Verification of changes in the time taken to initiate chest compressions according to modified basic life support guidelines

IntroductionIn conventional basic life support (c-BLS), a lone rescuer is recommended to start chest compressions (CCs) after activating the emergency medical system. To initiate earlier CCs in lone-rescuer BLS, we designed a modified BLS (m-BLS) sequence in which the lone rescuer commences one-handed CCs while calling for help using a handheld cellular phone with the other free hand. This study aimed to compare the quality of BLS between c-BLS and m-BLS.MethodsThis was a simulation study performed with a randomised cross-over controlled trial design. A total of 108 university students were finally enrolled. After training for both c-BLS and m-BLS, participants performed a 3-minute c-BLS or m-BLS on a manikin with a SkillReporter at random cross-over order. The paired mean difference with SE between c-BLS and m-BLS was assessed using paired t-test.ResultsThe m-BLS had reduced lag time before the initiation of CCs (with a mean estimated paired difference (SE) of −35.0 (90.4) s) (p<0.001). For CC, a significant increase in compression fraction and a higher number of CCs with correct depth were observed in m-BLS (with a mean estimated paired difference (SE) of 16.2% (0.6) and 26.9% (3.3), respectively) (all p<0.001). However, no significant paired difference was observed in the hand position, compression rate and interruption time. For ventilation, the mean tidal volumes did not differ. However, the number of breaths with correct tidal volume was higher in m-BLS than in c-BLS.ConclusionIn simulated lone-rescuer BLS, the m-BLS could deliver significantly earlier CCs than the c-BLS while maintaining high-quality cardiopulmonary resuscitation.

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BASIC LIFE SUPPORT GUIDELINES (OUT OF HOSPITAL)

Nursing & Health Survival Guide: Cardiopulmonary Resuscitation ◽

10.4324/9781315848167-5 ◽

2018 ◽

pp. 8-16

Keyword(s):

Basic Life Support ◽

Life Support ◽

Support Guidelines

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CPR Compression Rotation Every One Minute Versus Two Minutes: A Randomized Cross-Over Manikin Study

Emergency Medicine International ◽

10.1155/2020/5479209 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Nutthapong Pechaksorn ◽

Veerapong Vattanavanit

Keyword(s):

Heart Rate ◽

Respiratory Rate ◽

Chest Compression ◽

Life Support ◽

Chest Compressions ◽

Compression Depth ◽

End Points ◽

The One ◽

Support Guidelines

Background. The current basic life support guidelines recommend two-minute shifts for providing chest compressions when two rescuers are performing cardiopulmonary resuscitation. However, various studies have found that rescuer fatigue can occur within one minute, coupled with a decay in the quality of chest compressions. Our aim was to compare chest compression quality metrics and rescuer fatigue between alternating rescuers in performing one- and two-minute chest compressions. Methods. This prospective randomized cross-over study was conducted at Songklanagarind Hospital, Hat Yai, Songkhla, Thailand. We enrolled sixth-year medical students and residents and randomly grouped them into pairs to perform 8 minutes of chest compression, utilizing both the one-minute and two-minute scenarios on a manikin. The primary end points were chest compression depth and rate. The secondary end points included rescuers’ fatigue, respiratory rate, and heart rate. Results. One hundred four participants were recruited. Compared with participants in the two-minute group, participants in the one-minute group had significantly higher mean (standard deviation, SD) compression depth (mm) (45.8 (7.2) vs. 44.5 (7.1), P=0.01) but there was no difference in the mean (SD) rate (compressions per min) (116.1 (12.5) vs. 117.8 (12.4), P=0.08), respectively. The rescuers in the one-minute group had significantly less fatigue (P<0.001) and change in respiratory rate (P<0.001), but there was no difference in the change of heart rate (P=0.59) between the two groups. Conclusion. There were a significantly higher compression depth and lower rescuer fatigue in the 1-minute chest compression group compared with the 2-minute group. This trial is registered with TCTR20170823001.

