CPR question

[Sand_Dollar]

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 my head). I asked a nurse about it later and she said we are supposed to give compressions of AT LEAST 100/minute.

I thought 100 bpm or so was optimal, was his 200 bpm appropriate or just off the charts? I attributed the increased speed to adrenaline, but maybe he was going that fast on purpose.

Thanks for taking the time to answer this, I want to have my facts straight for the time when I'm the one giving compressions.

~SD

[limaRN, BSN, RN]

I work in open heart recovery. We had a post-op valve code one evening and the surgeon advised us to do compressions at a rate that kept the patient's systolic BP in the 70s per the arterial line. However I don't quite remember the exact rationale for this.[/quote']

Heart Surgeons tend to have a way of ignoring other systems in the body... I'm guessing it has something to do with not wanting to cause trauma to the valve, surgical incisions etc. but a sbp of 70 and the compressions that are providing it are likely not adequate for cerebral perfusion.

[aCRNAhopeful]

I work in open heart recovery. We had a post-op valve code one evening and the surgeon advised us to do compressions at a rate that kept the patient's systolic BP in the 70s per the arterial line. However, I don't quite remember the exact rationale for this.

Thats because there isn't one. The patients brain is literally dying rapidly during a code so trying to limit the blood pressure and perfusion is just silly. I can see not being over the top aggressive with compressions but anything else doesnt make sense

[Lovelymo79]

I have never seen a physician do chest compressions... but I admittedly don't get out much. I'd rather they give orders and stuff. Maybe start a central line.

I have not only seen docs doing compressions, but they have raised the legs up also when BP was low. And the ones that had performed compressions, they also were the surgeon who did the surgery. No residents here!

[Lovelymo79]

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 just got those. Very cool machines. Pun intended :)

[rcpals]

Several recent studies, document rates between 150 and 200 chest compressions. Survival starts to drop as compression rates get greater than 120. So 100-120 is optimal.