How to use CPR feedback differently
Sponsored by medical tree related
By Tim Nowak for EMS1 BrandFocus
It’s CPR renewal time. You enter a room with a floor (or tables) lined with mannequins and a screen at the front of the room already frozen at the start of the video series.
Sounds like every refresher course you’ve taken, doesn’t it?
Although the goal of CPR refresher courses is not necessarily to create a full and dynamic environment of critical thinking, they are designed to hone and solidify your squeezing skills in the moment. But CPR training should not be limited to semi-annual refreshers.
Having access to – and using – CPR feedback devices in your training scenarios can provide your agency and team members with individual data that can reshape practices, validate assumptions and provide comfort. quality supervision knowing that everyone is capable of effective CPR.
In fact, it’s helpful to use CPR feedback devices at every stage of your career, from a physical ability test scenario during the hiring process to continuing education labs and even skills validation sessions. skills and accreditation with your agency’s medical director.
However, resuscitation as we know it is not always so simple, or even the same in all situations.
Should you focus on continuous chest compressions and passive oxygenation while on the scene, or an immediate load-and-go situation with attempted chest compressions in your moving ambulance? Many protocols across the country place these two situations in entirely different buckets with respect to purpose, practicality, and protocol procedures.
Integrating training around these situations is therefore imperative and an area where CPR feedback can shine in your training environment.
Scenario A: On-stage compressions
You are directed to a possible cardiac arrest call in a residence. You arrive to find an unresponsive 62-year-old man lying on the floor and his wife performing chest compressions. His wife states that she heard her husband fall and rushed to his aid, finding him unconscious.
This situation puts our crew in “ideal” conditions, kneeling next to the patient in a spacious space like a living room (if your patient is in a hallway or bathroom, there’s no saying you can’t move them into the living room where you will have more space to work). Compressions can follow a continuous pattern for two minutes or be based on another format of 30 compressions for two ventilations.
In both protocols, the conditions are “ideal” for performing chest compressions. The results your crews provide here may be drastically different from future scenarios, and real-time feedback will help you measure the difference.
Scenario B: In transport
You arrive at the scene of a motorcycle accident against a van and find the motorcyclist ejected and lying far from the scene of the accident, unresponsive. You check the pulse and think you still feel one. Restriction of spinal movement is maintained, you place your patient on a stretcher or longboard and secure them to your bed, transporting them quickly to your ambulance. In your ambulance, you don’t feel a pulse, so you start chest compressions and tell your partner to step on it!
Performing chest compressions in the back of a moving ambulance is no longer recommended as “normal” practice in many EMS systems, at least for medically induced cardiac arrests. For traumatic arrests, however, this may be the patient’s only saving grace before reaching the nearest emergency department. As such, it is still important for us to practice situations involving practicing performing chest compressions in a moving ambulance.
Place your CPR training equipment in the back of one of your available ambulances and drive through a vacant parking lot for 10 minutes or more, monitoring the effectiveness of the chest compression as you accelerate, decelerate, stop, and turn ( again, it is recommended to do this in a vacant parking lot, not on an active roadway).
Try performing chest compressions with one hand while the other holds a hand bar overhead. Compare these results to two hands or to the previous scenario.
SCENARIO C: During patient transfer
You arrive at the hospital with your patient STEMI – who is now also a patient in cardiac arrest, and you have been performing chest compressions for two minutes. There are monitor and defibrillator cords everywhere, IV lines, oxygen tubing – and the patient’s arms not even attached to his body yet.
You need to get your patient from point A to point B safely, and during effectively perform chest compressions. But how?
If you think jumping on the bed and straddling your patient is a good idea, think again. Worse still, stepping on the side rails of the bed and “rolling over” while you bend over to compress yourself isn’t as effective as it sounds. Instead, you should remove the bed from the back of your ambulance, lower it to about a third of the loading height, and walk slowly along the bed while you and your partner roll it into the bay of the emergency department (while providing additional ventilation).
Using feedback as you train for this complicated scenario will help you provide effective care in the moment. In fact, the CPR feedback provided during training for each of these scenarios will help you validate which method is truly an evidence-based best practice.
Perform this training early and often to make your crews more efficient, effective, and better prepared every time, even when unusual situations arise.
For more information on training and patient care devices that provide real-time CPR information, visit medical tree related.
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