"Is it also common for CPR patients that have gone “brain dead” to relieve other bodily functions?"

A dead faint can do that!

Sue

I agree that the little mouth shields with the one-way valve that you carry on a key chain are not the best choice. Had opportunity to use the "keychain" style once and it was a pain, but better than nothing, That's why I keep a large faceshield with one-way valve and oxygen port (hard shell case) in my backpack. The "keychain" style is just as a last resort.

Just a thought about EDC infection control; not a bad idea to keep a pair or two of medical exam gloves on you, or handy just in case you feel the urge to stop and help out on a wreck, deliver a baby, etc... I keep two pair in my fanny pack and they don't take up much room. Plus, they came in handy when I had to do a little parking lot repair job on my car (kept my hands from getting dirty)

peace,
samhain

Use nitrile gloves; many people are allergic to latex and it can be fatal.
B

I did CPR on a person who had stopped breathing & circulating by an overdose of prescription drugs. Real people can be easier to inflate than the training dummy. This one also vomited first. <img src="/images/graemlins/frown.gif" alt="" />

I am sure the pocket shields are better than nothing, but how effective are they ?really? at preventing contamination of the CPR responder?
Pocket shield is plastic with a hole where you place your mouth. That barrier is made out of porus paper/fabric like material. It will prevent you from aspiring fluid and matter directly but it will soak up the moisture/fluid therefore you are exposed to the other person vomit anyway.

Are there any brands or models that should be avoided?
Well if you absolutely have to do CPR anything is better than nothing. Chances may be that this particular arrest would be a clean one. That's why the pocket shield is an absolute minimum.

Are there any brands or models that are recommended?
Pocket masks with one way valve and O2 ports are excelent. It is easy to maintain the seal on them but disadvatage are that they are little too big for everyday pocket carry.


Is it also common for CPR patients that have gone ?brain dead? to relieve other bodily functions?
Depending on the reason the person in fornt of you needs cpr than they might have relieved themselves. Example:
traumatic arrest - if the spine has been compromised there may be no muscle tone to hold the bladder and colon together
seizure - urination is frequent and they may go into respiratory arrest. Plus you got foam from the mounth and possibly blood from tongue that was bitten during the seizure.
cardiac arrest - everything goes althou very rearly I've seen urination and defacation. During cardiac arrect it is mostly stomach content that comes up.

Last night at the dinner table I had a discussion with fellow medics about new guidelines for CPR. We all know that brain is the organ that is the most sensitive to lack of Oxygen. Now if you start circulating deoxygenated blood (compressions only) don't you make the brain die faster? I mean it was just a talk and we had no data at hand as far as how big oxygen consumption is in the brain tissue as opposed to other organs but one thing we all knew for sure was that brain necrosis starts much quicker than necrosis of other tissues.

Also don't forget that part of the cpr is also rescue breathing. Now if you are set on doing chest compressions only and as per new standards you throw away the ABCs, by starting the compressions you will put somebody into cardiac arrest.

Jaded Polak <img src="/images/graemlins/smile.gif" alt="" />

ps.
I will just assume as per alternate deffinition that "jaded" means "A woman regarded as disreputable or shrewish. " LOL

Hey Billy if they are in the cardiac arrest I think that their latex allergy is the least of their problem.

But I second the gloves idea. I carry two pairs with me all the time and from acctual med work to stupid stuff like engine repair, emergency water carrier, small pain job, garden work, etc, etc they are a life saver. Plus when inflated they make a great fast and temporary toy.

"I will just assume as per alternate deffinition that "jaded" means "A woman regarded as disreputable or shrewish. " LOL, Jaded Polak "

JP,

Nah, you've never struck me as shrewish. <img src="/images/graemlins/wink.gif" alt="" />

Thank you for your input and candor.

TR, (Off to shop for a better portable vomit-stopper)

Please bear with me, I have to get this off my chest.

I am also jaded when it comes to current and the new CPR guidelines. I started giving CPR back in 1968 as a Inhalation Therapist, now currently known as a Respiratory Therapist, at a well known teaching hospital in Chicago. Procedures that we used to great success are now not taught and are in fact frowned upon. It has been many years since I was a therapist but with the aging population and the accidents I have come across, my CPR techniques have been very successful.

They no longer teach nor recommend the Pre-Cardiac Thump Technique in CPR. The conclusion being that the risk of causing physical injury outweighed the benefits. I however have used it on heart fibrillation due to trauma or shock in both adults and infants. I last used this technique to revived my neighbor three times prior to the paramedics arriving. Other CPR techniques on him were not required as he resumed breathing on his own until his heart started fibrillating again. He was a long time diabetic who suffered a recent heart attack. We were lunching together at the time.

Now they only want people to use compressions and not breathing techniques. Unskilled or over excited rescuers can and do break ribs in current CPR techniques just as with the Pre-Cardiac Thump technique but the risk is worth it in one case and not the other. Strange logic! I personally think one is based on fear of legal repercussions and the other is based on fear of disease transmission.

To keep the brain or other organs healthy, oxygen is needed. Evan when a body is to used as organ donor, we kept brain dead victims oxygenated until surgery was preformed to, pardon the expression, mine the organs.

My longest time using unassisted CPR was forty five minutes but I was using an Ambu bag. Unbeknownst to me, the young girl happened to be the daughter of a work associate at my main vocation as a Communications Engineer. Even being in great shape, I do not think I would have been able to do CPR that long without a bag. I trained a bystander while I was doing this so that I could rest my wrist and we continued “Two Person CPR” until the ambulance arrived. To this day I carry a Ambu bag in each of my vehicles including my RV and in my main first aid kit. I have not been able to EDC one but I will keep trying to figure out a way.

Many of my friends are First Responders and they wonder why I don’t become certified especially after staying current in all the courses. Evan though I live in a state that has very friendly “Good Samaritan Laws,” I could no longer use the techniques I know save lives without risking legal liability. Once you become certified, you must follow the current rules or directives. I will just remain a well trained amateur.

One last comment. In all the cases where I performed CPR, not once did the patient throw up during the procedure. This was not due to any unique technique, I was just one lucky guy. All my associates suffered though vomit but I never had to. I always was ready to turn the patient’s head, clear their airway, throw up myself, and start again but I never had to.

My down fall and the eventual end of my therapist career was due to the large number of terminal pediatric patients under my care. Their innocent eyes tore up my heart and to this day I still think about them. Medical professionals who specialize on terminally ill infants are unique and face more stress than I can endure.

Turbo,

Your story was informative and touching. Thank you.

I am curious, how does a responder determine whether the heart is fibrillating or stopped? Is it important to know the difference? Or, just use the "thump" anytime a pulse is not detected?

TR

As per AHA standards... If you witness the arrest than the thump is used (at least that's how protocols go here in NYC).

Vfib and Asystole are being treated the same as far as the CPR goes. Both require compressions and ventilations. Difference comes into play when defiblirator is involved. Vfib is a shockable rythm (AED will shock) while you don'r really shock asystole (AED will not shock). Vfib shows on the screen as a really crazy zig zag line with no pattern while asystole is a straight line. There is a belief in the field that sometimes asystole may be a very fine vfib and you can shock it. Doesn't really hurt since being is asystole is as dead as you are going to get. Does it make any difference if the patient is in asystole or vfib? Not really from cpr point of view.