scholarly journals Efficacy of Chest Compressions Directed by End‐Tidal CO 2 Feedback in a Pediatric Resuscitation Model of Basic Life Support

Author(s):  
Jennifer L. Hamrick ◽  
Justin T. Hamrick ◽  
Jennifer K. Lee ◽  
Benjamin H. Lee ◽  
Raymond C. Koehler ◽  
...  
2015 ◽  
Vol 06 (12) ◽  
pp. 944-953
Author(s):  
Pär Lindblad ◽  
Annika Åström Victorén ◽  
Christer Axelsson ◽  
Bjarne Madsen Härdig

2021 ◽  
pp. emermed-2021-211774
Author(s):  
Sang O Park ◽  
Dong Hyuk Shin ◽  
Changhoon Kim ◽  
Young Hwan Lee

IntroductionIn conventional basic life support (c-BLS), a lone rescuer is recommended to start chest compressions (CCs) after activating the emergency medical system. To initiate earlier CCs in lone-rescuer BLS, we designed a modified BLS (m-BLS) sequence in which the lone rescuer commences one-handed CCs while calling for help using a handheld cellular phone with the other free hand. This study aimed to compare the quality of BLS between c-BLS and m-BLS.MethodsThis was a simulation study performed with a randomised cross-over controlled trial design. A total of 108 university students were finally enrolled. After training for both c-BLS and m-BLS, participants performed a 3-minute c-BLS or m-BLS on a manikin with a SkillReporter at random cross-over order. The paired mean difference with SE between c-BLS and m-BLS was assessed using paired t-test.ResultsThe m-BLS had reduced lag time before the initiation of CCs (with a mean estimated paired difference (SE) of −35.0 (90.4) s) (p<0.001). For CC, a significant increase in compression fraction and a higher number of CCs with correct depth were observed in m-BLS (with a mean estimated paired difference (SE) of 16.2% (0.6) and 26.9% (3.3), respectively) (all p<0.001). However, no significant paired difference was observed in the hand position, compression rate and interruption time. For ventilation, the mean tidal volumes did not differ. However, the number of breaths with correct tidal volume was higher in m-BLS than in c-BLS.ConclusionIn simulated lone-rescuer BLS, the m-BLS could deliver significantly earlier CCs than the c-BLS while maintaining high-quality cardiopulmonary resuscitation.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
M. Binkhorst ◽  
J M Th Draaisma ◽  
Y. Benthem ◽  
E. M. R. van de Pol ◽  
M. Hogeveen ◽  
...  

Abstract Background Peer-led basic life support training in medical school may be an effective and valued way of teaching medical students, yet no research has been conducted to evaluate the effect on the self-efficacy of medical students. High self-efficacy stimulates healthcare professionals to initiate and continue basic life support despite challenges. Methods A randomized controlled trial, in which medical students received pediatric basic life support (PBLS) training, provided by either near-peer instructors or expert instructors. The students were randomly assigned to the near-peer instructor group (n = 105) or expert instructor group (n = 108). All students received two hours of PBLS training in groups of approximately 15 students. Directly after this training, self-efficacy was assessed with a newly developed questionnaire, based on a validated scoring tool. A week after each training session, students performed a practical PBLS exam and completed another questionnaire to evaluate skill performance and self-efficacy, respectively. Results Students trained by near-peers scored significantly higher on self-efficacy regarding all aspects of PBLS. Theoretical education and instructor feedback were equally valued in both groups. The scores for the practical PBLS exam and the percentage of students passing the exam were similar in both groups. Conclusions Our findings point towards the fact that near-peer-trained medical students can develop a higher level of PBLS-related self-efficacy than expert-trained students, with comparable PBLS skills in both training groups. The exact relationship between peer teaching and self-efficacy and between self-efficacy and the quality of real-life pediatric resuscitation should be further explored. Trial registration ISRCTN, ISRCTN69038759. Registered December 12th, 2019 – Retrospectively registered.


Resuscitation ◽  
2008 ◽  
Vol 77 (1) ◽  
pp. 95-100 ◽  
Author(s):  
Conrad Arnfinn Bjørshol ◽  
Eldar Søreide ◽  
Tor Harald Torsteinbø ◽  
Kristian Lexow ◽  
Odd Bjarte Nilsen ◽  
...  

