Commence High Quality, Task Focused, Minimally Interrupted Chest Compressions.
The treatment for Cardiac Arrest patients revolves around core requirements; excellent quality chest compressions that are never interrupted unnecessarily, timely defibrillation and oxygenation.
Traditionally, these care needs have been approached in a regimental manner, and often some skills are prioritised at the expense and quality of others. Prioritising the core elements is essential and apply each of the other principles around that as necessary – as soon as it is possible to do so.
There is no prescribed order for this; it is dynamic and circumstance dependant as reflected in the Circular Diagram below.
|Working space||Good resuscitation cannot generally be delivered in poor environments. A rapid and dynamic risk assessment should be done to either create space or move the patient.|
|Standardised equipment placement||The right equipment in the right place as often as possible.|
|High quality compressions||Focused compressions (attention to quality) that are minimally interrupted. The use of CPR Quality Feedback Devices (where available) is mandatory.|
|Swap compressor EVERY 2 MINUTES||A fatigued compressor delivers poor quality compressions. Prioritising paramedic skills over a swap of compressor in resource poor cases should not routinely occur unless it is critical to do so.|
|Create overview||Scene leadership should be established as soon as practicable. This person should NOT be delivering skills, and ideally be standing away.|
|Maintain a calm, coordinated scene||Encourage a calm and controlled scene with closed loop communication between the team, using functional language.|
|Ventilation||The use of a BVM should be viewed as an important task in providing controlled ventilation. Aim for correct rate without excessive volumes under pressure.|