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Javaudin F, Canon V, Heidet M, Bougouin W, Youssfi Y, Beganton F, Empana JP, Chocron R, Jouven X, Marijon E, Hubert H, Dumas F, Cariou A. HIV status and lay bystander cardiopulmonary resuscitation initiation for witnessed cardiac arrest. Resuscitation 2024:110269. [PMID: 38852828 DOI: 10.1016/j.resuscitation.2024.110269] [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: 03/28/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION Early initiation of cardiopulmonary resuscitation (CPR) by bystanders of out-of-hospital cardiac arrest (OHCA) significantly improves survival and neurological outcomes. However, misconceptions about human immunodeficiency virus (HIV) transmission risk during CPR can deter lay bystanders from performing resuscitation. The aim of this study was to compare the rate of CPR initiation by lay bystanders who witnessed OHCA in subjects with and without HIV infection. METHODS We analysed data from the two French cardiac arrest registries (SDEC and RéAC) from 2012 to 2020. We identified HIV-positive individuals from the French National Health Insurance database for the SDEC registry, and directly from the RéAC registry data. We used logistic regression models to assess the association between CPR initiation by lay bystanders and the victim's HIV status. RESULTS Of 58,177 witnessed OHCA cases, 192 (0.3%) occurred in HIV-positive subjects. These individuals were younger, more often male, and presented more shockable initial rhythms compared with subjects without HIV. Overall, there was no difference in the CPR initiation rate according to the HIV status (57.3% vs 47.6%, adjusted odds ratio 1.11, 95% confidence interval 0.83-1.48). The CPR initiation rate also did not differ by location between victims with or without HIV (home: 57.7% vs 45.4%; public places: 56.0% vs 53.6%; p for interaction = 0.46). Survival and neurological outcomes at hospital discharge did not differ based on the HIV status. CONCLUSIONS This study revealed that the rate of CPR initiation by lay bystanders did not differ between HIV and non-HIV subjects during OHCA.
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Affiliation(s)
- François Javaudin
- Paris Sudden Death Expertise Center, 75015 Paris, France; Emergency Department, Nantes University Hospital, 44000 Nantes, France. https://twitter.com/FJavaudin
| | - Valentine Canon
- Université de Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, 59000 Lille, France; French National Out-of-Hospital Cardiac Arrest Registry Research Group (Registre Électronique des Arrêts Cardiaques), 59000 Lille, France
| | - Matthieu Heidet
- Assistance Publique - Hôpitaux de Paris (AP-HP), SAMU 94 and Emergency Department, Hôpitaux universitaires Henri Mondor, Créteil, France; Université Paris-Est Créteil (UPEC), EA-3956 (Control in Intelligent Networks [CIR]), Créteil, France
| | - Wulfran Bougouin
- Paris Sudden Death Expertise Center, 75015 Paris, France; Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015 Paris, France; Medical Intensive Care Unit, Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, 6 Avenue du Noyer Lambert, 91300 Massy, France; AfterROSC Network, Paris, France
| | - Younès Youssfi
- Paris Sudden Death Expertise Center, 75015 Paris, France; Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015 Paris, France
| | - Frankie Beganton
- Paris Sudden Death Expertise Center, 75015 Paris, France; Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015 Paris, France
| | - Jean-Philippe Empana
- Paris Sudden Death Expertise Center, 75015 Paris, France; Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015 Paris, France
| | - Richard Chocron
- Paris Sudden Death Expertise Center, 75015 Paris, France; Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015 Paris, France; Emergency Department, Georges Pompidou European Hospital, Paris, France
| | - Xavier Jouven
- Paris Sudden Death Expertise Center, 75015 Paris, France; Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015 Paris, France; Cardiology Department, AP-HP, European Georges Pompidou Hospital, 75015 Paris, France
| | - Eloi Marijon
- Paris Sudden Death Expertise Center, 75015 Paris, France; Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015 Paris, France; Cardiology Department, AP-HP, European Georges Pompidou Hospital, 75015 Paris, France
| | - Hervé Hubert
- Université de Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, 59000 Lille, France; French National Out-of-Hospital Cardiac Arrest Registry Research Group (Registre Électronique des Arrêts Cardiaques), 59000 Lille, France
| | - Florence Dumas
- Paris Sudden Death Expertise Center, 75015 Paris, France; Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015 Paris, France; Emergency Department, AP-HP, Cochin-Hotel-Dieu Hospital, 75014 Paris, France
| | - Alain Cariou
- Paris Sudden Death Expertise Center, 75015 Paris, France; Université Paris Cité, INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, 75015 Paris, France; AfterROSC Network, Paris, France; Medical Intensive Care Unit, AP-HP, Cochin Hospital, 75014 Paris, France
