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An S, Liu Y, Xi Q, Zhang Y, Gao Y, Zhang W. Standard cardiopulmonary resuscitation versus chest compressions only after out-of-hospital cardiac arrest: a protocol for a systematic review and meta-analysis. BMJ Open 2024; 14:e079167. [PMID: 38724047 PMCID: PMC11086416 DOI: 10.1136/bmjopen-2023-079167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION The 2020 American Heart Association guidelines encourage lay rescuers to provide chest compression-only cardiopulmonary resuscitation to simplify the process and encourage cardiopulmonary resuscitation initiation. However, recent clinical trials had contradictory results about chest compression-only cardiopulmonary resuscitation. This study will aim to compare standard and chest compressions-only cardiopulmonary resuscitation after out-of-hospital cardiac arrest. METHODS AND ANALYSIS This study will retrieve only randomised and quasi-randomised controlled trials from the Cochrane Library, PubMed, Web of Science and Embase databases. Data on study design, participant characteristics, intervention details and outcomes will be extracted by a unified standard form. Primary outcomes to be assessed are hospital admission, discharge, and 30-day survival, and return of spontaneous circulation. The Grading of Recommendations, Assessment, Development and Evaluation framework will evaluate the quality of evidence. Cochrane's tool for assessing the risk of bias will evaluate risk deviation. If the I2 statistic is lower than 40%, the fixed-effects model will be used for meta-analysis. Otherwise, the random-effects model will be used. The search will be performed following the publication of this protocol (estimated to occur on 30 December 2024). DISCUSSION This study will evaluate the effect of chest compression-only cardiopulmonary resuscitation after out-of-hospital cardiac arrest and provide evidence for cardiopulmonary resuscitation guidelines. ETHICS AND DISSEMINATION No patient or public entity will be involved in this study. Therefore, the study does not need to be ethically reviewed. The results of the study will be disseminated through peer-reviewed journal publications and committee conferences. PROSPERO REGISTRATION NUMBER CRD42021295507.
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Affiliation(s)
- Shulin An
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Yi Liu
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Qian Xi
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Yongqing Zhang
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Yongli Gao
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Wei Zhang
- Department of Emergency Medicine and West China School of Nursing, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
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Hasegawa Y, Hanaki K. Factors Related to Young People's Willingness to Perform Basic Life Support. Yonago Acta Med 2023; 66:120-128. [PMID: 36820297 PMCID: PMC9937969 DOI: 10.33160/yam.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/13/2023] [Indexed: 02/11/2023]
Abstract
Background Survival rates increase when basic life support (BLS) is provided by bystanders to patients with acute diseases, such as out-of-hospital cardiac arrest; however, its implementation rate is not high. In this study, we investigated "interest on BLS," "knowledge on BLS," and "experience on BLS" as factors related to the willingness to implement BLS among junior high school, high school, and college students who have multiple opportunities to learn it. Methods This is an observational study using a questionnaire survey. The participants were 112 junior high school students, 114 high school students, and 109 university students (non-medical), totaling 294 (87.8% response rate). The questionnaire listed three items on the strength of willingness to perform BLS, three items on attributes of the participant, four items on the score of interest on BLS, one item on the score of knowledge on BLS, and two items on the score of experience on BLS. Results Among junior high school students, the factors that were significantly associated with the willingness to perform BLS were "Presence of someone who died" and "Interest on BLS" score. Among high school and college students, the factors that were significantly associated with the willingness to perform BLS were "Interest on BLS" and "Knowledge on BLS" scores. Conclusion For junior high school students, creating an environment in which they can visualize the actual situation may increase their interest, whereas for high school and university students, in addition to such an environment, conducting seminars of short duration may help them to consolidate their knowledge and increase their willingness to implement BLS.
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Affiliation(s)
- Yoshiyuki Hasegawa
- Graduate School of Medical Sciences Major in Health Sciences, Tottori University, Yonago 683-8503, Japan,School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Keiichi Hanaki
- School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
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Comparison of Long-Term Effects between Chest Compression-Only CPR Training and Conventional CPR Training on CPR Skills among Police Officers. Healthcare (Basel) 2021; 9:healthcare9010034. [PMID: 33401707 PMCID: PMC7824449 DOI: 10.3390/healthcare9010034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/24/2020] [Accepted: 12/29/2020] [Indexed: 12/22/2022] Open
Abstract
Despite of the changes of out-of-hospital cardiac arrest (OHCA) survival rise when bystander CPR is provided, this was only conducted in about 23% of OHCA patients in Korea in 2018. Police officers acting as first responders have a high chance of witnessing situations requiring CPR. We investigated long-term effects on CPR quality between chest compression-only CPR training and conventional CPR training in police officers to find an efficient CPR training method in a prospective, randomized, controlled trial. Police officers underwent randomization and received different CPR training. With the Brayden Pro application, we compared the accuracy of CPR skills immediately after training and the one after 3 months. Right after training, the conventional CPR group presented the accuracy of the CPR skills (compression rate: 74.6%, compression depth: 66.0%, recoil: 78.0%, compression position: 96.1%) and chest compression-only CPR group presented the accuracy of the CPR skills (compression rate: 74.5%, compression depth: 71.6%, recoil: 79.2%, compression position: 99.0%). Overall, both groups showed the good quality of CPR skills and had no meaningful difference right after the training. However, three months after training, overall accuracy of CPR skills decreased, a significant difference between two groups was observed for compression position (conventional CPR: 80.0%, chest compression only CPR: 95.0%). In multiple linear regression analysis, three months after CPR training, chest compression-only CPR training made CPR skills accuracy 28.5% higher. In conclusion, police officers showed good-quality CPR right after CPR training in both groups. But three months later, chest compression-only CPR training group had better retention of CPR skills. Therefore, chest compression-only CPR training is better to be a standard training method for police officers as first responders.
