Dr. Peter Antevy breaks down cardiac arrest response as a pit-crew model: one person does compressions at 110 per minute to a metronome, another manages the defibrillator, a third secures the airway. Poor compressions risk anoxic brain injury and death within 36 to 48 hours in the ICU.
Questions this video answers
Between 100 and 120 per minute; he suggests 110 as a target.
LifePak 15.
Death in the ICU 36 to 48 hours later.
Chapters
Hey, everyone, this is Dr. Peter Entevi for another edition of the Hentevi Minute. What I want to talk about today is seeing priorities in pediatric cardiac arrest, and for that matter, adult cardiac arrest. Well, we all know the concept of pit crew or high performance cpr. It's important that when you get to work in the morning that you all know what your position is going to be when you arrive on that scene. So if you're going to use position 1, position 2, position 3 type of model, it's very, very important that one person is actually pushing on the chest. Let's talk about that for a minute. What is your rate that we need to use? Well, it's between 100 and 120. Let's pick 110. It turns out that we've learned this through the resuscitation academy, who we've learned from in Seattle. It turns out that very few people, very few people can actually get to 100, 110 just by using row row row your boat. It turns out you need a metronome and the monitored defibrillators that you have have metronomes on them. So we have the LifePak 15. As soon as we get to the scene, we have that metronome on and that compressor. The number one person is basically just doing chest compressions to the metronome. Very important. And then when you're doing CQI on these cardiac arrests, look at it and make sure that the rate is not 180. Make sure the rate is not 70. You'll be very, very surprised when you see what you find when you do CQI at every single cardiac arrest. The second one is gonna be the person on the monitor, right? So that person should be coming in, the gear placement should be in the same place every time. So when you're coming into the scene of a cardiac arrest, that number two person should know exactly where they're putting the monitor. They're supposed to put the pads on right away. They're supposed to get the monitor charged right away. And then as soon as that monitor is charged, that compressor will hover. You're either going to shock or dump in kids, mainly asystole. You're going to dump that charge and then that person starts their two minute cycle and the airway is being taken care of at that time. So it's very important to understand that your scene priorities are important. And then of course, there's someone talking to the mom and advising them what's going on so that you don't rush off the scene. So if you look at this video here, you'll see that we're working on scene at the poolside notice. No one's rushing. We don't have one foot, you know, in the backyard like we want to leave. And it's very important that you have that feeling and that looks that you're staying on scene, that you're going to get these kids back to life. Remember, it's the brain that needs blood supply. So for every time that you're missing out on chest compressions, their brain's not getting perfused. It'll become hypoxic, anoxic and it'll end up swelling and that kid will die in the ICU 36 to 48 hours later. So getting a pulse back is not ideal. We need to perfuse the brain and that should happen from the time the 911 call starts all the way through until ROSC. So again, thank you guys for what you do. This is Dr. Peter Hentevi, another edition of the Hentevi Minute.
