Performing Chest Compressions Research Articles

Use of a SimBox, a Video-Augmented, Newborn Resuscitation Simulation for Prehospital Providers to Measure Clinical Performance and Educational Experience.

Few studies have described the current clinical practices, adherence to guidelines, and outcomes of newborn resuscitations attended by emergency medical services (EMS). SimBox, a novel, video-augmented simulation, was used to describe the adherence of prehospital providers to Neonatal Resuscitation Program guidelines, to measure satisfaction with the simulation intervention, and to describe the self-reported improvement in knowledge, skills, and attitudes after the simulation. A prospective observational cohort study of EMS providers was designed and conducted using SimBox, an open-access simulation platform, and facilitated by EMS educators. Clinical performance measures were collected using a five-item checklist. Simulation satisfaction measures were collected through net promoter scores. Learners' demographics, and self-reported knowledge, skills, and attitudes were measured using a retrospective survey of 25 questions. In total, 33 facilitator and 55 learner surveys were collected across Connecticut, Colorado, and Alaska between July 2021 and September 2022. At least one deviation from clinical guidelines occurred in 22/30 (73.3%) of the sessions, with 10/30 (33.3%) teams inappropriately performing chest compressions, 5/31 (16.1%) teams not warming, drying, stimulating, and suctioning the newborn, and 7/31 (22.6%) teams not performing positive pressure ventilation correctly. Lastly, 10/30 (33.3%) teams administered an incorrect dose of dextrose-containing fluids. Very high levels of satisfaction were reported with net promoter scores of 97 and 82 out of 100 for the facilitator and learner surveys, respectively. Finally, all 55/55 (100%) of the learners strongly or somewhat agreed that the simulation improved their knowledge, teamwork, communication, and psychomotor skills. In this cohort of prehospital providers, clinical management decisions during a newborn resuscitation simulation often deviated from the gold-standard, newborn resuscitation guidelines. Free, online, open-access simulation resources like SimBox can be used to identify and measure practice deviations from standardized resuscitation protocols in the prehospital setting.

Abstract P449: Closing the Gender Gap in Bystander Cardiopulmonary Resuscitation: Unveiling Disparities and Pathways to Equal Lifesaving

Introduction: Gender disparities in CPR persist, with women receiving CPR less frequently than men during out-of-hospital cardiac arrests. This abstract emphasizes the importance of addressing this disparity through awareness campaigns and offers innovative strategies for prevention, including gender-sensitive CPR training methods and a community program example from New Orleans. Methods: A comprehensive literature review was conducted to identify studies on gender disparities in bystander CPR. Factors contributing to these disparities were analyzed, including hesitations related to physical contact, challenges in recognizing cardiac arrest in women, and societal biases. Survival data were assessed to highlight the lifesaving potential of gender-equal CPR. Results: Research revealed that gender disparities in CPR provision are common, influenced by factors such as reluctance to perform chest compressions on women, difficulties in identifying cardiac arrest in female patients, and the perpetuation of gender stereotypes. These factors result in significantly different survival rates, with women facing a higher risk of worse outcomes. Discussion: Addressing gender disparities in bystander CPR provision requires a multifaceted approach, including community-based CPR training programs that emphasize gender sensitivity. These programs should feature anatomically correct CPR training dolls with breast attachments to ensure trainees are prepared to perform CPR on anyone. It is crucial that CPR course instruction also incorporate information on gender disparities to raise awareness among trainees. Public awareness campaigns should work to dispel myths and biases related to gender and CPR, promoting more equitable lifesaving practices. An exemplary program from New Orleans demonstrates the impact of community-based initiatives. In this effort, community members were trained in CPR using gender-inclusive materials, including CPR dolls with breast attachments. The training included statistical information on gender disparities, bias assessments, survivor testimonials, and discussions aimed at dispelling myths about providing CPR to women. This program successfully empowered the community with the knowledge and skills to overcome gender biases in CPR, promoting gender-equitable lifesaving measures. Conclusion: Preventing gender disparities in bystander CPR provision to women is essential to enhance survival rates for female cardiac arrest victims. Using public platforms to advocate for these initiatives and emphasizing the need for collaborative efforts to eliminate gender bias in lifesaving practices and CPR training is crucial. By illuminating the issue, proposing innovative solutions, and sharing successful community programs, a standard can be cultivated where every individual, regardless of gender, receives timely and effective CPR.

