Today CPR is one of the most accepted and standardized techniques used by emergency responders, and corporate onsite CPR training is offered in almost every major company and business in the United States. Though this has been the case for decades, there was a time when the technique was less accepted by the public and the medical community.
Like other medical breakthroughs, CPR was not discovered all at once. Instead it was slowly studied and refined until it became the standardized life-saving procedure that it is today. From its beginnings in the 1700s, cardiopulmonary resuscitation has continued to evolve as doctors have learned more about the human body, and now it is an extremely effective way to provide emergency medical response to a person suffering from sudden cardiac arrest.
The Beginning
The first mentions of the procedures that would one day become CPR appeared in the middle of 18th century. The Paris Academy of Science began to endorse mouth-to-mouth resuscitation for drowning victims in 1740.
Around the same time, the Society for the Recovery of Drowned Persons was organized. This organizations was founded in Amsterdam in response to the hundreds of citizens who died by drowning in the canals every year. Though not all of the society’s ideas were medically accurate or effective, some of their practices were very similar to how CPR is performed today. These practices would spread to other organizations that provided medical assistance to drowning victims, but it would still be some time before doctors and others studied these techniques in detail.
In the next 150 years, the medical community learned more about the human body and began to study resuscitation. Finally at the end of the nineteenth century two doctors, Dr. Friedrich Maass and Dr. George Crile, independently documented the medical use of chest compressions to resuscitate someone who had drowned. Dr. Maass performed and documented chest compressions, and Dr. Crile had similar success in 1903. From then on, medical organizations adopted chest compressions as a way to revive those who had drowned.
Mouth-to-Mouth CPR
Then in the 1950s, there was another breakthrough in cardiopulmonary resuscitation research. Dr. Peter Safar, Dr. James Elam, and Dr. Archer Gordon were able to prove that mouth-to-mouth resuscitation could provide adequate oxygen to the body and increase the chance of survival of a drowning victim. In 1956, they developed techniques that made mouth-to-mouth CPR more effective, and soon these practices were adopted by the U.S. military and emergency medical services.
In 1960, the American Heart Association started to teach physicians how to perform CPR. In the next decades, the practice became more and more accepted. The first large scale CPR training occurred in Seattle, Washington in 1972. Leonard Cobb led the training program called “Medic 2” which trained more than 100,000 people in the program’s first two years.
CPR in Businesses
Businesses also started providing corporate onsite CPR training, so employees could perform the technique during an emergency, and this became more and more common. Corporate onsite CPR training is now found in many of the world’s largest corporations and businesses. Not only does it help make offices safer, but it’s also a great team-building and leadership opportunity for organizations.
If you are interested in corporate onsite CPR training, there are many ways that you can provide training on a flexible schedule and give participants the chance to get certified in CPR. Our corporate onsite CPR training programs are designed to make CPR approachable and easy to learn, so that your staff will be able to use these techniques to save the lives of coworkers, family members, and anyone else who needs help.
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]]>CPR training in NJ will prepare you for many types of emergencies, but with any luck you’ll never find yourself in a situation where someone’s life is in danger. However, if that type of situation ever occurs, you’ll be prepared to quickly act, providing CPR and other emergency care to increase the victim’s chance of survival. After suffering sudden cardiac arrest, a person only has about an 8% chance of surviving before they make it to the hospital; however, immediate CPR can double the chance of survival and saves over 90,000 lives every year in the United States.
Though learning CPR is often a thankless task, those who are able to use it to save someone else’s life usually receive the gratitude of the person’s family and community. That gratitude is more than enough of a reward, but in New Jersey the American Heart Association actually gives an award to people who’ve used CPR to make the state a safer place. The New Jersey American Heartsaver Awards were given out on June 3rd and were awarded to 29 residents of New Jersey for their efforts to save people’s lives. Some of these individuals were recognized for individual acts of CPR and others were recognized for other efforts that advance CPR training in NJ.
Applying CPR Training and Other Knowledge to Save Lives
In addition to learning how to perform CPR specifically, CPR training in NJ also teaches individuals how to identify when someone needs emergency medical care and how to use an AED device to help people suffering from sudden cardiac arrest. These training programs provide participants with a lot of knowledge and skills that they can use in a number of different situations such as when someone has a heart attack, suffers an allergic reaction, almost drowns, is shocked with electricity, chokes, or suffocates.