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Cheng A, Magid DJ, Auerbach M, Bhanji F, Bigham BL, Blewer AL, Dainty KN, Diederich E, Lin Y, Leary M, Mahgoub M, Mancini ME, Navarro K, Donoghue A. Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S551-S579. [PMID: 33081527 DOI: 10.1161/cir.0000000000000903] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Malysz M, Dabrowski M, Böttiger BW, Smereka J, Kulak K, Szarpak A, Jaguszewski M, Filipiak KJ, Ladny JR, Ruetzler K, Szarpak L. Resuscitation of the patient with suspected/confirmed COVID-19 when wearing personal protective equipment: A randomized multicenter crossover simulation trial. Cardiol J 2020; 27:497-506. [PMID: 32419128 DOI: 10.5603/cj.a2020.0068] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/07/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The aim of the study was to evaluate various methods of chest compressions in patients with suspected/confirmed SARS-CoV-2 infection conducted by medical students wearing full personal protective equipment (PPE) for aerosol generating procedures (AGP). METHODS This was prospective, randomized, multicenter, single-blinded, crossover simulation trial. Thirty-five medical students after an advanced cardiovascular life support course, which included performing 2-min continuous chest compression scenarios using three methods: (A) manual chest compression (CC), (B) compression with CPRMeter, (C) compression with LifeLine ARM device. During resuscitation they are wearing full personal protective equipment for aerosol generating procedures. RESULTS The median chest compression depth using manual CC, CPRMeter and LifeLine ARM varied and amounted to 40 (38-45) vs. 45 (40-50) vs. 51 (50-52) mm, respectively (p = 0.002). The median chest compression rate was 109 (IQR; 102-131) compressions per minute (CPM) for manual CC, 107 (105-127) CPM for CPRMeter, and 102 (101-102) CPM for LifeLine ARM (p = 0.027). The percentage of correct chest recoil was the highest for LifeLine ARM - 100% (95-100), 80% (60-90) in CPRMeter group, and the lowest for manual CC - 29% (26-48). CONCLUSIONS According to the results of this simulation trial, automated chest compression devices (ACCD) should be used for chest compression of patients with suspected/confirmed COVID-19. In the absence of ACCD, it seems reasonable to change the cardiopulmonary resuscitation algorithm (in the context of patients with suspected/confirmed COVID-19) by reducing the duration of the cardiopulmonary resuscitation cycle from the current 2-min to 1-min cycles due to a statistically significant reduction in the quality of chest compressions among rescuers wearing PPE AGP.
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Affiliation(s)
- Marek Malysz
- Polish Society of Disaster Medicine, Warsaw, Poland
| | - Marek Dabrowski
- Chair and Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
| | - Bernd W Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Köln, Germany
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
| | | | | | - Milosz Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Krzysztof J Filipiak
- First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Jerzy R Ladny
- Clinic of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
| | - Kurt Ruetzler
- Departments of General Anesthesiology and Outcomes Research, Cleveland Clinic, Anesthesiology Institute, Cleveland, OH, USA
| | - Lukasz Szarpak
- Lazarski University, Warsaw, Poland. .,Polish Society of Disaster Medicine, Warsaw, Poland.
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Berg DD, Bobrow BJ, Berg RA. Key components of a community response to out-of-hospital cardiac arrest. Nat Rev Cardiol 2020; 16:407-416. [PMID: 30858511 DOI: 10.1038/s41569-019-0175-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Out-of-hospital cardiac arrest (OHCA) remains a leading cause of death worldwide, with substantial geographical, ethnic and socioeconomic disparities in outcome. Successful resuscitation efforts depend on the 'chain of survival', which includes immediate recognition of cardiac arrest and activation of the emergency response system, early bystander cardiopulmonary resuscitation (CPR) with an emphasis on chest compressions, rapid defibrillation, basic and advanced emergency medical services and integrated post-cardiac arrest care. Well-orchestrated telecommunicator CPR programmes can improve rates of bystander CPR - a critical link in the chain of survival. High-performance CPR by emergency medical service providers includes minimizing interruptions in chest compressions and ensuring adequate depth of compressions. Developing local, regional and statewide systems with dedicated high-performing cardiac resuscitation centres for post-resuscitation care can substantially improve survival after OHCA. Innovative digital tools for recognizing cardiac arrest where and when it occurs, notifying potential citizen rescuers and providing automated external defibrillators at the scene hold the promise of improving survival after OHCA. Improved implementation of the chain of survival can save thousands of lives each year.
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Affiliation(s)
- David D Berg
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Bentley J Bobrow
- Department of Emergency Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Robert A Berg
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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Kawase K, Ujiie H, Takaki M, Yamashita K. Clinical outcome of canine cardiopulmonary resuscitation following the RECOVER clinical guidelines at a Japanese nighttime animal hospital. J Vet Med Sci 2018; 80:518-525. [PMID: 29375087 PMCID: PMC5880836 DOI: 10.1292/jvms.17-0107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A set of evidence-based consensus guidelines for cardiopulmonary resuscitation (CPR) in dogs and cats (RECOVER guidelines) was published in 2012. The purpose of this study was to investigate the clinical outcomes of CPR
performed according to those guidelines in dogs. A total of 141 dogs with cardiopulmonary arrest (CPA) were identified and underwent CPR between January 2012 and December 2015 at the Sapporo Nighttime Animal Hospital.
CPR was performed according to no-consensus traditional veterinary CPR procedures in 68 dogs (TRADITIONAL group), and according to the RECOVER guidelines in 73 dogs (RECOVER group). There was no significant difference in
the age, body weight, or time from CPA identification to initiation of CPR between the TRADITIONAL and RECOVER groups (median [range]: 10 [0–16] vs. 11 [0–16] years; 6.6 [1.0–58.6] vs. 5.5 [1.1–30.4] kg; and 0 [0–30] vs.
0 [0–30] min, respectively). In the TRADITIONAL group, 12 dogs (17%) achieved a return of spontaneous circulation (ROSC), but none survived to hospital discharge. However, 32 dogs (43%) in the RECOVER group achieved
ROSC, and 4 dogs (5%) were discharged from the hospital. Incorporating the RECOVER guidelines into clinical practice significantly improved the ROSC rate (P<0.001). However, the rate of survival to
hospital discharge was still low. This may suggest that a superior intensive care unit that provides advanced post-CPA care could benefit veterinary CPR patients.
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Affiliation(s)
- Koudai Kawase
- Sapporo Nighttime Animal Hospital, Sapporo, Hokkaido 060-0062, Japan.,Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Hazuki Ujiie
- Sapporo Nighttime Animal Hospital, Sapporo, Hokkaido 060-0062, Japan
| | - Motonori Takaki
- Sapporo Nighttime Animal Hospital, Sapporo, Hokkaido 060-0062, Japan
| | - Kazuto Yamashita
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
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Ko RJM, Lim SH, Wu VX, Leong TY, Liaw SY. Easy-to-learn cardiopulmonary resuscitation training programme: a randomised controlled trial on laypeople's resuscitation performance. Singapore Med J 2017; 59:217-223. [PMID: 29167910 DOI: 10.11622/smedj.2017084] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Simplifying the learning of cardiopulmonary resuscitation (CPR) is advocated to improve skill acquisition and retention. A simplified CPR training programme focusing on continuous chest compression, with a simple landmark tracing technique, was introduced to laypeople. The study aimed to examine the effectiveness of the simplified CPR training in improving lay rescuers' CPR performance as compared to standard CPR. METHODS A total of 85 laypeople (aged 21-60 years) were recruited and randomly assigned to undertake either a two-hour simplified or standard CPR training session. They were tested two months after the training on a simulated cardiac arrest scenario. Participants' performance on the sequence of CPR steps was observed and evaluated using a validated CPR algorithm checklist. The quality of chest compression and ventilation was assessed from the recording manikins. RESULTS The simplified CPR group performed significantly better on the CPR algorithm when compared to the standard CPR group (p < 0.01). No significant difference was found between the groups in time taken to initiate CPR. However, a significantly higher number of compressions and proportion of adequate compressions was demonstrated by the simplified group than the standard group (p < 0.01). Hands-off time was significantly shorter in the simplified CPR group than in the standard CPR group (p < 0.001). CONCLUSION Simplifying the learning of CPR by focusing on continuous chest compressions, with simple hand placement for chest compression, could lead to better acquisition and retention of CPR algorithms, and better quality of chest compressions than standard CPR.
