scholarly journals CPR Compression Rotation Every One Minute Versus Two Minutes: A Randomized Cross-Over Manikin Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Nutthapong Pechaksorn ◽  
Veerapong Vattanavanit
Keyword(s):  
Heart Rate ◽  
Respiratory Rate ◽  
Chest Compression ◽  
Life Support ◽  
Chest Compressions ◽  
Compression Depth ◽  
End Points ◽  
The One ◽  
Support Guidelines

Background. The current basic life support guidelines recommend two-minute shifts for providing chest compressions when two rescuers are performing cardiopulmonary resuscitation. However, various studies have found that rescuer fatigue can occur within one minute, coupled with a decay in the quality of chest compressions. Our aim was to compare chest compression quality metrics and rescuer fatigue between alternating rescuers in performing one- and two-minute chest compressions. Methods. This prospective randomized cross-over study was conducted at Songklanagarind Hospital, Hat Yai, Songkhla, Thailand. We enrolled sixth-year medical students and residents and randomly grouped them into pairs to perform 8 minutes of chest compression, utilizing both the one-minute and two-minute scenarios on a manikin. The primary end points were chest compression depth and rate. The secondary end points included rescuers’ fatigue, respiratory rate, and heart rate. Results. One hundred four participants were recruited. Compared with participants in the two-minute group, participants in the one-minute group had significantly higher mean (standard deviation, SD) compression depth (mm) (45.8 (7.2) vs. 44.5 (7.1), P=0.01) but there was no difference in the mean (SD) rate (compressions per min) (116.1 (12.5) vs. 117.8 (12.4), P=0.08), respectively. The rescuers in the one-minute group had significantly less fatigue (P<0.001) and change in respiratory rate (P<0.001), but there was no difference in the change of heart rate (P=0.59) between the two groups. Conclusion. There were a significantly higher compression depth and lower rescuer fatigue in the 1-minute chest compression group compared with the 2-minute group. This trial is registered with TCTR20170823001.

Abstract 133: Electrical Insulating Gloves for Safe Hands-on Defibrillation Do Not Compromise the Quality of Chest Compressions

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Jakob E Thomsen ◽  
Martin Harpsø ◽  
Graham W Petley ◽  
Svend Vittinghus ◽  
Charles D Deakin ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Chest Compression ◽  
Electrical Insulation ◽  
Compression Rate ◽  
Chest Compressions ◽  
Compression Depth ◽  
Resuscitation Guidelines ◽  
Hands On ◽  
Class 1

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.

scholarly journals The potential of leg-foot chest compression as an alternative to conventional hands-on compression during cardiopulmonary resuscitation

2018 ◽  
Vol 26 (2) ◽  
pp. 106-110 ◽  
Author(s):  
Yoshiaki Takahashi ◽  
Takeji Saitoh ◽  
Misaki Okada ◽  
Hiroshi Satoh ◽  
Toshiya Akai ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Basic Life Support ◽  
Life Support ◽  
Vital Signs ◽  
Borg Scale ◽  
Compression Depth ◽  
Hands On ◽  
Scale Scores

Background: Conventional hands-on chest compression, in cardiopulmonary resuscitation, is often inadequate, especially when the rescuers are weak or have a small physique. Objectives: This study aimed to investigate the potential of leg-foot chest compression, with and without a footstool, during cardiopulmonary resuscitation. Methods and Results: We prospectively enrolled 21 medical workers competent in basic life support. They performed cardiopulmonary resuscitation on a manikin for 2 min using conventional hands-on compression (HO), leg-foot compression (LF), and leg-foot compression with a footstool (LF + FS). We analyzed the compression depths, changes in the rescuers’ vital signs, and the modified Borg scale scores after the trials. The compression depth did not differ between the cases using HO and LF. In the case of LF + FS, compression depths ⩾5 cm were more frequently observed (median, inter-quartile range: 93%, 81%–100%) than in HO (9%, 0%–57%, p < 0.01) and LF (28%, 11%–47%, p < 0.01). The increase in the heart rate or modified Borg scale scores, after the trials, did not differ between the HO and LF group; however, the values were the lowest in the case of LF + FS (49 ± 18 beats/min and 5 (4–7) in HO, 46 ± 18 and 6 (5–7) in LF, and 32 ± 11 and 2 (1–3) in LF + FS, respectively, p < 0.01). However, the increase in blood pressure, SpO2, and respiratory rate were not different among each group. The increases in the heart rate and modified Borg scale scores negatively were correlated with the rescuers’ body size, in the case of HO and LF, but not LF + FS. Conclusion: LF can be used as an alternative to HO, when adequate HO is difficult. LF + FS could be used when rescuers are weak or have a small physique and when the victims are bigger than the rescuers.

