Special Considerations for CPR, AED and Choking

ProCPR
8 Apr 201611:33
EducationalLearning
32 Likes 10 Comments

TLDRThe video script provides a comprehensive training guide on special considerations for CPR, AED use, and choking situations. It addresses concerns about patient size, the feeling of rib fractures during compressions, and impaled objects in CPR. For AED use, it covers jewelry interference, medication patches, under-wire bras, and breast tissue considerations. Choking rescue techniques are also discussed, including strategies for large patients, pregnant women, and hard-to-remove obstructions. The script emphasizes the importance of not letting these special considerations deter rescuers from performing life-saving procedures and encourages the use of EMS tools when available.

Takeaways
  • 🚑 **Patient Size and CPR**: Rescuers of any size can perform effective CPR, but if unable to, call for help and consider recruiting a larger rescuer.
  • 🔊 **Feeling Cracks or Pops**: During CPR, feeling a crack or pop is normal and not harmful to the patient; it's often due to the sternum separating from the rib cage.
  • 🚫 **Impaled Objects and CPR**: Avoid chest compressions if an impaled object is in the compression area; instead, call emergency services and manage the scene safely.
  • 💎 **Jewelry and AED Use**: Jewelry generally doesn't interfere with AED function, but remove any piercings or items directly in the pad placement path.
  • 💊 **Medication Patches and AED**: Remove any medication patches before AED use to prevent burns from the electrical current.
  • 👙 **Under-wire Bras and AED**: If an under-wire bra might interfere with the electrical pathway, it's safer to remove it before using an AED.
  • 🤰 **Pregnancy and CPR**: In cases of suspected pregnancy, perform chest thrusts instead of abdominal thrusts to avoid injury to the uterus and baby.
  • 🤰 **Pregnant Women and Choking**: Avoid abdominal thrusts on pregnant women and use chest thrusts under the breasts instead.
  • 🍫 **Choking on Sticky Objects**: Prevent choking on sticky or gooey foods; if it happens, continue with abdominal or chest thrusts until the object is cleared or help arrives.
  • 🆘 **Calling for Help**: Always call emergency services (911) when faced with a medical emergency while also administering first aid.
  • 🛡 **EMS Equipment**: EMS has specialized tools like suction devices and forceps to handle difficult airway obstructions that can't be cleared with basic first aid.
Q & A

  • What are the three most popular topics regarding special considerations for CPR?

    -The three most popular topics are the size of the patient, the feeling of crepitus or crunching during compressions due to rib fractures or cartilage separation, and the presence of impaled objects during CPR compressions.

  • What should a rescuer do if they cannot perform adequate chest compressions due to a size mismatch with the patient?

    -The rescuer should call 911 for help, recruit another bystander who may be better suited to perform the compressions, and teach them how to do effective chest compressions.

  • Why shouldn't rescuers be deterred by the feeling of snapping, cracking, or popping during chest compressions?

    -These sounds and feelings are often due to the normal separation of the sternum from the rib cage by cartilage, similar to cracking a knuckle. It is not harmful to the patient, who is already in a critical condition, and can only be helped by continuing CPR.

  • When should CPR compressions be stopped due to the presence of an impaled object?

    -CPR compressions should only be stopped if the impaled object is located exactly where chest compressions are to be performed. In such a case, one should call 911, ensure the scene is safe, and manage any bleeding or other issues.

  • What are the four main topics that often come up regarding the use of AEDs?

    -The four main topics are jewelry that might interfere with the electrical shock, medication patches that could be in the way of the pads, the use of an AED with an under-wire bra in place, and the issue of breast tissue interfering with pad placement.

  • How should jewelry or piercings be handled when using an AED?

    -Jewelry such as chains or necklaces can be moved to the side without being removed. Piercings can generally be left in place unless they are directly where the pad needs to be applied or in the path of the electrical current.

  • What should be done if a medication patch is found on the upper right side of the chest when using an AED?

    -The medication patch should be removed and the area wiped clean before applying the AED pads to avoid the risk of burns.

  • Is it safe to use an AED with an under-wire bra in place?

    -For safety, if the under-wire bra appears to interfere with the electrical pathway, it should be removed to prevent the electricity from being redirected along the surface of the chest wall.

  • How should rescuers handle chest compressions or abdominal thrusts for a choking patient who is too large for them to reach around?

    -Rescuers can attempt to perform inward thrusts on the sternum instead of the abdomen, or seek help from a larger bystander who may be able to reach around the patient.

  • What is the recommended approach for dealing with a choking patient who is pregnant?

    -Avoid abdominal thrusts that could harm the uterus and baby. Instead, perform inward thrusts on the sternum under the breasts while the patient is conscious. If unconscious, proceed with CPR compressions.

  • What is the best advice for dealing with a choking situation involving a hard-to-remove object?

    -Prevention is the best approach. Avoid situations that could lead to choking on sticky or gooey substances. If an obstruction occurs, continue with chest compressions or abdominal thrusts until the object is dislodged or help arrives.

Outlines
00:00
🆘 CPR Special Considerations

The first paragraph discusses special considerations for CPR, including patient size, the feeling of crepitus or crunching during compressions, and the presence of impaled objects. It emphasizes the importance of adequate chest compressions regardless of patient size and reassures that the sounds heard during compressions are normal and not harmful. It also advises on the approach to patients with impaled objects in the chest and introduces considerations for using AEDs.

05:01
🚨 AED Usage and Precautions

The second paragraph focuses on the use of Automated External Defibrillators (AEDs) and common concerns related to jewelry, medicated patches, under-wire bras, and breast tissue. It advises moving or removing jewelry and patches that may interfere with the electrical pathway and suggests safety measures such as removing an under-wire bra if it may redirect the electrical current. The paragraph also addresses how to handle chest compressions in the presence of breast tissue.