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Affiliation(s)
| | - Swee Han Lim
- Department of Emergency Medicine, Singapore General Hospital, Singapore
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Pearson DA, Darrell Nelson R, Monk L, Tyson C, Jollis JG, Granger CB, Corbett C, Garvey L, Runyon MS. Comparison of team-focused CPR vs standard CPR in resuscitation from out-of-hospital cardiac arrest: Results from a statewide quality improvement initiative. Resuscitation 2016; 105:165-72. [DOI: 10.1016/j.resuscitation.2016.04.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 03/29/2016] [Accepted: 04/11/2016] [Indexed: 10/21/2022]
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Min Ko RJ, Wu VX, Lim SH, San Tam WW, Liaw SY. Compression-only cardiopulmonary resuscitation in improving bystanders’ cardiopulmonary resuscitation performance: a literature review. Emerg Med J 2016; 33:882-888. [DOI: 10.1136/emermed-2015-204771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 11/12/2015] [Accepted: 12/28/2015] [Indexed: 11/03/2022]
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Can gentle chest compressions result in substantial ventilation? Resuscitation 2015; 92:A2-3. [PMID: 25936933 DOI: 10.1016/j.resuscitation.2015.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 04/01/2015] [Indexed: 11/23/2022]
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Effectiveness of simplified 15-min refresher BLS training program: A randomized controlled trial. Resuscitation 2015; 90:56-60. [DOI: 10.1016/j.resuscitation.2015.02.015] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 12/14/2014] [Accepted: 02/16/2015] [Indexed: 11/20/2022]
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Handley AJ. To ventilate or not to ventilate? That is the question--again. Resuscitation 2015; 91:A11-2. [PMID: 25840143 DOI: 10.1016/j.resuscitation.2015.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 03/23/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Anthony J Handley
- Hillcrest Cottage, Bartlow Road, Hadstock, Cambridge CB21 4PF, United Kingdom.
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Sánchez B, Algarte R, Piacentini E, Trenado J, Romay E, Cerdà M, Ferrer R, Quintana S. Low compliance with the 2 minutes of uninterrupted chest compressions recommended in the 2010 International Resuscitation Guidelines. J Crit Care 2015; 30:711-4. [PMID: 25797396 DOI: 10.1016/j.jcrc.2015.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 02/13/2015] [Accepted: 03/02/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND We aimed to analyze compliance with 2010 European guidelines' quality criteria for external chest compressions (ECC) during 2 minutes of uninterrupted cardiopulmonary resuscitation. METHODS Seventy-two healthy nurses and physicians trained in advanced cardiopulmonary resuscitation performed 2 uninterrupted minutes of ECC on a training manikin (Resusci Anne Advanced SkillTrainer; Laerdal Medical AS, Stavanger, Norway) that enabled us to measure the depth and rate of ECC. When professionals agreed to participate in the study, we recorded their age, body mass index (BMI), smoking habit, and their own subjective estimation of their physical fitness. To measure fatigue, we analyzed participants' heart rates, percentage of maximum tolerated heart rate (MHR), and subjective perception of their fatigue on a visual analog scale. RESULTS Nearly half (48.6%) the rescuers failed to achieve a minimum average ECC depth of 50 mm. Only 48.1% of ECCs fulfilled the 2010 guidelines' quality criteria; quality deteriorated mainly after the first minute. Poor ECC quality and deteriorating quality after the first minute were associated with BMI < 23 kg/m(2). Rescuers with BMI ≥ 23 kg/m(2) fulfilled the quality criteria throughout the 2 minutes, whereas those with BMI < 23 kg/m(2) fulfilled them for 80% of ECCs during the first minute, but for only 30% at the end of the 2 minutes. CONCLUSIONS Compliance with the 2010 guidelines' quality criteria is often poor, mainly due to lack of proper depth. The greater depth recommended in the 2010 guidelines with respect to previous guidelines requires greater force, so BMI < 23 kg/m(2) could hinder compliance. Limiting each rescuer's uninterrupted time doing ECC to 1 minute could help ensure compliance.
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Affiliation(s)
- Baltasar Sánchez
- Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain; Cardiorespiratory Arrest Committee, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
| | - Ramón Algarte
- Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Enrique Piacentini
- Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Josep Trenado
- Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Eduardo Romay
- Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Manel Cerdà
- Consell Català de Ressuscitació, Barcelona, Spain
| | - Ricard Ferrer
- Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain
| | - Salvador Quintana
- Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain; Cardiorespiratory Arrest Committee, Hospital Universitari Mútua Terrassa, Barcelona, Spain; Consell Català de Ressuscitació, Barcelona, Spain
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Rodríguez-Núñez A, Regueiro-García A, Jorge-Soto C, Cañas-González J, Leboráns-Iglesias P, García-Crespo O, Barcala-Furelos R. Quality of chest compressions by Down syndrome people: a pilot trial. Resuscitation 2015; 89:119-22. [PMID: 25637696 DOI: 10.1016/j.resuscitation.2015.01.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 01/17/2015] [Accepted: 01/21/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Immediate bystander cardiopulmonary resuscitation (CPR) is essential for survival after out-of-hospital cardiac arrest. Down syndrome (DS) citizens have improved their active engagement in society. The objective of this pilot trial was to investigate if they are able to perform quality chest compression-only CPR after a brief training. METHODS Nineteen DS young people (15-30 year old) and 20 University level subjects (18-29 year old) were trained by means of a short video and a brief hands-on session on manikins, to perform chest compression-only CPR. All participants were naïve in CPR. Chest compression (CC) quality (percentage of correct CC, CC rate and depth and chest complete release) was measured during a 2min test. CPR quality goal was according to 2010 European Resuscitation Council guidelines. RESULTS DS people had similar weight, lower height and a higher BMI than controls. They were able to deliver chest compression-only CPR but with higher mean CC rate (140±30 vs 123±12CC/min, p=0.03), less mean CC depth (35.4±10.3 vs 47.2±9.6mm, p=0.03) and lower % of full correct CC (13±18 vs 39±37, p=0.02) than controls. Differences were maintained when first and second minute of test were compared. CONCLUSIONS After a short instruction based on a brief video and hands-on session DS people were able to deliver CC but with poor quality.
