Cardiopulmonary resuscitation: the science behind the hands

Heart ◽  
2018 ◽  
Vol 104 (13) ◽  
pp. 1056-1061 ◽  
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.

scholarly journals Automatic and manual devices for cardiopulmonary resuscitation: A review

2018 ◽  
Vol 10 (1) ◽  
pp. 168781401774874 ◽  
Author(s):  
Carlo Remino ◽  
Manuela Baronio ◽  
Nicola Pellegrini ◽  
Francesco Aggogeri ◽  
Riccardo Adamini
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Early Recognition ◽  
Hemodynamic Effects ◽  
Chest Compressions ◽  
High Quality ◽  
Working Space ◽  
Meta Analyses ◽  
Positioning Time ◽  
Actuation Method

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.

Cardiopulmonary Resuscitation

2009 ◽  
Vol 20 (4) ◽  
pp. 373-383
Author(s):  
Cindy Goodrich
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Survival Rates ◽  
Sudden Cardiac Arrest ◽  
Heart Association ◽  
New Techniques ◽  
Cardiac Assist ◽  
Mechanical Devices

Dismal survival statistics associated with sudden cardiac arrest have led to the development of new strategies and mechanical devices aimed at improving the quality of cardiopulmonary resuscitation (CPR). The most recent American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care were published in 2005. Major changes included revisions to current practices related to airway and ventilation, circulation, and defibrillation management. Greater emphasis is placed on providing simple, high-quality, effective CPR. New techniques and mechanical devices have been developed to augment CPR, hopefully improving survival rates and long-term outcomes. These include active compression-decompression CPR, Lund University Cardiac Assist System, LifeBelt, AutoPulse, and the impedance threshold device. This article focuses on current strategies aimed at improving survival rates for patients with sudden cardiac arrest. New techniques and mechanical devices developed to augment cardiopulmonary resuscitation will be discussed. These strategies will most likely shape future resuscitation practices.

Scedosporium apiospermum infection: lethal complication after extracorporeal cardiopulmonary resuscitation

Perfusion ◽  
2017 ◽  
Vol 33 (1) ◽  
pp. 71-73 ◽  
Author(s):  
Yong Mei ◽  
Xufeng Chen ◽  
Kai Sun ◽  
Jinru Lv ◽  
Hao Sun ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Clinical Practice ◽  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Membrane Oxygenation ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Scedosporium Apiospermum ◽  
High Quality ◽  
Extracorporeal Cardiopulmonary Resuscitation

In recent years, the development of extracorporeal membrane oxygenation (ECMO) technology has led to its extensive use in clinical practice. In particular, ECMO can play an important role in cardiopulmonary resuscitation (CPR). The American Heart Association CPR guidelines recommend its use in patients with cardiac arrest due to reversible disorders, along with high-quality CPR. This is called extracorporeal cardiopulmonary resuscitation (ECPR). However, it is important to be aware of the possibility of infection-related complications. Here, we report on a patient who suffered a cardiac arrest in hospital and was rescued with ECMO, but who subsequently developed an infection with Scedosporium apiospermum.

Military application of mechanical CPR devices: a pressing requirement?

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.

scholarly journals Effect of cardiopulmonary resuscitation training towards cardiac arrest emergency knowledge upon students at Student Health Association of Universitas Gadjah Mada, Indonesia

2020 ◽  
Vol 8 (10) ◽  
pp. 3463
Author(s):  
Bayu Fandhi Achmad
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Sudden Cardiac Arrest ◽  
Emergency Situation ◽  
Heart Association ◽  
Student Health ◽  
Resuscitation Training ◽  
Health Association ◽  
Post Test ◽  
Cpr Training

