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Questions that need further answers.
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Who must do regular research relevant to cardiopulmonary resuscitation and share it with the public? Whose responsibility is it to teach cardiopulmonary resuscitation to the public? Which guidelines are best for cardiopulmonary resuscitation at this point? Whom should the public contact if they have further questions? |
Case scenario 1.
Case scenario 2.
Cardiopulmonary Resuscitation
Case Scenario Investigations
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At 9 PM on Friday, November 5, 2021, 8 people were dead and several injured in a crowd surge at the Astroworld Festival in Houston, Texas. Many more injuries are expected to be reported. The crowd included 50,000 attendees. What is another word or term for crowd surge? Stampede What did the eye witnesses reveal? Houston Police Executive Assistant Chief Larry Satterwhite, who was near the front of the crowd, said the surge happened all at once. Questions that need to be answered. Were several people down on the ground because of the stampede or something else? What exactly did you see relevant to this incident at 9 PM on Friday, November 5, 2021, in Houston, Texas? What exactly went wrong? 8 individuals died: Is that correct? Was cardiopulmonary resuscitation done for all 8 individuals on the spot? Who exactly administered cardiopulmonary resuscitation for the 8 people who later died? How long was the cardiopulmonary resuscitation continued? Did they have any type of cardiopulmonary certification or any medical experience? How could this tragedy have been prevented? Before allowing this gathering of 50,000 people to happen, did anyone determine whether it was safe to do so? |
Coma
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When should you start on-the-spot cardiopulmonary resuscitation? When should you start on-the-spot cardiopulmonary resuscitation? Was the patient alive a few minutes before? Is there a few minutes history of injury? Is there no pulse, breath movement, or heart sounds? Are there no signs of rigor mortis? Are extremities of victim warm like a living human being? If yes, start cardiopulmonary resuscitation. Before you begin Before starting CPR, check: •Is the person conscious or unconscious? •If the person appears unconscious, tap or shake his or her shoulder and ask loudly, "Are you OK?" •If the person doesn't respond and two people are available, one should call 911 or the local emergency number and one should begin CPR. If you are alone and have immediate access to a telephone, call 911 before beginning CPR — unless you think the person has become unresponsive because of suffocation (such as from drowning). In this special case, begin CPR for one minute and then call 911 or the local emergency number. •If an AED is immediately available, deliver one shock if instructed by the device, then begin CPR. Compressions: Restore blood circulation 1.Put the person on his or her back on a firm surface. 2.Kneel next to the person's neck and shoulders. 3.Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands. 4.Use your upper body weight (not just your arms) as you push straight down on (compress) the chest at least 2 inches (approximately 5 centimeters). Push hard at a rate of about 100 compressions a minute. 5.If you haven't been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to checking the airway and rescue breathing. Airway: Clear the airway 1.If you're trained in CPR and you've performed 30 chest compressions, open the person's airway using the head-tilt, chin-lift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway. 2.Check for normal breathing, taking no more than five or 10 seconds. Look for chest motion, listen for normal breath sounds, and feel for the person's breath on your cheek and ear. Gasping is not considered to be normal breathing. If the person isn't breathing normally and you are trained in CPR, begin mouth-to-mouth breathing. If you believe the person is unconscious from a heart attack and you haven't been trained in emergency procedures, skip mouth-to-mouth breathing and continue chest compressions. Breathing: Breathe for the person Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened. 1.With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal. 2.Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. Thirty chest compressions followed by two rescue breaths is considered one cycle. 3.Resume chest compressions to restore circulation. 4.If the person has not begun moving after five cycles (about two minutes) and an automated external defibrillator (AED) is available, apply it and follow the prompts. Administer one shock, then resume CPR — starting with chest compressions — for two more minutes before administering a second shock. If you're not trained to use an AED, a 911 or other emergency medical operator may be able to guide you in its use. If an AED isn't available, go to step 5 below. 5.Continue CPR until there are signs of movement or emergency medical personnel take over. To perform CPR on a child The procedure for giving CPR to a child age 1 through 8 is essentially the same as that for an adult. The differences are as follows: •If you're alone, perform five cycles of compressions and breaths on the child — this should take about two minutes — before calling 911 or your local emergency number or using an AED. •Use only one hand to perform chest compressions. •Breathe more gently. •Use the same compression-breath rate as is used for adults: 30 compressions followed by two breaths. This is one cycle. Following the two breaths, immediately begin the next cycle of compressions and breaths. •After five cycles (about two minutes) of CPR, if there is no response and an AED is available, apply it and follow the prompts. Use pediatric pads if available, for children ages 1 through 8. If pediatric pads aren't available, use adult pads. Do not use an AED for children younger than age 1. Administer