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Oh JH, Noh H, Lee JG, Kim DK. Effects of vertical compression during pediatric cardiopulmonary resuscitation using the one-handed chest compression technique. Am J Emerg Med 2022; 59:24-29. [PMID: 35772224 DOI: 10.1016/j.ajem.2022.06.044] [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: 04/13/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE The posture of the rescuer while performing the one-handed chest compression (OHCC) has not yet been evaluated. This study aimed to investigate the effect of vertical compression during pediatric cardiopulmonary resuscitation (CPR) using the OHCC technique. METHODS This was a prospective randomized crossover simulation trial. A total of 42 medical doctors conducted a 2-min single-rescuer CPR using the conventional OHCC (Test 1) or vertical OHCC (Test 2) technique on a pediatric manikin. The chest compression and ventilation parameters were measured in real time during the experiments using sensors embedded in the manikin. In addition, the compression force of each technique was measured using a force plate. RESULTS The average and adequate chest compression depth (CCD) were significantly higher in Test 2 than in Test 1 (average depth: 54.0 mm (interquartile range [IQR]: 48.5-56.0) in Test 2 vs. 49.0 mm (IQR: 40.0-54.0) in Test 1, P < 0.001; adequate depth: 99.0% (IQR: 36.3-100.0) in Test 2 vs. 52.0% (IQR: 0.0-98.0) in Test 1, P < 0.001). The average force of compression was also significantly higher in vertical OHCC than that in conventional OHCC (25.7 kg ± 4.4 in vertical OHCC vs. 24.5 kg ± 4.2 in conventional OHCC, P < 0.001). The ventilation parameters were not significantly different between Tests 1 and 2. CONCLUSIONS The vertical OHCC could provide a deeper and more adequate CCD compared with the conventional OHCC, and the advantages of the vertical OHCC originate from the superiority of the compression force.
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Affiliation(s)
- Je Hyeok Oh
- Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
| | - Hyeonseok Noh
- Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
| | - Jun Gyu Lee
- Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
| | - Don-Kyu Kim
- Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
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Tsou JY, Kao CL, Tu YF, Hong MY, Su FC, Chi CH. Biomechanical analysis of force distribution in one-handed and two-handed child chest compression- a randomized crossover observational study. BMC Emerg Med 2022; 22:13. [PMID: 35065602 PMCID: PMC8783411 DOI: 10.1186/s12873-022-00566-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/28/2021] [Indexed: 11/29/2022] Open
Abstract
Background Even force distribution would generate efficient external chest compression (ECC). Little research has been done to compare force distribution between one-hand (OH) and two-handed (TH) during child ECC. Therefore, this study was to investigate force distribution, rescuer perceived fatigue and discomfort/pain when applying OH and TH ECC in children. Methods Crossover manikin study. Thirty-five emergency department registered nurses performed lone rescuer ECC using TH and OH techniques, each for 2 min at a rate of at least 100 compressions/min. A Resusci Junior Basic manikin equipped with a MatScan pressure measurement system was used to collect data. The perceived exertion scale (modified Borg scale) and numerical rating scale (NRS) was applied to evaluate the fatigue and physical pain of delivering chest compressions. Results The maximum compression force (kg) delivered was 56.58 ± 13.67 for TH and 45.12 ± 7.90 for OH ECC (p < 0.001). The maximum-minimum force difference force delivered by TH and OH ECC was 52.24 ± 13.43 and 41.36 ± 7.57, respectively (p < 0.001). The mean caudal force delivered by TH and OH ECC was 29.45 ± 16.70 and 34.03 ± 12.01, respectively (p = 0.198). The mean cranial force delivered by TH and OH ECC was 27.13 ± 11.30 and 11.09 ± 9.72, respectively (p < 0.001). The caudal–cranial pressure difference delivered by TH and OH ECC was 19.14 ± 15.96 and 26.94 ± 14.48, respectively (p = 0.016). The perceived exertion and NRS for OH ECC was higher than that of the TH method (p < 0.001, p = 0.004, respectively). Conclusions The TH method produced greater compression force, had more efficient compression, and delivered a more even force distribution, and produced less fatigue and physical pain in the rescuer than the OH method. Trial registration The Cheng Kung University Institutional Review Board A-ER-103-387. http://nckuhirb.med.ncku.edu.tw/sitemap.php
