CPR Technique Research Articles

Basic Life Support Training on Cardio-Pulmonary Resuscitation among Class IV employees working in Pravara Rural Hospital, Loni (Bk)

Background: Cardiovascular disease is one of the common public health problems in the world. The cardiac arrest individual needs immediate rescue care (CPR) to support and maintain breathing and circulation. The public and non-medical professionals lack awareness and skill in performing CPR may leads to withdrawal and faulty CPR technique. Aim: The aim of the present study was to assess the effectiveness of Basic life support training on knowledge and skill of cardio-pulmonary resuscitation among class IV employees and compare the knowledge and skill with their demographic variables. Methods: A quasi experimental study, pre-test and post-test design with control group approach was conducted among 30 Class IV employees working in Pravara Rural Hospital, Loni. The class IV employees above 18 years were selected using simple random sampling. Data was collected by pre designed structured questionnaire and checklist. The results were analyzed using descriptive (percent, mean and SD), inferential statistics (paired “t” test and Chi square test). Results: The result revealed that there was an improvement in the knowledge on CPR (pre-test mean score 11.93±2.79 and post test score was 16.97±3.43, with effectiveness of 16.8%. The difference between the scores was significant ‘t’= 11.39 at 0.05 level. The participants exhibited partially adaptive skill on CPR with mean score of 13.4±3.12, scores range from 1 to 20. The socio demographic variables like age and area of work were significantly associated with knowledge, and age was significantly associated with skill on CPR (P<0.05). Conclusion: After the basic life support training there is a significant improvement in knowledge and skill on CPR by the class IV employees. This training can be used as standardized protocol for training the lay person on CPR which significantly contributes in reduction of mortality and morbidity.

Cardiopulmonary Resuscitation Techniques in the COVID-19 Pandemic Era: Literature Review

Cardiac resuscitation in the era of the COVID-19 pandemic meets its challenges; in addition to the high prevalence of cardiac and pulmonary arrest events in these patients, the transmission rate to health workers who carry out CPR assistance is also relatively high. Therefore, it is necessary to develop CPR techniques in COVID-19 patients that can increase the success of CPR and reduce transmission rates. The purpose of the study was to explain how CPR techniques are in COVID-19 patients. The literature review method through data collection with an electronic database and evaluation of the literature review will use Critical Appraisal to test validity. Data collection with electronic databases was conducted through PubMed, Tailor, Francis, and Google Scholar with the keyword "CPR," "COVID-19," and " technique. "The data was successfully collected in the database of 548 articles then filtered the inclusion and exclusion criteria into ten pieces; then the article passed the Critical Appraisal test. Hasil Literature review CPR technique in covid patients added is the use of PPE level C/3; The recommended compression depth is 2-2.4 inches (5-6cm); manual chest compression is described as effective when administered in the middle of the chest, at a rate of 100-120 minutes. , The recommended position is prone and supine.

Evaluation of abdominal compression–decompression combined with chest compression CPR performed by a new device: Is the prognosis improved after this combination CPR technique?

