The suprasternal notch as a landmark of chest compression depth in CPR

2016 ◽  
Vol 34 (3) ◽  
pp. 433-436 ◽  
Author(s):  
Tae Hu Kim ◽  
Soo Hoon Lee ◽  
Dong Hoon Kim ◽  
Ryun Kyung Lee ◽  
So Yeon Kim ◽  
...  
Author(s):  
Dongjun Yang ◽  
Wongyu Lee ◽  
Jehyeok Oh

Although the use of audio feedback with devices such as metronomes during cardiopulmonary resuscitation (CPR) is a simple method for improving CPR quality, its effect on the quality of pediatric CPR has not been adequately evaluated. In this study, 64 healthcare providers performed CPR (with one- and two-handed chest compression (OHCC and THCC, respectively)) on a pediatric resuscitation manikin (Resusci Junior QCPR), with and without audio feedback using a metronome (110 beats/min). CPR was performed on the floor, with a compression-to-ventilation ratio of 30:2. For both OHCC and THCC, the rate of achievement of an adequate compression rate during CPR was significantly higher when performed with metronome feedback than that without metronome feedback (CPR with vs. without feedback: 100.0% (99.0, 100.0) vs. 94.0% (69.0, 99.0), p < 0.001, for OHCC, and 100.0% (98.5, 100.0) vs. 91.0% (34.5, 98.5), p < 0.001, for THCC). However, the rate of achievement of adequate compression depth during the CPR performed was significantly higher without metronome feedback than that with metronome feedback (CPR with vs. without feedback: 95.0% (23.5, 99.5) vs. 98.5% (77.5, 100.0), p = 0.004, for OHCC, and 99.0% (95.5, 100.0) vs. 100.0% (99.0, 100.0), p = 0.003, for THCC). Although metronome feedback during pediatric CPR could increase the rate of achievement of adequate compression rates, it could cause decreased compression depth.


Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 846
Author(s):  
Liang Zhao ◽  
Yu Bao ◽  
Yu Zhang ◽  
Ruidong Ye ◽  
Aijuan Zhang

When the displacement of an object is evaluated using sensor data, its movement back to the starting point can be used to correct the measurement error of the sensor. In medicine, the movements of chest compressions also involve a reciprocating movement back to the starting point. The traditional method of evaluating the effects of chest compression depth (CCD) is to use an acceleration sensor or gyroscope to obtain chest compression movement data; from these data, the displacement value can be calculated and the CCD effect evaluated. However, this evaluation procedure suffers from sensor errors and environmental interference, limiting its applicability. Our objective is to reduce the auxiliary computing devices employed for CCD effectiveness evaluation and improve the accuracy of the evaluation results. To this end, we propose a one-dimensional convolutional neural network (1D-CNN) classification method. First, we use the chest compression evaluation criterion to classify the pre-collected sensor signal data, from which the proposed 1D-CNN model learns classification features. After training, the model is used to classify and evaluate sensor signal data instead of distance measurements; this effectively avoids the influence of pressure occlusion and electromagnetic waves. We collect and label 937 valid CCD results from an emergency care simulator. In addition, the proposed 1D-CNN structure is experimentally evaluated and compared against other CNN models and support vector machines. The results show that after sufficient training, the proposed 1D-CNN model can recognize the CCD results with an accuracy rate of more than 95%. The execution time suggests that the model balances accuracy and hardware requirements and can be embedded in portable devices.


2012 ◽  
Vol 29 ◽  
pp. 190 ◽  
Author(s):  
P. Schober ◽  
R. Krage ◽  
V. Lagerburg ◽  
D. van Groeningen ◽  
S. A. Loer ◽  
...  

Resuscitation ◽  
2015 ◽  
Vol 96 ◽  
pp. 13
Author(s):  
Digna María González-Otero ◽  
Sofía Ruiz de Gauna ◽  
Jesús Ruiz ◽  
Beatriz Chicote ◽  
Raquel Rivero ◽  
...  

2021 ◽  
Author(s):  
Matthias Ott ◽  
Alexander Krohn ◽  
Laurence H. Bilfield ◽  
F. Dengler ◽  
C. Jaki ◽  
...  

AbstractObjectiveTo evaluate leg-heel chest compression without previous training as an alternative for medical professionals and its effects on distance to potential aerosol spread during chest compression.Methods20 medical professionals performed standard manual chest compression followed by leg-heel chest compression after a brief instruction on a manikin. We compared percentage of correct chest compression position, percentage of full chest recoil, percentage of correct compression depth, average compression depth, percentage of correct compression rate and average compression rate between both methods. In a second approach, potential aerosol spread during chest compression was visualized.ResultsThere was no significant difference between manual and leg-heel compression. The distance to potential aerosol spread could have been increased by leg-heel method.ConclusionUnder special circumstances like COVID-19-pandemic, leg-heel chest compression may be an effective alternative without previous training compared to manual chest compression while markedly increasing the distance to the patient.


Author(s):  
Anna Vögele ◽  
Michiel Jan van Veelen ◽  
Tomas Dal Cappello ◽  
Marika Falla ◽  
Giada Nicoletto ◽  
...  

