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Discussion

Bad CPR techniques- do you say something?

Hey all,

So I was thinking the other day when codes happen, sometimes you are doing CPR, others are, or all of you are rotating. Obviously I think about what other things I can do to help my fellow nurses and the patient, but I do find myself making observations of myself and others on technique. Some people don't do it hard enough (me, I think), some do it too low, some too fast, some seem really calm, others kind of not panicky, but the adrenaline is definitely going. One when I worked a nursing home, I saw this paramedic do compressions and I was thinking that they were the most perfect compressions I've ever seen. It was perfect depth, timing, calm, controlled, everything. And the guy never seemed tired, and frankly made it look "easy." And another nurse commented to me later on that they were thinking the same thing.

Now if you do see any bad techniques, do you ever say anything about it? I've never done it, but I know I've thought it.

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    • Featured Replies

    • Admin

    It's actually one of the roles of the team leader in ACLS scenarios to monitor and provide feedback on CPR quality. However, anyone who notices should speak up.My facility only does manual compressions until the code team responds- they bring the LUCAS.

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    Please, what's LUCAS? I'm thinking some kind of mechanical pump machine (or Resusci Annie's long-lost brother?).

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    • Experts
    2 hours ago, Peditra said:

    Now if you do see any bad techniques, do you ever say anything about it?

    Yeah. At Wrongway we call it "Team Coaching".

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    Our Zoll tells us if the compressions are not adequate. It responds to the position, depth, and rate.

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    3 hours ago, Peditra said:

    Now if you do see any bad techniques, do you ever say anything about it? I've never done it, but I know I've thought it.

    Yes, you do.

    It works best when everyone understands and agrees that they will stay focused and accept feedback without feeling criticized or insulted. Use of feedback devices helps a lot; then the one who speaks up is simply reporting the feedback and encouraging, and there's less chance it comes off as a personal criticism.

    ***

    LUCAS is a mechanical compression device.

    https://www.lucas-cpr.com/

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    JKL - TY. I guessed some kind of assist device.

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    • Author

    Thanks everyone! Your responses made me realize I should speak up in the future.

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    The bottom line is chest compressions are incredibly physically taxing to administer well. With this in mind I would always assign chest compressions to the biggest available staff first. Staff who are 115 pounds soaking wet get AED, Airway, charting, drugs, runner anything but compressions.

    I get it, sometimes staffing is very limited and you have to use who is there, but if there are enough available to make choices. Tall, heavy, male staff are first choice. I've worked with plenty of really small people who were itching for "their turn" but seriously why would I put them on the chest when I have an orderly who is BLS certified and a gym junkie.

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    1 hour ago, kp2016 said:

    The bottom line is chest compressions are incredibly physically taxing to administer well. With this in mind I would always assign chest compressions to the biggest available staff first. Staff who are 115 pounds soaking wet get AED, Airway, charting, drugs, runner anything but compressions.

    I get it, sometimes staffing is very limited and you have to use who is there, but if there are enough available to make choices. Tall, heavy, male staff are first choice. I've worked with plenty of really small people who were itching for "their turn" but seriously why would I put them on the chest when I have an orderly who is BLS certified and a gym junkie.

    You have orderlies?

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    5 minutes ago, hherrn said:

    You have orderlies?

    You got me. Current job no. I’ve had lots of jobs and in the places we had them, the were 1st up on chest!

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    Yes. Right away, out loud. When I am running the code, I do it myself. If I am not (and I am fairly useless at pushing the chest and usually go bagging, so I directly observe quality of compressions), I will alert team leader.

    - (pusher's name), please slow down a bit, I do not feel recoil... now, that's good!

    - (pusher's name), are you tired? Who's next? Get ready, at pulse check.... change!

    - (leader's name), look, rate is 80... gotta speed it up.

    Yes, I love running codes. Sorry.

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    • Experts
    5 hours ago, KatieMI said:

    Yes, I love running codes. Sorry.

    Hats off; you're a better woman than I. Not sorry.

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