IntroductionThis study was designed to compare the outcomes of standard cardiopulmonary resuscitation (STD-CPR) and combined chest compression and abdominal compression–decompression cardiopulmonary resuscitation (CO-CPR) with a new device following out-of-hospital cardiac arrest (OHCA). Moreover, we investigated whether patient prognosis improved with this combination treatment.MethodsThis trial was a single-centre, prospective, randomized trial, and a blinded assessment of the outcomes was performed. A total of 297 consecutive patients with OHCA were initially screened, and 278 were randomized to the STD-CPR group (n = 135) or the CO-CPR group (n = 143). We compared the proportions of patients who achieved a return of spontaneous circulation (ROSC), survived to hospital admission and survived to hospital discharge. In addition, we also performed the Kaplan–Meier analysis with a log-rank test at the end of the follow-up period to compare the survival curves of the two groups.ResultsThe differences were not statistically significant in the proportion of patients who achieved ROSC [31/135 (23.0%) versus 35/143 (24.5%)] and survived to hospital admission [28/135 (20.7%) versus 33/143 (23.1%)] between the CO-CPR group and STD-CPR group. However, there was a significant difference in the proportion of patients who survived to hospital discharge [16/135 (11.9%) versus 7/143 (4.9%)] between the two groups. Nine patients (6.7%) in the CO-CPR group and 2 patients (1.4%) in the STD group showed good neurological outcomes according to the cerebral performance category (CPC) scale score, and the difference was statistically significant (P = 0.003). The Kaplan–Meier curves showed that the patients in the CO-CPR group achieved better survival benefits than those in the STD-CPR group at the end of the follow-up period (log-rank P = 0.007).ConclusionCO-CPR was more beneficial than STD-CPR in terms of survival benefits in patients who have suffered out-of-hospital cardiac arrest.Trial registration Chinese Clinical Trial Registry, registered number: ChiCTR2100049581. Registered 30 July 2021- Retrospectively registered. http://www.medresman.org.cn/uc/index.aspx.

Awareness and attitude about basic life support among medical school students in Jeddah University, 2019: A cross-sectional study.

Objectives:To measure the level of knowledge and awareness towards basic life support (BLS) among students in preclinical years at Jeddah University (JU), and to determine their willingness to participate in BLS training in the near future.Subjects and Methods:A cross-sectional study was conducted among first-, second-, and third-year medical students of JU. A 27-item questionnaire measured the level of awareness and knowledge about BLS, including: 1) basic Information (seven items); 2) rescue reflex (eight items); and 3) CPR technique and process (12 items). Demographic and academic data, experience and exposure to BLS, and attitude regarding BLS (six items) were analysed as factors of adequate knowledge.Results:One hundred and four male students participated and 65 (62.5%) of them were in the second academic year. The correct answers varied from 10.6% to 67.3%, with eight items having <30% correct answers; and seven items showed >50% correct answers. Mean (SD) and median (P75) overall knowledge scores were 37.86 (13.92) and 37.04 (44.44) out of 100, respectively. Twenty-four (23.11%) participants attended a training course in BLS and 13 (12.5%) have ever performed BLS, either voluntarily or not voluntarily, and 18 (17.3%) felt that their current knowledge was sufficient. Knowledge level showed no statistically significant association with any of the investigated factors.Conclusion:There is an urgent need to integrate BLS courses to medical students to enrich their knowledge and improve resuscitation skills and ensure implementation of correct resuscitation techniques.

California drownin’: An observational study of drowning and survival in the television drama Baywatch compared to real-life LA County

AimsTo examine the epidemiology of drowning in the television drama Baywatch, and to compare the fictional survival rate with resuscitations following drowning in real-life Los Angeles County. MethodsA retrospective observational study of all drownings, rescues and resuscitations in Baywatch (seasons 1–9), viewed on Amazon Prime. Comparison data describing rescues and drownings for real-life LA County from 1989 to 1999 were obtained from the online database of the United States Lifesaving Association. Results198 episodes were viewed. 650 water rescues were identified, including 209 drownings. Of these 203 (97.12%) survived. This was significantly lower than the survival rate achieved by the lifeguards of the real LA County over the same period (x2=107.41 p<0.001). Death following drowning in Baywatch was significantly associated with age group (p=0.001), grade of drowning (p<0.001), the absence of witnesses (p=0.016), total number of lifeguards involved (p=0.010), and the activity immediately preceding drowning (p=0.032), particularly if this involved criminal enterprise. Survival on Baywatch was not associated with the presence or absence of the show’s protagonist, rescue speedboats, helicopters, the lifeguards’ hair colour, or resuscitation by an actual lifeguard. ConclusionThe lifeguards of Baywatch underperformed compared to their real-life peers. Had they overseen the real beaches of LA County between 1989 and 1999, this might have potentially resulted in 1256 additional deaths. The reduced survival rate appeared to be related to the high levels of criminality in the area, and the lifeguards’ poor CPR technique.

