scholarly journals (A153) Analysis of Chest Compressions: Measured Using the Quality Compression Index and Performance Disparities among Demographic Characteristics

2011 ◽  
Vol 26 (S1) ◽  
pp. s43-s44
Author(s):  
J.H. Schwab ◽  
A.L. Williams ◽  
M.L. Birnbaum ◽  
Z.T. Emberts ◽  
P.D. Padjen ◽  
...  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Healthcare Providers ◽  
Hand Position ◽  
Compression Index ◽  
Chest Compressions ◽  
Male Sex ◽  
And Performance ◽  
Over Time

IntroductionCardiopulmonary resuscitation (CPR) guidelines throughout the world stress the importance of high quality chest compressions soon after cardiac arrest as the most significant factor in determining survival. Little evidence exists, internationally, documenting the quality of compressions provided by healthcare providers. In this study investigators sought to determine the quality of chest compressions delivered by rescuers. It was hypothesized that greater variably in compression quality exists between rescuers than variability in individual rescuers over time.MethodsIn this observational pilot study, basic life support (BLS) providers from prehospital and in-hospital settings were invited to participate in the investigation. Ten minutes of continuous chest compressions were recorded on the Resusci Anne and the Laerdal PC Skillreporting System. An adequate compression was defined as a compression with depth > 38mm, full chest recoil, and correct hand position. The Quality Compression Index (QCI) was developed to factor rate into the characteristics of an adequate compression. QCI is a scaled performance index calculated every 30 seconds.ResultsProviders came from a variety of clinical backgrounds, aged 35.5 ± 11.0 years. Of the 103 total participants, 94 (91.3%) completed 10 minutes of compressions. The most significant degradation in the quality of compressions occurred within the first two minutes. There was greater variability between different rescuers than the variability over time. Mean Square Error (MSE) due to subjects was comparatively greater than the MSE due to time (63.2 vs. 7.68). Performance of CPR, male sex, < 45 years of age, and prehospital background, correlated with higher quality. Time since last BLS certification and the number of times a rescuer completed a BLS class did not correlate with the quality.ConclusionsGreater variability in the quality of compressions exists between different rescuers than a rescuer over time. Some participants were not able to deliver ideal compressions from the start, when the effects of fatigue were minimal.

scholarly journals Quality of Chest Compressions Differs over Time between Advanced and Basic Life Support

2015 ◽  
Vol 06 (12) ◽  
pp. 944-953
Author(s):  
Pär Lindblad ◽  
Annika Åström Victorén ◽  
Christer Axelsson ◽  
Bjarne Madsen Härdig
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Chest Compressions ◽  
Over Time

Commencing one-handed chest compressions while activating emergency medical system using a handheld mobile device in lone-rescuer basic life support: a randomised cross-over simulation study

2021 ◽  
pp. emermed-2021-211774
Author(s):  
Sang O Park ◽  
Dong Hyuk Shin ◽  
Changhoon Kim ◽  
Young Hwan Lee
Keyword(s):  
Simulation Study ◽  
Basic Life Support ◽  
Life Support ◽  
Controlled Trial ◽  
Medical System ◽  
Emergency Medical System ◽  
Hand Position ◽  
Chest Compressions ◽  
Paired Difference ◽  
Emergency Medical

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.

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

Resuscitation ◽  
2008 ◽  
Vol 77 (1) ◽  
pp. 95-100 ◽  
Author(s):  
Conrad Arnfinn Bjørshol ◽  
Eldar Søreide ◽  
Tor Harald Torsteinbø ◽  
Kristian Lexow ◽  
Odd Bjarte Nilsen ◽  
...  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Chest Compressions

scholarly journals CPR with restricted patient access using alternative rescuer positions: a randomised cross-over manikin study simulating the CPR scenario after avalanche burial

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Bernd Wallner ◽  
Luca Moroder ◽  
Hannah Salchner ◽  
Peter Mair ◽  
Stefanie Wallner ◽  
...  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Limiting Factor ◽  
Hand Position ◽  
Patient Access ◽  
Compression Depth ◽  
Standard Position ◽  
Manikin Study ◽  
Significant Difference

