CPR Changes.. have you changed?

[JPINFV]

^

I wonder why the hospital kept them.

/1 ticket, window seat

[scottymedic]

Time for me to bring out the dead (pardon the movie pun) .

The standards have been in since begining of the year, teaching the 30:2 ratio and when a witnessed arrest occurs, your stacked shocks of 360 and then 2 mins cpr, fitting in adrenaline and intubation in that time (assuming of course the ryhthm doesnt come back in those shocks - I dont know this rhythm so I'm gonna shock you into something I do recognise )

The unwitnessed arrest is an instant two mins of CPR and then look at the monitor in that time, no pulse check unless its a rhythm that is sustainable with output, then check. In the last 30 seconds of the 2 minute cycle, the defib is charged so if its v-fib/v-tach then ready to instantly hit with 360.

I get nervous about that I must admit, just with people having a live charge sitting there, lol, pray that no one gets button happy and hits shock. The child of 50kg or 8 years and above is hit at 360 joules also. Havent heard of any successes yet in my area.

The comments from a lot of people, is just the change in mindset from automatically doing the stacked shocks, no pulse check and other interventions come second to CPR, but its just time and more practice in its own way .

I'm still to have a code (be it ems or nursing) with the new protocols. See how it turns out.

Please don't jump on me for reviving (another pun) an old thread, but be cool to see how the procedures are coming along as time progresses.

Scotty

[NREMT-Basic]

I am familiar with the new protocols, although I have yet to be certified in them since they were just implemented right after I got my certs. While the new standard is 30:2, the 4 or 5 agencies that I am riding with (while doing my MS degree in Disaster Medicine and Management) are inconsistant at best. Some are using 30:2, some 15:2 and some have responders using both (that is one responder using 15:2 and some using 30:2). I know that my MS program is teaching 30:2 and thats what I will get from the AHA when I renew my certs next year.

[AZCEP]

your stacked shocks of 360 and then 2 mins cpr...

Actually, the guideline is to use the maximum allowable by the manufacturer of your specific defibrillator. There is to much variation between devices, and the waveforms they use to deliver the energy to set one number as the recommendation.

The child of 50kg or 8 years and above is hit at 360 joules also.

You do not use the adult energy level on children over 8 years. They do not begin being treated as adults until the secondary sexual characteristics are present. This is vague at best, but for most it falls sometime between 11 and 13 years. The 50 kg child should receive 2 joules/kg initially, followed by 4 joules/kg for all subsequent shocks. American Heart and the American Academy of Pediatrics did not change the previous recommendations, due to a lack of evidence.

[scottymedic]

Actually, the guideline is to use the maximum allowable by the manufacturer of your specific defibrillator. There is to much variation between devices, and the waveforms they use to deliver the energy to set one number as the recommendation.

You do not use the adult energy level on children over 8 years. They do not begin being treated as adults until the secondary sexual characteristics are present. This is vague at best, but for most it falls sometime between 11 and 13 years. The 50 kg child should receive 2 joules/kg initially, followed by 4 joules/kg for all subsequent shocks. American Heart and the American Academy of Pediatrics did not change the previous recommendations, due to a lack of evidence.

Please remember AZCEP I am in New Zealand, we have the New Zealand Resuscitation Council guidelines which we follow and St John have developed their own set of protocols in conjunction with medical directors decisions. Whilst this may not concur with the AHA standards, there is life outside America

Scotty

[AZCEP]

Yes, I took that into account scottymedic, and thank you for pointing it out. I'm sure someone will use the information you provided as a reference point for their own mismanagement.