Resuscitation
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Randomized Controlled Trial Comparative Study Clinical Trial
Efficacy of the laryngeal tube by inexperienced personnel.
We compared the laryngeal tube and the laryngeal mask in the ease of insertion, ventilation volume and the incidence of gastric insufflation by inexperienced personnel. In a randomized, cross-over design, each of 28 students of a Fire Defense Academy attempted to insert the laryngeal tube and laryngeal mask in turn using an airway management trainer manikin. A self-inflating bag (2000 ml) was attached and ventilation volume was measured. ⋯ The incidence of gastric insufflation was significantly lower for the laryngeal tube (2 times) than for the laryngeal mask (10 times) (P < 0.05). Twenty six of 28 students stated that insertion of the laryngeal tube was easier than insertion of the laryngeal mask, whereas the remaining two stated that there was no difference in the ease of insertion between two devices. Therefore, the laryngeal tube has a potential role in providing a clear airway during cardiopulmonary resuscitation.
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Comparative Study
Defibrillation threshold and cardiac responses using an external biphasic defibrillator with pediatric and adult adhesive patches in pediatric-sized piglets.
Before recommendations for using an automatic external defibrillator on pediatric patients can be made, a protocol for the energy of a biphasic waveform energy dosing needs to be determined that will allow ventricular defibrillation of 8 year olds while causing only a minimal amount of cardiac damage to infants. Pediatric- and adult-sized electrode patches were alternately applied to 10 isoflurane-anesthetized piglets weighing 3.8-20.1 kg to approximate the body weights of newborns to children < 8 years old. The defibrillation threshold (DFT) was determined for biphasic truncated exponential waveform shocks. ⋯ The same amount of energy delivered with a biphasic external defibrillator successfully defibrillated VF whether adult or pediatric patches were used. Cardiac rhythm and hemodynamic variables were unaltered at 60 s after shocks delivered at energies of up to 360 J. These data suggest that there is a substantial safety margin above a DFT strength shock for this biphasic waveform in piglets.
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Review Practice Guideline Guideline
Common faults in resuscitation equipment--guidelines for checking equipment and drugs used in adult cardiopulmonary resuscitation.
Successful advanced life support relies, in part, upon the availability and correct functioning of resuscitation equipment. However, numerous publications report deficiencies and defects in key items of resuscitation equipment, particularly those relating to airway management and defibrillation. ⋯ This paper identifies the common, generic faults that lead to equipment malfunction and recommends the resuscitation equipment essential for successful cardiopulmonary resuscitation. It also describes examples of specific equipment malfunction and makes suggestions for the nature and frequency of resuscitation equipment and drug checks, using a structured, and easy-to-recall list.
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The aim of this study was to determine community application of cardiopulmonary resuscitation (CPR) skills in an emergency, and, thus, assess the value of training programmes in raising community competence. A cross-sectional telephone survey of the Western Australian population was chosen randomly (n = 803). An urban sub-sample (n = 100) performed a practical demonstration of CPR skills using a simulated collapse scenario using a recording manikin as the victim. ⋯ Theoretical competence poorly reflected practical performance in many tasks. This study provides a comprehensive database of CPR training and performance, and highlights future directions to ensure appropriate and cost-effective training. Specific factors to be addressed include increasing frequency of training, targeting of high-risk groups, simplification in teaching, and emphasising early activation of the emergency medical system.