rescue breathing

In my area we use AHA guidelines,

Here's a link to all the PALS info ( little dated @ 2005 )

http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-167

Something to note:

Precautions
Victims of cardiac arrest are frequently overventilated during resuscitation.12–14 Excessive ventilation increases intrathoracic pressure and impedes venous return, reducing cardiac output, cerebral blood flow, and coronary perfusion.13 Excessive ventilation also causes air trapping and barotrauma in patients with small-airway obstruction and increases the risk of stomach inflation, regurgitation, and aspiration.

Minute ventilation is determined by the tidal volume and ventilation rate. Use only the force and tidal volume needed to make the chest rise visibly.
 
I'm quite confused about what you want.

--> Are you talking about ventilating an apneic pt. If so:
Neonates: 40-60 pretty much anywhere you look. There is no specific number of 1-2 seconds or anything like that kicking around anywhere as far as I know.
Infants and Children - depends how you break it down and group people into age blocks. You won't find a number set in stone for venting "children" because its changes based on age and how much you need to achieve with the ventilation. In general, you ventilate usually with a target rate of somewhere near the normal resp rate range for that age. Particular agencies probably set numbers in stone in protocols and it would simply depend on that agency. Memorise it when you start working for them. If you want a rough idea of resp rates for ages, then any number of googlable web pages can help you out.

OR

-->Are you talking about ventilations during CPR? You keep mentioning compressions. If so whats wrong with the ratio? You won't be ventilating "every number-number" during CPR. You simply follow your ratio of compression to ventilations unless you have an advanced airway and you were quite clear that this is a BLS question. If you really want a number, figure it out from your CPR ratio over two minutes, but I can't see any benefit in doing that.



Ultimately though, if you're just after a number to make you feel better, then surely whatever nearby agency that you want to work for can provide you with protocols.
 
MrBrown said:
What is this, first aid class in the fifties?

If you are doing CPR it's 30:2 no matter who

If you are manually ventilating with a bag mask adults is 8-10 breaths a minute and children 16-20 .... or if you have an asthmatic patient then six breaths a minute and not more.
Click to expand...

It nust be the 50's because you are wrong. Our local protocols dictates a 3:1 ratio for newborns.
 
Melclin said:
I'm quite confused about what you want.

--> Are you talking about ventilating an apneic pt. If so:
Neonates: 40-60 pretty much anywhere you look. There is no specific number of 1-2 seconds or anything like that kicking around anywhere as far as I know.
Infants and Children - depends how you break it down and group people into age blocks. You won't find a number set in stone for venting "children" because its changes based on age and how much you need to achieve with the ventilation. In general, you ventilate usually with a target rate of somewhere near the normal resp rate range for that age. Particular agencies probably set numbers in stone in protocols and it would simply depend on that agency. Memorise it when you start working for them. If you want a rough idea of resp rates for ages, then any number of googlable web pages can help you out.

OR

-->Are you talking about ventilations during CPR? You keep mentioning compressions. If so whats wrong with the ratio? You won't be ventilating "every number-number" during CPR. You simply follow your ratio of compression to ventilations unless you have an advanced airway and you were quite clear that this is a BLS question. If you really want a number, figure it out from your CPR ratio over two minutes, but I can't see any benefit in doing that.



Ultimately though, if you're just after a number to make you feel better, then surely whatever nearby agency that you want to work for can provide you with protocols.
Click to expand...


Thank you.

I was refering to an apnic patient, ie, a pulse but no breathing.

I am in New York City. Unless I missed it, the protocols for the city or the state of New York do not adress it. Nor did my emt-b class.

My class taught 1:5-6 adult, and 1:3-5 for children but did not address infants or neo-nates.

I will certainly ask that question when employed, just using the forum for some thoughts.

I realize the street and book are two different things....
 
Keep in mind that it's highly unlikely you'll see an infant/neo nate that is apneic with a pulse.
 
Also, the compression:breath rate should be 30:2 for everyone, the only exception being infants during 2 rescuer cpr. Your local protocols may dictate otherwise. If, consider trying to change them.
 
reaper said:
Really? Where are you getting this from?
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Field experience, and the system that has the highest percentage of SCA saves in the United States. I'm not saying it's not possible, just that in an infant, once breathing stops, cardiac arrest is typically almost imminent.
 
jms81 said:
Field experience, and the system that has the highest percentage of SCA saves in the United States. I'm not saying it's not possible, just that in an infant, once breathing stops, cardiac arrest is typically almost imminent.
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That must be a big head! Do you truly believe the percentages? I have worked dozens of resp arrest neonates and infants, that still had pulses.
 
reaper said:
That must be a big head! Do you truly believe the percentages? I have worked dozens of resp arrest neonates and infants, that still had pulses.
Click to expand...

Sorry, I had no intention of offending you if that's what I did. I would think everyone could be respectful of each other here. Guess I was wrong.

BTW, like I said, I was speaking from experience, and yes, statistics. If you don't believe in statistics, I won't try to convince you.
 
I believe that would statistically be incorrect, just sounds not correct. Matter of fact.... 9 out of 10 adults who are apneic for more than 4 minutes often suffer cardiac arrest.
 
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MasterIntubator said:
I believe that would statistically be incorrect, just sounds not correct. Matter of fact.... 9 out of 10 adults who are apneic for more than 4 minutes often suffer cardiac arrest.
Click to expand...

Good point that it applies to adults too.
 
50's?

MrBrown said:
What is this, first aid class in the fifties?

If you are doing CPR it's 30:2 no matter who

If you are manually ventilating with a bag mask adults is 8-10 breaths a minute and children 16-20 .... or if you have an asthmatic patient then six breaths a minute and not more.
Click to expand...

Per the new BLS protocalls, Two - Person CPR on an Infant will be 15:2. (Someone correct me if im wrong)
 
From the American Heart Association

CPR for Newborns
Recommendations for the newborn are different from recommendations for infants. Because most providers who care for newborns do not provide care to infants, children, and adults, the educational imperative for universal or more uniform recommendations is less compelling. There are no major changes from the ECC Guidelines 2000 recommendations for CPR in newborns28:

The rescue breathing rate for the newborn infant with pulses is approximately 40 to 60 breaths per minute.

When providing compressions for newborn infants, the rescuer should compress to one third the depth of the chest.

For resuscitation of the newborn infant (with or without an advanced airway in place), providers should deliver 90 compressions and 30 ventilations (about 120 events) per minute.

Rescuers should try to avoid giving simultaneous compressions and ventilations
Click to expand...
 
VirginiaEMT said:
It nust be the 50's because you are wrong. Our local protocols dictates a 3:1 ratio for newborns.
Click to expand...

True, but that's ONLY neonatal resuscitation, a limited application. Every other category of patient gets 15:2 or 30:2, and I'd use those rates, based on the patient's heart rate range to get a judgment of what a good respiratory rate would be.

And then, if I was manually ventilating the patient, I'd use every ounce of myself to slow down a little further.

People bag too fast, and cause barotrauma.
 
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