CPR is an intervention within the BLS (Basic Life Support) scope of practice. When you are taking a "CPR" class you are actually taking a BLS class. BLS training or "class", is a more accurate definition then "CPR class". When taking a BLS course there are other skills in the class that are taught other then CPR. The class includes rescue breathing, using the AED, recovery positions as well as other skills. One of the most critical skills in the BLS programs is patient assessment.
Before an intervention can be applied to a patient in a situation, there must first be an accurate assessment of the condition. This is very important to understand, and it is the responsibility of the instructor to address this area in detail. If an accurate assessment isn't done prior to application of a skill, then it is very possible that the BLS provider can be going down the wrong road. It is not enough to just do CPR on someone who is unconscious. It may very well be the wrong thing to do. Many victims experience having low blood sugar, or have taken an excess amount of medication causing their level of consciousness to be very decreased.
If these people are still breathing, CPR is NOT what they need. In many cases they simply need to be put on their side in the recovery position, and someone needs to call for EMS. To do CPR on a person who doesn't need it can be fatal. 5-10 minutes of chest compressions on an 80 year old diabetic female who weighs about 90 lbs, (when it wasn't needed) does more harm then good. She will be very lucky to survive that kind of trauma.
Problems with the care that is given to a patient almost always occur from an inaccurate assessment. In regards to BLS, if an assessment is complete, the treatment needed really "jumps" out at you and is not something that you have to figure out. New BLS providers who struggle with which skill to apply in a scenario do so because either they have not done a correct assessment or they do not understand what their assessment findings mean.
Remember that patient assessment is a skill in itself. Master the patient assessment skill, and the other BLS skills will always be applied appropriately.
M.Morales EMT-Paramedic
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