The work by Taj Hassan and colleagues in Leicester was illuminating; the only patients who
survived prehospital arrest were those who went from a perfusing rhythm to VF in front of the
paramedics. 33 out of 700+, if I remember correctly. I appeal again to those who write the JRCALC
guidelines (Iain, are you there?) to add a rider that unless the crew achieve ROSC they don't
transport.
It is also illuminating to watch videos of CPR on fast forward - it is clear that the person performing
chest compression tires after 2 minutes or so and while the rate is maintained the depth of
compression slowly reduces, which is why I rotate compressionists every cycle.
> Some research found by our Care of the Elderly consultants (?US source)
> showed that around 11-14 minutes in to the resus attempt was the clear
> break-point - either successful or dead by then. Usual caveats of the
> cold/poisoned.
>
> Quality & effectiveness of chest compressions fall off rapidly as the
> team
> tires. How often is CPR done effectively for long preiods anyway?
>
> Starting with Asystole has only a 6% chance of ROSC (RCUK)
>
> DNAR system reduced the number of futile & distressing attempts on the
> Care
> of the Elderly wards. Large city general issues average of 3 DNARs a day
> with no marked effect on patient survival rates.
>
> Knowing when to start, stop or withold resus is just as important as
> rehearsing on plastic dolls
>
> Ian Wilson
> Resuscitation Officer
> Lincoln
>
>
Rowley Cottingham.
Consultant in Emergency Medicine.
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