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Noh H, Lee W, Yang D, Oh JH. Effects of resuscitation guideline terminology on pediatric cardiopulmonary resuscitation. Am J Emerg Med 2022; 54:65-70. [DOI: 10.1016/j.ajem.2022.01.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 10/19/2022] Open
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Effect of the Use of Metronome Feedback on the Quality of Pediatric Cardiopulmonary Resuscitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158087. [PMID: 34360379 PMCID: PMC8345427 DOI: 10.3390/ijerph18158087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/11/2022]
Abstract
Although the use of audio feedback with devices such as metronomes during cardiopulmonary resuscitation (CPR) is a simple method for improving CPR quality, its effect on the quality of pediatric CPR has not been adequately evaluated. In this study, 64 healthcare providers performed CPR (with one- and two-handed chest compression (OHCC and THCC, respectively)) on a pediatric resuscitation manikin (Resusci Junior QCPR), with and without audio feedback using a metronome (110 beats/min). CPR was performed on the floor, with a compression-to-ventilation ratio of 30:2. For both OHCC and THCC, the rate of achievement of an adequate compression rate during CPR was significantly higher when performed with metronome feedback than that without metronome feedback (CPR with vs. without feedback: 100.0% (99.0, 100.0) vs. 94.0% (69.0, 99.0), p < 0.001, for OHCC, and 100.0% (98.5, 100.0) vs. 91.0% (34.5, 98.5), p < 0.001, for THCC). However, the rate of achievement of adequate compression depth during the CPR performed was significantly higher without metronome feedback than that with metronome feedback (CPR with vs. without feedback: 95.0% (23.5, 99.5) vs. 98.5% (77.5, 100.0), p = 0.004, for OHCC, and 99.0% (95.5, 100.0) vs. 100.0% (99.0, 100.0), p = 0.003, for THCC). Although metronome feedback during pediatric CPR could increase the rate of achievement of adequate compression rates, it could cause decreased compression depth.
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Van de Voorde P, Turner NM, Djakow J, de Lucas N, Martinez-Mejias A, Biarent D, Bingham R, Brissaud O, Hoffmann F, Johannesdottir GB, Lauritsen T, Maconochie I. [Paediatric Life Support]. Notf Rett Med 2021; 24:650-719. [PMID: 34093080 PMCID: PMC8170638 DOI: 10.1007/s10049-021-00887-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 12/11/2022]
Abstract
The European Resuscitation Council (ERC) Paediatric Life Support (PLS) guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations of the International Liaison Committee on Resuscitation (ILCOR). This section provides guidelines on the management of critically ill or injured infants, children and adolescents before, during and after respiratory/cardiac arrest.
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Affiliation(s)
- Patrick Van de Voorde
- Department of Emergency Medicine, Faculty of Medicine UG, Ghent University Hospital, Gent, Belgien
- Federal Department of Health, EMS Dispatch Center, East & West Flanders, Brüssel, Belgien
| | - Nigel M. Turner
- Paediatric Cardiac Anesthesiology, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, Niederlande
| | - Jana Djakow
- Paediatric Intensive Care Unit, NH Hospital, Hořovice, Tschechien
- Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno, Medical Faculty of Masaryk University, Brno, Tschechien
| | | | - Abel Martinez-Mejias
- Department of Paediatrics and Emergency Medicine, Hospital de Terassa, Consorci Sanitari de Terrassa, Barcelona, Spanien
| | - Dominique Biarent
- Paediatric Intensive Care & Emergency Department, Hôpital Universitaire des Enfants, Université Libre de Bruxelles, Brüssel, Belgien
| | - Robert Bingham
- Hon. Consultant Paediatric Anaesthetist, Great Ormond Street Hospital for Children, London, Großbritannien
| | - Olivier Brissaud
- Réanimation et Surveillance Continue Pédiatriques et Néonatales, CHU Pellegrin – Hôpital des Enfants de Bordeaux, Université de Bordeaux, Bordeaux, Frankreich
| | - Florian Hoffmann
