HI ALTITUDE and heart COMPRESSIONS

www.medpagetoday.com/emergencymedicine/e...iology_Update_Active

DENVER is one locale that creates a deviation of standard care when crew is administering CPR to heart patients.....the factor is just now being discovered.

Could you please tell us how you determined that Denver creates a "deviation of standard care" from reading this article.

The trial had a randomized crossover design such that people tested their compression skills 5 minutes at a time at two out of the three simulated altitudes, the highest being 5,000 meters.

For comparison, the highest city in the world, La Paz, Bolivia, stands at 3,869 meters above sea level; the tallest city in the U.S., Denver, is 1,609 meters high.

Temperature, humidity, and carbon dioxide levels were kept constant at typical indoor levels. The hypobaric chamber's ascent and descent rates were set to a typical helicopter ascent rate of 4 m/s.

Manikins were connected to a tablet for CPR quality measurement. Participants also rated their performances subjectively on a visual analog scale.

Their perceived performance and effort did not correlate with the objective measures of performance.

"The trial had a randomized crossover design such that people tested their compression skills 5 minutes at a time at two out of the three simulated altitudes, the highest being 5,000 meters.

For comparison, the highest city in the world, La Paz, Bolivia, stands at 3,869 meters above sea level; the tallest city in the U.S., Denver, is 1,609 meters high.

Temperature, humidity, and carbon dioxide levels were kept constant at typical indoor levels. The hypobaric chamber's ascent and descent rates were set to a typical helicopter ascent rate of 4 m/s.

Manikins were connected to a tablet for CPR quality measurement. Participants also rated their performances subjectively on a visual analog scale.

Their perceived performance and effort did not correlate with the objective measures of performance."

What you posted is the findings of the investigators. It says nothing as to why you concluded that "Denver creates a deviation of standard of care" Do you know what a deviation of standard of care means?

Also Apen Co is a city that is "taller" than Denver. Aspen elevation approx 8000ft Denver elevation approx 5280.

I believe that what the authors intended is the use of supplemental oxygen by EMTs in this type of helicopter rescue. This has been the recommendation in the Rockies for a number of years.

I am NOT doin' the dance with u......
High Altitudes Mess With CPR Skills in Trained EMS Personnel
— Rescuers didn't notice their worsening chest compressions in simulated helicopter environment

by Nicole Lou, Staff Writer, MedPage Today December 3, 2021
The lead line states the obvious.....if it was WORSENING then it was NOT STANDARD....

You win, HA.
Your" won't do that dance" rebuttal is your default argument. Often used by those who are woefully of the facts.

www.reuters.com/article/us-health-cpr-ex...-think-idUSKCN1G72SW

I KNEW this info right out of the gate.....it is one reason I have DNR...a N.P. with a Masters,advised me of the woeful end results,the cracked ribs and the ratio of survival.....ADD THIS article onto that and it seems like a sad scenario to me

Please correct this scenario, if I am misstating your posting.

HA is found to have collapsed in the supermarket and is unconscious. It was not witnessed. She is without a pulse. She has stated emphatically to others in the store prior to the incident that she is a DNR.
Therefore nothing should be done and we should continue our shopping?

ramage wrote: Please correct this scenario, if I am misstating your posting.

HA is found to have collapsed in the supermarket and is unconscious. It was not witnessed. She is without a pulse. She has stated emphatically to others in the store prior to the incident that she is a DNR.
Therefore nothing should be done and we should continue our shopping?

Couple of things.....from my POV *CORRECT ME IF i AM IN ERROR.....

!. THE SUPERMARKET might be liable if they were notified and did not call 911.
2. I wear a DNR/DNI necklace at all times when out,it has a HUGE silver heart attached to the alert. IF I understand protocol ,anyone who would attempt CPR checks for medical alerts first. They would see the HUGE HEART AND THE ALERT. if i UNDERSTAND CORRECTLY,THE EMT'S WOULD TRANSPORT.if
i had NO PULSE, TOD would be declared at hospital by emer doc.
3. CAVEAT.....here in this rural,not too progressive town of Montrose, I have had EMT'S tell me their
protocol is STABILIZE AND TRANSPORT (even if there is a DNR)...i have an old college friend who was
an EMT for decades and is now teaching...he is afraid to retire because he KNOWS protocol will not be followed and THE ABOVE IS NOT PROTCOL (if DNR MED ALERT PRESENT)

1. The supermarket is immediately notified and calls 911.
2. While I was checking your carotid artery for a pulse I saw the necklace and backed away.
3. While waiting I receive a call from the ER telling me that EMT's are on their way. (I happen to be the on-call MD for Emergency Services. Here in the mountains response times are difficult to determine.
4. In order to stabilize they have to resuscitate and transport you they have to defibrillate and do chest compressions. Is that OK with you?
5. Well, to cut to the quick, I recognized pulslessness, gave you a sharp blow to the sternum and a pulse was recovered. When the EMT showed up, see through paddles show a slow sinus rhythm , responding to atropine, nothing more needed.
6. The next 2-3 yrs of my life are taken up with the lawsuit that you filed for disregarding your DNR order.
By the way you are alive during these next years because a pacemaker was implanted in order to prevent this happening again.