Effectiveness on Simulation Teaching Regarding Cardio Pulmonary Resuscitation among Workers of State Transport Depot

Introduction: Cardiopulmonary resuscitation is the technique of life-saving procedure in that artificial ventilation uses external chest compressions to maintain circulation flow of the heart and oxygenation during cardiac arrest. Many peoples in the developed and developing countries have taken known education of Cardiopulmonary resuscitation training which was launched jointly by Universal Medical Assistance International Center. Objectives: 1. To evaluate the previous knowledge and skill regarding CPR among workers of ST Depot. 2. To evaluate effectiveness and correlation the post-test knowledge and skill score regarding CPR among workers of ST Depot. 3. To identify the association with the post-test skill score regarding CPR among workers of ST Depot. Methodology: In this study, will the effectiveness of simulation teaching regarding cardiopulmonary resuscitation the sample will be the 100 ST depot workers. The workers will select according to inclusion and exclusion criteria as well as the Purposive sampling technique. One group pre-test and post-test design. It will be conducted at State Transport Depot. Wardha Maharashtra, India respectively. The data will be collected by using questionnaires and an observational checklist for simulation teaching on cardiopulmonary resuscitation. Conclusion: It is concluded that the effectiveness of simulation teaching on CPR was found to be effective in improving the knowledge and skill of workers of ST depot.

Cardiopulmonary Resuscitation in Hypogravity Simulation

BACKGROUND: Limited research exists into extraterrestrial CPR, despite the drive for interplanetary travel. This study investigated whether the terrestrial CPR method can provide quality external chest compressions (ECCs) in line with the 2015 UK resuscitation guidelines during ground-based hypogravity simulation. It also explored whether gender, weight, and fatigue influence CPR quality.METHODS: There were 21 subjects who performed continuous ECCs for 5 min during ground-based hypogravity simulations of Mars (0.38 G) and the Moon (0.16 G), with Earths gravity (1 G) as the control. Subjects were unloaded using a body suspension device (BSD). ECC depth and rate, heart rate (HR), ventilation (VE), oxygen uptake (Vo2), and Borg scores were measured.RESULTS: ECC depth was lower in 0.38 G (42.9 9 mm) and 0.16 G (40.8 9 mm) compared to 1 G and did not meet current resuscitation guidelines. ECC rate was adequate in all gravity conditions. There were no differences in ECC depth and rate when comparing gender or weight. ECC depth trend showed a decrease by min 5 in 0.38 G and by min 2 in 0.16 G. Increases in HR, VE, and Vo2 were observed from CPR min 1 to min 5.DISCUSSION: The terrestrial method of CPR provides a consistent ECC rate but does not provide adequate ECC depths in simulated hypogravities. The results suggest that a mixed-gender space crew of varying bodyweights may not influence ECC quality. Extraterrestrial-specific CPR guidelines are warranted. With a move to increasing ECC rate, permitting lower ECC depths and substituting rescuers after 1 min in lunar gravity and 4 min in Martian gravity is recommended.Sriharan S, Kay G, Lee JCY, Pollock RD, Russomano T. Cardiopulmonary resuscitation in hypogravity simulation. Aerosp Med Hum Perform. 2021; 92(2):106112.

Research and Development of a Low-Cost Smart Cardio-Pulmonary Resuscitation (CPR) Device Using Locally Available Raw Materials for Cardiac Arrest Patients

Cardiovascular disease is the main worldwide reason for death. Cardiovascular diseases can cause the heartbeat to stop. If a person experiences a cardiac arrest, then direct treatments such as cardio-pulmonary resuscitation (CPR) with chest compressions and artificial ventilation along with defibrillation are methods to greatly improve the patient’s possibility of survival. Usually, CPR is completed manually. Manual CPR is carried out by applying external chest compressions followed by artificial ventilation. It helps to pump blood around the person’s body when their heart cannot do this job. This paper presents the development and analysis of a low-cost cardio-pulmonary resuscitation (CPR) device using locally available raw materials for the treatment of cardiac arrest patients. This CPR is automated, portable, and very user friendly. This is a very cost-effective product which people can easily afford to buy. The unit price of this CPR is USD 500.

Calidad de las compresiones torácicas en resucitación cardiopulmonar practicada en condiciones extremas de temperatura ambiental

