1
|
Wray TC, Gerstein N, Ball E, Hanna W, Tawil I. Seeing the heart of the problem: transesophageal echocardiography in cardiac arrest: a practical review. Int Anesthesiol Clin 2023; 61:15-21. [PMID: 37602416 DOI: 10.1097/aia.0000000000000411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Affiliation(s)
- Trenton C Wray
- Department of Emergency Medicine, Division of Adult Critical Care, The University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Neal Gerstein
- Department of Anesthesiology and Critical Care, The University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Emily Ball
- Department of Emergency Medicine, Division of Adult Critical Care, The University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Wendy Hanna
- Department of Emergency Medicine, The University of New Mexico School of Medicine. Albuquerque, New Mexico
| | - Isaac Tawil
- Department of Emergency Medicine, Division of Adult Critical Care, The University of New Mexico School of Medicine, Albuquerque, New Mexico
| |
Collapse
|
2
|
Stephens AF, Šeman M, Nehme Z, Voskoboinik A, Smith K, Gregory SD, Stub D. Ex vivo evaluation of personal protective equipment in hands-on defibrillation. Resusc Plus 2022; 11:100284. [PMID: 35942482 PMCID: PMC9356271 DOI: 10.1016/j.resplu.2022.100284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Andrew F. Stephens
- Cardio-Respiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
- Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia
- Corresponding author at: Lab 2, Level 3, Baker Heart and Diabetes Institute, 75 Commercial Rd, 3004, Australia.
| | - Michael Šeman
- Cardio-Respiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Cardiology, Alfred Health, Melbourne, Australia
| | - Ziad Nehme
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Centre for Research and Evaluation, Ambulance Victoria, Melbourne, AU
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Australia
| | - Aleksandr Voskoboinik
- Department of Cardiology, Alfred Health, Melbourne, Australia
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Australia
- Electrophysiology Research, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Karen Smith
- Centre for Research and Evaluation, Ambulance Victoria, Melbourne, AU
| | - Shaun D. Gregory
- Cardio-Respiratory Engineering and Technology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
- Mechanical and Aerospace Engineering, Monash University, Melbourne, Australia
| | - Dion Stub
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Cardiology, Alfred Health, Melbourne, Australia
- Centre for Research and Evaluation, Ambulance Victoria, Melbourne, AU
| |
Collapse
|
3
|
Wight JA, Bigham TE, Hanson PR, Zahid A, Iravanian S, Perkins PE, Lloyd MS. Hands-on defibrillation with safety drapes: Analysis of compressions and an alternate current pathway. Am J Emerg Med 2021; 52:132-136. [PMID: 34922232 DOI: 10.1016/j.ajem.2021.11.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/26/2021] [Accepted: 11/28/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Hands-on defibrillation (HOD) could theoretically improve the efficacy of cardiopulmonary resuscitation (CPR) though a few mechanisms. Polyethylene drapes could potentially facilitate safe HOD, but questions remain about the effects of CPR on polyethylene's conductance and the magnitude of current looping through rescuers' arms in contact with patients. METHODS This study measured the leakage current through 2 mil (0.002 in.) polyethylene through two different current pathways before and after 30 min of continuous compressions on a CPR mannequin. The two pathways analyzed were the standardized IEC (International Electrotechnical Commission) leakage current analysis and a setup analyzing a current pathway looping through a rescuer's arms and returning to the patient. First, ten measurements involving the two pathways were obtained on a single polyethylene drape. 30 min of continuous compressions were applied to the drape on a CPR mannequin after which the ten measurements were repeated. RESULTS Twenty patients undergoing elective cardioversion for atrial fibrillation (18/20) or atrial flutter (2/20) at Emory University Hospital underwent analysis all receiving 200 J shocks (age 38-101, 35% female). Through the IEC measurement method the peak leakage current mean was 0.70 +/- 0.02 mA before compressions and 0.59 +/- 0.19 mA after compressions. Only three of the ten measurements assessing current passing through a rescuer's arms had detectable current and each was of low magnitude. All measurements were well below the maximum IEC recommendations of 3.5 mA RMS and 5.0 mA peak. CONCLUSIONS Polyethylene may facilitate safe HOD even after long durations of compressions. Current looping through a rescuer's arms is likely of insignificant magnitude.
Collapse
|
4
|
Adler DS, Jui J, Sahni R, Neth MR, Daya MR, Lupton JR. Emergency medical services medical director and first responder attitudes regarding hands-on defibrillation. Am J Emerg Med 2021; 55:206-208. [PMID: 34218994 DOI: 10.1016/j.ajem.2021.06.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/19/2021] [Accepted: 06/20/2021] [Indexed: 10/21/2022] Open
Affiliation(s)
- David S Adler
- Department of Emergency Medicine, Oregon Health & Science University School of Medicine, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239, United States of America.
| | - Jonathan Jui
- Department of Emergency Medicine, Oregon Health & Science University School of Medicine, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239, United States of America
| | - Ritu Sahni
- Department of Emergency Medicine, Oregon Health & Science University School of Medicine, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239, United States of America
| | - Matthew R Neth
- Department of Emergency Medicine, Oregon Health & Science University School of Medicine, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239, United States of America
| | - Mohamud R Daya
- Department of Emergency Medicine, Oregon Health & Science University School of Medicine, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239, United States of America
| | - Joshua R Lupton
- Department of Emergency Medicine, Oregon Health & Science University School of Medicine, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239, United States of America
| |
Collapse
|