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Affiliation(s)
- Antonio Rodríguez-Núñez
- Pediatric Area, Pediatric Emergency and Critical Care Division, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; School of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; Institute of Investigation of Santiago (IDIS), Santiago de Compostela, Spain; Research Network on Maternal and Child Health and Development II (Red SAMID II), Spanish Health Institute Carlos III, Madrid, Spain.
| | - Alexandra Regueiro-García
- Pediatric Area, Pediatric Emergency and Critical Care Division, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Cristina Jorge-Soto
- School of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Janali Cañas-González
- Education and Sports Sciences University School, University of Vigo, Pontevedra, Spain
| | - Pilar Leboráns-Iglesias
- Pediatric Area, Pediatric Emergency and Critical Care Division, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Down Compostela Foundation, Santiago de Compostela, Spain
| | | | - Roberto Barcala-Furelos
- School of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; Education and Sports Sciences University School, University of Vigo, Pontevedra, Spain
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Zou Y, Shi W, Zhu Y, Tao R, Jiang Y, Li S, Ye J, Lu Y, Jiang J, Tong J. Rate at 120/min provides qualified chest compression during cardiopulmonary resuscitation. Am J Emerg Med 2015; 33:535-8. [PMID: 25662803 DOI: 10.1016/j.ajem.2015.01.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 01/13/2015] [Accepted: 01/14/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The quality of cardiopulmonary resuscitation (CPR) is a very important prognostic factor for cardiac arrest. Chest compression is thought to be one of the most important aspects of high-quality CPR. Recent studies have prompted that there may be an interaction between chest compression rate and other factors related to the quality of chest compression. We aimed to investigate the effect of different compression rates on chest compression depth, recoil, and rescuers' fatigue point during CPR. METHODS Participants performed 2 minutes of chest compression-only CPR after the guiding sounds, at 3 rates (100, 120, and 140 compressions/min) in random sequence. A repeated-measures analysis of variance was used to compare the average chest compression depth and other factors related to the quality of chest compression among the groups. RESULTS As the chest compression rate increases through all the 3 rates, the fractions of chest compressions with complete release and the fractions of chest compressions with sufficient depth were deteriorated at the rate of 140 compressions/min (P < .05), although the average compression depth was above the recommended 2010 guideline depth of 5 cm(P > .05). Of note, the fatigue point at 140 compressions/min happened significantly (P < .05) sooner. CONCLUSION Our study supported the concern of some that there may be a risk of increasing recommended chest compression rate without providing an upper limit. An appropriate choice may be 120 compressions/min.
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Affiliation(s)
- Yaru Zou
- Department of Emergency Medicine, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Wen Shi
- Department of Emergency Medicine, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Ying Zhu
- Department of Emergency Medicine, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Ranjun Tao
- Department of Emergency Medicine, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Ying Jiang
- Ruijin Clinical Medical College, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Shanfeng Li
- Department of Emergency Medicine, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Jing Ye
- Department of Emergency Medicine, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Yiming Lu
- Department of Emergency Medicine, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Jie Jiang
- Department of Emergency Medicine, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China.
| | - Jianjing Tong
- Department of Emergency Medicine, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China.
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Nishiyama C, Iwami T, Kitamura T, Ando M, Sakamoto T, Marukawa S, Kawamura T. Long-term retention of cardiopulmonary resuscitation skills after shortened chest compression-only training and conventional training: a randomized controlled trial. Acad Emerg Med 2014; 21:47-54. [PMID: 24552524 DOI: 10.1111/acem.12293] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 07/22/2013] [Accepted: 08/06/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES It is unclear how much the length of a cardiopulmonary resuscitation (CPR) training program can be reduced without ruining its effectiveness. The authors aimed to compare CPR skills 6 months and 1 year after training between shortened chest compression-only CPR training and conventional CPR training. METHODS Participants were randomly assigned to either the compression-only CPR group, which underwent a 45-minute training program consisting of chest compressions and automated external defibrillator (AED) use with personal training manikins, or the conventional CPR group, which underwent a 180-minute training program with chest compressions, rescue breathing, and AED use. Participants' resuscitation skills were evaluated 6 months and 1 year after the training. The primary outcome measure was the proportion of appropriate chest compressions 1 year after the training. RESULTS A total of 146 persons were enrolled, and 63 (87.5%) in the compression-only CPR group and 56 (75.7%) in the conventional CPR group completed the 1-year evaluation. The compression-only CPR group was superior to the conventional CPR group regarding the proportion of appropriate chest compression (mean ± SD = 59.8% ± 40.0% vs. 46.3% ± 28.6%; p = 0.036) and the number of appropriate chest compressions (mean ± SD = 119.5 ± 80.0 vs. 77.2 ± 47.8; p = 0.001). Time without chest compression in the compression-only CPR group was significantly shorter than that in the conventional CPR group (mean ± SD = 11.8 ± 21.1 seconds vs. 52.9 ± 14.9 seconds; p < 0.001). CONCLUSIONS The shortened compression-only CPR training program appears to help the general public retain CPR skills better than the conventional CPR training program. CLINICAL TRIAL REGISTRATION UMIN-CTR UMIN000001675.
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Affiliation(s)
- Chika Nishiyama
- Department of Pharmacoepidemiology; Graduate School of Medicine and Public Health; Kyoto University; Kyoto
- Kyoto University Health Service; Kyoto
| | | | | | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research; Nagoya University Hospital; Nagoya
| | - Tetsuya Sakamoto
- Department of Emergency Medicine; Teikyo University School of Medicine; Teikyo Japan
| | | | - Takashi Kawamura
- Division of Environmental Medicine and Population Sciences; Department of Social and Environmental Medicine; Graduate School of Medicine; Osaka University; Osaka
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Yang Z, Li H, Yu T, Chen C, Xu J, Chu Y, Zhou T, Jiang L, Huang Z. Quality of chest compressions during compression-only CPR: a comparative analysis following the 2005 and 2010 American Heart Association guidelines. Am J Emerg Med 2013; 32:50-4. [PMID: 24210889 DOI: 10.1016/j.ajem.2013.09.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 09/28/2013] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The latest guidelines both increased the requirements of chest compression rate and depth during cardiopulmonary resuscitation (CPR), which may make it more difficult for the rescuer to provide high-quality chest compression. In this study, we investigated the quality of chest compressions during compression-only CPR under the latest 2010 American Heart Association (AHA) guidelines (AHA 2010) and its effect on rescuer fatigue. METHODS Eighty-six undergraduate volunteers were randomly assigned to perform CPR according to the 2005 AHA guidelines (AHA 2005) or AHA 2010. After the training course and theoretical examination of basic life support, eight min of compression-only CPR performance was assessed. The quality of chest compressions including rate and depth of compression was analyzed. The rescuer fatigue was evaluated by the changes of heart rate and blood lactate, and rating of perceived exertion. RESULTS Thirty-nine participants in the AHA 2005 group and 42 participants in the AHA 2010 group completed the study. Significantly greater mean chest compression depth and compression rate were both achieved in the AHA 2010 group than in the AHA 2005 group. And significantly greater rescuer fatigue was observed in the AHA 2010 group. In addition, the female in the AHA 2010 group could perform the compression rate required by the guidelines, however, significantly shallower compression depth and greater rescuer fatigue were observed when compared to the male. CONCLUSIONS The quality of chest compressions was significantly improved following the 2010 AHA guidelines, however, it's more difficult for the rescuer to meet the guidelines due to the increased fatigue of rescuer.
