scholarly journals Current Guideline of Chest Compression Depth for Children of All Ages May Be Too Deep for Younger Children

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Jang Hee Lee ◽  
Sang Kuk Han ◽  
Ji Ung Na

Aim. To determine whether the chest compression depth of at least 1/3 of the Anteroposterior (AP) diameter of the chest and about 5 cm is appropriate for children of all age groups via chest computed tomography. Methods. The AP diameter of the chest, anterior chest wall diameter, and compressible diameter (Cd) were measured at the lower half of the sternum for patients aged 1-18 years using chest computed tomography. The mean ratio of 5 cm compression to the Cd of adult patients was used as the lower limit, and the mean ratio of 6 cm compression to the Cd of adult patients was used as the upper limit. Also, the depth of chest compression resulting in a residual depth <1 cm was considered to cause internal injury potentially. With the upper and lower limits, the compression ratios to the Cd were compared when compressions were performed at a depth of 1/3 the AP diameter of the chest and 5 cm for patients aged 1-18 years. Results. Among children aged 1-7 years, compressing 5 cm was deeper than 1/3 the AP diameter. Also, among children aged 1-5 years, 5 cm did not leave a residual depth of 1 cm, potentially causing intrathoracic injury. Conclusion. Current pediatric resuscitation guidelines of chest compression depth for children were too deep for younger children aged 1-7 years.

Resuscitation ◽  
2017 ◽  
Vol 118 ◽  
pp. e56
Author(s):  
Nalinas Khunkhlai ◽  
Pakkaphon Aiempaiboonphan ◽  
Rathachai Kaewlai ◽  
Pinporn Jenjitranant ◽  
Krisna Dissaneevate ◽  
...  

2019 ◽  
Vol 27 (4) ◽  
pp. 197-201
Author(s):  
Libing Jiang ◽  
Jie Min ◽  
Fan Yang ◽  
Xiaotong Shao

Background: High-quality chest compression is crucial for cardiac arrest patients. However, only few studies are focusing on the optimal compression point. Objective: The aim of this study was to explore the optimal compression point based on chest-computed tomography. Methods: We retrospectively selected 166 adult health subjects between January 2018 and May 2018 in a university-affiliated hospital. Results: The median length of sternum was 14.9 cm. The median length from the inter-nipple line to the distal end of sternum was 1.0 cm. The median length from the point at which the maximal left ventricular diameter projected onto the sternum to the distal end of the sternum was −1.4 (–2.2 to 0.0) cm. The median value of the length from the inter-nipple line to the distal end of sternum plus the length from the point at which the maximal left ventricular diameter projected onto the sternum to the distal end of the sternum was 2.0 (1.0–3.1) cm. Conclusion: One size does not fit all. The point recommended by the current guideline may not appropriate for Chinese person. Further studies are required focusing on individual chest compression during cardiopulmonary resuscitation.


Author(s):  
Shimaa Farghaly ◽  
Marwa Makboul

Abstract Background Coronavirus disease 2019 (COVID-19) is the most recent global health emergency; early diagnosis of COVID-19 is very important for rapid clinical interventions and patient isolation; chest computed tomography (CT) plays an important role in screening, diagnosis, and evaluating the progress of the disease. According to the results of different studies, due to high severity of the disease, clinicians should be aware of the different potential risk factors associated with the fatal outcome, so chest CT severity scoring system was designed for semi-quantitative assessment of the severity of lung disease in COVID-19 patients, ranking the pulmonary involvement on 25 points severity scale according to extent of lung abnormalities; this study aims to evaluate retrospectively the relationship between age and severity of COVID-19 in both sexes based on chest CT severity scoring system. Results Age group C (40–49 year) was the commonest age group that was affected by COVID-19 by 21.3%, while the least affected group was group F (≥ 70 years) by only 6.4%. As regards COVID-RADS classification, COVID-RADS-3 was the most commonly presented at both sexes in all different age groups. Total CT severity lung score had a positive strong significant correlation with the age of the patient (r = 0.64, P < 0.001). Also, a positive strong significant correlation was observed between CT severity lung score and age in both males and females (r = 0.59, P < 0.001) and (r = 0.69, P < 0.001) respectively. Conclusion We concluded that age can be considered as a significant risk factor for the severity of COVID-19 in both sexes. Also, CT can be used as a significant diagnostic tool for the diagnosis of COVID-19 and evaluation of the progression and severity of the disease.


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.