one shock, then resume CPR — starting with chest compressions — for two more minutes before administering a second shock. If you're not trained to use an AED, a 911 or other emergency medical operator may be able to guide you in its use. Continue until the child moves or help arrives. To perform CPR on a baby Most cardiac arrests in babies occur from lack of oxygen, such as from drowning or choking. If you know the baby has an airway obstruction, perform first aid for choking. If you don't know why the baby isn't breathing, perform CPR. To begin, examine the situation. Stroke the baby and watch for a response, such as movement, but don't shake the baby. If there's no response, follow the CAB procedures below and time the call for help as follows: •If you're the only rescuer and CPR is needed, do CPR for two minutes — about five cycles — before calling 911 or your local emergency number. •If another person is available, have that person call for help immediately while you attend to the baby. Compressions: Restore blood circulation 1.Place the baby on his or her back on a firm, flat surface, such as a table. The floor or ground also will do. 2.Imagine a horizontal line drawn between the baby's nipples. Place two fingers of one hand just below this line, in the center of the chest. 3.Gently compress the chest about 1.5 inches (about 4 centimeters). 4.Count aloud as you pump in a fairly rapid rhythm. You should pump at a rate of 100 compressions a minute. Airway: Clear the airway 1.After 30 compressions, gently tip the head back by lifting the chin with one hand and pushing down on the forehead with the other hand. 2.In no more than 10 seconds, put your ear near the baby's mouth and check for breathing: Look for chest motion, listen for breath sounds, and feel for breath on your cheek and ear. Breathing: Breathe for the baby 1.Cover the baby's mouth and nose with your mouth. 2.Prepare to give two rescue breaths. Use the strength of your cheeks to deliver gentle puffs of air (instead of deep breaths from your lungs) to slowly breathe into the baby's mouth one time, taking one second for the breath. Watch to see if the baby's chest rises. If it does, give a second rescue breath. If the chest does not rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. 3.If the baby's chest still doesn't rise, examine the mouth to make sure no foreign material is inside. If an object is seen, sweep it out with your finger. If the airway seems blocked, perform first aid for a choking baby. 4.Give two breaths after every 30 chest compressions. 5.Perform CPR for about two minutes before calling for help unless someone else can make the call while you attend to the baby. 6.Continue CPR until you see signs of life or until medical personnel arrive. ACLS In the in-hospital setting or when a paramedic or other advanced provider is present, ACLS guidelines call for a more robust approach to treatment of cardiac arrest, including the following: • Drug interventions • ECG monitoring • Defibrillation • Invasive airway procedures Unconscious patient. What type of patient needs basic life support? An unconscious patient. Do all unconscious patients need cardiopulmonary resuscitation? No. How should you evaluate and treat an unconscious patient? Assessment is very important. Not all unconscious patients need cardiopulmonary resuscitation. For adults, assess the victim, activate EMS and get AED, check pulse, start CPR. When do you start cardiopulmonary resuscitation in adults? CPR is required someone's breathing or heartbeat has stopped, as in cases of electric shock, drowning, or heart attack. CPR is a lifesaving procedure in this situation. What is cardiopulmonary resuscitation? Cardiopulmonary resuscitation is a combination of rescue breathing and chest compressions. Rescue breathing provides oxygen to a person's lungs. Chest compressions keep the person's blood circulating. Permanent brain damage or death can occur within minutes if a person's blood flow stops. Therefore, you must continue these procedures until the person's heartbeat and breathing return, or trained medical help arrives. In what situations is a directive like "Do not Resuscitate" justified? Old age more than 95 years with known complications. What is unconsciousness? Unconsciousness means being unable to see, hear, and talk. Often, this is called a coma or being in a comatose condition. An unconsciousness person will be unresponsive to activity, touch, sound, or other stimulation. He or she will not be able to communicate and won’t respond to stimulation. Conscious means able to see, hear, and talk. In pediatric patients younger than six months of age, the ability to make any verbal noise or cry is equivalent to talking. A person may be unconscious for a few seconds (as is the case with fainting) or for longer periods of time. What are the causes of unconsciousness? Alcohol use. Drowning. Electric shock Substance abuse Severe blood loss 8 H's and 6 T's: mnemonic for mechanisms Hypoxia Hypovolemia Hyperkalemia Hypokalemia Hypoglycemia Hypothermia Hyperthermia (heat stroke) Hydrogen ions (acidosis) Thrombosis (MI/heart attack) Tension pneumothorax Tamponade Toxins/therapeutics Thromboembolism Trauma What is the difference between being asleep and being unconscious? Being asleep is not the same thing as being unconscious. A sleeping person will respond to loud noises or gentle shaking; an unconscious person will not. An unconscious person cannot cough or clear his or her throat. This can lead to death if the airway becomes blocked. Is there a difference between unconsciousness and cardiopulmonary arrest? Yes. What is the difference between unconsciousness and cardio pulmonary arrest? Unconsciousness is usually without cardiac arrest. If unconsciousness is associated with cardiac arrest or respiratory arrest, cardiopulmonary resuscitation is required. When should you start an on-the-spot intravenous line? If there is blood loss with hypotension. In case of cardiopulmonary arrest. Here are further guidelines. |