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Więch P, Muster M, Godek Ł, Sałacińska I, Guty E, Kucaba G, Bazaliński D. The Relationship between Selected Body Composition Components and Cardiopulmonary Resuscitation Parameters in Nurses: An Observational Simulation Study. J Clin Med 2021; 11:jcm11010049. [PMID: 35011790 PMCID: PMC8745276 DOI: 10.3390/jcm11010049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
The provision of cardiopulmonary resuscitation (CPR) may be related to the physical parameters of the medical personnel, including fat mass (FM) and fat-free mass (FFM) components. In this study, we aimed to assess the relationship between selected body composition components and chest compression and ventilation parameters provided by medical staff. An observational simulation study was undertaken between December 2017 and January 2019 at the Center for Innovative Research in Medical and Natural Sciences of Rzeszów. In all participants (505 nurses, 37.71 y ± 12.16), the body weight and height were measured and the body mass index (BMI) was calculated. The body composition indicators were obtained using a bioelectrical impedance device, AKERN BIA 101. Afterwards, all participants performed CPR sequences (30 chest compressions and rescue for 2 breaths) for 2 min on a Laerdal Resusci Anne simulator placed on an examination couch with a self-inflating bag and a face mask. Our observations proved that high values of the anthropometric, nutritional and body composition parameters of the medical staff demonstrated a positive significant correlation with the depth and rate chest parameters and were inversely related to the chest adequate recoil. No statistically significant differences were found between the FM or FFM components and ventilation parameters. This study showed that nutritional status and body composition components may be important factors affecting the quality of CPR.
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Affiliation(s)
- Paweł Więch
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszów, Poland; (M.M.); (I.S.); (D.B.)
- Institute of Social Sciences and Health Protection, East European State Higher School in Przemyśl, 37-700 Przemyśl, Poland;
- Correspondence: ; Tel.: +48-667-192-696
| | - Marek Muster
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszów, Poland; (M.M.); (I.S.); (D.B.)
| | - Łukasz Godek
- Institute of Physical Culture Studies, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszów, Poland;
| | - Izabela Sałacińska
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszów, Poland; (M.M.); (I.S.); (D.B.)
| | - Edyta Guty
- Institute of Social Sciences and Health Protection, East European State Higher School in Przemyśl, 37-700 Przemyśl, Poland;
| | - Grzegorz Kucaba
- Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszów, Poland;
| | - Dariusz Bazaliński
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszów, Poland; (M.M.); (I.S.); (D.B.)
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Abraldes JA, Fernandes RJ, Rodríguez N, Sousa A. Is Rescuer Cardiopulmonary Resuscitation Jeopardised by Previous Fatiguing Exercise? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6668. [PMID: 32933179 PMCID: PMC7559729 DOI: 10.3390/ijerph17186668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/02/2020] [Accepted: 09/11/2020] [Indexed: 12/02/2022]
Abstract
Survival outcomes increase significantly when cardiopulmonary resuscitation (CPR) is provided correctly, but rescuer's fatigue can compromise CPR delivery. We investigated the effect of a 100-m maximal run on CPR and physiological variables in 14 emergency medical technicians (age 29.2 ± 5.8 years, height 171.2 ± 1.1 cm and weight 73.4 ± 13.1 kg). Using an adult manikin and a compression-ventilation ratio of 30:2, participants performed 4-min CPR after 4-min baseline conditions (CPR) and 4-min CPR after a 100-m maximal run carrying emergency material (CPR-run). Physiological variables were continuously measured during baseline and CPR conditions using a portable gas analyzer (K4b2, Cosmed, Rome, Italy) and analyzed using two HD video cameras (Sony, HDR PJ30VE, Japan). Higher VO2 (14.4 ± 2.1 and 22.0 ± 2.5 mL·kg-1·min-1) and heart rate (123 ± 17 and 148 ± 17 bpm) were found for CPR-run. However, the compression rate was also higher during the CPR-run (373 ± 51 vs. 340 ± 49) and between every three complete cycles (81 ± 9 vs. 74 ± 14, 99 ± 14 vs. 90 ± 10, 99 ± 10 vs. 90 ± 10, and, 101 ± 15 vs. 94 ± 11, for cycle 3, 6, 9 and 12, respectively). Fatigue induced by the 100-m maximal run had a strong impact on physiological variables, but a mild impact on CPR emergency medical technicians' performance.
