CAB instead of ABC

[Ga-Lin 86]

Sorry, I wasn't sure what forum to post this to since it concerns all emergency service responders, EMS, FD & PD. New American Heart Assoc. guidelines issued today now recommend 30 hard & fast compressions 1st, for all cardiac arrest victims. This had been the recommendation for the lay public it is now recommended for all lay public & professional rescuers.

[PFDRes47cue 653]

I read an article about this this morning on Yahoo. Seems to make sense...

[IzzyEng4 427]

Seems like every time that I go for an EMT refresher they change CPR.

[Ga-Lin 86]

Seems like every time that I go for an EMT refresher they change CPR.

Yea, well like Hyman Roth (the Meyer Lansky character) said to Michael Coleone in the Godfather II "this is the life we've chosen!"

[antiquefirelt 994]

I'm almost certain that we're only one or two revisions away from doing CPR the way I first learned in the mid 80's. Shortly after I got my EMS license, a study out of Boston showed that providers needed to hyper-oxygenate the patient, as moving unoxygenated blood was though to be next to useless. We used to do 5 to 1 compressions to breathes and then we went to bagging on 1,3 and 5! None of which changed our outcomes until we got our first defibs.

[dmc2007 17]

I'm almost certain that we're only one or two revisions away from doing CPR the way I first learned in the mid 80's. Shortly after I got my EMS license, a study out of Boston showed that providers needed to hyper-oxygenate the patient, as moving unoxygenated blood was though to be next to useless. We used to do 5 to 1 compressions to breathes and then we went to bagging on 1,3 and 5! None of which changed our outcomes until we got our first defibs.

It looks as though we may be going in the opposite direction. Research is showing that compressions are far more important than providing ventilation. I can't seem to find the link, but I read that a study that stated the effective ratio for compressions to breaths was something like 2000 to 1. Another study seems to indicate that the benefit of doing breaths is far outweighed by the potential impact compressions lost to doing the breaths:

http://www.npr.org/blogs/health/2010/10/05/130352074/hands-only-cpr-better-than-mouth-to-mouth

[antiquefirelt 994]

It looks as though we may be going in the opposite direction.

True enough. That's why I noted we'll see it come circle in a few more revisions. Previous studies showed the need for oxygenated blood, newer studies find the need to blood to be moving. Likely there's s balance that'll be found sooner or later and that will become the goal. Or maybe not, I do know that I'll never have to do mouth to mouth again without a mask, so everything else is really no big deal.

[minivac 0]

I read Dr. Sanjay Gupta's book, Cheating Death, and he has an enitre chapter divoted to a study of CPR. His studies showed that when people recieved just chest compressions, they had a higher chance of survival. Intresting concept.

[wraftery 1,275]

All you long time EMT veterans get ready. I predict one more year and the "precordal thump" wiil be the next change in cpr. Just like when you learned CPR in the 70's.

[efdcapt115 1,511]

All you long time EMT veterans get ready. I predict one more year and the "precordal thump" wiil be the next change in cpr. Just like when you learned CPR in the 70's.

that was the only fun part of doing cpr..........

[Ga-Lin 86]

All you long time EMT veterans get ready. I predict one more year and the "precordal thump" wiil be the next change in cpr. Just like when you learned CPR in the 70's.

I think you're right. I've seen it work in monitored arrests both prehospitaly & in the CCU during my initial training. If it's done right away & without delay.

[wraftery 1,275]

I think you're right. I've seen it work in monitored arrests both prehospitaly & in the CCU during my initial training. If it's done right away & without delay.

The original CPR was to hold him by thhe ankles and roll him face-down over a barrel. It was used on nearly drowned sailors. (Hence the saying "They had him over a barrel")

It would probably work too in a percentage of arrests. If it makes a comeback, the Barrels-of-Life will cost about $1500, have a 10 page protocol for use, a 5-year lifespan, AND if you use the barrel to actually perform CPR, yo[ must dispose of it and buy a new barrel.

[RescueKujo 130]

Seems like every time that I go for an EMT refresher they change CPR.

Izz-AHA revises it's instructional standards every 5 years...

As an instructor, I've only heard about the changes, I have not seen the literature. That said, it takes approximately 8 compressions to prime the pump (heart), getting it to full capacity. Any stoppage in compressions you have to reprime the heart. That was the stated reason for the change to 30 compressions some time ago. As to the change to compression only CPR, it is felt that while doing compressions the change in the pressure in the chest cavity you are moving air in and out, rescue breathing only supplements that. It'll be interesting to actually hear about this when I go to the update meeting...