AHA....lay people don't check for a pulse?

[catlynLPN]

I just took my AHA CPR course the other day. They are telling us that AHA does not teach "lay" people to check for a pulse. Instead they are taught to check for leg or arm movement that would indicate a heartbeat. Only nurses or otherwise licensed medical personnel are taught to check for a pulse.

Anyone else heard of this?

AHA says that they found that "lay" people, not being trained on how to take a pulse, were found to be, at times, taking their OWN pulse.

I feel that if lay people can be taught to do CPR they could be taught to correctly check a pulse.

Any comments?

[SLS7533]

This change came when they released their 2005 guidelines. They release new guidelines/changes every 5 years based on the research they have completed. You can check out the summary of all the 2005 Guidelines here http://www.americanheart.org/downloadable/heart/1132621842912Winter2005.pdf

including the lay person changes located on page 4.

On page 7 it explains why lay person changes were made. If you read through it gives the rationale for each change made.

[Jolie, BSN]

Healthcare Provider BLS no longer includes pulse re-checks. After the initial assessment, providers are now taught to look for movement to determine whether a patient has responded to CPR.

I guess these changes are consistent with simplifying the process. And consistent with selling new books.

[CABG patch kid, BSN, RN]

One of the biggest goals now is to minimize interuptions when doing chest compressions (I just did my recert. last week). I think that's why we aren't doing pulse re-checks and lay people aren't doing them at all, especially for lay people, it probably takes too long for them to feel a pulse (sorry, big generalization there).

[sjt9721, BSN, RN]

Lay rescuers were often inaccurate in their pulse assessment, meaning that victims were not receiving CPR when needed.

In the 2010...I'm betting that the guidelines officially accept "compression-only" CPR for lay rescuers. Anyone want to take that bet? :cheers:

[Agnes Anne]

Our instructor said to expect to go with compressions only in the future based on research ongoing in greenbay that a good outcome is 50% more likley with 200 compressions. That's huge!

[Balder_LPN, LPN]

Lay rescuers were often inaccurate in their pulse assessment, meaning that victims were not receiving CPR when needed.

In the 2010...I'm betting that the guidelines officially accept "compression-only" CPR for lay rescuers. Anyone want to take that bet? :cheers:

I'm not taking that bet. I found some info that Australia has already done this and the results are looking good.

[scattycarrot, BSN, RN]

I feel that if lay people can be taught to do CPR they could be taught to correctly check a pulse.

Any comments?

I disagree. It can be hard enough for medical personnel to check for a pulse sometimes! For the lay person it can be alot harder, especially considering the stress of the situation and pulse-checking can take too long. The goal is to just keep those compressions going and minimise interruptions. And, not checking for a pulse just simplifies the procedure; the simpler the better and the more likely people will rmemeber what to do and get involved.

[CHATSDALE]

compressions plus abdominal thrusts give a patient air exhange and blood circulations

however i have talked with patients who say that they were grabbed and WERE ALERT but having some problems and some good meaning people attempted cpr, they said it was the most frightening thing they had ever been through

[santhony44, MSN, RN, NP]

I think it is very difficult for nervous people to find and check a pulse, even if they've had some practice.

[one_speed]

A lot of good p[oints are mentioned here, particularly the last point about lay people trying to do CPR on a conscious victim with other problems.

(funny aside - have you ever had to stand on the other side of a curtain of a VSA - CPR in progress dispatch that arrrived ambulatory, and listen to the pateint crying to their well meaning partner that their cheswt hurts too much after the chest compressions, trying not to laugh)

Anyways, the change from pulse checks for the lay person goes hand in hand to assessing the casualty for "signs of life", you know things like gray skin colour, lack of breathing, decreased LOC, etc. that accompanies a stopped or inadequate heart beat.

Just because you can feel one or two pulses in a 30 second pulse check doesn't mean they don't need compressions. If they look dead, start CPR...