Millions of people around the world experience cardiac arrest each year. About one-third of cardiac arrests in the United States happen in hospitals, Huff writes. When a patient's heart suddenly stops beating "that individual automatically becomes the sickest person in the whole hospital," according to cardiologist Brahmajee Nallamothu.
But unlike what's depicted on television, resuscitation can be "a messy and, in some respects, undignified process, full of beeping machines, ventilators and other paraphernalia," Huff writes. The resuscitation process also is physically demanding. When performing compression, Amy Dahart, an intensive care unit nurse at Mary Washington Hospital , always ensures that another clinician is nearby to step in.
For patients and loved ones witnessing the event, the experience can be harrowing, as it's not uncommon for the force of the compressions to break the patients' ribs. Olga Rafidi recalled a situation when clinicians had to work for 90 minutes to restore her year-old sister's heartbeat.
Rafidi said the room looked like a "war zone" with medical trash, including paper and gloves, strewn around on the floor. Less than a minute later, everyone arrives at the small cardiac observation room where cardiopulmonary resuscitation CPR had already begun.
She is shocked by not knowing what may happen. Providers pour into the room. A resident is beginning to work on accessing an airway. My senior resident quickly establishes herself as leader of the code, and all information and decisions pass through her. No pulse. No breathing. ABC: Airway, breathing, circulation. Another round of epi!
Prepare to shock! Back on the chest while the machine charges [to the determined voltage]. It is NOT an indication of recovery.
Continue chest compressions until paramedics arrive; gasping is a sign you are doing a good job. Chest compressions are hard work and after chest compressions or if you become fatigued, it is recommended that you switch chest comrpessions with someone nearby. To transfer chest compressions effectively, there must be less than a 10 second delay when trading off.
The physicians and scientists at the Sarver Heart Center, have found that the old saying "Never perform CPR on beating heart" is not valid. According to these professionals, the chances that a bystander could harm a person by pressing on their chest are slim to none, even if the heart is working normally.
Therefore, they recommend following the "Better safe than sorry" approach and begin chest compressions. It is better to perform a few unnecessary chest compressions for someone with a beating heart, rather than withhold chest compressions and circulation from someone in cardiac arrest. We do NOT recommend that lay public rescuers waste time trying to assess for a palpable pulse. During Dr. Public lay rescuers cannot reliably detect the absence of a pulse in a timely fashion, hence in the and AHA CPR Guidelines Circulation ; 24 : IV-3 , this requirement was removed.
Studies have also shown that even if a person manages to locate the correct spot for detecting a pulse, there is a high chance that the pulse they may detect is their own, especially considering heightened stress levels in such situations. Rather than wasting time trying to detect a pulse that may or may not be the victim's own pulse, it is better to get perfusion to the brain by continuous chest compressions. If by some chance an object is lodged in the throat, effective compressions likely will dislodge the object, similarly to the way abdominal thrusts the Heimlich Maneuver dislodges objects.
The person was breathing normally only seconds ago, so their blood contains enough oxygen to tide them over for several minutes. However, it is crucial to deliver blood and oxygen to the brain by performing chest compressions continuously.
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