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Affiliation(s)
- Zhengfei Yang
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-sen University, Guangzhou, China.
| | - Heng Li
- Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-sen University, Guangzhou, China; Department of Emergency Medicine, Taiping People's Hospital, Medical School of Jinan University, Dongguan, China.
| | - Tao Yu
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-sen University, Guangzhou, China.
| | - Changwei Chen
- Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-sen University, Guangzhou, China; Department of Emergency Medicine, Taiping People's Hospital, Medical School of Jinan University, Dongguan, China.
| | - Jiefeng Xu
- Department of Emergency Medicine, Yuyao People's Hospital, Medical School of Ningbo University, Ningbo, China.
| | - Yueyong Chu
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-sen University, Guangzhou, China
| | - Tianen Zhou
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-sen University, Guangzhou, China.
| | - Longyuan Jiang
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-sen University, Guangzhou, China.
| | - Zitong Huang
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-sen University, Guangzhou, China.
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An institutionwide approach to redesigning management of cardiopulmonary resuscitation. Jt Comm J Qual Patient Saf 2013; 39:157-66. [PMID: 23641535 DOI: 10.1016/s1553-7250(13)39022-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Despite widespread training in basic life support (BLS) and advanced cardiovascular life support (ACLS) among hospital personnel, the likelihood of survival from in-hospital cardiac arrests remains low. In 2006 a university-affiliated tertiary medical center initiated a cardiopulmonary (CPR) resuscitation redesign project. REDESIGNING THE HOSPITAL'S RESUSCITATION SYSTEM: The CPR Committee developed the interventions on the basis of a large-scale view of the process of delivering BLS and ACLS, identification of key decision nodes and actions, and compartmentalization of specific functions. It was proposed that arrest management follow a steady progression in a two-layer scheme from BLS to ACLS. Handouts describing team structure and specific roles were given to all code team providers and house staff at the start of their month-long rotations. To further increase role clarity and team organization, daily morning and evening meetings of the arrest team were instituted. Site-specific BLS training, on-site ACLS refresher training, and defibrillator training were initiated. Project elements also included use of unannounced mock codes to provide system oversight; preparation and distribution of cognitive aids (printed algorithms, dosing guides, and other checklists to ensure compliance with ACLS protocols), identification of patients who may be unstable or a source of concern, event review and analysis of arrests and other critical events, and a CPR website. CONCLUSION A mature hospital-based resuscitation system should include definition of arrest trends and resuscitation needs, development of local methods for approaching the arresting patient, an emphasis on prevention, establishment of training programs tailored to meet specific hospital needs, system examination and oversight, and administrative processes that maximize interaction between all components.
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Al-Rasheed RS, Devine J, Dunbar-Viveiros JA, Jones MS, Dannecker M, Jay GD, Kobayashi L. Development of Simulated Chest Compression Videos for Objective Evaluation of CPR Instructors. J Contin Educ Nurs 2013; 44:59-63; quiz 64-5. [DOI: 10.3928/00220124-20121203-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 11/01/2012] [Indexed: 11/20/2022]
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Hong CK, Park SO, Choi CS, Lee YH, Sung AJ, Lee JH, Cho KW, Hwang SY. Evaluation of Chest Compression Depth during Nine Minutes of Hands-Only Cardiopulmonary Resuscitation Performed by a Lone Rescuer and its Effect by Age Group: A Pilot Simulation Study Using a Manikin. HONG KONG J EMERG ME 2013. [DOI: 10.1177/102490791302000102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective There have been few studies on the use of long-standing hands-only cardiopulmonary resuscitation (CPR) by a lone rescuer. This study aimed to evaluate the long-standing (nine minutes) hands-only CPR by a lone rescuer, and the change of chest compression depth over time. The effect of age of rescuer on chest compression depth was also studied. Methods From a total of 404 adult lay-persons who participated in CPR training, 91 subjects were enrolled in the simulation trial of nine minutes of hands-only CPR using a manikin with a Skill-Reporter™. The quality of the chest compression over time and the effects of rescuer age were analysed. Results Of the 91 participants, 74 (81%) fully completed the nine minutes of CPR. No significant differences of incomplete CPR rate between each age group were observed. No significant differences in the degree of reduction in effective chest compressions were observed based on the time course among the different age groups. The total number of compressions decreased abruptly from the six-minute time point onwards (five minutes vs. six minutes, p=0.038). Conclusions Most trained lay-persons could complete the 9 minutes of hands-only CPR. The rate of chest compression shows a significant decrease after 6 minute. We do not find a significant difference in the decrease of adequate chest compressions over time among various age groups in this pilot simulation study.
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Affiliation(s)
| | - SO Park
- Konkuk University School of Medicine, Department of Emergency Medicine, Konkuk University Medical Center, 120-1 Neungdongro, Hwayang-dong, Gwangjin-gu, Seoul, Republic of Korea
| | - CS Choi
- Changwon Emergency Medical Information Center, Changwon 630-522, Republic of Korea; Choi Chang Shin, MD
| | - YH Lee
- Hallym Sacred Heart Hospital, Department of Emergency Medicine, School of Medicine, Hallym University, Anyang-si, Gyeonggi-do, Republic of Korea
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Jenko M, Frangez M, Manohin A. Four-stage teaching technique and chest compression performance of medical students compared to conventional technique. Croat Med J 2012; 53:486-95. [PMID: 23100211 PMCID: PMC3490459 DOI: 10.3325/cmj.2012.53.486] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 10/01/2012] [Indexed: 11/30/2022] Open
Abstract
AIM To compare the 2-stage and 4-stage basic life support teaching technique. The second aim was to test if students' self-evaluated knowledge was in accordance with their actual knowledge. METHODS A total of 126 first-year students of the Faculty of Medicine in Ljubljana were involved in this parallel study conducted in the academic year 2009/2010. They were divided into ten groups. Five groups were taught the 2-stage model and five the 4-stage model. The students were tested in a scenario immediately after the course. Questionnaires were filled in before and after the course. We assessed the absolute values of the chest compression variables and the proportions of students whose performance was evaluated as correct according to our criteria. The results were analyzed with independent samples t test or Mann-Whitney-U test. Proportions were compared with χ(2) test. The correlation was calculated with the Pearson coefficient. RESULTS There was no difference between the 2-stage (2S) and the 4-stage approach (4S) in the compression rate (126±13 min-1 vs 124±16 min -1, P=0.180, independent samples t test), compression depth (43±7 mm vs 44±8 mm, P=0.368, independent samples t test), and the number of compressions with correct hand placement (79±32% vs 78±12, P=0.765, Mann-Whitney U-test). However, students from the 4-stage group had a significantly higher average number of compressions per minute (70±13 min -1 2S, 78±12 min-1 4S, P=0.02, independent samples t test). The percentage of students with all the variables correct was the same (13% 2S, 15% 4S, P=0.741, χ2 test). There was no correlation between the students' actual and self-evaluated knowledge (P=0.158, Pearson coefficient=0.127). CONCLUSIONS The 4-stage teaching technique does not significantly improve the quality of chest compressions. The students' self-evaluation of their performance after the course was too high.