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Response to basic life support by lay rescuers: Reporting complications caused by unnecessary chest compressions

Resuscitation ◽

10.1016/j.resuscitation.2006.10.010 ◽

2007 ◽

Vol 72 (3) ◽

pp. 498-499

Author(s):

Jerry Nolan

Keyword(s):

Basic Life Support ◽

Life Support ◽

Chest Compressions

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Quality of chest compressions during 10min of single-rescuer basic life support with different compression: ventilation ratios in a manikin model

Resuscitation ◽

10.1016/j.resuscitation.2007.11.009 ◽

2008 ◽

Vol 77 (1) ◽

pp. 95-100 ◽

Cited By ~ 37

Author(s):

Conrad Arnfinn Bjørshol ◽

Eldar Søreide ◽

Tor Harald Torsteinbø ◽

Kristian Lexow ◽

Odd Bjarte Nilsen ◽

...

Keyword(s):

Basic Life Support ◽

Life Support ◽

Chest Compressions

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A comparison of manikin CPR performance by lay persons trained in three variations of basic life support guidelines

Resuscitation ◽

10.1016/s0300-9572(00)00186-6 ◽

2000 ◽

Vol 45 (3) ◽

pp. 195-199 ◽

Cited By ~ 39

Author(s):

Peter Donnelly ◽

David Assar ◽

Carolyn Lester

Keyword(s):

Basic Life Support ◽

Life Support ◽

Lay Persons ◽

Support Guidelines

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Efficacy of Chest Compressions Directed by End‐Tidal CO 2 Feedback in a Pediatric Resuscitation Model of Basic Life Support

Journal of the American Heart Association ◽

10.1161/jaha.113.000450 ◽

2014 ◽

Vol 3 (2) ◽

Cited By ~ 50

Author(s):

Jennifer L. Hamrick ◽

Justin T. Hamrick ◽

Jennifer K. Lee ◽

Benjamin H. Lee ◽

Raymond C. Koehler ◽

...

Keyword(s):

Basic Life Support ◽

Life Support ◽

Chest Compressions ◽

Pediatric Resuscitation ◽

End Tidal

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Is Mouth-to-mouth Ventilation Effective in Lifeguards?Comparing the Effects between 30:2 Algorithm Versus Hands-only. A Simulation Study

10.22514/sv.2020.16.0062 ◽

2020 ◽

Cited By ~ 1

Keyword(s):

Basic Life Support ◽

Life Support ◽

Duty Of Care ◽

Chest Compressions ◽

High Quality ◽

Clinical Simulation ◽

Extensive Training ◽

Specific Objective ◽

Quasi Experimental ◽

The Mean

Aim: Compare which resuscitation (for cardiac arrest scenario) has a higher quality when first responders with a duty of care are deprived of material: a standard resuscitation algorithm or a hands-only one when performed by lifeguards, who have had extensive training on mouth-to-mouth ventilation. Besides, a more specific objective was the analysis of the characteristics of these mouth-to-mouth ventilation. Methods: We conducted a prospective quasi-experimental crossover manikin study with clinical simulation with 41 lifeguards attached to the Plan of Surveillance and Rescue in Beaches. Each participant performed 2 minutes of basic life support (CPRb). Afterward, each participant performed 2 minutes of CPR with hands-only (CPRho). The data collection was carried out with a CPR calibrated Mannequin. Results: The mean depth was 48.05± 8.99 mm for CPRb, and 44.76 ± 9.73 mm for CPRho (t = 5.81, p < 0.001, 95% CI, 2.15 - 4.44), the rate was 123 ± 16.11 compressions/min for CPRb and 120 ± 17.89 for CPRho. The CPRho achieved a mean of 46 ± 42.6 complete chest recoil, versus 35 ± 35.19 for CPRb (z = -2.625, p = 0.009). 20.74% of ventilation were hypoventilation and 42.72% were hyperventilation. Conclusions: Mouth-to-mouth ventilation performed by lifeguards (without devices) was not effective. When ventilations were not performed, the number of high-quality compressions increased in absolute values. The mean depth of chest compressions was higher in the CPRho. Most of the participants did not perform the ventilations correctly, which resulted in time without compression and ventilation. The number of chest compressions with complete chest recoil was higher in CPRho. When ventilations were not performed, the number of high-quality compressions increased in absolute values.

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