Handling Patient Emergencies During Radiopharmaceutical Therapy

BackgroundRadiopharmaceutical therapy (RPT) is a rapidly growing treatment modality. Though uncommon, patients may experience complications during their RPT treatment, which may trigger a rapid response from the hospital team. However, members of this team are typically not familiar with precautions for radiation safety. During these events, it is important to prioritize the patient's health over all else. However, there are some practices that can help minimize the risk of radiation contamination spread and exposure to staff while tending to the patient. MethodsWe formed a team to develop a standard protocol for handling patient emergencies during RPT treatment. This team consisted of an authorized user, radiation safety officer, medical physicist, nurse, RPT administration staff, and a quality/safety coordinator. The focus for developing this standardized protocol for RPT patient emergencies was three-fold: (1) stabilize the patient, (2) reduce radiation exposure to staff, and (3) limit the spread of radiation contamination. ResultsWe modified our hospital's existing rapid response protocol to account for the additional staff and tasks needed to accomplish all three of these goals. Each team member was assigned specific responsibilities, which include serving as a gatekeeper to restrict traffic, managing the crash cart, performing chest compressions, timing chest compressions, documenting the situation, and monitoring/managing radiation safety in the area. We developed a small, easy-to-read card for rapid response staff to read while they are en route to the area so they can be aware of and prepare for the unique circumstances that RPT treatments present. ConclusionsThough rapid response events with RPT patients are uncommon, it is important to have a standardized protocol for how to handle these situations beforehand rather than improvise in the moment. We have provided an example of how our team adapted our hospital's current rapid response protocol to accommodate RPT patients.

Comprehensive Cardiopulmonary Resuscitation Training for Foreign Medical Students

The purpose of this study was to assess acquired knowledge and practical skills in foreign medical students (FMS) after theoretical and practical training in cardiopulmonary resuscitation.Material and methods. We conducted a prospective randomized trial «Simulation-based CPR training among international medical students: perspectives for medical education» envolving students undergoing training in the 31.05.01 specialty — General Medicine in English. Sealed envelope randomization was used to assign the participants (N=71) to 3 groups. European Resuscitation Council (ECR) educational Guidelines for Resuscitation was studied by students of all 3 groups. Group 1 (N=21) students did not receive additional training materials and practices. Group 2 (N=25) students were additionally provided with a link to a video lesson on CPR on the ECR Youtube channel. Students from Group 3 (N=25) were additionally involved in developing 3 mind maps: on the anatomy and physiology of the heart and CPR algorithm. All participants underwent theoretical training at the 1st stage, and «Basic Cardiopulmonary Resuscitation and Automated External Defibrillation (AED)» simulation training at the second stage. At the end of the course, students’ practical skill in performing continuous chest compressions were examined.Results. The majority of examinees passed the ECR platform test on the first or second attempt. The participants of the simulation course demonstrated high learning efficiency: there were no statistically significant differences between the groups in the number and average frequency of compressions performed. Almost all participants correctly performed hand placement in the center of the chest for chest compression. Decompression phase efficiency reached 71–77% (P=0.811) in all groups. The majority of examinees performed chest compressions to the required depth and with the recommended frequency (P=0.62).Conclusion. The educational project initiated by foreign students yielded positive results: acquired knowledge of CPR algorithm, gained essential techniques of performing chest compressions and giving rescue breaths, retained skills in using automated external defibrillator, as well as teamwork skills.

