Do you know how to do CPR well? - page 2

I was wondering..I graduated in May of this year..How important is to know CPR? I know some patients might stop breathing and the nurse has to do CPR on the patient right? I never done CPR on a live... Read More

  1. by   EricJRN
    Quote from gonzo1
    Just wanted to say that in our ER we do CPR alot and so far I have never seen or heard of ribs being cracked, if it is being done right the risk of that is slim.
    Do you work in a peds ER? The studies don't show CPR-associated rib fractures in adults to be a rare phenomenon. I think it's an interesting continuation of this thread that many people's experiences with CPR are so different.
  2. by   flashpoint
    I've cracked ribs a time or two and I think I do pretty good CPR. Obviously one of our PAs does too because he would always rotate someone else out to get me on the chest. It's not common and I've seen it happen more with elderly patients than any other age group, but it happens.
  3. by   Bala Shark
    The way I look at those CPR classes is that they will give you the CPR book on the day of the class..That is a lot of information to absorb...The CPR instructors will show you how to do CPR during the class session..Then you walk out carrying the BLS card..But for people who never done CPR like new nurses, I assume that the person would have to go through the book and practice since the class acutally did not really find the person competent..If you are new in doing CPR and you just got the book on how to do CPR on the day of the class, I think a percentage of the people will have to read the book and practice later on to be competent..
  4. by   kat911
    Quote from gonzo1
    Just wanted to say that in our ER we do CPR alot and so far I have never seen or heard of ribs being cracked, if it is being done right the risk of that is slim.

    Rib crack a lot when doing CPR in the elderly, no way around it. When it happens to you, you will never forget. Apparently you have been very lucky or haven't done many on the elderly, or perhaps some one else started the compressions, that's when it usually happens.
    CPR is an important skill to have for all health care presonnel. I wish more nurses would pay attention to the ABC's, I am always amazed that a code will be called but no one has started CPR until the Code team arrives. Every RN, LPN, and CNA in the place must be BLS certified, what gives? Or when I ask what happened the nurse can't tell me if the patient had a pulse or not! Of course for some reason the new Residents this year all want to check the pt pulse at the radial site, has something changed in ACLS?? Sorry for the rant, one of my long term frustrations!
  5. by   GatorRN
    Quote from Bala Shark
    Yea, I dont think ratting out places is good thou..I know a lot of places that are mickey mouse..It is just that they have a lot of people in the class..Maybe it is two instructors with 25 people..The ratio is bad..People get certified regardless..

    You can call it "ratting out" if you want, but the fact remains that these places are suppose to be teaching ppl to do CPR. If they are not doing exactly that then they should be reported to the AHA so the situation can be corrected ASAP. I sure wouldn't want to be the pt that needed CPR to save my life and have someone who was certified, but had no clue what to do, except stand there and watch me die!! Would you? :uhoh21:

    To answer your original question though, Yes, CPR is something that everyone working in the medical field should know how to do very well, without a moment of hesitation. Many units require you to be certified in both BLS and ACLS, as I am.
  6. by   GatorRN
    Quote from gonzo1
    Just wanted to say that in our ER we do CPR alot and so far I have never seen or heard of ribs being cracked, if it is being done right the risk of that is slim.

    I've cracked my share of ribs doing CPR. It's definately not a pleasant feeling to know you cracked someones rib. But, if they are alive afterwards due to the efforts to save their life, then we as nurses have done a wonderful job, in my opinion.

    I've done CPR on so many pts I lost count a long time ago working in ICU, and I was doing it correctly, trust me. However, it does usually happen in the elderly whose bones are old and brittle.
  7. by   Dratz
    Bala do you mind if I ask you how old you are?
  8. by   Melilem
    When I took my first 8 hour CPR class, I was confused and a little overwhelmed- and very unsure if I was ready to use my new skills on a real person. Of course, we have chosen this profession because we are the type of people who help when we can- so I'm sure I would have at the opportunity. During recertification, I remembered my first class, and I was confident.
    So my reply to the poster is- when the time comes, you will do just fine.
    You know, it would be nice if the Red Cross would make available their training tapes free of charge. I wonder if they do.
  9. by   vamedic4
    Hi Bala,
    First off, you don't do CPR on live do them on dead one's (unless of course they're little little kids) :wink2: !

