Performing CPR 10 to 15 minutes longer on cardiac arrest patients may be useful
40 replies, posted
[url]http://www.cbsnews.com/8301-504763_162-57506720-10391704/performing-cpr-10-to-15-minutes-longer-on-cardiac-arrest-patients-may-be-useful/[/url]
[quote=CBS News]It may be hard for a physician to decide when enough resuscitation efforts have been done on a patient who suffered a cardiac arrest. However, researchers at the University of Michigan Health System have discovered that longer attempts may be useful in some cases.
By just extending the length of resuscitation attempts for 10 to 15 minutes, doctors may be able to see more favorable outcomes without too much time and resources taken away from other cases.
About 200,000 hospitalized patients have an incidence of cardiac arrest yearly, with only half surviving - meaning their heart beats independently for 20 minutes or more - their first episode. Less than 20 percent survive to be discharged.
On average, most people who are resuscitated do so in about 12 minutes. Traditionally, it is believed that the longer it takes to bring someone back - typically 30 minutes or more - the worse their chances of survival. But, the new study, published Sept. 5 in the Lancet, showed that about 15 percent of patients who survived needed at least 30 minutes of resuscitation.
"Our findings suggest an opportunity for improving care in this high-risk population. Overall, it may involve standardizing the time required for continuing resuscitation attempts prior to decisions regarding termination of efforts," author Dr. Zachary D. Goldberger, an assistant professor at the University of Washington, said in a press release.
After looking at U.S. data from 435 hospitals and more than 64,000 patients, researchers discovered that average resuscitation times ranged from a median time of 16 minutes to 25 minutes. Overall, the median resuscitation time was 17 minutes.
Hospitals that had longer resuscitation times had patients who were 12 percent more likely to survive than those that had shorter times. In addition, patients didn't suffer any significant differences in neurological function the longer it took for them to regain their pulse.
Other factors such as the quality of chest compressions may have also attributed to the success rate, the researchers noted. They were unable to ascertain or recommend an average amount of time that resuscitation attempts should take.
"The optimal resuscitation duration for any individual patient will continue to remain a bedside decision that relies on careful clinical judgment," author Dr. Steven L. Kronic, emergency department physician and head of the CPR committee at the University of Michigan in Ann Arbor, said in the press release. "Overall, we believe these findings present an opportunity to improve resuscitation care, especially at a systems-level."
But Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital, in New York City, hypothesized to HealthDay that the results don't address the issues that most patients who have a cardiac arrest in a hospital are facing. He was not involved in the study.
"From clinical experience, overall survival after in-hospital cardiac arrest is quite poor when there is no clear reversible cause for the arrest," Glatter said. "However, when there is a potentially reversible cause for the arrest, successful resuscitation efforts may potentially improve. This suggests that in these limited clinical situations, there may be a window of opportunity to improve care by increasing duration of resuscitation time prior to termination of efforts."
He added that the study was completely observation and does not imply that longer resuscitation attempts cause a higher survival rate.[/quote]
Man, half an hour of performing CPR would be pretty hard work.
Is there any news on the rescue breaths? I heard that they are moving toward not even doing them because keeping the HR going is far more beneficial.
Also CPR for 10 minutes is fucking hard to do. Its hard to do CPR for 2 minutes.
Rescue breaths are better if you can tag team or you have a bag valve mask in a kit, personally I think that 30 minutes of CPR you're probably going to need a lot of rehabilitation or possibly be brain dead. AED's are life savers.
I'll do about a minute of CPR on you if you need it, then I'm declaring you dead. Then I need a beer. It's damn hard work to do it right.
Oh great. Now those fucking "GIVE IT UP, SHE'S DEAD" scenes in medical dramas will last even longer than normal.
i've given cpr before its fucking exhausting after a while
[editline]6th September 2012[/editline]
like, the dummies, shits easy, but on an actual person its so much more work to do the compressions
I need to freshen up my cpr knowledge, it's been a few years since I last checked the proper sequence
[QUOTE=sam6420;37559385]CPR is hard as fuck and doing it for 10-15 minutes would suck.[/QUOTE]
I'd do that much work to save a life though.