Background: The cardiovascular disease, especially the sudden cardiac arrest, was the main cause of death and disability throughout the world. The cardiopulmonary resuscitation (CPR) that should be taken by the first responder or witness was an important part in the chain of survival out of the hospital that could improve the prognosis and avoid the rest of the symptoms. Hence, it is important for students to know and possess the skill, especially the cardiopulmonary resuscitation, to handle the emergency situation. University became the appropriate place to organize the CPR training because the students were more conditioned in emotional, social and cultural terms.Methods: This research utilized the quasi-experiment method. The total number of research subject was 56 Universitas Gadjah Mada students at Student Health Association. The implementation of intervention of this research was conducted on 07 July, 2018. The topic in this research intervention were formed based on American Heart Association (AHA) Guideline 2015. Pretest and posttest instrument were 10 multiple choices with five choices of answer.Results: This research proved that the CPR training gave effect on the improvement of the knowledge about emergency situation, particularly the cardiac arrest through cardiopulmonary resuscitation. The pre-test and post-test results showed that there was a knowledge improvement after the training (p=0,000).Conclusions: CPR training could be recommended to have an impact on increasing student knowledge in emergency management, especially cardiac arrest.

scholarly journals Microglial Activation and Neurological Outcomes in a Murine Model of Cardiac Arrest

2021 ◽  
Author(s):  
Alaa Ousta ◽  
Lin Piao ◽  
Yong Hu Fang ◽  
Adrianna Vera ◽  
Thara Nallamothu ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Calcium Binding ◽  
Microglial Activation ◽  
Neuronal Degeneration ◽  
Treatment Options ◽  
Sudden Cardiac Arrest ◽  
Neurological Injury ◽  
Cell Integrity ◽  
Successful Resuscitation

Abstract Background Neurological injury following successful resuscitation from sudden cardiac arrest (CA) is common. The pathophysiological basis of this injury remains poorly understood, and treatment options are limited. Microglial activation and neuroinflammation are established contributors to many neuropathologies, such as Alzheimer disease and traumatic brain injury, but their potential role in post-CA injury has only recently been recognized. Here, we hypothesize that microglial activation that occurs following brief asystolic CA is associated with neurological injury and represents a potential therapeutic target. Methods Adult C57BL/6 male and female mice were randomly assigned to 12-min, KCl-induced asystolic CA, under anesthesia and ventilation, followed by successful cardiopulmonary resuscitation (n = 19) or sham intervention (n = 11). Neurological assessments of mice were performed using standardized neurological scoring, video motion tracking, and sensory/motor testing. Mice were killed at 72 h for histological studies; neuronal degeneration was assessed using Fluoro-Jade C staining. Microglial characteristics were assessed by immunohistochemistry using the marker of ionized calcium binding adaptor molecule 1, followed by ImageJ analyses for cell integrity density and skeletal analyses. Results Neurological injury in post-cardiopulmonary-resuscitation mice vs. sham mice was evident by poorer neurological scores (difference of 3.626 ± 0.4921, 95% confidence interval 2.618–4.634), sensory and motor functions (worsened by sixfold and sevenfold, respectively, compared with baseline), and locomotion (75% slower with a 76% decrease in total distance traveled). Post-CA brains demonstrated evidence of neurodegeneration and neuroinflammatory microglial activation. Conclusions Extensive microglial activation and neurodegeneration in the CA1 region and the dentate gyrus of the hippocampus are evident following brief asystolic CA and are associated with severe neurological injury.

Cardiac arrest

2020 ◽  
pp. 3839-3848
Author(s):  
Gavin D. Perkins ◽  
Jasmeet Soar ◽  
Jerry P. Nolan ◽  
David A. Gabbott
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Early Recognition ◽  
Sudden Cardiac Arrest ◽  
Early Defibrillation ◽  
High Quality ◽  
Common Cause ◽  
Initial Resuscitation ◽  
Treatment Plans

Cardiovascular disease is the most common cause of sudden cardiac arrest, which causes over 60% of adult coronary heart disease deaths. Most cardiac arrests are preventable. Survival depends on early recognition and prompt initiation of chest compressions and ventilations (cardiopulmonary resuscitation), and early defibrillation if appropriate. High-quality cardiopulmonary resuscitation is defined by compressions to a depth of 5–6 cm, at a rate of 100–120 per minute, full release of pressure between compressions and minimal interruptions to chest compression. Drugs have a limited role in treating cardiac arrest. If initial resuscitation is successful the quality of post-resuscitation care determines the patient’s final outcome. Use emergency care treatment plans to record in advance, recommendations for emergency treatments, including CPR.

