Prolonged Resuscitation and CPP

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Michael S., -

Excellent points, flog the compressor!

Currently we have one person do 200 uninterrupted compressions. We use a King airway and an IO so no interruptions are needed.

At compression #180, the next person in line prepares to take over compressions AND the defibrillator is charged while compressions continue to #200.

In the pause to switch compressors we analyse the rhythm. The shock is delivered and compressions continue, or compressions are immediately continued if it is a non-shockable rhythm (in which case the charge is dumped or it times out. With practice, you can interpret the rhythm and deliver the defibrillation within about 3 seconds.

My opinion is that these changes that force medics to do good, on scene resuscitation, as opposed to trying to rush patients to the ED while doing half-assed resuscitation, have led to increased ROSC rates. Personally, I have always believed in doing excellent resuscitation where they fall (or as close to it as possible) obtaining ROSC, and then transporting (or pronouncing them dead if they do not achieve ROSC).

Robert H., M.D. -

Can you tell me the literature citation from Circulation for hands on defibrillation so we can explore this at our hospital?

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