Development of competence in students when teaching practical skills in measuring blood pressure and cardiopulmonary resuscitation

In a study involving 33 fourth-year medical students, the BT-ACTB simulator was used to teach critical care skills. Students were trained in measuring blood pressure and cardiopulmonary resuscitation using Peyton’s methodology. The results showed that students made mistakes in performing chest compressions at the beginning of training, but by the 10th day the majority had achieved the required level. The depth and frequency of compressions, hand position, accuracy of ventilation and inspiratorytiming improved by the end of training. The use of the simulator was assessed as an eff ective means for developing student competence. Blood pressure measurements were also carried out, where students demonstrated high competence by the end of the training. The BT-ACTB simulator is considered an ideal tool for assessing and developing the practical skills of students in the fi eld of critical care.

Abstract 308: Comparison of Cardiopulmonary Resuscitation Performance Between Integrated CPR Device Performing Chest Compression and External Defibrillation versus LUCAS3 With Automated External Defibrillator: A Animal and Manikin-Based Pilot Study

Background: Early chest compression and defibrillation are important components for successful resuscitation. The use of mechanical CPR has increased after the outbreak of COVID-19, and this trend continued in the post-pandemic period. We developed an automatic CPR performing chest compression and external defibrillation simultaneously following current CPR algorithm. Methods: This study was designed as a study to compare the performance of CPR and AED between automatic CPR apparatus (A-CPR) and commercially proven mechanical CPR device (LUCAS3) plus AED (C-CPR) during CPR in swine cardiac arrest model and the study to evaluate feasibility of A-CPR in simulated cardiac arrest model. Results: There were no significant differences in hemodynamic variables between the groups. Time to ECG analysis [38.0 sec in A-CPR, 48.0 sec in C-CPR, p =0.010], time to initial shock advice plus subsequent chest compression [46.0 sec in A-CPR, 57.0 sec in C-CPR, p =0.017], time to first defibrillation [48.5 sec in A-CPR, 65.0 sec in C-CPR, p =0.004], charge to shock interval [3.0 sec in A-CPR, 8.0 sec in C-CPR, p =0.001], and hands-off time [11.0 sec in A-CPR, 22.5 sec in C-CPR, p =0.001] were significantly shorter in A-CPR group than C-CPR group. In the simulation study, the pure chest compression time [101 sec in A-CPR, 110 sec in C-CPR, p< 0.001], hands-off time [75 sec in A-CPR, 94 sec in C-CPR, p< 0.001], time from power-on to first chest compression [55 sec in A-CPR, 82 sec in C-CPR, p< 0.001], time to first shock delivery [40 sec in A-CPR, 51 sec in C-CPR, p= 0.001] were significantly shorter in A-CPR group than C-CPR group, respectively. Chest compression fraction showed a significant higher in A-CPR than C-CPR [57% in A-CPR, 54% in C-CPR, p <0.001]. Conclusions: The A-CPR device demonstrated significant time savings effect than conventional mechanical CPR device and automated external defibrillation device. In addition, A-CPR and C-CPR showed similar hemodynamic effects and resuscitation outcomes in a swine model of cardiac arrest

Education of schoolchildren in cardiopulmonary resuscitation - overview of the current literature.

Recognition of cardiac arrest and initiation of cardiopulmonary resuscitation (CPR) can be learned and adequately replicated by schoolchildren. Regular instruction of schoolchildren in CPR is therefore a core element to increase low bystander CPR rates. Thereby, schoolchildren CPR training evolved as own scientific field within the last decade. Aim was to describe current evidence in terms of epidemiology, teaching approaches and political aspects. Schoolchildren demonstrate a high motivation to be trained in CPR. Teaching approaches that combine theoretical and practical learning sessions guarantee a sustainable learning effect. Schoolchildren can adequately perform chest compressions and mouth-to-mouth ventilation from the age of 12 years. Use of digital media is a highly promising teaching approach. CPR training conducted by teachers from the own school is effective and guarantees continuous development of CPR skills. Integration of schoolchildren CPR training into school curricula is the foundation for a sustainable increase of lay resuscitation rates in the population. Scientific and political promotion of schoolchildren CPR training is needed to sensitize the population and move bystander CPR in the social focus. While bystander CPR rates are low in Europe comprehensive establishment of schoolchildren CPR training may sustainably increase survival after cardiac arrest.