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Shin J, Lee HJ, Jin KN, Shin JH, You KM, Lee SGW, Jung JH, Song KJ, Pak J, Park TY, Park CJ, Bae GT. Automatic Mechanical Ventilation vs Manual Bag Ventilation During CPR: A Pilot Randomized Controlled Trial. Chest 2024:S0012-3692(24)00248-4. [PMID: 38373673 DOI: 10.1016/j.chest.2024.02.020] [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: 10/11/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND There is insufficient evidence supporting the theory that mechanical ventilation can replace the manual ventilation method during CPR. RESEARCH QUESTION Is using automatic mechanical ventilation (MV) feasible and comparable to the manual ventilation method during CPR? STUDY DESIGN AND METHODS This pilot randomized controlled trial compared MV and manual bag ventilation (BV) during CPR after out-of-hospital cardiac arrest (OHCA). Patients with medical OHCA arriving at the ED were randomly assigned to two groups: an MV group using a mechanical ventilator and a BV group using a bag valve mask. Primary outcome was any return of spontaneous circulation (ROSC). Secondary outcomes were changes of arterial blood gas analysis results during CPR. Tidal volume, minute volume, and peak airway pressure were also analyzed. RESULTS A total of 60 patients were enrolled, and 30 patients were randomly assigned to each group. There were no statistically significant differences in basic characteristics of OHCA patients between the two groups. The rate of any return of spontaneous circulation was 56.7% in the MV group and 43.3% in the BV group, indicating no significant (P = .439) difference between the two groups. There were also no statistically significant differences in changes of PH, Pco2, Po2, bicarbonate, or lactate levels during CPR between the two groups (P values = .798, 0.249, .515, .876, and .878, respectively). Significantly lower tidal volume (P < .001) and minute volume (P = .009) were observed in the MV group. INTERPRETATION In this pilot trial, the use of MV instead of BV during CPR was feasible and could serve as a viable alternative. A multicenter randomized controlled trial is needed to create sufficient evidence for ventilation guidelines during CPR. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov; No.: NCT05550454; URL: www. CLINICALTRIALS gov.
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Affiliation(s)
- Jonghwan Shin
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Emergency Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Hui Jai Lee
- Department of Emergency Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea.
| | - Kwang Nam Jin
- Department of Radiology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Jung Ho Shin
- Department of Emergency Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Kyoung Min You
- Department of Emergency Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Stephen Gyung Won Lee
- Department of Emergency Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Jin Hee Jung
- Department of Emergency Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Kyoung Jun Song
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Emergency Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Jieun Pak
- Department of Emergency Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Tae Yun Park
- Department of Internal Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Chang Je Park
- Department of Emergency Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Gi Tak Bae
- Department of Nursing, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
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Kim HJ, Lee D, Moon HJ, Jeong D, Shin TY, In Hong S, Lee HJ. Real-world comparison between mechanical and manual cardiopulmonary resuscitation during the COVID-19 pandemic. Am J Emerg Med 2024; 76:217-224. [PMID: 38128162 DOI: 10.1016/j.ajem.2023.11.026] [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: 06/07/2023] [Revised: 10/23/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide, including an increase in out-of-hospital cardiac arrests (OHCA). Healthcare providers are now required to use personal protective equipment (PPE) during cardiopulmonary resuscitation (CPR). Additionally, mechanical CPR devices have been introduced to reduce the number of personnel required for resuscitation. This study aimed to compare the outcomes of CPR performed with a mechanical device and the outcomes of manual CPR performed by personnel wearing PPE. METHODS This multicenter observational study utilized data from the Korean Cardiac Arrest Research Consortium registry. The study population consisted of OHCA patients who underwent CPR in emergency departments (EDs) between March 2020 and June 2021. Patients were divided into two equal propensity score matched groups: mechanical CPR group (n = 421) and PPE-equipped manual CPR group (n = 421). Primary outcomes included survival rates and favorable neurological outcomes at discharge. Total CPR duration in the ED was also assessed. RESULTS There were no significant between-group differences with respect to survival rate at discharge (mechanical CPR: 7.4% vs PPE-equipped manual CPR: 8.3%) or favorable neurological outcomes (3.3% vs. 3.8%, respectively). However, the mechanical CPR group had a longer duration of CPR in the ED compared to the manual CPR group. CONCLUSION This study found no significant differences in survival rates and neurological outcomes between mechanical CPR and PPE-equipped manual CPR in the ED setting. However, a longer total CPR duration was observed in the mechanical CPR group. Further research is required to explore the impact of PPE on healthcare providers' performance and fatigue during CPR in the context of the pandemic and beyond.
