Resuscitation
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Observations of cardiopulmonary arrests (CPAs) reveal concerning patterns when clinicians identify a problem, (e.g. loss of pulse) but do not immediately initiate appropriate therapy (e.g. compressions) resulting in delays in life saving therapy. ⋯ Action-Linked Phrases innately used by residents in simulated CPAs were associated with faster initiation of compressions. Action-Linked Phrases were verbalized more frequently if taught as part of a regular BLS or ACLS course. This simple, easy to teach, and easy to implement technique holds promise for impacting cardiac arrest teams' performance of key actions.
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Observational Study
The association between chest compression release velocity and outcomes from out-of-hospital cardiac arrest.
Previous studies have demonstrated significant relationships between cardiopulmonary resuscitation (CPR) quality metrics and survival to hospital discharge from out-of-hospital cardiac arrest (OHCA). Recently, it has been suggested that a new metric, chest compression release velocity (CCRV), may be associated with improved survival from OHCA. ⋯ When adjusted for Utstein variables, CCRV was not significantly associated with outcomes from OHCA. Further research in other EMS systems is required to clarify the potential impact of this variable on OHCA survival.
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During cardiopulmonary resuscitation (CPR), myocardial blood flow generated by chest compression rarely exceeds 35% of its normal level. Cardiac output generated by chest compression decreases gradually with the prolongation of cardiac arrest and resuscitation. Early studies have demonstrated that myocardial blood flow during CPR is largely dependent on peripheral vascular resistance. In this study, we investigated the effects of chest compression in combination with physical control of peripheral vascular resistance assisted by tourniquets on myocardial blood flow during CPR. ⋯ T-CPR improves myocardial and cerebral perfusion during CPR. It may provide a new and convenient method for augmenting myocardial and cerebral blood flow during CPR.
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Randomized Controlled Trial Comparative Study
Effect of continuous oxygen insufflation on induced-gastric air volume during cardiopulmonary resuscitation in a cadaveric model.
The main objective of this study was to compare the volume of gas insufflated in the stomach with continuous external chest compressions plus continuous oxygen insufflation (C-CPR) versus standard-CPR (S-CPR) which alternates external chest compressions and synchronized positive insufflations through a bag-valve-mask with a 30/2 ratio. The secondary objective was to compare upper airway pressures (intratracheal and intramask) generated during continuous oxygen insufflation. ⋯ This human cadaver study demonstrates that continuous oxygen insufflation induced less gastric inflation than intermittent insufflation during CPR.