Implementation and use of a supraglottic airway device in the management of out-of-hospital cardiac arrest by firefighter first responders – A prospective feasibility study

AimWe wanted to assess the implementation and use of a supraglottic airway (SGA) for on-call firefighter first responders in out-of-hospital cardiac arrest. MethodsWe trained 502 firefighter first responders, located at 35 fire stations in the South-East of Norway, in the use of SGA during cardiopulmonary resuscitation in adult out-of-hospital cardiac arrest. Training consisted of 45 minutes of theoretical and practical training in small groups.Primary outcome was successful ventilation with SGA assessed by both firefighter first responders and first paramedic arriving on-scene. Secondary outcomes included time expenditure and complications related to the procedure, evaluation of the training, and descriptive characteristics of the out-of-hospital cardiac arrest cases. ResultsAn SGA was used by firefighter first responders in 23 out-of-hospital cardiac arrests, and successful ventilation was achieved in 20 (87%) cases. Air-leak was described in the three unsuccessful cases. The median procedural time was 30 seconds (IQR = 15–40), with no observed procedural complications. Firefighter first responders arrived in median time 9 minutes (IQR = 6–10 min) before the ambulance. They performed chest compressions on all patients and 6 (26%) of the patients received shock with semi-automatic external defibrillator. After training, all participants were able to successfully ventilate a manikin with the SGA. The cost of the SGA equipment for all fire stations was 3955 GBP. ConclusionImplementation of an SGA for firefighter first responders in out-of-hospital cardiac arrest management seems feasible, safe and can be introduced with limited amount of training and limited use of resources.

Investigation of the Effect of Using a Metronome or Song on the Lay Rescuers' Quality of Chest Compressions

Introduction: This study aimed to determine the quality of chest compressions performed by lay rescuers assisted by a healthcare worker over the telephone and investigate the effect of metronome use or the Stayin’ Alive song on the quality of these chest compressions.
 Material and Method: This study was conducted prospectively at the emergency department of a tertiary hospital. The lay rescuers were assisted by an emergency medicine specialist over the telephone to perform chest compressions using the CPR Lilly PRO+ simulator. Three groups were formed, and the same participants performed three cycles of chest compressions over the telephone for two minutes first without any external stimulus (Group 1), then using a metronome as an external stimulus (Group 2), and finally by listening to the Stayin’ Alive song as another external stimulus (Group 3). The obtained data were analyzed with IBM SPSS v. 23.0.
 Results: There was no statistically significant difference between the three groups in terms of the target number of chest compressions (p=0.404). However, the compression depth and chest compression fraction statistically significantly differed between the groups (p

Resuscitation Quality Improvement: Improving Clinicians' Performance.

Although cardiopulmonary resuscitation (CPR) renewal occurs every 2 years, quality of performed CPR at the study site was below American Heart Association (AHA) standards. Resuscitation Quality Improvement (RQI) is a new AHA program with the premise that practicing CPR more frequently using audiovisual feedback can improve performance. To identify whether performance of chest compressions during training reassessments improves with RQI. This study used a preintervention-postintervention design. Critical care nurses from 2 intensive care units performed a baseline round of chest compressions. These baseline data reflected CPR performance with traditional training. The next week, participants completed RQI training. Two weeks after RQI training, participants performed chest compressions. Five weeks after RQI training, participants performed a third round of chest compressions. The compressions performed 2 and 5 weeks after RQI used audiovisual feedback. Thirty nurses participated. Before intervention, the mean (SD) for overall compression compliance was 32.68% (26.96%), depth was 67.76% (30.15%), and rate was 39.95% (27.41%). The first postintervention (RQI plus 2 weeks) mean (SD) increased to 75.33% (33.70%) for overall compression compliance, 97.43% (12.04%) for depth, and 80.89% (29.35%) for rate. The second postintervention (RQI plus 5 weeks) mean (SD) decreased slightly to 73.16% (36.36%) for overall compression compliance, 96.57% (13.04%) for depth, and 78.75% (31.83%) for rate. Frequent CPR using RQI technology, with its immediate audiovisual feedback, helps maintain skills, which may improve patient outcomes.

