Posted on 01/19/2005 6:23:21 PM PST by neverdem
By THE ASSOCIATED PRESS
Cardiopulmonary resuscitation is often inadequately performed by doctors, paramedics and nurses, two studies of resuscitation efforts during cardiac arrest have found.
Two common problems are rescuers not pushing hard enough or frequently enough on the chest to restart the heart, and rescuers breathing air into the lungs too often, either mouth to mouth or through tubes.
In a study that involved 67 adults at the University of Chicago, doctors and nurses failed to follow at least one CPR guideline 80 percent of the time. Failure to follow several guidelines was common.
The other study involved 176 adults with out-of-hospital cardiac arrest treated by paramedics and nurse anesthetists in Akershus, Norway; London; and Stockholm. Chest compressions were done half the time, and most were too shallow.
Both studies used an experimental monitor that assesses CPR quality, and both received financing from Laerdal Medical, a Norwegian company that developed the monitor with Philips Medical Systems, a subsidiary of Royal Philips Electronics of Amsterdam.
The studies appear in The Journal of the American Medical Association.
bump
I've always thought I'd hook up jumper cables to their nipples to get them restarted. A man's gotta use the tools he has.
CPR does not restart the heart. It is not intended to.
CPR provides baseline minimal circulation until more advanced cardiac care can be provided.
CPR is also manual labor. Try it for 5 minutes and you will think you just ran a marathon.
It's hard to forget the first time the ribs crack while performing CPR.
In other breaking news:
Sex is often done wrong.
;-)
This is just the abstract. Quality of Cardiopulmonary Resuscitation During In-Hospital Cardiac Arrest
FReepmail me if you want on or off my health and science ping list.
TASMANIANRED, I'm quite familiar with CPR and ACLS. I've felt chests go "crunch" a number of times.
So it was done "wrong"....the "do-nothing" option is DEATH!
I like you.
As for doctors/nurses/paramedics not performing CPR correctly, I've seen/done CPR on babies, and instead of using 2 fingers of the same hand, we would oftentimes use both thumbs, with the index fingers down over the sides, and down toward the back, as if you were gripping something round. It seemed to work just as well as the 2 finger method taught by the ARC. Also, with the adrenaline of the code, the person bagging through the endo tube would often not sync to the person doing the compressions.
why is this a news story?
I learned to watch the monitor for full compression and return.
First-aid stuff often has to be done a lot harder than people think. After an angioplasty, I had the incision in my femoral artery pop open under the skin, causing what you might call the Ultimate Blood Blister. The doc had a nurse practically shove her thumbs down to the bone doing direct pressure on it until the midaeval plastic pressure torture device could be brought forth. I'm still full of heavyweight pain meds, and I thought she was trying to amputate my leg with her hands. I didn't say anything, but it's more than most people expect.
Thinking back on it now, a friend took an arterial hit in the foot once long ago, I probably did the same to him.
The first time you hear that cruch it's a shock.
The next time it's kinda cool, like "here we go!".
ping
Bingo. If you are doing CPR, the patient is literally DEAD. Not going-to-die - dead. You can't make it any worse.
That's why the snap-crackle-pop of the ribs only bothered me one time and one time only.
Bump.
Only had to do it once myself, and I was working the BVM, so I don't remember the sound of the ribs. I do remember pumping that BVM for 35-40 miles. Bad night.
When I taught CPR I would tell the students that it was better to do it wrong than to hesitate and not do it at all. That's also how I was taught.
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