Did CPR for the first time today.

[Amethya]

Student passed out on PE doing fitness gram, was having abnormal breathing and not responding. Called 911, operator gave instructions to do CPR and just did it, 3 mins, not stopping. Other people around me were freaking out, no one wanted to take over, so I kept going. EMTs came, took it over, student was fine after a while. She has done this before, basically anxiety/panic attacks, and parents are trying to find the cause of it. She went home, and was fine after all issue, talking and smiling. People were telling me good job, and was said I was very calm doing the issue, but in all honestly, I was trying to keep it together while everyone is panicking and I know I'll freak out later at home.

[bgxyrnf, MSN, RN]

Please read the thread before criticizing. This is ALL discussed. It WAS appropriate and warranted through 911 and OP level of education.

I read the who thing.

It was not appropriate to initiate compressions on a patient with pulses. There is nothing in BLS that says otherwise.

[emergenceRN17, ASN, BSN, RN]

Um, if the patient had a perfusing rhythm, you shouldn't have been doing compressions.

If the kid was so stable that EMS didn't see the need for transport, even more so.

And effective CPR is traumatic.

I'm truly stunned that you did CPR on a patient for three minutes and that didn't even buy the kid a basic ED work up.

I have similar thoughts but am a new nurse and didn't think that I should say anything.

I am happy she was there for this student as it must have been scary for the both of them. However ... the thing that made my heart sink the most about this situation was the response (multiple times) stating that she did chest compressions because she was told to... even though she questioned it and thought it was weird.. she did it because she was told to. That scares me... maybe its the still scared student in me, IDK but it was drilled into us that if someone tells us to do something that we in the slightest bit question.... we better have a good explanation other than we were told to.

[Queen of Icepacks, RN]

I too was hesitant to jump in here but for the person with basic CPR AED the Red Cross no longer even checks pulses. CPR is to be started for the unresponsive patient that is not breathing. If you are unable or unwilling to perform rescue breathing then Compression only CPR may be done.

[lifelearningrn, BSN, RN]

I have similar thoughts but am a new nurse and didn't think that I should say anything.

I am happy she was there for this student as it must have been scary for the both of them. However ... the thing that made my heart sink the most about this situation was the response (multiple times) stating that she did chest compressions because she was told to... even though she questioned it and thought it was weird.. she did it because she was told to. That scares me... maybe its the still scared student in me, IDK but it was drilled into us that if someone tells us to do something that we in the slightest bit question.... we better have a good explanation other than we were told to.

You went to nursing school. The OP Is a MA, and as such she followed the orders from the 911 operator, which is what she was supposed to do.

[audreysmagic, RN]

I read the who thing.

It was not appropriate to initiate compressions on a patient with pulses. There is nothing in BLS that says otherwise.

For healthcare BLS, yes. But the AHA is recommending no pulse checks in the presence of abnormal breathing for bystanders these days. I'm going to assume that's where the recommendation from the operator came from. And, in the heat of the moment, OP is not an RN and has been placed in a precarious position by what her school is doing to her. She did the right thing to follow the dispatcher's instructions. This situation makes more sense to me IN CONTEXT the more I think about it, remembering my Heartsaver teaching points as well as BLS. As we tell them in Heartsaver, focus on the compressions, and if the patient objects to what you're doing, you can stop.

[OldDude]

For healthcare BLS, yes. But the AHA is recommending no pulse checks in the presence of abnormal breathing for bystanders these days. I'm going to assume that's where the recommendation from the operator came from. And, in the heat of the moment, OP is not an RN and has been placed in a precarious position by what her school is doing to her. She did the right thing to follow the dispatcher's instructions. This situation makes more sense to me IN CONTEXT the more I think about it, remembering my Heartsaver teaching points as well as BLS. As we tell them in Heartsaver, focus on the compressions, and if the patient objects to what you're doing, you can stop.

Well said! Very!!

[Dempster]

I think that's crazy!! Amethya, when EMS got there did they resume compressions? Or did they just do rescue breaths? Or anything? As a parent I would've wanted her transported in case anything happened in the car, but of course, you can always refuse AMA.

Check airway for obvious obstruction and if there isn't anything blocking her throat, start compressions. Absolutely no breaths. It keeps the blood circulating to the brain and other vital organs. This method has decreased death rate of CPR recipient and decreases damage to organs, like the brain which has outcomes that show less brain damage. for example. Same rhythm and depth.