Comparison of chest compression quality between the overlapping hands and interlocking hands techniques: A randomised cross-over trial

BackgroundPerforming quality chest compressions is fundamental to the management of cardiopulmonary arrest. The aim of this study was to compare the efficacy of two hand positions: overlapping versus interlocking for performing chest compressions during cardiopulmonary arrest. MethodsThe HP2C (for Hands Position and Chest Compression) was a prospective, randomised, open-label, cross-over, single-centre study. Participants were recruited from the Emergency Medical Service (EMS) teams and the prehospital firefighter teams. They were randomised to start chest compressions either with overlapping or interlocking hands and then performed the other technique after a washout period. The judgement criteria were the overall chest compressions success score generated by software in accordance with ILCOR recommendations, the quality of compression, release, rate and subjective intensity measured with the Borg scale. ResultsA total of 100 participants were included in the study. The mean age of the caregivers was 38 ± 9.3 years. The median CPR score was 79.5% IQR [48.5–94.0] in the overlapping hands group and 71% IQR [38.0–92.8] in the interlocking hands group (p-value = 0.37). There was no significant difference for the other criteria, especially no difference in term of intensity of effort. However, there was a trend towards better results with overlapping hands. ConclusionsThis study failed to demonstrate a difference in effectiveness between overlapping and interlocking hand chest compressions during cardiopulmonary resuscitation.

Evaluation of compressor fatigue at 150 compressions per minute during cardiopulmonary resuscitation using a large dog manikin.

To determine whether CPR providers can perform chest compressions (CC) appropriately at a rate of 150 compressions per minute during a 2-minute cycle and to identify the presence of rescuer fatigue. High fidelity simulator study. University veterinary teaching hospital. Sixty subjects, 30 women and 30 men. Subjects performed CC at 150 compressions per minute on a dog manikin for 2 minutes. Real-time depth of compressions, compression release, and compression rate were measured using a CPR training device. Demographic data from the subjects were analyzed alongside data obtained from the monitoring device. Only 38.3% of participants were able to perform CC with appropriate depth and release at 150 compressions per minute during a 2-minute cycle. There was a decay in the quality of CC between the first and the second minute. The number of compressions and percentage of compressions with correct release were similar among various genders, ages, and professions. In contrast, the percentage of compressions with correct depth was significantly higher among individuals with higher body mass index (correlation coefficient [r]=0.293; P=0.023) and higher biceps brachii muscle circumference during muscle contraction (r=0.423; P=0.001). This study suggests that increasing the compression rate to 150 compressions per minute in large dogs using the thoracic pump technique might not be viable because most participants were not able to sustain enough appropriate CC. Rescuer fatigue affects compression depth at this rate, leading to a decay in CPR quality.

Development of an automatic device performing chest compression and external defibrillation: An animal-based pilot study.

