Have you ever done CPR off duty?

blueheaven · Jan 30, 2007

I've done CPR in the community setting only 2 times. Our church choir had just completed singing in another church and we were getting ready for evening service in our own church. The guys were bringing in equipment etc. One of the men went up on the risers, sat down, put his head in his hand and just fell over. I ran up and immediately started CPR, there was another nurse there and she helped. EMS was 5 minutes in getting there. Unfortunately he did not make it. What made it worse was his wife was a former ICU nurse.

The other time was at WalMart. Guy went down, promptly turned blue, pulseless. Initiated CPR, got a thready pulse. The EMS crew that arrived were "greenhorns" and did NOT follow ACLS protocol, nor the ABCs. Talk about frustrated! I often wonder if this man would have survived if a "more seasoned" crew had answered the 911 call. BTW I did report them.

pagandeva2000, LPN · Jan 30, 2007

Yes I had to do cpr on my own mother. I had gone to her apartment as usual in the morning but she was still in bed and said she wasn't feeling good, she had chest pain and back pain all night and had taken ntg but had gotten no relief and was sick to her stomach. While I was calling 911 she collapsed and I had to start CPR. There was no equipment, no one to help
(i remember screaming for help while doing compressions, there was no suction and I tried pulling the secretions out of the back of her throat with my hands) EMS took forever..it was a fight for her between me and GOD ...and he won.

Oh, My God...I am so sorry to hear this. How do you deal with this, now?

pagandeva2000, LPN · Jan 30, 2007

I also worry about making a mistake. I am not exposed to codes or CPR on a regular basis, so, I admit, I am afraid. I just took CPR last week, and it made me think; because this was my first time taking CPR as an LPN, where I am definitely responsible for the outcome of the patient. Reading this reminds me that I have to purchase a few face shields. I am already a walking suitcase...I always carry my digital thermometer, automated blood pressure reader, drug book, herbal book and stethoscope...I guess that one more thing... a mask is good.

RNsRWe, ASN, RN · Jan 30, 2007

I've implemented a no-CPR-for-pythons policy that will greatly reduce my risk of CPR-related salmonellosis. :)

LOL! But seriously, I recently had a pt who had been dx'd with salmonella (after admission), so she had been walking around with it prior to that. Thing is, you never know what ANYONE has when they drop in front of you :eek:

loquacity · Jan 30, 2007

re: "Just in case you don't want to do breaths, here's a little bit of info that I heard about in my latest CPR class: Apparently, in Europe, compressions are done but rescue breathing is not. Studies have shown that the success rate of CPR is higher in Europe than in America. This is why we have increased our ratio to 30/2."

At least where I am, so as not to be sued, and be protected by the "Good Samaritan Act", you must act within your scope and as trained as a CPR trained person (regardless of what your occupation is)...anyways CPR courses do teach that you are to give breaths, so you could probably be sued if you did not give any breaths just compressions just because you were afraid of getting germs, that being said i still don't think i'd give CPR to a stranger without a mask of some sort (even if it is just a shirt or something, (im always wearing one of those lol!). Oh and i was also taught as of this year the 30:2 ratio, & because thye're always cahnging the rules, in my palce now there is only 1 basic CPR course, where everyhting is standardized (eg ratio) for all age groups and as simple as possilbe since most laypeople who take CPR don't ever take it again, and forget things, howevor there is a seperate CPR for healthcare workers. (Oh and we have to recertify q Year, not q2 year), oh and i've never had to give CPR, although a gril in my class did to another tourist when vacationing, though they didn't survive, but thats why she went into nursing.

withasmilelpn · Jan 31, 2007

I also worry about making a mistake. I am not exposed to codes or CPR on a regular basis, so, I admit, I am afraid. I just took CPR last week, and it made me think; because this was my first time taking CPR as an LPN, where I am definitely responsible for the outcome of the patient. Reading this reminds me that I have to purchase a few face shields. I am already a walking suitcase...I always carry my digital thermometer, automated blood pressure reader, drug book, herbal book and stethoscope...I guess that one more thing... a mask is good.

Don't worry too much about making a mistake. As one of my instructors said, there is nothing worse than dead. If you don't act they will stay that way. Your training will kick in.

Shamira Aizza · Jan 31, 2007

Resuscitated a man on a plane somewhere over western Canada; I was in coach class and assistance was requested for an "ill person" in first class. We were only 20 minutes into the flight, and over 3 hours to go, so I figured if the man was sick enough and we had to return to Anchorage, there would be an opening in first class....evil of me, eh?

I found a young girl with her hand on the shoulder of a very large fellow in the aisle seat. He looked dead already; ashen fading to purple, drenched in sweat, and not breathing. The girl was saying something to him in a soft voice...didn't seem very therapeutic in the resuscitative sense, but at least she wasn't disturbing the other passengers.

I've worked a code or two during my days as a paramedic, and the 2 second eyeball I gave him told me right away that this was far more than I bargained for. I briefly contemplated returning to my seat, but I was a capture audience for at least three more hours. Fortunately one of the flight attendants was burly enough to help me wrestle this fellow out of his seat and onto the aisle floor...which you could imagine was about 1/2 (or less) the width of this mans natural expanded state. I requested an AED and any medical gear they might have and started compressions (remember, no mask, no mouthie). The attendant hooked up the AED and shocked the fellow once per the "shock advised." I could not find a pulse...but the AED was not advising a second shock.