- Pädiatrische Intensiv- und Notfallmedizin, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Ludwig-Maximilians-Universität, München, Deutschland
| | | | - Torsten Lauritsen
- Paediatric Anaesthesia, The Juliane Marie Centre, University Hospital of Copenhagen, Kopenhagen, Dänemark
| | - Ian Maconochie
- Paediatric Emergency Medicine, Faculty of Medicine Imperial College, Imperial College Healthcare Trust NHS, London, Großbritannien
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Gugelmin-Almeida D, Clark C, Rolfe U, Jones M, Williams J. Dominant versus non-dominant hand during simulated infant CPR using the two-finger technique: a randomised study. Resusc Plus 2021; 7:100141. [PMID: 34223397 PMCID: PMC8244244 DOI: 10.1016/j.resplu.2021.100141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/10/2021] [Accepted: 05/16/2021] [Indexed: 11/28/2022] Open
Abstract
Aims The aim of this randomised study was to compare the two-finger technique (TFT) performance using dominant hand (DH) and non-dominant hand (NH) during simulated infant CPR (iCPR). Methods 24 participants performed 3-min iCPR using TFT with DH or NH followed by 3-min iCPR with their other hand. Perceived fatigue was rated using visual analogue scale. Primary outcomes - (i) difference between DH and NH for compression depth (CCD), compression rate (CCR), residual leaning (RL) and duty cycle (DC); (ii) difference between first and last 30 s of iCPR performance with DH and NH. Secondary outcomes - (i) perception of fatigue between DH and NH; (ii) relationship between perception of fatigue and iCPR performance. Results No significant difference between DH and NH for any iCPR metric. CCR (DH: P = 0.02; NH: P = 0.004) and DC (DH: P = 0.04; NH: P < 0.001) were significantly different for the last 30 s for DH and NH. Perception of fatigue for NH (76.8 ± 13.4 mm) was significantly higher (t = -3.7, P < 0.001) compared to DH (62.8 ± 12.5 mm). No significant correlation between iCPR metrics and perception of fatigue for DH. However, a significant correlation was found for CCR (r = 0.43; P = 0.04) and RL (r = -0.48; P = 0.02) for NH. Conclusion No difference in performance of iCPR with DH versus NH was determined. However, perception of fatigue is higher in NH and was related to CCR and RL, with no effect on quality of performance. Based on our results, individuals performing iCPR can offer similar quality of infant chest compressions regardless of the hand used or the perception of fatigue, under the conditions explored in this study.
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Affiliation(s)
- Debora Gugelmin-Almeida
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth Gateway Building, St. Pauls Lane, Bournemouth, BH8 8GP, England.,Department of Anaesthesiology, Main Theatres, Royal Bournemouth and Christchurch Hospitals, Castle Lane East, Bournemouth, BH7 7DW, England
| | - Carol Clark
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth Gateway Building, St. Pauls Lane, Bournemouth, BH8 8GP, England
| | - Ursula Rolfe
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth Gateway Building, St. Pauls Lane, Bournemouth, BH8 8GP, England
| | - Michael Jones
- Cardiff School of Engineering, Cardiff University, Cardiff, CF23 3AA, Wales
| | - Jonathan Williams
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth Gateway Building, St. Pauls Lane, Bournemouth, BH8 8GP, England
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Van de Voorde P, Turner NM, Djakow J, de Lucas N, Martinez-Mejias A, Biarent D, Bingham R, Brissaud O, Hoffmann F, Johannesdottir GB, Lauritsen T, Maconochie I. European Resuscitation Council Guidelines 2021: Paediatric Life Support. Resuscitation 2021; 161:327-387. [PMID: 33773830 DOI: 10.1016/j.resuscitation.2021.02.015] [Citation(s) in RCA: 170] [Impact Index Per Article: 56.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
These European Resuscitation Council Paediatric Life Support (PLS) guidelines, are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the management of critically ill infants and children, before, during and after cardiac arrest.
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Affiliation(s)
- Patrick Van de Voorde
- Department of Emergency Medicine Ghent University Hospital, Faculty of Medicine UG, Ghent, Belgium; EMS Dispatch Center, East & West Flanders, Federal Department of Health, Belgium.