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Affiliation(s)
- Hyun Joon Kim
- Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Cheonan 31151, Republic of Korea
| | - Dongwook Lee
- Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Cheonan 31151, Republic of Korea.
| | - Hyung Jun Moon
- Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Cheonan 31151, Republic of Korea
| | - Dongkil Jeong
- Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Cheonan 31151, Republic of Korea
| | - Tae Yong Shin
- Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Cheonan 31151, Republic of Korea
| | - Sun In Hong
- Department of internal medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Cheonan 31151, Republic of Korea
| | - Hyun Jung Lee
- Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Cheonan 31151, Republic of Korea
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Mathew MJ, Kundra P, Vinayagam S. Chest compression quality comparing 1-min vs 2-min rotation of rescuers wearing N95 masks. Am J Emerg Med 2024; 76:75-81. [PMID: 38006635 DOI: 10.1016/j.ajem.2023.11.025] [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: 07/11/2023] [Revised: 10/31/2023] [Accepted: 11/14/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, cardiopulmonary resuscitation (CPR) performed by rescuers wearing well-sealed respirators such as N95 masks, was associated with significant reduction in the chest compression rate and depth. This was attributed to fatigue during the standard 2-min rescuer rotations. We hypothesized that in such situations, rotating rescuers every one minute, instead of the standard two minutes would improve CPR quality. AIM To compare the quality of chest compressions when rescuers wearing N95 masks are rotated every one minute, instead of the standard practice of two-minute rotations. METHODS A randomized, controlled, crossover trial was conducted, with the approval of the institutional Ethics Committee. Medical students who volunteered as rescuers were trained to perform high-quality chest compressions on a manikin, and then randomly allocated into pairs. Each pair was randomized to one of two trial groups viz. one-minute rotations crossed-over to two-minute rotations; and vice versa. Thus, each pair performed CPR with one-minute rotations, as well as two-minute rotations Each CPR session included chest compressions for a duration of 12 min. The outcome parameters included CPR quality, compression depth, compression rate, and chest compression fraction. Rescuer fatigue was measured before and after each study session using the modified Borg scale. RESULTS Fifty-six participants completed the study. The overall CPR quality was statistically similar in the study arms (median 88% vs. 81%, p = 0.09). However, the minute-to-minute inter-arm comparison revealed significantly lower CPR quality in the 2-min rotation arm, at the end of minutes 4, 6, 8, 10 and 12 (respective p-values 0.03, 0.001, 0.008, 0.02, 0.002). A similar trend was observed in compression depth also. Rescuer fatigue score was significantly less with 1-min rotations compared to 2-min rotations (p < 0.001). Rescuer vital signs and cardiorespiratory parameters were not different with the two types of rotations. CONCLUSION During CPR performed by rescuers wearing N95 masks, the quality of CPR appears to be superior with rescuers rotating at 1-min instead of 2-min intervals. More frequent rotation was also associated with less rescuer fatigue.
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Affiliation(s)
- Maria J Mathew
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantari Nagar, Puducherry 605006, India
| | - Pankaj Kundra
- Department of Anaesthesiology & Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantari Nagar, Puducherry 605006, India
| | - Stalin Vinayagam
- Department of Anaesthesiology & Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantari Nagar, Puducherry 605006, India.