One of the recipients of the award this year was Melanie Mercado, a resident of Union County who works as a registered nurse at RWJ University Hospital in Rahway. When she was going home from work one day, she saw someone lying in the middle of the street and realized they were the victim of a hit-and-run. Using her CPR training, Mercado told someone else to call 911 while she began performing CPR. She continued to provide CPR until the paramedics arrived and the woman would not have survived without her help and immediate action.
Providing CPR Skills and Training to More NJ Residents
Though the American Heart Association honors a lot of people who directly perform CPR to save another’s life, it also uses its awards to bring attention to people and organizations that provide CPR training in NJ and increase the number of trained and prepared citizens who can perform CPR. This year Joseph Przytula also received an award for his efforts to do just that.
After the state government passed legislation to provide CPR training in NJ public schools, Pryztula helped implement the program in Elizabeth Public Schools. As the supervisor of health, safety, and physical education, he makes sure that every student receives CPR and AED training before they graduate—more than 700 students every year. His fantastic efforts to expand CPR training have made his school, community, and state a much safer place for everyone who lives and works here.
For those interested in CPR training in NJ, there are many places across the state where this type of training is available. The more people that learn how to respond in emergencies, the safer everyone will be when emergencies happen. When a person performs immediate CPR and AED, they can triple the chance of the victim surviving the ordeal. If you are looking for CPR training in NJ, contact us today.
Sources:
http://www.nj.com/suburbannews/index.ssf/2015/06/two_union_county_residents_hon.html
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Though CPR, which stands for cardio pulmonary resuscitation, has been around for a long time, many people don’t know exactly how it works, the science behind it, or how effective it is. This is too bad, because if the public better understood how important CPR is, more people would enroll in CPR training in NJ. Fortunately, more and more public schools are providing CPR training in NJ, and this is making all communities in the state safer. The number of corporations offering this training to employees is also increasing around New Jersey.
Though some people are turned off by the idea of having to perform CPR on total strangers, the truth is that most medical emergencies occur at home and at work. In addition to potentially saving the lives of strangers, CPR training in NJ can also help you save the lives of your family, friends, and others you care about. CPR training is most likely to save the life of someone you know and care about, and that’s why so many people are interested in learning how to safely perform it. Additionally, there are hands-only CPR techniques that can be learned that avoid mouth-to-mouth resuscitation for those who are squeamish about that type of technique.
CPR Saves Lives
Research conducted on CPR continues to show that CPR can potentially save a person’s life — about 92,000 lives every year. CPR can be an effective way to restore breathing and normal heart function, and it can increase a person’s chance of survival after
- sudden cardiac arrest
- heart attack
- choking
- suffocating
- almost drowning
- suffering an allergic reaction
- getting shocked with electricity
- overdosing on drugs
This isn’t to say that CPR will always save a person’s life. When a person requires CPR, their body is already under an extreme amount of stress, and the problems that caused their heart to stop may be too serious to repair with CPR. About 92% of people who experience sudden cardiac arrest do not survive before they arrive at the hospital; however, performing CPR immediately can double or triple that person’s chances to survive.
When a person stops breathing, every second counts. That’s why it’s so important that one of the first people who reach the victim can perform CPR without any hesitation. CPR training in NJ doesn’t just teach people how to perform CPR, which is relatively simple; it also provides each participant with the confidence they need to act decisively in an emergency situation.
Who Can Use CPR Training?
Everyone can benefit from learning how to perform CPR. It is not just something for lifeguards and medical professionals. Many businesses offer corporate onsite CPR training to their employees because it’s a great team-building exercise and increases the safety of every employee in the office. Most offices now have AED devices, which use electricity to restart the heart. During CPR training, employees can also learn how to use these devices which can save someone who’s in sudden cardiac arrest.
CPR training in NJ is also popular among private citizens who want to be able to perform CPR for their family members and friends. When there is an emergency, it is very important that someone nearby can perform CPR immediately before the medical professionals arrive.
If you have family members with heart problems, children with congenital defects, or just want to be prepared for an emergency, CPR training is right for you. We provide different types of training and certification to give you the tools you need to save someone’s life. Contact us for more information about our next session of CPR training in NJ.
Sources:
http://lasvegassun.com/news/2015/jul/13/how-perform-adult-cpr/
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It’s Alive!
We’re pleased to announce that our new website is now live; it has been completely revamped and refreshed with each of our user’s needs in mind. We have redesigned our layout and navigation so you can easily find information and quickly register for CPR classes. The menus and registration process have both been enhanced and completely simplified.