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Affiliation(s)
- J Arturo Abraldes
- Department of Physical Activity and Sport, Faculty of Sports Sciences, University of Murcia, 30720 Murcia, Spain
- Porto Biomechanics Laboratory, University of Porto, 4200-450 Porto, Portugal
| | - Ricardo J Fernandes
- Porto Biomechanics Laboratory, University of Porto, 4200-450 Porto, Portugal
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Núria Rodríguez
- Department of Physical Activity and Sport, Catholic University of San Antonio, 30107 Murcia, Spain
| | - Ana Sousa
- Research Center for Sports, Exercise and Human Development, 5001-801 Vila Real, Portugal
- University Institute of Maia, 4475-690 Maia, Portugal
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Pauses in compressions during pediatric CPR: Opportunities for improving CPR quality. Resuscitation 2019; 145:158-165. [PMID: 31421191 DOI: 10.1016/j.resuscitation.2019.08.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/07/2019] [Accepted: 08/07/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Minimizing pauses in chest compressions during cardiopulmonary resuscitation (CPR) is recommended by the American Heart Association (AHA) and is associated with improved patient outcomes. We studied the quality of pediatric CPR performed in a tertiary pediatric emergency department (ED) with a focus on pauses in chest compressions. METHODS We conducted an observational study of CPR quality in two pediatric EDs using video review during pediatric cardiac arrest. Events were reviewed for AHA guideline adherence. Parameters of CPR performance were described according to individual compressor segment. Pauses in compressions were analyzed for duration and pause activities. RESULTS From a 30-month period, 81 cardiac arrests were analyzed, including 1003 individual compressor segments and 900 pauses. Median chest compression fraction was 91%, with a median pause duration of 4 s (IQR 2, 10); 22% of pauses were prolonged (>10 s). Pulse checks occurred in 23% of pauses; 62% were prolonged. Checking a single pulse site (p < 0.001) and having fingers ready pre-pause (p = 0. 001) were associated with significantly shorter pause duration. Pause duration was correlated with the number of pause tasks (r = 0.559, p < 0.001). "Coordinated pauses" (pulse check, rhythm check and compressor change) were rare (6%) and long in duration (19 s; IQR 11, 30). CONCLUSIONS Prolonged pauses in chest compressions occurred frequently during CPR and were associated with pulse checks and multiple simultaneous tasks. Checking a single pulse site with fingers ready on the pulse site pre-pause could decrease pause duration and improve CPR quality.
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COSCA (Core Outcome Set for Cardiac Arrest) in Adults: An Advisory Statement From the International Liaison Committee on Resuscitation. Resuscitation 2018; 127:147-163. [DOI: 10.1016/j.resuscitation.2018.03.022] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Haywood K, Whitehead L, Nadkarni VM, Achana F, Beesems S, Böttiger BW, Brooks A, Castrén M, Ong ME, Hazinski MF, Koster RW, Lilja G, Long J, Monsieurs KG, Morley PT, Morrison L, Nichol G, Oriolo V, Saposnik G, Smyth M, Spearpoint K, Williams B, Perkins GD. COSCA (Core Outcome Set for Cardiac Arrest) in Adults: An Advisory Statement From the International Liaison Committee on Resuscitation. Circulation 2018; 137:e783-e801. [PMID: 29700122 DOI: 10.1161/cir.0000000000000562] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cardiac arrest effectiveness trials have traditionally reported outcomes that focus on survival. A lack of consistency in outcome reporting between trials limits the opportunities to pool results for meta-analysis. The COSCA initiative (Core Outcome Set for Cardiac Arrest), a partnership between patients, their partners, clinicians, research scientists, and the International Liaison Committee on Resuscitation, sought to develop a consensus core outcome set for cardiac arrest for effectiveness trials. Core outcome sets are primarily intended for large, randomized clinical effectiveness trials (sometimes referred to as pragmatic trials or phase III/IV trials) rather than for pilot or efficacy studies. A systematic review of the literature combined with qualitative interviews among cardiac arrest survivors was used to generate a list of potential outcome domains. This list was prioritized through a Delphi process, which involved clinicians, patients, and their relatives/partners. An international advisory panel narrowed these down to 3 core domains by debate that led to consensus. The writing group refined recommendations for when these outcomes should be measured and further characterized relevant measurement tools. Consensus emerged that a core outcome set for reporting on effectiveness studies of cardiac arrest (COSCA) in adults should include survival, neurological function, and health-related quality of life. This should be reported as survival status and modified Rankin scale score at hospital discharge, at 30 days, or both. Health-related quality of life should be measured with ≥1 tools from Health Utilities Index version 3, Short-Form 36-Item Health Survey, and EuroQol 5D-5L at 90 days and at periodic intervals up to 1 year after cardiac arrest, if resources allow.