Automatic chest compression devices (ACCDs) can promote high-quality cardiopulmonary resuscitation (CPR) and are widely used worldwide. Early application of automated external defibrillators (AEDs) along with high-quality CPR is crucial for favorable outcomes in patients with cardiac arrest. Here, we developed an automated CPR (A-CPR) apparatus that combines ACCD and AED and evaluated its performance in a pilot animal-based study. Eleven pigs (n = 5, A-CPR group; n = 6, ACCD CPR and AED [conventional CPR (C-CPR)] group) were enrolled in this study. After 2 min observation without any treatment following ventricular fibrillation induction, CPR with a 30:2 compression/ventilation ratio was performed for 6 min, mimicking basic life support (BLS). A-CPR or C-CPR was applied immediately after BLS, and resuscitation including chest compression and defibrillation, was performed following a voice prompt from the A-CPR device or AED. Hemodynamic parameters, including aortic pressure, right atrial pressure, coronary perfusion pressure, carotid blood flow, and end-tidal carbon dioxide, were monitored during resuscitation. Time variables, including time to start rhythm analysis, time to charge, time to defibrillate, and time to subsequent chest compression, were also measured. There were no differences in baseline characteristics, except for arterial carbon dioxide pressure (39 in A-CPR vs. 33 in C-CPR, p = 0.034), between the two groups. There were no differences in hemodynamic parameters between the groups. However, time to charge (28.9 ± 5.6 s, A-CPR group; 47.2 ± 12.4 s, C-CPR group), time to defibrillate (29.1 ± 7.2 s, A-CPR group; 50.5 ± 12.3 s, C-CPR group), and time to subsequent chest compression (32.4 ± 6.3 s, A-CPR group; 56.3 ± 10.7 s, C-CPR group) were shorter in the A-CPR group than in the C-CPR group (p = 0.015, 0.034 and 0.02 respectively). A-CPR can provide effective chest compressions and defibrillation, thereby shortening the time required for defibrillation.

The impact of a smartphone‐based cognitive aid on clinical performance during cardiac arrest simulations: A randomized controlled trial

AbstractObjectivesIn‐hospital cardiac arrests are common and associated with high mortality. Smartphone applications offer quick access to algorithms and timers but often lack real‐time guidance. This study assesses the impact of the Code Blue Leader application on the performance of providers leading cardiac arrest simulations.MethodsThis open‐label randomized controlled trial included Advanced Cardiac Life Support (ACLS)–trained medical doctors (MD) and registered nurses (RN). Participants were randomized to lead the same ACLS simulation with or without the app. The primary outcome, “performance score,” was assessed by a trained rater using a validated ACLS scoring system. Secondary outcomes included percentage of critical actions performed, number of incorrect actions, and chest compression fraction (percentage of time spent performing chest compressions). A sample size of 30 participants was calculated to detect a difference of 20% at the 0.05 alpha level with 90% power.ResultsFifteen MDs and 15 RNs underwent stratified randomization. The median (interquartile range) performance score in the app group was 95.3% (93.0%–100.0%) compared to 81.4% (60.5%–88.4%) in the control group, demonstrating an effect size of r = 0.69 (Z = −3.78, r = 0.69, p = 0.0002). The percentage of critical actions performed in the app group was 100% (96.2%–100.0%) compared to 85.0% (74.1%–92.4%) in the control group. The number of incorrect actions performed in the app group was 1 (1) compared to 4 (3–5) in the control group. Chest compression fraction in the app group was 75.5% (73.0%–84.0%) compared to 75.0% (72.0%–85.0%) in the control group.ConclusionsThe Code Blue Leader smartphone app significantly improved the performance of ACLS‐trained providers in cardiac arrest simulations.

Mouse Cardiac Arrest Model for Brain Imaging and Brain Physiology Monitoring During Ischemia and Resuscitation.

Most cardiac arrest (CA) survivors experience varying degrees of neurologic deficits. To understand the mechanisms that underpin CA-induced brain injury and, subsequently, develop effective treatments, experimental CA research is essential. To this end, a few mouse CA models have been established. In most of these models, the mice are placed in the supine position in order to perform chest compression for cardiopulmonary resuscitation (CPR). However, this resuscitation procedure makes the real-time imaging/monitoring of brain physiology during CA and resuscitation challenging. To obtain such critical knowledge, the present protocol presents a mouse asphyxia CA model that does not require the chest compression CPR step. This model allows for the study of dynamic changes in blood flow, vascular structure, electrical potentials, and brain tissue oxygen from the pre-CA baseline to early post-CA reperfusion. Importantly, this model applies to aged mice. Thus, this mouse CA model is expected to be a critical tool for deciphering the impact of CA on brain physiology.

