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A dying child, a distraught father, and a stranger....


Osteward
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Thanks for sharing that, Osteward.

 

For the (important) record:

Yes, as Osteward points out (you beat me to it! :) ), the "new", "hands-only" CPR for non-medical persons is: "Compressions-Only", not "No Compressions".

(For infants and children, it is still preferable to give both pushes/compressions AND breaths. "Hands-Only", "Compressions-Only" CPR is targeted largely to adults and children over 8 years of age in cardiac arrest who are not choking.)

 

At the risk of providing TMI and being the skunk at the garden party, I feel that it's important to point out that, while the end may justify the means in the video, the methods used in the video do NOT represent the current, evidence-based standards advocated by the American Heart Association and other official groups who write the world standards for CPR.

 

Disclaimer: This content is presented solely for general information to clarify/correct some of the methods shown in the video. It is not a substitute for proper training in CPR or for proper medical care.  I assume no liability for your use of this information.

 

This child appears to have started out as a choking victim (common for this age group).

For the record, help should be summoned immediately (call 911 & get an AED (Automated External Defibrillator)). 

If the child is coughing effectively and moving air OK (not turning blue), allow him/her to cough. 

If the child's efforts become ineffective, or (s)he turns blue, attempts to remove the foreign body ought to proceed ONLY until one of 2 things happens:

  1. The child gets better: foreign body is expelled/removed; OR
  2. The child gets worse: once the child becomes unresponsive/unconscious, immediate CPR should be started, beginning with the pushes/compressions, not the breaths!  This is done by compressing the child's chest on the lower half of the breast bone 100-120 times per minute and 1/2-1/3 the depth of the chest each time. This can be "hands-only", if necessary, or (preferably) standard infant/child CPR at a push-to-breath ratio of 30:2.  Before giving breaths, it's OK to look in the mouth to remove a VISIBLE foreign body, but no blind sweeps should be performed.  If the breaths don't go in, chest compressions should be performed anyway until trained medical providers arrive.

If the choking is "fixed", and the child has a pulse, but is still not breathing effectively, mouth-to-mouth "rescue" breaths can be delivered 12-20 times per minute (for infants and children), or once every 3-5 seconds, until trained medical providers arrive.

 

Excessive time spent trying to relieve the airway blockage after the child becomes unconscious, without starting chest compressions (as was shown in the video) is not advisable and is associated with a poor outcome.

 

I have ZERO financial interest whatsoever in the AHA or any of its products, but I will provide some links so that everyone can learn more about how to save a life with effective CPR.

 

Apps - Pocket First Aid & CPR

Family & Friends® CPR

Infant CPR Anytime

Family & Friends CPR Anytime

 

For medical folks: 2010 AHA Guidelines for CPR & ECC

 

Cheers,

 

daledoc1 (No, I didn't stay at a Holiday Inn Express last night)

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Thank you for clearing that up. However, it is possible for someone to not be breathing but still have a pulse, which would lead to rescue breathing only.

 

My CPR/AED training was before the new hands only method, so cannot wait until it's time to renew. 

 

I'm a Registered Nurse and there has been some heated discussion over the new method. Some people just don't like change.

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Thank you for clearing that up. However, it is possible for someone to not be breathing but still have a pulse, which would lead to rescue breathing only.

 

Yes, you are correct.

That's why I mentioned the "rescue breathing" of 12-20 times per minute (for a child with a pulse, who is not breathing normally, after relieving the choking). :)

 

It's REALLY beyond the scope and purpose of this forum to get into the finer points of infant/child CPR here. :)

Moreover, it's pretty hard to say from the video exactly who was doing WHAT to that child for a good portion of the film.

And we can't determine when (s)he did/didn't have a pulse, was/wasn't breathing, did/didn't have the choking relieved.