Modern Look
You’ll notice that our new website has a modern, sleek look featuring a fresh layout to make it easier for you to find a CPR, AED and BLS class to fit your schedule. Plus, since it’s mobile-friendly, you can access it on the go and conveniently book your class right from your phone or tablet.
Find What You Need
We’ve put added focus on the on-site group classes including CPR, BLS, first aid training and certification options for larger groups. Plus you can now conveniently filter your search by date, location and subject.
Personalized
Our mission is to spread awareness of the importance of CPR and BLS skills and we’re excited to share this easy-to-use site with visitors. As CPR instructors with over 25 years of experience, we are able to provide a relaxed and comfortable teaching environment, no matter what class you are looking for. Our goal is to prepare you with the confidence so you can perform CPR in any life-threatening emergency – Without Hesitation!
Enrich Knowledge
Our sleek new design makes it easier to access our blog, learning about qualities of a good CPR instructor, how to choose a CPR training class, FAQs regarding CPR classes and important updates in the news.
Get Connected
Stay in the know through our social media channel buttons linked conveniently in the bottom right of the website to foster improved communications about the importance of CPR on Facebook, Twitter and Google+.
We, at Oceanside CPR, hope you enjoy the fresh look of our new website, designed specifically with each of your needs in mind. We look forward to hearing your feedback and feel free to contact us if you have any questions.
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A doctor who presented research on the importance of CPR during the American Heart Association’s resuscitation conference in Chicago proved her point hours later, saving a man who collapsed in a hotel lobby.
Monique Anderson, M.D., was talking with another doctor about the importance of fast response to cardiac emergencies while leaving a reception Sunday night when they saw a middle-age man face down on the ground.
Anderson and three other doctors ran to him, rolled him over and saw that his face was ashen. He was not breathing and had no pulse.
Anderson – who had never performed CPR outside a hospital setting – quickly yelled out instructions to one of the doctors to call 9-1-1 and started chest compressions. After a few rounds, the man sat up and said, “I’m OK, I’m OK,” Anderson said.
Anderson said her first thought when they saw him was, “Is this real?” The second thought was, “Take action.”
“We knew we had to get to him,” she said. “We assessed, we called for help and initiated what we learned.”
As she was giving CPR, one of the other doctors cheered her on, yelling, “Keep pushing! Keep pushing!”
“It was a team effort,” Anderson said.
As of Monday afternoon, the man had undergone tests at a hospital and was doing well.
The doctor who called 9-1-1 was Eric Peterson, M.D., M.P.H., a longtime volunteer with the American Heart Association and director of cardiovascular medicine for the Duke Clinical Research Institute in Durham, North Carolina, where Anderson also works as a medical instructor.
“Panic quickly sets in to even the best of us, but really having somebody there who knew what they were doing, doing CPR, was really key to keeping this organized and running well,” Peterson said. “And once it was all done, what an amazing feeling. This is sort of what we all do and talk about in research, now coming to life.”
Anderson, who is also an active volunteer with the American Heart Association, focuses exclusively on cardiac arrest research and has trained thousands of people in CPR at Duke and throughout North Carolina.
She has pursued resuscitation as a career ever since she treated a patient in the cardiac critical care unit. She was so inspired by that patient that she made a short documentary about it called, “Surviving Cardiac Arrest, A Family’s Perspective on a Second Chance at Life.”
“It’s amazing to see that there’s been a lot of research in the area and it’s growing, but survival has not changed to the point that we’re happy about,” she said.
Only 10 percent of people who suffer out-of-hospital cardiac arrests survive, and the majority don’t get the immediate help they need from bystanders. High-quality CPR can double or triple a victim’s chance of survival.
As a volunteer for the AHA, Anderson serves on the Emergency Cardiovascular Care Committee. She also serves on the planning committee for the Resuscitation Science Symposium, held Saturday and Sunday in Chicago.
In addition to presenting research on the importance of high quality in-hospital CPR this year, Anderson also led a first-of its kind study showing where CPR training is happening across the United States.
Her lifesaving experience Sunday reinforced the importance of her work.
“I want to reiterate how important it is for people to act fast in emergency situations and remind everyone to learn CPR,” she said.
]]>The frantic situation occurred Wednesday inside a store in High Ridge, Missouri. Surveillance video showed the mother desperately trying to revive her baby.
The store’s manager called 911.
