute counts.

 

[shorthairedpunk]

the speed at which one travels in an ambulance is irrelevant. It is the skill of the driver that matters. I have a few people where I work that I call to drive when we have a bad transfer going out that needs to be there yesterday, I know they can handle a rig at 90+ mph. Then theres a few i work with that scare the hell out of me at 30 mph. Its not spped, its skill that sets the level of danger.

 

[Jon]

Originally posted by ffemt8978+Mar 1 2005, 02:04 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (ffemt8978 @ Mar 1 2005, 02:04 AM)</td></tr><tr><td id='QUOTE'>

Originally posted by medic03@Feb 28 2005, 10:29 PM
<!--QuoteBegin-ffemt8978

@Feb 27 2005, 01:16 AM
Only in the back of the ambulance doing 90+ mph and hanging on to the overhead bar.

what's the point of going +90 down the road? it will only lead to another dead person when someone crashes. no reason to go that fast. take the extra min and get to the ER safely.

It's sixty miles to the nearest ED from where we're at. At that distance, every minute counts. [/b][/quote]
Ummm....Last time I checked, they don't save most prehospital codes that are still in arrest at the ED. Even better discussion is "should we run hot on code transports"

The point has been raised by several EMS greats that it doesn't make sense to run hot with a virtual coprse in the back of your rig, and that Arrests should be non-emergency transport, because if you haven't saved the patient in the first few minutes, you aren't going to, and the risk / benifit ratio isn't worth it at all.

So I have to agree with medic03 on this one.

Plus, if you have a 60mile distance, what is the ALS protocol for field pronouncement?

Jon

 

[rescuecpt]

Besides the fact that in most places it is illegal for even ambulances to do ninety... I have to find the code on that, but I'm close to positive that in NY it's 10 miles over the speed limit (although we break that all the time of course) but it comes down to liability in the event of an accident.

 

[ffemt8978]

In WA we just have to drive with due care. Also, like I said before, it's 60 miles to the nearest hospital on some very deserted desert roads. In town or in traffic, we don't drive that fast.

I'm not sure what the ALS protocols are for field pronouncement of death, but ours involve having to call medical control for those situations. I understand the part about resucitation efforst over the first 10 minutes, which is why my department doesn't usually transport field codes. We work them an call in for permission to stop working them.

The incident I was referring to in my first post dealt with a retired FF/City Council member from my previous department. That was an ALS unit that took two of my department's EMT's with them to work him while in route to the hospital. The trip was 15 miles, all of which was on the interstate. 90mph on the interstate isn't as dangerous as 90mph on a two lane county road.

 

[shorthairedpunk]

Originally posted by MedicStudentJon+Mar 1 2005, 12:02 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Mar 1 2005, 12:02 PM)</td></tr><tr><td id='QUOTE'>

Originally posted by ffemt8978@Mar 1 2005, 02:04 AM

Originally posted by medic03@Feb 28 2005, 10:29 PM
<!--QuoteBegin-ffemt8978

@Feb 27 2005, 01:16 AM
Only in the back of the ambulance doing 90+ mph and hanging on to the overhead bar.

what's the point of going +90 down the road? it will only lead to another dead person when someone crashes. no reason to go that fast. take the extra min and get to the ER safely.

It's sixty miles to the nearest ED from where we're at. At that distance, every minute counts.

Ummm....Last time I checked, they don't save most prehospital codes that are still in arrest at the ED. Even better discussion is "should we run hot on code transports"

The point has been raised by several EMS greats that it doesn't make sense to run hot with a virtual coprse in the back of your rig, and that Arrests should be non-emergency transport, because if you haven't saved the patient in the first few minutes, you aren't going to, and the risk / benifit ratio isn't worth it at all.

So I have to agree with medic03 on this one.

Plus, if you have a 60mile distance, what is the ALS protocol for field pronouncement?

Jon [/b][/quote]
I never looked at the transport from that angle. Running hot is kind of silly when you think about it. I think I might pose this to the EMS coordinator. Personally Im all for not working them, but its hard to get everyone on scene here to agree to that and it takes 100% here to call it in the field.

 

[Summit]

Originally posted by shorthairedpunk@Mar 1 2005, 11:45 AM
the speed at which one travels in an ambulance is irrelevant. It is the skill of the driver that matters. I have a few people where I work that I call to drive when we have a bad transfer going out that needs to be there yesterday, I know they can handle a rig at 90+ mph. Then theres a few i work with that scare the hell out of me at 30 mph. Its not spped, its skill that sets the level of danger.

I agree with this statement.

The fastest I've ever driven an ambulance is 85 (vs 125 in my POV). I don't think our rigs can go 90+... no mountain road here is straight enough long enough to even accelerate to that speed. We'd have to be going down the mountain on the interstate and then the road is far too curvy to exceed 75 most of the time for anyone, or the hill goes back up steeply and you have to floor it to keep above 55.

