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: 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.

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.

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.

scholarly journals Effect of Maternal Positioning During Cardiopulmonary Resuscitation: A Systematic Review and Meta-analyses

2021 ◽  
Author(s):  
Naosuke Enomoto ◽  
Tomoyuki Yamashita ◽  
Marie Furuta ◽  
Hiroaki Tanaka ◽  
Edomond Ng ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Pregnant Women ◽  
Supine Position ◽  
Survival Rates ◽  
Controlled Trials ◽  
Chest Compressions ◽  
Lateral Tilt ◽  
Meta Analyses

Abstract Background: Although rare, cardiac arrest during pregnancy is the leading cause of maternal death. Recently, its incidence has been increasing worldwide because more pregnant women have risk factors. The provision of early, high-quality cardiopulmonary resuscitation (CPR) plays a major role in the increased likelihood of survival; therefore, clinicians should be familiar with its management. Due to the aortocaval compression caused by the gravid uterus, clinical guidelines often emphasise the importance of maternal positioning during CPR, but there has been little evidence regarding which position is most effective.Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and OpenGrey (updated on April 3, 2021). We included clinical trials and observational studies with reported outcomes related to successful resuscitations. Results: We included eight studies out of the 1,490 screened. All of these were simulation-based cross-over randomised controlled trials examining the quality of chest compressions. No data were available about the survival rates of mothers or fetuses/neonates. Meta-analyses indicated that resuscitation of pregnant women in the 27°–30° left-lateral tilt position lowered the quality of chest compressions, and the rates of correct compression depth and correct hand position decreased by 17% and 9%, respectively when compared with resuscitation in the supine position. Inexperienced clinicians faced difficulties in performing chest compressions in the left-lateral tilt position. Conclusions: Given that manual left uterine displacement allows the patient to remain supine, the resuscitation of women in the supine position using manual left uterine displacement should continue to be supported. Further research is needed to fill knowledge gaps regarding the effects of maternal positioning on clinical outcomes, such as survival rates following maternal cardiac arrest.

scholarly journals Adverse Hemodynamic Effects of Interrupting Chest Compressions for Rescue Breathing During Cardiopulmonary Resuscitation for Ventricular Fibrillation Cardiac Arrest

Circulation ◽  
2001 ◽  
Vol 104 (20) ◽  
pp. 2465-2470 ◽  
Author(s):  
Robert A. Berg ◽  
Arthur B. Sanders ◽  
Karl B. Kern ◽  
Ronald W. Hilwig ◽  
Joseph W. Heidenreich ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Cardiopulmonary Resuscitation ◽  
Hemodynamic Effects ◽  
Chest Compressions ◽  
Rescue Breathing

scholarly journals The Effect of Implementing Mechanical Cardiopulmonary Resuscitation Devices on Out-of-Hospital Cardiac Arrest Patients in an Urban City of Taiwan

2021 ◽  
Vol 18 (7) ◽  
pp. 3636
Author(s):  
Yi-Rong Chen ◽  
Chi-Jiang Liao ◽  
Han-Chun Huang ◽  
Cheng-Han Tsai ◽  
Yao-Sing Su ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Primary Outcome ◽  
Medical Service ◽  
Spontaneous Circulation ◽  
High Quality ◽  
Urban City ◽  
Service Response Time ◽  
Mechanical Cpr ◽  
Hospital Cardiac Arrest

High-quality cardiopulmonary resuscitation (CPR) is a key element in out-of-hospital cardiac arrest (OHCA) resuscitation. Mechanical CPR devices have been developed to provide uninterrupted and high-quality CPR. Although human studies have shown controversial results in favor of mechanical CPR devices, their application in pre-hospital settings continues to increase. There remains scant data on the pre-hospital use of mechanical CPR devices in Asia. Therefore, we conducted a retrospective cohort study between September 2018 and August 2020 in an urban city of Taiwan to analyze the effects of mechanical CPR devices on the outcomes of OHCA; the primary outcome was attainment of return of spontaneous circulation (ROSC). Of 552 patients with OHCA, 279 received mechanical CPR and 273 received manual CPR, before being transferred to the hospital. After multivariate adjustment for the influencing factors, mechanical CPR was independently associated with achievement of any ROSC (OR = 1.871; 95%CI:1.195–2.930) and sustained (≥24 h) ROSC (OR = 2.353; 95%CI:1.427–3.879). Subgroup analyses demonstrated that mechanical CPR is beneficial in shorter emergency medical service response time (≤4 min), witnessed cardiac arrest, and non-shockable cardiac rhythm. These findings support the importance of early EMS activation and high-quality CPR in OHCA resuscitation.

