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#265703 - 12/13/13 06:01 PM Re: Beginner First Aid [Re: hikermor]
MDinana Offline
Pooh-Bah

Registered: 03/08/07
Posts: 2208
Loc: Beer&Cheese country
Originally Posted By: hikermor
Originally Posted By: MDinana

CPR success rates of 30% are, IIRC, in-hospital only. Closer to 5-10% traditionally in the street. Highly dependent on time to CPR and first shock. Some of the "push only" CPR rates look better, but time will tell.



The 30% figure is in my head from a project in Seattle in the early 80's where there was a push to qualify everyone in basic CPR - undoubtedly that represents a very best case scenario.

On the other hand,my CERT trainer, a very experienced fire captain, stated that he witnessed about 300 cases where CPR was administered; in his opinion, only about seven were successful; i.e., the patient walked out of the hospital after treatment. That is probably more realistic.

Current CERT training for a mass casualty situation is to dispense with CPR - more lives will be saved if the effort is devoted to other victims. But that is a different situation from the more normal situation where help is available.

Elapsed time does seem to be critical in achieving a good outcome, which is why CPR training is desirable and recommended

That mirrors my experience, about 10% success rate (roughly 75 codes worked).

Lono, you have a source to back up that figure?

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#265717 - 12/14/13 05:53 AM Re: Beginner First Aid [Re: hikermor]
Bingley Offline
Veteran

Registered: 02/27/08
Posts: 1576
Originally Posted By: hikermor
The 30% figure is in my head from a project in Seattle in the early 80's where there was a push to qualify everyone in basic CPR - undoubtedly that represents a very best case scenario.


I heard that O'Hare Airport in Chicago used to be heart attack central in the 1980s. It was one of the world's busiest airports, with plenty of overweight, under-exercised, stressed-to-the-brink businessmen traveling through. Supposedly they had close to 1,000 heart attacks per year. The airport was able to reduce the number of deaths substantially by installing AED throughout the airport and by training the staff in the use of AED and CPR.

Can anyone confirm/elaborate on this?

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#265720 - 12/14/13 06:11 AM Re: Beginner First Aid [Re: Bingley]
benjammin Offline
Rapscallion
Carpal Tunnel

Registered: 02/06/04
Posts: 4020
Loc: Anchorage AK
Reminds me of a Saturday night live skit.
_________________________
The ultimate result of shielding men from the effects of folly is to fill the world with fools.
-- Herbert Spencer, English Philosopher (1820-1903)

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#265725 - 12/14/13 07:38 AM Re: Beginner First Aid [Re: MDinana]
Lono Offline
Old Hand

Registered: 10/19/06
Posts: 1013
Loc: Pacific NW, USA
Originally Posted By: MDinana
Originally Posted By: hikermor
[quote=MDinana]
CPR success rates of 30% are, IIRC, in-hospital only. Closer to 5-10% traditionally in the street. Highly dependent on time to CPR and first shock. Some of the "push only" CPR rates look better, but time will tell.



Lono, you have a source to back up that figure?


Why sure - http://www.kingcounty.gov/healthservices/health/news/2013/13090401.aspx

The 2013 figure is a 57% survival rate in King County. The 2013 EMS Annual Report gives a good indication of how this is done.

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#265740 - 12/14/13 04:07 PM Re: Beginner First Aid [Re: Lono]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7705
Loc: southern Cal
Thanks, that is a really interesting report. One wonders - are seismographs picking up the compressions resulting from all that training? We thought it was just football fans.....
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#265765 - 12/15/13 03:15 AM Re: Beginner First Aid [Re: TeacherRO]
Fyrediver Offline
Newbie

Registered: 09/08/10
Posts: 46
CPR success rates are climbing pretty dramatically in King County. We have a lot of trained civilians that keep the patient going until we show up and get the patient to the hospital. Additionally, we've changed protocols which has increased survival rates. There's constant research into the protocols and we're seeing positive responses.