Aim: Compare which resuscitation (for cardiac arrest scenario) has a higher quality when first responders with a duty of care are deprived of material: a standard resuscitation algorithm or a hands-only one when performed by lifeguards, who have had extensive training on mouth-to-mouth ventilation. Besides, a more specific objective was the analysis of the characteristics of these mouth-to-mouth ventilation. Methods: We conducted a prospective quasi-experimental crossover manikin study with clinical simulation with 41 lifeguards attached to the Plan of Surveillance and Rescue in Beaches. Each participant performed 2 minutes of basic life support (CPRb). Afterward, each participant performed 2 minutes of CPR with hands-only (CPRho). The data collection was carried out with a CPR calibrated Mannequin. Results: The mean depth was 48.05± 8.99 mm for CPRb, and 44.76 ± 9.73 mm for CPRho (t = 5.81, p < 0.001, 95% CI, 2.15 - 4.44), the rate was 123 ± 16.11 compressions/min for CPRb and 120 ± 17.89 for CPRho. The CPRho achieved a mean of 46 ± 42.6 complete chest recoil, versus 35 ± 35.19 for CPRb (z = -2.625, p = 0.009). 20.74% of ventilation were hypoventilation and 42.72% were hyperventilation. Conclusions: Mouth-to-mouth ventilation performed by lifeguards (without devices) was not effective. When ventilations were not performed, the number of high-quality compressions increased in absolute values. The mean depth of chest compressions was higher in the CPRho. Most of the participants did not perform the ventilations correctly, which resulted in time without compression and ventilation. The number of chest compressions with complete chest recoil was higher in CPRho. When ventilations were not performed, the number of high-quality compressions increased in absolute values.


2001 ◽  
Vol 37 (4) ◽  
pp. S26-S35 ◽  
Author(s):  
Robert A. Berg ◽  
Leonard A. Cobb ◽  
Alidene Doherty ◽  
Gordon A. Ewy ◽  
Michael J. Gerardi ◽  
...  

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Michael Mueller ◽  
Christian Rudolph ◽  
Cynthia Poenicke ◽  
Andre Eichelkraut ◽  
Norbert Papkalla ◽  
...  

The current international guidelines for resuscitation recommend high quality chest compressions with minimal interruptions as important prerequisite for optimal survival after cardiac arrest. During the standard four hours BLS course of the European Resuscitation Council (ERC) the participants learn to provide chest compressions, ventilations and to use an automated external defibrillator. We know that lay rescuers are able to learn these skills. However, it is unclear whether lay rescuers manage to minimize interruptions of chest compressions. Objective: To evaluate the no-flow fraction (NFF) during lay rescuer BLS including chest compressions, ventilation and the use of an AED. Methods: 24 participants of a BLS/ AED course were assessed before (T1) and after (T2) the BLS training in a standardized scenario in pairs of 2 rescuers. We used a Resusci Anne Simulator manikin (Laerdal, Norway) and a Lifepak 1000 AED trainer device for the assessment. The scenario was an adult patient with cardiac arrest and persistent ventricular fibrillation (VF), duration of the scenario was 5 minutes. 28 lay persons served as control group and were assessed in pairs of 2 rescuers twice at the same day. Two-sided t-test was used to test differences between groups and between test scenarios (T1 vs. T2), p<.05 was considered significant. Results: The NFF decreased from 0.68 ± 0.1 (before the course) to 0.5 ± 0.07 (after the course), p=.000. In the control group the NFF was 0.63 ± 0.1 (scenario 1) and 0.59 ± 0.14 (second scenario), p=.244. Conclusion: A standard BLS course reduces the interruptions of chest compressions during lay rescuer CPR. However, 50% of the scenario no chest compressions are given. Interruptions are mainly due to ventilations or related to the use of the AED. Further research is necessary to improve the BLS algorithm regarding reduction of interruptions.


2016 ◽  
Vol 34 (3) ◽  
pp. 381-385 ◽  
Author(s):  
Zenon Truszewski ◽  
Lukasz Szarpak ◽  
Andrzej Kurowski ◽  
Togay Evrin ◽  
Piotr Zasko ◽  
...  

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