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Introduction:
Chest compression fraction (CCF) is the cumulative time spent providing chest compressions divided by the total time taken for the entire resuscitation. Targeting a CCF of at least 60% is intended to limit interruptions in compressions and maximize coronary perfusion during resuscitation. We aimed to identify the mean CCF and its rel...
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... feedback device CPRmeter2™ was attached to the body and switched on before compressions were started [ Figure 1]. The device provides real-time auditory and visual feedback of the resuscitation measures with the help of two sensors -an accelerometer measuring depth, rate and a force sensor that gives information on compression/recoil. ...
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Aim: The most common causes of blunt trauma are traffic accidents and falls from height. Thoracic region complications may be seen in cardiopulmonary resuscitation (CPR). The aim of this study was to examine thoracic complications developing in cases applied with CPR following a fall from height with no direct chest trauma. Materials and Methods: T...
Citations
... There was a linear relationship between CCF and the recovery of spontaneous circulation, which was also correlated with the immediate and longterm prognoses; lower CCF is associated with higher patient mortality. [19][20][21] Therefore, during simulation training and clinical maternal resuscitation, every effort should be made to perform teamwork efficiently and in an orderly manner to facilitate CCF improvement. ...
Background and Aims
Maternal cardiac arrest is the most urgent clinical event in obstetrics and can lead to serious consequences, such as maternal or fetal death. Therefore, the training of team cardiopulmonary resuscitation (CPR) skills for obstetricians is essential. The aim of this study was to investigate the effect of applying intelligent simulation to CPR in maternal cardiac arrest teamwork training for obstetricians.
Methods
Twenty‐four obstetricians who participated in the “Maternal First Aid Workshop,” organized by our hospital in 2018, were selected as training participants. The SimMan intelligent comprehensive patient simulator was used to train the CPR team collaboration with first‐aid skills. Each team participating in the training was assessed before and after the training using a questionnaire survey.
Results
The evaluation of the results after the training showed that all four teams were qualified and that the timing of the cesarean section was 100% correct. The mean score, team collaboration score, and chest compression fraction were significantly higher than before training. Teamwork CPR assessment time, interruption time of chest compressions, and artificial airway establishment time were significantly shorter than before training. The questionnaire survey showed that 95.8% of the physicians reported that the training was rewarding and helpful to their clinical work, and 100% of the physicians believed that obstetricians require similar training.
Conclusion
Using the SimMan intelligent comprehensive patient simulator to train obstetricians for CPR of maternal cardiac arrest teamwork first‐aid skills can significantly improve the training effect, clinical first‐aid skills, and teamwork awareness.
... Bystander high-quality CPR contributes to improved survival in patients with OHCA [8,9], including adequate chest compression rate (CCR), chest compression depth (CCD), and full Ivyspring International Publisher chest recoil, as well as interruption reduction in chest compressions and prevention of excessive ventilation [2]. While chest compression is the most important and fundamental skill in effective CPR [10], compression-only CPR is strongly recommended by the American Heart Association (AHA) for inexperienced rescuers [7,2]. According to the 2020 AHA's recommended guidelines, rescuers should perform chest compression for adults in cardiac arrest at a rate of 100-120 compressions per minute (cpm), and CCD should be maintained at 5-6 cm. ...
... In the single-rescuer scenario, although emergency medical services (EMS) response times vary widely, they generally exceed 2 minutes, so rescuers may need to continuously perform chest compressions for 5 to 10 minutes or more [8]. Prolonged continuous compressions lead to increased fatigue [28,29], which prevents rescuers from maintaining adequate depth and rate of compressions throughout the EMS reaction time, CCF and chest compression rebound rate (CCRR) also decreased with resuscitation time [8,10,20]. ...
... Previous studies have shown that providing appropriate CCR during CPR can help improve the return of spontaneous circulation in patients with OHCA [23]. According to the latest AHA guidelines, rescuers should maintain a CCR between 100 -120 compressions per minute (cpm) for 2 min [10], which means no more than 2 compressions per second. However, many previous studies have found that when chest compression is performed without metronome guidance, lower CCR phenomenon is not common, but higher CCR than recommended phenomenon often occurs [19,22,27,28], this study confirmed this phenomenon. ...
Background: Chest compressions are the basis of cardiopulmonary resuscitation (CPR), and high-quality chest compressions can improve survival rate in patients with out-of-hospital cardiac arrest. Although many efforts have been made to improve the quality of CPR in inexperienced adults, the results are still not high, especially during emergencies. The primary purpose of this study is to investigate whether a brief instructional chest compression-only CPR video could improve chest compression quality in inexperienced adults.
Methods: One hundred adults with no CPR experience (age: 20.28 ± 2.28 years; women: 50, men: 50) participated in this study. Participants completed body composition and handgrip strength measurements, and performed two CPR quality tests on the Laerdal® Little Anne QCPR Manikin, namely without video-CPR (WV-CPR) and video-CPR (V-CPR). The WV-CPR quality test was performed first. After 2 minutes of continuous chest compression, the participants rested for 10 seconds and repeated 3 cycles (phase 1, phase 2, and phase 3). After resting for more than 72 hours, V-CPR quality test was conducted. During the V-CPR with video intervention, the participants also continued to compress the chest for 2 minutes, and then rested for 10 seconds, repeating 3 cycles.