Abby Snodgrass, 17, heard the commotion from aisles away and ran to help, performing CPR. She had recently learned the procedure in her health class at Hillsboro High School in Hillsboro, Missouri.
“The one thought that crossed my mind was, ‘What if this doesn’t work?’ And I just had to push it out of my mind and keep going because I knew that’s what I had to do,” Snodgrass said.
Eventually the baby started breathing again.
“I can’t explain how happy I was when she started to breathe,” Snodgrass said. “It was a huge relief.”
Without the teen’s swift action, the infant may have died, emergency responders said.
Authorities said that the mother and child were doing well.
The baby’s family released a statement to ABC News acknowledging Snodgrass’s efforts.
“We are exceedingly grateful to the young woman who helped our daughter,” the statement read. “Our daughter is home and healthy, and we couldn’t be more thankful.”
Related articles
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As you’ll read in multiple other sections of this supplement, we continue to discern insights into more effective treatment approaches to out-of-hospital sudden cardiac arrest. In reality, we’ve collectively learned more in just the last decade than ever before about the pathophysiology of cardiac arrest.
With considerations about cooling (therapeutic hypothermia), chest compression continuity and alternative ventilation strategies, is there really much to talk about when it comes to something as simple as the rate of chest compressions?
“So, Dr. G, what’s your interest in chest compression rate? The American Heart Association (AHA) says to compress the cardiac arrest victim’s chest at least 100 times a minute. That’s all there is to it, right?”
That’s a good place to start and an understandable question. For purposes of this particular conversation, let’s discuss victims who are of adult age. You’re correct in your interpretation of the AHA guidelines released in late 2010.1 How the 2015 guidelines on chest compression rate will change, if at all, is unknown.
There’s been some interesting science published regarding chest compression rates since those 2010 guidelines.2,3 I’m quite sure the clinicians and scientists charged with formulating those 2015 guidelines will certainly take such discoveries into account. The fact is — no surprise here, I think — nothing is very simple when it comes to a condition as dynamic, dramatic and challenging as cardiac arrest.
Key among the latest scientific papers on chest compression rate is work done by Dr. Ahamed Idris and his colleagues in the Resuscitation Outcomes Consortium. In short, Dr. Idris and the research team found that exactly 100 chest compressions per minute didn’t produce the highest number of survivors among the large group of cardiac arrest victims who were treated by systems that participate in the ROC.4
The “sweet spot” of chest compression rate in that review, published in 2012, was much nearer to 120 chest compressions per minute.4 So, you might say that the AHA is still right because 120 compressions per minute fits the definition of “at least 100 times a minute,” although so does 140 compressions per minute, correct?
“The patients (and their families) we treat often think more is better, and if we want to be honest, many EMTs and paramedics subscribe to that belief about a lot of interventions. That said, I bet you’re getting ready to burst that bubble and tell us 140 compressions per minute may not be better?”
Actually, I’m not going to say 140 compressions per minute may not be better than a rate of 120. Instead, I’m going to say, based upon the Idris paper, that 140 compressions per minute are definitely not better for survival than 120. In that report, a very compelling graph is presented that I choose to describe as a “wave of survival per compression rates.”
The reason I call it a “wave” is that a curve implies an even rise and fall and this isn’t that. The scientific term for the actual curvilinear shape is a cubic spline model, but that’s hard for a guy like me to immediately grasp. I can visualize a wave that rises and then fades out, and I think most people can as well.
So back to that study, it’s not too hard to imagine that survival proved lower at rates less than 100 compressions per minute and then there is a slow increase to a peak in survival near 120 compressions per minute.
Here’s my key point: After 125 and towards 140 and beyond, the survival line drops off! That’s why this study is so important in my opinion, and I trust the researchers, their method of study, plus the number of patients involved was large. This is science you and I can use in our quest to produce more neurologically intact survivors from out of hospital sudden cardiac arrest.
“Why do you think 140 isn’t better than 120? Besides, are people in real life compressing at 140 anyway? That seems pretty fast and not what’s taught in the first place.”
Let me break that up into two answers. First, we have to think about this amazing organism that is the human body. What happens when you and I decide we’re going to get our particular organisms in better shape and do some aerobic conditioning or weightlifting? Why does our heart rate rise and breathing increase? We are doing the “Magic C” as I call it — compensating!
That workout-induced tachycardia and tachypnea is getting greater-than-usual oxygen-enriched blood flow to muscles that require it to perform what we’re asking of them. As long as we are pulsatile, and your patient is pulsatile, our human bodies will stretch compensation to impressive levels. But, what happens when pulsatile becomes pulseless? Compensation ceases, at least the intrinsic compensation.