scholarly journals Hány éves kortól képesek a gyermekek újraéleszteni? – A hatékonyság felmérése általános iskolás gyermekek körében

2017 ◽  
Vol 158 (4) ◽  
pp. 147-152 ◽  
Author(s):  
Bálint Bánfai ◽  
Attila Pandur ◽  
Emese Pék ◽  
Henrietta Csonka ◽  
József Betlehem
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Small Groups ◽  
Basic Life Support ◽  
Life Support ◽  
Primary School Children ◽  
Average Depth ◽  
Chest Compressions ◽  
Physical Capability ◽  
Compression Depth

Abstract: Introduction: In cardiac arrest life can be saved by bystanders. Aim: Our aim was to determine at what age can schoolchildren perform correct cardiopulmonary resuscitation. Method: 164 schoolchildren (age 7–14) were involved in the study. A basic life support training consisted of 45 minutes education in small groups (8–10 children). They were tested during a 2-minute-long continuous cardiopulmonary resuscitation scenario using the “AMBU CPR Software”. Results: Average depth of chest compression was 44.07 ± 12.6 mm. 43.9% of participants were able to do effective chest compressions. Average ventilation volume was 0.17 ± 0.31 liter. 12.8% of participants were able to ventilate effectively the patient. It was significant correlation between the chest compression depth (p<0.001) and ventilation (p<0.001) and the children’s age, weight, height and BMI. Conclusions: Primary school children are able to learn cardiopulmonary resuscitation. The ability to do effective chest compressions and ventilation depended on the children’s physical capability. Orv. Hetil., 2017, 158(4), 147–152.

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.

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

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.

scholarly journals 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

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.

Abstract 122: Compression-Induced Ventilation Volumes Decrease with Chest Compression Depth and Prolonged CPR

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Simone Ordelman ◽  
Paul Aelen ◽  
Paul van Berkom ◽  
Gerrit J Noordergraaf
Keyword(s):  
Gas Exchange ◽  
Endotracheal Tube ◽  
Chest Compression ◽  
Minute Ventilation ◽  
Time Effect ◽  
Chest Compressions ◽  
Initial Value ◽  
Compression Depth ◽  
Minute Period ◽  
Over Time

Introduction: Compression-induced ventilation may aid gas exchange during CPR. We hypothesized that the amount of gas moving in and out of the lungs depends on chest compression depth. Methods: VF was induced in five female, anesthetized and intubated pigs of about 30 kg. After 30 seconds of non-intervention time, chest compressions were started and maintained at a rate of 100 compressions per minute. Every two minutes chest compression depth was altered, resulting in 14 minutes of CPR with a depth sequence of 4 cm, 3 cm, 4 cm, 5 cm, 5.5 cm, 5 cm and 4 cm. Ventilations were performed manually with a bag-valve device 10 times per minute during continuous chest compressions by a dedicated expert. Airway flow was measured at the end of the endotracheal tube. Compression-induced ventilation was determined from the periods between the manual ventilations. The average compression-induced minute ventilation volume was determined over the last minute of each two minute period of CPR at each specific chest compression depth. Results: The compression-induced ventilation volume in the first period of CPR at 4 cm of depth was 1.6 ± 0.9 L/min (about 4% of total ventilation volume). The figure shows how the compression-induced ventilation volume decreases with increasing chest compression depth, relative to this initial value. CPR with a chest compression depth of 4 cm was performed three times in each pig, and the corresponding compression-induced ventilation volumes decreased with time. This suggested that there might be just a time effect (e.g. atelectasis). However, the final compression depth of 4 cm resulted in larger compression-induced ventilation volumes than the preceding 5 cm and 5.5 cm compression depths, indicating that the decreased volume over time could not purely be a time effect, but must also be an effect of the depth. Conclusion: In conclusion, compression-induced ventilation volume appears to decrease with deeper chest compressions as well as with prolonged CPR.