En la atención del equipo de profesionales de la salud en una parada cardiorrespiratoria extrahospitalaria (PCREH), se pueden encontrar en condiciones extremas de temperatura ambiental, según la zona donde se encuentren, la época del año, e incluso la franja horaria. Objetivo: El objetivo de este trabajo fue comprobar si la eficacia de la Reanimación Cardiopulmonar (RCP) se veía afectada en ambientes de temperatura calor (40ºC) y frío (0ºC) extremos, en comparación con una RCP en temperatura ambiental (22ºC).Método: Se realizaron 2 minutos de compresiones torácicas (CT) ininterrumpidas en las condiciones de temperatura de 40ºC, 0ºC y 22ºC, en un maniquí realista Resusci Anne QCPR con SIMPAD. Resultados: 30 participantes, tanto con formación previa en RCP (86,7%) o sin ella (13,3%), formaron parte de la muestra, 26 mujeres (86,7%) y 4 hombres (13,3%), con una media de edad de 27,37±8,88 años. No se encontraron diferencias estadísticamente significativas en la eficacia de la RCP; pero sí que hubo diferencias entre el número total de CT (p=0,042), la profundidad media de las CT (p=0,015) y en la frecuencia media (p=0,034). La escala de Borg de esfuerzo percibido (RPE) mostró una media de 4,4±1,303 a 22ºC, 4,97±1,402 a 40ºC y 4,87±2,08 a 0ºC (p>0,05). No hubo diferencias significativas en el lactato capilar.Conclusiones: Se concluye que no existen diferencias significativas entre las tres condiciones, aunque parece que la temperatura ambiental y la fría se asemejan en los resultados y la temperatura calor ofrece una ligera desventaja al respecto. Under the care of a team of health professionals in an out-of-hospital cardiorespiratory arrest (PCREH), they can be found in conditions in extreme conditions of ambient temperature, depending on the area where they are located, the time of the year, and even the time of day.Objective: The objective of this study was to verify whether the efficacy of Cardiopulmonary Resuscitation (CPR) was affected by extreme heat (40ºC) and cold (0ºC) temperature environments, compared to a CPR in ambient temperature (22ºC).Method: 2 minutes of uninterrupted external chest compressions (ECC) were performed under ambient temperature conditions of 40ºC, 0ºC and 22ºC, in a realistic mannequin Resusci Anne QCPR with SIMPAD.Results: 30 participants, both people with prior training in CPR (86.7%) and without it (13.3%), were part of the sample, 26 women (86.7%) and 4 men (13.3%), with a mean age of 27.37 ± 8.88 years. No statistically significant differences were found in the efficacy of CPR; but there were differences between the total number of CT (p = 0.042), the average depth of the ECC (p = 0.015) and the average frequency (p = 0.034). The Borg scale of perceived exertion (RPE) showed an average of 4.4 ± 1.303 at 22° C, 4.97 ± 1.402 at 40° C and 4.87 ± 2.08 at 0° C (p> 0.05). There were no significant differences in hair lactate.Conclusions: It is concluded that there are no significant differences between the three conditions, although it seems that the cold and room temperatures resemble results and that the heat temperature offers a slight disadvantage of the others.

Abstract 167: Epinephrine Plus Chest Compressions May Be Superior to Epinephrine Alone in a Hypoxia-Induced Porcine Model of Lifeless Shock

Background: Lifeless shock (LS) (previously called EMD and pseudo-PEA) is a global hypotensive ischemic state with retained coordinated myocardial contractile activity and an organized ECG. We have previously described our hypoxic LS model. The role of standard external chest compressions remains unclear in the setting of LS and its associated intrinsic hemodynamics. Although it is known the patients with LS have better prognosis compared to PEA, it is unclear what is the best treatment strategy. Prior work has shown that chest compressions (CC) when synchronized with native systole results in significant hemodynamic improvement, most notably coronary perfusion pressure (CPP), and hence it is plausible that standard dyssynchronous CC may be detrimental to hemodynamics. Furthermore, retrospective clinical data has shown that LS patients treated with vasopressors and no CC, may have better outcomes. We compared epinephrine only versus epinephrine and chest compression, in a porcine model of LS. Methods: Our porcine model of hypoxic LS has previously been described. We randomized pigs to episodes of LS treated with epinephrine only (control) (0.0015 mg/kg) versus epinephrine plus standard external chest compressions (intervention). Animals were endotracheally intubated and mechanically ventilated, and the fraction of inspired oxygen (FiO 2 ) was gradually lowered from room air (20-30% O 2 ) to a target FiO 2 of 3-7% O 2 . This target FiO 2 was maintained until the systolic blood pressure (SBP) dropped to 30 mmHg for 30 seconds, or the animal became bradycardic (HR less than 40), which was defined as the start of LS. FiO 2 was then raised to 100%, and then animal would receive control or intervention. Return of spontaneous circulation (ROSC) was defined as SBP 60 mmHg, stable after 2 minutes. Results: Twenty-six episodes of LS in 11 animals received epinephrine only control and 21 episodes the epinephrine plus chest compression intervention. The rates of ROSC in two minutes or less were 5/26 (19%) in the control arm vs 14/21 (67%) in the intervention arm (P=0.001;95% CI 19.7 %-67.2%). Conclusions: In a swine model of hypoxia induced LS, epinephrine plus CPR may be superior to epinephrine alone.

Impact of loading and transport on effectiveness of external chest compressions – a simulation study

IntroductionEffective external chest compressions (ECC) are recognised as being critical for increasing chances of survival in out-of-hospital cardiac arrest. The aim of this study was to: 1) determine the impact of movement and transport on effectiveness of ECC performed by student paramedics; 2) provide results to inform a future larger study; and 3) validate teaching methods in an undergraduate paramedicine program.MethodsA prospective cohort design was utilised. Student paramedics performed ECC on a manikin under three different conditions: at ground level on a hard floor surface (ground ECC); at waist-height on a moving ambulance stretcher (extrication ECC; and during transport in the rear of a moving ambulance (transport ECC). Three minutes of ECCs was performed under each condition, with periods of rest between phases. The primary outcome was the composite ‘compression score’ (CS) (%).ResultsTwenty-seven student paramedics performed chest compressions under all three conditions. For the primary outcome comparison of CS, there were clinically significant differences in ECC quality across the three conditions. Ground ECC produced the highest CS (89%; IQR 46), followed by transport ECC (54%; IQR 40). Extrication ECC was least effective (CS 0%; IQR 14).ConclusionThe conditions under which ECC are performed significantly affects ECC quality. The quality of ECC is substantially reduced if performed in the back of a moving ambulance, and futile if performed on a moving ambulance stretcher. Paramedics should consider these findings when deciding whether or not to move or transport patients before return of spontaneous circulation. Lower than expected CS on hard ground surfaces may indicate a need to review teaching of ECC in this cohort of students.

Cardiopulmonary resuscitation: the science behind the hands

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.