Abstract Background The aim of this manikin study was to evaluate the quality of cardiopulmonary resuscitation (CPR) with restricted patient access during simulated avalanche rescue using over-the-head and straddle position as compared to standard position. Methods In this prospective, randomised cross-over study, 25 medical students (64% male, mean age 24) performed single-rescuer CPR with restricted patient access in over-the-head and straddle position using mouth-to-mouth ventilation or pocket mask ventilation. Chest compression depth, rate, hand position, recoil, compression/decompression ratio, hands-off times, tidal volume of ventilation and gastric insufflation were compared to CPR with unrestricted patient access in standard position. Results Only 28% of all tidal volumes conformed to the guidelines (400–800 ml), 59% were below 400 ml and 13% were above 800 ml. There was no significant difference in ventilation parameters when comparing standard to atypical rescuer positions. Participants performed sufficient chest compressions depth in 98.1%, a minimum rate in 94.7%, correct compression recoil in 43.8% and correct hand position in 97.3% with no difference between standard and atypical rescuer positions. In 36.9% hands-off times were longer than 9 s. Conclusions Efficacy of CPR from an atypical rescuer position with restricted patient access is comparable to CPR in standard rescuer position. Our data suggest to start basic life-support before complete extrication in order to reduce the duration of untreated cardiac arrest in avalanche rescue. Ventilation quality provided by lay rescuers may be a limiting factor in resuscitation situations where rescue ventilation is considered essential.

scholarly journals (P2-3) Analysis of Chest Compression Rate and Its Affect on the Quality of Chest Compressions

2011 ◽  
Vol 26 (S1) ◽  
pp. s136-s136
Author(s):  
Z.T. Emberts ◽  
J.H. Schwab ◽  
A.L. Williams ◽  
M.L. Birnbaum ◽  
P.D. Padjen ◽  
...  
Keyword(s):  
Life Support ◽  
Survival Rates ◽  
Heart Association ◽  
Hand Position ◽  
Compression Rate ◽  
Chest Compressions ◽  
Support Providers ◽  
Position Data ◽  
Modern Era

BackgroundIn the last 50 years of modern-era cardiopulmonary resuscitation (CPR), survival rates remain dismal, worldwide. International CPR guidelines recommended a compression rate of at least 100 per minute. There is little evidence documenting if and to what extent high compression rates affect the quality of chest compressions.ObjectivesAn objective of this study was to evaluate the effect mean compression rate (MCR) had on the overall quality of chest compressions. Investigators hypothesized that MCRs > 110 would result in a smaller percentage of adequate: compressions (PAC); depth (PAD); and recoil (PAR).MethodsIn this observational pilot study, basic life support providers were recruited from prehospital and in-hospital settings to provide 10 minutes of continuous chest compressions, based on the 2005 American Heart Association guidelines. An adequate compression was defined as a compression that was > 35 mm, had full recoil, and correct hand position. Data were recorded using the Laerdal PC Skill reporting System.ResultsNinety four (91.3%) of 103 participants completed 10 minutes of compressions. Rescuers represented a variety of backgrounds, average age of 35.5 ± 11.0 years. Fifty eight (56.2%) rescuers had performed CPR in the last two years, and 54 (52.4%) practiced prehospital EMS. Providers that did not complete the entire 10 minutes tended to have a higher MCR than those completing 10 minutes, 114.2 ± 19.3 vs. 105.8 ± 15.4 respectively. Within the first two minutes, rescuers with a MCR > 110 delivered 45% of their compressions adequately, compared to 60% when a rescuer's MCR was < 110. This initial disparity was primarily due to decreased PAR, not decreased PAD. After 2 minutes, higher MCRs correlated with decreased PAC, due to decreased PAD.ConclusionsData indicates a higher MCR results in decreased PAC, PAD, and PAR, likely attributed to increased rescuer fatigue.

scholarly journals Basic Life-Support Learning in Undergraduate Students of Sports Sciences: Efficacy of 150 Minutes of Training and Retention after Eight Months

2019 ◽  
Vol 16 (23) ◽  
pp. 4771 ◽  
Author(s):  
Silvia Aranda-García ◽  
Ernesto Herrera-Pedroviejo ◽  
Cristian Abelairas-Gómez
Keyword(s):  
Undergraduate Students ◽  
Basic Life Support ◽  
Life Support ◽  
Training Session ◽  
Skills Training ◽  
Hand Position ◽  
Professional Groups ◽  
Sports Science ◽  
Sports Sciences

