Got CPR?

[Meadow Skipper]

You've got the gear, you've got your avy class, you practice regularly...how about your basic 1st responder skills like CPR?:
http://www.sltrib.com/sltrib/news/55...untry.html.csp

[Hacksaw]

You've got the gear, you've got your avy class, you practice regularly...how about your basic 1st responder skills like CPR?:
http://www.sltrib.com/sltrib/news/55...untry.html.csp

Yes, I have those skills.... Sadly, the last time I did CPR on someone it didn't work in the end.

[snoboy]

Yes, I have those skills.... Sadly, the last time I did CPR on someone it didn't work in the end.

Usually doesn't. :-( New protocols are helping though.

[summit]

It shocks me how many people drop $350 on a 3 day Level 1 course and don't have a 1 day $50 first aid/CPR course.

[xtrmjoe]

I did almost 10 years ago. Whats the recommended refresher timing?
Still usually carry mask in cars and packs.

[Meadow Skipper]

I did almost 10 years ago. Whats the recommended refresher timing?

http://www.redcrossrefresher.com/

Every three months seems a little over the top, but probably more than every 10 years. My CPR card (BLS) expires every two years.

[Shredhead]

Protocols are always changing. Still better to have old technique than none.

[Bromontana]

did this lady really die and need CPR, or was she simply not breathing and her bf performed rescue breathing? Having a full no pulse/CPR resuscitation would be pretty crazy.

Very, very close call either way.

[summit]

did this lady really die and need CPR, or was she simply not breathing and her bf performed rescue breathing? Having a full no pulse/CPR resuscitation would be pretty crazy.

Very, very close call either way.

Rescue breathing only per the avalanche center's accident report.

[bluemtn]

Just took a CPR class this morning. The biggest change in protocol is not doing the rescue breaths, compressions only. The thinking is that some people don't want to do rescue breaths, therefore they won't do CPR at all.

However, this is only in urban areas where paramedics can be on the scene within 5 minutes. In the backcountry, the 30 compressions to 2 breaths rule still apply.

[jables]

When I too my WFR class a few years back (it just expired) our instructor said that one of the other changes was the speed of the chest compressions. He suggested to think of "Another one bites the dust" and to do compression to that beat, I think roughly 100BPM? He recommended not humming or singing out loud though.

Not sure if that speed still holds true, but that will wear your ass out.

They say CPR is most effective with lightning strikes and drownings, so I'd imagine it could be successful on snow suffocation as well, but in the end, sadly, more often than not it doesn't help.

Something to think about and have a grasp of nonetheless.

[arild]

over here the frequency is 100comps/minute, meaning 30 comps in about 18 seconds, between two ventilations, if the pt doesnt have a tube in place, that is. in my professional setting, we need recertification every year and refreshing every six months.

norsk

[Meadow Skipper]

When I too my WFR class a few years back (it just expired) our instructor said that one of the other changes was the speed of the chest compressions. He suggested to think of "Another one bites the dust" and to do compression to that beat, I think roughly 100BPM? He recommended not humming or singing out loud though.

Not sure if that speed still holds true, but that will wear your ass out. .

Heh. My last couple of BLS CPR classes suggested using the old disco hit "Staying Alive" by the BeeGees. That's a little less macabre and also 100 bpm.

Just took a CPR class this morning. The biggest change in protocol is not doing the rescue breaths, compressions only. The thinking is that some people don't want to do rescue breaths, therefore they won't do CPR at all.

However, this is only in urban areas where paramedics can be on the scene within 5 minutes. In the backcountry, the 30 compressions to 2 breaths rule still apply.

The rescue breaths are still the rule for EMTs etc.

[~mikey b]

I'd love to teach a class that combines avalanche and medical components.

Avy 2 + WFR

[Unfrozen Caveman Lawyer]

Yeah, when I took WFR this past May, they used both Staying Alive and Another One Bites the Dust as the cadences.

WFR is an awesome course. (as was AAIRE Level 2 actually).

[Crass3000]

over here the frequency is 100comps/minute, meaning 30 comps in about 18 seconds, between two ventilations, if the pt doesnt have a tube in place, that is. in my professional setting, we need recertification every year and refreshing every six months.

norsk

Pretty sure that is the new protocol in the states too. I took and emergency first responder class a few months ago and that's exactly what they taught. The idea is that not much oxygen is used quickly so people benefit from it being pumped around the body more than extra breaths.