| | - Nigel M Turner
- Paediatric Cardiac Anesthesiology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, Netherlands
| | - Jana Djakow
- Paediatric Intensive Care Unit, NH Hospital, Hořovice, Czech Republic; Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno, Medical Faculty of Masaryk University, Brno, Czech Republic
| | | | - Abel Martinez-Mejias
- Department of Paediatrics and Emergency Medicine, Hospital de Terassa, Consorci Sanitari de Terrassa, Barcelona, Spain
| | - Dominique Biarent
- Paediatric Intensive Care & Emergency Department, Hôpital Universitaire des Enfants, Université Libre de Bruxelles, Brussels, Belgium
| | - Robert Bingham
- Hon. Consultant Paediatric Anaesthetist, Great Ormond Street Hospital for Children, London, UK
| | - Olivier Brissaud
- Réanimation et Surveillance Continue Pédiatriques et Néonatales, CHU Pellegrin - Hôpital des Enfants de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Florian Hoffmann
- Paediatric Intensive Care and Emergency Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | | | - Torsten Lauritsen
- Paediatric Anaesthesia, The Juliane Marie Centre, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Ian Maconochie
- Paediatric Emergency Medicine, Imperial College Healthcare Trust NHS, Faculty of Medicine Imperial College, London, UK
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Topjian AA, Raymond TT, Atkins D, Chan M, Duff JP, Joyner BL, Lasa JJ, Lavonas EJ, Levy A, Mahgoub M, Meckler GD, Roberts KE, Sutton RM, Schexnayder SM. Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S469-S523. [PMID: 33081526 DOI: 10.1161/cir.0000000000000901] [Citation(s) in RCA: 198] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Quality of chest compressions during pediatric resuscitation with 15:2 and 30:2 compressions-to-ventilation ratio in a simulated scenario. Sci Rep 2020; 10:6828. [PMID: 32322023 PMCID: PMC7176711 DOI: 10.1038/s41598-020-63921-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/06/2020] [Indexed: 02/01/2023] Open
Abstract
The main objetive was to compare 30:2 and 15:2 compression-to-ventilation ratio in two simulated pediatric cardiopulmonary resuscitation (CPR) models with single rescuer. The secondary aim was to analyze the errors or omissions made during resuscitation. A prospective randomized parallel controlled study comparing 15:2 and 30:2 ratio in two manikins (child and infant) was developed. The CPR was performed by volunteers who completed an basic CPR course. Each subject did 4 CPR sessions of 3 minutes each one. Depth and rate of chest compressions (CC) during resuscitation were measured using a Zoll Z series defibrillator. Visual assessment of resuscitation was performed by an external researcher. A total of 26 volunteers performed 104 CPR sessions. Between 54–62% and 44–53% of CC were performed with an optimal rate and depth, respectively, with no significant differences. No differences were found in depth or rate of CC between 15:2 and 30:2 compression-to-ventilation ratio with both manikins. In the assessment of compliance with the ERC CPR algorithm, 69.2–80.8% of the subjects made some errors or omissions during resuscitation, the most frequent was not asking for help and not giving rescue breaths. The conclusions were that a high percentage of CC were not performed with optimal depth and rate. Errors or omissions were frequently made by rescuers during resuscitation.
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Lee SS, Lee SD, Oh JH. Comparison between modified and conventional one-handed chest compression techniques for child cardiopulmonary resuscitation: A randomised, non-blind, cross-over simulation trial. J Paediatr Child Health 2019; 55:1361-1366. [PMID: 30854750 DOI: 10.1111/jpc.14422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 12/10/2018] [Accepted: 02/12/2019] [Indexed: 11/26/2022]
Abstract
AIM Chest compression depth (CCD) decreases significantly when performing one-handed chest compression (OHCC). We modified OHCC posture to increase CCD as follows: first, the axis of the compression hand was adjusted to the compression area; second, the opposite hand was wrapped around the elbow of the compression arm. This study compared modified OHCC with conventional OHCC for child cardiopulmonary resuscitation. METHODS A total of 46 health-care providers performed 2 min of continuous chest compression using conventional OHCC (trial 1) and modified OHCC (trial 2) in a random order on a 5-year-old-sized child manikin lying on a bed. Chest compression parameters were assessed with an accelerometer and analysed by comparing the mean values of 30-s segments. RESULTS The average CCD decreased significantly in all segments in both trials (trial 1 (segments 1-4): 40.9 ± 5.6 mm, 39.4 ± 6.6 mm, 38.0 ± 6.9 mm, 36.7 ± 7.3 mm, P < 0.001; trial 2 (segments 1-4): 42.3 ± 5.4 mm, 41.2 ± 6.2 mm, 40.1 ± 6.8 mm, 39.0 ± 6.9 mm, P < 0.001). However, the average CCD in trial 2 was significantly greater in all segments than that in trial 1 (segments 1-4: P = 0.016; P = 0.009; P = 0.004; P = 0.001). The average chest compression rates were comparable in all segments in both trials. CONCLUSION By modifying OHCC posture, a deeper mean CCD could be maintained for 2 min than by using conventional OHCC.
