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Rescue breathing with CPR?

Discussion in 'Firefighter/EMS Talk' started by Alpha752, Nov 20, 2004.

  1. Alpha752

    Alpha752

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    We had a discussion in class the other day and I wanted your opinions. In this scenario, you are off duty, with no equiptment and come across an unknown unresponsive, no respers, no pulse. You initiate CPR, but do you do mouth to mouth with out a barier?

    We tossed this around for a while and while I understand the risk for infection and such, I am still in the newbie, save everyone phase and would probibly do it. The older seasoned guys say no way, compressions only. Someone said use their shirt as a barier, but there can still be fluid transfer through a shirt. I have a pocket mask in my bag, and several at work, so most everywhere I go I have a barier (not that I am expecting to save the world or anything like that), but what if you dont have one.

    Thoughts?

    Russ
     
  2. obxprnstar

    obxprnstar Goth Lover

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    My understanding is that layman CPR is now being taught as compression only now. Somthing to do with the lack of adaquate ventilation being done, and when you stop compressions it takes like nine or twelve compressions for the coranary pressure to rise to an acceptable level.

    I suppose all of this is moot as you are an EMT. My dad had a guy drop in front of him when he worked in DC, circa late eighteies. Apparently old pops started CPR on the guy and someone from the firemarshalls office, they shared an office building, joined in to do CPR.

    While we sit here and all of this is strictly academic it would not be very likley that I would not stop, and if I did compresions would be it. I don't care what the odds are that I will not catch anything, I am not inclined to push my luck.
     

  3. glockster96

    glockster96 Moderator Lifetime Member

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    Compressions only. You will get enough pseudo-ventilations (I just made up a word) from the intrathoracic pressure changes that occur during compressions. :)
     
  4. TerraMedicX

    TerraMedicX

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    The lack of adaquate ventilation in bystander CPR is usually a result of the "ew! Puke!" mentality and not a problem with mouth-to-mouth being effective. The research on transmition of diseases by mouth-to-mouth is actually fairly conclusive that there is very little risk (Mejicano and Maki, Annals of Internal Medicine, Nov. 15, 1998 for those of you who care). Now, there is obviously SOME risk, but I don't really think that anyone can truly justify not doing mouth-to-mouth for this reason. Now, personally, I probably wouldn't do mouth-to-mouth on anyone short of a family member or good friend, but not because I'm affraid of getting anything....I just don't want anyone to puke in my mouth!!

    Nate.
     
  5. jlw_84

    jlw_84 General Glocker

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    I had a guy go down, pulse weak and irregular, NO Breathing, already turned blue/sweaty/cold, and had puked all over himself. It was a big mess.

    Anyway, I had NO equipment with me, not even gloves. Being a fairly new EMT at the time, I knew he needed breaths.

    Long story short, there was a plastic grocery bag nearby, I took out my pocket knife and cut off a section, then put a slit in it.

    I used that as a barrier device.

    Any who, the gun is still living today, had a brain aneurysm.
     
  6. DaleGribble

    DaleGribble Sandwich!

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    If it's a family member, friend or a co-worker (some of them anyway ;g) I'd give rescue breaths without any barrier device.

    If it's a total stranger, well...

    My wife and I both have one of those little pouches that fits on key rings so we always have a mask with us.
     
  7. OXCOPS

    OXCOPS

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    FWIW, when I went through ARC instructor school back in March, they were still teaching rescue breathing as part of the whole process. They have not sent me any updates so I assume that is still the current plan.
     
  8. obxprnstar

    obxprnstar Goth Lover

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    Me thinks it is American Heart Assoc that teaches no breathes for "lay person" CPR.

    ARC and AHA are at times diffrent. If the AHA upholds this standard during their next review you will probabbly see a change is ARC.
     
  9. OXCOPS

    OXCOPS

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    True. From what I have seen, the AHA is geared more for the professional rescuer. Fire/EMS/Nursing/etc. ARC is more for everyone else.

    But, you are right. When one changes, the other one usually follows suit shortly after. Is AHA still teaching two-man CPR? ARC has gone to teaching only one-man rescue.
     
  10. obxprnstar

    obxprnstar Goth Lover

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    Yes, to the best of my knoledge AHA still teaches two man CPR.

    I would imagine you are right when you say AHA is focused more for the healthcare provider/practicioner.

    I would imagine ARC figures that if you are doing somthing, then no one else has any training.
     
  11. Alpha752

    Alpha752

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    AHA is teaching 2 man in the sence that there are 2 people doing it. There are no longer any diffrences between 1 man and 2 man, its all 15 compressions to 2 breaths no matter how many people are doing it.

    Now they are looking at taking breaths out of it for non rescuers (thats what brought this thread on), and I have also heard that they are considering inplementing a series of abdominal compressions along with the chest.
     
  12. OXCOPS

    OXCOPS

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    That is what I was wondering. The ARC has gone with the standard 15/2 no matter how many people are working on the subject. I guess you couls still add however many you needed to get the job done.

    As far as stopping the rescue breathing, I think that is a bad idea. Every little bit of O2 helps.
     
  13. DepChief

    DepChief Get Tous's Rope

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    I am currently a BLS instructor with AHA. While performing CPR without providing ventilations has been discussed in the AHA instructor classes, we ARE still teaching layperson and professional CPR using mouth to mouth and BVM to mouth ventilations. As far as using shirts or plastic bags as barrier devices, neither of these incorporate a "one way" valve and therefore would offer no protection in the transmission of communicable diseases. You would be just as protected as if you used direct contact mouth to mouth. While the possibility of the transmission of these diseases is very small doing mouth to mouth, I still would not risk my health or life on someone in which I do not know their past medical history. Would you go into a structure fire without turnout gear or an airpack? We also know that CPR alone does not usually get the desired results when dealing with Sudden Cardiac Arrest (SCA), that early defibrillation and ACLS is the patients best hope. I would simply perform just the chest compressions and pray that an ALS unit was on the way!!!
     
  14. m1685

    m1685 Senior Member

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    If you don't have a barrier device( w/one way valve), stay on the safe side with compressions only.

    Remember, WE are the number one priority in the Fire Service/Emergency Services. If we get injured or sick, we can't do our jobs. We must protect ourselves first and foremost.

    If I recall correctly, the statistics for cpr actually saving someone is very low. But used in conjunction with early difibrilation can be helpful.
     
  15. bsvfd625

    bsvfd625

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    I am a firefighter/reserve officer in the local town i live in. I came across that situation before and I was not going to give rescue breathing to the pt. Luckly, her live in boyfriend was willing to breathe for her. The first thing you should always think about is saftey. You don't know what the pt. has. It turns out that the woman i did compressions on had HIV. So, i am dang glad i didn't even attempt it.
     
  16. 40Niner

    40Niner

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    The Charlotte Observer had an article on compressions only...It seems that a high enough percentage of 911 callers are reluctant to do mouth to mouth,even on family members.As a result,in some instances,the dispatchers may instruct the caller to do compressions only.I guess some is better than none until the "real" help arrives.
     
  17. OXCOPS

    OXCOPS

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    Something is better than nothing.