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Segond N, Viglino D, Duhem H, Vigneron C, Vallot C, Brenckmann V, Blancher M, Versini S, Serruys A, Savary D, Bellier A, Debaty G. Neurological outcome of cardiac arrest patients in mountain areas: An analysis of the Northern French Alps Emergency Network. Am J Emerg Med 2024; 81:47-52. [PMID: 38663303 DOI: 10.1016/j.ajem.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Mountainous areas pose a challenge for the out-of-hospital cardiac arrest (OHCA) chain of survival. Survival rates for OHCAs in mountainous areas may differ depending on the location. Increased survival has been observed compared to standard location when OHCA occurred on ski slopes. Limited data is available about OHCA in other mountainous areas. The objective was to compare the survival rates with a good neurological outcome of OHCAs occurring on ski slopes (On-S) and off the ski slopes (OffS) compared to other locations (OL). METHODS Analysis of prospectively collected data from the cardiac arrest registry of the Northern French Alps Emergency Network (RENAU) from 2015 to 2021. The RENAU corresponding to an Emergency Medicine Network between all Emergency Medical Services and hospitals of 3 counties (Isère, Savoie, Haute-Savoie). The primary outcome was survival at 30 days with a Cerebral Performance Category scale (CPC) of 1 or 2 (1: Good Cerebral Performance, 2: Moderate Cerebral Disability). RESULTS A total of 9589 OHCAs were included: 213 in the On-S group, 141 in the Off-S group, and 9235 in the OL group. Cardiac etiology was more common in On-S conditions (On-S: 68.9% vs OffS: 51.1% vs OL: 66.7%, p < 0.001), while Off-S cardiac arrests were more often due to traumatic circumstances (OffS: 39.7% vs On-S: 21.7% vs OL: 7.7%, p < 0.001). Automated external defibrillator (AED) use before rescuers' arrival was lower in the Off-S group than in the other two groups (On-S: 15.2% vs OL: 4.5% vs OffS: 3.7%; p < 0.002). The first AED shock was longer in the Off-S group (median time in minutes: OffS: 22.0 (9.5-35.5) vs On-S: 10.0 (3.0-19.5) vs OL: 16.0 (11.0-27.0), p = 0.03). In multivariate analysis, on-slope OHCA remained a positive factor for 30-day survival with a CPC score of 1 or 2 with a 1.96 adjusted odds ratio (95% confidence interval (CI), 1.02-3.75, p = 0.04), whereas off-slope OHCA had an 0.88 adjusted odds ratio (95% CI, 0.28-2.72, p = 0.82). CONCLUSIONS OHCAs in ski-slopes conditions were associated with an improvement in neurological outcomes at 30 days, whereas off-slopes OHCAs were not. Ski-slopes rescue patrols are efficient in improving outcomes.
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Affiliation(s)
- N Segond
- Emergency Department and Mobile Intensive Care Unit, University Hospital of Grenoble Alpes, Grenoble, France; Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France.
| | - D Viglino
- Emergency Department and Mobile Intensive Care Unit, University Hospital of Grenoble Alpes, Grenoble, France; HP2 Laboratory, INSERM U1300, Univ. Grenoble Alpes, Grenoble, France
| | - H Duhem
- Albertville-Moûtiers Hospital, Emergency Department and Intensive Care Unit, Albertville, France
| | - C Vigneron
- Annecy-Genevois Hospital, Emergency Department and Mobile Intensive Care Unit, Annecy, France
| | - C Vallot
- Annecy-Genevois Hospital, Emergency Department and Mobile Intensive Care Unit, Annecy, France
| | - V Brenckmann
- Emergency Department and Mobile Intensive Care Unit, University Hospital of Grenoble Alpes, Grenoble, France; Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France
| | - M Blancher
- Emergency Department and Mobile Intensive Care Unit, University Hospital of Grenoble Alpes, Grenoble, France
| | - S Versini
- Chambery Metropole Savoie Hospital, Emergency Department and Mobile Intensive Care Unit, Chambery, France
| | - A Serruys
- Chambery Metropole Savoie Hospital, Emergency Department and Mobile Intensive Care Unit, Chambery, France
| | - D Savary
- Emergency Department, Angers University Hospital, Angers, France; Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S1085, SFR ICAT, CAPTV-CDC, F-49000 Angers, France
| | - A Bellier
- Univ. Grenoble Alpes, CIC INSERM 1406, AGEIS, Grenoble, France
| | - G Debaty
- Emergency Department and Mobile Intensive Care Unit, University Hospital of Grenoble Alpes, Grenoble, France; Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France