So what’s the extrinsic compensation during CPR? You. Me. Your partner(s). Bystander(s). CPR is, in one word, compensation.
What percent of compensation do you and I have to attain for a person when we do CPR? 100%! Sobering, huh? We don’t even get to outsource 1%; that 100% needs to be the very best it can be, at least according to the best understanding of what works today.
As important as each compression is, the decompression phase is just as important because that’s when intrathoracic pressure drops and blood flow can return to the heart to be available for flow from the heart on the next compression. Think about the last sick patient you had in a true tachydysrhythmia with a pulse? Why were they so weak, hypotensive and likely even hypoxic? The rapidity of their pulse prevented good cardiac output and perfusion, both to central and peripheral circulation.
We may not be so worried about peripheral perfusion in cardiac arrest, but if our compressions are going to produce helpful cerebral and coronary perfusion pressures, we have to let enough decompression time occur. That doesn’t happen if we compress at 140 times a minute.
So do professionally trained EMTs and paramedics compress that fast anyway? Actually, yes, a lot do. Good – hearted, enthusiastic police officers, firefighters, EMTs and paramedics perform too many compressions. How do I know this? Back in 2011, we discovered in the process of reviewing chest compression fundamentals with each and every EMT and paramedic in the EMS System for Metropolitan Oklahoma City and Tulsa, that without a metronome to guide compressions, nearly 90% of these incredibly well-trained men and women were compressing somewhere between 135–145 times per minute!
That really opened my eyes. It affirmed to me several things: 1) We have EMS professionals in our system who really care about — and work hard at — treating cardiac arrest. Even in training scenarios, their adrenaline kicks in and they go after it! I had honestly thought if we did start using metronomes set at 120 beeps per minute, directly influenced by that ROC study we’ve been talking about, those metronomes would be needed to speed up the rates. But, I was wrong. The reverse was true; we were compressing too fast and the metronomes would help us to slow down.
It became crystal clear to me we needed to begin using metronomes to change natural compression rate tendencies. This turned out to not just be a positive for the patients, but our crews also, because we were actually able to reduce the physical work necessary in performing optimal manual chest compressions.
“Cool, Dr. G. So just compress at 120 a minute in adults, use metronomes set to that and that’s all there is to it?”
Even with what we’ve discussed so far, there’s more to it. To prove the point, I’ll share with you now that we recently changed our compression rate guideline, and metronomes, to 110 compressions per minute in rate.
“What?!?! How does that make sense based upon what we’ve been talking about?”
Back to the “nothing is really simple when it comes to cardiac arrest” mindset. In our particular system, we currently don’t use mechanical chest compression devices like the Physio-Control LUCAS 2 chest compression system or ZOLL AutoPulse non-invasive cardiac support pump. We use a team dynamic plan for coordinated resuscitation (aka the “pit crew” approach). The most common resuscitation in metro Oklahoma City or Tulsa has 5–8 EMS professionals on scene within 4–10 minutes.
In addition, one of the devices we choose to use in our airway management and cardiac arrest care is the ResQPOD impedance threshold device (ITD) for its capability of reducing intrathoracic pressure during decompression — another important factor in cardiac arrest resuscitation.
Further, because of the emphasis we’ve been placing on the continuity of chest compressions and getting quick feedback to our colleagues about how consistent in rates and continuity that their compressions were or were not in individual resuscitations, we’ve seen our chest compression fraction (time of resuscitation in which chest compressions are occurring) move from a typical 85% to more than 95%.
Without getting too far down in the weeds of science, it’s important to point out that use of mechanical chest compressors and/or the impedance threshold device can influence the basic physiology of hemodynamics produced by compressions.
Through very in-depth conversations that I’ve had over the past few years with the clinical scientists who developed the impedance threshold device, it appears that the ideal compression rate for CPR without an ITD, as reported in the Idris paper, differs from what’s ideal if an impedance threshold device is used in-line in the airway circuit.
It seems the best rate when using an impedance threshold device is much closer to the 100 compression rate per minute; in fact, in subsequent data analysis, the best overall survival in the ROC study occurred in patients who received an active ITD with chest compression rates close to 100/min. So, we’re slowing down to 110 for now, primarily based upon both this specific data analysis and our system-specific chest compression fraction and effective compressions per minute. We’ll continue to follow our survival outcomes and adjust our chest compressions rates as further observation and science dictates.
