I totally agree on the lights & siren issue when transporting a cardiac arrest. I never did see the sense of rushing a dead person to the hospital, putting the responders in the back, none of whom are restrained, most of which are positioned awkwardly doing CPR, airway stuff, meds, etc, the driver & everyone else on the street at risk.When I am in the back with a critical patient, I tell my driver “I want you to drive slow. Not what you think is slow, but what you think I think is slow.” Works like a charm. It really makes them think about how fast they’re going.
Qoute – Hyperventilation increases intrathoracic pressure, which inhibits venous return. Since venous return determines cardiac output, hyperventilation reduces cardiac output, causing reduced oxygenation.I agree with almost everything you post, 99% of the time. On on this you have been sold a myth. But so has almost everyone else too. Blood flow is caused by the change in intrathorasic pressure. Not high pressure or low pressure, it’s the change from high to low that moves blood. Unfortunately with (and ONLY with) a BVM you typically deliver such a meager tidal volume that “a positive pressure is not recorded in the lung nearly 50% of the time” If you just “bag fast” the pressure remains fairly constant, hence the outcome of the cited AHA reference. But hyperventilation does not really mean just bag fast. That is the myth. Use a time-cycled volume constant device and you can hyperventilate AND improve blood flow due to a nice high/low pressure ventilatory cycle. Hyperventilation really means, “To increase minute volume ventilation and thereby reduce PCO2”.
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