That said, without the quick intervention of a Aid Crew and Medic crew (Advanced Cardiac Life Support) and a good, nearby ER, CPR only prolongs the scenario but doesn't effect the outcome. CPR is only a stopgap to keep oxygen flowing to the heart and brain.

First aid is, in my opinion, far more valuable in a remote situation like backpacking or survival scenario. CPR in the wilderness doesn't save the patient like in the movies. First Aid does!

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#265767 - 12/15/13 03:30 AM Re: Beginner First Aid [Re: Fyrediver]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7705
Loc: southern Cal
Originally Posted By: Fyrediver

First aid is, in my opinion, far more valuable in a remote situation like backpacking or survival scenario. CPR in the wilderness doesn't save the patient like in the movies. First Aid does!


You simply have too much time between the incident and arrival time in a hospital for CPR to work effectively. Without reasonably competent first aid, a lot of victims simply bleed out who would otherwise survive.
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#265848 - 12/17/13 07:33 AM Re: Beginner First Aid [Re: TeacherRO]
quarterflash14 Offline
Stranger

Registered: 10/02/12
Posts: 2
Loc: Oklahoma
As a former EMT I must disagree with the use of "pressure points" .I tried to use the upper arm point. Twice. Didn't work. Talked to 2 paramedics who had more street experience than I did. (One of them had 7 yrs. on the job) Their experience was the same as mine. In both cases paras showed up and stopped bleeding w/hemostats, fortunately, as basic EMT at the time we were not authorized tourniquets. This was back in 1980's.

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#265851 - 12/17/13 12:01 PM Re: Beginner First Aid [Re: TeacherRO]
WB2QGZ Offline
Newbie

Registered: 03/01/03
Posts: 25
Loc: FN30gq Long Island, NY
My experience with CPR as an EMT-B over 10 or so years is 2 saves out of around 20 cardiac arrests that were run as BLS calls. Saves in this case defined as went home. The biggest determining factor for my experience was rapid notification of EMS, a lot of these calls were folks who had been down for a while and found unresponsive. Both of the saves were witnessed attacks with quick notification and transport to local definitive care. In my case that local definitive care is going away as hospitals close or beds are absorbed into larger, more distant facilities, we used to have a hospital in town and one next door giving us less than 5 minute transport times, now we' re looking at up to 15 minutes, a big difference. More rural areas of the state have much longer transport times and this is a factor, perhaps alleviated by more ALS or ALS intercept.

Pressure points have worked for me once, with a hand through a window and arterial bleed. I compressed the brachial against the bone and the flow decreased dramatically, although this poor guy probably still has my fingerprints on his arm 'cause I was afraid it wasn't going to keep working and squeezed for all I was worth.

I still carry a blowout kit in my bag and have one in reach in each vehicle, that way I can have at least a chance with the rare but quickly fatal big bleeds and punctures even on myself. I don't know about getting a TQ around my own leg while sitting in a car, for example, but at least the materials are there and I won't be trying to improvise and waste time looking for something to use.

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#265854 - 12/17/13 02:17 PM Re: Beginner First Aid [Re: WB2QGZ]
chaosmagnet Online   content
Sheriff
Carpal Tunnel

Registered: 12/03/09
Posts: 3819
Loc: USA
Originally Posted By: WB2QGZ
I still carry a blowout kit in my bag and have one in reach in each vehicle, that way I can have at least a chance with the rare but quickly fatal big bleeds and punctures even on myself. I don't know about getting a TQ around my own leg while sitting in a car, for example, but at least the materials are there and I won't be trying to improvise and waste time looking for something to use.


I keep a large-ish trauma kit in my range bag, a small one in each car, and a Patrol Officer's Pocket Trauma Kit upgraded with some Combat Gauze in my laptop bag. The POPTK is so small and cheap there's no excuse to not carry one.

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