Forum menu
What are the success rates of CPR in that situation?
Does it matter? What about yourself? Would you be prepared to just stand there, then wonder "what if?" for the next month or two?
don't know how long they have been down
Exactly.
So, if it's an hour and you do something, you have nothing to loose
But it's just as likely it's 30 seconds as it is an hour. If it's 30 seconds and you do nothing, what will happen? You have [i]everything[/i] to loose.
I would be looking for the other signs tho - the fixed dilated pupils
But I'm not a medical professional, so I don't know what that is. So I'd use the first aid I've been taught. I might be wasting my time, but I won't get it wrong.
Does it matter? What about yourself? Would you be prepared to just stand there, then wonder "what if?" for the next month or two?
Exactly. You try your best. If that's not good enough and he dies, so be it. But you don't just stand there.
Fair enough PP.
I have done CPR a good few times in hospitals. I have never seen anyone brought back in any meaningful way. Its made me very sceptical and that is in ideal circumstances where you have O2 and drugs to hand tho sick people. In the sort of situation described the odds on bringing them back if they really are not breathing and you don't restart them very quickly are next to nil
Of course I would not stand around and do nothing but I don't know how long if at all I would attempt CPR for.
edit - 30 mins from help remember. 30 mins CPR on your own?
I don't think it necessarily applies in this situation, but I can sort of see where TJ is coming from.
When my friend died, the 999 operator asked me to perform CPR on my friend and when I said I wouldn't asked if I could find someone who was prepared to. As my friend had clearly been dead for some time, I decided it was better for my mental health not to perform CPR. The phrasing the 999 operator used annoyed me, but I don't hold any guilt over this decision.
Back on topic a bit more, when I did my lifeguard training it was interesting how many people would try and preserve the spinal cord over all else. Lots of "well done, you got the casualty out of the water without damaging his spinal cord, unfortunately he wasn't breathing so he's dead"
are next to nil
Given 'no chance' and 'next to no chance' of living, which would YOU choose?
True enough, the odds aren't good, but you try your best. 🙂
As my friend had clearly been dead for some time, I decided it was better for my mental health not to perform CPR
Which is obviously a good call in that situation. I'm guessing it becomes obvious they're dead after a certain time, but I've never seen a dead body?
I am not saying I am right but merely posing a question / showing an alternate viewpoint.
When does a casualty become a corpse? Finding someone not breathing and you don't know how long they have been not breathing is it right to do CPR? A few mins without O2 to irreversible brain damage.
If you don't CPR tho you had better be damn sure its the right decision and to do CPR should be the default.
When does a casualty become a corpse? Finding someone not breathing and you don't know how long they have been not breathing is it right to do CPR? A few mins without O2 to irreversible brain damage.
I did hear about a woman who fell through some ice into water, and was underwater for 50 minutes. They got her out, got her to hospital, and performed CPR for 7 and a half hours. Apart from a bit of frost bite on her fingers, she made a full recovery.
Actually before ABC is assess, think about your own safety too ;
listen and feel for breathing, if necessary put hand inside clothing on chest, if breathing effort is low you may not be able to see chest movement through clothing. Get help by shouting / mobile if signal available. Keep casualty warm as possible, talk to and raessure if conscious. Deal with any obvious injury only if airway and breathing established. If unconscious breathing >> recovery position, get help as above but may have to consider leaving casualty. Unconscious not breathing > CPR but on your own this is going to be extremely difficult situation, you may ahve to make call on when to stop if no help arrives
I did the 16hr adventure first aid course about 6 months back. The instructor said he'd done CPR three times and two had died.
I suggested 999 as first response because the scenario said I was on my own, so whatever happened next I'd probably be too busy to get on the phone. Any mention of 'unconcious' will get the ambulance scrambled to your location.
Current (6 months or so) training was DR AB (danger, responses, airways, breathing) C has left the building.
The immersion hypothermia is a slightly different issue - according to the trainer on the first aid course I did a couple of months ago, the current thinking on dealing with a hypothermic casualty is "[i]they're not dead until their warm and dead[/i]" so you treat them accordingly until the professionals roll up and take over.
If that's not the case, the trainer and his accomplice (forces paramedic and civvie paramedic) were pretty frank about the success rate for CPR on adults who've had a heart attack/stroke etc - it's pretty much as TJ says.
