CPR and AED

[Sluggo]

I am taking my NYS EMT-B exam in march. I was given a HW assignment which includes explaining different protocols. One of them is to describe the difference between witnessed and non witnessed AED/CPR. My question is not what is it but were do I find it? I searched all of my NYS BLS protocols, and checked my entire text book, and even my cpr sheets we received the day we were certified. I cannot for the life of me find this info. Please help a tired and frustrated student.

Thanks in advance.

 

[Medic x]

I am taking my NYS EMT-B exam in march. I was given a HW assignment which includes explaining different protocols. One of them is to describe the difference between witnessed and non witnessed AED/CPR. My question is not what is it but were do I find it? I searched all of my NYS BLS protocols, and checked my entire text book, and even my cpr sheets we received the day we were certified. I cannot for the life of me find this info. Please help a tired and frustrated student.

Thanks in advance.

If a person standing next to you collapses and is in cardiac arrest, you would use the AED first, before compressions. The reason is during the first two minutes of a cardiac arrest the heart responds better(granted it's a shockable rhythm). And it's more likely to return to a rhythm with a pulse.

On the other hand if it's not witnessed, you do 5 cycles of compressions first, to "prime the pump."

 

[Sluggo]

thanks,

But what i am really looking for is where this is found. In our protocols? From AHA? I cannot find it in black and white other than forums and by asking senior ems personnel. Where do I find this?

 

[Steam Engine]

thanks,

But what i am really looking for is where this is found. In our protocols? From AHA? I cannot find it in black and white other than forums and by asking senior ems personnel. Where do I find this?

I would imagine that it could be found in both AHA material and your protocols.

 

[EpiEMS]

http://www.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadable/ucm_317350.pdf

Page 9.

"When any rescuer witnesses an out-of-hospital arrest and an AED is immediately available on-site, the rescuer should start CPR with chest compressions and use the AED as soon as possible. Healthcare providers who treat cardiac arrest in hospitals and other facilities with on-site AEDs or defibrillators should provide immediate CPR and should use the AED/defibrillator as soon as it is available. These recommendations are designed to
support early CPR and early defibrillation, particularly when an AED or defibrillator is available within moments of the onset of sudden cardiac arrest. When an out-of-hospital cardiac arrest is not witnessed by EMS personnel, EMS may initiate CPR while checking the rhythm with the AED or on the electrocardiogram (ECG) and preparing for defibrillation. In such instances, 2 to 3 minutes of CPR may be considered before attempted defibrillation. Whenever 2 or more rescuers are present, CPR should be provided while the defibrillator is retrieved."

 

[94H]

http://www.nycremsco.org/images/articlesserver/BLS_Protocols_August_2011_v07012011b.pdf


Protocol 403

Got it from NYC REMSCO

 

[Aprz]

And for the AHA, you can find it here.

Shock First Versus CPR First

When any rescuer witnesses an out-of-hospital arrest and an AED is immediately available on-site, the rescuer should use the AED as soon as possible. Healthcare providers who treat cardiac arrest in hospitals and other facilities with AEDs on-site should provide immediate CPR and should use the AED/defibrillator as soon as it is available. These recommendations are designed to support early CPR and early defibrillation, particularly when an AED is available within moments of the onset of SCA.

When an out-of-hospital cardiac arrest is not witnessed by EMS personnel, they may give about 5 cycles of CPR before checking the ECG rhythm and attempting defibrillation (Class IIb). One cycle of CPR consists of 30 compressions and 2 breaths. When compressions are delivered at a rate of about 100 per minute, 5 cycles of CPR should take roughly 2 minutes (range: about 1½ to 3 minutes). This recommendation regarding CPR prior to attempted defibrillation is supported by 2 clinical studies (LOE 25; LOE 36) of adult out-of-hospital VF SCA. In those studies when EMS call-to-arrival intervals were 46 to 55 minutes or longer, victims who received 1½ to 3 minutes of CPR before defibrillation showed an increased rate of initial resuscitation, survival to hospital discharge,5,6 and 1-year survival5 when compared with those who received immediate defibrillation for VF SCA. One randomized study,12 however, found no benefit to CPR before defibrillation for non-paramedic-witnessed SCA.

EMS system medical directors may consider implementing a protocol that would allow EMS responders to provide about 5 cycles (about 2 minutes) of CPR before defibrillation of patients found by EMS personnel to be in VF, particularly when the EMS system call-to-response interval is >4 to 5 minutes. There is insufficient evidence to support or refute CPR before defibrillation for in-hospital cardiac arrest.

 

[emt seeking first job]

http://www.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadable/ucm_317350.pdf

Page 9.

"When any rescuer witnesses an out-of-hospital arrest and an AED is immediately available on-site, the rescuer should start CPR with chest compressions and use the AED as soon as possible. Healthcare providers who treat cardiac arrest in hospitals and other facilities with on-site AEDs or defibrillators should provide immediate CPR and should use the AED/defibrillator as soon as it is available. These recommendations are designed to
support early CPR and early defibrillation, particularly when an AED or defibrillator is available within moments of the onset of sudden cardiac arrest. When an out-of-hospital cardiac arrest is not witnessed by EMS personnel, EMS may initiate CPR while checking the rhythm with the AED or on the electrocardiogram (ECG) and preparing for defibrillation. In such instances, 2 to 3 minutes of CPR may be considered before attempted defibrillation. Whenever 2 or more rescuers are present, CPR should be provided while the defibrillator is retrieved."

Is the baove document the most current?

I had heard that AHA changed their system from abc to cab?

I realize that is not what the OP is about but I looked around the website and saw nothing newer than 2010.

Does anyone know?