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Talikowska M, Tohira H, Inoue M, Bailey P, Brink D, Finn J. Lower chest compression fraction associated with ROSC in OHCA patients with longer downtimes. Resuscitation 2017; 116:60-65. [DOI: 10.1016/j.resuscitation.2017.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/06/2017] [Accepted: 05/02/2017] [Indexed: 11/30/2022]
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Mullan PC, Cochrane NH, Chamberlain JM, Burd RS, Brown FD, Zinns LE, Crandall KM, O'Connell KJ. Accuracy of Postresuscitation Team Debriefings in a Pediatric Emergency Department. Ann Emerg Med 2017; 70:311-319. [PMID: 28259482 DOI: 10.1016/j.annemergmed.2017.01.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/19/2017] [Accepted: 01/23/2017] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVE Guideline committees recommend postresuscitation debriefings to improve performance. "Hot" postresuscitation debriefings occur immediately after the event and rely on team recall. We assessed the ability of resuscitation teams to recall their performance in team-based, hot debriefings in a pediatric emergency department (ED), using video review as the criterion standard. We hypothesized that debriefing accuracy will improve during the course of the study. METHODS Resuscitation physician and nurse leaders cofacilitated debriefings after ED resuscitations involving cardiopulmonary resuscitation (CPR) or intubation. Debriefing teams recorded their self-assessments of clinical performance measures with standardized debriefing forms. The debriefing form data were compared with actual performance measured by video review at 2 pediatric EDs over 22 months. CPR performance measures included time to automated external defibrillator pad placement, epinephrine administration timing, and compression pause timing. Intubation measures included occurrences of oxygen desaturation, number of intubation attempts, and use of end-tidal carbon dioxide monitoring. RESULTS We analyzed 100 resuscitations (14 cardiac arrests, 22 cardiac arrests with intubation, and 64 intubations). The accuracy of debriefing answers was 87%, increasing from 83% to 91% between the first and second halves of the study period (7.7% difference; 95% confidence interval 0.2% to 15%). Debriefings that acknowledged an error in certain performance measures (ie, automated external defibrillator pad placement delay, multiple intubation attempts, and occurrence of oxygen desaturation) had significantly worse performance in those specific measures on video review. CONCLUSION Teams in postresuscitation debriefings had a higher degree of debriefing answer accuracy in the final 50 debriefings than in the first 50. Teams also distinguished various degrees of resuscitation performance.
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Affiliation(s)
- Paul C Mullan
- Division of Emergency Medicine, Children's Hospital of the King's Daughters, Eastern Virginia Medical School, Norfolk, VA; Division of Emergency Medicine, Children's National Health System, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC.
| | | | - James M Chamberlain
- Division of Emergency Medicine, Children's National Health System, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Randall S Burd
- Division of Trauma and Burn Surgery, Children's National Health System, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Fawn D Brown
- Division of Emergency Medicine, Children's National Health System, Washington, DC
| | - Lauren E Zinns
- Division of Emergency Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Kristen M Crandall
- Division of Emergency Medicine, Children's National Health System, Washington, DC
| | - Karen J O'Connell
- Division of Emergency Medicine, Children's National Health System, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC
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