I've seen some crazy things, but that girl needed to take that EMS to the freaking ER for all types of scans, diagnostic procedures, drug screening, and a cornucopia of lab tests. I can think of several likely problems ranging from "inconvenient" to "confess your sins" bc she is about to catch the Jesus Buss.

[Dempster]

She and her family are so ignorant. Dear Lord. Probably wanted to avoid a bill. Nonsensical crap goes thru some minds instead of the ******* obvious.

[Dempster]

I think that's crazy!! Amethya, when EMS got there did they resume compressions? Or did they just do rescue breaths? Or anything? As a parent I would've wanted her transported in case anything happened in the car, but of course, you can always refuse AMA.

Check airway for obvious obstruction and if there isn't anything blocking her throat, start compressions. Absolutely no breaths. It keeps the blood circulating to the brain and other vital organs. This method has decreased death rate of CPR recipient and decreases damage to organs, like the brain which has outcomes that show less brain damage. for example. Same rhythm and depth.

I've seen some crazy things, but that girl needed to take that EMS to the freaking ER for all types of scans, diagnostic procedures, drug screening, and a cornucopia of lab tests. I can think of several likely problems ranging from "inconvenient" to "confess your sins" bc she is about to catch the Jesus Buss.

[Dempster]

For healthcare BLS, yes. But the AHA is recommending no pulse checks in the presence of abnormal breathing for bystanders these days. I'm going to assume that's where the recommendation from the operator came from. And, in the heat of the moment, OP is not an RN and has been placed in a precarious position by what her school is doing to her. She did the right thing to follow the dispatcher's instructions. This situation makes more sense to me IN CONTEXT the more I think about it, remembering my Heartsaver teaching points as well as BLS. As we tell them in Heartsaver, focus on the compressions, and if the patient objects to what you're doing, you can stop.

Without an AED, her cardiac rhythm cannot truly be known, even by checking pulse. I agree there should be no breaths or stops for pulse checks. Perfusion, perfusion, perfusion. RBCs normally complete their job every min. The iron hemes carry an Oxygen. So that's 2 tiny doses of O2, however there are around somewhere b/t 260 to 300 MILLION iron+oxygen bonds (hemoglobin). The cells are flattened-discoid in shape, thereby increasing surface area and easier to get all those O2 molecules to vital organs. FYI: They are flexible sponges when they pick up O2. They carry A LOT of oxygen this way and get into tiny vessels like they do yoga. However, the last thing to worry about during a code or with CPR on someone put in your path that day (Fate) is their capillaries. Capillary refill doesn't apply in such a moment.

So you have millions of hemoglobin molecules in a single RBC, and depending on sex and size (and comorbidities) we have about 25 TRILLION RBC, give or take a few TRILLION. Plus RBCs are continuously, non-stop pump out Retics that are "adults" in about a week.

When under extreme conditions, like an MI, RBCs pull off magic tricks to keep vessels dilated and flexible, while releasing other substances that constrict vessels in extremities, keeping vital organs top priority. ATP (clot-buster) is also released when the body is in shock.

I love A&P and as you might see, I'm a dork. This is ultimately why you keep pumping until you pass out or they come to and push you off! It sounds like this girl's situation had to have caused AMS which gives you legal protection until she is oriented to self and situation, then you might get charged with Assault and Battery. This does not apply when an ambulance takes you to an ER. If you don't make sense or aren't awake and fully oriented, legal liability is (should be) removed by "Implied Consent." Similarly, if you voluntarily commit yourself, you also give "Implied Consent." You may think it's time to go home, but doc says no way and changes your status to "Involuntary" by way of AMS.

Ok, so all that was to help explain compression only CPR. Plus, your other cells are getting funky. It doesn't take long AT ALL for standing blood to clot, despite the RBCs Atp magic. You may end up with a clot to your pt's lungs, brain, or branch of vessels in an already sick heart. I've seen this too many times, but they lived (mostly) and now have a life-threatening condition from clots.

No matter what the outcome, the fact that CPR was ever attempted makes you a Life Saver. Better to be a little heavy handed to pump the heart, than not. I'm sure you did fine though, esp bc females generally are easier to compress than males (just my experience). You don't try to break ribs, but imagine pressing down really close to them. At some point, esp if in ER, ICU, or on Code Team, you will almost definitely break a rib or few r/t osteoporosis, age, size and density of bones. Think about their musculature as you do your split second head to toe by your senses only. Greater muscle size and tone would lead you to think that bones are stronger. A petite elderly, white lady with skin sliding over her skeletal frame will most likely be broke and bruised- Better broken and bruised than dead.

