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Thread: CPR Breaths or No Breaths

  1. #11
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    One of the hurdles to getting more bystander CPR was aversion to ventilations. The criticality of consistent, continuous compressions was already known. AHA, ARC, and the medical community made peace with the blockers and rewrote some lay curriculum for compressions-only. They also created some options for familiarization/completion courses instead of certified courses that didn't require portions of the usual testing, increasing the amount of people willing to take the class at least have the knowledge in a credible way.

    Certification courses that include ventilations and barrier devices are still the standard of care for medical personnel and professional rescuers.
    Properly performed ventilation+compression courses in general are still better than compressions-only.
    Rescue breathing is a critical skill in infant/child products.
    Ventilations haven't gone away, they are just made optional/deemphasized by training product. Anyone that says otherwise is wrong.

    Another factor in this is access time. Compressions-only is most viable where there is fast access to rescuers. In areas of delayed response, ventilations become important again for everyone. However, even then the longer you're doing even good CPR the lower chances of survival are.

    Contents of various training products are available the ARC, AHA, and NSC websites.
    2012 National Zumba Endurance Champion
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  2. #12
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    Quote Originally Posted by ST911 View Post
    One of the hurdles to getting more bystander CPR was aversion to ventilations. The criticality of consistent, continuous compressions was already known. AHA, ARC, and the medical community made peace with the blockers and rewrote some lay curriculum for compressions-only. They also created some options for familiarization/completion courses instead of certified courses that didn't require portions of the usual testing, increasing the amount of people willing to take the class at least have the knowledge in a credible way.

    Certification courses that include ventilations and barrier devices are still the standard of care for medical personnel and professional rescuers.
    Properly performed ventilation+compression courses in general are still better than compressions-only.
    Rescue breathing is a critical skill in infant/child products.
    Ventilations haven't gone away, they are just made optional/deemphasized by training product. Anyone that says otherwise is wrong.

    Another factor in this is access time. Compressions-only is most viable where there is fast access to rescuers. In areas of delayed response, ventilations become important again for everyone. However, even then the longer you're doing even good CPR the lower chances of survival are.

    Contents of various training products are available the ARC, AHA, and NSC websites.
    Well said. Especially about the kids.

    The main reason I place an “advanced” airway device (adults) early on is to explain in my documentation why we started continuous compressions. AHA guidelines. Well, that, and because whoever got there before me inflated the belly.

    This topic can be both very simple, and complicated, hence my earlier answers of “if you’re asking...push”.
    RLTW

    “What’s New” button, but without GD: https://www.m4carbine.net/search.php...new&exclude=60 , courtesy of ST911.

    Disclosure: I am affiliated PRN with a tactical training center, but I speak only for myself. I have no idea what we sell, other than CLP and training. I receive no income from sale of hard goods.

  3. #13
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    The last two times recert it's been just compressions only. Main reason is the American Heart certified not Red Cross and their fee for a card. My organization is probably going to skip recertification this year due to budget cut to only if required for mission. I was informed 6 days before I had training on new Alcohol breath testing machine to cancel it that I wouldn't be paid for going.
    I thought it was quite odd I just got a new CPR Rescue mask in I ordered and have it in front of me when I seen this thread. My old one is probably in my SCUBA diving bag still.
    NRA Life Member.

  4. #14
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    Quote Originally Posted by 1168 View Post
    Well said. Especially about the kids.

    The main reason I place an “advanced” airway device (adults) early on is to explain in my documentation why we started continuous compressions. AHA guidelines. Well, that, and because whoever got there before me inflated the belly.

    This topic can be both very simple, and complicated, hence my earlier answers of “if you’re asking...push”.
    Organizations can do whatever they want, I worked for EMS agency where we stopped doing ACLS because we had better outcomes with our own protocols.

    The hospital in which I work now, the cardiac service uses their own protocols. They still have to take ACLS for accreditation purposes, but their internal policies and protocols are different than some of the AHA algorithms.

    For the others: this is not a new change and has been the standard for lay people life support for a while now. It is merely to ensure better community compliance with compressions.

  5. #15
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    Quote Originally Posted by ST911 View Post
    One of the hurdles to getting more bystander CPR was aversion to ventilations.

    Ventilations haven't gone away, they are just made optional/deemphasized by training product. Anyone that says otherwise is wrong.

    Another factor in this is access time.

    ...the longer you're doing even good CPR the lower chances of survival are.
    Quoting the above for absolute truth. Great post and the bullet points above are why you see such a widespread adoption of "hands-only" CPR being taught to laypeople.

    The 2 biggest factors to surviving (adult) pre-hospital cardiac arrest are downtime to CPR and early defibrillation if appropriate. Time is muscle, and your brain tissue will begin to die after roughly 5 minutes without blood circulating to exchange oxygen for the waste products of metabolism. Performance-wise, the most significant things are to ensure that compressions are at an adequate depth (you can feel a carotid pulse when someone is performing chest compressions if you're unsure if they are deep enough. This is usually a problem with bystander CPR or with infants) and that the chest is allowed to fully recoil. We naturally ventilate through negative pressure; by allowing the chest to fully recoil, we not only provide time for the chambers of the heart to fill with blood, but we also allow our lungs to fill to their functional residual volume with room air. While this is obviously not the same volume as ventilating, it is sufficient for gas exchange in the lungs and is part of why you'll see some environments push for passive oxygenation without interrupting chest compressions.

    Great posts in this thread.
    Last edited by GTF425; 06-27-21 at 11:10.

  6. #16
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    Quote Originally Posted by chuckman View Post
    Organizations can do whatever they want, I worked for EMS agency where we stopped doing ACLS because we had better outcomes with our own protocols.
    I left an EMS agency that was pretty much ACLS/PALS to the T and my current employer has a vastly different standard of care. Heads-up CPR, passive oxygenation via high-flow NC, single-dose Epi, Levophed for certain PEAs, etc.

    Quite a...shock...for crews on a scene flight when we take over care for an arrest.
    Last edited by GTF425; 06-27-21 at 16:08.

  7. #17
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    I’m also into passive oxygenation via ETCO2 nasal cannula.
    RLTW

    “What’s New” button, but without GD: https://www.m4carbine.net/search.php...new&exclude=60 , courtesy of ST911.

    Disclosure: I am affiliated PRN with a tactical training center, but I speak only for myself. I have no idea what we sell, other than CLP and training. I receive no income from sale of hard goods.

  8. #18
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    We just reverted recently and compressions only seems to be the new way for us to in CA

    Sent from my moto g power (2021) using Tapatalk

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