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Rupp SL, Overberger RC. Manual vs Mechanical Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest on a Ski Slope: A Pilot Study. Wilderness Environ Med 2023; 34:289-294. [PMID: 37169609 DOI: 10.1016/j.wem.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 05/13/2023]
Abstract
INTRODUCTION The quality of cardiopulmonary resuscitation (CPR) is critical in increasing the probability of survival with a good neurologic outcome after out-of-hospital cardiac arrest. In an austere environment with a potentially salvageable patient, bystanders or first responders may need to provide chest compressions for a prolonged duration or during physically challenging transportation scenarios. Consequently, they may be at risk of fatigue or injury, and chest compression quality may deteriorate. The study sought to assess whether or not access to and utilization of a mechanical compression device (Lund University Cardiopulmonary Assist System) was feasible and not inferior to manual compressions while extricating and transporting a patient from a ski slope. METHODS Variable 3-person ski patrol teams responded to a simulated patient with out-of-hospital cardiac arrest in a nonshockable rhythm. Using a mannequin and CPR quality monitor, performance during manual CPR was compared with that of a mechanical compression device. This is a prospective, crossover analysis of CPR quality during extrication from a ski slope. Across 8 total runs, chest compression fraction, which is the proportion of time without spontaneous circulation during which compressions occurred, and high-quality CPR, as measured by appropriate rate and depth, were compared between the 2 groups. Extrication times between the 2 groups were also measured. RESULTS There was no difference in compression fraction between the manual (91.4%; 95% CI [86.8-96.1]) and mechanical arms (92.8%; 95% CI [88.8-96.8]) (P=0.67). There was an increase in the time performing high-quality CPR in the mechanical group (58.5%; 95% CI [45.8-71.2]) vs that in the manual group (25.6%; 95% CI [13.5-37.8]) (P<0.001). There was a statistically significant difference in the extrication times between the 2 groups, 7.6 ± 0.5 min in the manual group vs 8.6 ± 0.4 min in the mechanical group (P=0.014). CONCLUSIONS Mechanical CPR devices are noninferior for use in ski areas during initial resuscitation and transportation. Compared with manual CPR, mechanical CPR would likely improve the fraction of time performing high-quality CPR.
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Affiliation(s)
- Scott L Rupp
- Department of Emergency, Albert Einstein Medical Center, Philadelphia, PA.
| | - Ryan C Overberger
- Department of Emergency, Albert Einstein Medical Center, Philadelphia, PA.
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Mikiewicz M, Polok K, Szczeklik W, Górka A, Kosiński S. Sudden Cardiac Arrests in the Polish Tatra Mountains: A Retrospective Study. Wilderness Environ Med 2023; 34:128-134. [PMID: 36710127 DOI: 10.1016/j.wem.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/07/2022] [Accepted: 11/29/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Achieving the optimal survival rate for sudden cardiac arrest in mountains is challenging. The odds of surviving are influenced mainly by distance, response time, and organization of the emergency medical system. The aim of this study was to analyze the epidemiology and outcomes of patients with out-of-hospital cardiac arrest in whom cardiopulmonary resuscitation was performed in the Polish Tatra Mountains. METHODS This was a retrospective analysis of data on sudden cardiac arrest collected from the database of the Tatra Mountain Rescue Service and local emergency medical system from 2001 to 2021. RESULTS A total of 74 cases of sudden cardiac arrest were recorded. The mortality rate was 88% (65/74). Return of spontaneous circulation was achieved in 22 (30%) patients. A group of survivors was characterized by more frequent use of an automated external defibrillator (AED) (56% vs 14%, P=0.011), a shorter interval between cardiac arrest and emergency team arrival (12 vs 20 min, P=0.005), and a shorter time to initiation of advanced life support (ALS) (12 vs 22 min, P=0.004). All survivors had a shockable initial rhythm. The majority of survivors (8/9, 89%) had a good or moderate neurological outcome. CONCLUSIONS This study confirms poor survival rate after sudden cardiac arrest in the mountain area. The use of AED, shockable initial rhythm, and shorter time interval to emergency team arrival and ALS initiation are associated with better outcomes.
