CPR

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Tinman74

Guest
#1
What is the current practice for administrating CPR in a RTA when the person is seated?
 
#4
Only stating what i would do, be interesting in reading a practicing paramedics advice.

999 first off, you need a defibrillator asap

The operator should be talking you through it if mobile phone available.

Extricating casualty in need of CPR should be attempted, as seated CPR is better than none but not that effective.

If seated CPR only way then getting the seat as recumbent as possible is best way, if can get something firm between seat and thorax then chest compressions more effective.

If the patient is dead you cannot do any more harm, so by you getting stuck you are to be applauded.

If you are willing/able can you say how the CPR went?
 
#5
Well done for getting involved, but sadly in a cardiac arrest from blunt trauma there is little that can be done.
At least by being there and trying your best it may give some comfort to the person's family.
 
#6
What is the current practice for administrating CPR in a RTA when the person is seated?
You don't......

Rapid ex followed by control of any catestrophic bleeding followed by best effort BLS until help arrives. Then if you're suitable equipped, into ALS.

Statistically, the chances of a casualty surviving a trauma arrest in a pre-hospital setting are almost zero. Doesn't mean you should give it a spin though.
 
#7
As a Pre-Hospital Doctor in a blunt traumatic arrest my actions would be rapid extrication if possible, Laryngeal mask airway, and bilateral thoracostomies, IO access to humerus and fluids ++ plus adrenaline. I would not perform CPR as the likely cause is hypovolemia (most likely from the aortic transection, but could be a smaller one that might respond to fluids) and if there is no blood in the heart the best CPR in the world will not make any difference.

That is from a professional fully equipped viewpoint. If I didn't have my kit with me, I would try CPR assuming there were no other injured people who needed urgent assistance.
 
#8
What is the current practice for administrating CPR in a RTA when the person is seated?
Did the Red Cross first aiders course about 4 weeks ago. Realistically, you need to be fit to do CPR properly. 30 compressions 2 breaths. It's hard work. Seated? I'd probably use my knee.
 
#9
Thing is you did something, which I suspect many people would not have the nerve to attempt. Fantastic for doing so in my opinion, hope it worked out ok
 
T

Tinman74

Guest
#10
Thanks for the replies, what I did is as follows.

Traffic had slowed as it does when rubber neckers pass by, the wife was driving slowly as the accident resulted a car (old MR2) placed on the embankment (traveling north) and a new model ka in lane one.

MR2 driver side on to traffic flow, Ka passenger side on to traffic flow.

IA was to pull in pass the vehicles as there was a lot of people standing around and one individual doing the "staying alive CPR" to the driver of the MR2.
He was clearly non responsive, slack jawed, eyes rolled back.

A brief argument tool place as the people there didn't want to move him as the risk of spinal injuries.

We took control and moved aside the people and forced open the door, removed the drive and provided CPR till the police and medics arrived.

TBH as we drove past, he looked dead and was still being worked on by the professionals as the Helo landed.

Will let you know what happens.


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#13
Presuming here you were providing assistance as a first aider rather than medical professional? As above CPR whilst the patient is seated is not particularly effective; the movement of the seat means compression is difficult and having to push blood up against gravity to perfuse the brain doesn't help either. But if the casualty is wedged in, you have to adjust your actions to the situation. If able to pull them out of the vehicle it'll help but with survival chances of near zero anyway, it is unfortunately something of a token effort.

If you're trying to weigh up the options, first aid asks if actions are safe, prompt, and effective. Safe - the chap is in cardiac arrest anyway, even if you do cause any damage in your treatment the arrest is your immediate priority; as cliche'd as it may sound, every second counts. Prompt - whatever you did, if you did what was best in the situation then you're doing something to help, so good effort there. Effective - as I said a casualty in this situation is in a very bad place, so whether CPR was attempted in situ or he was pulled out, it's still giving them a chance. In an nutshell you were spot on trying to help, and however the scene was when you arrived, any direct action to try and save the casualty warrants a pat on the back.
 
T

Tinman74

Guest
#14
Like I said earlier he looked dead, infact really dead.

As an aside it was Intresting how people were standing watching one bloke try before we arrived.

Fair few cases of shock, infact tbh 40 years worth of experience between the three of us infanteers, the normalcy of the situation was a curve ball.




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#15
Tinman you gave the casualty the best chance possible given the situation.

If a casualty is going to benefit from the paramedics advanced life support interventions, then a oxygenated casualty handed over to them enhances the prognosis, and if resuscitated successfully brain function will be maintained to best level possible.

Taking control in such a situation is not easy for a member of the public, so well done.
 
#18
Statistically, the chances of a casualty surviving a trauma arrest in a pre-hospital setting are almost zero. Doesn't mean you should give it a spin though.
Correct. It is more about P/R than CPR. However, the new portable defibrillators have definitely made it more than a tactical exercise without hope.

Edited to add: Actually I've just noticed that I've posted in a thread where everybody else probably knows a lot more than I do about the subject.
 
T

Tinman74

Guest
#19
Correct. It is more about P/R than CPR. However, the new portable defibrillators have definitely made it more than a tactical exercise without hope.
Like I said he looked proper dead, white skin, slack jaw, non responsive, but you never know air in lungs, artificial circulation of his blood.

It makes you grateful for MERT, the CMT's that are on the ground with you and last luck.


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DieHard

LE
Book Reviewer
#20
Statistically, the chances of a casualty surviving a trauma arrest in a pre-hospital setting are almost zero. Doesn't mean you should give it a spin though.
I have and i was very lucky that 3 members of my rugby team were doctors, one was the A&E registra. I went down in a scrum and someone used my chest as a springboard to get up, leaving stud marks and hitting me so hard my heart stopped.
My mrs turned up just in time tn see me being put into the ambulance. If the guys had not played that day then i would of died.
Op by even attempting to help someone marks you out as a decent bloke and someone who cares, you didn't have to stop and help but you did, and you took control. Good drills


Sent by Crapatalk. Sitting on my bog having a dump.
 
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