Abstract 262: Hemodynamically-Guided Optimum Chest Compression Point in a Rat Model of Cardiopulmonary Resuscitation

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Davide Olivari ◽  
Daria De Giorgio ◽  
Deborah Novelli ◽  
Aurora Magliocca ◽  
Laura Ruggeri ◽  
...  
Keyword(s):  
Chest Compression ◽  
Rat Model ◽  
Coronary Perfusion Pressure ◽  
Male Rats ◽  
Right Atrial ◽  
Maximum Diameter ◽  
Coronary Perfusion ◽  
Successful Resuscitation ◽  
The One

Introduction: CPR aims to re-establish blood flow by chest compression (CC), achieving threshold levels of coronary perfusion pressure (CPP). For this, current guidelines recommend the lower sternal half as optimum CC point. However, this point might be not optimal for every individual. We investigated the hemodynamics generated by CC performed on different chest points in a rat model of CPR. We hypothesized that a CC point hemodynamically-identified would be a better approach compared to the lower sternal half. Methods: Ten male rats were anesthetized and arterial and right atrial pressures monitored. Ventricular fibrillation was induced and untreated for 8 min. CPR, including mechanical CC, ventilation, and epinephrine, was then performed for 8 min. Animals were divided to receive CC performed either on the lower sternal half (standard (STD), n=5) or on an optimum point identified as the one able to generate the maximum CPP (MaxCPP group, n=5). Cardiac districts involved in CC were subsequently identified by computed tomography (CT). Results: STD CC produced a CPP that was constantly below the threshold for successful resuscitation and trended to decrease over time. When the optimum CC point was identified hemodynamically, the CPP generated was constantly > 20 mmHg. Indeed, CPP was significantly higher in the MaxCPP group compared to the STD one for the whole 8 min of CPR (p<0.01, Fig). Moreover, administration of epi rapidly further improved CPP (p<0.01 vs. pre-epi) in the group with an optimized CC point, while no drug effect was observed in the STD one. CT scan showed that the lower sternal half did not correspond to the LV maximum diameter, known to account for a maximum stroke volume generation during CC (Fig). Conclusion: Standard lower sternal half CC point is not able to maximize hemodynamics during CPR, making ineffective CC efforts and vasopressor administration. The quality of CPR may improve if the optimum CC point is identified as a reflection of CPP generated.

Effectiveness of education intervention programme on life support measures for the nurses working in emergency unit of BPKIHS: a pre-experimental study

2018 ◽  
Vol 1 (1) ◽  
pp. 14-19
Author(s):  
Upendra Yadav ◽  
RS Mehta
Keyword(s):  
Chest Compression ◽  
Emergency Service ◽  
Basic Life Support ◽  
Life Support ◽  
Health Sciences ◽  
Education Intervention ◽  
Advance Life Support ◽  
Intervention Programme ◽  
Support Measures

Introduction: Lack of resuscitation skills of nurses in basic life support (BLS) and advanced life support (ALS) has been identified as a contributing factor to poor outcomes of cardiac arrest victims.Objective: To assess the effectiveness of education intervention programme to improve the knowledge of, and thereby the quality of Emergency service; especially in the area of Basic Life Support, Advance Life Support and Triage system.Method: Pre-experimental research design was used to conduct the study among the nurses working in Emergency units of B. P. Koirala Institute of Health Sciences where CPR is very commonly performed. Using convenient sampling technique, a total of 24 nurses agreed to participate and to give consent were included in the study. The theoretical, demonstration and re-demonstration sessions were arranged, involving the trained doctors and nurses during the three hours educational programme. Post-test was carried out after education intervention programme. The 2010 BLS and ALS guidelines were used as guide for the study contents. The collected data were analyzed using SPSS-15 software.Result: It was found that there is significant increase in knowledge after education intervention in the components of life support measures (BLS/ALS) i.e. ratio of chest compression to ventilation in BLS (P= 0.001), correct sequence of CPR (p< 0.001), rate of chest compression in ALS (P= 0.001), the depth of chest compression in adult CPR (p< 0.001), and position of chest compression in CPR (P= 0.016). The participating nurses well appreciated the programme and requested to continue in future for all the nurses.Conclusion: The workshop certainly improves the knowledge of the working nurses, and thereby the quality of Emergency service; especially in the areas of Basic Life Support, Advance Life Support and Triage System.Journal of BP Koirala Institute of Health Sciences, Vol. 1, No. 1, 2018, page: 14-19

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