scholarly journals Impact of Application of Multifunction Electrode (MFE) Pads on Cardiopulmonary Resuscitation Quality

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Radosław Zalewski ◽  
Mateusz Puślecki ◽  
Łukasz Szarpak ◽  
Tomasz Kłosiewicz ◽  
Marek Dąbrowski ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Sudden Cardiac Arrest ◽  
Flow Time ◽  
Early Defibrillation ◽  
Chest Compressions ◽  
Airway Patency ◽  
Emergency Team ◽  
Simulation Based ◽  
Cpr Quality

Background. Early defibrillation and high-quality chest compressions are crucial in treatment of sudden cardiac arrest (SCA) subjects. The aim of this study was to assess an impact of defibrillation methods on cardiopulmonary resuscitation (CPR) quality. Methods. A randomized simulation cross-study was designed, in which 100 two-person paramedical teams participated. Two 10-minute scenarios of SCA in the mechanism of ventricular fibrillation were analysed. In the first one, teams had at their disposal defibrillator with hard paddles (group C), whereas in the second one, adhesive electrodes were used (group MFE). The CPR quality was evaluated on the basis of the chest compression parameters (rate, depth, recoil, compression fraction (CCF), and no-flow time), airways patency achievement, and successful emergency drug administration. Results. Substituting standard hard paddles with adhesive electrodes led to an increase in CCF (77% vs 73%; p < 0.05 ), higher rate of complete chest recoil, and a decrease in no-flow time (6.0 ± 1.1 vs. 7.3 ± 1.1; p < 0.001 ). The airway patency was ensured sooner in group MFE (271 ± 118 s vs. 322 ± 106 s in group C; p < 0.001 ). All teams in scenario with adhesive electrodes were able to administer two doses of adrenaline, meanwhile only 74% of them in group C ( p < 0.001 ). Moreover, in 8% of group C scenarios, paramedics did not have enough time to administer amiodarone. Conclusion. Our simulation-based analysis revealed that use of adhesive electrodes during defibrillation instead of standard hard paddles may improve the quality of CPR performed by two-person emergency team.

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 481: Cardiopulmonary Resuscitation: The Effect of Fatigue on Professional Rescuers During Continuous Chest Compressions

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Olibhear McAlister ◽  
Adam Harvey ◽  
Hannah Torney ◽  
Ben McCartney ◽  
Laura Davis ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Sudden Cardiac Arrest ◽  
Multiple Linear Regression Model ◽  
Rate Data ◽  
Chest Compressions ◽  
Minute Period ◽  
Significant Difference ◽  
The Mean ◽  
External Defibrillator

Introduction: It is reported that quality of chest compressions (CC) during cardiopulmonary resuscitation (CPR) for both professional and non-professional rescuers often do not meet guideline requirements. Devices which provide feedback on the quality of CCs are designed to reduce the incidence of suboptimal compressions and promote the administration of effective CCs. Objective: This analysis investigates the effect of CPR duration on the performance of continuous CCs delivered by professional rescuers. Methods: Data were collected from a first responder group based in Texas, USA. Responders were instructed to use a CPR depth feedback device (Laerdal CPRmeter) and an automatic external defibrillator (AED; HeartSine SAM 350P) when attending sudden cardiac arrest events. The AED was configured with a shock protocol separated by 2-minute episodes of CPR and rescuer CC depth and rate were guided by the CPR depth feedback device. CC depth and rate data were processed for 174 patient events. Each CPR episode was divided into 4-analysis windows, 30-seconds in duration. Mean CC depth and rate data was calculated for each window. There were 1433 observations of CC depth and rate available for analysis across 414 CPR episodes. The data was fitted by a multiple linear regression model to assess the effect of CPR duration on CC performance. Results: The mean CC depth at the beginning of an event was 49.01 +/-0.51 mm. CC depth decreased by 0.82 mm, for each passing 30-second interval (p < 0.001). The mean CC rate at the beginning of an event was 111.17 +/- 0.33 compression per minute (CPM). No significant difference was observed between CC rate and duration of continuous CCs (p = 0.896) however there was a significant increase in CC rate observed of 0.408 CPM for each elapsed 2-minute CPR episode (p = 0.011). Conclusion: A reduction in CC depth was observed within each CPR episode, which may be indicative of fatigue during continuous CCs. Although a reduction of 3.28 mm throughout a 2-minute period of CPR may be clinically insignificant, this effect was observed within a trained rescuer group with CPR feedback. Further research is required to assess the effect of fatigue in non-professional responders.

