Just to play devils advocate...if you start cpr on a pulsless patient who has an uncontrolled bleed that you haven't found or didn't address yet you're just pumping blood out of them faster. This has happened...it's also one of the factors why .mil switched away from IV access and trying to maintain BP being such an immediate priority during a TCCC type scenario. They had guy's bleeding pink from the fluid bolus from hemorrhages that hadn't yet been controlled.
Not saying your wrong at all btw...just something to think about. Every scenario is going to be different and the real trick is being able to quickly process the information you've been presented with and act accordingly.
Also, superglue is awsome for cuts!
Last edited by TCB; 03-15-2017 at 05:25 PM.
If someone's pulseless because they're in traumatic cardiac arrest, odds are pretty decent it won't matter what you do. They are dead or on their way to being dead. If it's a peripheral bleed you can tie on a TQ but they needed a surgeon 15 minutes ago. Only way you will fix that is rapid volume resuscitation and a resuscitative thoracotomy to find and fix the hole(s). That said, I've never seen someone exsanguinate from a peripheral injury - not because it doesn't happen, but because I still have a lot more learning ahead of me.
But yeah your basic point is a valid one. You should be constantly assessing and reacting accordingly. You should be systematic in the way you assess and treat - not rigid.
Excellent points sir. I to have a lot of learning to do! But that's why we have these discussions are why they can be so beneficial. I had a coworker recount to me a situation where he preformed CPR on a Pt. and with every compression he heard and felt blood shooting out of the wound...one of the reasons why I brought it up.
GSW, entered I believe R side near the lower rib cage just missing his plates, no exit. Hit the descending aorta. He went down quickly...CPR was preformed until being called at the hospital. No intervention would have made a difference so it's purely an academic example.