How can we administer high-quality chest compressions to a cardiac arrest patient on a bed?

Rate of survival without any neurological consequence after cardiac arrest is driven not only by early recognition but also by high-quality cardiopulmonary resuscitation. Because the effectiveness of the manual cardiopulmonary resuscitation is usually impaired by rescuers’ fatigue, devices have been devised to improve it by appliances or ergonomic solutions. However, some devices are thought to replace the manual resuscitation altogether, either mimicking its action or generating hemodynamic effects with working principles which are entirely different. This article reviews such devices, both manual and automatic. They are mainly classified by actuation method, applied force, working space, and positioning time. Most of the trials and meta-analyses have not demonstrated that chest compressions given with automatic devices are more effective than those given manually. However, advances in clinical research and technology, with an improved understanding of the organizational implications of their use, are constantly improving the effectiveness of such devices.

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Neo Automatic Code (NAC) To Improve Return Of Spontaneus Circulation (ROSC) In Hospital Cardiac Arrest (IHCA) Patients

JENDELA NURSING JOURNAL ◽

10.31983/jnj.v5i1.6911 ◽

2021 ◽

Vol 5 (1) ◽

pp. 10-15

Author(s):

Rendi Editya Darmawan ◽

Untung Sujianto ◽

Nana Rochana

Keyword(s):

Cardiac Arrest ◽

Sampling Technique ◽

Control Group ◽

P Value ◽

Chest Compressions ◽

High Quality ◽

Post Test ◽

Quasi Experimental ◽

Automatic Code ◽

Hospital Cardiac Arrest

Background: a higher rate of recommended chest compression is needed for neo automatic code (NAC)-guided cardiopulmonary resuscitations (CPR) to obtain high-quality chest compressions. High-quality chest compressions could improve ROSC. Purpose: the study aim to analyze the effects of CPR using NAC on the ROSC in-hospital cardiac arrest in Indonesia. Methods: this study used a quantitative, post-test quasi-experimental design with a control group. The samples were 74 cardiac arrest patients in two hospitals in Surakarta and Klaten, Indonesia, who were selected using a purposive sampling technique. The data were analyzed by the Mann-Whitney test. Results: the incidence of ROSC in the control group was 30%, and in the treatment group was 35%. The result of statistical analysis showed that there were differences in the ROSC in the intervention and control group with a p-value of 0.003. Conclusion: NAC assisted cardiopulmonary resuscitations increased ROSC. It is recommended that Code Blue Teams should use NAC to improve the quality of chest compressions for the better result of ROSC.

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Cardiopulmonary resuscitation: the science behind the hands

Heart ◽

10.1136/heartjnl-2017-312696 ◽

2018 ◽

Vol 104 (13) ◽

pp. 1056-1061 ◽

Cited By ~ 7

Author(s):

Andrew W Harris ◽

Peter J Kudenchuk

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Sudden Cardiac Arrest ◽

Heart Association ◽

Scientific Basis ◽

Chest Compressions ◽

High Quality ◽

Physiological Basis ◽

Successful Resuscitation ◽

External Chest Compressions

Sudden cardiac arrest is a leading cause of death worldwide. Despite significant advances in resuscitation science since the initial use of external chest compressions in humans nearly 60 years ago, there continues to be wide variability in rates of successful resuscitation across communities. The American Heart Association (AHA) and European Resuscitation Council emphasise the importance of high-quality chest compressions as the foundation of resuscitation care. We review the physiological basis for the association between chest compression quality and clinical outcomes and the scientific basis for the AHA’s key metrics for high-quality cardiopulmonary resuscitation. Finally, we highlight that implementation of strategies that promote effective chest compressions can improve outcomes in all patients with cardiac arrest.

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Smartwatch feedback device for high-quality chest compressions by a single rescuer during infant cardiac arrest

European Journal of Emergency Medicine ◽

10.1097/mej.0000000000000537 ◽

2019 ◽

Vol 26 (4) ◽

pp. 266-271 ◽

Cited By ~ 5

Author(s):

Juncheol Lee ◽

Yeongtak Song ◽

Jaehoon Oh ◽

Youngjoon Chee ◽

Chiwon Ahn ◽

...

Keyword(s):

Cardiac Arrest ◽

Chest Compressions ◽

High Quality

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Military application of mechanical CPR devices: a pressing requirement?

Journal of the Royal Army Medical Corps ◽

10.1136/jramc-2018-000908 ◽

2018 ◽

Vol 164 (6) ◽

pp. 438-441

Author(s):

Iain T Parsons ◽

A T Cox ◽

P S C Rees

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Potential Utility ◽

Operational Environment ◽

Chest Compressions ◽

High Quality ◽

Military Application ◽

The Military ◽

Mechanical Cpr

Maintaining high-quality chest compressions during cardiopulmonary resuscitation following cardiac arrest presents a challenge. The currently available mechanical CPR (mCPR) devices are described in this review, coupled with an analysis of the evidence pertaining to their efficacy. Overall, mCPR appears to be at least equivalent to high-quality manual CPR in large trials. There is potential utility for mCPR devices in the military context to ensure uninterrupted quality CPR following a medical cardiac arrest. Particular utility may be in a prohibitive operational environment, where manpower is limited or where timelines to definitive care are stretched resulting in a requirement for prolonged resuscitation. mCPR can also act as a bridge to advanced endovascular resuscitation techniques should they become more mainstream therapy.

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Cardiac arrest

Challenging Concepts in Paediatric Critical Care ◽

10.1093/med/9780198794592.003.0004 ◽

2020 ◽

pp. 43-54

Author(s):

Andrew J. Lautz ◽

Ryan W. Morgan ◽

Vinay M. Nadkarni

Keyword(s):

Blood Pressure ◽

Cardiac Arrest ◽

Chest Compression ◽

Blood Pressure Monitoring ◽

Temperature Management ◽

Chest Compressions ◽

High Quality ◽

Arterial Blood ◽

Paediatric Cardiac Arrest ◽

End Tidal

High-quality cardiopulmonary resuscitation (CPR) with targeted post-arrest management have resulted in dramatic improvements in survival with favourable neurological outcome from in-hospital paediatric cardiac arrest over the past two decades. High-quality CPR focuses on five key components: (1) chest compression depth of at least one-third of the anterior–posterior chest diameter; (2) chest compression rate between 100 and 120 compressions per minute; (3) limitation of interruptions in chest compressions; (4) full chest recoil between compressions; and (5) avoidance of overventilation. Quantitative capnography with a target end-tidal CO2 of at least 20 mmHg and invasive arterial blood pressure monitoring targeting a diastolic blood pressure of at least 25 mmHg in infants and 30 mmHg in children during chest compressions are promising markers of effective CPR. Post-arrest management should target normoxia, normocarbia, normotension for age, and normoglycaemia with active targeted temperature management to prevent hyperthermia and surveillance for and aggressive treatment of seizures.

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