CPR question - page 2

by Sand_Dollar 6,012 Views | 28 Comments

Hi there! I am a student and was on the CVCU last week. I saw my first code and noticed the doctor doing compressions was going at least twice as fast as I thought we were supposed to (had the song Staying Alive going through... Read More


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    @umc - I'm very intrigued with the cooling of the coding ped pt. I understand it from a hyperthermia situation and for spinal cord injuries from my first career as an athletic trainer, but never thought of applying it in other situations. I'm going to keep an eye out when I start my program in June at a major teaching hospital and see / ask about it.
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    We have a hypothermia protocol for witnessed pre-hospital cardiac arrest with return of spontaneous circulation after resuscitation. Although our Intensivists have done the protocol on in hospital arrest as well.
    tewdles likes this.
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    Quote from KAR813
    @umc - I'm very intrigued with the cooling of the coding ped pt. I understand it from a hyperthermia situation and for spinal cord injuries from my first career as an athletic trainer, but never thought of applying it in other situations. I'm going to keep an eye out when I start my program in June at a major teaching hospital and see / ask about it.
    Our hospital is currently conducting a study for therapeutic hypothermia after cardiac arrest. Any patient who receives greater than 2 minutes of chest compressions is eligible All patients have their heads cooled during resuscitation, post resuscitation they are randomized into a control group or study group. Control group is kept normothermic 36-37 degrees. Hypothermia group is cooled to 33 degrees. Cooling lasts three days and a variety of labs are drawn on both groups at set time intervals.

    The study is similar to what is done for neonates who are cooled for hypoxic birth injury, something my hospital also does in the NICU.

    As of right now I can't really comment on the outcomes. I have seen it go either way for both groups but I've only worked in this particular unit for two years.
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    We use the ArcticSun machine to initiate and carry out our hypothermia protocol. We do it for most all of our cardiac arrests. It's quite nice. It uses a core temp probe and circulates cold water through blankets on the skin and then cold saline infusing. The machine adjusts everything to keep the temp at goal and the cooling and rewarming controlled and gradual.
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    Quote from Dodongo
    We use the ArcticSun machine to initiate and carry out our hypothermia protocol. We do it for most all of our cardiac arrests. It's quite nice. It uses a core temp probe and circulates cold water through blankets on the skin and then cold saline infusing. The machine adjusts everything to keep the temp at goal and the cooling and rewarming controlled and gradual.
    We use something quite similar, I don't know the brand name, blanketrol? I think. Anyways, rectal probe and a cooling blanket they lay on that circulates the water and keeps their temp regulated
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    Quote from umcRN
    We use something quite similar, I don't know the brand name, blanketrol? I think. Anyways, rectal probe and a cooling blanket they lay on that circulates the water and keeps their temp regulated
    Oh, we have the blanketrol for sure. Same thing really. The arcticsun blankets just stick to the patient's skin.
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    Quote from dah doh
    Probably just adrenaline. One of our doctors does CPR so hard that the patient flies off the bed with each recoil!
    Yikes. Careful there.. I heard of a situation where a new resident with a lot of adrenaline did compressions so hard that it caused massive internal injuries and bleeding and was the likely cause of pts death.
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    Quote from limaRN
    Yikes. Careful there.. I heard of a situation where a new resident with a lot of adrenaline did compressions so hard that it caused massive internal injuries and bleeding and was the likely cause of pts death.
    Considering the patient was DEAD before compressions were started...
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    but wooh, would you really want to go to court on that one???
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    Quote from morte
    but wooh, would you really want to go to court on that one???
    Would love to. It would be entertaining watching an attorney try to convince a jury that the doc killed a dead person.


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