scholarly journals Coastal Fishermen as Lifesavers While Sailing at High Speed: A Crossover Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Ramón Fungueiriño-Suárez ◽  
Roberto Barcala-Furelos ◽  
Marta González-Fermoso ◽  
Santiago Martínez-Isasi ◽  
Felipe Fernández-Méndez ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Crossover Study ◽  
High Speed ◽  
Chest Compressions ◽  
International Guidelines ◽  
Small Boat ◽  
Cpr Quality ◽  
Simulated Scenario

Purpose. Starting basic cardiopulmonary resuscitation (CPR) early improves survival. Fishermen are the first bystanders while at work. Our objective was to test in a simulated scenario the CPR quality performed by fishermen while at port and while navigating at different speeds. Methods. Twenty coastal fishermen were asked to perform 2 minutes of CPR (chest compressions and mouth-to-mouth ventilations) on a manikin, in three different scenarios: (A) at port on land, (B) on the boat floor sailing at 10 knots, and (C) sailing at 20 knots. Data was recorded using quality CPR software, adjusted to current CPR international guidelines. Results. The quality of CPR (QCPR) was significantly higher at port (43%±10) than sailing at 10 knots (30%±15; p=0.01) or at 20 knots (26%±12; p=0.001). The percentage of ventilation that achieved some lung insufflation was also significantly higher when CPR was done at port (77%±14) than while sailing at 10 knots (59%±18) or 20 knots (57%±21) (p=0.01). Conclusion. In the event of drowning or cardiac arrest on a small boat, fishermen should immediately start basic CPR and navigate at a relatively high speed to the nearest port if the sea conditions are safe.

scholarly journals Effect of Using a Cardiac Catheterization Table-Stabilizing Stick on the Quality of Cardiopulmonary Resuscitation in the Cardiac Catheterization Laboratory: A Simulation-Based Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Tsuyoshi Yamada ◽  
Morihiro Ito ◽  
Hisako Urai ◽  
Yumiko Ueda ◽  
Hiroaki Maki ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Cardiac Catheterization ◽  
Cardiopulmonary Arrest ◽  
Neutral Position ◽  
X Ray ◽  
Cardiac Catheterization Laboratory ◽  
Cantilever Structure ◽  
Simulation Based ◽  
Cpr Quality

Rapid defibrillation and high-quality cardiopulmonary resuscitation (CPR) are necessary for patients with cardiopulmonary arrest, one of the most serious and frequently encountered complications in cardiac catheterization laboratories. However, when the catheterization table is withdrawn from its neutral position for fluoroscopy, it is unstable and unsuitable for resuscitation because of its cantilever structure. To stabilize the table in its withdrawn position, the use of a table-stabilizing stick might improve CPR quality. To investigate the effect of using a cardiac catheterization table-stabilizing stick on CPR quality, a CPR simulation mannequin was placed on a cardiac catheterization table that was withdrawn from the C-arm of the X-ray machine. CPR quality was assessed with or without the use of a table-stabilizing stick under the table. The CPR quality assessment (Q-CPR) scores were 79.6 ± 11.4% using the table-stabilizing stick and 47.7 ± 30.3% without the use of the stick device (p = 0.02). In this simulation-based study, the use of a table-stabilizing stick in a cardiac catheterization table withdrawn from the C-arm of the X-ray machine improved the quality of CPR.

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.

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

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.

