Resus video
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NomadicMedic
I know a guy who knows a guy.
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Nope. Far too much time with hands off the chest, they stopped compressions during the excessively long intubation attempt. Many cycles before compressor change. Not a great code, but he appeared to be in asystole from the beginning... So at best, it was a skill station.
A good example of how to NOT perform high performance CPR.
The medics leaving their yellow pelican ALS box on the scene as the pick up truck drove away was a classy move too.
A good example of how to NOT perform high performance CPR.
The medics leaving their yellow pelican ALS box on the scene as the pick up truck drove away was a classy move too.
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Years ago, this was how a typical "good" code worked. Now it is a poor example as for the reasons mentioned above by DEmedic.
NomadicMedic
I know a guy who knows a guy.
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And to be honest, I've been on codes like this. Recently.
You really have to be a strict taskmaster to keep everyone focused on running a good code when you're striving for a high compression factor and really minimizing hands off time. Having Physio code stat and actual metrics to look at immediately following a code are great ways to reinforce keeping the compressions constant. Our Lucas device does a great job of pounding away, but you have to watch the perishock pauses.
You really have to be a strict taskmaster to keep everyone focused on running a good code when you're striving for a high compression factor and really minimizing hands off time. Having Physio code stat and actual metrics to look at immediately following a code are great ways to reinforce keeping the compressions constant. Our Lucas device does a great job of pounding away, but you have to watch the perishock pauses.
medicasaurus
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I don't understand what the rush for the C-Collar is... seriously the guy is in cardiac arrest. Most likely due to mechanical asphyxiation so my priorities would be trying to work that water out and maintaining the airway. I probably wouldn't even think C-Collar unless I got pulses back.
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Indeed. Really if at all possible you need one person whose only assignment is to quarterback the entire operation. I realize that this isn't possible with many agency's staffing configurations, but if it's possible it's certainly advisable.
Usually we get a P/B ambulance and two-five FF/EMTs. We try and have the fire guys rotate between CPR and bagging but a lot of them are loathe to switch after 200 compressions because they don't *feel* tired yet. I wish we had a monitor that could show CPR quality, I think that would show the switches need to be made earlier. We do our best to coach them but it can be a challenge at times.
Generally when we arrive behind fire I'll get the patient on our monitor while the medic sets up an IO. He looks at the rhythm, advises shock or no shock, and then drills the patient. Once the needle is in I'll get a line set up and give the medications at his request. He moves to the head and starts on intubation. At the next rhythm check he'll interpret and advise on shocking. This can leave me with a lot of idle time, so I do my best to try and orchestrate people and minimize off chest time.
IslandTime
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The Philips MRX units we use have an optional "puck" that is placed between the patient's chest and the Hands of the person administering CPR. It provides visual feedback as the the depth of compressions and the rate. The data is stored in memory and can be reviewed latter. I don't know if effectiveness can be monitored in real time, other than by watching the indicators on the puck.
One interesting feature is that it attempts to show circulation. This provides a vivid illustration of what happens internally when the hands are off the body, and how long it takes to get things moving again once you restart compressions.