scholarly journals Is Rescuer Cardiopulmonary Resuscitation Jeopardised by Previous Fatiguing Exercise?

2020 ◽  
Vol 17 (18) ◽  
pp. 6668
Author(s):  
J. Arturo Abraldes ◽  
Ricardo J. Fernandes ◽  
Núria Rodríguez ◽  
Ana Sousa
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Technicians ◽  
Survival Outcomes ◽  
Compression Rate ◽  
Strong Impact ◽  
Gas Analyzer ◽  
Video Cameras ◽  
Physiological Variables ◽  
Emergency Medical ◽  
Fatiguing Exercise

Survival outcomes increase significantly when cardiopulmonary resuscitation (CPR) is provided correctly, but rescuer’s fatigue can compromise CPR delivery. We investigated the effect of a 100-m maximal run on CPR and physiological variables in 14 emergency medical technicians (age 29.2 ± 5.8 years, height 171.2 ± 1.1 cm and weight 73.4 ± 13.1 kg). Using an adult manikin and a compression-ventilation ratio of 30:2, participants performed 4-min CPR after 4-min baseline conditions (CPR) and 4-min CPR after a 100-m maximal run carrying emergency material (CPR-run). Physiological variables were continuously measured during baseline and CPR conditions using a portable gas analyzer (K4b2, Cosmed, Rome, Italy) and analyzed using two HD video cameras (Sony, HDR PJ30VE, Japan). Higher VO2 (14.4 ± 2.1 and 22.0 ± 2.5 mL·kg−1·min−1) and heart rate (123 ± 17 and 148 ± 17 bpm) were found for CPR-run. However, the compression rate was also higher during the CPR-run (373 ± 51 vs. 340 ± 49) and between every three complete cycles (81 ± 9 vs. 74 ± 14, 99 ± 14 vs. 90 ± 10, 99 ± 10 vs. 90 ± 10, and, 101 ± 15 vs. 94 ± 11, for cycle 3, 6, 9 and 12, respectively). Fatigue induced by the 100-m maximal run had a strong impact on physiological variables, but a mild impact on CPR emergency medical technicians’ performance.

scholarly journals Previous Intensive Running or Swimming Negatively Affects CPR Effectiveness

2021 ◽  
Vol 18 (18) ◽  
pp. 9843
Author(s):  
J. Arturo Abraldes ◽  
Ricardo J. Fernandes ◽  
Ricardo Morán-Navarro
Keyword(s):  
Heart Rate ◽  
Cardiopulmonary Resuscitation ◽  
Physiological Stress ◽  
Survival Outcomes ◽  
Compression Rate ◽  
Gas Analyzer ◽  
Intense Exercise ◽  
Video Cameras ◽  
Physiological Variables ◽  
Water Rescue

Survival outcomes increase significantly when cardiopulmonary resuscitation (CPR) is provided correctly, but rescuers’ fatigue can compromise its delivery. We investigated the effect of two exercise modes on CPR effectiveness and physiological outputs. After 4 min baseline conditions, 30 lifeguards randomly performed a 100 m run and a combined water rescue before 4 min CPR (using an adult manikin and a 30:2 compression–ventilation ratio). Physiological variables were continuously measured during baseline and CPR using a portable gas analyzer (K4b2, Cosmed, Rome, Italy) and CPR effectiveness was analyzed using two HD video cameras. Higher oxygen uptake (23.0 ± 9.9 and 20.6 ± 9.1 vs. 13.5 ± 6.2 mL·kg·min−1) and heart rate (137 ± 19 and 133 ± 15 vs. 114 ± 15 bpm), and lower compression efficacy (63.3 ± 29.5 and 62.2 ± 28.3 vs. 69.2 ± 28.0%), were found for CPRrun and CPRswim compared to CPRbase. In addition, ventilation efficacy was higher in the rescues preceded by intense exercise than in CPRbase (49.5 ± 42.3 and 51.9 ± 41.0 vs. 33.5 ± 38.3%), but no differences were detected between CPRrun and CPRswim. In conclusion, CPRrun and CPRswim protocols induced a relevant physiological stress over each min and in the overall CPR compared with CPRbase. The CPRun protocol reduces the compression rate but has a higher effectiveness percentage than the CPRswim protocol, in which there is a considerably higher compression rate but with less efficacy.

scholarly journals Bystander Cardiopulmonary Resuscitation Quality: Potential for Improvements in Cardiac Arrest Resuscitation

2021 ◽  
Author(s):  
Richard Chocron ◽  
Julia Jobe ◽  
Sally Guan ◽  
Madeleine Kim ◽  
Mia Shigemura ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Performance Metrics ◽  
Medical System ◽  
Emergency Medical System ◽  
Compression Rate ◽  
Emergency Medical ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Bystander Cpr ◽  
Hospital Cardiac Arrest