    But seriously, YES it is an absolute necessity that you know how to do CPR, and I tell every one of my new (and old ) nurses that perhaps THE MOST important SKILL you can have is the ability to effectively bag a patient with a BVM or similar device.

    waking the boys up
  10. by   MissJoRN
    Just remember the new ACLS guidelines are heavily stressing CPR esp chest compressions. They are finding that many people are getting sloppy with the basics and thinking that defibbing and meds are all that matters anyway. Sorry, I don't know all the details of the new ACLS algorithms since I'm definitely more of a PALS girl, LOL. Just reminding that it is very important.

    I've seen the same type of mickey mouse classes, too, at many facilities. I just don't think employers think that CPR is important enough to invest employee time in. They'd rather not pay us to be in a conference room for 8 hrs if they can throw cards at us in 15 min and get us back on the floor!!
    So what else is new??
  11. by   vampiregirl
    Quote from catlady
    I can't speak for the OP, but if the so-called CPR class I witnessed this year is any indication, there are indeed "Mickey Mouse" certifications out there. I thought I was going to get my BLS recertified. My then-employer had brought in some credentialing authority I'd never heard of, and the participants were "recertified" in less than 15 minutes. I dropped my alleged certification card in a drawer. I'll do the real BLS when I come up for recert. Hope none of those people are called upon to work on the chest of anyone I care about.
    As a CPR instructor, it saddens and scares me that there are "CPR certifications" that are just basically handed out. I've heard horror stories about several different CPR classes. It makes the reputable courses, such as the American Red Cross and AHA, look bad. I "took" a totally online certification course (I truly don't remember which one) just to see what it entailed... I wasn't impressed. The lack of a clinical skills portion with supervision from an experienced instructor concerned me. Unfortunately, some of the less reputable courses offer "advantages" to employers and students such as cost and convience. But why would you want to sacrifice quality, especially when it could mean life or death literally?

    A quick story... in my state, firefighters are not required to have CPR certifications, it's just recommended (I won't even get started on this topic!!!). I offerred the training at our local fire department and almost the entire department got certified. Within a couple weeks of class, a couple of our firefighters found themselves doing CPR when a boat pulled up at their dock (they live on the lake) with a man in cardiac arrest in the boat. The boat driver had just seen a crowd of people and swung in to get help. They had no idea that it was a group of firefighters. Two more of the firefighters (separate incidents) have done CPR in the last year at their places of work. One resulted in a save.

    One more thought... the cartilage pulling away from the sternum (especially in elderly) produces a horrible sound/ feeling. I sometimes wonder if people think they "breaking ribs" when actually they are encountering this.
  12. by   NRSKarenRN
    Remember Mom or Dad saying "Practice makes perfect"...same with CPR.

    More courses one takes or chances one gets to use skill working in hospital setting vs out patient area, better one gets at CPR. There are few "perfect" codes outside critical care units + hospital setting. HOWEVER, many lives HAVE been saved due to prompt recognition of heart attack and CPR started by lay persons.

    When in nursing school, our instructors used to take an individual student to witness a code so we could get an idea what went on/roles etc. Teaching friendly places often had student participate in chest compressions or bagging patient.

    With new grads during orientation, we tried to get them to attend code on our or neighboring unit: observer, recorder then participant role. Checking crash cart afterwards allowed one to get to actually SEE where equipment stored with advent of locked carts. Working in a teaching facility, educators developed "post code wrap-up" where change nurse/resident discussed what went right, problems encountered and areas of improvement needed ---everyone on team thanked for their participation. In home health past 10 year, staff are provided CPR training and rarely get to use that skill: we mostly call 911 for transport prior to point of CPR. Those agencies handeling vent patients have higher chance of using skill.

    American Heart Association and American Red Cross are the organizations who provide training and where instructors obtain cards. If someone NOT providing proper training, please report them to group listed on card.
    There are scammers in every part of our lives....part of our professional obligations to report substandard care and training...just not talk about it.
  13. by   RunnerRN
    Ditto to the above poster - you have to DO CPR to be good at it (and that doesn't mean doing it on the mannequins). My first experience w CPR was on a guy who crumped during dialysis...I was on a ride-a-long w paramedics, and the code had been handled poorly before we arrived (imagine ept and atropine being "pushed" into a running line without clamping above, etc etc). I always saw these big firefighters and medics doing CPR one handed, so I thought I could do that too once I started to get tired. My poor medic friend I was riding with had to redirect me. Unfortunately, the pt died....was dead before we even pulled up.

    The whole point of the above story is that the first time you do CPR on someone, it is a scary thing. Just remember to go for the chest and go hard. I'd rather break a few ribs than not perfuse the brain. It is just like everything else in nursing-you won't be good at it until you try it.