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EnsenadaDr
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How to use an AED in conjunction with CPR
http://www.nhlbi.nih.gov/health/health-topics/topics/aed/how...
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MrBillM
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An Added Incentive for Universal Distribution
Would be incorporating a "Betting Scheme" into the usage wherein bystanders could place bets on the result.
Of course, there's the danger that having a stake in the result might influence those applying treatment.
But, it's a little detail easily worked out.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
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Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Bill this is a serious matter. There is always room on the OT for effects of hallucinogenic mushrooms. | Quote: | Originally posted by MrBillM
Would be incorporating a "Betting Scheme" into the usage wherein bystanders could place bets on the result.
Of course, there's the danger that having a stake in the result might influence those applying treatment.
But, it's a little detail easily worked out. |
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CortezBlue
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Yes, we bought one about a year ago. We have had our home in baja for many years, but decided it was probably cheap insurance not only for us, but
for our guests and neighbors.
We carry the unit in our vehicle just to be on the safe side, you never know what you may come across while driving.
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EnsenadaDr
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Posts: 5027
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Location: Baja California
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Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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You might want to let us in on the battery maintenance requirements, seems that even in hospital the unit defibrillators have had malfunction when
someone forgets to plug the cord in to charge the battery and fails in an emergency. | Quote: | Originally posted by CortezBlue
Yes, we bought one about a year ago. We have had our home in baja for many years, but decided it was probably cheap insurance not only for us, but
for our guests and neighbors.
We carry the unit in our vehicle just to be on the safe side, you never know what you may come across while driving. |
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DavidE
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Location: Baja California México
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Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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O2 is CRITICAL. Having the CPR administrator saturate THEMSELVES with O2, then administering CPR can increase the O2 level in the patient 200 - 300
percent. And O2 to the heart is what is the key. Once sinus rhythm has been re-established with a defibrillator, CPR and medications, a PULSE OXIMETER
can VERIFY O2 blood level in the extremities. So after the CPR ADMINISTRATOR ceases the use of O2 the cannula SHOULD BE TRANSFERRED TO THE PATIENT
with "X" number of liters O2 flow. And then maintained on O2 all the way to the hospital.
So having a defibrillator is excellent. Having inject able medications is also vital O2 is CRUCIAL. A pulse oximeter is a real help here.
A Lot To See And A Lot To Do
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EnsenadaDr
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Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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David, O2 is important usually because the patient may be unconscious and can't breathe correctly. Pulse oximeters are helpful but most of the time a
patient might be saturating in the 70's or 80's anyway even with the O2 turned up flush unless they have a patent airway and breathing sufficiently,
or have an artificial airway and are intubated. Pulse oximeters are usually for fine tuning.
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luv2fish
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It would do everyone justice to take a basic CPR class and also take an ACLS class (Advanced Cardiac Life Support)
Where could one take C.P.R. classes ?? ( L.A. Area)
[Edited on 9-3-2013 by luv2fish]
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DENNIS
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| Quote: | Originally posted by luv2fish
Where could one take C.P.R. classes ?? ( L.A. Area)
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Is that Los Angeles? Maybe call any hospital or the Red Cross. They should have that info readily available.
If you're a Vet, call the VA. It's almost time for your flu shot anyway. 
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DavidE
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Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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Ensenada Dra. what are your thoughts of supersaturating the lungs of the person administering CPR with O2?
O2 is NOT the 1st in line for treatment, getting the heart back into sinus rhythm is. Using a defibrillator All this stuff needs to be done quickly to
minimize terminal damage to the heart muscle, right? So after re-establishing (termination of ventricular fibrillation), with a non breathing patient,
super O2 saturated CPR seems to be "quite" important.
In lieu of injectable drugs, with a conscious patient, does it make sense to administer 10mg of Isosorbide Dinitrate sublingual?