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Ferguson M, Rittenbach K, Leece P, Adams A, Ali F, Elton-Marshall T, Burmeister C, Brothers TD, Medley A, Choisil P, Strike C, Ng J, Lorenzetti DL, Gallant K, Buxton JA. Document d’orientation sur la distribution et l’utilisation de trousses de naloxone à emporter par les intervenants et intervenantes communautaires en cas de surdose au Canada. CMAJ 2023; 195:E1312-E1325. [PMID: 37788838 PMCID: PMC10637331 DOI: 10.1503/cmaj.230128-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Affiliation(s)
- Max Ferguson
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Katherine Rittenbach
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Pamela Leece
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Alison Adams
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Farihah Ali
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Tara Elton-Marshall
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Charlene Burmeister
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Thomas D Brothers
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Andrea Medley
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Paul Choisil
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Carol Strike
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Justin Ng
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Diane L Lorenzetti
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Kat Gallant
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B
| | - Jane A Buxton
- Centre de contrôle des maladies de la Colombie-Britannique (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, C.-B.; Département de psychiatrie (Rittenbach), Université de Calgary, Calgary, Alb.; Département de psychiatrie (Rittenbach), Université de l'Alberta, Edmonton, Alb.; Santé publique Ontario (Leece); École Dalla Lana de santé publique (Leece, Elton-Marshall, Strike) et Département de médecine familiale et communautaire (Leece), Université de Toronto; Institut de recherche sur les politiques de santé mentale (Ali, Elton-Marshall), Centre de toxicomanie et de santé mentale, Toronto, Ont.; École d'épidémiologie et de santé publique (Elton-Marshall), Université d'Ottawa, Ottawa, Ont.; Département de médecine (Brothers), Université Dalhousie, Halifax, N.-É.; Centre collaboratif pour la santé inclusive UCL (Brothers), Collège universitaire de Londres, Londres, Royaume-Uni; Centre de santé des Autochtones (Medley), École de santé publique Johns Hopkins Bloomberg, Baltimore, Md.; Programme d'interventions d'urgence en cas de surdose et de toxicomanie (Medley), Régie de la santé du littoral de Vancouver, Vancouver, C.-B.; Bibliothèque des sciences de la santé (Lorenzetti), Université de Calgary; Département des sciences de la santé communautaire (Lorenzetti), École de médecine Cumming, Université de Calgary; Institut O'Brien de santé publique (Lorenzetti), Université de Calgary, Calgary, Alb.; Centre de traitement de la toxicomanie de la Colombie-Britannique (Gallant); École de santé des populations et de santé publique (Buxton), Université de Colombie-Britannique, Vancouver, C.-B.
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Tangpaisarn T, Chaiyakot N, Saenpan K, Sriphrom S, Owattanapanich N, Kotruchin P, Phungoen P. Surgical mask-to-mouth ventilation as an alternative ventilation technique during CPR: A crossover randomized controlled trial. Am J Emerg Med 2023; 72:158-163. [PMID: 37536087 DOI: 10.1016/j.ajem.2023.07.046] [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: 03/19/2023] [Revised: 06/07/2023] [Accepted: 07/23/2023] [Indexed: 08/05/2023] Open
Abstract
INTRODUCTION Chest compression with rescue breathing improves outcomes in cardiac arrest. However, the efficacy of rescue breathing through surgical masks has not been investigated. OBJECTIVE We aimed to compare the tidal volume generated by mouth-to-mouth ventilation (MMV) with that generated by surgical mask-to-mouth ventilation (SMV), mouth-to-surgical mask ventilation (MSV), and surgical mask-to-surgical mask ventilation (SSV) in a manikin. METHODS A crossover randomized controlled trial was conducted in 42 medical personnel volunteers randomly assigned to perform four ventilation techniques: MMV (no protective equipment), SMV (participant wearing a mask), MSV (manikin wearing a mask), and SSV, (both participant and manikin wearing a mask). The average tidal volume and the proportion of adequate ventilation, evaluated using a manikin, were compared across different ventilation methods. RESULTS The average tidal volume of MMV (828 ± 278 ml) was significantly higher than those of the MSV (648 ± 250 ml, P < 0.001) and SSV (466 ± 301 ml, P < 0.001), but not SMV (744 ± 288 ml, P = 0.054). Adequate ventilation was achieved in 144/168 (85.7%) cases in the MMV group, a proportion significantly higher than in the SMV (77.4%, P = 0.02), MSV (66.7%, P < 0.001) and SSV (39.3%, P < 0.001) groups. The willingness to perform SMV was higher than that to perform MMV. CONCLUSIONS MMV resulted in a superior average tidal volume when compared to both MSV and SSV. However, SMV achieved a comparable average tidal volume to MMV.