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Affiliation(s)
- Matej Jenko
- Katedra za anesteziologijo in reanimatologijo, Zaloska 7/I, Ljubljana, Slovenia.
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Wang S, Wu JY, Li CS. Load-distributing band improves ventilation and hemodynamics during resuscitation in a porcine model of prolonged cardiac arrest. Scand J Trauma Resusc Emerg Med 2012; 20:59. [PMID: 22938018 PMCID: PMC3492085 DOI: 10.1186/1757-7241-20-59] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Accepted: 08/25/2012] [Indexed: 11/10/2022] Open
Abstract
Background The use of mechanical cardiopulmonary resuscitation (CPR) has great potential for the clinical setting. The purpose of present study is to compare the hemodynamics and ventilation during and after the load-distributing band CPR, versus the manual CPR in a porcine model of prolonged cardiac arrest, and to investigate the influence of rescue breathing in different CPR protocols. Methods Sixty-four male pigs (n = 16/group), weighing 30 ± 2 kg, were induced ventricular fibrillation and randomized into four resuscitation groups: continuous load-distributing band CPR without rescue ventilation (C-CPR), load-distributing band 30:2 CPR (A-CPR), load-distributing band CPR with continuous rescue breathing (10/min) (V-CPR) or manual 30:2 CPR (M-CPR). Respiratory variables and hemodynamics were recorded continuously; blood gas was analyzed. Results Tidal volume produced by compressions in the A-, C- and V-CPR groups were significantly higher compared with the M-CPR group (all p < 0.05). Coronary perfusion pressure of the V-CPR group was significantly lower than the C-CPR group (p < 0.01), but higher than the M-CPR group. The increasing of lung dead space after restoration of spontaneous circulation was significantly greater in the M-CPR group compared with the A-, C- and V-CPR groups (p < 0.01). Blood pH gradually decreased and was lower in the M-CPR group than that in the A-, C- and V-CPR groups (p < 0.01). PaO2 of the A-, C- and V-CPR groups were significantly higher and PaCO2 were significantly lower compared with the M-CPR (both p < 0.05). Cerebral performance categories were better in the A-, C- and V-CPR groups compared with the M-CPR group (p < 0.0001). Conclusions The load-distributing band CPR significantly improved respiratory parameters during resuscitation by augmenting passive ventilation, and significantly improved coronary perfusion pressure. The volume of ventilation produced by the load-distributing band CPR was adequate to maintain sufficient gas exchange independent of rescue breathing.
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Affiliation(s)
- Shuo Wang
- Department of Emergency Medicine, Beijing Chaoyang Hospital, Affiliated to Capital Medical University, Chaoyang District, Beijing 100020, China
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Fletcher DJ, Boller M, Brainard BM, Haskins SC, Hopper K, McMichael MA, Rozanski EA, Rush JE, Smarick SD. RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 7: Clinical guidelines. J Vet Emerg Crit Care (San Antonio) 2012; 22 Suppl 1:S102-31. [PMID: 22676281 DOI: 10.1111/j.1476-4431.2012.00757.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To present a series of evidence-based, consensus guidelines for veterinary CPR in dogs and cats. DESIGN Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Questions in five domains were examined: Preparedness and Prevention, Basic Life Support, Advanced Life Support, Monitoring, and Post-Cardiac Arrest Care. Standardized worksheet templates were used for each question, and the results reviewed by the domain members, by the RECOVER committee, and opened for comments by veterinary professionals for 4 weeks. Clinical guidelines were devised from these findings and again reviewed and commented on by the different entities within RECOVER as well as by veterinary professionals. SETTING Academia, referral practice and general practice. RESULTS A total of 74 worksheets were prepared to evaluate questions across the five domains. A series of 101 individual clinical guidelines were generated. In addition, a CPR algorithm, resuscitation drug-dosing scheme, and postcardiac arrest care algorithm were developed. CONCLUSIONS Although many knowledge gaps were identified, specific clinical guidelines for small animal veterinary CPR were generated from this evidence-based process. Future work is needed to objectively evaluate the effects of these new clinical guidelines on CPR outcome, and to address the knowledge gaps identified through this process.
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Affiliation(s)
- Daniel J Fletcher
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
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Hopper K, Epstein SE, Fletcher DJ, Boller M. RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 3: Basic life support. J Vet Emerg Crit Care (San Antonio) 2012; 22 Suppl 1:S26-43. [DOI: 10.1111/j.1476-4431.2012.00753.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kate Hopper
- School of Veterinary Medicine; Department of Veterinary Surgical and Radiological Sciences; University of California at Davis; Davis; CA
| | - Steven E. Epstein
- School of Veterinary Medicine; Department of Veterinary Surgical and Radiological Sciences; University of California at Davis; Davis; CA
| | - Daniel J. Fletcher
- College of Veterinary Medicine; Department of Clinical Sciences; Cornell University; Ithaca; NY
| | - Manuel Boller
- Department of Clinical Studies; School of Veterinary Medicine; and the Department of Emergency Medicine; School of Medicine; Center for Resuscitation Science University of Pennsylvania; Philadelphia; PA
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Affiliation(s)
- David D Berg
- The Brigham and Women's Hospital and Harvard Medical School, Internal Medicine Residency Office, Boston, MA 02115, USA.
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Heidenreich JW, Bonner A, Sanders AB. Rescuer Fatigue in the Elderly: Standard vs. Hands-only CPR. J Emerg Med 2012; 42:88-92. [DOI: 10.1016/j.jemermed.2010.05.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Revised: 02/02/2010] [Accepted: 05/17/2010] [Indexed: 11/26/2022]
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Tanigawa K, Iwami T, Nishiyama C, Nonogi H, Kawamura T. Are trained individuals more likely to perform bystander CPR? An observational study. Resuscitation 2011; 82:523-8. [PMID: 21354688 DOI: 10.1016/j.resuscitation.2011.01.027] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 01/18/2011] [Accepted: 01/22/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study aimed to evaluate the association of cardiopulmonary resuscitation (CPR) training with bystander resuscitation performance and patient outcomes after out-of-hospital cardiac arrest (OHCA). METHODS This was a prospective, population-based cohort study of all persons aged 18 years or older with OHCA of presumed intrinsic origin and their rescuers from January through December 2008 in Takatsuki, Osaka prefecture, Japan. Data on resuscitation of OHCA patients were obtained by emergency medical service (EMS) personnel in charge based on the Utstein style. Rescuers' characteristics including experience of CPR training were obtained by EMS personnel interview on the scene. The primary outcome was the attempt of bystander CPR. RESULTS Data were collected for 120 cases out of 170 OHCAs of intrinsic origin. Among the available cases, 60 (50.0%) had previous CPR training (trained rescuer group). The proportion of bystander CPR was significantly higher in the trained rescuer group than in the untrained rescuer group (75.0% and 43.3%; p = 0.001). Bystanders who had previous experience of CPR training were 3.40 times (95% confidence interval 1.31-8.85) more likely to perform CPR compared with those without previous CPR training. The number of patients with neurologically favorable one-month survival was too small to evaluate statistical difference between the groups (2 [3.3%] in the trained rescuer group versus 1 [1.7%] in the untrained rescuer group; p = 0.500). CONCLUSIONS People who had experienced CPR training had a greater tendency to perform bystander CPR than people without experience of CPR training. Further studies are needed to prove the effectiveness of CPR training on survival.
