Cardiopulmonary Resuscitation Quality by Helicopter Rescue Swimmers While Flying

Twelve Tips for using Learning Curves in Health Professions Education Research

Learning curves can be used to design, implement, and evaluate educational interventions. Attention to key aspects of the method can improve the fidelity of this representation of learning as well as its suitability for education and research purposes. This paper addresses when to use a learning curve, which graphical properties to consider, how to use learning curves quantitatively, and how to use observed thresholds to communicate meaning. We also address the associated ethics and policy considerations. We conclude with a best practices checklist for both educators and researchers seeking to use learning curves in their work.

Mechanical Cardiopulmonary Resuscitation's Role in Helicopter Air Ambulances: A Narrative Review

Helicopter emergency medical services (HEMS) frequently respond to out-of-hospital cardiac arrest (OHCA) situations. Some have speculated mechanical cardiopulmonary resuscitation (mCPR) may be able to rectify the inadequacy of human performance of cardiopulmonary resuscitation (CPR) during transport. A number of studies have examined the performance of mCPR devices in the air medical setting specifically. Many aspects of the HEMS environment seem uniquely conducive to mCPR, and a growing body of research seems to suggest mCPR holds promise for the treatment of cardiac arrest by HEMS clinicians. Simulation studies show that mCPR leads to improved CPR performance compared with manual CPR in HEMS. Case reports and the experience of several HEMS programs suggest that mCPR can be effectively integrated into HEMS care. However, further research regarding the effectiveness of mCPR in the HEMS environment and in general cardiac arrest care is needed.

Performance of Basic Life Support by Lifeboat Crewmembers While Wearing a Survival Suit and Life Vest: A Randomized Controlled Trial

Introduction: Crewmembers of the “Royal Netherlands Sea Rescue Institution” (KNRM) lifeboats must wear heavy survival suits with integrated lifejackets. This and the challenging environment onboard (boat movements, limited space) might influence Basic Life Support (BLS) performance. The primary objective of this study was to assess the impact of the protective gear on single-rescuer BLS-quality.

Material and Methods: Sixty-five active KNRM crewmembers who had recently undergone a BLS-refresher course were randomized to wear either their protective gear (n = 32) or their civilian clothes (n = 33; control group) and performed five 2-min sessions of single rescuer BLS on a mannequin on dry land. BLS-quality was assessed according to Dutch and European Resuscitation guidelines. A between group analysis (Mann-Whitney U) and a repeated within group analysis of both groups (Friedman test) were performed.

Results: There were no major demographic differences between the groups. The protective gear did not significant impair BLS-quality. It was also not associated with a significant increase in the perceived exertion of BLS (Borg's Rating scale). Compression depth, compression frequency, the percentage of correct compression depth and of not leaning on the thorax, and ventilation volumes in both groups were suboptimal when evaluated according to the BLS-guidelines.

Conclusions: The protective gear worn by KNRM lifeboat-crewmembers does not have a significant influence on BLS-quality under controlled study conditions. The impact and significance on outcome in real life situations needs to be studied further. This study provides valuable input for optimizing the BLS-skills of lifeboat crewmembers.

The Efficacy of Chest Compressions in the Bell 407

OBJECTIVE

The Air Medical industry is fraught with obstacles to patient care and providers can recognize that several sub-groups of patients can provide very challenging scenarios while in flight. However, the patient experiencing cardiac arrest in flight is, by its very nature, one that poses the most severe risk to the patient and provider. This study seeks to explore the capability of a highly trained emergency medical provider to provide adequate chest compressions while in a Bell 407 helicopter.

METHODS

59 participants were evaluated in two separate scenarios. Scenario A consisted of 2 rounds of of 200 chest compressions performed on a flat, uncrowded surface. Scenario B consisted of 200 chest compressions performed in the cabin of a Bell 407. Participants performed 2 rounds of 200 chest compressions. The results were then compared to each other and to the AHA 2010 CPR guidelines.

RESULTS

The findings of the study show that compressions performed in the aircraft do not meet AHA guidelines for chest compressions in regard to depth and duration of compressions. The deviation from guideline in regard to rate was found to be not statistically significant.

CONCLUSION

Chest compressions performed in a Bell 407 helicopter do not meet AHA guidelines.