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Affiliation(s)
- Sung Shim Lee
- Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Sang Dae Lee
- Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Je Hyeok Oh
- Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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Current Guideline of Chest Compression Depth for Children of All Ages May Be Too Deep for Younger Children. Emerg Med Int 2019; 2019:7841759. [PMID: 31321100 PMCID: PMC6607725 DOI: 10.1155/2019/7841759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 05/26/2019] [Indexed: 01/23/2023] Open
Abstract
Aim To determine whether the chest compression depth of at least 1/3 of the Anteroposterior (AP) diameter of the chest and about 5 cm is appropriate for children of all age groups via chest computed tomography. Methods The AP diameter of the chest, anterior chest wall diameter, and compressible diameter (Cd) were measured at the lower half of the sternum for patients aged 1-18 years using chest computed tomography. The mean ratio of 5 cm compression to the Cd of adult patients was used as the lower limit, and the mean ratio of 6 cm compression to the Cd of adult patients was used as the upper limit. Also, the depth of chest compression resulting in a residual depth <1 cm was considered to cause internal injury potentially. With the upper and lower limits, the compression ratios to the Cd were compared when compressions were performed at a depth of 1/3 the AP diameter of the chest and 5 cm for patients aged 1-18 years. Results Among children aged 1-7 years, compressing 5 cm was deeper than 1/3 the AP diameter. Also, among children aged 1-5 years, 5 cm did not leave a residual depth of 1 cm, potentially causing intrathoracic injury. Conclusion Current pediatric resuscitation guidelines of chest compression depth for children were too deep for younger children aged 1-7 years.
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Chauvin A, Truchot J, Bafeta A, Pateron D, Plaisance P, Yordanov Y. Randomized controlled trials of simulation-based interventions in Emergency Medicine: a methodological review. Intern Emerg Med 2018; 13:433-444. [PMID: 29147942 DOI: 10.1007/s11739-017-1770-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/10/2017] [Indexed: 11/27/2022]
Abstract
The number of trials assessing Simulation-Based Medical Education (SBME) interventions has rapidly expanded. Many studies show that potential flaws in design, conduct and reporting of randomized controlled trials (RCTs) can bias their results. We conducted a methodological review of RCTs assessing a SBME in Emergency Medicine (EM) and examined their methodological characteristics. We searched MEDLINE via PubMed for RCT that assessed a simulation intervention in EM, published in 6 general and internal medicine and in the top 10 EM journals. The Cochrane Collaboration risk of Bias tool was used to assess risk of bias, intervention reporting was evaluated based on the "template for intervention description and replication" checklist, and methodological quality was evaluated by the Medical Education Research Study Quality Instrument. Reports selection and data extraction was done by 2 independents researchers. From 1394 RCTs screened, 68 trials assessed a SBME intervention. They represent one quarter of our sample. Cardiopulmonary resuscitation (CPR) is the most frequent topic (81%). Random sequence generation and allocation concealment were performed correctly in 66 and 49% of trials. Blinding of participants and assessors was performed correctly in 19 and 68%. Risk of attrition bias was low in three-quarters of the studies (n = 51). Risk of selective reporting bias was unclear in nearly all studies. The mean MERQSI score was of 13.4/18.4% of the reports provided a description allowing the intervention replication. Trials assessing simulation represent one quarter of RCTs in EM. Their quality remains unclear, and reproducing the interventions appears challenging due to reporting issues.
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Affiliation(s)
- Anthony Chauvin
- Service d'Accueil des Urgences, Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 Rue Ambroise Paré, 75010, Paris, France.
- Faculté de Médecine, Université Diderot, Paris, France.
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel-Dieu Hospital, Paris, France.