Anterior referencing of tibial slope in total knee arthroplasty considerably influences knee kinematics: a musculoskeletal simulation study

PurposeIn total knee arthroplasty (TKA), the posterior tibial slope is not always reconstructed correctly, and the knee ligaments may become too tight in flexion. To release a tight flexion gap, surgeons can increase the posterior tibial slope using two surgical resection techniques: the anterior tibial cortex (ACR) or the centre of tibial plateau (CPR) referencing. It is not known how this choice affects the knee laxity and function during activities of daily living. The aim of this study was to investigate the effect of tibial slope on knee laxity, kinematics and forces during a squatting activity using computer simulation techniques. We hypothesised that the effects depend on the referencing technique utilised.MethodsA validated musculoskeletal model of TKA was used. Knee laxity tests were simulated in flexion and extension. Then, a squat motion was simulated to calculate: movement of the tibiofemoral joint (TFJ) contact points and patello-femoral joint (PFJ) contact force. All analyses were repeated with more anterior (−3°), neutral (0°), and more posterior tibial slope (+3°, +6°, +9°), and with two referencing techniques (ACR, CPR).ResultsKnee laxities increased dramatically with more posterior slope with the ACR technique (up to 400%), both in flexion and in extension. The CPR technique, instead, had much smaller effects (up to 42% variations). During squatting, more slope with the ACR technique resulted in larger movements of the TFJ contact point. The PFJ contact force decreased considerably with more slope with the CPR technique (12% body weight reduction every 3° more posterior slope), thanks to the preservation of the patellar height and quadriceps–femur load sharing.ConclusionACR technique alters considerably the knee laxity, both in flexion and extensions, and surgeons should be cautious about its use. More slope with CPR technique induces more favourable TFJ kinematics and loading of the knee extensor apparatus and does not substantially alter knee laxity. Preferably, the tibial slope resection should be pre-planned thoroughly and performed using CPR technique as accurately as possible. Surgeons can directly translate the results of this study into the clinical practice.

Introducing non-technical skills teaching to the Resuscitation Council (UK) Advanced Life Support Course

s / Resuscitation 85S (2014) S15–S121 S71 Results: Survey (parents): 100% optimal evaluation; parents said their children learned. Test (children): 94–100% knew how to respond: body-, armsand hands-position in CPR, where and how fast to press; 88% knew “how warn and when start CPR.” Conclusion: Children demonstrated they knew:When and how towarn; Basic techniques of CPR; Rate of compressionswithmusic; Transmit Adult CPR technique. http://dx.doi.org/10.1016/j.resuscitation.2014.03.177

Investigation and analysis on disaster site first aid skills of community healthcare workers

Objective The aim of this study was to investigate the status on disaster site first aid skills of community healthcare workers at Hangzhou and to provide medical institution with a reference to train the disaster site first aid skills .Methods The researchers investigated 400 healthcare workers ’ disaster site first aid skills from 8 community health service centers .Results Totals of 373 questionnaires were returned with an effective rate of 93.5%.The average score of disaster site first aid skills of community healthcare workers was （3.83 ±0.28）.The score of using simple breathing bag was （4.33 ±0.70）.The score of performing CPR technique was （4.21 ±0.70）.Logistic regression analysis showed that the influencing factors of disaster site first aid skills were participation in disaster rescue and the male gender （P〈0.05）.100% of the community healthcare workers were interested in learning disaster site first aid skills .93.7% of the community healthcare workers expressed a strong willingness to learn relevant skills .Conclusions The overall level of the disaster site first aid skills of community healthcare workers is not good , but their learning intention are strong .It is necessary to strengthen the disaster site first aid skills training and to take various training programs which cover a wide range of contents , such as disaster rescue simulation exercises , scenario simulation test and participation in the site rescue.Meanwhile, continuing education opportunities should be actively provided to enhance the disaster site first aid skills of community healthcare workers . Key words: Community health care service; Disaster; Data collection; Healthcare professional; On-site first aid skills

