CPR Question

Slobgob · May 17, 2005

Its 1 Resp for 5 Compressions...

Think of it logically... if the normal heart is 60-100... then the normal resp would be about 12-20 if you used this 5:1 ratio...

That is the correct number...

sjt9721, BSN, RN · May 17, 2005

If the patient was intubated, bagging should be at 12-20 per minute, and compressions should be at 100 per minute without pause for respirations.

But...if you were still using a bag-valve-mask device (patient was not intubated), AHA recommends 15 compressions to every 2 breaths. Even in the healthcare setting with 2-man CPR, 15 compressions is recommended for pulseless patients because it provides more central circulation than only 5 compressions at a time.

Fun2, BSN, RN · May 17, 2005

I learned the 5/1 ???? for a 2-man, but now I see they are teaching to stay with the 15/2 either way. FYI

Ditto This: :)

But...if you were still using a bag-valve-mask device (patient was not intubated), AHA recommends 15 compressions to every 2 breaths. Even in the healthcare setting with 2-man CPR, 15 compressions is recommended for pulseless patients because it provides more central circulation than only 5 compressions at a time.

z's playa · May 17, 2005

15/2 too. :)

Z

CoffeeRTC, BSN, RN · May 17, 2005

5/1 with the two man. Wasn't that the change this year?

casualjim · May 17, 2005

Just taught this class for the Red Cross last night so it's "fresh" this morning. It really doesnt matter anymore if it's 1 provider,or 2 provider, healthcare setting or the side of the road. it's 15:2 compressions to ventilations. There was just way too much confusion in the past as to 1 provider ratio, 2 provider ratio, so it was all driven to 15:2

The big exceptions (there's always one of those huh?)

Infants and Children are 5:1

aloha

Jim

zambezi, BSN, RN · May 17, 2005

If the patient was intubated, bagging should be at 12-20 per minute, and compressions should be at 100 per minute without pause for respirations.
But...if you were still using a bag-valve-mask device (patient was not intubated), AHA recommends 15 compressions to every 2 breaths. Even in the healthcare setting with 2-man CPR, 15 compressions is recommended for pulseless patients because it provides more central circulation than only 5 compressions at a time.

This is exactly what I was going to say...15:2, even with a two person rescue team...Here is a link to another thread where this discussion has been going on (it is from a little while ago, though)

https://allnurses.com/forums/showthread.php?t=80526&highlight=compressions

mommatrauma, RN · May 17, 2005

Per the AHA 2000 guidelines and ILCOR recommendations (International Liaison Committee on cardiac resuscitation) :

Compressions to Ventilations Ratio Current literature suggests that several compressions are needed to achieve optimal perfusion pressures in the brain and coronary arteries. Because of this, excessive pauses for ventilations may be detrimental. The 15:2 ratio is now recommended for adults with an unprotected airway in the BLS and DLS(dispatcher assisted) setting, in both one and two-rescuer CPR (this is the current MPDS standard). 15 consecutive compression preferred over 5 because more compressions actually occur per minute and greater intravascular pressures are generated with 15 compressions in a row-both lay public and healthcare providers should do this for one and two-person CPR in the non-intubated patient.

Intubated patients get asyncronous compressions to ventilations...so its not such a strict 15 to 2 ratio as it is keeping with the 80-100 compressions and 12-20 respirations...and asyncronous because you compress part of the lung as you do compressions thereby decreasing the tidal volume and increasing the risk for getting gastric air...

sjt9721, BSN, RN · May 17, 2005

mommatrauma...

Glad you posted the documentation. My 'paraphrasing' on the reason behind 15/2 is a little too brief! :)

bobnurse · May 17, 2005

the AHA 2000 guidelines state the following:

Mouth to Mouth, Mouth to Mask, BVM: You do the following:

1 person CPR 15 compressions followed by 2 ventilations

2 person CPR 15 compressoins followed by 2 ventilations

Intubated Patient:

5 compressions followed by 1 ventilation. You do not interrupt the Compression to ventilation cycle, as the ventilation is given between the 5th and 6th compression, so essentially you are doing compressions non-stop.

Rescue breathing for the adult is 1 breath every 5 seconds. This has been the standard according to AHA and Red cross since the Guidelines 2000...July 2000 to be exact.

New standards should be coming out soon, but until then, that is how its been done and should be taught.

So to answer your question, SHe was doing them incorrectly, by ventilating twice every 5 compressions, as this will cause a delay and prevent you in completing the recommended 100 compressions per minute. If the patient was not intubated, its 15 compressions per 2 ventilations with a pause in compressions to allow the ventilations.

Chad_KY_SRNA · May 17, 2005

I am as confused as before. I guess that you just do whatever rate you were taught. When I first got certified you did one man 15:2 and two man 5:1 but I was told that when they changed the protocols including cutting out mouth to mouth they changed all of the compression rates to 5:1 for everyone.