Emergency Kit

TheSquire, DNP, APRN, NP · Jun 17, 2012

Maybe they meant hospital/EMS level CPR?

But even then, you're still supposed to know how to do it as a lay rescuer as well.

theantichick · Jun 18, 2012

But even then, you're still supposed to know how to do it as a lay rescuer as well.

There's a difference between "won't" and "can't".

I *won't* do CPR on someone without a barrier. I certainly prefer at least an OPA to help maintain a patent airway, and prefer a BVM over MTM.

*CAN* someone do CPR without any of that? Of course.

However, it's worth noting that the CPR guidelines are changing soon to compressions only - no ventilations - in the prehospital setting. I was assured that this is an evidence-based change, even though it's counter-intuitive since I've been trained for some 30 years now to do CPR with ventilations. :)

emtb2rn, BSN, RN, EMT-B · Jun 18, 2012

To esme's point about getting vs for the 911 dispatcher, here's what the medics will probably hear:

"dispatched to xxxx church for the cardiac". Might get a "cpr in progress", might not.

Music in My Heart · Jun 18, 2012

Anyway, we want to put together an emergency kit, something that would be useful, just in case. But we must do it within the realm of our license, thus no drugs, other than aspirin.
The church does have an oxygen tank, so I want a non rebreather mask, aspirin, gloves, stethoscope, bp cuff. I also thought about making a cheat sheet in the box, for CP and stroke guidelines.

1) "no drugs, other than aspirin" == Um, were ASA to be developed today, it would likely be a prescription med... not something to be administered to a patient in distress without a doctor's order or standing protocol...

"What, you gave 324 mg of aspirin to this person who's taking coumadin and seems to have an acute GI bleed?" Not a question I want to face?

No meds means just that: No meds.

2) Oxygen... I'd hesitate to throw a NR on somebody without doing a thorough assessment and being ready to bag 'em... MD order or standing protocol required for oxygen... and many hospitals/providers are now saying, even for CP, no oxygen unless they're hypoxic.

3) BP cuff: Why? So it's high or low, what are you going to do besides either (1) call EMS or (2) take 'em directly to the ER? (20 minutes for ALS on scene vs. 5-10 minutes to the hospital and through triage... still opt for EMS... unless it's only BLS).

Do you want to make the call as to whether the person needs to go to the ER based on their BP? Not a liability I want to assume for anybody outside of my immediate circle.

If you're concerned enough to check their pressure, you're concerned enough to get them to a doc... Sure, knowing the pressure at onset can be a useful piece of information, it's not critical... and will probably be ignored by the ER doc if it's not coming from EMS... though maybe not.

======

What I'd have is simply some dressings (abds, telfa, kerlix), cold packs, aluminum splint, and... an AED. Anything beyond that should be under EMS protocols...

And certainly NO ASPIRIN!!!

Music in My Heart · Jun 18, 2012

I also see no point in CP or stroke guidelines... in the event of concern about either, call 911 and/or immediately transport to that nearby ER...

EMS knows their authority's protocols... which may dictate flying from scene to a CP stroke center rather than going to the local ER who may or may not be best equipped to handle such things.

Really, other than an AED, you don't need much besides some bandages... shears are always good... especially if you do find yourself doing CPR.

Murse901, MSN, RN · Jun 19, 2012

However, it's worth noting that the CPR guidelines are changing soon to compressions only - no ventilations - in the prehospital setting. I was assured that this is an evidence-based change, even though it's counter-intuitive since I've been trained for some 30 years now to do CPR with ventilations.

This change is only for untrained lay people and not for EMS or other trained personnel in the prehospital setting. Just thought I'd throw that clarification out there, because when I think prehospital, I think EMS.

If you haven't read the information on the reason for the change, you should. The takeaway is that there is still residual O2 in the circulatory system, and that just doing chest compressions will continue to perfuse this residual O2. I don't remember how long it takes for the residual O2 to get used up (I want to say about 8-10 minutes). Hopefully, by that time, EMS will be on scene and will start administering O2 via ETT/BVM with compressions.

Additionally, it's easier for the untrained public to remember to just do chest compressions, and more palatable for the untrained public to be able to help someone without putting their mouth near the victim's mouth.

brainkandy87 · Jun 21, 2012

I say to hell with the emergency kit. All your church needs is an AED, a telephone, and a pair of hands. If you want to help them prepare for an emergency, help them get into CPR classes. That will help not only those in your church, but anyone they happen to see drop in public. CPR is the life saver, not the aspirin or the oxygen or the bandages.

Music in My Heart · Jun 25, 2012

I say to hell with the emergency kit. All your church needs is an AED, a telephone, and a pair of hands. If you want to help them prepare for an emergency, help them get into CPR classes. That will help not only those in your church, but anyone they happen to see drop in public. CPR is the life saver, not the aspirin or the oxygen or the bandages.

I totally agree with the essence of your post but - as you know - it's time-to-shock that's the lifesaver (to ICU d/c)... even with the best CPR in progress at the moment of arrest. Without a nearby AED, in practical terms, the rest is mostly just window dressing.

Music in My Heart · Jun 25, 2012

and more palatable for the untrained public to be able to help someone without putting their mouth near the victim's mouth.

And more palatable for professionals, too. Outside of my immediate circle, if I'm not bagging 'em, I'm not ventilating them... period. (Pocket masks are worthless, IMO).

TheSquire, DNP, APRN, NP · Jun 25, 2012

And more palatable for professionals too. Outside of my immediate circle, if I'm not bagging 'em, I'm not ventilating them... period. (Pocket masks are worthless, IMO).[/quote']
An odd opinion to have, since in my EMT class it was hammered home that a pocket mask with additional O2 was the most effective means of ventilation.

brainkandy87 · Jun 25, 2012

I totally agree with the essence of your post but - as you know - it's time-to-shock that's the lifesaver (to ICU d/c)... even with the best CPR in progress at the moment of arrest. Without a nearby AED in practical terms, the rest is mostly just window dressing.[/quote']
Hence the reason I said they need an AED in addition.

Murse901, MSN, RN · Jun 25, 2012

And more palatable for professionals too. Outside of my immediate circle, if I'm not bagging 'em, I'm not ventilating them... period. (Pocket masks are worthless, IMO).[/quote']
Explain to me why you believe pocket masks are worthless? I'd be interested in reading your research.