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Friday, December 17, 2010

Bureaucracy, Reprise

One of the things I griped about in my long and rambly rant about our company's bureaucracy and resulting daysleeper stint I pulled for mandatory safety/medical training, was the lame videos and poor actors showing us poor techniques.

One of the things I didn't like was when there were two people doing civilian CPR under the new rules with no one giving ventilations, that (a) they didn't check for a pulse before commencing compressions, and (b) the bystander just watched impassively when they could have at least verified/maintained a good airway.

Then I got a comment from mack505 regarding those observations.

"Don't check for a pulse, just start compressions." -- I believe this is what AHA is teaching non-rescuers now. Something about not properly recognizing agonal respirations. Perhaps your instructor is just ahead of the curve? :-)

Wouldn't you know, this weeks EMS training was about the new Professional Rescuer's CPR being rolled out in our area. As expected, a huge emphasis on fast and uninterrupted compressions, but with some new local twists that I won't get into here as they are not terribly important. But really the new stuff makes so much sense that if you're like me you're kicking yourself that we didn't all go to this years ago.

Amazing that we had our two local CPR full saves in the past six months or so under the old rules, and now they're telling us that if we get numbers like other study areas, we might get up to 50% of our codes to the ER alive, and something north of 20% might go on to make it out of the hospital.

Anyway, nods and props to mack505, as sure enough our FD paramedic proctor provided some anecdotal information regarding bystander CPR cases, where bystanders performed compressions over hearts that were still beating, resulting in a relatively minuscule number of actual rib injuries (and one broken leg, WTF????), but zero deaths. Result? Bystanders should not waste time checking for a pulse - a skill set they usually don't have in the first place - when they can't do any real harm by just pumping away and asking questions later. Can you feel me now?

So there you have it. I actually DID learn something in the company training. I just didn't know it at the time.

Still, that second bystander should have been maintaining the airway, right?


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