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Affiliation(s)
- Kayo Tanigawa
- Department of Preventive Services, Kyoto University School of Public Health, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan
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de Caen AR, Kleinman ME, Chameides L, Atkins DL, Berg RA, Berg MD, Bhanji F, Biarent D, Bingham R, Coovadia AH, Hazinski MF, Hickey RW, Nadkarni VM, Reis AG, Rodriguez-Nunez A, Tibballs J, Zaritsky AL, Zideman D. Part 10: Paediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2011; 81 Suppl 1:e213-59. [PMID: 20956041 DOI: 10.1016/j.resuscitation.2010.08.028] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Allan R de Caen
- Stollery Children's Hospital, University of Alberta, Canada.
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Hui CM, Brindley PG. Continuous chest compression cardiopulmonary resuscitation following out-of-hospital cardiac arrest. Can J Anaesth 2010; 58:330-3. [PMID: 21107778 DOI: 10.1007/s12630-010-9426-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 11/11/2010] [Indexed: 11/29/2022] Open
Affiliation(s)
- Carolyn M Hui
- Division of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada
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Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW, Berg RA, Sutton RM, Hazinski MF. Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010; 122:S862-75. [PMID: 20956229 PMCID: PMC3717258 DOI: 10.1161/circulationaha.110.971085] [Citation(s) in RCA: 193] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Kleinman ME, de Caen AR, Chameides L, Atkins DL, Berg RA, Berg MD, Bhanji F, Biarent D, Bingham R, Coovadia AH, Hazinski MF, Hickey RW, Nadkarni VM, Reis AG, Rodriguez-Nunez A, Tibballs J, Zaritsky AL, Zideman D. Pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Pediatrics 2010; 126:e1261-318. [PMID: 20956433 PMCID: PMC3784274 DOI: 10.1542/peds.2010-2972a] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW, Berg RA, Sutton RM, Hazinski MF. Pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics 2010; 126:e1345-60. [PMID: 20956430 PMCID: PMC3741664 DOI: 10.1542/peds.2010-2972c] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kleinman ME, de Caen AR, Chameides L, Atkins DL, Berg RA, Berg MD, Bhanji F, Biarent D, Bingham R, Coovadia AH, Hazinski MF, Hickey RW, Nadkarni VM, Reis AG, Rodriguez-Nunez A, Tibballs J, Zaritsky AL, Zideman D. Part 10: Pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2010; 122:S466-515. [PMID: 20956258 PMCID: PMC3748977 DOI: 10.1161/circulationaha.110.971093] [Citation(s) in RCA: 143] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Note From the Writing Group: Throughout this article, the reader will notice combinations of superscripted letters and numbers (eg, “Family Presence During ResuscitationPeds-003”). These callouts are hyperlinked to evidence-based worksheets, which were used in the development of this article. An appendix of worksheets, applicable to this article, is located at the end of the text. The worksheets are available in PDF format and are open access.
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Effect of continuous compressions and 30:2 cardiopulmonary resuscitation on global ventilation/perfusion values during resuscitation in a porcine model. Crit Care Med 2010; 38:2024-30. [PMID: 20683258 DOI: 10.1097/ccm.0b013e3181eed90a] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Rescue ventilations during bystander resuscitation, although previously considered essential, interrupt the continuity of chest compressions and might have deleterious effects in basic life support. This study was undertaken to analyze the global ventilation/perfusion values of continuous compressions and 30:2 cardiopulmonary resuscitation to determine the effectiveness for each approach in a porcine model of prolonged bystander cardiopulmonary resuscitation for ventricular fibrillation. DESIGN Prospective, randomized animal study. SETTING A university animal research laboratory. SUBJECTS Twenty-four male domestic pigs (n = 12/group) weighing 30 ± 2 kg. INTERVENTIONS All animals had ventricular fibrillation induced by programmed electrical stimulation instruments and were randomized into two groups. Continuous compressions or 30:2 compression/rescue ventilation cardiopulmonary resuscitation was performed in each group. MEASUREMENTS AND MAIN RESULTS Continuous respiratory variables, hemodynamic parameters, and blood gas analysis outcomes were recorded, and global ventilation/perfusion values were calculated. Alveolar minute volume and global ventilation/perfusion values decreased progressively after ventricular fibrillation, but cardiac output was stable. The global ventilation/perfusion value was higher in the ventilation cardiopulmonary resuscitation group than that in the continuous compression group (p < .0001) and was higher than normal. Coronary perfusion pressure was progressively decreased after 6 mins of cardiopulmonary resuscitation and greatly fluctuated in the ventilation cardiopulmonary resuscitation group. Coronary perfusion pressure was higher in the continuous compression group than that in the ventilation cardiopulmonary resuscitation group after 9 mins of cardiopulmonary resuscitation (p < .05). Values for pH and Pao2 progressively decreased, but there were no significant differences between the two groups, except for pH at 12 mins of cardiopulmonary resuscitation and Paco2 after 3 mins of cardiopulmonary resuscitation. CONCLUSIONS In the first 12 mins of cardiopulmonary resuscitation, continuous compressions could maintain relatively better coronary perfusion pressure, Pao2, and global ventilation/perfusion values than 30:2 cardiopulmonary resuscitation. Therefore, rescue ventilation during 12 mins of simulated bystander cardiopulmonary resuscitation did not improve hemodynamics or outcomes compared with compression-only cardiopulmonary resuscitation.
