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2016 High Performance CPR Part 2
ACCESS – BT – 2016 03 HP CPR PT 2
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What are our goals
For HP CPR?
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IMPORTANT POINT!• RATE
– (110/min)– (Continuous 2 minute cycles)
• DEPTH – At least 2”
• RELEASE/RECOIL (complete)
• UNINTERRUPTED – (pauses <10 sec)– (prefer less than 3 sec)
• DECREASED VENTILATION (6-10/minute)
5 KEY ASPECTS
OF GOOD CPR!
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A Little More in Depth
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The Basics….
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POSITION 1 (Compressor- Left)TASKS
• BLS– Switch off compressions– Switch off Squeezing Bag on BVM
• Asynchronous ventilations 6-10/minute (less is more)– Coach Position 2 on rate, depth, recoil
• If LUCAS– Helps place Lucas
• If ALS/ILS– May assist with IV/IO/Meds ONLY if not actively doing
compressions or assisting position 3 (Compressions take priority)
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POSITION 2 (Compressor- RIGHT)TASKS
• BLS– Switch off compressions– Switch off Squeezing Bag on BVM
• Asynchronous ventilations 6-10/minute (less is more)– Coach Position 1 on rate, depth, recoil
• If LUCAS– Helps place Lucas– Runs Lucas once placed
• If ALS/ILS– May assist with IV/IO/Meds ONLY if not actively doing
compressions or assisting position 3 (Compressions take priority)
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POSITION 3 (AIRWAY)• BLS: – Facemask Seal (two handed) – Suction (Have Near By)– Monitors ventilator rate– Run the AED
• ALS– All BLS AND…– Run the Monitor– Place Advanced Airway– ETCO2– May also function as intervention medic if needed
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Intervention Medic (TASKS)
• Medic If available, – AEMT if not– May be responsibility of Code Commander
• Establish IV/IO/ access• Push meds (as appropriate)• May also run Monitor/Defib (as appropriate)
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Code Commander/IC (TASKS)
• Mind on Big Picture• Direct Interventions– EKG determination– Meds when/what/how much
• Perform ALS interventions if no other ALS on scene
• The CODE COMMANDER is the only one who can direct compression cycle to stop
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Minimal Interruptions
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HOVERING
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Pre-Charging
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Ventilation Control
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2 Step Lucas Placement
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LUCAS PLACEMENT• STEP 1: Continue Compressions. Plan on completing the 2 minute cycle• STEP 2: Power on LUCAS before placement• STEP 3:LET EVERYONE KNOW WHAT YOUR DOING• STEP 4: During 2 minute pause, lift patient and place back plate (Less
than 10 seconds)• STEP 5: RESUME COMPRESSIONS IMMEDIATELY• STEP 6: Hook one side of Lucas, leave it “hanging” if feasible• STEP 7: During NEXT 2 minute pause, swing Lucas into place, position,
and press start. (less than 10 seconds). • STEP 8: place neck strap and secure hands to prevent LUCAS “slip” • If at any time you face difficulty, resume manual compressions• If ROSC: Leave in place on “standby”, in case of re-arrest.
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Only the Code commander can
stop CPR(No more stopping for airway)
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“It is up to us to save the world.”- Peter Safar