I recently took CPR class and got a question wrong concerning a choking child: The question portrayed a child eating, then coughing, then falling down unresponsive. My response... I would do the Heimlich maneuver to dislodge the food item which is likely obstructing the airway.
They say to go ahead and start chest compressions (CPR) with no mention of Heimlich.
Once, in real life, I had something similar happen to an adult. I did the Heimlich first and it saved the patient's life.
Specializes in Emergency Dept. Trauma. Pediatrics.
I just renewed my CPR and they said if it was unwitnessed you do the CPR right away (if unconscious) with the new standard. If you witnessed the child start choking to know 100% they were choking, then you attempt the maneuver first. The reasoning being although choking would be the obvious problem if the kiddo was eating, if it was unwitnessed you can't say for sure, and if they are unresponsive for any other reason you're wasting valuable time.
pumping deoxygenated blood is NOT an intervention....
Then please explain why compression only CPR has been proven to be successful and in some circumstances more successful than standard CPR. I provided links to studies and there are plenty more. Please provide yours.
If you are certified in BLS and PALS, and you were in this situation, what intervention would you do if not the AHA guidelines?
Then please explain why compression only CPR has been proven to be successful and in some circumstances more successful than standard CPR. I provided links to studies and there are plenty more. Please provide yours.
It's worth pointing out that the AHA doesn't actually believe ventilation is of no benefit, nor do they believe that someone who really has a complete airway obstruction will benefit more from CPR than from more effective methods of removing the obstruction, such as abdominal thrusts.
The reason "hands only" CPR is taught is that, particularly among laypeople, too much time is spent trying to ventilate the person, and often doesn't result in effective ventilation anyway so the victim ends up being without both ventilation and circulation.
The reasoning for their recommendations regarding choking victims is the same. Too often, people mistakenly believe that someone is or was choking when they are not, particularly "guppy breathing", and then spend valuable time trying to dislodge an obstruction that doesn't exist. Making a recommendation that has responders going directly to CPR is based on the idea is that there will be a higher overall survival benefit even though those who really do have an obstructed airway will probably be less likely to survive. This rationale has to be understood and appropriately applied to different types of responders and environments. A qualifier is added to this recommendation in my ACLS class that none of the EMS protocols in my area include treating a true complete airway obstruction with CPR, they all prioritize clearing the airway over compressions.
Then please explain why compression only CPR has been proven to be successful and in some circumstances more successful than standard CPR. I provided links to studies and there are plenty more. Please provide yours.
you are talking about two different things, please only compare apples to apples and oranges to oranges.
It's worth pointing out that the AHA doesn't actually believe ventilation is of no benefit, nor do they believe that someone who really has a complete airway obstruction will benefit more from CPR than from more effective methods of removing the obstruction, such as abdominal thrusts.
The reason "hands only" CPR is taught is that, particularly among laypeople, too much time is spent trying to ventilate the person, and often doesn't result in effective ventilation anyway so the victim ends up being without both ventilation and circulation.
The reasoning for their recommendations regarding choking victims is the same. Too often, people mistakenly believe that someone is or was choking when they are not, particularly "guppy breathing", and then spend valuable time trying to dislodge an obstruction that doesn't exist. Making a recommendation that has responders going directly to CPR is based on the idea is that there will be a higher overall survival benefit even though those who really do have an obstructed airway will probably be less likely to survive. This rationale has to be understood and appropriately applied to different types of responders and environments. A qualifier is added to this recommendation in my ACLS class that none of the EMS protocols in my area include treating a true complete airway obstruction with CPR, they all prioritize clearing the airway over compressions.
Recommendations change. Once the person becomes unconscious, we now begin chest compressions rather than abdominal thrusts. The Heimlich is only for those who remain conscious.
Agreed with her, We go for CPR if the patient is unconscious.
The people that say not to do compressions first, I have one question and one statement...
How (and why?) would you pull a kid up (especially if they bigger- like, are older than about 5 years old) to do the heimlich maneuver on a kid that now is a limp rag doll? Chest compressions makes more sense because it will not only pump blood but also provide pressure that will dislodge what they are choking on.
Also, whoever says "but they are choking so why do they need CPR?!" has never seen how fast a kid without oxygen loses their pulse. its fast. like sometimes REALLY FAST. Kids are not small adults, guys.
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Wuzzie
5,238 Posts
Chest-Compression-Only CPR Saves More Lives
Chest-Compression-Only CPR (CCO-CPR) | Sarver Heart Center
Granted these studies were on adult patients in cardiac arrest but I have to think some intervention is better than no intervention at all.