Single Rescuer CPR

EMTProject

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Ok, so basically I only work for a private ambulance company right now and so any call that we do is always only me and a partner. Say you have a patient in the back and your partner is driving when your patient goes into cardiac arrest. You're still 10 minutes out from any hospital, what do you do? Obviously I know CPR needs to be started but since it's only you back there in a moving vehicle would you immediately just start chest compressions and do those continuously? Hook up the AED? Get out the BVM and get his airway prepared for breaths? I am just confused because there are a lot of things that need to be done in order to effectively give CPR and I feel like chest compressions are the most important but can you really afford to interrupt chest compressions to try and find all the other stuff (BVM, AED and pads) and get it all together on the patient?
 

Tigger

Dodges Pucks
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Ok, so basically I only work for a private ambulance company right now and so any call that we do is always only me and a partner. Say you have a patient in the back and your partner is driving when your patient goes into cardiac arrest. You're still 10 minutes out from any hospital, what do you do? Obviously I know CPR needs to be started but since it's only you back there in a moving vehicle would you immediately just start chest compressions and do those continuously? Hook up the AED? Get out the BVM and get his airway prepared for breaths? I am just confused because there are a lot of things that need to be done in order to effectively give CPR and I feel like chest compressions are the most important but can you really afford to interrupt chest compressions to try and find all the other stuff (BVM, AED and pads) and get it all together on the patient?
Start compressions and pull over. Work it like any other arrest.
 

DrParasite

The fire extinguisher is not just for show
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I will add to what @Tigger said.. pull over and call for help (FD, second BLS ambulance, paramedics, etc).

From a practical standpoint, hook up the AED first, and see if you can shock the patient. CPR is only 30% as effective as the actual beating heart, so if you do get ROSC, that's one less thing to worry about. than do airway and monitor on the way to the hospital.

Also, it's your truck, that you checked at the beginning of your shift. you should know where everything is. so yes, it might take you 3 seconds to grab the BVM, 1 to get the AED, etc, but tell your partner to pull out, call for help, and assist you with the cardiac arrest.
 

NomadicMedic

EMS Edumacator
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Compressions.
Yell at your partner to pull over and come back to help you.
When he gets there, apply the AED.
Someone call for additional assistance.
Stay where you are, doing KICKASS CPR until help gets there.

Your BEST chance to save a witnessed arrest is high quality CPR and a shock as soon as it can be delivered, if indicated.
 

johnrsemt

Forum Deputy Chief
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Been there, done that; it sucks, and even more fun when dispatch doesn't believe you.

Tell partner to tell dispatch on the radio, then call 911 on cell phone
 

VFlutter

Flight Nurse
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there are a lot of things that need to be done in order to effectively give CPR and I feel like chest compressions are the most important but can you really afford to interrupt chest compressions to try and find all the other stuff (BVM, AED and pads) and get it all together on the patient?
You can skip the BVM however the AED is mandatory. Perform two minutes of quality compressions then pause and get the AED, preferably within 10 seconds. If it takes longer make sure that you do some compression prior to analyzing for a shock.
 

NPO

Forum Deputy Chief
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Witnessed arrests get the AED right away.
Shock if indicted.
Provide compressions non-stop until additional help arrives (partner, FD, ALS, etc).

Everything else is of secondary importance.
Heck, we don't even use a BVM on cardiac arrests until after intubation which is several cycles in the algorithm. They get high flow nasal cannula until then.
 

TheEleventhHour

Forum Crew Member
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Witnessed arrests get the AED right away.
Shock if indicted.
Provide compressions non-stop until additional help arrives (partner, FD, ALS, etc).

Everything else is of secondary importance.
Heck, we don't even use a BVM on cardiac arrests until after intubation which is several cycles in the algorithm. They get high flow nasal cannula until then.
Nasal Cannula even if they're not breathing on their own? I'm asking because I seen something similar a while back where a patient went into Cardiac Arrest & instead of ventilations I witnessed the RN place an oxygen mask on them... or maybe I'm misunderstanding what you meant.
 

VFlutter

Flight Nurse
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Nasal Cannula even if they're not breathing on their own? I'm asking because I seen something similar a while back where a patient went into Cardiac Arrest & instead of ventilations I witnessed the RN place an oxygen mask on them... or maybe I'm misunderstanding what you meant.
Yes, high flow NC or NRB.

Think of how oxygenation works. Which gas law? Also there is some degree of air movement with compressions.

Do you do apenic oxygenation during intubation?

Another good example is if you ever get the chance to see a brain death exam when intubated patients are taken off the ventilator and left on just a T piece with oxygen
 
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