Abstract 449: Cost Analysis of a Contextualized Cardiopulmonary Resuscitation Training for Orderlies Participating in In-Hospital Cardiac Arrests

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Christian Vincelette ◽  
Catalina Sokoloff ◽  
François-Martin Carrier ◽  
Pierre Desaulniers ◽  
Nathalie Nadon
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Cost Analysis ◽  
Life Support ◽  
Heart Association ◽  
Time Lapse ◽  
Performance Outcomes ◽  
Chest Compressions ◽  
High Quality ◽  
Resuscitation Training ◽  
The Cost

Introduction: Basic life support (BLS) training poses challenges for healthcare organizations. It requires numerous resources, complicates scheduling and is expensive. Orderlies typically provide chest compressions during in-hospital cardiac arrests, and are therefore recertified in cardiopulmonary resuscitation (CPR) every 2 years. However, such time lapse between CPR certifications induces skills decay. Hypothesis: Based on the American Heart Association statement on resuscitation education science published in 2018, we aimed to train all orderlies (n= 900) in less than 1 year, in order to reach proficiency in chest compressions, at a fraction of the cost. Method: A shortened (20 minutes), and adapted version of CPR training was created. This training specifically addressed high quality chest compressions, the cornerstone skill relevant to the scope of practice of orderlies in CPR. It was delivered in situ during working hours, as a mass training program that spanned over a period of 1 week. The training was provided through Mastery Learning and Deliberate Practice with direct feedback and live coaching. The cost analysis aimed to compare the costs of the new approach as compared to BLS training. Results: With this innovative approach, 30 trainers were able to train 600 employees in only 5 days. Preliminary results suggest most were able to perform high quality compressions after training. The total cost of the activity was 2 347.21 $CAD which represents 3% (2 347 of 76 200) of what it would take to train 600 people in BLS (76 200$CAD), and 13% (2 347 of 18 000) of the budget planned per year for orderlies’ BLS training at our institution (~18 000$CAD). The individual cost of our initiative was 4.13$CAD per employee. This method allowed to train employees around the clock, to cover all working shifts, thereafter preventing the removal of employees from the rolling schedule. Also, this solution allows us to repeat the experience another time this year, to train all orderlies. Conclusions: Although further research is needed to assess if skills are sustained over time and comparable based on performance outcomes, our inquiry is an innovative, sustainable and cost-effective way to train specific CPR skills to large groups.

scholarly journals Immediate Bystander Cardiopulmonary Resuscitation to Sudden Cardiac Arrest During Sports is Associated with Improved Survival—a Video Analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nicole M. Panhuyzen-Goedkoop ◽  
Hein J. Wellens ◽  
André L. M. Verbeek ◽  
Jan J. Piek ◽  
Ron J. G. Peters
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Sudden Cardiac Arrest ◽  
Early Defibrillation ◽  
Chest Compressions ◽  
Sports Activity ◽  
Link Type ◽  
Elite Level ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Bystander Cpr

Abstract Background Sudden cardiac arrest (SCA) during sports can be the first symptom of yet undetected cardiovascular conditions. Immediate chest compressions and early defibrillation offer SCA victims the best chance of survival, which requires prompt bystander cardiopulmonary resuscitation (CPR). Aims To determine the effect of rapid bystander CPR to SCA during sports by searching for and analyzing videos of these SCA/SCD events from the internet. Methods We searched images.google.com, video.google.com, and YouTube.com, and included any camera-witnessed non-traumatic SCA during sports. The rapidity of starting bystander chest compressions and defibrillation was classified as < 3, 3–5, or > 5 min. Results We identified and included 29 victims of average age 27.6 ± 8.5 years. Twenty-eight were males, 23 performed at an elite level, and 18 participated in soccer. Bystander CPR < 3 min (7/29) or 3–5 min (1/29) and defibrillation < 3 min was associated with 100% survival. Not performing chest compressions and defibrillation was associated with death (14/29), and > 5 min delay of intervention with worse outcome (death 4/29, severe neurologic dysfunction 1/29). Conclusions Analysis of internet videos showed that immediate bystander CPR to non-traumatic SCA during sports was associated with improved survival. This suggests that immediate chest compressions and early defibrillation are crucially important in SCA during sport, as they are in other settings. Optimal use of both will most likely result in survival. Most videos showing recent events did not show an improvement in the proportion of athletes who received early resuscitation, suggesting that the problem of cardiac arrest during sports activity is poorly recognized.

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