To illustrate how complex this can get, if active compression – decompression CPR with an ITD finds its way to the streets of the United States, that ideal chest compression rate may be as low as 80/min according to a recent U.S. study!
It does make sense when you appreciate that all of these things produce different compression types and intrathoracic pressure and, thus, different compression types and adjuncts, like the ResQPOD ITD and mechanical compression devices, will produce different optimal rates.
Just remember, it still is all about survival and there are a lot of “fine tuning” knobs to turn back and forth as science gives us updates to our user’s manual for resuscitation.
“Wait, Dr. G. So you’re talking a lot about rate, but not so much specifically about metronomes. Seems like those are more important than you first thought and if anything, they’re getting even more important. Why don’t the monitor/defibrillators have metronomes adjustable from 100 per minute? Should we ignore those? And, what metronomes should we be buying?”
First, you’re right. Metronomes are far more important than I first thought. In fact, credit goes to paramedics in our system who pushed the concept. I’ll claim to be smart — smart enough to listen to what proved to be their great idea.
Those early metronomes came about because not all the responding companies (fire-based) had manual monitor/defibrillators and not all of our monitor/defibrillators had built-in metronomes at the time. And, for my manufacturing colleagues reading this article, I’ll admit some frustration at the lack of their built-in metronomes being changeable in rate. But, I’ll also admit that I understand the frustration that these manufacturers have themselves because they can’t put a “dial the rate up or down” knob or touchscreen on their devices without a time-intensive and costly journey through the Food and Drug Administration review and approval process.
Should you ignore those metronomes that come with the cardiac monitor/defibrillators? Not if your local medical oversight physician(s) want you to use them. If they do, please use them per your system-specific treatment guidelines.
In our system, we’ve purchased musical metronomes that do allow for rate changes. This made it possible to start at 120 beeps per minute, change to our current 110 beeps per minute, and still allow for future changes. I’m pretty sure these music industry companies have no idea what paramedics are doing ordering dozens of metronomes. They probably think we’ve got some great garage bands in urban Oklahoma!
Many options exist in the marketplace. I recommend you try to find something that’s easy to activate and see or hear, with the durability of the proverbial EMS steel ball, something that allows for rate changes (but doesn’t allow crews to change it to undesired rates or allow unintended changes in rates), and something sized to promote ready accessibility.
There are a lot of smartphone apps with audible and visual metronomes that are adjustable as well. We considered use of smartphone apps, but didn’t want to ask our EMS professionals to use their personally owned devices in the provision of resuscitation.
Many of the agencies in our EMS system have found great ways to physically attach metronomes to the outside of their AEDs or manual monitor/defibrillators so initial arrival EMTs and paramedics don’t have to go fishing in a pocket or compartment to find it in the early and chaotic first minutes of resuscitation. Easy access always promotes consistency in early use.
“So, Dr. G.: What kind of improvement have you seen in resuscitation practices in the EMS System for Metropolitan Oklahoma City and Tulsa since your crews started using these metronomes during cardiac arrest resuscitations?”
We made an assumption when the pit crew protocol was finalized and initially implemented, that the medics were providing 120 compressions per minute per our protocol. All of the involved agencies had metronomes at that time and there was nothing to lead us to believe this rate was in question.
When we participated in a cardiac arrest resuscitation analytics annotation pilot project sponsored by one of our industry partners in February and March of 2014, we found that the compression rates on some cases were alarmingly high while others were at or near 120. So we added a field to the data we collect and the CPR rates have been continuously tracked since that time.
One of the things we found early on was that some of the smaller sized metronomes were not being used for various reasons. In some cases, it was simply because the crews forgot to use them, though in others it was because the Velcro that had been used to attach them to the monitors had become worn and the metronomes either fell off and were lost, or they were simply placed in the monitor case where EMTs and paramedics didn’t know they were relocated. Like they say, out of sight can equal out of mind!
We also learned that environmental noise can cover the sound of the metronome, so, whatever metronome you use, it has to be capable of being heard and/or seen. The metronomes built into the cardiac monitor/defibrillators do seem to solve that problem, but I want to caution that I personally don’t think 100 compressions per minute for all cardiac arrest patients, in all resuscitation practices is the optimal rate as we know it today.