Quality of CPR performed by trained bystanders with optimized pre-arrival instructions

ObjectiveTelephone-CPR (T-CPR) can increase initiation of bystander CPR. We wanted to study if quality oriented continuous T-CPR would improve CPR performance vs. standard T-CPR. MethodNinety-five trained rescuers aged 22–69 were randomized to standard T-CPR or experimental continuous T-CPR (comprises continuous instructions, questions and encouragement). They were instructed to perform 10min of chest compressions-only on a manikin, which recorded CPR performance in a small, confined kitchen. Three video-cameras captured algorithm time data, CPR technique and communication. Demography and training experience were captured during debriefing. ResultsParticipants receiving continuous T-CPR delivered significantly more chest compressions (median 1000 vs. 870 compressions, p=0.014) and compressed more frequently to a compression rate between 90 and 120min−1 (median 87% vs. 60% of compressions, p<0.001), compared to those receiving standard T-CPR. This also resulted in less time without compressions after CPR had started (median 12s vs. 64s, p<0.001), but longer time interval from initiating contact with dispatcher to first chest compression (median 144s vs. 84s, p<0.001). There was no difference in chest compression depth (mean 47mm vs. 48mm, p=0.90) or in demography, education and previous CPR training between the groups. ConclusionIn our simulated scenario with CPR trained lay rescuers, experimental continuous T-CPR gave better chest compression rate and less hands-off time during CPR, but resulted in delayed time to first chest compression compared to standard T-CPR instructions.

CPR-Related Rib Fractures After Change in Infant CPR Technique

CPR-Related Rib Fractures After Change in Infant CPR Technique

Video analysis of dispatcher–rescuer teamwork–Effects on CPR technique and performance

ObjectiveWe wanted to study the effect of continuous dispatcher communication on CPR technique and performance during 10min of simulated cardiac arrest. MethodWe reviewed video recordings and manikin data from 30 CPR trained lay people who where left alone in a simulated cardiac arrest situation with a manikin in a home-like environment (in a small, confined kitchen with the disturbing noise of a radio).CPR was performed for 10min with continuous telephone instructions via speaker function from a dispatcher. The dispatcher was blinded for CPR performance and video.Dispatcher communication, compression technique and ventilation technique was scored as accomplished or failed in the 1st and 10th minute. Results29/30 rescuers were able to hear instructions, answer questions from the dispatcher and perform CPR in parallel. Rescuer position beside manikin was initially correct for 13/30, improving to 21/30 (p=0.008). Compression technique was adequate for the whole episode, with an insignificant trend for improvement; 29 to 30/30 using straight arms, 28 to 30/30 in a vertical position over chest and 24 to 27/30 counting loudly. 17/29 placed their hands between the nipples initially, improving to 24/29 (p=0.065). Mean compression rate improved from 84 to 101min−1 (p<0.001), and compression depth maintained adequate (43 to 42mm). Initially, 17/29 used chin-lift manoeuvre, 14/30 used head-tilt and 19/29 used nose pinch to manage open airways, compared to 18, 20 and 22/29 (ns) in the 10th minute, respectively. Successful delivery of ventilation improved from 13/30 to 23/30 (p=0.006). ConclusionBystander and dispatcher can communicate successfully during ongoing CPR using a telephone with speaker function. CPR technique and quality improved or did not change over 10min with continuous dispatcher assistance. These results suggest a potential for improved bystander CPR using rescuer–dispatcher teamwork.

