Elective in CPR Instruction

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Elective in CPR Instruction

• Sam Keim, MD
• Emergency Medicine
• University of Arizona College of Medicine

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Why should we care?

• 700,000 cardiac arrests per year
• 250,000 die
• Survival to hospital discharge neurologically
  intact 3 - 8
• Substantial variation among
• different geographical locations and
• initial cardiac rhythms
• bystander CPR or not

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Who survives Cardiac Arrest?

• Some things we know.
• Majority Do NOT have Myocardial Infarct
• Ventricular Fibrillation is most common and best
  initiating rhythm
• Bystander CPR by a witness is crucial to survival
• Citizens who witness frequently do NOT provide CPR

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Who Survives Cardiac Arrest?Some things we
know...continued

• Most occur at home without a witnessing bystander
  who knows CPR (bummer..)
• Continuous Chest Compressions is a good thing
• Early Defibrillation is the most crucial link in
  the chain of survival
• Survival of 59 in VF (Valenzuela, Casino)
• Pretty much worthless if NO CPR was given
• Can be given by an AED by a 6th grader

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The Bottom line

• Citizens must learn CPR and how to activate 911
• Rapid Defibrillation must occur
• Advanced Cardiac Life Support must reach the
  patient relatively soon

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How can we do it

• Chain of Survival
• Early Access
• Bystander CPR
• Early Defibrillation
• Early ALS
• ECC - Emergency Cardiovascular Care
• Training Pyramid

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How can we do it

• Armed Services support, Biomedical, Citizen
  health and safety, disaster relief, international
  relief
• Courses
• CPR-AED
• First-Aid
• Sport injuries
• Workplace First-aid

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How can we do itSarver Heart Center

• Cardiocerebral Resuscitation
• Continuous Chest Compression
• Developed here
• Extremely important advance
• YOU can learn from source

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Gordon Ewy, MD

• Cardiac arrestGuideline changes urgently needed
  Gordon A Ewy. The Lancet, Volume 369, Issue
  9565, 17 March 2007-23 March 2007, Pages 882-884

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Elective in CPR-GOALS

• Become certified as CPR Instructor
• Teach CPR
• Learn the science behind and in front of current
  CPR strategies
• Learn about the educational issues
• Learn about the Ethical dilemmas
• Do something good for your community

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Elective in CPR

• EMed 816J part I and part II
• Part I years 1 and 2
• Part II years 3 and 4
• Final Grade - P/F

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EMED 816J Part 1 Objectives

• Become a CPR certified instructor
• Learn to teach CCC-CPR
• Teach CPR (2 course credits)
• Each half-day CPR course 1 credit
• Each CCC-CPR course 1 credit
• Attend or view Didactic Sessions
• Complete Critical Appraisal exercise (1)
• Take Part 1 final exam

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EMED 816J Part 1Objectives

• Become a CPR Instructor
• American Heart Association
• American Red Cross
• Teach CPR (2 credits) ARC/AHA
• Multiple sites throughout state
• 1 4 hour class session 1 CPR Credit

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EMED 816J Part 1Objectives

• Teach Continuous Chest Compression (CCC-CPR)
• Sarver-DuVal Auditorium and elective-organized
  sessions, one-hour sessions 1 credit each
• Log your teaching sessions on web check your
  progress at
• http//www.emergencymed.arizona.edu/cpr/

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EMED 816J Part 1Objectives

• Attend or View Didactic Sessions
• http//www.emergencymed.arizona.edu/cpr/
• 4 5 year
• Critical Appraisal exercise
• Final exam online (70 pass)
• Online journal club
• Read and critically appraise CPR and CCC-CPR
  scientific articles

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EMED 816J Part 2 Objectives

• Teach CPR and CCC-CPR
• 8 total credits
• Each half-day CPR course 1 credit
• Each CCC-CPR course 1 credit
• Complete Critical Appraisal exercises (2)
• Take Part 2 final exam