The last first aid course I was on (which was specifically for osteopaths) had lots of role play discussions, interestingly when this one came up people were less concerned about the potential spinal injury for a cyclist (more about safety from traffic) than they were when it was a motorcyclist. Anyway, you've already got the right answers, if you can't tell their breathing within ten to twenty seconds then you have to assume their not, also key is breathing [b]normally[/b] not one gasp then nothing. google agonal breathing, a lifeguard was found incompetent for mistaking one breath for normal breathing and ceasing cpr. and current evidence shows little benefit from mouth to mouth, its the chest pumps which are most important, the blood is reasonably oxygenated for about six minutes of pumping.
About 6 successful resuscitations now, some with drugs, cpr and shocking odd 1 with just cpr and shocks, then 1 with just CPR.
In fact tune into BBC 3 next week and you may see the evidence. 😉
inigomontoya - Member
, its the chest pumps which are most important, the blood is reasonably oxygenated for about six minutes of pumping.
In the scenario given its 30 mins to get help. This sort of changes the odds somewhat.
inigomontoya - Member
, its the chest pumps which are most important, the blood is reasonably oxygenated for about six minutes of pumping.
In the scenario given its 30 mins to get help. This sort of changes the odds somewhat.
That's the thing though you could do the CPR whilst you wait for the help.
If I was found to not resuscitate someone because I don't believe it works or because I didn't know how long they'd been there I'd be struck off. I mean being outside of work too not just at work.
Drac - sounds good. Without being too rude (I hope) is that successful as in "in a stable rhythm on admission to A&E" or " gets out of hospital and lives happily ever after" ?
The ones I count as successful or responsive with stable rhythm and resps, that might just be a simple grunt or reaction to pain response but least something. I've had them sit up though and ask what was going on. I don't count just a change in rhythm with an out put, myself I don't class that as successful although yes technical it is.
As for happily ever after, well we never find out.
If I was found to not resuscitate someone because I don't believe it works or because I didn't know how long they'd been there I'd be struck off. I mean being outside of work too not just at work.
Its interesting that one. I as a trained nurse have to be able to justify my actions in doing or not doing CPR. If I don't do it I must be damn sure of my ground but there are many occcasions when we don't.
You must be able to draw a line somewhere tho surely - cold with fixed dilated pupils?
Sorry OP - I have puled this thread off at a tangent.
[i]When does a casualty become a corpse? [/i]
When a doctor say so I guess.
Its interesting that one. I as a trained nurse have to be able to justify my actions in doing or not doing CPR. If I don't do it I must be damn sure of my ground but there are many occcasions when we don't
I have to justify too and saying it doesn't work or I wasn't sure how long they'd been there isn't going to work. Yes there's times when it justifiable.
You must be able to draw a line somewhere tho surely - cold with fixed dilated pupils?
We have a recognition of death yes of course but not on the grounds you mentioned earlier.
Ta.
Don't worry about removing the helmet, leave it on, current guidelines say that CPR is way more important than mouth to mouth, put all your efforts into that as without a pulse everything is useless.....
Don't worry about removing the helmet, leave it on, current guidelines say that CPR is way more important than mouth to mouth, put all your efforts into that as without a pulse everything is useless.....
But what if they do have something blocking their airway, and their heart is fine? I would take the helmet off if I wasn't sure if they were breathing.
Yes, but how is the bike?
What bike? no bike was here when I came officer *walks of whistling*
Realman - maybe take the helmet off if you are sure they are not breathing? You really should be able to tell with it on.
If they're not breathing, and I felt I needed to take the helmet off to perform CPR effectively, I would take it off.
IF I COULD NOT TELL, and could not perform CPR effectively with it on, I would take it off.
hypothermia rules appear to be you`re only dead when warm and dead; sveral case histories now from MR when casualty with core temp <30c have lived when rewarmed ....with great care and expertise 🙂
re helmet removal: proper ventilation will only be possible with helmet removed; it`s no good having an undamaged spinal cord but cannot breathe. My worst 1st aider case was very bad motorcyclist injury, chap choking to death on own blood; was unsure about removing helmet, but rolled him on side which cleared airway; when ambulance arrive first thing they did was remove helmet to get access to airway with guedels , suction etc. Possible damage to spine takes second place in such scenarios
What's the point of a dead person with an intact spine? Maintain airway first and then cpr. 2 breaths 30 chest compressions
Just to throw something else in on my last First Aid course we were told dispense with the breaths just go with chest compressions. We were told that there would still be sufficient O2 in the blood stream and that blood flow to the brain is way more important (especially if you are by yourself as those of you that have done full on CPR for 20 minutes will know).