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 PENGETAHUAN PERAWAT TENTANG HIGH-QUALITY CARDIOPULMONARY RESUSCITATION (CPR) DI ENAM RUMAH SAKIT SWASTA DI INDONESIA [NURSES' KNOWLEDGE ABOUT HIGH-QUALITY CARDIOPULMONARY RESUSCITATION (CPR) IN SIX PRIVATE HOSPITALS IN INDONESIA]

2021 ◽  
Vol 9 (2) ◽  
pp. 149
Author(s):  
Anugerah Ruben Ananda ◽  
Desi Friska Dela Zalukhu ◽  
Firdaus G Junior ◽  
Marisa Junianti Manik ◽  
Swingly Wikliv D
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Sampling Technique ◽  
Total Sample ◽  
Health Providers ◽  
High Quality ◽  
Private Hospitals ◽  
Heart Attacks ◽  
Quantitative Descriptive

<p><em>Cardiac arrest is a significant cause of death worldwide, and an estimated 17.9 million people die from heart disease. In 2016, cardiac arrest represented 31% of all global deaths, and heart attacks and strokes caused 85%. In the treatment of cardiac arrest, health providers must perform cardiac and pulmonary resuscitation, a combination of chest compressions, and assistance for the victim's breathing. Nurses must be able to provide high-quality CPR to the patients for optimal outcomes. This study aimed to describe the knowledge of nurses in six private hospitals in Indonesia about high-quality CPR. This research was quantitative descriptive using a modified questionnaire regarding the theory of high-quality CPR. The population in this study were nurses from adult inpatient wards at six private hospitals in Indonesia with a total sample of 86 respondents through convenience sampling technique. The results showed that 79.1% inpatient nurses at six hospitals in Indonesia had good knowledge about high-quality CPR. Nurses are expected to maintain and improve their knowledge and ability to provide high-quality CPR so that the basic life support provided will be of high quality and provide optimal results for cardiac arrest patients in hospitals.</em><strong><br /><br />BAHASA INDONESIA ABSTRAK: </strong>Henti jantung merupakan penyebab kematian yang signifikan di dunia dan diperkirakan 17,9 juta orang meninggal karena penyakit jantung. Pada 2016, henti jantung mewakili 31% dari semua kematian global, dan 85% disebabkan oleh serangan jantung dan stroke. Dalam penanganan henti jantung, perawat harus melakukan resusitasi jantung dan paru yaitu kombinasi dari kompresi dada dan bantuan terhadap pernafasan korban. Tenaga kesehatan harus mampu memberikan<em> high-quality</em> CPR kepada korban untuk hasil yang optimal. Penelitian ini bertujuan untuk mengetahui gambaran pengetahuan perawat tentang high-quality CPR di enam rumah sakit swasta di Indonesia. Penelitian ini merupakan studi deskriptif kuantitatif dengan menggunakan kuesioner mengenai teori <em>high-quality</em> CPR yang telah dimodifikasi. Populasi dalam penelitian ini adalah perawat ruang rawat inap dewasa di enam rumah sakit swasta di Indonesia dengan jumlah sampel sebanyak 86 responden melalui teknik sampel konvenien. Hasil penelitian menunjukan 79.1% perawat rawat inap di enam rumah sakit di Indonesia memiliki pengetahuan tentang <em>high-quality</em> CPR pada tingkat yang baik. Perawat diharapkan untuk tetap mempertahankan dan meningkatkan pengetahuan dan kemampuan pemberian <em>high-quality CPR</em> sehingga bantuan hidup dasar yang diberikan akan berkualitas dan memberikan hasil optimal bagi pasien henti jantung dalam rumah sakit.</p>

Out of Hospital Cardiac Arrest

2018 ◽  
pp. 89-93
Author(s):  
Erik Rueckmann
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Services ◽  
Evidence Based ◽  
Early Defibrillation ◽  
Key Factors ◽  
High Quality ◽  
Key Points ◽  
Neurologically Intact ◽  
Hospital Cardiac Arrest

The management of out-of-hospital, atraumatic cardiac arrest has changed over the past decade. This case details the evidence-based changes in care that optimize the chance of neurologically intact survival. The key factors include immediate, continuous, high-quality cardiopulmonary resuscitation with minimal interruptions, early defibrillation, and the use of capnography to assess resuscitative efforts. The orchestration of resuscitative efforts is a bundle of care that must all be met to provide the patient the best chance of survival. Furthermore, this case illustrates the key points of postarrest care and touches on termination of resuscitation. This chapter examines the case of emergency medical services call for an unresponsive patient in cardiac arrest on arrival.

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