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Affiliation(s)
- Maciej Mikiewicz
- Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland; Tatra Mountains Rescue Service, Zakopane, Poland.
| | - Kamil Polok
- Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Wojciech Szczeklik
- Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland
| | | | - Sylweriusz Kosiński
- Tatra Mountains Rescue Service, Zakopane, Poland; Department of Interdisciplinary Intensive Care, Jagiellonian University Medical College, Kraków, Poland
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Burtscher M, Hefti U, Ruedl G, Hefti JP. Editorial on the Research Topic the 2nd Edition of Mountain Sports Activities: Injuries and Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159510. [PMID: 35954866 PMCID: PMC9368657 DOI: 10.3390/ijerph19159510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 02/05/2023]
Abstract
Mountain sports are continuously gaining popularity, currently fueled by the post-pandemic period expanding travel opportunities and the desire to escape the increasingly hot environmental conditions of urban areas—ambient temperature decreases by about 6 [...]
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Affiliation(s)
- Martin Burtscher
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria;
- Austrian Society for Alpine and High-Altitude Medicine, 6020 Innsbruck, Austria
- Correspondence:
| | - Urs Hefti
- Swiss Sportclinic, 3014 Bern, Switzerland; (U.H.); (J.P.H.)
- Medical Commission, International Climbing and Mountaineering Federation (UIAA), 3014 Bern, Switzerland
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria;
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Posch M, Burtscher J, Ruedl G, Pocecco E, Burtscher M. Unchanged Fatality Rate on Austrian Ski Slopes during the COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137771. [PMID: 35805425 PMCID: PMC9265540 DOI: 10.3390/ijerph19137771] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 02/01/2023]
Abstract
Fatalities on ski slopes are very rare, with about one death per one million skier days. Whether the fatality rate is affected by substantial changes in the number of skier days and potentially associated alterations in the structure of the skier population is unknown. Thus, we compared the fatality rate on Austrian ski slopes in the winter season of 2020/21, when skiing activities were dramatically restricted during the COVID-19 lockdown, with those of the previous winter seasons. As a consequence of COVID-19 measures, the number of skier days dropped from over 50 million in previous years to 9.2 million skier days in the winter season of 2020/21. Still, the fatality rate (6.5 deaths/10 million skier days) was not different when compared to any of the seasons from 2011/12 to 2019/20. Despite the lack of international skiers and the reduction in skier days by more than 80%, the fatality rate remained surprisingly unchanged. The weather and snowfall conditions were on average comparable to those of previous winters, and, except for nationality, the composition of the skier population appears to have remained relatively unaltered. In conclusion, the fatality rate during downhill skiing is low and the absolute fatality numbers are primarily a function of the number of skier days.
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Affiliation(s)
- Markus Posch
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.P.); (G.R.); (E.P.)
| | - Johannes Burtscher
- Department of Biomedical Sciences, University of Lausanne, 1005 Lausanne, Switzerland;
- Institute of Sport Sciences, University of Lausanne, 1015 Lausanne, Switzerland
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.P.); (G.R.); (E.P.)
| | - Elena Pocecco
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.P.); (G.R.); (E.P.)
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.P.); (G.R.); (E.P.)
- Austrian Society for Alpine and High-Altitude Medicine, 6020 Innsbruck, Austria
- Correspondence:
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[Time comparison of artificial airway establishment in operating room and on slope using endotracheal intubation and laryngeal mask]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54. [PMID: 35165485 PMCID: PMC8860658 DOI: 10.19723/j.issn.1671-167x.2022.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To compare the completion time of endotracheal intubation and laryngeal mask implantation in operating room and on slope of ski resort, and to discuss the optimal method of estab-lishing artificial airway on slope of ski resort. METHODS The simulator was placed with the head under the feet on slope of ski resort. The artificial airway was established by tracheal intubation assisted by video laryngoscope (endotracheal intubation group) and laryngeal mask placement (laryngeal mask group) respectively by an anesthesiologist who wore full set of ski suits, helmets, goggles, gloves and ski boots. Each method was repeated 5 times, and the operation time of artificial airway establishment was recorded. While the simulated human was placed flat on the operating table in an operating room of a hospital, and the artificial airway was established by the same anesthesiologist using the same methods. Time was recorded and repeated for 5 times. The completion time of endotracheal intubation and laryngeal mask placement in the operating room and on the ski slope were compared. RESULTS The operating time of tracheal intubation in the operating room was longer than that of laryngeal mask placement [(79.8±10.4) s vs. (53.4±2.7) s, P=0.005], and the operating time of endotracheal intubation on the ski slope was longer than that of laryngeal mask placement [(209.2±32.7) s vs. (72.2±3.1) s, P=0.001]. The time of endotracheal intubation group on the slope of the ski resort was longer than that in the opera-ting room(t=-7.851, P=0.001). The time of laryngeal mask group on the slope was longer than that in the operating room (t=-19.391, P < 0.001). CONCLUSION On ski slope, both of tracheal intubation assisted by video laryngoscope and laryngeal mask placement can quickly complete the establishment of artificial airway, but the time required is longer than that in the operating room. The time of laryngeal mask placement to establish artificial airway is shorter than that of tracheal intubation assisted video laryngoscope, which may have a certain advantage in ski rescue.