Impact of Personal Protective Equipment on the Quality of Chest Compressions in Prehospital Care: A Prospective Randomized Crossover Study

AbstractIntroduction:The use of personal protective equipment (PPE) in prehospital emergency care has significantly increased since the onset of the coronavirus disease 2019 (COVID-19) pandemic. Several studies investigating the potential effects of PPE use by Emergency Medical Service providers on the quality of chest compressions during resuscitation have been inconclusive.Study Objectives:This study aimed to determine whether the use of PPE affects the quality of chest compressions or influences select physiological biomarkers that are associated with stress.Methods:This was a prospective randomized, quasi-experimental crossover study with 35 Emergency Medical Service providers who performed 20 minutes of chest compressions on a manikin. Two iterations were completed in a randomized order: (1) without PPE and (2) with PPE consisting of Tyvek, goggles, KN95 mask, and nitrile gloves. The rate and depth of chest compressions were measured. Salivary cortisol, lactate, end-tidal carbon dioxide (EtCO2), and body temperature were measured before and after each set of chest compressions.Results:There were no differences in the quality of chest compressions (rate and depth) between the two groups (P >.05). After performing chest compressions, the group with PPE did not have elevated levels of cortisol, lactate, or EtCO2 when compared to the group without PPE, but did have a higher body temperature (P <.001).Conclusion:The use of PPE during resuscitation did not lower the quality of chest compressions, nor did it lead to higher stress-associated biomarker levels, with the exception of body temperature.

An Evaluation of the Quality of CPR Chest Compressions Performed on Football-Equipped and Obese Simulation Manikins

Objective Protective athletic equipment may hamper the delivery of effective chest compressions. Unfortunately, an algorithm for managing cardiac arrest emergencies with equipment-laden athletes has yet to be established by national CPR certifying agencies. Further, athletes classified as being overweight or obese carry adipose in the thoracic region, which has been reported to inhibit the ability of rescuers to provide quality chest compressions. Thus, the purpose of this study was two-fold. The first purpose was to assess the ability of emergency responders to perform CPR chest compressions on an obese manikin. The second purpose was to analyze the effect of American football protective equipment on the performance of chest compressions by emergency responders. Methods Fifty emergency responders completed four 2-minute bouts of compression-only CPR. The scenarios included performing chest compressions on both traditional and obese CPR manikins, and performing chest compressions over a set of shoulder pads/chest protector that is used in the sport of American football on both traditional and obese manikins. Results The most notable outcomes in this study were related to chest compression depth, which fell well below the minimum recommended depth published by the American Heart Association in all conditions. Mean compression depth was significantly lower when performed on the obese manikin (avg over pads = 32.8, SD = 9.2 mm; avg no pads = 38.2, SD = 9.1 mm) compared to the traditional manikin (avg over pads = 40.0, SD = 10.9 mm; avg no pads = 40.8, SD = 14.8 mm), with statistical analyses revealing a significant effect due to both manikin size (p < 0.001) and the presence of equipment (p = 0.003), and a statistically significant interaction effect (p = 0.035). Chest recoil data revealed a statistically significant effect due to both manikin size (p = 0.017) and the presence of chest/shoulder safety pads (p = 0.003). Conclusion Within this sample of emergency responders, chest compressions were adversely affected both by the equipment and obesity. Additionally, the traditional manikin received comparable chest compressions regardless of the presence or absence of football protective equipment, albeit both conditions resulted in poor depth performance.

Introduction to ecological innovations in resuscitation training. Does made of cardboard has to mean single-use?