In all of the cases in our specific system when the metronome wasn’t used, the compression rate was certainly faster than the 120/min we desired. Interestingly, when the ambulance would go en route to the hospital, rates often jumped almost immediately from around 120 to 130 and above.
After we mounted a concerted effort to have the providers utilize the metronomes and began revealing the patterns in compression rates at our monthly CQI meetings and additionally in emails to the education departments in our system agencies, we found almost immediate elimination of extreme compression rate deviations (e.g., greater than 160/min).
Our typical rate is now 123/min. Keep in mind we’re still rolling out the change to 110/min. This is down from 129/min. It doesn’t sound like much, but there are nearly 100 workable arrests every month in our system and that’s a great achievement by our fire and EMS crews in focusing on hitting that compression “sweet spot” of compressions per minute. We believe it has strongly contributed in increasing our successful resuscitations.
“Thanks, Dr. G. Do you have any parting thoughts?”
It’s an exciting time in EMS resuscitation. It takes work on everyone’s part to keep pace with the findings we’re putting into practice. Thanks for your commitment to excellence in out-of-hospital EMS medicine by reading this article. Together we’re finding better answers to challenges like cardiac arrest, answers that truly make a life or death difference to people we serve, and when they need those answers most. Keep reading and asking questions because scientific discoveries are happening in EMS medicine now more than ever.
References
1. Field JM, Hazinski MF, Sayre MR, et al. Part 1: Executive summary: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(suppl 3):S640–S656.
2. Field RA, Soar J, Davies RP, et al. The impact of chest compression rates on quality of chest compressions: A manikin study. Resuscitation. 2012;83(3):360–364.
3. Jäntti H, Silfvast T, Turpeinen A, et al. Influence of chest compression rate guidance on the quality of cardiopulmonary resuscitation performed on manikins. Resuscitation. 2009;80(4):453–457.
4. Idris AH, Guffey D, Aufderheide TP, et al. The relationship between chest compression rates and outcomes from cardiac arrest. Circulation. 2012; 125(24):3004–3012.
5. Aufderheide TP, Nichol G, Rea TD, et al. A trial of an impedance threshold device in out-of-hospital cardiac arrest. N Engl J Med. 2011;365(9):798–806.
6. Aufderheide TP, Frascone RJ, Wayne MA, et al. Standard cardiopulmonary resuscitation versus active compression-decompression cardiopulmonary resuscitation with augmentation of negative intrathoracic pressure for out-of-hospital cardiac arrest: A randomized trial. Lancet. 2011;377(9762):271–352.
7. Kern KB, Stickney RE, Gallison L, et al. Metronome improves compression and ventilation rates during CPR on a manikin in a randomized trial. Resuscitation. 2010;81(2):206–210.
When taking a CPR course, many instructors are quite skilled at delivering their curriculum to students. Everyone can expect to learn the basics and obtain what they need to know in order to be certified at performing CPR should an emergency situation arise. Yet the curriculum isn’t the entire story. Like other healthcare related fields, CPR students should consider supporting their coursework with added resources and tools that may help them gain a broader understanding and appreciation for CPR and their place in the field. The following tools can be enriching resources for anyone learning CPR or getting recertified.
Many hospitals, especially large ones, have medical libraries. These libraries are excellent facilities that often contain the latest medical journals in various fields along with computers, research databases, and a wide array of research materials. Moreover, they may even contain mixed media materials like videos that can help people in the healthcare field study or perform research on a given topic like CPR. Medical libraries also employ librarians that may provide knowledgeable assistance about their resource materials and can help point out items that may be useful for anyone training in CPR.
Digital Resources
Many people taking CPR training classes find that apps can be especially useful. The American Heart Association has developed an app called Pocket First Aid & CPR. The app provides concise and clear information as well as step-by-step instructions. For use with both iPhones and Android smartphones, the app and others like it are essential for trainees. Moreover, even people who have completed their CPR training will find this app can bolster all that they have learned which can be especially helpful as people are likely to forget important details of training when they have not used them on a regular basis. A simple Google search will reveal many other important apps that can assist trainees involved with CPR or BLS (Basic Life Support).
Internet Blogs
Many certified CPR instructors post regular blogs as do many other instructors in related fields. Reading blogs is a great way to stay tuned to the latest news stories associated with CPR or BLS and to connect with other certified CPR instructors or trainees. Blogs contain all sorts of useful information–even anecdotes that may impart some important advise that didn’t come up in class. Often CPR blogs will focus on life-saving events where CPR was used to help someone in an emergency situation. See if your CPR training professional has a blog or, perhaps, you may even follow several that can provide you with a multitude of CPR-related posts.