A pulse oximeter with AUDIBLE ALARM to me is a great way to help alert personnel that O2 blood saturation levels have decreased (i.e. 2nd attack
unconscious patient). Most of the ambulances now have electrocardiogram monitors with alarms, but the pulse oximeter would be useful in lieu of having
a electrocardiograph.
A Lot To See And A Lot To Do
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DENNIS
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| Quote: | Originally posted by DavidE
Ensenada Dra. what are your thoughts of supersaturating the lungs of the person administering CPR with O2?
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I feel this "help thy neighbor" stuff is going too far. What are the legal ramifications of killing someone with these experiments?
These procedures are best left to Trapper John and Hawkeye.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
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Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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We are talking Mexico here David, not a critical care ambulance 3 minutes to a designated trauma center in LA. I did mention that getting the heart
out of a life threatening rhythm was the first thing, then you mentioned O2. Isosorbide can cause a very low blood pressure, and usually, as RedMesa
pointed out, a person in asystole is suffering from a resultant low blood pressure. Isosorbide in this situation will kill the patient. You need
epinephrine in cases of asystole. Isosorbide is not an anti-arrhythmic drug either, so you need to administer something like amiodarone to keep the
patient from reverting back into an irregular rhythm if the original dysrhythmia was VTach or VFib. Isosorbide is an anti-angina agent, and has
absolutely no anti-arrhythmic properties. No code that I have ever seen run includes isosorbide in its emergency protocol. If the person is not
breathing and you do have 100% O2 then by all means crank up the O2. Pulse oximeters are great in controlled Oxygen environments, and if you have the
money by all means go out and buy one. The question is if you do use the pulse oximeter and you have cranked up the O2 all the way and the person's
O2 sat is still low, then what do you do? Intubate? That still might not solve your problem. | Quote: | Originally posted by DavidE
Ensenada Dra. what are your thoughts of supersaturating the lungs of the person administering CPR with O2?
O2 is NOT the 1st in line for treatment, getting the heart back into sinus rhythm is. Using a defibrillator All this stuff needs to be done quickly to
minimize terminal damage to the heart muscle, right? So after re-establishing (termination of ventricular fibrillation), with a non breathing patient,
super O2 saturated CPR seems to be "quite" important.
In lieu of injectable drugs, with a conscious patient, does it make sense to administer 10mg of Isosorbide Dinitrate sublingual?
A pulse oximeter with AUDIBLE ALARM to me is a great way to help alert personnel that O2 blood saturation levels have decreased (i.e. 2nd attack
unconscious patient). Most of the ambulances now have electrocardiogram monitors with alarms, but the pulse oximeter would be useful in lieu of having
a electrocardiograph. |
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Not really Dennis. Since you have been converted literally into realizing how beneficial cardioversion/defibrillation can be to the patient, the
protocol for running a code, or treating a person in respiratory or cardiac failure, IF there is oxygen available, IS to administer 100% Oxygen. If
you are in Mexico and out in the field Oxygen might not be available. But normally running a code will include supersaturating the lungs or turning
up the oxygen to 100%. The problem is as I have mentioned to David, is that if the person is not breathing correctly or the delivery system is faulty
the oxygen might not reach all the lung tissue available. | Quote: | Originally posted by DENNIS[/i
| Quote: | Originally posted by DavidE
Ensenada Dra. what are your thoughts of supersaturating the lungs of the person administering CPR with O2?
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I feel this "help thy neighbor" stuff is going too far. What are the legal ramifications of killing someone with these experiments?
These procedures are best left to Trapper John and Hawkeye. |
[Edited on 9-3-2013 by EnsenadaDr]
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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There are CPR classes at every street corner literally
| Quote: | Put your area in Google and type CPR or call your local hospital or fire department. They will be able to guide you. I also recommend an ACLS class.