Several professional groups, which are not health professionals, are more likely to witness situations requiring basic life support (BLS) due to the nature of their job. The aim of this study was to assess BLS learning after 150 min of training in undergraduate students of sports science and their retention after eight months. Participants trained on BLS (150-min session: 30 theory, 120 practice). After training (T1) and after 8 months (T2), we evaluated their performance of the BLS sequence and two minutes of cardiopulmonary resuscitation (CPR). At T1, the 23 participants presented a mean score of 72.5 ± 21.0% in the quality of the CPRs (compressions: 78.6 ± 25.9%, ventilation: 69.9 ± 30.1%). More than 90% of the participants acted correctly in each step of the BLS sequence. At T2, although the overall quality of the CPR performed did not decrease, significant decreases were observed for: correct hand position (T1: 98.2 ± 8.8, T2: 77.2 ± 39.7%), compression depth (T1: 51.4 ± 7.9, T2: 56.0 ± 5.7 mm), and compression rate. They worsened opening the airway and checking for breathing. In conclusions, participants learned BLS and good-quality CPR after the 150-min training session. At eight months they had good retention of the BLS sequence and CPR skills. Training on airway management and the position of the hands during CPR should be reinforced.

Arguments for ‘ocular donation’ as standardised terminology to reduce the ‘ick factor’ of ‘eye donation’

2022 ◽  
pp. medethics-2021-108003
Author(s):  
Katrina A Bramstedt
Keyword(s):  
Life Support ◽  
Deceased Donor ◽  
Informed Consent Process ◽  
Tissue Donation ◽  
Ocular Tissue ◽  
Corneal Tissue ◽  
Root Cause ◽  
Eye Donation ◽  
Over Time

This brief report presents the global problem of the shortfall of donor corneal tissue for transplantation, a potential root cause (‘ick factor’ language), and a potential solution (modification of ‘ick factor’ language). Specifically, use of the term ‘eye donation’ is a potential hurdle to ocular tissue donation as it can stimulate the ‘ick factor.’ Verbiage such as ‘ocular (eye tissue)’ could be a method of providing terminology that is less emotive than ‘eye donor’ or ‘eye donation.’ The field of transplantation has experienced terminology shifts over time; for example, ‘cadaver’ has been replaced with ‘deceased donor,’ ‘harvest’ has been replaced with ‘recover,’ and ‘life support’ has been replaced with ‘ventilated.’ Notably, only a small number of regions worldwide are using ‘ocular’ terminology, yet it could be an important step to enhancing the informed consent process and improving donation rates, potentially increasing transplant and optimising patient quality of life for those with treatable blindness.

scholarly journals Basic life support providers’ assessment of centre of the chest and inter-nipple line for hand position and their underlying anatomical structures

Resuscitation ◽  
2011 ◽  
Vol 82 (2) ◽  
pp. 190-194 ◽  
Author(s):  
Joyce Yeung ◽  
Thomas Butler ◽  
James W. Digby ◽  
John Hughes ◽  
David Higgie ◽  
...  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Hand Position ◽  
Support Providers ◽  
Anatomical Structures

scholarly journals An alternative method of chest compression from over-the-head during cardiopulmonary resuscitation

2019 ◽  
Author(s):  
Michał Ćwiertnia ◽  
Marek Kawecki ◽  
Tomasz Ilczak ◽  
Monika Mikulska ◽  
Mieczyslaw Dutka ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Artificial Respiration ◽  
Hand Position ◽  
Chest Compressions ◽  
Confined Spaces ◽  
Medical Response ◽  
Emergency Interventions ◽  
The Subject

Abstract Background Maintaining highly effective cardiopulmonary resuscitation (CPR) can be particularly difficult when artificial respiration using a bag-valve-mask device, combined with chest compression have to be carried out by one person. The aim of the study is to compare the quality of CPR conducted by one paramedic using chest compression from the patient’s side, with compression carried out from behind the patient’s head. Methods The subject of the study were two methods of CPR – ‘standard’ (STD) and ‘over-the-head’ (OTH). The STD method consisted of 30 chest compressions from the patient’s side, and two attempts at artificial respiration after moving round to behind the patient’s head. In the OTH method, both compression and respiration were conducted from behind the patient’s head. Results Both CPR methods were conducted by 38 paramedics working in medical response teams. The average time of the interruptions between compression cycles (STD 9.184 s, OTH 7.316 s, p<0.001); the depth of compression 50–60 mm (STD 50.65%, OTH 60.22%, p<0.001); the rate of compression 100–120/min. (STD 46.39%, OTH 53.78%, p<0.001); complete chest wall recoil (STD 84.54%, OTH 91.46%, p<0.001); correct hand position (STD 99.32%, OTH method 99.66%, p<0.001). The remaining parameters showed no significant differences in comparison to reference values. Conclusions The demonstrated higher quality of CPR in the simulated research using the OTH method conducted by one person justifies the use of this method in a wider range of emergency interventions than only for CPR conducted in confined spaces.

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