Good quality compressions and early defibrillation could lead to clear recovery with the only issue being a displaced rib fx?
Good compressions are often rough on the rib cage and fractures are exceedingly common(I believe almost 75%), lung damage can follow as circle bones often break in multiple places and are sharp. However no one is upset about broken ribs though sitting in a hospital bed recovering.
Much of the “better outcomes” from what I have read is based upon Joe Dirt actually doing it because of the simplification. One of the most successful programs I’ve heard about is in, of all place’s(given this event), Cincinnati
We have had resuscitations started by bystanders who took a CPR course, and had a life returned. I’ve done CPR on a person in an unshockable rhythm only to have the rhythm convert and deliver a shock. Unshockable now does not always translate to unshockable forever, good compressions buys time for ALS arrival with other options to impact surviveability.
The biggest advice I can give is keep pushing on the chest and allow it to fully rebound. Allowing the chest to fully rebound and not “lean” on the chest allows good veinous return to the heart from the brain allowing oxygen rich arterial blood to return and keep the most important organ oxygenated to allow full recovery potential. Hollywood has trained a global market how to do poor quality t-Rex elbow bend cpr.
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If it can be done in rural New England with 25-30 minute trips via ambulance to the hospital, outcomes can be dramatically improved in cities.
The poster child for this is King County
in Washington state, they consistently score extremely high in recovery percentages.
Early call to efficient 911 systems, with good bystander cpr, to high compression fraction BLS to fast ALS response is the golden ticket. However in nearly 100% of the cases if the first parts of 911 notification and compression are not started is death. Push the chest save a life.