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Çavuş K, Tiryaki O, Tiryaki E, Çelik S, Saçar HB. The Effect of Fatigue During Search and Rescue Efforts in Debris on the Quality of Cardiopulmonary Resuscitation. PREHOSP EMERG CARE 2025:1-7. [PMID: 39786729 DOI: 10.1080/10903127.2025.2450072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 12/07/2024] [Accepted: 12/15/2024] [Indexed: 01/12/2025]
Abstract
OBJECTIVES Cardiopulmonary resuscitation (CPR), which is used in cases of life-threatening cardiopulmonary arrest, is a physically exhausting procedure. Adding to that, sometimes, even before performing CPR, interventions to rescue the injured person from a challenging environment have caused significant fatigue. In this study, taking a novel research approach, we generated a scenario of fatigue during a rescue from earthquake debris and aimed to measure the effect of that fatigue on the quality of CPR performed by paramedics. METHODS The research followed an experimental design with 2 groups (experimental/control) and 2 measurements (pretest/post-test). The study population was selected using power analysis. The sample, consisting of 84 paramedic students, was randomly divided into 42 control and 42 experimental participants. Current American Heart Association (AHA 2020) and European Resuscitation Council (ERC 2021) guidelines were strictly followed when performing CPR. In order to assess the accuracy of CPR, a General Doctor GD-CPR200S-A (2010 standard) simulator was utilized. The participants were fatigued by practicing the process of extracting and transporting earthquake victims from rubble. A personal information form with 20 questions and a CPR measurement form were used to obtain the data. RESULTS In the analysis performed to measure the differences between the CPR indicators for the control and experimental groups in the post-test and pretest, the difference in compression (control: 6.5 ± 50.1 and experimental: -10.3 ± 46.0) was not significant. Meanwhile, we found that the difference in ventilation (control: 0.3 ± 5.4 vs. experiment: 8.1 ± 4.6) and the difference in CPR completion times (control: 0.2 ± 1.2 vs. experiment: -0.7 ± 0.7) between the post-test and pretest were significant. CONCLUSIONS There was no significant difference in correct compressions between the control and experimental groups, but there was a significant difference in ventilation and CPR completion times. For this reason, it is recommended to focus on the effect of fatigue on CPR quality, especially on the ventilation process. It is also recommended to include fatigue scenarios in CPR trainings.
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Affiliation(s)
- Kadir Çavuş
- Department of Disaster Management Doctorate Program, Institute of Graduate Studies, Gümüşhane University, Gümüşhane, Turkey
| | - Oğuzhan Tiryaki
- Department of Nursing, Graduate School of Health Sciences, Karadeniz Technical University, Ortahisar, Turkey
| | - Elif Tiryaki
- Department of Pediatric Nursing, Graduate School of Health Sciences, Atatürk University, Erzurum, Turkey
| | - Suat Çelik
- First and Emergency Aid Program, Health Services Vocational School, Artvin Çoruh University, Artvin, Turkey
| | - Hüseyin Bora Saçar
- Occupational Therapy Program, Health Services Vocational School, Artvin Çoruh University, Artvin, Turkey
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Kobayashi K, Hiiragi Y. Effect of mannequin sex on the quality of chest compressions. Am J Emerg Med 2024; 79:223-224. [PMID: 38000987 DOI: 10.1016/j.ajem.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 10/30/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Affiliation(s)
- Kaoru Kobayashi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan.
