help! CPR question

[sweetieann]

If you are responding to an unwitnessed collapse, do you provide CPR first THEN use AED?

I know that if the collapse it witnessed, you use the AED as soon as possible. But I have heard mixed opinions on whether or not to use it ASAP if the collapse is unwitnessed? So say (hypothetically), someoen codes on a floor and a code is called and you get to the person first, (but you didn't actually see them collapse,etc) and there is an AED right there...do you start some CPR cycles first or attach the AED? What do the guidelines say, I tried looking this up but always see conflicting things.

Thanks so much!

[RN1982]

The AED should be placed on the patient ASAP but that does not always mean that you will have to use it. It depends on the patient's rhythm. If they are in asystole, you don't shock, if its V-fib, yes you shock. CPR should be initated immediately until the AED is available. When the AED is available, it should be attached to the patient immediately to check if the patient has a shockable rhythm. If not, you just resume CPR.

You should look up ACLS guidelines for reference.

[MassED, BSN, RN]

If you are responding to an unwitnessed collapse, do you provide CPR first THEN use AED?

I know that if the collapse it witnessed, you use the AED as soon as possible. But I have heard mixed opinions on whether or not to use it ASAP if the collapse is unwitnessed? So say (hypothetically), someoen codes on a floor and a code is called and you get to the person first, (but you didn't actually see them collapse,etc) and there is an AED right there...do you start some CPR cycles first or attach the AED? What do the guidelines say, I tried looking this up but always see conflicting things.

Thanks so much!

A,B,C - check for breathing, always first - if not breathing (no rise and fall, nothing felt on cheek) provide 2 breaths - is there a pulse? If not start CPR. While doing all of that, then you have someone get the AED, call a code in house.... Current ACLS guidelines are that someone gets the AED set up while CPR continues - once the pads are in place then the compressor can move aside so it can analyze - limited interruptions in CPR is the rule now.

[SweetTeaRN, BSN, RN]

I agree with the above posters. I just took ACLS last week. My understanding is that, like you said, if the collapse is witnessed then the AED should be applied and used immediately. However, if the collapse is not witnessed, then you should provide 5 cycles of CPR (approx. 2 min.) before allowing the AED to analyze the rhythm. The main thing with ACLS now is to minimize interruption in CPR, keeping any interventions to less than 10 seconds.

[sjt9721, BSN, RN]

I agree with the above posters. I just took ACLS last week. My understanding is that, like you said, if the collapse is witnessed then the AED should be applied and used immediately. However, if the collapse is not witnessed, then you should provide 5 cycles of CPR (approx. 2 min.) before allowing the AED to analyze the rhythm. The main thing with ACLS now is to minimize interruption in CPR, keeping any interventions to less than 10 seconds.

The above (emphasis is mine) typically refers to out-of-hospital arrest situations. I believe the AHA guidelines discuss this as an option for EMS medical directors.

[sjt9721, BSN, RN]

The above (emphasis is mine) typically refers to out-of-hospital arrest situations. I believe the AHA guidelines discuss this as an option for EMS medical directors.

Continued from above...(I wasn't quick enough to edit my previous post!)

It's important to remember that guidelines are just that: guidelines. They aren't written in stone and facilities, individual physicians, or EMS systems may choose to do certain things that aren't necessarily included in the guidelines. (Our local EMS doc implemented the above a few years before the 2005 guidelines were even released.)

[firecoins]

The AED should be placed on the patient ASAP but that does not always mean that you will have to use it. It depends on the patient's rhythm. If they are in asystole, you don't shock, if its V-fib, yes you shock. CPR should be initated immediately until the AED is available. When the AED is available, it should be attached to the patient immediately to check if the patient has a shockable rhythm. If not, you just resume CPR.

You should look up ACLS guidelines for reference.

If your using an AED, you wouldn't need to interpret any rhythms. AEDs are dummy proof and tell you if a shock is needed. The A stands for automatic.

[RN1982]

Yeah, thanks for the correction. I was thinking about the monitors we use at work, mixed that up with the AEDs.