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Vinnie Jones and 'Staying alive' confussion
pjb002 Offline
#21 Posted : 06 February 2012 21:45:51(UTC)
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Thanks, Bingers




Any ideas for the lonely rescuer?
pond life Offline
#22 Posted : 07 February 2012 01:29:57(UTC)
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Excellent, good to know.

How much input do you guys as first aiders have in resus guidelines and which route do you take to impart your experiences. I'm not being flippant here - genuine question. Because the cardiac consultants need to know what works and what doesn't from the ground up.
kevwilson Offline
#24 Posted : 07 February 2012 08:37:39(UTC)
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The answer to 002's question about the lone rescuer is go for the defib first, apply pads and follow the prompts, as stated in the AED algorthym, if not breathing normally, send for or get the defib.......

The AED guidelines also states:
"CPR before defibrillation: Provide good quality CPR while the AED is brought to the scene. Continue CPR whilst the AED is turned on, then follow the voice and visual prompts. Giving a specified period of CPR, as a routine before rhythm analysis and shock delivery, is not recommended."

the statement above assumes you are not on your own tho'

I hope that clarifies a couple of points.

How have we gone from Vinny Jones chest only compressions to lone aed protocols ?????
pjb002 Offline
#25 Posted : 07 February 2012 17:01:22(UTC)
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Thanks Kev. I am pretty familiar with the guidelines but as you say they aren't always written for the lone rescuer and people do ask a few 'what if' questions. Your interpretation is the same as mine. It's just good to bounce ideas off other people sometimes and this forum is great for that. Perhaps I am guilty of the diversion from Vinnie so unless anyone out there has something different to add, I'll say thanks to those who replied to my question and draw a line under it.


Back to Vinnie. I taught the topic in a school today and used the Vinnie video. It is generally liked by the children and they had picked up on the compressions but if there is one thing they needed reminding of, strangely, it was the need to call 999.

I still like it though.



Peter






amandajlay Offline
#26 Posted : 11 February 2012 01:49:19(UTC)
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    Firstly, I think it's great that this is being shown...BUT, the film shown on the adverts is different to the you tube version which is better (other than the sovereign!!)



http://www.youtube.com/watch?v=ILxjxfB4zNk



I have taught multiple courses since this first came out, & I always say...'if you go blank remember Vinnie'...the reason is, in emergencies, people DO panic, & something is better than nothing.



BUT, they are all taught & assessed on full CPR.



I think it's great for kids as youngsters may not be able to do rescue breaths, but they'll have a go at compressions, using any means possible which will make the difference for someone.  Glad we live in Wales where kids are being taught first aid (my little bit was voluntary as part of the activities for holiday club provision) in school.
glennjo Offline
#27 Posted : 11 February 2012 10:53:51(UTC)
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Whilst its easy to say ..."send for the defib" where I work I'm the only FA left on site during the late afternoons. Yes I carry a radio, but I am just thinking about 1. having to describe the deifb. 2. how to open the cabinet & 3. where its located, to a say a cleaner who only works in a certain area. There isnt many "knowledgable" staff around at certain times - and this include school holiday where we can still have a few dozen people (staff / contractors) on site.



So, where do you locate a defib, we've go a huge building complex full of inquistive kids during the day! Do you leave the patient and get the defib yourself which can be several minutes away and then back. Or stay with patient?



I agree perhaps the Cardiac Specialists need to take on board what happens on the ground with First Aiders, before ambos turn up.



Maybe soon defibs will become very cheap with some oxygen readily available in some instant-to-use packs. 
Deek Offline
#30 Posted : 16 February 2012 12:35:24(UTC)
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I am a Paramedic sole responder (RRV) - in the event of attending a cardiac arrest I am to perform BLS until the arrival of somebody else who can perform BLS before I attach a defib; AED or otherwise.



Reasoning behind this is the drop in blood pressure and ultimately perfusion once the hands are removed from the chest for more than a few seconds.



Focus is now all about hands on the chest time...



But, if I arrive and somebody is already performing good BLS then I will attach a defib.



Not sure what the official line is regarding AED training but this is what we do in a large NHS Trust.



Also, just to comment on a post on the other page about First Aiders MUST perform rescue breaths... you can't make anybody do rescue breaths; there is no law saying they must, and if the First Aider feels like they don't want to perform the rescue breaths then yo you can't force them to. You can however encourage them that this would be in the best interests of the patient, but ultimately the whole point of the Vinnie campaign is the fact people weren't doing CPR at all because they didn't want to do the rescue breaths... Hands only CPR is better than no CPR - and we don't need any research to suggest otherwise...
JonAcc Offline
#31 Posted : 16 February 2012 15:14:32(UTC)
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Welcome to the forum. Another professional voice is always welcome



You raise an interesting point about the "lone rescuer". I understand the reasoning; equally it would seem to go against the knowledge that the longer a VF remains unconverted, the more fragile it becomes.

Is this just SOP for your Trust, or do you know if it is promulgated in any national documentation?

I will also take this up with one of my staff, who is an ALS instructor and also a Senior Resus Officer for a Trust.

resq Offline
#23 Posted : 16 February 2012 20:58:43(UTC)
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Originally Posted by: pond life Go to Quoted Post
Excellent, good to know.



How much input do you guys as first aiders have in resus guidelines and which route do you take to impart your experiences. I'm not being flippant here - genuine question. Because the cardiac consultants need to know what works and what doesn't from the ground up.