They brought two huge bags loaded with IV supplies, airway gear, and drugs (and seemingly enough narcs to drug the entire plane). Can you imagine this...the one item missing was a flipping bag-valve mask...still no ventilations for Mr. Large.

I'm on the floor doing compressions and talking about the stuff I still need. I asked for a bag-valve mask and got a couple of blank looks. I asked if any of the attendants had ever watched "ER," to which one answered "Yes." I asked if she had ever seen them using that round football-looking thing to help patients breath, and she said "YES!, We have one of those in the back!" It arrived in less than a minute.

I tore the bag open, and to my dismay, there was no mask. This bag-valve was useless, and this man's chances for living were being shat away for lack of basic planning.

Since I worked as a flight nurse, I asked if they had a "first-aid kit" that was just for the pilots...because I was making my last bet that this kit might have a simple face mask in it...and goshdang it did! And it fit onto the bag-valve!

A few dead brain-cells later, we've got compressions (the young girl is doing them now), and some high flow O2 via the desperately obtained bag-valve mask!

Meanwhile, there is a fantastically-dressed woman standing behind me kicking the bottoms of my shoes (I'm on the floor with this fellow), and she is prattling on about how she's an RN and someone needs to ventilate this fellow. I seriously doubted she was going to stoop over even a little bit and muss up her hair, let alone actually lock lips with this big purple sweaty guy, so I told her we were working on it. The third time she kicked me, I turned around, stoop up, and told her to either leave me alone or BACK OFF. She chose to stand there silently.

That dilemma solved, I asked the attendant that was sitting perkily in the dying man's seat if I could see the screen to the AED that she was holding. She looked at me with her perfect perky demeanor and said with great confidence, "it says, no shock advised." Proud of her as I was, I said, "that's good, but could I see the tracing, you know, the EKG readout, please?" She must've graduate at the top of her flight attendant class, because she said, "you don't need to see it because I just told you what it said." I am not kidding you!

The wise attendant behind her saw me swallow my fleeting frustration, she pulled the monitor from the perky one and turned it up so I could see it, and hot-dang, the fellow was in a sinus tachycardia!

I could now feel a weak carotid pulse (this guys fat arms were deep beneath the seats on either side), but no respiratory effort. At this point, the young girl asked what she could do. I promised her I had no intent to offend her, but I wondered what her experience was; she was 8 months into a family practice residency. I figured she had at least learned how to start an IV, but she assured me that it was one of her worst skills. Given that we couldn't pry this fellows arms out from under the seats without inverting the plane, I opted to establish an external jugular IV and gave him a saline bolus. Given his predisposition to a v-fib arrest, I also bolused him with lidocaine.

By the time we arrived back in Anchorage, he was taking breaths on his own and exhibiting weak movement of his head.

The ambulance crew came on board and found all the cool stuff done already, so they opted to tackle the most daunting task...getting this huge man out where they could actually do some work.

The newly minted FP resident took over transferring care at this point and I receded back to my seat where I grabbed my jacket and tiptoed back to the almost-dead man's seat. By this time the man is combative, and has to be sedated...but I'm not too concerned; he is safely in the care of the honeymooning resident and the EMS crew, and I'm about to wheedle my way into a first class meal and free booze for my efforts.

The attendant graciously awarded me the seat (and the resident had to go back to cattle class with her new husband). I don't know what happened to Ms. Shoe-kicker, RN. They gave me a bottle of wine, a discount voucher (which I never used) and I asked her to keep the Bailey's coming on the rocks non-stop until Minneapolis.

Two days later after the wine was gone and I sobered up, I called the hospital where the large man was taken; he had been discharged from CCU to step-down. The nurse said he was sleeping, so we let him sleep.

The End.

caroladybelle, BSN, RN · Jan 31, 2007

I've implemented a no-CPR-for-pythons policy that will greatly reduce my risk of CPR-related salmonellosis. :)

Not to mention turtles.

58flyer · Jan 31, 2007

Resuscitated a man on a plane somewhere over western Canada .......................................The End.

Awesome post Shamira!! Loved every word of it. You really earned that first class seat the hard way. :wink2:

SK-222 · Jan 31, 2007

Yes. Several years ago on an airplane of all places. I was seated in an exit row and traveling home after a vacation. I looked like your typical tourist wearing a ball cap, amusement park shirt, and I looked younger than my actual age on top of that. The steward asked if I was old enough to be seated at that exit row, and little did he know I was not only old enough, but a certified EMT at the time. While taxing down the runway before takeoff, all of a sudden there was a sense of panic in the cabin. An older gentleman keeled over the seat. Instinctively I got up to go help and saw there was no pulse and no breathing. For any who have traveled on a domestic flight, there is not much room to work in when in the aisle. I instructed a couple of larger passengers to assist getting him from the seat to the floor. I had no BSI or face shield, so instructed the pt's son on giving rescue breaths. Did compressions until getting back to the terminal. Medics come on board with a defib unit, drugs, etc, and got him back! (always an exciting time when it works!) a stewardess gave me an update when landing at home and I found out he was still alive though in critical condition. I never heard any more after that, but it's nice to think I made a difference in someone's life.