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Affiliation(s)
- Thanat Tangpaisarn
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
| | - Narubet Chaiyakot
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
| | - Konglar Saenpan
- CPR training unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.
| | - Sumana Sriphrom
- CPR training unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.
| | - Natthida Owattanapanich
- Division of Trauma Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Praew Kotruchin
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
| | - Pariwat Phungoen
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
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Ferguson M, Rittenbach K, Leece P, Adams A, Ali F, Elton-Marshall T, Burmeister C, Brothers TD, Medley A, Choisil P, Strike C, Ng J, Lorenzetti DL, Gallant K, Buxton JA. Guidance on take-home naloxone distribution and use by community overdose responders in Canada. CMAJ 2023; 195:E1112-E1123. [PMID: 37640401 PMCID: PMC10462409 DOI: 10.1503/cmaj.230128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The increasing toxicity of opioids in the unregulated drug market has led to escalating numbers of overdoses in Canada and worldwide; takehome naloxone (THN) is an evidence-based intervention that distributes kits containing naloxone to people in the community who may witness an overdose. The purpose of this guidance is to provide policy recommendations for territorial, provincial and federal THN programs, using evidence from scientific and grey literature and community evidence that reflects 11 years of THN distribution in Canada. METHODS The Naloxone Guidance Development Group - a multidisciplinary team including people with lived and living experience and expertise of drug use - used the Appraisal of Guidelines for Research & Evaluation (AGREE II) instrument to inform development of this guidance. We considered published evidence identified through systematic reviews of all literature types, along with community evidence and expertise, to generate recommendations between December 2021 and September 2022. We solicited feedback on preliminary recommendations through an External Review Committee and a public input process. The project was funded by the Canadian Institutes of Health Research through the Canadian Research Initiative in Substance Misuse. We used the Guideline International Network principles for managing competing interests. RECOMMENDATIONS Existing evidence from the literature on THN was of low quality. We incorporated evidence from scientific and grey literature, and community expertise to develop our recommendations. These were in 3 areas: routes of naloxone administration, THN kit contents and overdose response. Take-home naloxone programs should offer the choice of both intramuscular and intranasal formulations of naloxone in THN kits. Recommended kit contents include naloxone, a naloxone delivery device, personal protective equipment, instructions and a carrying case. Trained community overdose responders should prioritize rescue breathing in the case of respiratory depression, and conventional cardiopulmonary resuscitation in the case of cardiac arrest, among other interventions. INTERPRETATION This guidance development project provides direction for THN programs in Canada in the context of limited published evidence, with recommendations developed in collaboration with diverse stakeholders.
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Affiliation(s)
- Max Ferguson
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Katherine Rittenbach
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Pamela Leece
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Alison Adams
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Farihah Ali
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Tara Elton-Marshall
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Charlene Burmeister
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Thomas D Brothers
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Andrea Medley
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Paul Choisil
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Carol Strike
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Justin Ng
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Diane L Lorenzetti
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Kat Gallant
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
| | - Jane A Buxton
- BC Centre for Disease Control (Ferguson, Adams, Burmeister, Choisil, Ng, Buxton), Vancouver, BC; Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Public Health Ontario (PHO) (Leece); Dalla Lana School of Public Health (Leece, Elton-Marshall, Strike) and Department of Family and Community Medicine (Leece), University of Toronto; Institute for Mental Health Policy Research (Ali, Elton-Marshall), Centre for Addiction and Mental Health, Toronto, Ont.; School of Epidemiology and Public Health (Elton-Marshall), University of Ottawa, Ottawa, Ont.; Department of Medicine (Brothers), Dalhousie University, Halifax, NS; UCL Collaborative Centre for Inclusion Health (Brothers), University College London, London, UK; Center for Indigenous Health (Medley), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; Overdose Emergency Response and Addictions Program (Medley), Vancouver Coastal Health, Vancouver, BC; Health Sciences Library (Lorenzetti), University of Calgary; Department of Community Health Sciences (Lorenzetti), Cumming School of Medicine, University of Calgary; O'Brien Institute for Public Health (Lorenzetti), University of Calgary, Calgary, Alta.; BC Centre on Substance Use (Gallant); School of Population and Public Health (Buxton), University of British Columbia, Vancouver, BC
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8
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Jung WJ, Roh YI, Im H, Lee Y, Im D, Cha KC, Hwang SO. Efficacy of Cardiopulmonary Resuscitation Using Automatic Compression-Defibrillation Apparatus: An Animal Study and A Manikin-Based Simulation Study. J Clin Med 2023; 12:5333. [PMID: 37629377 PMCID: PMC10455516 DOI: 10.3390/jcm12165333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Chest compression and defibrillation are essential components of cardiac arrest treatment. Mechanical chest compression devices (MCCD) and automated external defibrillators (AED) are used separately in clinical practice. We developed an automated compression-defibrillation apparatus (ACDA) that performs mechanical chest compression and automated defibrillation. We investigated the performance of cardiopulmonary resuscitation (CPR) with automatic CPR (A-CPR) compared to that with MCCD and AED (conventional CPR: C-CPR). METHODS Pigs were randomized into A-CPR or C-CPR groups: The A-CPR group received CPR+ACDA, and the C-CPR group received CPR+MCCD+AED. Hemodynamic parameters, outcomes, and time variables were measured. During a simulation study, healthcare providers performed a basic life support scenario for manikins with an ACDA, MCCD, and AED, and time variables and chest compression parameters were measured. RESULTS The animals showed no significant in hemodynamic effects, including aortic pressures, coronary perfusion pressure, carotid blood flow, and end-tidal CO2, and resuscitation outcomes between the two groups. In both animal and simulation studies, the time to defibrillation, time to chest compression, and hands-off time were significantly shorter in the A-CPR group than those in the C-CPR group. CONCLUSIONS CPR using ACDA showed similar hemodynamic effects and resuscitation outcomes as CPR using AED and MCCD separately, with the advantages of a reduction in the time to compression, time to defibrillation, and hands-off time.