Results: In phase 1, compared with WV-CPR, the V-CPR has a significant increase (p < 0.001) in chest compression fraction (CCF) (56.31 ± 33.22% vs. 41.82 ± 32.30%) and percent of correct compression rate (PCCR) (96.17 ± 8.45% vs. 26.31 ± 37.55%). In addition, the V-CPR has significantly lower (p < 0.001) chest compression rate (CCR) (110.85 ± 2.40 cpm vs. 128.86 ± 24.52 cpm) and rating of perceived exertion (RPE) (11.89 ± 2.25 vs. 12.87 ± 2.25). For phases 2 through 3, V-CPR and WV-CPR achieved significant differences in CCF, CCD, CCR, PCCR, and RPE (p < 0.01). There were significant differences (p < 0.05) in CCF, CCD, chest compression rebound rate, and RPE among the different administration stages of both WV-CPR and V-CPR.
Conclusions: The results of this study revealed that a brief instructional chest compression-only CPR video could improve chest compression quality for inexperienced adults by reducing fatigue and CCR, and increasing CCF and PCCR.
Objectives
To determine the association between chest compression interruption (CCI) patterns and outcomes in pediatric patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR).
Design
Cardiopulmonary resuscitation (CPR) data were collected using defibrillator-electrode and bedside monitor waveforms from pediatric ECPR cases between 2013 and 2021. Duration and variability of CCI during cannulation for ECPR was determined and compared with survival to discharge using Fishers exact test and logistic regressions with cluster-robust se s for adjusted analyses.
Setting
Quaternary care children’s hospital.
Patients
Pediatric patients undergoing ECPR.
Interventions
None.
Measurements and Main Results
Of 41 ECPR events, median age was 0.7 years (Q1, Q3: 0.1, 5.4), 37% (15/41) survived to hospital discharge with 73% (11/15) of survivors having a favorable neurologic outcome. Median duration of CPR from start of ECPR cannulation procedure to initiation of extracorporeal membrane oxygenation (ECMO) flow was 21 minutes (18, 30). Median duration of no-flow times associated with CCI during ECMO cannulation was 11 seconds (5, 28). Following planned adjustment for known confounders, survival to discharge was inversely associated with maximum duration of CCI (odds ratio [OR] 0.91 [0.86–0.95], p = 0.04) as well as the variability in the CCI duration (OR 0.96 [0.93–0.99], p = 0.04). Cases with both above-average CCI duration and higher CCI variability ( sd > 30 s) were associated with lowest survival (12% vs. 54%, p = 0.009). Interaction modeling suggests that lower variability in CCI is associated with improved survival, especially in cases where average CCI durations are higher.
Conclusions
Shorter duration of CCI and lower variability in CCI during cannulation for ECPR were associated with survival following refractory pediatric cardiac arrest.
Background
Out-of-hospital cardiac arrest (OHCA) is a persistent global health challenge, owing, in part, to low rates of population CPR training. Smartphone applications have the potential to widely disseminate CPR basic training to a populace, but other studies have found multiple limitations in previously developed CPR guidance applications (CPR-GA). This study aims to use medical simulation to assess the relative CPR performance of novices using the ‘Rescue Me CPR!’ (RMC) app, a custom CPR-GA designed by this research team, to novices using ‘PG-CPR!’ (PGC), the most downloaded CPR-GA available in the USA, and to CPR certified medical personnel.
Methods
In a prospective randomized experimental trial of 60 individuals, subjects were either given the RMC app, the PGC app, or had active CPR certification. They were presented a cardio-pulmonary arrest scenario and were observed while performing CPR on a high-fidelity manikin. Data was collected through four cycles of CPR, during which time 24 pertinent performance metrics and CPR steps were timed and recorded. These metrics were assessed on their own and used to calculate average time to compressions, average chest compression fraction, and rate of high-quality CPR for each study group.
Results
CPR certified subjects called 911 in 100 % of simulation cases, started compressions 34 ± 10 s after first seeing the simulated patient, had an average chest compression fraction of 0.52, and performed high-quality CPR in 25 % of aggregate compression cycles. PGC app users called 911 in 70 % of simulation cases, started compressions 86 ± 17 s after first seeing the simulated patient, had an average chest compression fraction that could not be assessed due to inconsistent pauses during CPR, and performed high-quality CPR in 2.5 % of aggregate compression cycles. RMC app users called 911 in 100 % of simulation cases, started compressions 55 ± 6 s after first seeing the simulated patient, had an average chest compression fraction of 0.48, and performed high-quality CPR in 50 % of aggregate compression cycles.
Conclusion
The results of this study demonstrate that in all studied metrics, except time-to-first-compression, CPR provided by individuals using the RMC app is statistically equivalent or superior to CPR performed by a CPR certified individual and, in almost every metric, superior to CPR performed by users of the most downloaded android CPR guidance application, PG-CPR.
