2016 High Performance CPR Part 2

ACCESS – BT – 2016 03 HP CPR PT 2

What are our goals

For HP CPR?

IMPORTANT POINT!• RATE

– (110/min)– (Continuous 2 minute cycles)

• DEPTH – At least 2”

• RELEASE/RECOIL (complete)

• UNINTERRUPTED – (pauses <10 sec)– (prefer less than 3 sec)

• DECREASED VENTILATION (6-10/minute)

5 KEY ASPECTS

OF GOOD CPR!

A Little More in Depth

The Basics….

POSITION 1 (Compressor- Left)TASKS

• BLS– Switch off compressions– Switch off Squeezing Bag on BVM

• Asynchronous ventilations 6-10/minute (less is more)– Coach Position 2 on rate, depth, recoil

• If LUCAS– Helps place Lucas

• If ALS/ILS– May assist with IV/IO/Meds ONLY if not actively doing

compressions or assisting position 3 (Compressions take priority)

POSITION 2 (Compressor- RIGHT)TASKS

• BLS– Switch off compressions– Switch off Squeezing Bag on BVM

• Asynchronous ventilations 6-10/minute (less is more)– Coach Position 1 on rate, depth, recoil

• If LUCAS– Helps place Lucas– Runs Lucas once placed

• If ALS/ILS– May assist with IV/IO/Meds ONLY if not actively doing

compressions or assisting position 3 (Compressions take priority)

POSITION 3 (AIRWAY)• BLS: – Facemask Seal (two handed) – Suction (Have Near By)– Monitors ventilator rate– Run the AED

• ALS– All BLS AND…– Run the Monitor– Place Advanced Airway– ETCO2– May also function as intervention medic if needed

Intervention Medic (TASKS)

• Medic If available, – AEMT if not– May be responsibility of Code Commander

• Establish IV/IO/ access• Push meds (as appropriate)• May also run Monitor/Defib (as appropriate)

Code Commander/IC (TASKS)

• Mind on Big Picture• Direct Interventions– EKG determination– Meds when/what/how much

• Perform ALS interventions if no other ALS on scene

• The CODE COMMANDER is the only one who can direct compression cycle to stop

Minimal Interruptions

HOVERING

Pre-Charging

Ventilation Control

2 Step Lucas Placement

LUCAS PLACEMENT• STEP 1: Continue Compressions. Plan on completing the 2 minute cycle• STEP 2: Power on LUCAS before placement• STEP 3:LET EVERYONE KNOW WHAT YOUR DOING• STEP 4: During 2 minute pause, lift patient and place back plate (Less

than 10 seconds)• STEP 5: RESUME COMPRESSIONS IMMEDIATELY• STEP 6: Hook one side of Lucas, leave it “hanging” if feasible• STEP 7: During NEXT 2 minute pause, swing Lucas into place, position,

and press start. (less than 10 seconds). • STEP 8: place neck strap and secure hands to prevent LUCAS “slip” • If at any time you face difficulty, resume manual compressions• If ROSC: Leave in place on “standby”, in case of re-arrest.

Only the Code commander can

stop CPR(No more stopping for airway)

“It is up to us to save the world.”- Peter Safar