New CPR Technique for out-of-Hospital Cardiac Arrest Increases Survival by 53 Percent

New CPR Technique for out-of-Hospital Cardiac Arrest Increases Survival by 53 Percent

Video analysis of dispatcher-rescuer teamwork—Effects on CPR technique and quality

1 CC only (n = 85) 46 0.87 (0.54-1.38) 0.54 0.78 (0.48-1.27) 0.32 Full-CPR (n = 71) 62 1.66 (1.00-2.78) 0.05 1.32 (0.77-2.27) 0.31 1.2 1.09 (0.85-1.39) 0.51 1.02 (0.80-1.31) 0.85 Full-CPR 2.8 1.50 (1.13-1.99) 0.005 1.34 (1.00-1.78) 0.048 Purpose of the study: Intrathoracic pressure variation (ITPV) during resuscitation (the thoracic pump) results from pressure generated by chest compression and ventilation. We studied the relation between chest compression depth, ventilation pressure and ITPV. Materials and methods: The study was approved by the Ethics Committee of Ghent University Hospital. In 51 patients undergoing out-of-hospital resuscitation by a physician-staffed team, compression depth (CD) during manual chest compression was measured using an accelerometer (Zoll, US). After intubation, airway pressure (a surrogate for intrathoracic pressure) was measured. Accelerometer and airway pressure data were synchronised offline using custom Visual Basic code in Excel. For every chest compression, ITPV (the difference between the compression-induced peak and nadir pressure) was sep- arated from the concomitant ventilation pressure (Pvent). The relationship between ITPV and CD was analysed with linear regression for a CD range of 2.5-6 cm. Pvent ranges of 0-10 and 10-30 cm H2O were analysed separately because of a breakpoint in the regres- sion line. In order to weigh each patient equally, the median ITPV value at each Pvent or CD within each patient was used for regression analysis. Results: A total of 39,278 datasets were analysed. For Pvent 0-10 cm H2O, the rela- tionship with ITPV was described as ITPV = 2*Pvent + 6 (R2 = 0.96), for Pvent 10-30 cm H2O as ITPV = 0.6*Pvent + 29 (R2 = 0.94). For CD 2.5-6 cm, the relationship with ITPV was described as ITPV = 0.3*CD + 19 (R2 = 0.82). Therefore, an increase of Pvent from 0 to 10 cm H2O increased ITPV with 20 cm H2O, while an increase of CD by 2 cm increased ITPV by only 0.6 cm H2O. Conclusions: The effect of chest compression depth on ITPV is small, but can be increased very significantly by Pvent. Further studies are needed to investigate the relation

Part 5: Adult Basic Life Support

Part 8 : Advanced life support : 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Feasibility of Coupled Pattern Reconstruction Technique in the Detection of Internal Waves

The main focus of this paper is to study the feasibility of coupled pattern reconstruction technique (CPR) developed by Nardelli and Santoleri (2004) in detecting the internal waves at three locations in the north Indian Ocean. In all the cases, the first two modes, viz. Mode 0 and Mode 1, explained most of the co-variability between these two parameters at all the three locations (91% in the northern Bay of Bengal and 97% in the coastal waters). Moreover, the coefficients that relate the amplitudes of temperature and steric height for the first two modes follow a linear relationship, satisfying the conditions of the CPR. The temporal variations of these two modes are found to be within the bands of tidal periodicity. The CPR technique was able to reconstruct the synoptic scale variation in the temperature at different depths with a reasonable degree of accuracy. This technique was able to capture the variability within the bands of tidal periodicity (6–24 hrs) as evident from the oscillations in the thermocline region. Even though there are small differences in the amplitude of oscillations, very good agreement is observed and simulated phase of these oscillations, which is important in the study of internal waves. The analysis supported that the CPR technique is suitable for the simulation of low frequency internal waves provided the surface fields are available at this time intervals.

Improved CPR Technique Would Increase Survival

Improved CPR Technique Would Increase Survival

Incomplete chest wall decompression: A clinical evaluation of CPR performance by trained laypersons and an assessment of alternative manual chest compression–decompression techniques