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Affiliation(s)
- Woo Jin Jung
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea; (W.J.J.); (Y.-I.R.); (H.I.); (Y.L.); (D.I.)
- Research Institute of Resuscitation Science, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Young-Il Roh
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea; (W.J.J.); (Y.-I.R.); (H.I.); (Y.L.); (D.I.)
- Research Institute of Resuscitation Science, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Hyeonyoung Im
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea; (W.J.J.); (Y.-I.R.); (H.I.); (Y.L.); (D.I.)
- Research Institute of Resuscitation Science, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Yujin Lee
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea; (W.J.J.); (Y.-I.R.); (H.I.); (Y.L.); (D.I.)
- Research Institute of Resuscitation Science, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Dahye Im
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea; (W.J.J.); (Y.-I.R.); (H.I.); (Y.L.); (D.I.)
- Research Institute of Resuscitation Science, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Kyoung-Chul Cha
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea; (W.J.J.); (Y.-I.R.); (H.I.); (Y.L.); (D.I.)
- Research Institute of Resuscitation Science, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Sung Oh Hwang
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea; (W.J.J.); (Y.-I.R.); (H.I.); (Y.L.); (D.I.)
- Research Institute of Resuscitation Science, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
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9
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Renza M, Peřan D, Sýkora R, Stern M, Zvoníček V, Waldauf P, Duška F. Influence of additional personal protective equipment on team performance in simulation-based emergency scenarios: a randomised controlled trial. Br J Anaesth 2023; 130:e494-e496. [PMID: 36935308 PMCID: PMC10028374 DOI: 10.1016/j.bja.2023.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 03/21/2023] Open
Affiliation(s)
- Metoděj Renza
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic
| | - David Peřan
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic; Emergency Medical Services of the Karlovy Vary Region, Karlovy Vary, Czech Republic
| | - Roman Sýkora
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic; Emergency Medical Services of the Karlovy Vary Region, Karlovy Vary, Czech Republic
| | - Michael Stern
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic
| | - Václav Zvoníček
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic
| | - Petr Waldauf
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic
| | - František Duška
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic.
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10
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Latsios G, Leopoulou M, Synetos A, Karanasos A, Papanikolaou A, Bounas P, Stamatopoulou E, Toutouzas K, Tsioufis K. Cardiac arrest and cardiopulmonary resuscitation in “hostile” environments: Using automated compression devices to minimize the rescuers’ danger. World J Cardiol 2023; 15:45-55. [PMID: 36911750 PMCID: PMC9993930 DOI: 10.4330/wjc.v15.i2.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/25/2023] [Accepted: 02/15/2023] [Indexed: 02/21/2023] Open
Abstract
Mechanical automated compression devices are being used in cardiopulmonary resuscitation instead of manual, “hands-on”, rescuer-delivered chest compressions. The -theoretical- advantages include high-quality non-stop compressions, thus freeing the rescuer performing the compressions and additionally the ability of the rescuer to stand reasonably away from a potentially “hazardous” victim, or from hazardous and/or difficult resuscitation conditions. Such circumstances involve cardiopulmonary resuscitation (CPR) in the Cardiac Catheterization Laboratory, especially directly under the fluoroscopy panel, where radiation is well known to cause detrimental effects to the rescuer, and CPR during/after land or air transportation of cardiac arrest victims. Lastly, CPR in a coronavirus disease 2019 patient/ward, where the danger of contamination and further serious illness of the health provider is very existent. The scope of this review is to review and present literature and current guidelines regarding the use of mechanical compressions in these “hostile” and dangerous settings, while comparing them to manual compressions.
