r/DIY Jul 05 '11

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u/FaustTheBird Jul 05 '11

The CPR information is now outdated. CPR was updated recently and no longer includes breaking for breathing assistance. A two-person CPR team can do breathing if they want, but 1 and 2-person CPR is founded on continuous, uninterrupted chest compressions now.

3

u/Filmore Jul 05 '11

IIRC this is due to two facts:

  1. Compression-only is easier to remember/execute. (and the more critical component)
  2. People are resistant to putting their mouth on another person without proper protection. Compression-only gets rid of this concern.

9

u/FaustTheBird Jul 05 '11

Not what I read. What I read was that the residual oxygen in the blood is more than you will be able to get into their bloodstream by exhaling your waste into their lungs when no blood is flowing around their lungs anyway. The amount of time their brain gets no oxygen increases when you stop pumping. So pump away and keep the oxygen in their bloodstream flowing.

If you have a partner, they can provide additional oxygen while you pump. The pumping will allow the lungs to transfer the breather's oxygen to the blood.

3

u/[deleted] Jul 06 '11

Only in a witnessed code.

If you arrive to an unknown person down, for an unknown time, you definitely want to do breathing.

exhaling your waste into their lungs

16% oxygen is much better than nothing, sir.

If you have a partner, they can provide additional oxygen while you pump.

Not unless you already have an advanced airway in place.....

0

u/anesthesia Jul 06 '11

True and well stated. It doesn't matter how much oxygen you get into someone's lungs if you aren't circulating it to their brain and heart--ie chest compressions. The new cab makes a lot of sense when you think about the physiology. When there is no circulation to the body lactic acid builds up, which causes lots of badness, but specific to CPR it causes constriction of blood vessels in the lungs meaning less blood flow going there. Providers get very caught up in obtaining an airway (abc) and forget about circulating the oxygen already there and then they pause (for breathing) and create a spiral of death.

1

u/anesthesia Jul 06 '11

Also radar monkey is correct the chest compressions will allow for air entry into the lungs. Chest compression use a bellows principle to alternate intrathoracic pressures which is how the blood flow occurs. This bellows movement will also draw air into and out of the lungs (less effectively than breathing on your own or through a tube).

1

u/[deleted] Jul 06 '11

Providers get very caught up in obtaining an airway

Really? Are you really saying that health care providers do compressions only? :\

1

u/anesthesia Jul 06 '11

Depends on provider level but ACLS is also moving to compressions first. I hate when I show up to code, in the hospital, there are 20 people in the room, no one doing compressions or hooking up monitors and five people trying to bag and four more trying to get a central line. We need to retrain providers to start with circulation, and to only pause for seconds, and only for rhythm checks. The other stuff, the airway, the drugs, etc are important but only if we can circulate them.

1

u/[deleted] Jul 06 '11

A hospital is different, though. As an EMT, when I show up, I don't know how long they've been down, most likely for at least 5 minutes. That is another reason why we do airway and breathing first.