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Discussion

CPR! quick question!

I have a question that, believe it or no, I have gotten various different answers to.

If you witness a cardiac arrest, and an AED is immediately available to you, do you begin CPR first or use the AED first? (I always thought that if the arrest was witnessed, you defib first. If it wasn't witnessed, you start CPR first).

What are your thoughts?

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I've ALWAYS been told you start CPR and then send someone else for the AED.

I am not sure what you mean by "immediately"? Is the AED right by you, or you at least know where in the building it is located? If so, don't waste time with beginning CPR. Only reason CPR is even started is when Advance Life Support is not immediately available. If another individual is present, you may wish to begin CPR, and have the other individual locate the AED. CPR is an substandard procedure (although it all we have, and it is quite ineffective) to keep the blood flow going brain, until the better treatment becomes available. IF the individual's heart is in an arrhythmia situation, the only way to correct this issue is attempt (s) to "shock" it back into rhythm. CPR is not going able to do that! :eek:

  • Author

say the AED is right next to you and you witness the patient arrest....you would IMMEDIATELY apply the AED correct? you wouldn't start CPR first and then apply AED?

I haven't gone over this in Nursing School yet, but I'd assume it would be the same as my EMT experience, which is:

-If witnessed and you can immediately shock them, do so.

-If not witnessed, do CPR for 2 minutes and THEN apply AED.

Perhaps the mixed answers you've received are due to several possible extenuating circumstances? For instance, you may want your partner to go ahead and do some CPR while you are getting the AED prepared and ready, even though it may not be necessary. Or, if YOU didn't personally witness it, but someone else did and said it was just moments earlier, you might want to do CPR for 2 minutes just because you may question the validity of the witnessed event and want to cover all your bases. But as a general rule, if you do witness it, just go ahead and apply the AED. Hope that helped!

  • Author

what id the AED is say, right beside you?

what id the AED is say, right beside you?

Like I said in my previous response, the answer is probably yes, go ahead and apply the AED. But the thing about the medical profession is that not every situation is "textbook", and you may have to make accomodations for special situations.

From my experience, you always apply the AED the minute it is available when a person does not have a pulse. Rarely would the AED be right next to the unconscious person, so, I bet under most circumstances you probably have the opportunity to do a few chest compressions.

If it's IMMEDIATELY right next to you, grab it and go with it...but if it's going to be just a few seconds before you have it, start with CPR.

i agree with the above. i thought CPR class said that you never delay cpr.. it might take a lil for the aed to be ready.

I agree with start CPR until AED ready and shock if indicated. not all arrhythmias can be shocked some need synchronized cadioversion

Just finished PALS a few weeks ago, and it was CPR.....get AED set up......even if it is right at the bedside it has to be opened, turned on, and if it is right at bedside possibly another person to set up while you begin CPR. I guess it just does depend on the exact situation...but in this recent class it was CPR first, and also in all the ACLS courses I've done...like everything else there will always be times when it will be a judgment call.

CPR first, AED after two minutes. Rationale is if you DIDN'T witness the arrest you're not doing anything 'pulmonary' with an AED, only cardiac. With CPR you're expanding and contracting the lungs, providing some (though minimal) oxygenation. Please remember the ambu bag if you have it!

Finally, CPR can be started while the AED is being opened, the patches are being unwrapped and applied, etc. You probably can get a good 1.5minutes to 2 in the time the AED is ready and raring to go :)

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