Re: CPR best practices and barriers?
"Best practice' is always up for debate.
It appears that the studies and field experince are leaning towards CCR (cardio cerbral rescucitation, but sometimes referred to as continuous compression rescucitation). AHA and ARC are starting to come around and incorporate many of the CCR principles that have already been discussed, but it will probably be a few years before they get to full CCR. As jhayes noted, things like rescue breathing and pulse checks have tended to cause problems for lay responders. When implementing full CCR however, even for ALS responders, it is compression only for the first couple minutes, O2 via non-rebreather, and no pulse check after the first defib-just more compressions. Then you start considering things like an advanced airway or ACLS meds.
Regardless, even though CCR is helping to improve the outcomes, it is still a low-percentage game. Given his background, I suspect jhayes' experience is primarily due to dealing with patients who are PNB secondary to trauma, in which case the outcome is always the same. There is zero chance of rescuscusitating a traumatic PNB. In a wilderness/backwoods setting that is something to consider before using valuable energy and/or resources in a rescusitation attempt.
When in doubt, start pumping....
"Pleasure ?" I said. "I don't understand the question."
I didn't do it for pleasure. I did it for pain.