new cocepts in cpr


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new cocepts in cpr

  1. 1. New Concepts in CPR Presented by Alyson Welch EMS Educator Gilbert Fire Department
  2. 2. Objectives <ul><li>Overview of new concepts in CPR </li></ul><ul><li>Discuss CC CPR including: </li></ul><ul><ul><li>Who, Why, and How </li></ul></ul><ul><li>Watch demonstration of CC CPR </li></ul><ul><li>Overview case with CC CPR </li></ul><ul><li>Discuss CCR </li></ul><ul><ul><li>Including Who, Why, and How </li></ul></ul><ul><li>Watch demonstration of CCR </li></ul><ul><li>Overview of case with CC CPR </li></ul><ul><li>Review </li></ul>
  3. 3. Three Types of CPR used in Arizona <ul><li>AHA CPR 2005 Guidelines (CPR) </li></ul><ul><li>Continuous Chest Compresssion CPR (CC CPR) </li></ul><ul><li>Cardio Cerebral Resusitation (CCR) </li></ul>
  4. 4. Abbreviations <ul><li>SCA - Sudden Cardiac Arrest </li></ul><ul><li>CPR – Cardio Pulmonary Resuscitation </li></ul><ul><li>CC CPR – Chest Compression CPR </li></ul><ul><li>CCR – Cardio Cerebral Resuscitation </li></ul>
  5. 5. Alternatives to Traditional CPR <ul><li>Why are alternatives acceptable? </li></ul><ul><li>How are alternatives developed? </li></ul><ul><li>Were these piloted and where? </li></ul>
  6. 6. Why are alternatives acceptable? <ul><li>Oxygen Supply in the Body </li></ul><ul><li>Respiratory Arrest patients have depleted oxygen stores in their blood. </li></ul><ul><li>Sudden Cardiac Arrest patients have non circulating oxygen supply in their blood. </li></ul>
  7. 7. How are alternatives developed? <ul><li>University of Arizona has been studying version of CPR and their outcomes on pigs. </li></ul>
  8. 8. Were these piloted and where? <ul><li>Tucson began a pilot study using a version of CPR. </li></ul><ul><li>Other cities in the state joined in after being approached and reviewing the data. </li></ul><ul><li>Mesa, Gilbert, and Apache Junction began using this during the summer of 2005. </li></ul>
  9. 9. Phases of CPR Possible therapeutic hypothermia or other new concepts After about 10 to 15 min Metabolic phase 3 CPR before electrical therapy About 5 min to 10 or 15 min after arrest Circulatory (hemodynamic) phase 2 Electrical therapy From time of arrest to about the first 5 min after arrest Electrical phase 1 Important intervention Time from VF arrest Phase Name Phase
  10. 10. CPR <ul><li>Cardio Pulmonary Resuscitation = heart, lung resuscitation </li></ul><ul><li>During traditional CPR, patients are given both chest compressions and ventilations during resuscitation attempts. </li></ul>
  11. 11. Continuous Chest Compresssion CPR (CC CPR) <ul><li>This type of CPR is taught to lay people. (non health care providers) </li></ul><ul><li>CC CPR emphasizes on hard, fast chest compressions, minimizing interruptions. </li></ul><ul><li>During CC CPR, a patient receives chest compressions that circulates oxygenated blood. </li></ul><ul><li>Early defibrillation when a device is available. </li></ul>
  12. 12. CC CPR Demonstration <ul><li> </li></ul><ul><li> </li></ul>
  13. 13. CPR Jackhammer Steve Berry
  14. 14. Survivor Story
  15. 15. Cardio Cerebral Resuscitation (CCR) <ul><li>This type of CPR is taught to healthcare providers, with approval from medical direction. </li></ul><ul><li>CCR emphasizes on hard, fast chest compressions, minimizing interruptions, defibrillation, and administration of epinephrine and atropine.. </li></ul><ul><li>During CCR, a patient receives chest compressions that circulates oxygenated blood, vital defibrillations, and medications. </li></ul>
  16. 16. CCR <ul><li>CCR is used on patient who have a sudden cardiac arrest </li></ul><ul><li>DO NOT USE ON : </li></ul><ul><li>Primary Respiratory Arrest </li></ul><ul><li>Overdose Arrest </li></ul><ul><li>Traumatic Arrest </li></ul><ul><li>Drowning </li></ul><ul><li>Any patient <8 years old </li></ul>
  17. 17. Why CCR? <ul><li>Oxygenated heart is critical to defibrillation </li></ul><ul><li>Sudden Cardiac Arrest patients have non circulating oxygen supply in their blood </li></ul><ul><li>The medications given help to increase a heart rate </li></ul>
  18. 18. Results <ul><li>Since the pilot began, CCR has changed several times based on the patient outcomes. </li></ul><ul><li>Save rate was at <3% in the Town of Gilbert prior to using CCR. </li></ul><ul><li>Current save rate is at 33% in the Town of Gilbert using CCR. </li></ul>
  19. 20. CCR Demonstration <ul><li>Please welcome Gilbert Fire Department L253 A shift. </li></ul><ul><li>Captain Paramedic Frank Plite </li></ul><ul><li>Engineer Dave Tavares </li></ul><ul><li>Firefighter Paramedic Jodi Spargo </li></ul><ul><li>Firefighter Chris Mills </li></ul>
  20. 22. Return of spontaneous pulses during cardiocerebral resusitation (CCR) <ul><li>If patient has an organized rhythm with a pulse during the analysis phase, then proceed with the following: </li></ul><ul><li>1.  Support patient ventilation with BVM at 8/min (strictly avoid </li></ul><ul><li> hyperventilation) 2.  Administer 250 ml of intravenous fluid 3.  Administer Lidocaine bolus at 1 to 1.5 mg/kg IV and hang a drip. </li></ul><ul><li>4.  Perform 12-lead ECG to check for STEMI (ST elevation MI) and </li></ul><ul><li>pre-notify ED </li></ul><ul><li>If patient goes into cardiac arrest again, perform chest compressions at a rate of 100/per minute. Ventilate the patient at 8 breaths per minute. Follow ACLS protocols. </li></ul>