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Discussion

Student wanting clarification on CPR in ED

Apologies if this is in the wrong place. Also want to preface that I've been trying to find answers to this for a while and for some reason can't figure it out!

I will be doing a short ER rotation as a student nurse starting tomorrow and wanted to make sure I know enough about codes to be able to jump in if I can. I remember from my CPR class it's 2 breaths every 30 compressions. Do you stop compressions to do breaths? I remember that if you're alone doing CPR you only do compressions as that's the priority, but in an ED you've got a massive team. If you don't stop compressions, how exactly are you timing the breaths, since you'll probably get in a dozen compressions during the time it takes to give them?

I'm sure I'm massively overthinking this and it's not an exact science but I do want to have it straight in my head and I hope you all are of the philosophy of no dumb questions :) :)

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    • Admin

    Chances are, you're going to get that patient intubated PDQ if they weren't intubated in the field, and then it's just compressions and breaths with the Ambu bag attached to the ETT. Once the patient is intubated, there is no need to stop compressions- just keep going until it's time to switch out.

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    • Author

    Sweet, thanks! So how often do you do breaths at that point? Still 30:2? Seems hard to tell if you're not stopping compressions.

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    • Admin

    It's not in a ratio with compressions. It's a normal rate of 8-10 breaths/minute.

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    • Author

    That makes sense! Thank you!

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    No dumb questions. I always prefer people ask than do what they think is right or make assumptions. Especially as a student or a new nurse. Heck, I'm not a new nurse and I always ask if I'm unsure about something.

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    Very good chance that as a student if you run into a code they will have you doing compressions, usually RT will be handling the airway stuff and if no RT probably someone with experience. But Codes never end up going like they do in the classes, you'll have someone telling you what to do but it's always a perfect opportunity for students to practice their compressions. Something they don't warn you about, if there comes a time you get to be the first one on the chest, be prepared that there is a very good chance you're cracking ribs. It's a unsettling feeling and as you go to push down you will literally feel the ribs crunching under your hands. No one warned me for that and it's what I remember most from the first time I did CPR. I love doing CPR though and love doing compressions. Well except on heroine overdoses, which usually seems to be majority of the times I am doing CPR. At least 70% of the time.

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    I'm wondering how OP's ED rotation went!:nurse:

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    • Author
    I'm wondering how OP's ED rotation went!:nurse:

    It was fantastic! It was only 2 shifts, so more of an introduction to the ED, but I learned a ton and it was quite an experience. There were no codes, so my question never ended up being relevant, but plenty of trauma. The most acute trauma case was a head injury from riding a motorcycle without a helmet. During the process, everything was so fast-paced that it wasn't until he was off to surgery that it really hit me how crazy it was, and he was so young. But I suppose that's a day in the life of the ED! I really appreciated how much everyone works together much more closely compared with other specialties. The residents and doctors and RT's and nurses are all just one big team. And I got plenty of practice starting IV's!

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