Complete chest wall recoil improves hemodynamics during CPR by generating relatively negative intrathoracic pressure, which draws venous blood back to the heart, providing cardiac preload prior to the next chest compression. This study was designed to assess the quality of CPR delivered by trained laypersons and to determine if a change in CPR technique or hand position would improve complete chest wall recoil, while maintaining adequate duty cycle, compression depth, and proper hand position placement. Standard manual CPR and three alternative manual CPR approaches were assessed. This randomized prospective trial was performed on an electronic test manikin. Thirty laypersons (mean age of 40.6 years (range 28-55)), who were trained in CPR within the last 24 months, signed an informed consent and participated in the trial. Subjects performed 3 min of CPR on a Laerdal Skill Reportertrade mark CPR manikin using the Standard Hand Position followed by 3 min of CPR (in random order) using three alternative CPR techniques: (1) Two-Finger Fulcrum Technique - lifting the heel of the hand slightly but completely off the chest during the decompression phase of CPR using the thumb and little finger as a fulcrum; (2) Five-Finger Fulcrum Technique - lifting the heel of the hand slightly but completely off the chest during the decompression phase of CPR using all five fingers as a fulcrum; (3) Hands-Off Technique - lifting the heel and all fingers of the hand slightly but completely off the chest during the decompression phase of CPR. The participants did not know the purpose of the study prior to, or during this investigation. Adequate compression depth was poor for all hand positions tested and ranged only from 18.6 to 35.7% of all compressions. When compared with the Standard Hand Position, the Hands-Off Technique decreased the mean compression duty cycle from 39.0 +/- 1.0 to 33.5 +/- 1.0%, (P < 0.0001) but achieved the highest rate of complete chest wall recoil (92.5% versus 24.1%, P < 0.0001) and was 46.3 times more likely to provide complete chest wall recoil (OR: 46.3; CI: 16.4-130.3). There were no significant differences in accuracy of hand placement, adequate depth of compression, or perceived discomfort with its use compared with the Standard Hand Position. The Hands-Off Technique decreased compression duty cycle but was 46.3 times more likely to provide complete chest wall recoil (OR: 46.3; CI: 16.4-130.3) compared to the Standard Hand Position without differences in accuracy of hand placement, adequate depth of compression, or perceived discomfort with its use. All forms of manual CPR tested (including the Standard Hand Position) in trained laypersons produced an inadequate depth of compression for two-thirds of the time. These data support development and testing of more effective layperson CPR training programmes and more effective means to deliver manual as well as mechanical CPR.

Subconscious Passive Learning of CPR Techniques through Television Medical Drama

A cardiac arrest victim's chances of survival are largely dependant on the availability at the scene, of a witness familiar with CPR skills. Many efforts have been invested in teaching CPR skills to as many people as possible and new ways are constantly being researched to distribute and extend these skills to the wider population. We report a case whose survival was due to CPR performed by a lay family member with no previous official training in resuscitation. The rescuer admitted that she had recalled the CPR technique from a popular medical drama on television (TV) and that she was absolutely unaware of her CPR potential capabilities. TV producers and health policy makers should exploit highly rated TV feature programs such as medical dramas to transmit useful hidden messages such as CPR skill to the public. In due time this policy may prove to be a life saver.

Chest wall injuries following cardiopulmonary resuscitation

The forensic records were reviewed of 1823 deaths referred to Edinburgh City Mortuary for autopsy over a 15-month period, 2000-2001; 499 cases (343 males, 156 females) that received CPR prior to death were studied. Rib fractures were found in 29%, sternal fracture in 14%, and 11% of cases showed external chest wall bruising or abrasion. More females sustained rib fractures than males (37% versus 26%; P <0.05). There was no significant gender difference for sternal fracture (females 17%, males 12%; P=0.051). The incidence of rib fractures increased with age (P <0.001). There was no significant difference in the number of left or right ribs fractured (P=0.631). This study incorporates all cases of in and out-of-hospital CPR and does not discriminate for the CPR provider or technique employed, therefore, providing a current and representative overview of the incidence of rib and sternal fractures in non-survivors of CPR.

Cardiopulmonary Resuscitation and Oxygen Therapy

Cardiopulmonary resuscitation and oxygen therapy are often necessary procedures done in veterinary practice. There are variations in CPR technique, especially in cardiac life support. Oxygen therapy can be an important adjunctive therapy in emergency and critical care medicine. The techniques used for oxygen administration differ depending on the medical problem and the animal.