[~mikey b]

shock = inadequate tissue perfusion

compressions = providing oxygenated blood to tissues

[jables]

I'd love to teach a class that combines avalanche and medical components.

Avy 2 + WFR

Not sure how the AIARE 1 to AIARE 2 transition goes, but a good idea would also be:

WAFA (Wilderness Advanced First Aid, roughly 20 hours, major protocols) and a AIARE 1

I'd worry that an Avy 2 and WFR would be a lot of time commitment. 80 hours or so, right? I liked taking a WAFA in three days, then a WFR bridge later in 3-4 days. All at once was better for me to absorb than spread out.

Regardless, it's a good idea.

[~mikey b]

some sorta "putting it all together" course could be taught in a weekend

avalanche rescue skills and WFA/WFR/EMT patient handling skills

pick up where avalanche class leaves off and medical class begins

[summit]

I've taught that kind of avalanche medical training.
It would be super fun to teach that stuff to trained members of the public.
I think that Mike has the idea right that you should take people who already have their medical certs and tack on 2 hours of lecture and 2 hours of field time (could even count as EMT CEU hours if you have your ducks in a row).

jables point in that combining a 24 or 32 hour avalanche course with a 4 hour CPR + 16 hour WFA, 32 hour WAFA, 80 hr WFR, or 130 hour EMT would be more commitment than you'd get out of most students unless it was in the context of a college outdoor education/studies program (which would be fun).

[~mikey b]

I've taught that kind of avalanche medical training.
It would be super fun to teach that stuff to trained members of the public.
I think that Mike has the idea right that you should take people who already have their medical certs and tack on 2 hours of lecture and 2 hours of field time (could even count as EMT CEU hours if you have your ducks in a row).

jables point in that combining a 24 or 32 hour avalanche course with a 4 hour CPR + 16 hour WFA, 32 hour WAFA, 80 hr WFR, or 130 hour EMT would be more commitment than you'd get out of most students unless it was in the context of a college outdoor education/studies program (which would be fun).

that's what I did

[BaNosser]

shock = inadequate tissue perfusion

compressions = providing oxygenated blood to tissues

^^ This

Compressions allow the 'pulse' pressure to build up to actually pump/move red blood cells (oxygen) into the cardiac tissue.. the heart will not restart without oxygen.. The old 15/2 cycle was not adequate to oxygenate the heart muscle.. the pulse pressure would get build up to just the minimum needed only for the compressions to stop for breaths.. dropping the pressure back to near zero and starting the process over again.. Consistent quality compressions are also very important to maximize pulse pressure/O2... 1 1/2 - 2 inch deep (adult).. and let the chest fully recoil between compressions.. that's when the blood/oxygen actually goes into the heart muscle and also allows venus blood to refill the ventricles... Your not really doing compressions to move blood around the body.. you're doing them to move blood into the heart muscle to give it oxygen so it can restart..

30/2.. 100bpm.. swap the person doing compressions whenever possible.. good compressions are tiring.

If sudden cardiac arrest happens in public.. the mall, basketball game, office building.. make sure someone is going for an AED asap.. make sure 911 is called.. check for pulse, if none, start compressions until AED is hooked up and begins it analysis.

Young and/or healthy hearts are screaming to be restarted... they need oxygen for it to happen

[old goat]

Compression-only CPR is based on the premise that there is oxygen-saturated blood in the heart when the heart stops due to a heart attack. That is clearly not the case when the reason the heart stops is suffocation. In an avalanche burial rescue breaths are clearly more important than they are in other settings. It is likely that any successful resuscitation in an avalanche setting would be due to the fact that the heart never stopped. It is also very difficult to tell if someone's heart is beating or not in the snow, with the victim heavily dressed, the rescuer with cold hands and exhausted. I'm not aware if there's a specific protocol for suffocation. Remember that there are infrequent cases of recovery from cardiac arrest after prolonged burial where there was an air pocket and cardiac arrest was due to hypothermia. After warming--best done by heart-lung bypass but can be done by putting warm water into the chest and abdomen--complete recovery can result. In cold water drowning the saying is you're not dead until you're warm and dead.

[~mikey b]

Good post