As for helmet removal, if it has to come off to open airway then so be it but obviously with as much care as possible.
Nothing worse than doing CRP on a dead body either.....
Northerner you are wrong. Breathing first heart second. No point sending blood round with no o2. Brain dies in 3-4 mins with no oxygen
Northerner you are wrong. Breathing first heart second. No point sending blood round with no o2. Brain dies in 3-4 mins with no oxygen
You need to read the latest guidelines.
Jamesb the Ambulance are trained and experienced professionals so use to removing helmets.
1st aid training last weekend said so
1st aid training last weekend said so
Then he needs to read them.
Guideline changes
It is well documented that interruptions in chest compression are common11, 12 and are
associated with a reduced chance of survival.13 The ‘perfect’ solution is to deliver
continuous compressions whilst giving ventilations independently. This is possible when
the victim has an advanced airway in place, and is discussed in the adult advanced life
support (ALS) chapter. Compression-only CPR is another way to increase the number
of compressions given and will, by definition, eliminate pauses. It is effective for a
Resuscitation Council (UK)
16 RESUSCITATION GUIDELI NE S 2010
limited period only (probably less than 5 min)14 and is not recommended as the
standard management of out-of-hospital cardiac arrest.
It is also known that chest compressions, both in hospital and outside, are often
undertaken with insufficient depth and at the wrong rate.12, 15
The following changes in the BLS guidelines have been made to reflect the importance
placed on chest compression, particularly good quality compressions, and to attempt to
reduce the number and duration of pauses in chest compression:
1. When obtaining help, ask for an automated external defibrillator (AED), if
one is available.
2. Compress the chest to a depth of 5-6 cm and at a rate of 100-120 min-1.
3. Give each rescue breath over 1 s rather than 2 s.
4. Do not stop to check the victim or discontinue CPR unless the victim starts to
show signs of regaining consciousness, such as coughing, opening his eyes,
speaking, or moving purposefully AND starts to breathe normally.
5. Teach CPR to laypeople with an emphasis on chest compression, but
include ventilation as the standard, particularly for those with a duty of care.
In addition, advice has been added on the use of oxygen, and and how to manage a victim
who regurgitates stomach contents during resuscitation.
First of all stash the bike then with all your might drag the body and hide it in the nearest bushes ( removing the helmet is optional at this stage) if you hear reports there has been a walkers body found you'll know your safe to go back and claim your new bike. ?
I got taught ABCD: Airways, Breathing, Circulation, Disability.
i.e. Only AFTER ABC do you worry about the risk of disability. Wheelchair's no good to the fellow if he's dead...
If he ain't breathing and you need to remove the helmet to get some air in, do it.
I got taught ABCD: Airways, Breathing, Circulation, Disability.Only AFTER ABC do you worry about the risk of disability. Wheelchair's no good to the fellow if he's dead...
ABC C-spine Circulation is what I was taught, no point in doing CPR on a guy with a broken neck.
c345 keep the diaphragm alive
Thanks for that Drac, thought I hadnt been listening properly for a moment. I have to say that a lot of firts aid courses delivered are not necessarily by trainers with up to date training packs ie they may not be specialist first aid trainers but trainers given a first aid lesson plan to deliver.
Interesting, interesting. I think I should probably get an up-to-date first aid session sorted in the very near future!
Anyone have any recommendations for organisations, etc? e.g. SJA any good?
Circulation now encompasses the DRRABC assessment as a priority with trauma injuries to prevent major blood loss. One of the lessons learnt in Afganistan. No point checking the airway and breathing whilst those precious 5-6 litres of blood leak out.
I think your guidelines are different for a reason.
If he deffo wasn't breathing I'd start the CPR (becasue I'd not know how long he'd been down) to get some oxygen in, then get help within a minute or so (Assuming I have phone signal) But if he's not breathing you won't 'cure' him on your own
This is unwise as if you have ever done CPR on someone, you can't just stop to make a phone call. CPR is no good unless you KNOW someone is on their way!
Oh now I've read your post properly budgie, you talking about reversible causes that's been in long before Afghanistan my friend.
I think your guidelines are different for a reason.
I'm not in the armed forces and my guidelines cover all trauma care. A mountain biker suffering trauma in a high speed collision with rocks, branches etc could quite possibly get an injury causing them to bleed out.