Successful resuscitation with shallow chest compression depth: A pediatric case

Introduction: Current guidelines require a 50 mm compression depth for manual chest compression. During mechanical chest compression, however, because of the design of each device, whether this depth yields the most optimal hemodynamic efficacy remains to be tested. In this study, we investigated the effects of compression depth on hemodynamics efficacy during mechanical CPR with the Weil Mini Chest Compressor in a porcine model. Hypothesis: There is no significant difference in hemodynamic efficacy between compression depth of 30 mm and 50 mm during mechanical CPR with the Weil Mini Chest Compressor. Methods: Ten male domestic pigs weighing 34±2 kg were utilized. Ventricular fibrillation was electrically induced and untreated for 7 min. The animals were then randomized to receive compression depth of 30 mm or 50 mm. Coincident with the start of precordial compression, the animals were mechanically ventilated at a rate of 10 breaths per minute. Defibrillation was attempted by a single 150 J shock. If resuscitation was not successful, CPR was resumed for 2 mins prior to the next defibrillation until either successful resuscitation or for a total of 15 mins. Results: All animals were successfully resuscitated. There were no differences in coronary perfusion pressure (CPP), end-tidal carbon dioxide (ETCO2) and carotid blood flow (CBF) between the two groups (Table). A significantly less rib fracture was observed in the 30 mm group [0 (0-0) vs 1.2 (0-2), p<0.05]. Conclusion: Similar hemodynamic efficacy was observed between 30 and 50 mm compression depth during mechanical CPR with the Weil Mini Chest Compressor.

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Effect of the Use of Metronome Feedback on the Quality of Pediatric Cardiopulmonary Resuscitation

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158087 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8087

Author(s):

Dongjun Yang ◽

Wongyu Lee ◽

Jehyeok Oh

Keyword(s):

Cardiopulmonary Resuscitation ◽

Chest Compression ◽

Healthcare Providers ◽

Compression Rate ◽

Audio Feedback ◽

Simple Method ◽

Compression Depth ◽

Pediatric Resuscitation ◽

Cpr Quality

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.

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Recognition of Abnormal Chest Compression Depth Using One-Dimensional Convolutional Neural Networks

Sensors ◽

10.3390/s21030846 ◽

2021 ◽

Vol 21 (3) ◽

pp. 846

Author(s):

Liang Zhao ◽

Yu Bao ◽

Yu Zhang ◽

Ruidong Ye ◽

Aijuan Zhang

Keyword(s):

Chest Compression ◽

Sensor Data ◽

Evaluation Procedure ◽

Support Vector ◽

Portable Devices ◽

Sensor Signal ◽

Distance Measurements ◽

Compression Depth ◽

One Dimensional ◽

Starting Point

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.

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

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2015.11.026 ◽

2016 ◽

Vol 34 (3) ◽

pp. 433-436 ◽

Cited By ~ 1

Author(s):

Tae Hu Kim ◽

Soo Hoon Lee ◽

Dong Hoon Kim ◽

Ryun Kyung Lee ◽

So Yeon Kim ◽

...

Keyword(s):

Chest Compression ◽

Suprasternal Notch ◽

Compression Depth

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Does the Q-CPR chest compression pad reliably determine compression depth during cardiopulmonary resuscitation?

European Journal of Anaesthesiology ◽

10.1097/00003643-201206001-00629 ◽

2012 ◽

Vol 29 ◽

pp. 190 ◽

Cited By ~ 1

Author(s):

P. Schober ◽

R. Krage ◽

V. Lagerburg ◽

D. van Groeningen ◽

S. A. Loer ◽

...

Keyword(s):

Cardiopulmonary Resuscitation ◽

Chest Compression ◽

Compression Depth

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Accurate feedback of chest compression depth and rate on a manikin in a moving train

Resuscitation ◽

10.1016/j.resuscitation.2015.09.030 ◽

2015 ◽

Vol 96 ◽

pp. 13

Author(s):

Digna María González-Otero ◽

Sofía Ruiz de Gauna ◽

Jesús Ruiz ◽

Beatriz Chicote ◽

Raquel Rivero ◽

...

Keyword(s):

Chest Compression ◽

Compression Depth ◽

Moving Train

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Leg-heel chest compression as an alternative for medical professionals in times of COVID-19

10.1101/2021.03.09.21253220 ◽

2021 ◽

Author(s):

Matthias Ott ◽

Alexander Krohn ◽

Laurence H. Bilfield ◽

F. Dengler ◽

C. Jaki ◽

...

Keyword(s):

Chest Compression ◽

Effective Alternative ◽

Medical Professionals ◽

Compression Rate ◽

Compression Depth ◽

Significant Difference ◽

Manual Chest Compression ◽

Special Circumstances ◽

Previous Training

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.

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Effect of Acute Exposure to Altitude on the Quality of Chest Compression‐Only Cardiopulmonary Resuscitation in Helicopter Emergency Medical Services Personnel: A Randomized, Controlled, Single‐Blind Crossover Trial

Journal of the American Heart Association ◽

10.1161/jaha.121.021090 ◽

2021 ◽

Author(s):

Anna Vögele ◽

Michiel Jan van Veelen ◽

Tomas Dal Cappello ◽

Marika Falla ◽

Giada Nicoletto ◽

...

Keyword(s):

Emergency Medical Services ◽

Chest Compression ◽

Acute Exposure ◽

Medical Services ◽

Compression Depth ◽

Helicopter Emergency Medical Services ◽

Emergency Medical ◽

Emergency Medical Services Personnel ◽

Cpr Quality

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.

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