That girl lived until an ambulance arrived. You did something right for a sudden fall with respiratory dysfunction. Surely if her CNS may be a cause; if not, her CNS became involved. Thats a whole lot of failing organ systems girl! Be proud!

Dempster- Too many years of experience, starting out as an ADN, BSN, FNP-BC with PICC Line Cert from Vanderbilt, and some teaching in Community Health and Med/Surg I and II, guest lecturing, and tutoring/mentoring from the very beginning.

-"What a long, strange trip it's been." - Grateful Dead

[OldDude]

Without an AED, her cardiac rhythm cannot truly be known, even by checking pulse. I agree there should be no breaths or stops for pulse checks. Perfusion, perfusion, perfusion. RBCs normally complete their job every min. The iron hemes carry an Oxygen. So that's 2 tiny doses of O2, however there are around somewhere b/t 260 to 300 MILLION iron+oxygen bonds (hemoglobin). The cells are flattened-discoid in shape, thereby increasing surface area and easier to get all those O2 molecules to vital organs. FYI: They are flexible sponges when they pick up O2. They carry A LOT of oxygen this way and get into tiny vessels like they do yoga. However, the last thing to worry about during a code or with CPR on someone put in your path that day (Fate) is their capillaries. Capillary refill doesn't apply in such a moment.

So you have millions of hemoglobin molecules in a single RBC, and depending on sex and size (and comorbidities) we have about 25 TRILLION RBC, give or take a few TRILLION. Plus RBCs are continuously, non-stop pump out Retics that are "adults" in about a week.

When under extreme conditions, like an MI, RBCs pull off magic tricks to keep vessels dilated and flexible, while releasing other substances that constrict vessels in extremities, keeping vital organs top priority. ATP (clot-buster) is also released when the body is in shock.

I love A&P and as you might see, I'm a dork. This is ultimately why you keep pumping until you pass out or they come to and push you off! It sounds like this girl's situation had to have caused AMS which gives you legal protection until she is oriented to self and situation, then you might get charged with Assault and Battery. This does not apply when an ambulance takes you to an ER. If you don't make sense or aren't awake and fully oriented, legal liability is (should be) removed by "Implied Consent." Similarly, if you voluntarily commit yourself, you also give "Implied Consent." You may think it's time to go home, but doc says no way and changes your status to "Involuntary" by way of AMS.

Ok, so all that was to help explain compression only CPR. Plus, your other cells are getting funky. It doesn't take long AT ALL for standing blood to clot, despite the RBCs Atp magic. You may end up with a clot to your pt's lungs, brain, or branch of vessels in an already sick heart. I've seen this too many times, but they lived (mostly) and now have a life-threatening condition from clots.

No matter what the outcome, the fact that CPR was ever attempted makes you a Life Saver. Better to be a little heavy handed to pump the heart, than not. I'm sure you did fine though, esp bc females generally are easier to compress than males (just my experience). You don't try to break ribs, but imagine pressing down really close to them. At some point, esp if in ER, ICU, or on Code Team, you will almost definitely break a rib or few r/t osteoporosis, age, size and density of bones. Think about their musculature as you do your split second head to toe by your senses only. Greater muscle size and tone would lead you to think that bones are stronger. A petite elderly, white lady with skin sliding over her skeletal frame will most likely be broke and bruised- Better broken and bruised than dead.

That girl lived until an ambulance arrived. You did something right for a sudden fall with respiratory dysfunction. Surely if her CNS may be a cause; if not, her CNS became involved. Thats a whole lot of failing organ systems girl! Be proud!

Dempster- Too many years of experience, starting out as an ADN, BSN, FNP-BC with PICC Line Cert from Vanderbilt, and some teaching in Community Health and Med/Surg I and II, guest lecturing, and tutoring/mentoring from the very beginning.

-"What a long, strange trip it's been." - Grateful Dead

You need to cut back on the energy drinks...

[OyWithThePoodles, RN]

For those who have not had PALS, if this child was young (age wasn't specified) compressions were indicated. Please see #4. I can't get a hold of anything from AHA because my computer is being stupid and blocking me from it. Boo. I don't know how many times I killed a kid on the PALS online recert because their pulse was less than 60 and I didn't immediately begin CPR.

PALS - Bradycardia: Pediatric Advanced Life Support (PALS): Bradycardia

I still can't believe she wasn't transferred. Crazy.