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Nishiyama C, Iwami T, Kawamura T, Ando M, Yonemoto N, Hiraide A, Nonogi H. Quality of chest compressions during continuous CPR; comparison between chest compression-only CPR and conventional CPR. Resuscitation 2010; 81:1152-5. [DOI: 10.1016/j.resuscitation.2010.05.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 04/11/2010] [Accepted: 05/08/2010] [Indexed: 10/19/2022]
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Effectiveness of simplified chest compression-only CPR training program with or without preparatory self-learning video: A randomized controlled trial. Resuscitation 2009; 80:1164-8. [DOI: 10.1016/j.resuscitation.2009.06.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 06/08/2009] [Accepted: 06/17/2009] [Indexed: 11/22/2022]
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Mancini ME, Cazzell M, Kardong-Edgren S, Cason CL, Berryman P, Lukes E. Improving Workplace Safety Training Using a Self-Directed CPR-AED Learning Program. ACTA ACUST UNITED AC 2009. [DOI: 10.1177/216507990905700406] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
RESEARCH ABSTRACT Adequate training in cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED) is an important component of a workplace safety training program. Barriers to traditional in-classroom CPR-AED training programs include time away from work to complete training, logistics, learner discomfort over being in a classroom setting, and instructors who include information irrelevant to CPR. This study evaluated differences in CPR skills performance between employees who learned CPR using a self-directed learning (SDL) kit and employees who attended a traditional instructor-led course. The results suggest that the SDL kit yields learning outcomes comparable to those obtained with traditional instructor-led courses and is a more time-efficient tool for CPR-AED training. Furthermore, the SDL kit overcomes many of the barriers that keep individuals from learning CPR and appears to contribute to bystanders' confidently attempting resuscitation.
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Mancini ME, Cazzell M, Kardong-Edgren S, Cason CL. Improving Workplace Safety Training Using a Self-Directed CPR-AED Learning Program. ACTA ACUST UNITED AC 2009; 57:159-67; quiz 168-9. [DOI: 10.3928/08910162-20090401-02] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Adequate training in cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED) is an important component of a workplace safety training program. Barriers to traditional in-classroom CPR-AED training programs include time away from work to complete training, logistics, learner discomfort over being in a classroom setting, and instructors who include information irrelevant to CPR. This study evaluated differences in CPR skills performance between employees who learned CPR using a self-directed learning (SDL) kit and employees who attended a traditional instructor-led course. The results suggest that the SDL kit yields learning outcomes comparable to those obtained with traditional instructor-led courses and is a more time-efficient tool for CPR-AED training. Furthermore, the SDL kit overcomes many of the barriers that keep individuals from learning CPR and appears to contribute to bystanders' confidently attempting resuscitation.
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Effects of BLS training on factors associated with attitude toward CPR in college students. Resuscitation 2009; 80:359-64. [DOI: 10.1016/j.resuscitation.2008.11.023] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Revised: 11/13/2008] [Accepted: 11/28/2008] [Indexed: 12/14/2022]
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Improving the Quality of Cardiac Arrest Resuscitation Care. Intensive Care Med 2009. [DOI: 10.1007/978-0-387-77383-4_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wiese CHR, Wilke H, Bahr J, Graf BM. Practical examination of bystanders performing Basic Life Support in Germany: a prospective manikin study. BMC Emerg Med 2008; 8:14. [PMID: 19021907 PMCID: PMC2600625 DOI: 10.1186/1471-227x-8-14] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2008] [Accepted: 11/20/2008] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND In an out-of-hospital emergency situation bystander intervention is essential for a sufficient functioning of the chain of rescue. The basic measures of cardiopulmonary resuscitation (Basic Life Support - BLS) by lay people are therefore definitely part of an effective emergency service of a patient needing resuscitation. Relevant knowledge is provided to the public by various course conceptions. The learning success concerning a one day first aid course ("LSM" course in Germany) has not been much investigated in the past. We investigated to what extent lay people could perform BLS correctly in a standardised manikin scenario. An aim of this study was to show how course repetitions affected success in performing BLS. METHODS The "LSM course" was carried out in a standardised manner. We tested prospectively 100 participants in two groups (Group 1: Participants with previous attendance of a BLS course; Group 2: Participants with no previous attendance of a BLS course) in their practical abilities in BLS after the course. Success parameter was the correct performance of BLS in accordance with the current ERC guidelines. RESULTS Twenty-two (22%) of the 100 investigated participants obtained satisfactory results in the practical performance of BLS. Participants with repeated participation in BLS obtained significantly better results (Group 1: 32.7% vs. Group 2: 10.4%; p < 0.01) than course participants with no relevant previous knowledge. CONCLUSION Only 22% of the investigated participants at the end of a "LSM course" were able to perform BLS satisfactorily according to the ERC guidelines. Participants who had previously attended comparable courses obtained significantly better results in the practical test. Through regular repetitions it seems to be possible to achieve, at least on the manikin, an improvement of the results in bystander resuscitation and, consequently, a better patient outcome. To validate this hypothesis further investigations are recommended by specialised societies.
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Affiliation(s)
- Christoph HR Wiese
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Germany
| | - Henryk Wilke
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Germany
| | - Jan Bahr
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Germany
| | - Bernhard M Graf
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Germany
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Gold LS, Eisenberg M. Chest-compression-only vs. standard cardiopulmonary resuscitation: shouldn't we wait for more evidence? PREHOSP EMERG CARE 2008; 12:406-9. [PMID: 18584513 DOI: 10.1080/10903120802096696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nishiyama C, Iwami T, Kawamura T, Ando M, Yonemoto N, Hiraide A, Nonogi H. Effectiveness of simplified chest compression-only CPR training for the general public: A randomized controlled trial. Resuscitation 2008; 79:90-6. [DOI: 10.1016/j.resuscitation.2008.05.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Revised: 05/08/2008] [Accepted: 05/14/2008] [Indexed: 10/21/2022]
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Sanders AB. Progress in improving neurologically intact survival from cardiac arrest. Ann Emerg Med 2008; 52:253-5. [PMID: 18490079 DOI: 10.1016/j.annemergmed.2008.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2008] [Revised: 04/06/2008] [Accepted: 04/16/2008] [Indexed: 10/22/2022]
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Abstract
PURPOSE OF REVIEW Bystander cardiopulmonary resuscitation increases the chances of survival after out-of-hospital cardiac arrest. Existing bystander cardiopulmonary resuscitation rates are poor. There are several strategies for increasing the frequency and effectiveness of bystander cardiopulmonary resuscitation. These include simplifying the technique for basic life support, emphasizing the importance of compressions over ventilation, reducing the length of training by using video-based self-instruction and widening the range of those trained to include school children. RECENT FINDINGS A change in compression-ventilation ratio from 15: 2 to 30: 2 increases the number of compressions delivered. There is some evidence that compression-only cardiopulmonary resuscitation may increase survival rates from out-of-hospital cardiac arrest. Video-based self-instruction enables laypeople to be trained in basic life support in a fraction of the time of traditional courses. School children can be taught basic life support and can be used to help disseminate the skill. SUMMARY The optimal basic life support technique that will generate the highest survival rates from out-of-hospital cardiac arrest has not been determined, but there is increasing evidence that the existing technique needs to be simplified. Bystander cardiopulmonary resuscitation increases survival but it needs to be undertaken more frequently if overall survival rates are to be improved significantly.
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Abstract
American Heart Association advocates chest compression without ventilation
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Sayre MR, Berg RA, Cave DM, Page RL, Potts J, White RD. Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee. Circulation 2008; 117:2162-7. [PMID: 18378619 DOI: 10.1161/circulationaha.107.189380] [Citation(s) in RCA: 273] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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