Questions about CPR

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MrCurious

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I am considering eventually pursuing a career as an EMT. I know that EMT's perform CPR on people suffering from cardiac arrest. When i was in Boy Scouts, I was trained on how to do CPR on a dummy. And I was trained to put my mouth right onto the mouth of the person I am giving CPR to in order to blow air into the person's mouth. But since ambulances travel with a lot of medical equipment, EMT's might use some type of machine to blow air into a person's lungs when performing CPR on a person.

As a layman (not being a veteran EMT), I am a little bit grossed out and squeamish at the idea of putting my mouth on another man's mouth (or an ugly woman's mouth LOL) to perform CPR.

Do EMT's usually put their mouths on another person's mouth to blow air into a person's lungs when performing CPR? If so, weren't you kind of squeamish about this when you first did it?

Or do EMT's usually use a machine to blow air into another person's lungs when performing CPR?

How often do you personally perform CPR on a patient in your job as an EMT?

In percentage terms, How often does the person you are performing CPR on survive? I know you don't get statistics on this. So you don't know the exact percentages. But does the person you are performing CPR on survive most of the time?
 
No, we have a piece of equipment that does it for us. Also laypeople are generally taught hands-only cpr now..
 
To answer your questions specifically:

No, providers don't typically do mouth to mouth, they use a bag valve mask. If not using a BVM, they use a pocket mask that has a filter.

There are machines that will mechanically ventilate a patient, but in the first few minutes of the response we typically use a BVM.

As far as how often we typically perform CPR, It depends on many factors. A typical EMT responding to 911 calls in an active system might do CPR once every month or two. I never did CPR in the field.

The CPR survival rate is about 10%, but that doesn't speak to quality of life issues afterwards.

If you're hesitant to initiate CPR in the field, call 911 and begin hands only CPR.
 
MMiz said:
To answer your questions specifically:

No, providers don't typically do mouth to mouth, they use a bag valve mask. If not using a BVM, they use a pocket mask that has a filter.

There are machines that will mechanically ventilate a patient, but in the first few minutes of the response we typically use a BVM.

As far as how often we typically perform CPR, It depends on many factors. A typical EMT responding to 911 calls in an active system might do CPR once every month or two. I never did CPR in the field.

The CPR survival rate is about 10%, but that doesn't speak to quality of life issues afterwards.

If you're hesitant to initiate CPR in the field, call 911 and begin hands only CPR.
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Very interesting.

Why did you never do CPR in the field? Were you only an EMT for a very short time?
 
MrCurious said:
Very interesting.

Why did you never do CPR in the field? Were you only an EMT for a very short time?
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I believe the answer is due to @MMiz having a real job, in addition to an EMS job, and he didn't spend much time in a 911 system... Believe it or not, not every EMT is on an ambulance answering 911 calls.

I've done CPR more times than I can remember... however, the overwhelming number of EMS calls do NOT require CPR. Thankfully, people aren't dying left and right, lining the streets with dead bodies, requiring lots of 911 calls. and I haven't lip-locked anyone in the ambulance (well, not a patient anyway).

if you want to learn more about CPR, I encourage you to take a Basic Life Support (BLS) course through the American Heart Association. It will update much of your knowledge since your boy scout days.

cpr.heart.org

Basic Life Support (BLS)

Sign up for a Basic Life Support (BLS) course from the American Heart Association. Teaches basic life support skills for application in both prehospital and in-facility environments.
cpr.heart.org cpr.heart.org
 
MrCurious said:
Very interesting.

Why did you never do CPR in the field? Were you only an EMT for a very short time?
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Many in EMS are volunteers, or only work PRN or Part-Time, they do not work EMS as their Full-Time career (paying their mortgage, vehicles, food, etc.)

When I went thru Paramedic school in 1984, we were told the "average" length of time in EMS, for an individual was 5 years

I would hazard a guess that it's about the same now, or perhaps even less since COVID
 
In over ten years, I've never once put my mouth near a patient's mouth. OPA and a BVM.

I know old habits die hard, but in our district we teach hands-only CPR in the schools.
 
chriscemt said:
In over ten years, I've never once put my mouth near a patient's mouth. OPA and a BVM.