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Affiliation(s)
- George Latsios
- 1st University Department of Cardiology, "Hippokration" University Hospital, Athens Medical School, Athens 11527, Greece
| | - Marianna Leopoulou
- 1st Cardiology Clinic, 'Hippokration' University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 11527, Greece
- Department of Cardiology, "Elpis" Athens General Hospital, Athens 11522, Greece
| | - Andreas Synetos
- 1st Department of Cardiology, Athens Medical School, University Athens, Hippokrat Hospital, Athens 11527, Greece
| | - Antonios Karanasos
- 1st University Department of Cardiology, "Hippokration" University Hospital, Athens Medical School, Athens 11527, Greece
| | - Angelos Papanikolaou
- 1st Cardiology Department Athens Medical School, Hippokration General Hospital, Athens 11527, Greece
| | - Pavlos Bounas
- Department of Cardiology, “Thriasio” General Hospital, Thriasio General Hospital, Elefsina 19600, Greece
| | - Evangelia Stamatopoulou
- CathLab, 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, “Attikon” University Hospital, Attikon University Hospital, Athens 12462, Greece
| | | | - Kostas Tsioufis
- 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, “Hippokration” General Hospital, "Hippokration" University Hospital, Athens 11527, Greece
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11
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Bianchi FP, Stefanizzi P, Diella G, Martinelli A, Di Lorenzo A, Gallone MS, Tafuri S. Prevalence and management of rubella susceptibility in healthcare workers in Italy: A systematic review and meta-analysis. Vaccine X 2022; 12:100195. [PMID: 36032697 PMCID: PMC9399279 DOI: 10.1016/j.jvacx.2022.100195] [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: 01/13/2022] [Revised: 03/18/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction In the pre-vaccination era, all adults acquired immunity status due to natural infections during childhood and adolescence, whereas universal mass vaccination has changed the seroepidemiology of rubella among adults, showing lack of immunity in some subgroups. National and international guidelines recommend evaluating all healthcare workers (HCWs) for their immune status to rubella and possibly vaccinating those who are seronegative. We conducted a systematic review and meta-analysis to estimate the susceptibility rate to rubella among HCWs in Italy and to explore possible options for the management of those found to be susceptible. Methods Eight studies were included in the meta-analysis, selected from scientific papers available in the MEDLINE/PubMed and Google Scholar (till page 10) databases between January 1, 2015 and November 30, 2021. The following terms were used for the search strategy: (sero* OR seroprevalence OR prevalence OR susceptibilit* OR immunit* OR immunogenict*) AND (healthcare worker* OR health personnel OR physician* OR nurse OR student*) AND (rubella OR german measles OR TORCH) AND (Italy) Results The prevalence of rubella-susceptible HCWs was 9.0 % (95 %CI: 6.4–12.1 %). In a comparison of female vs. male serosusceptible HCWs, the RR was 0.67 (95 %CI = 0.51–0.88). Occupational medicine examinations for rubella screening with possible subsequent vaccination of seronegatives and exclusion of susceptible HCWs from high-risk settings were common management strategies. Conclusions HCWs susceptible to rubella are an important epidemiological concern in Italy, and efforts to identify and actively offer the vaccine to this population should be increased.
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12
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Thin foil body-shield resuscitation barrier device to protect from blood: an experimental study. Sci Rep 2022; 12:13573. [PMID: 35945452 PMCID: PMC9362170 DOI: 10.1038/s41598-022-17915-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/02/2022] [Indexed: 01/29/2023] Open
Abstract
In times of collective concern about pandemics, body-shield resuscitation barrier devices are more and more considered to protect against transmission of different pathogens between rescuers and patients. The objective of this experimental study was to investigate the characteristics of blood drops dispersed on the surface of four different foils suitable for blanketing patients during resuscitation. We analyzed run-off characteristics of blood stains depending on surface properties of polyvinyl chloride, polyethylene, polyethylene terephthalate and aluminum-coated polyethylene terephthalate. Confocal fluorescence microscopy revealed less cellular density and lack of fibrin networks in blood stains on the four foil surfaces than on paper towel. Delayed clotting went along with larger areas of contamination indicating a greater likelihood of coming into contact with potential germs but a smaller chance of contracting an infection. Space blankets as obligatory components of first aid kits are readily available for rescuers and serve as a mechanical barrier between rescuers and patients during resuscitation.