Effectiveness of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program Developed by the Thailand National Institute of Emergency Medicine (NIEMS)

2021 ◽  
pp. 1-6
Author(s):  
Chuenruthai Angkoontassaneeyarat ◽  
Chaiyaporn Yuksen ◽  
Chetsadakon Jenpanitpong ◽  
Pemika Rukthai ◽  
Marisa Seanpan ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Health Care Providers ◽  
Care Providers ◽  
Chest Compressions ◽  
Threatening Condition ◽  
Life Threatening

Abstract Background: Out-of-hospital cardiac arrest (OHCA) is a life-threatening condition with an overall survival rate that generally does not exceed 10%. Several factors play essential roles in increasing survival among patients experiencing cardiac arrest outside the hospital. Previous studies have reported that implementing a dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) program increases bystander CPR, quality of chest compressions, and patient survival. This study aimed to assess the effectiveness of a DA-CPR program developed by the Thailand National Institute for Emergency Medicine (NIEMS). Methods: This was an experimental study using a manikin model. The participants comprised both health care providers and non-health care providers aged 18 to 60 years. They were randomly assigned to either the DA-CPR group or the uninstructed CPR (U-CPR) group and performed chest compressions on a manikin model for two minutes. The sequentially numbered, opaque, sealed envelope method was used for randomization in blocks of four with a ratio of 1:1. Results: There were 100 participants in this study (49 in the DA-CPR group and 51 in the U-CPR group). Time to initiate chest compressions was statistically significantly longer in the DA-CPR group than in the U-CPR group (85.82 [SD = 32.54] seconds versus 23.94 [SD = 16.70] seconds; P <.001). However, the CPR instruction did not translate into better performance or quality of chest compressions for the overall sample or for health care or non-health care providers. Conclusion: Those in the CPR-trained group applied chest compressions (initiated CPR) more quickly than those who initiated CPR based upon dispatch-based CPR instructions.

scholarly journals Metronome Use Positively Affect Cardiopulmonary Resuscitation Parameters: Prospective Observational Multicenter Manikin Study

2020 ◽  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Minute Ventilation ◽  
Heart Association ◽  
High Volume ◽  
Compression Rate ◽  
Compression Depth ◽  
Manikin Study ◽  
Volume Ventilation ◽  
Cpr Quality

Objective: Clinical studies have shown that eliminating performer errors is important to ensure high quality cardiopulmonary resuscitation (CPR). Literature on the effects of metronome use on the quality of CPR is scarce. This study aimed to investigate the effect of metronome use on the quality of cardiopulmonary resuscitation. Methods: Thirty volunteer emergency physicians who were divided into 15 groups participated in this prospective, observational, multi-center, manikin study. Firstly, each participant performed conventional CPR on a manikin, and then performed metronome-guided CPR after a short break. Parameters affecting CPR quality were evaluated based on the recommendations of the 2015 American Heart Association CPR and Emergency Cardiovascular Care Guideline. In addition, the fatigue levels of participants were evaluated using the Borg Fatigue Index. Results: Metronome-guided CPR significantly improved the chest compression rate (median (Interquartile Range-IQR); 128 (22) compressions/min vs. 110 (2) compressions/min; 95%CI, p < 0.001), deep compression rate (median (IQR); 95.25 (80) compressions/min vs. 72.63 (105) compressions/min; 95%CI, p < 0.001), compression depth (median (IQR); 62.50 (11) mm vs. 60.25 (14) mm; 95%CI, p = 0.016), ventilation number (median (IQR); 11.25 (6) ventilations/min vs. 9.50 (1) ventilations/min; 95%CI, p = 0.001), high-volume ventilation count (median (IQR); 10.13 (6) ventilations/min vs. 9.50 (1) ventilations/min; 95%CI, p = 0.026), minute ventilation volume (median (IQR); 11.75 (10) L/min vs. 8.03 (3) L/min; 95%CI, p < 0.05), and fatigue levels (median (IQR); 3 (2) vs. 2 (2); in 95%CI, p < 0.05). Conclusions: Our study showed that metronome is a useful device for reaching effective CPR. Metronome guidance may change the CPR parameters positively. This study is in accordance with previous studies which have investigated the effect of metronome-guided CPR on survival.

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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