Aim: To assess the initial usefulness of an innovative, ecological manikin made of cardboard and coconut fiber, which is intended for resuscitation training. Material and methods: The study was conducted with the use of a mechanical chest compression device and assistance of human subjects. The first phase quantified the initial durability of the manikin. Phases two and three initially assessed manikins’ mechanical properties, its resistance to repetitive chest com¬pression training, and the quality of chest compressions performed on the tested manikin. Results: 268 and 49 participants took part in the first and the second phase of the study, respectively. The total number of chest compressions performed on the manikin was 30.736 and 4.928, respectively. The number of mechanical chest compressions reached 75.000 in phase three. The mean compression depth ranged between 47.1 ± 1.4 and 52.7 ± 0.6 mm, and the compression force ranged from 577 ± 10.0 to 686 ± 187 N. The rate of compressions ranged from 99.5 to 133/min, and the percentage of complete chest recoil ranged from 62.1 ± 20.3% to 100%. Conclusions: The tested ecological manikin invented for the purpose of resuscitation training provides the parameters necessary for students to master the ability to deliver high-quality chest compressions in terms of depth, rate, full recoil and force needed to perform chest compressions in a large adult. Durability tests showed that a manikin made of ecological materials can also be used multiple times, for many training groups.

CHEST COMPRESSION WORKSHOP BASED ON RULE OF FIVE ON DEPTH AND CHEST COMPRESSION FREQUENCY AT THE GRANDMED HOSPITAL IN 2022

Several measures to maintain life in cardiac arrest according to the American Heart, namely the application of a chain of survival, namely first aid when cardiac arrest occurs until treatment afterward. The rule of five is a rhythm calculation technique in chest compressions using the numbers 1,2,3,4,5, and 6 which adopts only 2 syllables. The purpose of this community service is to determine the ability of nurses to perform chest compressions based on the rule of five on the depth and frequency of chest compressions at Grandmed Hospital, Lubuk Pakam District, Deli Serdang Regency. The results of community service before being given a workshop show that nurses who perform chest compressions based on the rule of five to patients, namely all respondents have different percentage levels, namely good category as many as 7 people (23.3%), sufficient category as many as 14 people (46.7% ), and the less category as many as 9 people (30%). While the results obtained after being given a workshop show that nurses who perform chest compressions based on the rule of five to patients, namely all respondents have an increase in different percentage levels, namely the good category as many as 17 people (56.7%), the sufficient category as many as 9 people (30%), and the less category as many as 4 people (13,3%). The chest compression calculation system applied is the rhythm calculation system, namely and one, and two, and three, and four. If chest compressions are carried out properly and correctly according to the rules, compression pauses and consistency will create good tissue perfusion.

GAMBARAN PELAKSANAAN CPR DENGAN LAGU SORRY - JUSTIN BIEBER TERHADAP KECEPATAN KOMPRESI DADA PADA PENOLONG AWAM

Cardiopulmonary resuscitation (CPR) with a chest compression rate of 100 - 120 beats per minute is difficult without guidance. To maintain chest compression, the rhythm of a song can stabilize CPR rates of 100 - 120 beats per minute. The purpose of this study was to describe the implementation of CPR with the song Sorry-Justin Bieber on the speed of chest compression for lay rescuers. The method uses quantitative research with descriptive design with 30 respondents and uses probability sampling technique with random sampling. The instrument used is a QCPR Training application. Data were analyzed using descriptive statistic. The result of this research are compression speed have an average result of 109,83 beats / minute with a minimum speed of 100, maximum speed of 116, and standard deviation of 5,446. The success rate of respondents in performing chest compression is known to be 30 successful respondents. Hands Only CPR chest compression speed using the song Sorry - Justin Bieber had good results. Variations in the results of chest compression in this study were still within the range of 100 - 120 beats / minute in accordance with high quality CPR standards. This shows the picture that when performing Hands Only CPR with the song Sorry - Justin Bieber, the chest compression speed level will meet the right compression speed standard.