| | - Yukinobu Hiiragi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
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Bala-Kerr R, Sullivan B, Martin S. The Five-4-Life Quality Improvement Program: Improving Frontline Nurses' Cardiopulmonary Resuscitation Leadership and Team Management Skills. J Nurs Care Qual 2023; 38:40-46. [PMID: 36084315 DOI: 10.1097/ncq.0000000000000648] [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: 11/25/2022]
Abstract
BACKGROUND Poor leadership and teamwork in cardiopulmonary resuscitation (CPR) are associated with poor patient outcomes. PROBLEM Frontline nursing staff frequently identify patients in cardiac arrest but may not have the initial leadership and teamwork skills to organize their initial rescue response. APPROACH The Five-4-Life Quality Improvement (QI) program was pilot tested in a pediatric unit within a 510-bed acute care hospital in 2 phases: first, an educational program focused on leadership, team dynamics, and CPR skills, followed by sustaining interventions in the unit. Video recordings of 12 mock codes (4 pre-, 4 post-, 4 follow-up) were analyzed by trained observers. OUTCOMES Descriptive statistical tests indicated a significant improvement in leadership, teamwork, and task management scores pre- and post-program, and sustained after the program. CONCLUSION Implementing the Five-4-Life QI program is feasible in improving leadership, teamwork, and task management of first responding frontline nurses.
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Affiliation(s)
- Ruth Bala-Kerr
- Department of Nursing, Harbor-UCLA Medical Center, Torrance, California
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Martin-Conty JL, Martin-Rodríguez F, Criado-Álvarez JJ, Castillo-Sarmiento CA, Maestre-Miquel C, Mohedano-Moriano A, Polonio-López B, Durantez-Fernández C, Castro-Villamor MÁ, Viñuela A. How Health Habits Influence the Physiological Response During a Physical Activity in Extreme Temperatures? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6374. [PMID: 32882968 PMCID: PMC7503269 DOI: 10.3390/ijerph17176374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/30/2020] [Accepted: 08/31/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The purpose of the study was to determine to what degree the health habits of university students influence their physiological response during a 10-min high-intensity exercise. METHODS We conducted a cross-sectional cohort study with 59 health science students, in which we analyzed their adherence to a Mediterranean and low-fat diet, as well as their activity levels. We correlated these factors with the physiological response (lactic acid and heart rate) and a series of anthropometric parameters in intense physical activity (cardiopulmonary resuscitation (CPR) for 10 min) in three scenarios: extreme cold, extreme heat and a control situation at room temperature. RESULTS The results of this study demonstrate that in university students, a greater adherence to the Mediterranean diet was associated with a better response to physical exercise, in this case, 10-min CPR, in hostile environments. CONCLUSIONS Following healthy eating guidelines improves physical performance and delays the appearance of fatigue; both are important aspects for a better performance of CPR.
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Affiliation(s)
- José Luis Martin-Conty
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
| | - Francisco Martin-Rodríguez
- Advanced Clinical Simulation Center, School of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain; (F.M.-R.); (M.Á.C.-V.)
| | - Juan José Criado-Álvarez
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
- Integrated Care Management of Talavera de la Reina, Health Services of Castilla-La Mancha (SESCAM), 45600 Talavera de la Reina, Spain
| | | | - Clara Maestre-Miquel
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
| | - Alicia Mohedano-Moriano
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
| | - Begoña Polonio-López
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
| | - Carlos Durantez-Fernández
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
| | - Miguel Ángel Castro-Villamor
- Advanced Clinical Simulation Center, School of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain; (F.M.-R.); (M.Á.C.-V.)