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An Exploration and Technical Notes for Advanced Airway Management on the Ski Slope: A Simulation Experiment. Emerg Med Int 2021; 2021:9241891. [PMID: 34912582 PMCID: PMC8668322 DOI: 10.1155/2021/9241891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/20/2021] [Indexed: 11/17/2022] Open
Abstract
Background Skiing is a high-risk winter sport, and the rate of injury fatality is the highest compared to other winter sports. During skiing rescue, the harsh natural environments will increase the difficulty of artificial airway establishment. There has been no research focusing on the establishment of the artificial airway during skiing rescue site. This study aims to simulate the real-world scenario, calculating and comparing the operation time of different artificial airways on the cold slope, and to explore the optimal method of establishing artificial airway on the cold slope, sharing our experience, technical notes, and pitfalls we encountered, hoping to help establish a standard operating procedure in advanced airway management on the ski slope. Methods The simulated human was placed on the cold slope with the head under the feet. Artificial airway was established by the same anesthesiologist using endotracheal intubation (endotracheal intubation group), LMA Supreme laryngeal mask (LMA group), and I-gel laryngeal mask (I-gel group). Each method was repeated 5 times, and the operation time and whether it was successful by one attempt were recorded and compared between groups. Results Three groups of artificial airway were successful by one attempt.. The bite block dropped and drifted away for one time in the endotracheal intubation group. Operation time is 209.2 ± 32.7 seconds in the endotracheal intubation group, 72.2 ± 3.1 seconds in the LMA group, and 52.6 ± 4.2 seconds in the I-gel group. ANOVA showed that there was a significant difference in the operation time among the three groups (p < 0.001). Tukey's post hoc test showed that there were statistically significant differences between the endotracheal intubation group and the other two groups in operation time, p < 0.001, while there was no significant difference between the LMA group and I-gel group (p=0.275). Conclusion The artificial airway can be completed by endotracheal intubation and LMA and I-gel laryngeal mask insertion on the cold slope. Artificial airway with the I-gel laryngeal mask takes the shortest time in this study. Extra caution should be paid to slippery and drifting.
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Clebone A, Reis K, Tung A, OConnor M, Ruskin KJ. Chest Compression Duration May Be Improved When Rescuers Breathe Supplemental Oxygen. Aerosp Med Hum Perform 2020; 91:918-922. [PMID: 33243334 DOI: 10.3357/amhp.5698.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND: At sea level, performing chest compressions is a demanding physical exercise. On a commercial flight at cruise altitude, the barometric pressure in the cabin is approximately equal to an altitude of 2438 m. This results in a Po₂ equivalent to breathing an FIo₂ of 15% at sea level, a condition under which both the duration and quality of cardiopulmonary resuscitation (CPR) may deteriorate. We hypothesized that rescuers will be able to perform fewer rounds of high-quality CPR at an FIo₂ of 15%.METHODS: In this crossover simulation trial, 16 healthy volunteers participated in 2 separate sessions and performed up to 14 2-min rounds of chest compressions at an FIo₂ of either 0.15 or 0.21 in randomized order. Subjects were stopped if their Spo₂ was below 80%, if chest compression rate or depth was not achieved for 2/3 of compressions, or if they felt fatigued or dyspneic.RESULTS: Fewer rounds of chest compressions were successfully completed in the hypoxic than in the normoxic condition, (median [IQR] 4.5 [3,8.5]) vs. 5 [4,14]). The decline in arterial Spo₂ while performing chest compressions was greater in the hypoxic condition than in the normoxic condition [mean (SD), 6.19% (4.1) vs. 2% (1.66)].DISCUSSION: Our findings suggest that the ability of rescuers to perform chest compressions in a commercial airline cabin at cruising altitude may be limited due to hypoxia. One possible solution is supplemental oxygen for rescuers who perform chest compressions for in-flight cardiac arrest.Clebone A, Reis K, Tung A, OConnor M, Ruskin KJ. Chest compression duration may be improved when rescuers breathe supplemental oxygen. Aerosp Med Hum Perform. 2020; 91(12):918922.
