New CPR guidelines.

[Bypah]

I read an interesting article about the new changes in the guidelines for performing CPR at least in the US.
Here is the article.
http://www.msnbc.msn.com/id/39715696/ns ... rt_health/

[rationtin440]

Interesting and seems to make sense. housil, are the techiniques and steps used by your medical people similar to American CPR?

[housil]

Ja.

The ERC (European Resucsitation Counsil) is very similar to the AHA (American Heart Association). we have just some local differences as we allways respond together with a ER Doc unit to the scene.

The number 1 goal is, to keep the "no flow time" as short as possible (< 10 sec.)
An adault (!) has always enough oxygen in his lungs. That need to come into his brain.
Peopes have disgust to make mouth-to-mouth breathing to a stranger person that maybe has vomit in his mouth etc...
Also they changed the heart rate while CPR up to 100 and give 30 compressions and ventilate 2 times.

Bystanders also don´t have to check for a puls, if they don´t find "vital signs" (moving etc) start CPR.

They also changed from an immediate shock to give 2 min CPR fist. This is necessary to lower the pressure in the heart muscle. During an cardiac arrest, the blood will overfill the heart.

We give one shock (200, 300, 360) only, followed by 2 min of CPR in case of VF etc.

In case of an asystolia, we give CPR only supported by drugs until we get a shockable VF or a heart beat - or the ER Doc declares the patient for dead.

Mrs Housil did two successfully CPRs on duty last week

[rationtin440]

Interesting, same basic principle sounds like. Are citizens in your country given courses like those available here? Not on same topic but I recall my chemical warfare training in the military, and we were taught the difficulties of rescusitating a victim of blood agent poisoning, especially aerosolized hydrogen cyanide. I'm trying to recall exactly what we did, but it involved a modified form of CPR and a special oxygen system to force air into the lungs (my memory is terrible lately) and we only had a few seconds to get the lungs and heart going again, casualty would likely be classified as "expectant."

[housil]

Are citizens in your country given courses like those available here?

You don´t get a drivers license over here without a first aid training (incl. CPR) of 8 hrs.
At high school we had 2 first aid trainings (and still that cold war duck and cover stuff )
Bigger companies must have first responders.
We (Red Cross) provide first aid trainings (8 and 16 hrs) with CPR at every Saturday to the public

aerosolized hydrogen cyanide...

Cyanide?!

As cyanide will "block" the "inner respiration" (exchange of oxygen between the blood and the cells), you can "pump" as much oxygen as you want into theat poor dude. He will die for sure (ask, Göhring, Himmler, the whole Göbbels family...)
You need an antidode against that intoxiation first.

and a special oxygen system to force air into the lungs

We are using "ventilator machines" at every ambulance:


(upper)

As soon as the patient is intubated, we ventilate him (IPPV) with the machine and can set it to 100% Oxygen (FiO² = 1)
To "force" more oxygen into his blood, we keep the air into his lungs at a higher perssure via PEEP.

But without that antidote, a cyanide intoxication will kill the patient for sure.

[rationtin440]

Housil, remember when I said my memory is terrible lately? Here is a classic example, I completely forgot about the amyl nitrate ampules we were issued in our aid bags and more on our combat ambulance. If I recall correctly, they were to be crushed and inserted into the mask of the victim to counteract the cyanide, does that sound familiar to you? I hate getting old and I'm only 46!

[housil]

...does that sound familiar to you? I hate getting old and I'm only 46!

Don´t worry. You will forget that you were frustrated too...

We inject 4-DMAP or use "Cyanokit". Every country has it´s own antidote - but you need to use any!

[rationtin440]

Yes housil, you're probably right, lol! Actually while we were getting ready to deploy for desert shield, my unit was given extensive NBC training, and the thinking at the time was that amyl nitrate would probably not do any good because it would be "improperly administered" How do you "improperly administer" it? All you do is "pop, insert" totally GI-proof! OK since we had only seconds to save the casualty, I dunno what else they expected. Anyway that was then.

[Cracker]

I think that if you are critically injured in an NBC contaminated area, your screwed anyway. Even if you manage to do succesfull CPR, you are still unlikely to get him out in time.

(you can't just fly an contaminated person to a hospital)
So basically, if you get hit in an NBC area.. your dead already, if the bullet/shrapnell doesn't kill you, the NBCagent will.

It's also net very smart to respond to an critically wounded person on that moment. Rule number one, safety first. I also don't think you will be able to do a perfect CPR round if your in full NBC gear. The gear makes you clumsy, and the suite makes you overheat when "pumping" the heart. It might be cruel, but I think not responding at all for CPR at that moment saves more lifes then responding.

Moral of this story: Stay out of NBC areas and gunfights

[rationtin440]

Actually Cracker I totally agree with you, and even our instructors at NBC school and our pre-deployment training would shake their heads at how absurd and ridiculous alot of the procedures would be. But they reminded us that the military has a system of procedures for everything and it does not have to make sense to us. They went on to inform us that we should be lucky that we did not do NBC training like the Soviets did; live nerve, blood, and blister agents which killed dozens or more Soviet conscripts every year in very realistic training.