:unsure:

I don't know what we do with our codes. I've been on the county ambulance service for 3 months and there has yet to be a code in that time that anyone even tried to work (a guy who played pingpong with two Union Pacifics and a lady who catapulted her Minivan off a 60ft cliff doing 90+).

 

[daemonicusxx]

Originally posted by MedicStudentJon+Mar 1 2005, 12:02 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Mar 1 2005, 12:02 PM)</td></tr><tr><td id='QUOTE'>

Originally posted by ffemt8978@Mar 1 2005, 02:04 AM

Originally posted by medic03@Feb 28 2005, 10:29 PM
<!--QuoteBegin-ffemt8978

@Feb 27 2005, 01:16 AM
Only in the back of the ambulance doing 90+ mph and hanging on to the overhead bar.

what's the point of going +90 down the road? it will only lead to another dead person when someone crashes. no reason to go that fast. take the extra min and get to the ER safely.

It's sixty miles to the nearest ED from where we're at. At that distance, every minute counts.

Ummm....Last time I checked, they don't save most prehospital codes that are still in arrest at the ED. Even better discussion is "should we run hot on code transports"

The point has been raised by several EMS greats that it doesn't make sense to run hot with a virtual coprse in the back of your rig, and that Arrests should be non-emergency transport, because if you haven't saved the patient in the first few minutes, you aren't going to, and the risk / benifit ratio isn't worth it at all.

So I have to agree with medic03 on this one.

Plus, if you have a 60mile distance, what is the ALS protocol for field pronouncement?

Jon [/b][/quote]
IMHO ffemt8978 is expressing my point of view. i would use my better judgement. if there is any chance of saving the person, i would be going fast. not 90, but 75 sounds right, depending on traffic. my partner is very good at handling a box at that speed. opticom helps too. what if the family is in the medic, up front? i would want to be seen doing everything possible. what if they are following you in a private vehicle? you go into the definiton of death. what rythms people consider savable. is your patient decapitated? Bilat leg amputations? what is savable? I guess there are valid arguments on creating more patients by having an accident. the other day i read somewhere in our protocols that we stop for school busses and go the speed limit in school zones while running code. that i understand. i would just use my better judgement on the driving, considering all aspects.

 

[medic03]

Originally posted by shorthairedpunk@Mar 1 2005, 11:45 AM
the speed at which one travels in an ambulance is irrelevant. It is the skill of the driver that matters. I have a few people where I work that I call to drive when we have a bad transfer going out that needs to be there yesterday, I know they can handle a rig at 90+ mph. Then theres a few i work with that scare the hell out of me at 30 mph. Its not spped, its skill that sets the level of danger.

and when that little old lady pulls out in front of the rig going +90 and you slam into her, the lawyers are going to have a field day on you. People, I'm telling you it is stupid and so wrong to go that fast in an ambulance. If one person blows a red light as you are crossing the intersection or pulls out in front of you, there is no way anyone can manuver a rig at 90 mph and you will hit something or even worse someone. at 60 miles to the nerest ED, well they are dead aren't they, so that extra min or so isn't going to matter now is it. I use to volly in New York and I see so many young, new ems providers go mach 1 down the road it's scary. They have no idea that they can be taken for everything if they are speeding and the courts find it was unjust for that speed. Please people, just be careful.

 

[Summit]

Originally posted by medic03+Mar 4 2005, 08:34 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (medic03 @ Mar 4 2005, 08:34 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-shorthairedpunk@Mar 1 2005, 11:45 AM
the speed at which one travels in an ambulance is irrelevant. It is the skill of the driver that matters. I have a few people where I work that I call to drive when we have a bad transfer going out that needs to be there yesterday, I know they can handle a rig at 90+ mph. Then theres a few i work with that scare the hell out of me at 30 mph. Its not spped, its skill that sets the level of danger.

and when that little old lady pulls out in front of the rig going +90 and you slam into her, the lawyers are going to have a field day on you. People, I'm telling you it is stupid and so wrong to go that fast in an ambulance. If one person blows a red light as you are crossing the intersection or pulls out in front of you, there is no way anyone can manuver a rig at 90 mph and you will hit something or even worse someone. at 60 miles to the nerest ED, well they are dead aren't they, so that extra min or so isn't going to matter now is it. I use to volly in New York and I see so many young, new ems providers go mach 1 down the road it's scary. They have no idea that they can be taken for everything if they are speeding and the courts find it was unjust for that speed. Please people, just be careful. [/b][/quote]
Everyone would agree it's lunacy to go this fast in city streets with regular intersections. On country roads and limited access highways its another story entirely. Not everyone lives in an urban jungle