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Abrams T, Torfason L. Evaluation of the Quality of Manual, Compression-Only Cardiopulmonary Resuscitation in a Moving Ski Patrol Toboggan. High Alt Med Biol 2019; 21:52-61. [PMID: 31855467 DOI: 10.1089/ham.2019.0047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Cardiopulmonary resuscitation (CPR) quality may be impacted by location and setting of an out of hospital cardiac arrest. This study compared the quality of CPR performed on a moving ski patrol toboggan versus stationary CPR, both performed outdoors in winter. Materials and Methods: Compression-only CPR was performed on a manikin attached to a backboard secured into a toboggan. A CPR device was used to measure compression rate, depth and recoil, and elapsed time. A convenience sample of 30 patrollers, in weather-appropriate clothing, participated in this nonrandomized, crossover study. Each first performed 5 continuous sets of 30 compressions of stationary CPR straddling the manikin while kneeling. After 15 minutes rest, participants performed CPR while moving down the designated ski run (fixed length, vertical drop, and slope angles). Each ski run was video captured with a GoPro camera. Quality was defined as compliance with 2015 International Liaison Committee on Resuscitation (ILCOR) guidelines for CPR. Results: Overall, stationary and moving chest compressions complied with ILCOR guidelines, but there was a statistically significant degradation of CPR quality while moving and over time. Fewer compressions met ILCOR guidelines in comparison to stationary CPR compressions: (1) stationary mean depth 87% compliant, moving mean depth 35% compliant, 95% confidence interval: 39-65 (p < 0.001); (2) stationary mean rate 90% while moving mean rate 64% compliant; and (3) stationary recoil 74%, while moving recoil 77% compliant. Noncompliant compressions were typically too shallow, and noncompliance for rate was typically too fast. There were no pauses over 10 seconds once compressions were started. Conclusions: Despite CPR quality being reduced while moving, there were sufficient compliant compressions to support the use of CPR in this setting. Maintaining regular CPR training in a working environment and optimal body position in relation to the patient may be keys to performing high quality CPR on a moving toboggan.
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Affiliation(s)
- Terry Abrams
- Advanced Care Paramedic, Calgary, Canada.,Canadian Ski Patrol, Ottawa, Canada
| | - Lois Torfason
- University Health Services Clinic, Calgary, Canada.,Nakiska Ski Resort, Kananaskis, Canada
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Rossi VA, Schmied C, Niebauer J, Niederseer D. Cardiovascular effects and risks of recreational alpine skiing in the elderly. J Sci Med Sport 2019; 22 Suppl 1:S27-S33. [PMID: 30772188 DOI: 10.1016/j.jsams.2019.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 11/14/2018] [Accepted: 01/22/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Alpine skiing is one of the most popular recreational winter sports and attracts millions of tourists every year alone in the Alpine region. Several studies highlight the positive effects of alpine skiing as aerobic physical training and isometric muscle activity that is able to increase exercise capacity and reduce cardiovascular risk factors. However, a certain cardiovascular risk mainly related to an abrupt increase of myocardial oxygen consumption during skiing especially in otherwise sedentary subjects and effects of hypoxia in untrained patients have to be acknowledged. DESIGN In this article, we provide an up-to-date evaluation of risks and benefits of alpine skiing in relation of cardiovascular disease and elderly persons. METHODS Narrative Review. RESULTS In the first section, the current recommendations of physical activity and effects of alpine skiing - with particular attention to the elderly population - are described. In the second section, the present knowledge regarding cardiovascular risk and alpine skiing is summarized and possible pathophysiological mechanisms are highlighted. Finally, a summary regarding actual clinical recommendations is provided. CONCLUSIONS Alpine skiing may safely be recommended also to the elderly if certain precautions are applied, as the benefits outbalance the potential risks in most subjects.
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Affiliation(s)
- Valentina Alice Rossi
- Department of Cardiology, University Heart Center, University of Zurich, University Hospital Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center, University of Zurich, University Hospital Zurich, Switzerland
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Center, University of Zurich, University Hospital Zurich, Switzerland.
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