| | - Antonio Viñuela
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
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Martin-Conty JL, Polonio-López B, Maestre-Miquel C, Mohedano-Moriano A, Durantez-Fernández C, Mordillo-Mateos L, Jurado-Palomo J, Viñuela A, Bernal-Jiménez JJ, Martin-Rodríguez F. Physiological Response of Quality Cardiopulmonary Resuscitation, Crossover Trial on Mannequin in Extreme Temperature Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5835. [PMID: 32806606 PMCID: PMC7460077 DOI: 10.3390/ijerph17165835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 12/02/2022]
Abstract
BACKGROUND To determine the relationship between physiological fatigue and the quality of cardiopulmonary resuscitation (CPR) in trained resuscitators in hostile thermal environments (extreme cold and heat) simulating the different conditions found in an out-of-hospital cardiorespiratory arrest. METHODS Prospective observational study involving 60 students of the health sciences with training in resuscitation, who simulated CPR on a mannequin for 10 min in different thermal environments: thermo-neutral environment (21 °C and 60% humidity), heat environment (41 °C and 98% humidity) and cold environment (-35 °C and 80% humidity). Physiological parameters (heart rate and lactic acid) and CPR quality were monitored. RESULTS We detected a significant increase in the number of compressions per minute in the "heat environment" group after three minutes and in the mean rate after one minute. We observed a negative correlation between the total number of compressions and mean rate with respect to mean depth. The fraction of compressions (proportion of time in which chest compressions are carried out) was significant over time and the mean rate was higher in the "heat environment". Physiological parameters revealed no differences in heart rate depending on the resuscitation scenario; however, there was a greater and faster increase in lactate in the "heat environment" (significant at minute 3). The total proportion of participants reaching metabolic fatigue was also higher in the "heat environment". CONCLUSIONS A warm climate modifies metabolic parameters, reducing the quality of the CPR maneuver.
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Affiliation(s)
- José Luis Martin-Conty
- Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina (Toledo), Spain; (J.L.M.-C.); (B.P.-L.); (C.M.-M.); (A.M.-M.); (C.D.-F.); (L.M.-M.); (J.J.-P.); (J.J.B.-J.)
| | - Begoña Polonio-López
- Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina (Toledo), Spain; (J.L.M.-C.); (B.P.-L.); (C.M.-M.); (A.M.-M.); (C.D.-F.); (L.M.-M.); (J.J.-P.); (J.J.B.-J.)
| | - Clara Maestre-Miquel
- Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina (Toledo), Spain; (J.L.M.-C.); (B.P.-L.); (C.M.-M.); (A.M.-M.); (C.D.-F.); (L.M.-M.); (J.J.-P.); (J.J.B.-J.)
| | - Alicia Mohedano-Moriano
- Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina (Toledo), Spain; (J.L.M.-C.); (B.P.-L.); (C.M.-M.); (A.M.-M.); (C.D.-F.); (L.M.-M.); (J.J.-P.); (J.J.B.-J.)
| | - Carlos Durantez-Fernández
- Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina (Toledo), Spain; (J.L.M.-C.); (B.P.-L.); (C.M.-M.); (A.M.-M.); (C.D.-F.); (L.M.-M.); (J.J.-P.); (J.J.B.-J.)
| | - Laura Mordillo-Mateos
- Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina (Toledo), Spain; (J.L.M.-C.); (B.P.-L.); (C.M.-M.); (A.M.-M.); (C.D.-F.); (L.M.-M.); (J.J.-P.); (J.J.B.-J.)
| | - Jesús Jurado-Palomo
- Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina (Toledo), Spain; (J.L.M.-C.); (B.P.-L.); (C.M.-M.); (A.M.-M.); (C.D.-F.); (L.M.-M.); (J.J.-P.); (J.J.B.-J.)
| | - Antonio Viñuela
- Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina (Toledo), Spain; (J.L.M.-C.); (B.P.-L.); (C.M.-M.); (A.M.-M.); (C.D.-F.); (L.M.-M.); (J.J.-P.); (J.J.B.-J.)
| | - Juan José Bernal-Jiménez
- Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina (Toledo), Spain; (J.L.M.-C.); (B.P.-L.); (C.M.-M.); (A.M.-M.); (C.D.-F.); (L.M.-M.); (J.J.-P.); (J.J.B.-J.)