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13
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Oh TK, Jo YH, Song KH, Song IA. Impacts of symptomatic HIV infection on In-Hospital Cardiopulmonary Resuscitation Outcomes: A Population-Based Cohort Study in South Korea. Open Forum Infect Dis 2022; 9:ofac144. [PMID: 35493117 PMCID: PMC9045954 DOI: 10.1093/ofid/ofac144] [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: 01/18/2022] [Accepted: 03/17/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The impacts of human immunodeficiency virus (HIV) infection on survival outcomes after in-hospital cardiopulmonary resuscitation (ICPR) remains controversial. This study aimed to investigate the impacts of HIV infection on both short-term and long-term outcomes after ICPR.
Methods
This nationwide, population-based cohort study used data taken from the South Korean National Health Insurance Service database. All adult (≥18 years old) patients who experienced ICPR between January 1, 2010, and December 31, 2019, were included.
Results
A total of 298,676 adult patients who underwent ICPR were initially included in the analysis. Among them, 586 (0.2%) patients were assigned to the PWH group (patients with symptomatic HIV infection), while 298,090 (99.8%) patients were assigned to the control group. After 1:10 propensity score (PS) matching, 586 patients in the PWH group and 5,845 patients in the control group were included in the analysis. Logistic regression analysis after PS matching showed that the PWH group had a 20% lower live discharge rate after ICPR compared to the control group (odds ratio: 0.80, 95% confidence interval [CI]: 0.65, 0.97; P=0.024). However, Cox regression analysis after PS matching showed that the risks of 6-month survival (hazard ratio [HR]: 1.01, 95% CI: 0.93, 1.11; P=0.768) and 1-year survival (HR: 1.02, 95% CI: 0.93, 1.11; P=0.702) were not significantly different between the PWH and control groups.
Conclusion
Although the PWH group showed lower live discharge rates compared to the control group after ICPR, long-term survival outcomes from 6 months and 1 year were not significantly different.
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Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea
| | - You Hwan Jo
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyoung-Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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14
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Latsios G, Synetos A, Leopoulou M, Stamatopoulou E, Koukopoulos P, Parisis C, Karanasos A, Fragkou P, Toutouzas K, Kanakakis J, Tsioufis K. Greek BLS Certified Providers’ CPR Willingness and Skill Retention During the Pre-Vaccine Covid-19 Pandemic Period. A Survey of the Hellenic Society of Cardiology. Open Access Emerg Med 2022; 14:63-75. [PMID: 35210874 PMCID: PMC8860398 DOI: 10.2147/oaem.s340567] [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: 10/05/2021] [Accepted: 12/30/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Methods Results Conclusion
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Affiliation(s)
- George Latsios
- First Department of Cardiology, National and Kapodistrian University of Athens, “Hippocration” General Hospital, Athens, Greece
- Correspondence: George Latsios, 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, AlexAndroupoleos 9, Athens, 11527, Email
| | - Andreas Synetos
- First Department of Cardiology, National and Kapodistrian University of Athens, “Hippocration” General Hospital, Athens, Greece
| | | | - Evaggelia Stamatopoulou
- Catheterization Laboratory, University of Athens Medical School, “Attikon” University Hospital, Athens, Greece
| | | | | | - Antonios Karanasos
- First Department of Cardiology, National and Kapodistrian University of Athens, “Hippocration” General Hospital, Athens, Greece
| | - Paraskevi Fragkou
- First Department of ICU, National and Kapodistrian University of Athens, “Evaggelismos” General Hospital, Athens, Greece
| | - Konstantinos Toutouzas
- First Department of Cardiology, National and Kapodistrian University of Athens, “Hippocration” General Hospital, Athens, Greece
| | - John Kanakakis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, “Alexandra” Hospital, Athens, Greece
| | - Kostas Tsioufis
- First Department of Cardiology, National and Kapodistrian University of Athens, “Hippocration” General Hospital, Athens, Greece
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