Just for info the working groups who develop the guidelines are made up of experienced clinicians many of whom are prehospital providers in their own right.
resq Offline
#28 Posted : 16 February 2012 21:01:01(UTC)
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Originally Posted by: glennjo Go to Quoted Post
Whilst its easy to say ..."send for the defib" where I work I'm the only FA left on site during the late afternoons. Yes I carry a radio, but I am just thinking about 1. having to describe the deifb. 2. how to open the cabinet & 3. where its located, to a say a cleaner who only works in a certain area. There isnt many "knowledgable" staff around at certain times - and this include school holiday where we can still have a few dozen people (staff / contractors) on site.



So, where do you locate a defib, we've go a huge building complex full of inquistive kids during the day! Do you leave the patient and get the defib yourself which can be several minutes away and then back. Or stay with patient?



I agree perhaps the Cardiac Specialists need to take on board what happens on the ground with First Aiders, before ambos turn up.



Maybe soon defibs will become very cheap with some oxygen readily available in some instant-to-use packs. 




Send one of the kids to help, get others involved in CPR some simple instruction like push down hard as you can about 120 times a min
goodhealthCPR Offline
#32 Posted : 17 February 2012 20:18:47(UTC)
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I think that they are just trying to educate the public to do SOMETHING, rather than just sit there on the phone. It is way less intimidating to give chest compressions than to do mouth to mouth. I would recommend learning and performing BOTH when they are needed, but if you are afraid to simply put your mouth up to some stranger to save their life, then at least give them chest compressions.
Deek Offline
#33 Posted : 21 February 2012 20:37:10(UTC)
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Thanks for the welcome :)



Not sure if it is a national policy, but looking at the 2010 Guidelines again this is what I found under Pre-Hospital Cardiac Arrest: http://www.resus.org.uk/pages/prehosca.pdf (under Defibrillation Vs CPR )



There is the argument about keeping compressions going to maintain perfusion, which I think is the idea behind our local policy.



Cardiac Arrest calls are the highest priority in my service, and if the dispatcher can't get a vehicle to back-up an RRV in a timely manner they will often dispatch another RRV to assist, and it has been known for them to ask the Police to attend to give assistance, so it normally isn't long before the defib can be attached.



The part about AEDs is interesting as well: http://www.resus.org.uk/pages/aed.pdf as it states minimal disruption to good quality CPR - it is a decision you will have to make; do you cease good quality CPR to attach the AED or wait for help to arrive?



In my experience it can take quite a few seconds to turn on the machine, open the pads and apply them in the correct fashion and then check the machine for shock / no shock, and I am an experience practitioner; you need to figure in uncertainty on the part of the lay responder when using an AED...



As with most things if you can justify your actions... :)
Witchfinder Offline
#34 Posted : 22 February 2012 08:32:43(UTC)
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As First Responders we are taught to continue CPR whilst the Defib is being prepared and positioned, you may miss one or two beats as clothing is removed to clear the chest for the pads to be attached but bar that good CPR can be maintained right up until the defib starts to analyze.



The only time there might be a problem is with a single rescuer, however the BHF and UK resuscitation council have both said that the quicker the Defib can be attached then the greater the chance of it being able to work.



So, do you continue with CPR knowing that the casualties chances are diminishing 10% for every minute or do you connect the Defib in the hope that the heart is in VF and thus stand a good chance of an early shock bringing the rhythm back.



Personally, I would get the defib on as soon as it arrives.
ppp Offline
#35 Posted : 24 February 2012 12:18:33(UTC)
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I agree with Deek, I am also a RRV paramedic and first on scene at arrests, usually when I arrive at an arrest there is someone who has called the ambulance in the first place. Depending on who and how they are they can be instructed to assist but failing that basic life support only is done and cpr is continued until back up arrives.

With regards to the vinnie thing, does he actually say he needs a victim who is not breathing or does this advert take into account normal breathing which is what trainers teach. (maybe this would complicate the simple message they are trying to get over.
resq Offline
#36 Posted : 24 February 2012 22:13:22(UTC)
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Key points to this





The BHF vinnie jones add is based on the

KISS principle (keep it simple stupid). If in doubt geton the chest and request help



For the loan rescuer, how long do you think you can carryour effective chest compression for?



(average about 90secs your technique deteriates even before your subjectively feel tired). At work I advocate changing every 1-2 minutes with a well drilled team,( a well drilled team will have shorter interuptions in chest compressions)





Find someone in cardiac arrest not breathing normally and you have no repsonse to yor shouts for help, runaway bravely get help and either send someone for the defib or go and get it.




mrsafetytraining Offline
#37 Posted : 07 March 2012 22:55:44(UTC)
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the BHF compressions only campaign is really good, however not everyone wears a sovereign round their neck, and also there should have been a note on the ad, "adults only" whereas drowned adults, and paediatrics whole different ball game.
davidsf2 Offline
#38 Posted : 12 March 2012 16:14:37(UTC)
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32 to 2 compressions would fit in with the tune better.

Ah Ah Ah Ah 4 beats
Staying Alive Staying Alive 4 beats

Repeat 3 more times.
Rescure Breath Rescue Breath

Just an observation, not suggesting changing the ratio to fit the tune
Witchfinder Offline
#39 Posted : 13 March 2012 08:20:37(UTC)
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LOL, sorry but I still will not be kneeling in the middle of the local high street pounding on some one's chest whilst singing my head off.


JEFFK Offline
#40 Posted : 13 March 2012 20:43:16(UTC)
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2 lots of Nellie the elle = 30 compressions
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