Resuscitation
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Comparative Study
Effect of rescuer fatigue on performance of continuous external chest compressions over 3 min.
Guidelines for the performance of cardiopulmonary resuscitation (CPR) have been revised recently and now advocate that chest compressions are performed without interruption for 3 min in patients during asystole and pulseless electrical activity. The aim of the present study was to determine if rescuer fatigue occurs during 3 min of chest compressions and if so, the effects on the rate and quality of compressions. Forty subjects competent in basic life support (BLS) were studied. ⋯ Seven subjects (five female, two male) were unable to complete the second 3-min period because of exhaustion. We conclude that rescuer fatigue adversely affects the quality of chest compressions when performed without interruption over a 3-min period and that this effect may be greater in females due to their smaller stature. Consideration should be given to rotating the rescuer performing chest compressions after 1 min intervals.
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The treatment of massive pulmonary embolus remains controversial. We describe the first report of the successful use of the thrombolytic agent, tenecteplase, in treating a hypotensive elderly patient with a saddle embolus. A brief review of the current literature concerning thrombolysis for massive pulmonary embolus is given.
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To examine the quality and comprehensiveness of documentation in Paediatric 'cardiac arrests'. ⋯ Documentation of critical resuscitation episodes in children is below recognised standards and this has potential quality of care and medicolegal implications. Current teaching needs to emphasise this essential aspect of clinical care from the earliest level of training.