[QUOTE=areolop;37558645]Is there any news on the rescue breaths? I heard that they are moving toward not even doing them because keeping the HR going is far more beneficial.
[/QUOTE]
They're trying to teach non-healthcare people to do chest compressions only and not do rescue breaths because they might screw up on the head-tilt chin-lift and not open up the person's airway so your rescue breath would be useless or something.
[QUOTE=Uber|nooB;37558642]Man, half an hour of performing CPR would be pretty hard work.[/QUOTE]
I had to do it for 14 minutes straight in the back of a moving ambulance once. My wrists were throbbing for days.
Half-hour on one person is practically impossible, you'd need to switch off. So it's feasible if you have extra hands.
Rescue Breaths are essential I thought? There's Cardiac arrest and respiratory arrest, If they're going through respiratory arrest the only thing that will help is Rescue Breaths, and in the case of Cardiac Arrest, they don't breathe anyway, so what's the point of pumping the heart if there's no oxygen for the blood to send to the body. I always thought as long as you supplied Oxygen to the body, and as long as their core body temperature never dropped below a certain point, then you could do it indefinitely, or until the temperature of the body is too low to even bother
i'm up for it, being blown air into my longs by a beautiful bonde for 15 minutes is a day dream cum true
You do understand that CPR will most likely cause rib / chest injuries, right Breen ?
It's no fun to do. It's also tiring as fuck.
[QUOTE=Dbuhos;37560786]You do understand that CPR will most likely cause rib / chest injuries, right Breen ?
It's no fun to do. It's also tiring as fuck.[/QUOTE]
Yeah i know.. :(
Here in the UK performing CPR/any firstaid (When not a paramedic or a member of st. johns/red cross) leaves you liable to be taken to court, even if you have firstaider insurance.
Sucks.
[QUOTE=Ereunity;37561220]Here in the UK performing CPR/any firstaid (When not a paramedic or a member of st. johns/red cross) leaves you liable to be taken to court, even if you have firstaider insurance.
Sucks.[/QUOTE]
This stuff i so stupid... If a man is dying on the floor, he is better off being helped by a random or waiting 4 minutes for a paramedic. You shouldnt be held accountable for any damage done if you helped them.
[QUOTE=Pteradactyl;37559525]They're trying to teach non-healthcare people to do chest compressions only and not do rescue breaths because they might screw up on the head-tilt chin-lift and not open up the person's airway so your rescue breath would be useless or something.[/QUOTE]
I was under the impression they abandoned the practice of rescue breaths because it was redundant assuming the airway isn't obstructed.
[QUOTE=fantafuzz;37561254]This stuff i so stupid... If a man is dying on the floor, he is better off being helped by a random or waiting 4 minutes for a paramedic. You shouldnt be held accountable for any damage done if you helped them.[/QUOTE]
Except here in the UK you are held accountable. As soon as you administer [i]any[/i] firstaid, even so much as a bandage, if they then drop dead you become liable for court action or prosecution.
It's why you see so few people helping in accidents. It's also part of the reasons why police officers won't jump into rivers to save lives.
Too much red tape in the country is costing us lives.
[QUOTE=Ereunity;37561310]Except here in the UK you are held accountable. As soon as you administer [i]any[/i] firstaid, even so much as a bandage, if they then drop dead you become liable for court action or prosecution.
It's why you see so few people helping in accidents. It's also part of the reasons why police officers won't jump into rivers to save lives.
Too much red tape in the country is costing us lives.[/QUOTE]
Wow, that's a pretty stupid fucking rule.
I thought the UK was a nice place. Didn't know that being a decent human being was a liability now
[QUOTE=Ereunity;37561310]Except here in the UK you are held accountable. As soon as you administer [i]any[/i] firstaid, even so much as a bandage, if they then drop dead you become liable for court action or prosecution.