| | - Jennifer Truchot
- Service d'Accueil des Urgences, Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 Rue Ambroise Paré, 75010, Paris, France
- Faculté de Médecine, Université Diderot, Paris, France
- Ilumens Simulation Department, Paris Descartes University, 45 rue des Saint Pères, 75006, Paris, France
| | - Aida Bafeta
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel-Dieu Hospital, Paris, France
| | - Dominique Pateron
- Sorbonne Universités, UPMC Paris Univ-06, Paris, France
- Service des Urgences-Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Patrick Plaisance
- Service d'Accueil des Urgences, Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 Rue Ambroise Paré, 75010, Paris, France
- Faculté de Médecine, Université Diderot, Paris, France
| | - Youri Yordanov
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel-Dieu Hospital, Paris, France
- Sorbonne Universités, UPMC Paris Univ-06, Paris, France
- Service des Urgences-Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
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López J, Fernández SN, González R, Solana MJ, Urbano J, Toledo B, López-Herce J. Comparison between manual and mechanical chest compressions during resuscitation in a pediatric animal model of asphyxial cardiac arrest. PLoS One 2017; 12:e0188846. [PMID: 29190801 PMCID: PMC5708730 DOI: 10.1371/journal.pone.0188846] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 11/14/2017] [Indexed: 02/06/2023] Open
Abstract
Aims Chest compressions (CC) during cardiopulmonary resuscitation are not sufficiently effective in many circumstances. Mechanical CC could be more effective than manual CC, but there are no studies comparing both techniques in children. The objective of this study was to compare the effectiveness of manual and mechanical chest compressions with Thumper device in a pediatric cardiac arrest animal model. Material and methods An experimental model of asphyxial cardiac arrest (CA) in 50 piglets (mean weight 9.6 kg) was used. Animals were randomized to receive either manual CC or mechanical CC using a pediatric piston chest compressions device (Life-Stat®, Michigan Instruments). Mean arterial pressure (MAP), arterial blood gases and end-tidal CO2 (etCO2) values were measured at 3, 9, 18 and 24 minutes after the beginning of resuscitation. Results There were no significant differences in MAP, DAP, arterial blood gases and etCO2 between chest compression techniques during CPR. Survival rate was higher in the manual CC (15 of 30 = 50%) than in the mechanical CC group (3 of 20 = 15%) p = 0.016. In the mechanical CC group there was a non significant higher incidence of haemorrhage through the endotracheal tube (45% vs 20%, p = 0.114). Conclusions In a pediatric animal model of cardiac arrest, mechanical piston chest compressions produced lower survival rates than manual chest compressions, without any differences in hemodynamic and respiratory parameters.
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Affiliation(s)
- Jorge López
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain
- Pediatrics Department, School of Medicine, Complutense University of Madrid, Spain
- Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
- Red de Salud Maternoinfantil y del Desarrollo (Red SAMID) RETICS, Madrid, Spain
| | - Sarah N. Fernández
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain
- Pediatrics Department, School of Medicine, Complutense University of Madrid, Spain
- Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
- Red de Salud Maternoinfantil y del Desarrollo (Red SAMID) RETICS, Madrid, Spain
| | - Rafael González
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain
- Pediatrics Department, School of Medicine, Complutense University of Madrid, Spain
- Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
- Red de Salud Maternoinfantil y del Desarrollo (Red SAMID) RETICS, Madrid, Spain
| | - María J. Solana
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain
- Pediatrics Department, School of Medicine, Complutense University of Madrid, Spain
- Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
- Red de Salud Maternoinfantil y del Desarrollo (Red SAMID) RETICS, Madrid, Spain
| | - Javier Urbano
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain
- Pediatrics Department, School of Medicine, Complutense University of Madrid, Spain
- Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
- Red de Salud Maternoinfantil y del Desarrollo (Red SAMID) RETICS, Madrid, Spain
| | - Blanca Toledo
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain
- Pediatrics Department, School of Medicine, Complutense University of Madrid, Spain
- Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
- Red de Salud Maternoinfantil y del Desarrollo (Red SAMID) RETICS, Madrid, Spain
| | - Jesús López-Herce
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain
- Pediatrics Department, School of Medicine, Complutense University of Madrid, Spain
- Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
- Red de Salud Maternoinfantil y del Desarrollo (Red SAMID) RETICS, Madrid, Spain
- * E-mail:
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Out-of-hospital cardiopulmonary resuscitation strategies using one-handed chest compression technique for children suffering a cardiac arrest. Eur J Emerg Med 2017; 24:255-261. [DOI: 10.1097/mej.0000000000000350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Cheong SA, Oh JH, Kim CW, Kim SE, Lee DH. Effects of alternating hands during in-hospital one-handed chest compression: A randomised cross-over manikin trial. Emerg Med Australas 2015; 27:567-572. [DOI: 10.1111/1742-6723.12492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Sin Ae Cheong
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Republic of Korea
| | - Je Hyeok Oh
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Republic of Korea
| | - Chan Woong Kim
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Republic of Korea
| | - Sung Eun Kim
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Republic of Korea
| | - Dong Hoon Lee
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Republic of Korea
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