| | - Francisco Martin-Rodríguez
- Advanced Clinical Simulation Center, School of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain;
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Rössler B, Goschin J, Maleczek M, Piringer F, Thell R, Mittlböck M, Schebesta K. Providing the best chest compression quality: Standard CPR versus chest compressions only in a bystander resuscitation model. PLoS One 2020; 15:e0228702. [PMID: 32053634 PMCID: PMC7017996 DOI: 10.1371/journal.pone.0228702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/21/2020] [Indexed: 11/18/2022] Open
Abstract
AIM OF THE STUDY Bystander-initiated basic life support (BLS) for the treatment of prehospital cardiac arrest increases survival but is frequently not performed due to fear and a lack of knowledge. A simple flowchart can improve motivation and the quality of performance. Furthermore, guidelines do recommend a chest compression (CC)-only algorithm for dispatcher-assisted bystander resuscitation, which may lead to increased fatigue and a loss of compression depth. Consequently, we wanted to test the hypothesis that CCs are more correctly delivered in a flowchart-assisted standard resuscitation algorithm than in a CC-only algorithm. METHODS With the use of a manikin model, 84 laypersons were randomized to perform either flowchart-assisted standard resuscitation or CC-only resuscitation for 5min. The primary outcome was the total number of CCs. RESULTS The total number of correct CCs did not significantly differ between the CC-only group and the standard group (63 [±81] vs. 79 [±86]; p = 0.394; 95% CI of difference: 21-53). The total hand-off time was significantly lower in the CC-only group than in the standard BLS group. The relative number of correct CCs (the fraction of the total number of CCs achieving 5-6cm) and the level of exhaustion after BLS did not significantly differ between the groups. CONCLUSION Standard BLS did not lead to an increase in correctly delivered CCs compared to CC-only resuscitation and exhibited significantly more hand-off time. The low rate of CCs in both groups indicates the need for an increased focus on performance during BLS training.
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Affiliation(s)
- Bernhard Rössler
- Medical Simulation and Emergency Management Research Group, University Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
- Academic Simulation Center Vienna, Medical University of Vienna and Vienna Hospital Association, Vienna, Austria
| | - Julius Goschin
- Medical Simulation and Emergency Management Research Group, University Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Mathias Maleczek
- Medical Simulation and Emergency Management Research Group, University Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
- St. John Ambulance, Vienna, Austria
| | | | | | - Martina Mittlböck
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Medical University of Vienna, Vienna, Austria
| | - Karl Schebesta
- Medical Simulation and Emergency Management Research Group, University Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
- Academic Simulation Center Vienna, Medical University of Vienna and Vienna Hospital Association, Vienna, Austria
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Comparison of chest compression quality in walking versus straddling cardiopulmonary resuscitation during stretcher transportation: A prospective randomised crossover study using manikins. PLoS One 2019; 14:e0216739. [PMID: 31112576 PMCID: PMC6528974 DOI: 10.1371/journal.pone.0216739] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 04/26/2019] [Indexed: 11/25/2022] Open
Abstract
The optimal strategy to ensure chest compression quality for patients being transported on a stretcher has not been established yet. We hypothesised that straddling cardiopulmonary resuscitation may improve chest compression quality in patients being transported on stretchers. We conducted a prospective randomised crossover study using manikins to investigate whether straddling cardiopulmonary resuscitation improves chest compression quality (depth, recoil, rate, correct hand position) performed on patients during stretcher transportation compared to walking cardiopulmonary resuscitation. Walking and straddling cardiopulmonary resuscitation were performed for 2 minutes each. The mean chest compression depth (mm) for 2 minutes was significantly greater in the straddling cardiopulmonary resuscitation group than in the walking cardiopulmonary resuscitation group (median, 51.3 [interquartile range, 46.7–55.5] versus 40.9 [34.6–50.1], P = 0.003). An adequate depth of chest compressions could not be achieved when walking cardiopulmonary resuscitation was performed by female participants, but the depth of chest compressions was within the acceptable range when female participants performed straddling cardiopulmonary resuscitation. On the other hand, the degree of deterioration was relatively small in male participants, even when they performed walking cardiopulmonary resuscitation. In patients with cardiac arrest being transported on a stretcher, straddling cardiopulmonary resuscitation improved the depth of chest compressions compared to walking cardiopulmonary resuscitation. Female rescuers, in particular, may consider using straddling cardiopulmonary resuscitation.
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