It's why you see so few people helping in accidents. It's also part of the reasons why police officers won't jump into rivers to save lives.
Too much red tape in the country is costing us lives.[/QUOTE]
Sounds like something the daily mail would make up, I don't think it's true considering we actually have adverts and stuff on how to do CPR
ah wait nevermind, "if they then drop dead". Well I dont know about that :v:
[QUOTE=Ereunity;37561310]Except here in the UK you are held accountable. As soon as you administer [i]any[/i] firstaid, even so much as a bandage, if they then drop dead you become liable for court action or prosecution.
It's why you see so few people helping in accidents. It's also part of the reasons why police officers won't jump into rivers to save lives.
Too much red tape in the country is costing us lives.[/QUOTE]
I'm going to go ahead and call bullshit on this.
[QUOTE=Charybdis;37561460]Sounds like something the daily mail would make up, I don't think it's true considering we actually have adverts and stuff on how to do CPR
ah wait nevermind, "if they then drop dead". Well I dont know about that :v:[/QUOTE]
If they live, and you've cracked their ribs from performing CPR (Which will happen if you administer it correctly majority of the time) and you are not A) A paramedic B) Combat medic OR C) Registered Red-Cross or St. Johns (etc) first aider you are able to be taken to court and be sued by them.
I will admit, it is unlikely that someone you save will sue you, but they are able to. Which is why many doctors and other trained personnel avoid giving it because even first aid insurance will not protect against it.
And if they die, well then you are liable for prosecution by the state and to be sued by the relatives of the deceased.
"There is understandable concern that individuals who attempt to resuscitate someone in a
state of cardiopulmonary arrest may be at risk of having a claim brought against them if
that person suffers harm as a result of their intervention."
> [url]http://www.resus.org.uk/pages/legal.pdf[/url]
There have been claims brought against people, but I don't think any of them were successful.
I do first aid at events with the British Red Cross, and I've seen a member of the public try to do CPR on someone who didn't need it. The casualty was having a seizure, and the member of the public hadn't opened the airway to check if they were actually breathing (they were). By the time we got to them, the casualty had 2 broken ribs. It's a bit of a grey area. Technically, the casualty could sue them for assault and negligence.
However, if someone actually really needs CPR/AED, then they are clinically dead, and therefore you can't actually do anything to worsen their situation, so it's very unlikely any legal action against you will be successful... if they survive. If you're a member of the public, you do need to follow the current accepted modern practices in resuscitation, otherwise you could be liable for negligence.
Personally, I wouldn't hesitate to help, but that's because I'm confident with CPR/AEDs, having done it a couple of times in the past.
if you were ever to get sued as a result, just cite the [URL="http://www.youtube.com/watch?v=ILxjxfB4zNk"]British Heart Foundation[/URL] advert or something
[QUOTE=Uber|nooB;37558642]Man, half an hour of performing CPR would be pretty hard work.[/QUOTE]
Paramedics and such are generally in good shape.
[QUOTE=Ereunity;37561310]Except here in the UK you are held accountable. As soon as you administer [i]any[/i] firstaid, even so much as a bandage, if they then drop dead you become liable for court action or prosecution.
It's why you see so few people helping in accidents. It's also part of the reasons why police officers won't jump into rivers to save lives.
Too much red tape in the country is costing us lives.[/QUOTE]
This is 100% bullshit, my mum is a qualified first aider, has insurance etc but says this is nonsense. You only need the insurance if you actually kill them by accident.
[QUOTE=Catdaemon;37561810]This is 100% bullshit, my mum is a qualified first aider, has insurance etc but says this is nonsense. You only need the insurance if you actually kill them by accident.[/QUOTE]
My father and stepmother are both first aiders.
And for your information, you can be held liable for the death of someone if you injure them while performing resuscitation or providing medical care.
As I posted before see: [url]http://www.resus.org.uk/pages/legal.pdf[/url]
I don't even know how to do CPR.
I thought the people suffered brain damage after 10 minutes so it's not worth reviving them after that?
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