CPR is some of the most important training you can do. Yet one never knows when it may be needed. Therefore, it’s vital to stay up on the topic and to review various aspects of the training. Resources like apps and blogs can certainly help. If you are currently enrolled in CPR training, don’t forget to check the medical library for added support materials that can enhance your coursework.
]]>When most people sign up for CPR training, they may have the idea that their newly acquired skills will be helpful to mankind, possibly even someone among their acquaintance at the grocery store, in the office, or even at home. Yet there have been cases where CPR skills and know-how have saved the life of an animal such as a family pet. Though CPR is usually regarded as a renowned set of procedures that can save a human life, it can actually be used to save the lives of some animals too.
Humans to the Rescue
This past spring the Huffington Post reported on animal CPR and shed light on some astounding instances where CPR was used to save animals. For instance, an Australian woman happened to notice that a pigeon wasn’t breathing. She knelt down, gave it three or four breaths, and pumped its chest; the bird revived and again showed signs of life. Instead of a human in a park, it was a pigeon near a lane and the instance showed how CPR can work wonders on other forms of life too. The report also mentioned that CPR has been employed to save other animals, too, such as a cheetah cub, tapir, hamster, bald eagle, lemur, panda bear, tiger, and many more. (huffingtonpost.com/2013/03/03/animal-cpr-tapir-cheetah_n_2734549.html)
What about Fangs? What about Claws?
It might be worth noting that the cheetah and tiger listed above were young; few certified CPR experts would have the nerve to give a full-grown tiger mouth-to-mouth no matter how out of commission it might seem. That said, coming into such close proximity with a wild animal is a risk. These were unusual instances where individuals assessed their personal risk very quickly and made the decision to help. In essence, these were personal choices. The eagle, mentioned above, was given mouth-to-mouth resuscitation by an Oregon veterinarian who had, of course, considerable experience providing care for animals. The eagle had been hit by a car and the subsequent CPR saved its life.
CPR Tips for Animals
One might thing that bird or cheetah–what’s the difference? Doesn’t a one-size CPR fit all? The fact is that there are some nuances as well as some precautions involved with animal CPR. For one, experts recommend that CPR should not be attempted unless the animal has no pulse and isn’t breathing. First, it’s vital to see if the animal has choked on an object. In the case of the tiger cub, it was choking on some meat it was eating at a zoo. Also, the mouth-to-mouth technique actually works better, according to the news report, if the human delivers life-saving breaths via the nose. For more information about delivering CPR to animals, check with the American Red Cross that has a webpage about pet first aid (redcross.org/prepare/disaster/pet-safety).
While it’s common knowledge among veterinarians and even their staff members that CPR saves pets, it isn’t something most people think of when they sign up for CPR training. On the other hand, since many people have beloved pets, it might be helpful to know how one performs CPR on the family dog or cat. Discuss your questions about specific pets with yourinstructor.
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“Around 800,000 people suffer a cardiac arrest in the European Union every year and only 8.0 percent survive,” Momont, 23, said at the TU Delft University.
“The main reason for this is the relatively long response time of emergency services of around 10 minutes, while brain death and fatalities occur with four to six minutes,” he said in a statement.
“The ambulance drone can get a defibrillator to a patient within a 12 square kilometre (4.6 square miles) zone within a minute, reducing the chance of survival from 8 percent to 80 percent.”
Painted in emergency services yellow and driven by six propellers, the drone can carry a four kilogram load — in this case a defibrillator.
It tracks emergency mobile calls and uses the GPS to navigate.
Once at the scene, an operator, like a paramedic, can watch, talk and instruct those helping the victim by using an on-board camera connected to a control room via a livestream webcam.
The prototype has already attracted the interest of emergency services including that of Amsterdam, the Dutch daily Algemeen Dagblad said.
The Dutch Heart Foundation also applauded the idea, the newspaper added.
Momont however wants his drone to become a “flying medical toolbox” able to carry an oxygen mask to a person trapped in a fire or an insulin injection to a diabetes sufferer.
However, the drone is still in its infancy as far as developing its steering mechanism and legal issues regarding its use are concerned, Momont said.
He said he hopes to have an operational emergency drone network across the Netherlands in five years.
The drone is expected to cost around 15,000 euros ($19,000) each.
“I hope it will save hundreds of lives in the next five years,” Momont said.
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