10:07
🤰 Choking Emergencies and Solutions

The third paragraph deals with special considerations for choking patients, particularly when the rescuer is smaller than the patient, in cases of pregnancy, and when dealing with hard-to-remove obstructions. It suggests alternative methods for performing abdominal thrusts and emphasizes the importance of avoiding abdominal thrusts in pregnant women to prevent injury to the uterus and baby. The paragraph concludes with a warning about the dangers of certain types of obstructions and the importance of prevention, as well as the capabilities of EMS in handling such emergencies.

Mindmap
Keywords
💡CPR
CPR, or cardiopulmonary resuscitation, is a life-saving technique used in emergencies where a person's breathing or heartbeat has stopped. In the video, it is discussed in the context of providing aid to patients of varying sizes, addressing concerns about causing harm, and dealing with complications such as rib fractures or impaled objects. The script emphasizes the importance of not hesitating to perform CPR even in challenging situations.
💡Automated External Defibrillators (AEDs)
AEDs are devices that automatically diagnose life-threatening cardiac arrhythmias and treat them through defibrillation, which can potentially save a person's life during sudden cardiac arrest. The video script addresses common concerns about using AEDs, such as the presence of jewelry, medication patches, under-wire bras, and considerations for female patients with breast tissue, providing guidance on how to handle these situations effectively.
💡Choking
Choking is a blockage of the airway that prevents a person from breathing properly. The video discusses special considerations for aiding choking patients, including the challenges faced when the rescuer is smaller than the patient, the precautions needed when dealing with a pregnant woman, and the difficulties associated with dislodging certain types of obstructions. It emphasizes the importance of proper technique and the potential need for EMS intervention.
💡Rib Fractures
Rib fractures refer to breaks in the ribs, which can occur during CPR if the compressions are performed with the necessary force. The script mentions that while the 'crunching' feeling might be concerning, it is not harmful to the patient who is already in a critical condition and that rescuers should not be deterred from performing effective chest compressions.
💡Impaled Objects
Impaled objects are foreign objects that have penetrated the skin and are embedded in the body. The video clarifies that CPR should only be withheld if the impaled object is in the exact location of chest compressions. In such cases, the rescuer is advised to call for emergency services and manage the scene safely while attempting other life-saving measures.
💡Jewelry
The presence of jewelry, such as necklaces or piercings, can sometimes interfere with the placement of AED pads or the pathway of the electrical current. The video advises moving or removing jewelry if it is in the way of the pads or the electrical current's path, to ensure the effectiveness of the AED.
💡Medication Patches
Medication patches, such as nitro patches or pain relief patches, can be a concern when using an AED due to the risk of causing burns if the patch is in the path of the electrical current. The script instructs to remove such patches and clean the area before applying AED pads to prevent injury.
💡Under-wire Bras
An under-wire bra, if it appears to interfere with the electrical pathway of the AED, poses a risk of redirecting the electrical current along the surface of the chest wall. The video recommends removing the bra if necessary to prevent this potential complication and ensure the AED can be used safely.
💡Pregnancy
Pregnancy is a special consideration in both CPR and choking scenarios because it involves two patients: the woman and her unborn baby. The video emphasizes avoiding abdominal thrusts or compressions that could harm the uterus and baby, instead suggesting chest thrusts or inward compressions on the sternum as safer alternatives.
💡Obstruction
An obstruction refers to a blockage in the airway due to a foreign object or food item. The video discusses the challenges of dislodging certain types of obstructions, such as gooey food items, mylar, latex, or coins, which can be difficult to remove with standard first aid techniques. It stresses the importance of persistent attempts and the potential need for specialized EMS tools.
💡EMS
EMS, or Emergency Medical Services, refers to emergency healthcare services typically provided by personnel trained in rescue operations. The video mentions EMS in the context of calling for professional help when dealing with complex medical emergencies, such as a choking incident with a hard-to-remove obstruction or when advanced medical equipment is required.
Highlights

Discussing special considerations for CPR, AED use, and choking skills to avoid confusion during training.

Three popular topics in CPR: patient size, feeling of crepitus during compressions, and impaled objects.

Encouraging rescuers to call for help and recruit additional rescuers if unable to perform adequate chest compressions.

Reassuring that the snapping or cracking sounds during compressions are normal and do not harm the patient.

Impaled objects only prevent CPR if they are in the exact location of chest compressions; otherwise, work around them.

Four common questions about AED use: jewelry interference, medication patches, under-wire bras, and breast tissue.

Jewelry like necklaces can be moved aside, while piercings may need to be removed if in the way of pad placement.

Medication patches can cause burns if left on during AED use, so they should be removed.

Under-wire bras may redirect electricity and should be removed if they could interfere with the electrical pathway.

Breast tissue should be moved out of the way to place the AED pad correctly on the left mid-axillary rib cage.

Three common concerns when rescuing a choking patient: size disparity, pregnancy, and hard-to-remove obstructions.

For large patients, try to find a larger rescuer or perform chest thrusts instead of abdominal thrusts.

Pregnant females require special care to avoid injuring the uterus and baby; use chest thrusts instead of abdominal thrusts.

Prevention is key for hard-to-remove obstructions; EMS has special tools to help in severe cases.

Continue performing chest compressions or abdominal thrusts until the obstruction is cleared or help arrives.

The importance of understanding and addressing special considerations to maximize the effectiveness of CPR, AED use, and choking rescue.

Transcripts

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CPR TrainingAED UseChoking RescueFirst AidEmergency ResponseHealthcare SkillsSafety MeasuresTrauma CareMedical EmergenciesLifesaving Techniques