But, doing this & teaching this every day for many years, I can say that what I saw was not good technique. :(

 

Anyway, suffice it to say, that the 1st step should be to call 911 & get an AED, especially if there are lots of folks around to do so while one starts to help the child:

  • Choking and conscious and coughing well, NOT turning blue: watch them closely but allow them to cough;
  • Choking and conscious, but turning blue or not "moving air": relieve the choking/blockage with abdominal thrusts (alternating chest thrusts/back blows for infant under 1). (It's unlikely that rescue breaths will be be needed after the blockage is removed).
  • Choking and UNCONSCIOUS: start CPR. Rationale: lack of oxygen from unrelieved airway blockage will cause cardiac arrest very soon > child needs CPR; chest compressions may relieve the blockage; infant/child with a pulse less than 60 & poor circulation needs chest compressions anyway. 
  • (Kids over 8/adults, it's nearly identical.)

I wasn't trying to be nit-picky or argumentative, but it's been confirmed by research that >95% of the public, unofficial "CPR videos" on the internet (youtube, etc) show INCORRECT, HARMFUL technique.

IOW, this video falls into the "better lucky than good" category.

 

Having said all of that, the unorthodox methods don't negate what we hope was a favorable outcome for that child. :) :)

Moreover, your sharing it with us reinforces the very important take-home message that we ALL need to know how to do CPR! :) :)

With the newest, more effective, simpler methods, it's easier than ever!

 

Thanks!

 

daledoc1

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Awesome video...... ..... I'm out of here..... 

No need to run. :)

We all need to know how to do CPR -- bystander CPR is a critical factor in saving a life.

ANY CPR is better than NO CPR!

  1. Savor the happy ending of the video.
  2. Follow the links in my original reply (or to a similar reputable source) or even just watch an AHA youtube video to learn citizen CPR.
  3. Done!
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Post number 2 was sort of misunderstood. I saw the video was not showing compressions being made with being a recent YouTube video. My apology to all that misunderstood.

 

"New CPR with no compressions being done" (A question mark should of been added, I suppose.)

My "Bad"!

 

I should of known better with being retired after working for 40 years as a "Pre-Press Printer-Compositor" for a well known company that prints tickets worldwide. I am not in the medical field.

 

An untrained person in CPR such as I know better as I've viewed videos of the "New CPR being performed with compressions". With the distaught father freaking out dashing around, I did not observe the child choking. The video was not that clear. I saw someone making a cell phone call but no response was made by any "Emergency" personnel.

 

Ron

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Hi, W3FSY: :)

 

Sorry for late reply - I was offline for a few days.

 

No worries & no problem with your original reply. :)

It was a perfectly honest & well-intentioned observation and one that might be easily made by folks who haven't taken a CPR class in a while. :)

 

In fact, you accurately described what was actually seen in the video -- a lot of cringe-worthy flailing about and futile attempts at mouth-to-mouth rescue breathing without chest compressions, even after the child had become unconscious, unresponsive, blue and floppy.

(Although it's very hard to determine exactly what was happening and when.)

 

It's also true that the initial response to a conscious, choking victim is a bit different from the vastly more common "Sudden Cardiac Arrest" in persons over 8 years of age.

(As you and Osteward both correctly point out, chest compressions/CPR are not (yet) needed for a conscious, choking victim.)

But it would be VERY important to try to give breaths to the unconscious choking victim, alternating with effective chest compressions!

30 compressions - 2 (attempted) breaths - 30 compressions - 2 (attempted) breaths, and so on, until medical professionals arrive.

 

In any event I reiterate my sincere encouragement for everyone to learn the new CPR to acquire the skills to save a life. :)

Bystander CPR is an absolutely critical determinant of a "good outcome" for out-of-hospital cardiac arrest.

 

NOTE: I have ZERO financial or other interest in any of these products, but they are the most current and the most intensively tested/researched:

 

Apps - Pocket First Aid & CPR

Family & Friends® CPR

Infant CPR Anytime

Family & Friends CPR Anytime

 

Cheers,

 

daledoc1

 

P.S. For medical folks: 2010 AHA Guidelines for CPR & ECC

 

 

 

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