AnthonyM83

I couldn't find any studies on this, but I was told today that Washington requires CPR certification in order to obtain one's driver's license and also has a higher survival rate for cardiac arrests. Can someone support or refute this? If true, it would be a testament to how government can have an impact of civilian awareness.

Realistically, increasing of survival rates does have to come from public education. You need government support to spread the message, but it's been done. The whole wave about warning kids of strangers or the drug PSAs (whether they work or not, everyone's seen "this is your brain on drugs") or California's Click It or Ticket seatbelt campaign. You can influence a community through media. And this is something people WANT to do...help their friends/family survive.

Eh, except you can wear other school's sweatshirts if you support their teams....

Where are you getting these stats from?

This is true. BTW, a lot of people don't use proper grammar/spelling, not because they don't know it, but rather since it's an online forum, they don't put that much effort into it. I know I make typos online, but my important narratives IRL are spotless.

Guys, go easy on him. Dust just needs a little more field experience and maybe a little more education to knock that cookbook medic out of him. We should not discriminate just b/c he rides in the shortbus ambulance at work. Though, personally I'm just nice to him b/c he has a hawt girlfriend

I've been wrong once. Once when doing some homework, I thought I made a mistake, and went back to check. I realized I was, of course, right after all. That was my one. I'm only human, I suppose. 8)

Yup, the placing of 12-leads is definitely a BLS skill. The only difficult part is maneuvering through the saggy boobies without feeling too awkward.

I'm not sure if I follow. The article studies only traumatic arrests and says "The two groups were homogeneous for mechanism of injury, gender, and time interval before cardiopulmonary resuscitation (CPR)." So, there should be no real difference. The article shouldn't be used for anything definitive, but it still provides interesting information, such as the physician group attempted rescuss more than the BLS group....it might not be too crazy of an idea that they also go more saves.

And if you survive that, you have to worry about formaldehyde being a carcinogen

Too much education related discussion going on right now. Thought I'd throw in an interesting study to change topics. Prehosp Emerg Care. 2005 Jan-Mar;9(1):79-84.Click here to read Links HEMS vs. Ground-BLS care in traumatic cardiac arrest. Di Bartolomeo S, Sanson G, Nardi G, Michelutto V, Scian F. OBJECTIVE: To assess whether a top-level type of prehospital care, made of helicopter, physician, and advanced life support (ALS) procedures, improves the outcome of blunt trauma victims found in cardiac arrest (CA) as compared with a simpler type, composed of ground ambulance, nurse, and expanded basic life support (BLS). METHODS: This was a cohort study from the data set of a prospective, population-based, 12-month study targeting the 1,200,000 inhabitants of the Italian region Friuli Venezia Giulia. RESULTS: Fifty-six victims received the higher level of care (helicopter emergency medical services [HEMS] group) and 73 received the lower one (ground-BLS group). The two groups were homogeneous for mechanism of injury, gender, and time interval before cardiopulmonary resuscitation (CPR). Age was lower in the ground-BLS group. The percentage of patients in which CPR was attempted was significantly higher in the HEMS group (43% vs. 20%; CI 0.061 to 0.379). On-scene return of spontaneous circulation (ROSC) was also more likely in the HEMS group (37.5% of attempted CPRs vs. 6.6%; CI 0.027 to 0.591). None of the patients evacuated from the scene without ROSC ever attained it in hospital. This policy was virtually exclusive to the ground-BLS group. Survival to hospital discharge was 3.5% (severely disabled) in the HEMS group and 0% in the ground-BLS group (CI -0.008 to 0.078). CONCLUSION: A top-level type of prehospital care had significantly more chances to resuscitate blunt trauma victims found in CA as compared with a simpler level. No significant benefit on long-term outcome was found, but more cases might be needed in future studies because of the inevitably low number of survivors.

What a brilliant idea

I actually just heard that this weekend...except it was the other way around. Someone was talking aboug EtOH IVs and I brought up the nebulizers But no one knew what they (the IVs) were used for in the clinical setting.

Gotcha. And no worries on rambling. I've quite enjoyed the discussion in this thread.

Another thought is, are there any OTHER reasons for substernal CP that might require O2 that wouldn't present with other symptoms?

I get you. My previous post was not an actual argument. It was explaining why people in this thread might think CP patients need high flow. What their logical line of thinking is. Sorry if I didn't make that clear enough. As a sidenote: In the article you posted, it says that hypoxia didn't affect the availability of oxygen for myocardial metabolism until around 50%... If this were true, wouldn't one expect that we shouldn't worry about MI's unless the patient's O2 sat were in the 50s...? This would mean pretty much all concious MI patients even showing SOB should have no heart damage because heart tissue has enough O2... I might just not know enough about what happens in MIs, but I thought the main concern was ischemia which would lead to tissue death.

Where did this 30-40 compressions per minute number come from? I want to confirm with others it's a rate I should follow

Is hypercapnia another term for relying on their hypoxic drive, such as those with COPD? Well, the concern is that they're HEART isn't receiving enough oxygen at certain spots, so they might not be classically short of breath, but certain areas of their heart could be ischemic...and they are presenting...it's the chest pain. I'm not saying they thus need high flow, b/c we're looking at articles about how they might not, but in response to your question, that's why I would think they might need high flow. I think it's a logical reason.

I was actually thinking about that at work the other day. How long the vasoconstriction takes. This is extremely important, because the patient could be missing out on a good deal of oxygen. I think saying it's largely case by case is sidestepping the issue, though. What factors does the onset of vasoconstrction depend on?

Waiting on-scene might or might not be a bad idea, depending on how far away the doctor/nurse team is... Yes, what a trauma patient really needs is surgery, but more urgently (I'm assuming) would be types of procedures done in the ER trauma rooms, such as chest tubes.

How much weight can that hold...

Uhh...that's the whole discussion we're having about how it actually could be hurting them... Also, do people have studies on how high flow O2 increases cardiac output...?

Just FYI, O2 protocols differ by area. High flow would be required here.

Gotcha. Interesting concept, the MUGs thing. I'd like to work in an ambulance like that...of course everything looks good when it's new. Then again it's a Mercedes.