You will be exerting yourself and working in tight quarters onboard the aircraft. You may need to relocate the patient if the cardiac arrest occurs in the lavatory or cockpit. Your patient may end up being one of the pilots and will need to be moved to a better treatment location.
Also prepare yourself for the very real probability that it may not lead to the patient waking up. Do your best and realize you are giving your patient the best chance of survival. Continue CPR until:
1. The patient wakes up.
2. Someone of equal or higher training relieves you.
3. You are physically too exhausted to continue doing CPR.
Adult CPR Guidelines
Cardiopulmonary Resuscitation (CPR) is a crucial life- saving technique that can be performed by anyone, regardless of their medical training. The American Heart Association (AHA) provides these guidelines for performing adult CPR effectively:
• Compression-only CPR for untrained responders: The 2020 AHA guidelines emphasized the use of hands-only CPR for untrained individuals. This means that if someone witnesses a cardiac arrest and is unsure or uncomfortable providing rescue breaths, they are encouraged to perform hands- only CPR by doing chest compressions at a rate of 100-120 compressions per minute until professional help arrives.
• Change in compression depth: The recommended compression depth for adult CPR changed from a range of 2 to 2.4 inches (5 to 6 centimeters) to at least 2 inches (5 centimeters). The emphasis was placed on deeper compressions to ensure adequate blood flow during resuscitation.
• Rhythm check before defibrillation: The guidelines advised a "rhythm check" (a quick check for a shockable rhythm) before each defibrillation attempt. This change aimed to reduce pauses in chest compressions during the resuscitation process.
• Update on the use of feedback devices: The guidelines encouraged the use of real-time audio and visual feedback devices during CPR to help rescuers optimize compression depth, rate, and recoil.
• Recognition of cardiac arrest and CPR initiation: There was a renewed emphasis on the early
42 Circulatory System
recognition of cardiac arrest and the importance of starting CPR immediately. The guidelines highlighted the importance of starting compressions within the first few minutes of cardiac arrest.
Pediatric CPR Guidelines
Pediatric CPR differs slightly from adult CPR due to the unique needs of infants and children. The AHA guidelines provide specific instructions for performing CPR on pediatric patients
• Update on compression depth and rate: The 2020 AHA guidelines recommended a change in compression depth for pediatric CPR. For children, the guideline emphasized a compression depth of at least 2 inches (5 centimeters) but no more than 2.4 inches (6 centimeters). The compression rate for pediatric CPR remained the same at 100-120 compressions per minute.
• Compression-to-ventilation ratio: The guidelines maintained a compression-to-ventilation ratio of 30:2 for a single rescuer providing CPR to children (except for newborns).
• Single rescuer vs. two-rescuer CPR: The guidelines recognized the challenges of performing high-quality CPR with multiple rescuers. In specific situations, it was recommended to minimize interruptions in chest compressions and focus on high-quality compressions, even if the ratio of compressions to ventilations was not strictly 30:2.
• Age-based classification: The guidelines provided clearer age-based classifications for pediatric CPR, categorizing children into different age groups, including infants (0 to 12 months), children (1 to 8 years), and adolescents (9 to 18 years).
• Update on the use of feedback devices: Similar to adult CPR, the guidelines encouraged the use of real-time audio and visual feedback devices during pediatric CPR to optimize compression depth, rate, and recoil.
• Compression depth in newborns: For newborns (birth to 1 month), the guideline maintained the recommendation for a compression depth of about 1.5 inches (4 centimeters).
• Use of mobile devices for emergency dispatch: The guidelines explored the use of mobile devices equipped with video capabilities for emergency dispatch, allowing dispatchers to assess the situation remotely and guide bystanders in CPR and other life-saving interventions.
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