Specifically, this is how we have modified our training process since attending the Resuscitation Academy in Seattle / King County.
Each rescuer should experience each position at least twice. In other words, you run the drill, stop and switch, run the drill, stop and switch. This drill is very well received by EMTs and paramedics! It’s fun to watch the performance improve over time.
That’s what it’s all about — perfecting resuscitation!
In a perfect world you would use an instrumented manikin to measure rate, depth, recoil; and volume of air when you squeeze the bag.
The Resuscitation Academy uses Laerdal‘s Resusci Anne QCPR AED Torso with Shock Link and SimPad in each “pod” of 6 rescuers. Each setup retails for about $6,000.00. I like how this particular setup “feels”. We have several different manikins and the more “advanced” ones don’t feel quite right when performing chest compressions.
We break our training down into four positions.
- Position 1: Monitor / Code Commander
- Position 2: Chest Compressions
- Position 3: Airway
- Position 4: Assistant / Next on Chest Compressions
Once High Performance CPR is up and running we allow two additional rescuers to arrive on scene so we can establish IV/IO access and give epinephrine. We teach our teams to defer advanced airway management for the first 5 cycles unless it’s absolutely necessary (e.g., asphyxial arrest, unable to ventilate, need to protect airway).
- Places monitor at 45 degree angle to left shoulder (monitor can be set back a few feet from working area)
- Checks pulse and announces “no pulse, begin CPR”
- Attaches capnography circuit to monitor
- Extends pads and coordinates placement with rescuer on chest compressions
- Changes monitor to pediatric mode if applicable
- Deploys metronome at a rate of 110
- When appropriate pre-charges the monitor at correct energy dose and coordinates peri-shock pause
- Acts as Code Commander, gives clear directions, solves problems
- “Hovers” during pulse check
- Performs CPR at correct rate, depth, and recoil
- Accepts feedback from crew members about CPR quality
- Coordinates pad placement with rescuer on monitor
- Counts out loud “13, 14, 15″ or “28, 29, 30” to prompt rescuer on airway to give breaths
- Waits two full seconds for airway man to give breaths and continues compressions
- Helps keep track of 2 minute cycle
- When Code Commander announces “stop CPR” at the beginning of the peri-shock pause this rescuer clears out of the way
- Announces “I’ve got airway”
- Selects the correct sized BVM and attaches capnography between mask and bag
- Announces “ready for 15:2″ or “ready for 30:2”
- Reminds rescuer on compressions to count last three
- Ventilations are given correctly (just enough to produce chest rise with full release between ventilations)
- Manages the patient’s airway as necessary
- Immediately deploys and tests suction unit
- Turns on oxygen and hooks up BVM to oxygen at 15 LPM
- If necessary takes out Handtevy book and determines child’s age
- Announces child’s age and weight in kilograms
- Selects correct sized OPA for the rescuer on the airway
- Hands Hantevy book to rescuer on monitor
- This rescuer is next on chest compressions
So far our crews have really enjoyed this method of training. When is the last time you’ve heard cheering and applause during a CPR class?
Check out the South Carolina Resuscitation Academy on Facebook!