I know old habits die hard, but in our district we teach hands-only CPR in the schools.
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Almost the same. my very first call was cpr in a snowbank and I've performed it probably 3 dozen time since then. Never put my mouth on a patient...it was always OPA or Combi-tube
 
I would never put my mouth on a patients. We have BVMs that are used to breathe for someone when they are unable. Be it dead or just not able to breathe adequately on their own. Unfortunately, most don’t survive. The out of hospital cardiac arrest survival rate is really low. Out of the 7 I have ran, only one has survived.
 
bdoss2006 said:
I would never put my mouth on a patients. We have BVMs that are used to breathe for someone when they are unable. Be it dead or just not able to breathe adequately on their own. Unfortunately, most don’t survive. The out of hospital cardiac arrest survival rate is really low. Out of the 7 I have ran, only one has survived.
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I was talking to my dad about this last night. And he also made a distinction between cardiac arrest survival rates inside a hospital and outside a hospital just like you did. My dad said that a person suffering from cardiac arrest has a much higher chance of survival inside a hospital than inside an ambulance. Do you have any thoughts on that?
 
MrCurious said:
I was talking to my dad about this last night. And he also made a distinction between cardiac arrest survival rates inside a hospital and outside a hospital just like you did. My dad said that a person suffering from cardiac arrest has a much higher chance of survival inside a hospital than inside an ambulance. Do you have any thoughts on that?
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It’s a much more controlled environment with doctors that can do more. Plus most out of hospital cardiac arrests that we encounter have had a long downtime. If you just count the ones that code in the back of the truck (which is less frequent), the rate would probably be higher.
 
Out of the dozens of times I've done CPR on an ambulance, I've only had one save that lived beyond 24 hours. It was a witnessed arrest where one of our department's EMT watched her son collapse at school
 
MrCurious said:
My dad said that a person suffering from cardiac arrest has a much higher chance of survival inside a hospital than inside an ambulance. Do you have any thoughts on that?
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This needs clarification: the over whelming majority of people treated by EMS don't go into cardiac arrest in an ambulance. 99 times out of a 100, they are somewhere that isn't the back of an ambulance, so you have the built in delay of notification, having responders arrive on scene, and initiating CPR. Depending on where you live, that could be anywhere from 30 seconds to 30 minutes, and every minute after a cardiac arrest occur decreases survival rates by 10%. Rural areas, 30 minute ambulance response time is not uncommon, but inner city responses can be as short at 30 seconds for the closest engine or BLS ambulance, with additional resources coming from another part of the city or from a neighboring city.

In a hospital, you have nurses/techs every 100ft or so, and continuous monitoring occurring that is transmitting to a nurses station, so if a lethal rhythm is detected, your response times can be as short at 30 seconds (when the first person arrives) to 3-5 minutes when the entire team of multiple doctors, nurses, and techs arrive with additional equipment.

It's not an apples to apples comparison, but more like an apples to watermelons; both are fruit, and they have seeds, but that's where the similarities end.
 
MrCurious said:
Very interesting.

Why did you never do CPR in the field? Were you only an EMT for a very short time?
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I worked PRN, a few shifts a month, on the midnight shift on a BLS ambulance. Though we responded to 911 calls, the majority of our calls were patient discharges, dialysis runs, and and non-emergent transports. You do enough of those and you'll surely do CPR, but I wasn't in EMS long enough.

The few times CPR I witnessed CPR being performed it either wasn't my patient or wasn't my place to get involved. The first time was an infant in a hospital during a clinical rotation. A nurse or doctor was performing CPR with an entire qualified code team. The second time fire was on scene and we showed up at the same time as a an ALS rig, they took the call. There was no shortage of BLS firefighters on scene to support them.

Towards the end of my career on the truck our protocols changed to work cardiac codes on scene for 30 minutes before calling it or transporting. When that happened they transitioned from dispatching one ALS and one BLS unit to dispatching 2 ALS ambulances and a often an ALS quick response unit to allow the CPR compressor role to rotate.
 
This thread reminds me how the role of prehospital CPR has changed. When I started in EMS, a solo medic in back during a cardiac arrest was expected to assess an EKG, make a defib decision, intubate, ventilate, start a line, push drugs, and maybe do some chest compressions en route. There were no widely available mechanical devices to help with that.

Other than timely defib and a good tube, anything else we did instead of CPR probably had less than a 1% chance of making a difference. For every 100 fatal arrests, perhaps 10 could have survived if the priorities had been different.
 
mgr22 said:
This thread reminds me how the role of prehospital CPR has changed. When I started in EMS, a solo medic in back during a cardiac arrest was expected to assess an EKG, make a defib decision, intubate, ventilate, start a line, push drugs, and maybe do some chest compressions en route. There were no widely available mechanical devices to help with that.
Click to expand...

Did you do mouth to mouth resuscitation when performing CPR when you first became an EMT?
 
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