Resuscitation
-
Comparative Study
Basic life support with four different compression/ventilation ratios in a pig model: the need for ventilation.
During cardiac arrest the paramount goal of basic life support (BLS) is the oxygenation of vital organs. Current recommendations are to combine chest compressions with ventilation in a fixed ratio of 30:2; however the optimum compression/ventilation ratio is still debatable. In our study we compared four different compression/ventilation ratios and documented their effects on the return of spontaneous circulation (ROSC), gas exchange, cerebral tissue oxygenation and haemodynamics in a pig model. ⋯ During BLS, a compression/ventilation-ratio of 100:5 seems to be equivalent to 30:2, while ratios of 100:2 or compressions-only detoriate peripheral arterial oxygenation and reduce the chance for ROSC.
-
Multicenter Study Comparative Study
Rescuer fatigue during actual in-hospital cardiopulmonary resuscitation with audiovisual feedback: a prospective multicenter study.
Rescuer fatigue during cardiopulmonary resuscitation (CPR) is a likely contributor to variable CPR quality during clinical resuscitation efforts, yet investigations into fatigue and CPR quality degradation have only been performed in simulated environments, with widely conflicting results. ⋯ During actual in-hospital CPR with audiovisual feedback, CC depth decay became evident after 90s of CPR, but CC rate did not change. These data provide clinical evidence for rescuer fatigue during actual resuscitations and support current guideline recommendations to rotate rescuers during CC delivery.
-
Randomized Controlled Trial Comparative Study
Does Dual Operator CPR help minimize interruptions in chest compressions?
Basic Life Support Guidelines 2005 emphasise the importance of reducing interruptions in chest compressions (no-flow duration) yet at the same time stopped recommending Dual Operator CPR. Dual Operator CPR (where one rescuer does ventilations and one chest compressions) could potentially minimize no-flow duration compared to Single Operator CPR. This study aims to determine if Dual Operator CPR reduces no-flow duration compared to Single Operator CPR. ⋯ Dual Operator CPR with a compression to ventilation rate of 30:2 provides marginal improvement in no-flow duration but CPR quality is otherwise equivalent to Single Operator CPR. There seems little advantage to adding teaching on Dual Operator CPR to lay/trained first responder CPR programs.
-
Randomized Controlled Trial Comparative Study
Comparison of two mechanical intraosseous infusion devices: a pilot, randomized crossover trial.
Administration of medications via the intraosseous (IO) route has proven to be a lifesaving procedure in critically ill or injured children. Two mechanical IO infusion devices have been approved for use in children, the spring-loaded IO infusion device (Bone Injection Gun, BIG) and the battery-powered IO infusion drill (EZ-IO). The objective of this pilot study was to compare the success rates for insertion and the ease-of-use of the two devices. ⋯ As tested by paramedic students on a turkey bone model, the EZ-IO demonstrated higher success rates than the BIG and was the preferred device. Future studies are planned to determine which of the two devices is more appropriate for obtaining IO access in the setting of paediatric emergencies.
-
Comparative Study
Incidence of iatrogenic dyscarbia during mild therapeutic hypothermia after successful resuscitation from out-of-hospital cardiac arrest.
To investigate the incidence of iatrogenic dyscarbia in survivors of out-of-hospital cardiac arrest treated with induced mild hypothermia. We performed a retrospective cohort study of the ventilatory management based on blood gas analyses of patients resuscitated from prehospital cardiac arrest. In the pilot phase, we assessed the ventilatory management in the patients treated in one university hospital during a 4-year study period. ⋯ The incidence of hypo- or hyper-carbia (dyscarbia) was high (45%). This may predispose for serious derangements in the cerebral perfusion of the resuscitated patient. These results call for vigilance in adjustment of the ventilatory management to meet the needs of the patients treated with mild hypothermia.