AHA 2005 - I'm Lost

[MMiz]

I'm putting the final touches on the school's CPR/AED policy, and I must admit that I'm absolutely lost with AHA 2005. I was an AHA BLS instructor back in the day, but things have changed quite a bit, and my online resources are just plain confusing.

So, can anyone help me with shock advised/no shock advised lay rescuer CPR/AED?

I got:

SHOCK ADVISED:
1. Clear area, making sure no one is touching the victim.
2. Push SHOCK button when prompted (if the AED is a fully automatic unit, the shock occurs without rescuer interaction).
3. Device will analyze the victim’s heart rhythm and shock up to one time
4. If pulse signs of circulation such as normal breathing and movement are absent, perform CPR for two minutes (30:2)
5. Device will countdown two minutes of CPR and will automatically evaluate victim’s heart rhythm when CPR time is over.

What about No Shock Advised? Start CPR, do it for two minutes, then analyze?

Thanks!

 

[Epi-do]

You are correct, if no shock is advised you do CPR again for 2 minutes and then reanalyze. You continue to repeat the cycle until additional help arrives.

 

[rescuecpt]

In my crazy county, once you get in the ambulance, no more shocky-shocky, even if it's advised. They'd rather you get to definitive care than pull over to shock.

I hope the updated ACLS guidelines aren't as retarded, but since it comes from the same people, you know it's going to be.

 

[Stevo]

in the broader scope of cric updates, where do the field cpr studies come from that motivate the AHA & ARC?

think about it, the changes they have foisted on ems in the last 10 years can't all come from pig (et all barnyard fare) clinicals, can they?

and they can't count on anything 15 to (whatever) minutes after the inital arrest in the truama room right?

so they HAVE to be basing it on field studies

anyone out there been polled by the AHA/ARC?

~S~

 

[Guardian]

I'm putting the final touches on the school's CPR/AED policy, and I must admit that I'm absolutely lost with AHA 2005. I was an AHA BLS instructor back in the day, but things have changed quite a bit, and my online resources are just plain confusing.

So, can anyone help me with shock advised/no shock advised lay rescuer CPR/AED?

I got:

SHOCK ADVISED:
1. Clear area, making sure no one is touching the victim.
2. Push SHOCK button when prompted (if the AED is a fully automatic unit, the shock occurs without rescuer interaction).
3. Device will analyze the victim’s heart rhythm and shock up to one time
4. If pulse signs of circulation such as normal breathing and movement are absent, perform CPR for two minutes (30:2)
5. Device will countdown two minutes of CPR and will automatically evaluate victim’s heart rhythm when CPR time is over.

What about No Shock Advised? Start CPR, do it for two minutes, then analyze?

Thanks!

looks right to me

 

[Guardian]

You know, with all the publication out and the simplicity, you would think it would be easier to understand but it's still confusing.

 

[MMiz]

You know, with all the publication out and the simplicity, you would think it would be easier to understand but it's still confusing.

I spent a good two hours going over the literature before posting. I read the scientific stuff and the watered down stuff. Nowhere did I see the algorithm that I expected. Every PDF, the AHAs included, was focused on changes. There wasn't a single 1, 2, 3 document. It was frustrating, and after reading it, I can't help but feel like we've dumbed it down far too much.

 

[fm_emt]

Teh book sez....

"No Shock Indicated" Message: Pulse and Breathing Absent

If the AED does not detect a rhythm requiring a shock, the AED will prompt you to resume CPR, beginning with chest compressions. Do not recheck to see if there is a pulse. The AED may prompt you to clear the victim to allow analysis in about 2 minutes. Follow the AED voice prompts. Continue until advance care providers take over or the victim starts to move. Advanced care providers will indicate when a pulse check or other therapies are appropriate.

American Heart Association "BLS for Healthcare Providers" Student Manual, Page 34

 

[rescuecpt]

"No Shock Indicated" Message: Pulse and Breathing Absent

If the AED does not detect a rhythm requiring a shock, the AED will prompt you to resume CPR, beginning with chest compressions. Do not recheck to see if there is a pulse. The AED may prompt you to clear the victim to allow analysis in about 2 minutes. Follow the AED voice prompts. Continue until advance care providers take over or the victim starts to move. Advanced care providers will indicate when a pulse check or other therapies are appropriate.

American Heart Association "BLS for Healthcare Providers" Student Manual, Page 34

My first thought in the update class was "wow, this is really insulting to BLS providers"... they aren't supposed to check for a pulse? I can't wait to hear the docs or nurses say something like "why are you doing cpr, moron, the patient has a pulse!"....

 

[DT4EMS]

The main reason for not checking for a pulse after a shock is because "if" there was an organized rhythm it is usually PEA. SO the theory is to continue to prime the pump to perfuse the coronary arteries.

The push is to have a little pause as possible in CPR.

 

[Guardian]

I like the BLS healthcare provider professional student manual with CD (for watching demonstration on computer).

 

[BossyCow]

http://www.americanheart.org/downloadable/heart/1132621842912Winter2005.pdf

This document has the best comparison of old standard to new standard I've ever seen come out of the AHA. It gives actual reasons.

We have to remember that AHA is not in the business of making things easy for EMS or even in the Education Business. They are a research organization. Their mandate is to raise money to support research. New data will always lead to new conclusions.