Background Bystander cardiopulmonary resuscitation (CPR) is a critical intervention to improve survival following out‐of‐hospital cardiac arrest. We evaluated the quality of bystander CPR and whether performance varied according to the number of bystanders or provision of telecommunicator CPR (TCPR). Methods and Results We investigated non‐traumatic out‐of‐hospital cardiac arrest occurring in a large metropolitan emergency medical system during a 6‐month period. Information about bystander care was ascertained through review of the 9‐1‐1 recordings in addition to emergency medical system and hospital records to determine bystander CPR status (none versus TCPR versus unassisted), the number of bystanders on‐scene, and CPR performance metrics of compression fraction and compression rate. Of the 428 eligible out‐of‐hospital cardiac arrest, 76.4% received bystander CPR including 43.7% unassisted CPR and 56.3% TCPR; 35.2% had one bystander, 33.3% had 2 bystanders, and 31.5% had ≥3 bystanders. Overall compression fraction was 59% with a compression rate of 88 per minute. CPR differed according to TCPR status (fraction=52%, rate=87 per minute for TCPR versus fraction=69%, rate=102 for unassisted CPR, P <0.05 for each comparison) and the number of bystanders (fraction=55%, rate=87 per minute for 1 bystander, fraction=59%, rate=89 for 2 bystanders, fraction=65%, rate=97 for ≥3 bystanders, test for trend P <0.05 for each metric). Additional bystander actions were uncommon to include rotation of compressors (3.1%) or application of an automated external defibrillator (8.0%). Conclusions Bystander CPR quality as gauged by compression fraction and rate approached guideline goals though performance depended upon the type of CPR and number of bystanders.

scholarly journals For how long can two emergency medical technicians perform high-quality cardiopulmonary resuscitation?

2015 ◽  
Vol 43 (6) ◽  
pp. 841-850
Author(s):  
Chu Hyun Kim ◽  
Gi Woon Kim ◽  
Won Chul Cha ◽  
Bo Ra Kang ◽  
Han ho Do ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Technicians ◽  
High Quality ◽  
Emergency Medical

Abstract 273: Exploring the Role of the Emergency Medical System in Promoting Bystander Cardiopulmonary Resuscitation During Out-of-hospital Cardiac Arrests

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Sydney Fouche ◽  
Mahshid Abir ◽  
Jessica Lehrich ◽  
Stuart Hammond ◽  
Wilson Nham ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Medical System ◽  
Emergency Medical System ◽  
Survival Outcomes ◽  
Medical Systems ◽  
Emergency Medical ◽  
Bystander Response ◽  
Emergency Medical Systems

Introduction: Early bystander initiated cardiopulmonary resuscitation (BCPR) is a key link in the cardiac arrest chain of survival. Prior work indicates that BCPR has a greater impact on survival outcomes when arrests are witnessed, and bystanders are actively prepared. This study explores the role of the emergency medical system—including dispatch, police, fire, and emergency medical services (EMS), in promoting timely bystander response during an out-of-hospital cardiac arrest (OHCA) event. Methods: This sequential mixed-methods study used 2014-2017 data from the Michigan Cardiac Arrest Registry to Enhance Survival (MI-CARES) to analyze the effect of BCPR on OHCA survival outcomes. Logistic regression models were used to analyze the effect of BCPR on sustained ROSC with pulse upon emergency department (ED) arrival and secondary outcomes. These data were supplemented with semi-structured key informant interviews and multidisciplinary focus groups conducted during site visits to 9 emergency medical systems across Michigan including dispatch, police, fire, EMS, and ED. Results: A total of 21,044 OHCA incidents met inclusion criteria. OHCA patients who received BCPR had 1.32 times higher odds of achieving ROSC with pulse upon ED arrival than those that did not after multivariable adjustment (Table 1). Qualitative data from interviews suggest that emergency medical systems can play a critical role in promoting BCPR. Several salient themes emerged across stakeholders including: 1) Preparing the community for proactive bystander response through educational campaigns; 2) Facilitating BCPR during an event through dispatch-assisted CPR and on-scene responders providing positive reinforcement to bystanders; and 3) Reinforcing the importance of performing bystander CPR to the involved community after post arrest care. Conclusion: We found that BCPR was associated with statistically significant improvements in survival outcomes compared to those that did not receive BCPR. These findings emphasize the importance of training bystanders to initiate and perform CPR, and points to engaging the emergency medical system as a leader for this initiative to improve OHCA survival across US communities.

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