The point here is to get educated so you can help in an emergency. | Quote: | Originally posted by luv2fish
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It would do everyone justice to take a basic CPR class and also take an ACLS class (Advanced Cardiac Life Support)
Where could one take C.P.R. classes ?? ( L.A. Area)
[Edited on 9-3-2013 by luv2fish] |
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MrBillM
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Street Corner CPR lessons ?
Are those Certified ?
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
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Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Maybe in your next of the woods, Bill.  | Quote: | Originally posted by MrBillM
Are those Certified ? |
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MrBillM
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My WHAT ?
NEXT ?
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DavidE
Ultra Nomad
Posts: 3814
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Location: Baja California México
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Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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The issue I was discussing with isosorbide is AFTER normal sinus rhythm is achieved not before. The heart event occurred because of lack of O2.
Restoring sinus rhythm does zero to correct why the event took place in the first place. Are you suggesting that AFTER restoring normal sinus rhythm
Systolic and Diastolic values remain subnormal?
Sort of like saying applying 36 volts to the starter motor and an automobile should run OK at 25,000 feet. The heart has to pump, the pumping has to
deliver O2, the question is ENOUGH O2. Blocked arteries don't do a hell of a lot to help deliver the O2. That's why I am suggesting HAMMER the system
with higher than 21% atmospheric O2. It has to pass through BLOCKED arteries even after sinus rhythm is restored.
Also oral or intravenous AMIODARONE is not the fastest reacting drug on the planet*. So this and everything above leads me back to a more simplistic
approach, defribrillate + CPR get the heart back to normal sinus rhythm while administering lots of O2. A CPR course is mandatory. I can just see a
patient being given 5.0 O2 while some nimwit stands close smoking a cigarette.
*But by god it is one of the most effective.
A Lot To See And A Lot To Do
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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David, amiodarone is not my suggestion. It is the Red Cross and American Heart association's medication of choice for an antiarrhythmic protocol for
emergency ACLS. I worked on cardiac floors for many years and isosorbide was given at times, but it wasn't a medication that was included in
stabilizing a patient after a code. I suggest you read the ACLS protocols for cardiac arrest and see what medications they use. Isosorbide will help
open up clogged arteries, but I have seen other forms of nitrates used with more frequency, such as nitroglycerin sublingual and nitro patches at
least in the hospital. And yes I have seen patients with low blood pressures after they are stabilized, so you have to check their blood pressure. I
think we both think oxygen is a given, and it is recommended in the algorithm. | Quote: | Originally posted by DavidE
The issue I was discussing with isosorbide is AFTER normal sinus rhythm is achieved not before. The heart event occurred because of lack of O2.
Restoring sinus rhythm does zero to correct why the event took place in the first place. Are you suggesting that AFTER restoring normal sinus rhythm
Systolic and Diastolic values remain subnormal?
Sort of like saying applying 36 volts to the starter motor and an automobile should run OK at 25,000 feet. The heart has to pump, the pumping has to
deliver O2, the question is ENOUGH O2. Blocked arteries don't do a hell of a lot to help deliver the O2. That's why I am suggesting HAMMER the system
with higher than 21% atmospheric O2. It has to pass through BLOCKED arteries even after sinus rhythm is restored.
Also oral or intravenous AMIODARONE is not the fastest reacting drug on the planet*. So this and everything above leads me back to a more simplistic
approach, defribrillate + CPR get the heart back to normal sinus rhythm while administering lots of O2. A CPR course is mandatory. I can just see a
patient being given 5.0 O2 while some nimwit stands close smoking a cigarette.
*But by god it is one of the most effective. |
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DENNIS
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Posts: 29510
Registered: 9-2-2006
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| Quote: | Originally posted by DavidE
Restoring sinus rhythm does zero to correct why the event took place in the first place. Are you suggesting that AFTER restoring normal sinus rhythm
Systolic and Diastolic values remain subnormal?
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In the case of a stroke caused in large part by an irregular rhythm, the recovery of Sinus Rhythm is all important to the threat of an ensuing
episode...another stroke.
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