2021 ◽  
Vol 67 (11) ◽  
pp. 1531-1537
Author(s):  
Safiye Sanem Dereli Bulut ◽  
Zakir Sakci ◽  
Aslihan Semiz Oysu ◽  
Fatma Kulali ◽  
Mehmet Taha Avci ◽  
...  

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Jakob E Thomsen ◽  
Martin Harpsø ◽  
Graham W Petley ◽  
Svend Vittinghus ◽  
Charles D Deakin ◽  
...  

Introduction: We have recently shown that Class 1 electrical insulating gloves are safe for hands-on defibrillation. Continuous chest compressions during defibrillation reduce the peri-shock pauses and increase the subsequent chance of successful defibrillation. In this study we have investigated the effect of these electrical insulation gloves on the quality of chest compressions, compared with normal clinical examination gloves. Methods: Emergency medical technicians trained in 2010 resuscitation guidelines delivered uninterrupted chest compressions for 6 min on a manikin, whilst wearing Class 1 electrical insulating gloves or clinical examination gloves. The order of gloves was randomized and each session of chest compressions was separated by at least 30 min to avoid fatigue. Data were collected from the manikin. Compression depth and compression rate were compared. Results: Data from 35 participants are shown in Figure 1. There was no statistically significant difference between Class 1 electrical insulating gloves in chest compression depth (median±range: 45 (28-61) vs 43 (28-61) p=0.69) and chest compression rate (113 (67-150) vs 113(72-145), p=0.87) when compared to clinical examination cloves. Conclusion: These preliminary data suggest that the use of Class 1 electrical insulation gloves does not reduce the quality of chest compressions during simulated CPR compared to clinical examination gloves.


Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1023
Author(s):  
Temitope Emmanuel Komolafe ◽  
John Agbo ◽  
Ebenezer Obaloluwa Olaniyi ◽  
Kayode Komolafe ◽  
Xiaodong Yang

Background: The pooled prevalence of chest computed tomography (CT) abnormalities and other detailed analysis related to patients’ biodata like gender and different age groups have not been previously described for patients with coronavirus disease 2019 (COVID-19), thus necessitating this study. Objectives: To perform a meta-analysis to evaluate the diagnostic performance of chest CT, common CT morphological abnormalities, disease prevalence, biodata information, and gender prevalence of patients. Methods: Studies were identified by searching PubMed and Science Direct libraries from 1 January 2020 to 30 April 2020. Pooled CT positive rate of COVID-19 and RT-PCR, CT-imaging features, history of exposure, and biodata information were estimated using the quality effect (QE) model. Results: Out of 36 studies included, the sensitivity was 89% (95% CI: 80–96%) and 98% (95% CI: 90–100%) for chest CT and reverse transcription-polymerase chain reaction (RT-PCR), respectively. The pooled prevalence across lesion distribution were 72% (95% CI: 62–80%), 92% (95% CI: 84–97%) for lung lobe, 88% (95% CI: 81–93%) for patients with history of exposure, and 91% (95% CI: 85–96%) for patients with all categories of symptoms. Seventy-six percent (95% CI: 67–83%) had age distribution across four age groups, while the pooled prevalence was higher in the male with 54% (95% CI: 50–57%) and 46% (95% CI: 43–50%) in the female. Conclusions: The sensitivity of RT-PCR was higher than chest CT, and disease prevalence appears relatively higher in the elderly and males than children and females, respectively.


2011 ◽  
Vol 1 (1) ◽  
pp. 6
Author(s):  
Junichi Ochi ◽  
Minoru Ohkouchi ◽  
Yoshikazu Tsukada ◽  
Shinichiro Tominaga ◽  
Satoshi Takayama ◽  
...  

Amiodarone-induced pulmonary toxicity is a critical and potentially fatal side effect of amiodarone. Our study was designed to reveal its clinical features, including KL-6, as an interstitial marker. The medical records of eight patients (five men and three women) with amiodarone-induced pulmonary toxicity, who had been referred to our hospital, were examined. The mean age at the initiation of amiodarone was 48 years (range, 54-87 years) and mean duration of medication prior to the development of pulmonary toxicity was 18 months (range, 7-33 months). Serum KL-6 was elevated in six of the eight patients with a range of 525-2915 U/mL. Chest computed tomography (CT) findings showed non-segmental consolidation and/or ground glass opacity. Foamy macrophages were found in bronchoalveolar lavage (BAL) fluids of all examined patients and in transbronchial lung biopsy (TBLB) specimens in half of the examined patients. We concluded that serum KL-6, chest CT findings, and foamy macrophages in BAL fluids and TBLB specimens will be helpful for the diagnosis of amiodarone-induced pulmonary toxicity.


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