Background Helicopter emergency medical services personnel operating in mountainous terrain are frequently exposed to rapid ascents and provide cardiopulmonary resuscitation (CPR) in the field. The aim of the present trial was to investigate the quality of chest compression only (CCO)‐CPR after acute exposure to altitude under repeatable and standardized conditions. Methods and Results Forty‐eight helicopter emergency medical services personnel were divided into 12 groups of 4 participants; each group was assigned to perform 5 minutes of CCO‐CPR on manikins at 2 of 3 altitudes in a randomized controlled single‐blind crossover design (200, 3000, and 5000 m) in a hypobaric chamber. Physiological parameters were continuously monitored; participants rated their performance and effort on visual analog scales. Generalized estimating equations were performed for variables of CPR quality (depth, rate, recoil, and effective chest compressions) and effects of time, altitude, carryover, altitude sequence, sex, qualification, weight, preacclimatization, and interactions were analyzed. Our trial showed a time‐dependent decrease in chest compression depth ( P =0.036) after 20 minutes at altitude; chest compression depth was below the recommended minimum of 50 mm after 60 to 90 seconds (49 [95% CI, 46–52] mm) of CCO‐CPR. Conclusions This trial showed a time‐dependent decrease in CCO‐CPR quality provided by helicopter emergency medical services personnel during acute exposure to altitude, which was not perceived by the providers. Our findings suggest a reevaluation of the CPR guidelines for providers practicing at altitudes of 3000 m and higher. Mechanical CPR devices could be of help in overcoming CCO‐CPR quality decrease in helicopter emergency medical services missions. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04138446.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Simone Ordelman ◽  
Paul Aelen ◽  
Paul van Berkom ◽  
Gerrit J Noordergraaf

Introduction: Compression-induced ventilation may aid gas exchange during CPR. We hypothesized that the amount of gas moving in and out of the lungs depends on chest compression depth. Methods: VF was induced in five female, anesthetized and intubated pigs of about 30 kg. After 30 seconds of non-intervention time, chest compressions were started and maintained at a rate of 100 compressions per minute. Every two minutes chest compression depth was altered, resulting in 14 minutes of CPR with a depth sequence of 4 cm, 3 cm, 4 cm, 5 cm, 5.5 cm, 5 cm and 4 cm. Ventilations were performed manually with a bag-valve device 10 times per minute during continuous chest compressions by a dedicated expert. Airway flow was measured at the end of the endotracheal tube. Compression-induced ventilation was determined from the periods between the manual ventilations. The average compression-induced minute ventilation volume was determined over the last minute of each two minute period of CPR at each specific chest compression depth. Results: The compression-induced ventilation volume in the first period of CPR at 4 cm of depth was 1.6 ± 0.9 L/min (about 4% of total ventilation volume). The figure shows how the compression-induced ventilation volume decreases with increasing chest compression depth, relative to this initial value. CPR with a chest compression depth of 4 cm was performed three times in each pig, and the corresponding compression-induced ventilation volumes decreased with time. This suggested that there might be just a time effect (e.g. atelectasis). However, the final compression depth of 4 cm resulted in larger compression-induced ventilation volumes than the preceding 5 cm and 5.5 cm compression depths, indicating that the decreased volume over time could not purely be a time effect, but must also be an effect of the depth. Conclusion: In conclusion, compression-induced ventilation volume appears to decrease with deeper chest compressions as well as with prolonged CPR.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Katrine Bjørnshave ◽  
Lise Q Krogh ◽  
Svend B Hansen ◽  
Mette A Nebsbjerg ◽  
Troels Thim ◽  
...  

Introduction: The ability of laypersons to perform BLS/AED increases immediately after resuscitation training. Studies indicate that resuscitation skills rapidly decay after initial training, however it is unknown whether teaching technique influence retention of skill. Aim: To study the retention of BLS/AED skills three months after training when teaching laypersons using a four-stage and two-stage teaching technique. Methods: Laypersons (exclusion: health care professionals/students) were randomized to a standardized ERC BLS/AED courses using the four-stage teaching technique or to courses with the same content but modified to a two-stage teaching technique. Participants were tested in a simulated cardiac arrest scenario three months (±five days) after their course to assess retention of BLS/AED. Tests were video recorded and reviewed by two independent assessors blinded to training technique. Skills were assessed using the ERC BLS/AED assessment form. The primary endpoint was passing the test (17 out of 17 skills adequately performed). Results: A total of 160 participants were included in the study. No difference was found in pass rate immediately after training (diff. -1.6%; 95%CI -17.9%; 14.6%). There was no statistical difference in retention of BLS/AED skills (pass rate: both 11%, diff. -0.4%; 95%CI -28%-27%) three months after training . Total average skills adequately performed (of 17) were 13.7 versus 13.3 among laypersons trained with the four-stage (n=64) and the two-stage technique (n=64). No difference was found in number of chest compressions delivered per compression cycle (29±2.8 vs 30±3.1), chest compression rate (107±17 vs 108±19 minute-1), chest compression depth (46±11 vs 43±12 mm), number of effective rescue breaths between compression cycles (1.6±0.7 vs 1.6±0.5) and tidal volume (0.6±0.4 0.7±0.4 L). Conclusion: We found no difference in retention of BLS/AED skills among laypersons taught using a four-stage teaching technique compared to a two-stage teaching technique.


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