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Resuscitating your cardiopulmonary skills
RESUSCITATING YOUR CARDIOPULMONARY SKILLS by Vivian Biggers, MSN, RNC, CDE, CS
The emotions that prompt patients who have suffered a heart attack and their families to seek cardiopulmonary resuscitation (CPR) training are sometimes the very things that inhibit learning. Shock, denial, anger, and fear can have an adverse impact on the opportunity to master vital skills.
The American Heart Association and the American Red Cross provide CPR courses for both medical and nonmedical participants. Even though the standards are consistent between the organizations, the course instructor may be instrumental in facilitating or inhibiting learning. Anxiety is diminished when relevant, simple examples are given. The following mnemonics can serve as aids to reinforce a more thorough explanation of CPR concepts for the adult patient.
CPR ASSESSMENT/RESPONSE After determining the patient’s responsiveness and contacting 9-l- I, reciting this mnemonic can help the CPRgiver remember the proper course of action: Check Fix Check Fix
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Because airway access is always a priority, the first check refers to checking for breathing. Open the airway (head tilt/chin lift maneuver) and look, listen, and feel for 3 to 5 seconds. If the patient is not breathing, fix the situation with two breaths lasting between i -l/2 and 2 seconds each. The next check is related to the pulse. Find the “Adam’s apple” with three fingers and slide them into the groove formed by the large muscle in the neck; hold in place for 5 to 10 seconds. If you don’t detect a pulse, administer 15 compressions. The cycle of 15:~ is repeated four times and ends with two breaths, After the fourth cycle, recheck the pulse for 3 to 5 seconds and resume CPR. If necessary, the count for the initial assessment (3 to 5 seconds to look, listen, and feel), the initial pulse check (5 to 10 seconds), and subsequent pulse checks (3 to 5 seconds) can be simplified to 5 seconds because they all have 5 seconds in common. Again, after determining responsiveness and calling 9- 1 - 1, just remember check, fix, check, and fix.
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PRACTICE
TEACHING
CHOKING The universal sign for choking is hands on the neck. Because this may be confused with heart attack (grasping the chest), you should ask, “Are you choking?’ If the victim nods “yes,” it will be helpful also to say, “I can help you.” This reassurance is important because it helps calm the victim more so than saying, “Calm down!” Tighten your fist (with the dominant hand underneath) and deliver abdominal thrusts until the patient ejects the content or becomes unconscious. If the obstructed victim becomes unconscious, call 9-i - 1. Remember this mnemonic: sat spelled SAAT,
lies. Anecdotal stories have confirmed the value and effectiveness of remembering the phrases during an emergency situation. This simple approach may assistmastery of the skills necessary to help save a life-something anyone can do! Sometimes CPR training can be a challenge, but through the use of these mnemonics, perhaps the challenge will be met!
BIBLIOGRAPHY American
Heart
Association.
Basic
Life Support
Heartsaver
Guide,
1993. American
S-finger sweep A-attempt a breath A-reposition the head and attempt another breath T-perform five abdominal thrusts
Red Cross.
First Aid Training,
1993.
Repeat the procedure until the obstruction is relieved or until the rescue squad arrives.
CONCLUSlON These mnemonics have been shared with thousands of medical rescuers, as well as with patients and their fami-
Join the Association that’s Uniting Postactute Care Professionals The American SubacuteCare Associationoffers the latest professional education and information for postacute care professionals. Membership benefits include: Savings of up to 70% on over 200 business products and services ASCA Quarterly, the newsletter for subacuteprofessionals Discounts on ASCAconferencesand seminars Information resourcesand listing on ASCA Internet Page Opportunities to network with subacutecare professionals Research and information from theASCA ResourceCenter Eligibility to servein ASCA leadership positions Subacute Care Directory Discounts on related healthcarepublications subscriptions.Individual Membership $99 CorporateMembership $500 How to Reach ASCA I Phone 305-864-0396 Fax 305-868-0905 Registerby February 15,1997for earlybird disEmail ascamail@ aolcom count on the ASCAin Denver Conference,at the Internet http://members.aol.com/ascamail DenverMarriott West,March lo- 11,includesopI tional ski trip, Sunday,March 9,1997 Conference I includes sessionson SubacuteCareResearch,,4th GenerationMarketing to ManagedCare,RegionalandNational ManagedCareIssues,Strategic PostacutePartnering,Pain Managementfor SubacuteCare, Critical Pathways,Changesin Subacute Medicine, Advancesin SubacuteNursing, WoundCare2000andHot New Technologiesfor Subacute ~ Care.Call 305-864-0396for details. l
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The emotions that prompt patients who have suffered a heart attack and their families to seek cardiopulmonary resuscitation (CPR) training are sometimes the very things that inhibit learning. Shock, denial, anger, and fear can have an adverse impact on the opportunity to master vital skills.
