Expired Air Resuscitation Research Articles

The introduction of expired air resuscitation into Surf Life Saving Australia.

Surf Life Saving Australia, which began in the early 1900s, initially adopted the indirect resuscitation methods used by the Royal Life Saving Society. As new indirect methods became available, both organisations adapted their resuscitation techniques and followed international developments closely. In the 1950s, accumulating evidence suggested that direct methods of resuscitation, such as mouth-to-mouth ventilation, might be more efficacious. Subsequently a number of investigations were carried out in Sydney at the Royal Prince Alfred Hospital on anaesthetised and paralysed patients. These experiments were recorded for an ABC documentary and reported at the International Convention on Life Saving Techniques held in Sydney in March 1960. Following the convention, Queensland Surf Life Saving conducted training sessions in cooperation with anaesthetists Roger Bennett and Tess Brophy (later Cramond), at St Andrew's Hospital in Brisbane. Two volunteers were anaesthetised and paralysed on two separate weekends to allow over one hundred people to gain experience in expired-air and bag-mask ventilation. One of the volunteers in these training exercises kindly provided much of the material that led to this paper, providing a first hand account of the experiments and an invaluable insight into the cooperation between anaesthetists and volunteer rescue associations.

Improved response by peers after witnessed heroin overdose in Melbourne

In response to concerns about the prevalence of heroin-related morbidity and mortality, overdose response training programs have been implemented in Victoria, with the aim of improving outcomes after heroin overdose. The aim of this study was to examine reported overdose response by current injecting drug users (IDU) during overdose events, in comparison with previous studies. A total of 99 IDU (median age 35 years, 72% male) were administered a questionnaire that collected information on knowledge and experience regarding recognition of heroin overdose and response. The primary outcome measure was the rate of ambulance notification and expired air resuscitation during witnessed heroin overdose. Data were analysed using descriptive statistics and univariate analysis. Sixty participants had overdosed at least once, and 84% had witnessed an overdose. 78% recognised altered consciousness as a sign of heroin overdose, but less were aware of depressed breathing (42%) or cyanosis (61%). Reported overdose interventions included correct positioning (39%), expired air resuscitation (32%), ambulance notification (76%) and staying with the victim (87%). Our study has found improved responses to heroin overdose during witnessed heroin overdose among current IDU, compared with earlier work. However, a lack of knowledge regarding appropriate first-aid response persists, which might improve with the development and implementation of training initiatives in this area, ranging from identification of overdose to the administration of life-saving measures.

An Assessment of Small Simulators Used to Teach Basic Airway Management

This study assessed small simulators sold for teaching basic airway management. The assessment used criteria based on guidelines produced by the Australian Resuscitation Council and our experience teaching health professional trainees. Criteria included how well the simulators demonstrated manoeuvres to open the airway, mouth-to-mouth and mask-to-mouth expired air resuscitation and artificial ventilation using a bag and mask. Simulators with permanently open airways (as is the case with some intubation manikins) were not tested. Each simulator was also assessed for realism in relation to look and feel, hygiene and sturdiness of construction. Clinical staff and medical students who teach basic airway management undertook a standardized assessment of nine simulators. There were significant differences between simulators that could impact on learning. Generally, models with hard surfaces tended to be less realistic in both look and feel compared to those with flexible "skin". Realism of lung inflation and its relationship to airway opening manoeuvres varied greatly between simulators. The Little Anne small simulator functioned most realistically in our tests.

Efficacy of cardiopulmonary resuscitation performed in a dental chair.

Within the dental setting, historically there has been some concern as to whether cardiopulmonary resuscitation (CPR) can be performed effectively in the dental chair. This study tested the hypothesis that there is no difference in the efficacy of CPR performed in the dental chair or on the floor. Four cycles of two-person CPR were performed by three health professionals on a manikin positioned alternately on the floor and in a dental chair. Ventilation was performed using a Laerdal pocket mask, without oxygen supplementation. Compression and ventilation performance was recorded using a computerized manikin skill meter. Each of the participants was able to achieve a mean cardiac compression depth of between 41 and 50cm, irrespective of the CPR surface. The only statistically significant difference found in expired air resuscitation (EAR) and external cardiac compression performance was that 37 per cent of ventilations performed on the floor were deemed to be too shallow, compared to only 15 per cent in the dental chair (p=0.001). It is possible for those trained in basic life support to perform CPR effectively in the dental chair. Each of the participants agreed that CPR, in particular EAR, was easier to perform when the manikin was in the dental chair compared with the floor. Dentists are encourage to regularly update their CPR knowledge and skills, including the practice of CPR in the dental chair.

Witnessing heroin-related overdoses: the experiences of young injectors in San Francisco.

