CPR discussion

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In another thread started by Matt Colman, titled “My ‘Back of the Car’ Rescue/Trauma Management Kit”, (found here: http://edcforums.com/threads/my-back-of-the-car-rescue-trauma-management-kit.96534/#post-1251515) questions were raised about CPR, working outside the scope of your training, and what the current American Heart Association guidelines state about hands-only CPR, especially as it relates to lay rescuers. In an attempt to not thread jack that thread I am posting what I learned today at my BLS for Healthcare providers refresher course regarding CPR and the necessity of breaths. This information should not be construed in any way to be me giving anyone advice on how to conduct CPR and should not replace quality instruction. This is only a discussion of the methods I learned and the opinions of the instructors I dealt with.

So the issue seemed to be whether or not breaths were needed for CPR and what was currently being taught. As of the 2010 AHA guidelines for CPR, non-Healthcare providers do not use rescue breaths. It was the opinion of the instructors that when AHA revises their guidelines for 2015 (as they release new ones every five years on schedule) rescue breaths will no longer be a part of the protocols for individual Healthcare Providers. That is, healthcare providers acting alone. When done in a team setting with a bag valve mask, they will possibly still be a part of the equation, but may be out as well. The reasons given were that whenever you stop giving compressions in order to give breaths, it takes the first 10-12 compressions of the next cycle to get back to the level of profusion achieved with your last set. Also, air is being moved with compressions anyway. The final reason is that giving breaths, via mouth to mouth, mask, or BVM, can create its own set of problems; generally, pushing air into the stomach, causing the victim to vomit, which can occlude the airway and/or get vomitus everywhere, including on you, which is a biohazard.

But that is for adults. For infants and children, breaths will likely be a part of the equation for some time, as children do not generally suffer from cardiac arrest, and when they go down, it is because they are not getting air. The emphasis for infants and children was on providing breaths, to the point that if you come on a child/infant victim, we were taught to begin CPR right away and do a full five cycles, or two minutes of compressions AND breaths, before even calling for help.

That’s what I remember for now. Feel free to ask any other questions and I’ll check my brain and notes to see if I can answer them.

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