The American Heart Association and the American Red Cross provide CPR courses for both medical and nonmedical participants. Even though the standards are consistent between the organizations, the course instructor may be instrumental in facilitating or inhibiting learning. Anxiety is diminished when relevant, simple examples are given. The following mnemonics can serve as aids to reinforce a more thorough explanation of CPR concepts for the adult patient.
CPR ASSESSMENT/RESPONSE After determining the patient’s responsiveness and contacting 9-l- I, reciting this mnemonic can help the CPRgiver remember the proper course of action: Check Fix Check Fix
60
HOME
CARE PROVIDER
Because airway access is always a priority, the first check refers to checking for breathing. Open the airway (head tilt/chin lift maneuver) and look, listen, and feel for 3 to 5 seconds. If the patient is not breathing, fix the situation with two breaths lasting between i -l/2 and 2 seconds each. The next check is related to the pulse. Find the “Adam’s apple” with three fingers and slide them into the groove formed by the large muscle in the neck; hold in place for 5 to 10 seconds. If you don’t detect a pulse, administer 15 compressions. The cycle of 15:~ is repeated four times and ends with two breaths, After the fourth cycle, recheck the pulse for 3 to 5 seconds and resume CPR. If necessary, the count for the initial assessment (3 to 5 seconds to look, listen, and feel), the initial pulse check (5 to 10 seconds), and subsequent pulse checks (3 to 5 seconds) can be simplified to 5 seconds because they all have 5 seconds in common. Again, after determining responsiveness and calling 9- 1 - 1, just remember check, fix, check, and fix.
APRIL 1997, VOL.
2
NO.
2
PRACTICE
TEACHING
CHOKING The universal sign for choking is hands on the neck. Because this may be confused with heart attack (grasping the chest), you should ask, “Are you choking?’ If the victim nods “yes,” it will be helpful also to say, “I can help you.” This reassurance is important because it helps calm the victim more so than saying, “Calm down!” Tighten your fist (with the dominant hand underneath) and deliver abdominal thrusts until the patient ejects the content or becomes unconscious. If the obstructed victim becomes unconscious, call 9-i - 1. Remember this mnemonic: sat spelled SAAT,
lies. Anecdotal stories have confirmed the value and effectiveness of remembering the phrases during an emergency situation. This simple approach may assistmastery of the skills necessary to help save a life-something anyone can do! Sometimes CPR training can be a challenge, but through the use of these mnemonics, perhaps the challenge will be met!
BIBLIOGRAPHY American
Heart
Association.
Basic
Life Support
Heartsaver
Guide,
1993. American
S-finger sweep A-attempt a breath A-reposition the head and attempt another breath T-perform five abdominal thrusts
Red Cross.
First Aid Training,
1993.
Repeat the procedure until the obstruction is relieved or until the rescue squad arrives.
CONCLUSlON These mnemonics have been shared with thousands of medical rescuers, as well as with patients and their fami-
Join the Association that’s Uniting Postactute Care Professionals The American SubacuteCare Associationoffers the latest professional education and information for postacute care professionals. Membership benefits include: Savings of up to 70% on over 200 business products and services ASCA Quarterly, the newsletter for subacuteprofessionals Discounts on ASCAconferencesand seminars Information resourcesand listing on ASCA Internet Page Opportunities to network with subacutecare professionals Research and information from theASCA ResourceCenter Eligibility to servein ASCA leadership positions Subacute Care Directory Discounts on related healthcarepublications subscriptions.Individual Membership $99 CorporateMembership $500 How to Reach ASCA I Phone 305-864-0396 Fax 305-868-0905 Registerby February 15,1997for earlybird disEmail ascamail@ aolcom count on the ASCAin Denver Conference,at the Internet http://members.aol.com/ascamail DenverMarriott West,March lo- 11,includesopI tional ski trip, Sunday,March 9,1997 Conference I includes sessionson SubacuteCareResearch,,4th GenerationMarketing to ManagedCare,RegionalandNational ManagedCareIssues,Strategic PostacutePartnering,Pain Managementfor SubacuteCare, Critical Pathways,Changesin Subacute Medicine, Advancesin SubacuteNursing, WoundCare2000andHot New Technologiesfor Subacute ~ Care.Call 305-864-0396for details. l
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