Assessment of young injectors' exposure and response to others' heroin-related overdose. Cross-sectional survey. San Francisco, CA, United States. Nine hundred and seventy-three street-recruited current injectors under 30 years old. Self-reported experiences of witnessing heroin-related overdoses from structured interviews. Seven hundred and nine of 973 (73%) had ever witnessed at least one heroin-related overdose, and 491 of 973 (50%) had witnessed an overdose in the last 12 months. Fourteen per cent of those who had witnessed an overdose in the past year reported that the outcome of the overdose was death. Emergency services were called to 52% of most recent witnessed overdoses. Cardiopulmonary resuscitation (CPR) or expired air resuscitation (EAR or 'rescue breathing') was performed in 61% of cases. Inappropriate strategies such as injection with stimulants or application of ice were rare. In 67% of cases in which emergency services were not called the witness said this was because the victim regained consciousness. In the remaining 33%, 56% stated emergency services were not called due to fear of the police. Respondents were willing to act at overdoses at which they were present, but frequently did not do so in the most efficacious manner. Fear of police was identified as the most significant barrier to the ideal first response of calling emergency services.

Farm Safety - A Family Priority: The Implementation of a Collaborative Approach to Primary Health Care in a Rural Setting

Farm Safety - A Family Priority' was a collaborative, integrated primary health care promotion conducted during Rural Health Week, starting 27th May 1999 in the rural town of Elmore, Victoria. Five primary schools in surrounding districts were invited to participate: Goornong, Colbinabbin, Drummartin, Our Lady of the Sacred Heart, Elmore, and Elmore Primary School. Involving 113 children and five teachers, issues concerning safety on the farm included riding on tractors, horses and agriculture bikes, the safe use and storage of chemicals, safe places to play, the importance of displaying emergency telephone numbers, and a demonstration on Expired Air Resuscitation. By using a demonstration and an interactive teaching method it was envisaged that student participation would be encouraged and learning through practical application reinforced. Further, students were provided with ample time to ask questions of the demonstrators regarding any displays and activities. At the conclusion of the day a questionnaire was distributed to all children while teachers' perceptions were recorded by interview. Children took away some clear messages about farm safety, and the coordination and content of the activities impressed teachers. The activity clearly demonstrated the need for more integrated, collaborative approaches in promoting primary health care in rural settings, that are relevant to the community concerned in order to create a sustainable healthy community.

A questionnaire survey of dentists regarding knowledge and perceived competence in resuscitation and occurrence of resuscitation emergencies.

Little information has been published on the knowledge and perceived competence of dentists in resuscitation or the occurrence of resuscitation emergencies in dental practice. Further, no such surveys have been done in Australia. A postal survey was therefore devised and the names of 350 dentists were randomly selected from the Australian Dental Association national membership registry. The response rate was approximately 45 per cent and the main results included: just under half of the respondents felt they were competent in basic resuscitation at the time of graduation, that is, in expired air resuscitation (EAR) and cardiopulmonary resuscitation (CPR); just less than two-thirds had undertaken resuscitation training since graduation; about three-quarters felt they would be able to perform EAR and almost two-thirds felt they would be able to perform CPR; almost 90 per cent gained a satisfactory score in a Resuscitation Quiz included in the survey; and just over 5 per cent had had to resuscitate a patient.

Physikalische Charakteristika von Hilfsmitteln zur Atemspende

Expired air resuscitation forms an essential part of First Aid in patients with respiratory insufficiency. The use of devices should encourage the rescuer to start the measure, make it easier to perform and protect him from a possible transmission of infectious material. 17 devices (mask, tube instruments) were examined in respect of their physical properties (resistance, leakage). None of them fulfilled all the criteria relevant for their use. In most of them changes and modifications seem to be necessary. Mask and tube instruments have definitive disadvantages compared to foil-like adjuncts which are being developed at present.

Community training programme in CPR is already saving lives

Medical Journal of AustraliaVolume 1, Issue 7 p. 338-339 Mja News Features Community training programme in CPR is already saving lives Operation Four Minutes celebrates first birthday First published: April 1983 https://doi.org/10.5694/j.1326-5377.1983.tb136114.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Tea Tree Gully, a South Australian community of 65 000, has begun the ambitious task of training all residents over the age of 10 in cardiopulmonary resuscitation (CPR). Called Operation Four Minutes, the programme has trained nearly 1500 adults and children in CPR, expired-air resuscitation and cardiac compression since April, 1982. Volume1, Issue7April 1983Pages 338-339 RelatedInformation

