Hover - Shock - CPR
What does hover mean to you?
Do not touch the patient, hover over the chest to quickly start CPR if needed.
In AED mode the LP15 just completed the analyze phase. The monitor states to start compression's and a 17 second count down begins. What will happen when the count down reaches zero
The monitor will announce to SHOCK the patient. Announce hover and deliver the shock.
BLS providers, knowing there is a shock coming, there should have zero delay in the shock sequence. Have our finger over the shock button - Announce hover and immediately shock then immediately go bac to CPRP
Have your count down to hover be a second behind the AED count down. If you push shock a millisecond to soon it will not deliver the shock
You have put on the Combi-pads and have pre-charged the monitor. Hover is called but there is no rhythm on the screen. What did you forget to do?
Put the LP15 in paddle mode.
As the shock was delivered you felt the muscles twitch and you believe you were just shocked. Who is to blame for this happening?
You. :)
It is your responsibility to come off the patient when hover is announced.
AHA states these three things increase survival rates in cardiac arrests
Good quality CPR
Time to first shock delivery
Time to first Epi administration
Both BLS and ALS - When arriving on scene and finding a person with not pulse your next priority is to the first shock/no shock sequence. EMT's, as soon as the pads on, call out hover and and push analyze. Medics, as soon as the pads are on, complete your pre-charge and call out hover.
When hover is announced by the lead provider what should your response be?
Hands off patient, hover over chest.
The LP15 in AED mode has just finished analyzing the rhythm and states, "No shock advised, start CPR" what do you do?
Check for a pulse. This is the one time you need to be smarter than the AED.
On the very first rhythm check you may go straight to CPR.
I know of two ways do get the LP15 out of AED mode into Medic mode. Can you name two of them or show me a new way?:
Press the increase/decrease energy button
Press the charge button
Press the lead button twice sometimes works but randomly some of our monitors switch back into AED mode. WEIRD
The lead provider called hover and delivered a shock that you felt. What did you forget to do?
Hover.
Your patient is a 7 month old female in cardiac arrest. What size pads do you use for the LP15 in AED mode.
Adult
ALS providers may need to change pads to deliver the proper joules.
You arrive on a CPR call with only BLS providers on scene. When you make contact with the lead EMT he states "stand by for a second, it is time for me to push analyze". What do you do?
Do not let him push analyze. Hands have to come off the chest for a longer period of time for the monitor to analyze.
Take over the monitor and complete the Shock/No Shock sequence. Then get the story from your lead EMT.
Everyone else in the CPR line stays on the pulse when hover is called, what do you do when hover is called.
Hover
Does the femoral pulse confirm that good quality CPR is being done.
Nope
Long story short, that position was created to keep the next person in line for CPR from leaving to do another task.
Explain the reasoning why we are stressing all hands come off the patient when hover is called.
HPCPR resuscitation academy stresses that when compressions are stopped the coronary artery pressures fall immediately. Any delay in giving the shock will decrease the chance that you will convert into a perfusing rhythm.
Our muscle memory must be to come off the patient when hover is called. With each passing moment the likelihood the the heart will convert back into a perfusing rhythm decreases.
If you are the lead provider running the call and you announce hover, what do you expect the crew should do.
Hover
These three things are what the AHA states will confirm good quality CPR
Depth
Recoil
Rate
***The AHA states there is no correlation between a good femoral pulse and good quality CPR.
There are some reasons to give one on one directions to the person who is on a pulse to stay on that pulse when hover is called. Can you name at least two of them.
You have a jump in your ETCO2
You notice a rhythm change under your CPR compressions
Your PEA went from a wide complex to a narrow complex.
You have a color change in your patient.