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Oh J, Cha KC, Lee JH, Park S, Kim DH, Lee BK, Park JS, Jung WJ, Lee DK, Roh YI, Kim TY, Chung SP, Kim YM, Park JD, Kim HS, Lee MJ, Na SH, Cho GC, Kim ARE, Hwang SO. 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 4. Adult advanced life support. Clin Exp Emerg Med 2021; 8:S26-S40. [PMID: 34034448 PMCID: PMC8171171 DOI: 10.15441/ceem.21.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/19/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jaehoon Oh
- Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Kyoung-Chul Cha
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jong-Hwan Lee
- Department of Anesthesiology and Pain Medicine, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Seungmin Park
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Hyeok Kim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Byung Kook Lee
- Department of Emergency Medicine, Chonnam National University College of Medicine, Gwangju, Korea
| | - Jung Soo Park
- Department of Emergency Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Woo Jin Jung
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dong Keon Lee
- Department of Anesthesiology and Pain Medicine, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Young Il Roh
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Tae Youn Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Phil Chung
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Young-Min Kim
- Department of Emergency Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - June Dong Park
- Department of Emergency Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Han-Suk Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Mi Jin Lee
- Department of Emergency Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Sang-Hoon Na
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Gyu Chong Cho
- Department of Emergency Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Ai-Rhan Ellen Kim
- Department of Pediatrics, Ulsan University College of Medicine, Seoul, Korea
| | - Sung Oh Hwang
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Deakin CD, Sidebottom DB, Potter R. Can rescuers accurately deliver subtle changes to chest compression depth if recommended by future guidelines? Resuscitation 2018; 124:58-62. [PMID: 29309883 DOI: 10.1016/j.resuscitation.2018.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/27/2017] [Accepted: 01/04/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND A recent study reported that a compression depth of 4.56 cm optimised survival following cardiac arrest, which is at variance with the current guidelines of 5.0-6.0 cm. A reduction in recommended compression depth is only likely to improve survival if healthcare professionals can accurately deliver a relatively small change in target depth. This study aimed to determine if healthcare professionals could accurately judge their delivered compression depth by 0.5 cm increments. METHOD This randomised interventional trial asked BLS-trained healthcare professionals to complete two minutes of continuous chest compressions on an adult manikin, randomised (without any feedback device), to compress to one of three target depth ranges of 4.0-5.0 cm, 4.5-5.5 cm or 5.0-6.0 cm, at the recommended rate of 100-120 compressions min-1. Basic demographic data, compression rate, and compression depth were recorded. RESULTS One hundred and one participants were recruited, of whom one withdrew. Median depths of 3.66 cm (IQR: 3.37-4.16 cm), 4.13 cm (IQR: 3.65-4.36 cm) and 4.76 cm (IQR: 4.16-5.24 cm) were found for the target depths of 4.0-5.0 cm (n = 30), 4.5-5.5 cm (n = 35) and 5.0-6.0 cm (n = 35) respectively (P < 0.001). Overall, 18 participants successfully compressed to their target depth. CONCLUSIONS Rescuers are able to judge 0.5 cm differences in compression depth with precision, but remain unable to accurately judge overall target depth. Reducing the current recommended compression depth to 4.56 cm is likely to result in delivered compressions significantly below the optimal depth.
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Affiliation(s)
- Charles D Deakin
- NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton, SO16 6YD, UK; South Central Ambulance Service NHS Foundation Trust, Otterbourne, SO21 2RU, UK.
| | - David B Sidebottom
- Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK
| | - Ryan Potter
- Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK
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Mygind-Klausen T, Jæger A, Hansen C, Aagaard R, Krogh LQ, Nebsbjerg MA, Krogh K, Løfgren B. In a bed or on the floor? - The effect of realistic hospital resuscitation training: A randomised controlled trial. Am J Emerg Med 2017; 36:1236-1241. [PMID: 29276031 DOI: 10.1016/j.ajem.2017.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/11/2017] [Accepted: 12/11/2017] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION In-hospital cardiac arrest has a poor prognosis and often occurs in patients lying in a hospital bed. A bed mattress is a soft compressible surface that may decrease cardiopulmonary resuscitation (CPR) quality. Often hospital CPR training is performed with a manikin on the floor. AIM To study CPR quality following realistic CPR training with a manikin in a bed compared with one on the floor. METHODS We conducted a randomised controlled study. Healthcare professionals were randomised to CPR training with a manikin in a hospital bed or one on the floor. Data on CPR quality was collected from manikins. The primary outcome measure was chest compression depth. RESULTS In total, 108 healthcare professionals (age: 40years, female: 94%) were included. The mean chest compression depth was 39mm (standard deviation (SD): 10), for the bed group compared with 38mm (SD: 9) for the floor group, p=0.49. A post hoc analysis showed that regardless of the training method, the participants who optimised their working position by jumping onto the bed or lowering the bed had a median chest compression depth of 39mm (25th-75th percentiles: 33-45) compared with 29mm (25th-75th percentiles: 23-41) for participants who did neither, p=0.04. CONCLUSION There was no significant difference in chest compression depth between healthcare professionals who trained CPR on a manikin in a hospital bed compared with one on the floor. Chest compression depth was too shallow in both groups. Irrespective of the training method, participants who optimised their working position performed deeper chest compressions.
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Affiliation(s)
- Troels Mygind-Klausen
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark.
| | - André Jæger
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark.
| | - Camilla Hansen
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark.
| | - Rasmus Aagaard
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark.
| | - Lise Qvirin Krogh
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark.
| | - Mette Amalie Nebsbjerg
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark.
| | - Kristian Krogh
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Aarhus N, Denmark.
| | - Bo Løfgren
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Blvd. 99, 8200 Aarhus N, Denmark.
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