DROWNING AND THE TREATMENT OF NON-FATAL SUBMERSION

Animal studies have shown that fluid enters the body via the lungs in sea-water and fresh-water drowning. In fresh-water drowning in dogs, there is marked and rapid hemodilution with death due to ventricular fibrillation in about 4 minutes. In sea-water drowning in dogs, there is hemoconcentration; the blood water is lost into the sea water in the lungs with bradycardia and death due to asystole in 6 to 8 minutes. Studies of human drowning victims show similar, but less striking, changes in hemodynamics. In human non-fatal submersion the problems are usually those produced by impaired pulmonary function and central nervous system damage due to hypoxia. Hemodilution and ventricular fibrillation have not been documented in human nonfatal submersion. Therapeutic measures may be divided into those of an immediate urgent nature to be employed at the accident scene: expired air resuscitation, which should be started on reaching the unconscious victim in the water, and external cardiac massage, when indicated. Later measures to be instituted in the hospital include: cardiac resuscitation, intermittent positive-pressure breathing, hypothermia, tracheostomy and tracheal tiolet, oxygen therapy, antibiotics, steroids, and intravenous fluids to correct defects in blood elements (hemoglobin, electrolytes, pH). Later, pulmonary function should be studied for impairment due to alveolar damage and fibrosis. Permanent neurologic sequellae may develop.

Expired air resuscitation in industry. Mouth-to-mouth, mouth-to-nose.

Expired air resuscitation in industry. Mouth-to-mouth, mouth-to-nose.

Expired air resuscitation in a contaminated atmosphere.

Expired air resuscitation in a contaminated atmosphere.

EXPIRED-AIR RESUSCITATION

EXPIRED-AIR RESUSCITATION

Expired-air Resuscitation

Expired-air Resuscitation

Pulmonary ventilation and respiratory gas exchange during manual artificial respiration and expired-air resuscitation on apnoeic normal adults. A comparison of the Holger Nielsen method and the mouth-to-mouth method.

SUMMARY Comparative experimental studies on resuscitation by the mouth‐to‐mouth and Holger Nielsen (back‐pressure arm‐lift) methods are reported. The experiments were performed on five normal unconscious apnoeic adults and extended over periods of from 20 to 40 minutes. Tidal air, minute volume and alveolar ventilation/min. were determined pneumographically and/or spirometrically and/or volumetrically. The oxygen saturation and carbon dioxide tension of the arterial blood were determined during the experiments. Sufficient alveolar ventilation with normal arterial oxygen saturation and PCO2 was obtained by the mouth‐to‐mouth method in four out of five cases. In one case, hypoventilation occurred during the performance of the mouth‐to‐mouth method. Sufficient alveolar ventilation with normal arterial oxygen saturation and constant PCO2 was obtained by the Holger Nielsen method in one out of five cases. In four cases, variable degrees of hypoventilation occurred during the performance of the manual manoeuvres with an increase in the PCO2 of the arterial blood. However, an arterial oxygen saturation of more than 80% was maintained throughout the experimental period (30–40 minutes), although resuscitation with atmospheric air was given during the greater part of the period. The advantages and disadvantages of the two methods are discussed. Maintenance of a patent airway during artificial respiration must be considered to constitute a conditio sine qua non. If the Holger Nielsen method is to produce sufficient alveolar ventilation in the field, the respiratory frequency must be 15–16 breaths per minute, and the victim's head should be bent backwards (extension in the atlanto‐occipital joint). The authors are unable to recommend one of the two methods as being superior to the other in adults, but agree with the American investigators in their recommendation of the mouth‐to‐mouth method in infants and small children. The view is expressed that it would be desirable to train the general population as “two‐method” resuscitation operators.

Oxygen and carbon dioxide exchange and energy cost of expired air resuscitation.

This report reviews results of several studies of expired air resuscitation carried out in our laboratories over four years.¹After a preliminary survey in 1952, a coordinated series of measurements were made in Buffalo, Baltimore, and at the Army Chemical Center, Edgewood, Md. These projects were sponsored by the Office of the Surgeon General, Department of the Army, because of the urgency of problems of resuscitation in nerve gas poisoning. Requirements called for a method of artificial respiration possessing high efficiency, simplicity, and inherent safety. The data reviewed here have been the basis for recent adoption in principle by the Army of expired air resuscitation as the field method of choice in the treatment of nerve gas casualties. The possibilities of using the expired air of one person to ventilate another are apparent from simple calculations. The concentration of oxygen in expired air is dependent upon the oxygen consumption,

Expired air resuscitation in paralyzed human subjects.

Expired air resuscitation has been evaluated in 16 anesthetized curarized human subjects. A mask resuscitator suitable for use in contaminated atmospheres was employed. The parameters measured include the alveolar carbon dioxide and oxygen concentrations of the operator and of the subject, the air flow and tidal volume, the subject's oxygenation by ear oximeter and the subject's arterial oxygen saturation, carbon dioxide tension and ph. All parameters independently indicated the complete adequacy of the method under widely varying conditions of rate and volume of inflations and with multiple operators. Alveolar oxygen concentrations in the subject during prolonged performance of the method were sustained above the normal range. Submitted on February 6, 1957