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Cardiopulmonary Resuscitation

Authors:
Faizan Khan at University of Ottawa
Faizan Khan
Christian Vaillancourt
Christian Vaillancourt
Christian Vaillancourt
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Abstract

Review of the most important recent advances in CPR; from chest compression speed to post-cardiac arrest care.
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... In 2011, the American Heart Association (AHA) published a statement recommending CPR training as a requirement for high school graduation, but this is not a common practice in most areas (Cave et al., 2011). CPR uses chest compressions to manually push the heart, pumping blood throughout the body, which circulates oxygen to vital organs (Khan & Vaillancourt, 2017). This is done by pushing on the person's sternum with the heel of the hand and compressing the area at a rate of 100-120 beats per minute with a compression depth of five to six centimeters (Khan & Vaillancourt, 2017). ...
... CPR uses chest compressions to manually push the heart, pumping blood throughout the body, which circulates oxygen to vital organs (Khan & Vaillancourt, 2017). This is done by pushing on the person's sternum with the heel of the hand and compressing the area at a rate of 100-120 beats per minute with a compression depth of five to six centimeters (Khan & Vaillancourt, 2017). ...
Using an Instructional Package to Teach Cardiopulmonary Resuscitation With Automated External Defibrillator to College Students With Intellectual Disability
Article
Full-text available
  • Nov 2018
Adults with intellectual disability may not learn safety skills needed to maintain the safety of those within their communities. Basic life-saving skills are valued by community members and increase independent and integrated living and employment opportunities. This study used an instructional package consisting of modeling, task analysis, and simultaneous prompting to teach college students with intellectual disability a basic life-saving skill, specifically how to perform cardiopulmonary resuscitation (CPR) with the use of an automated external defibrillator (AED). Phase 1 of the study used the instructional package to teach the students to perform CPR. Once mastered, Phase 2 of the study taught students to use an AED, incorporating it into the CPR chain. Results showed that the students’ accuracy with the tasks increased after the introduction of the instructional package, generalized to a novel environment, and maintained once the instructional package was removed. Implications and future research are discussed.
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... The healthcare system has shifted from a paternalistic attitude to the principle of personal autonomy, and family members are often expected to actively participate in care decisions related to the treatment of their relatives [11]. Even during cardiopulmonary resuscitation (CPR), patients prefer to have their relatives near them, and many relatives also tend to be there [22]. ...
The attitude of the resuscitation team members and the patient’s companions toward the presence of the patient’s first-degree relatives during cardiopulmonary resuscitation in the emergency departments
Article
  • Dec 2023
The presence of the patient’s family at their bedside during cardiopulmonary resuscitation (CPR) is one of the challenging issues that has been frequently taken into consideration. Considering the importance of this topic. The objective of the present study was conducted to determine the attitude of the CPR team members and the patient’s companions toward the presence of the patient’s first-degree relatives during CPR. Materials and methods. The descriptive-analytical cross-sectional study was conducted on 100 CPR team members of two University Hospitals and 120 near relatives of patients undergoing CPR in 2021. The data were collected by the researcher-made questionnaire and depression, anxiety, stress scale (DASS) during CPR. The collected data were analyzed by SPSS (version 22) statistical software. Results. From the perspective of both the CPR team members and the patient’s companions, the highest mean response was related to the fact that it would be better for the patient to agree on the presence or absence of their family before hospitalization and whether they have favorable conditions. The attitude toward the presence of the patient’s family during CPR was statistically significantly associated with the companions’ gender ( p < 0.05) and with the experience of work and participation in CPR of the CPR team members ( p < 0.05). Conclusion. Taking into account the different opinions of the CPR team members and the patient’s relatives about the presence of family during resuscitation, additional studies with a large sample size should be carried out.
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... One of the explanations is sudden cardiac death (SCD) caused by cardiac arrest, which is most commonly triggered by the consequences of acute myocardial infarction (AMI) (Dumcke et al., 2019). Immediate cardiopulmonary resuscitation (CPR) or at least immediate chest compressions by nonprofessionals are necessary as Basic Life Support (BLS) techniques reduce out-ofhospital cardiac arrest fatality rates and raise the odds of survival rate by more than twice as high as that associated with no CPR before emergency medical services arrival (Khan & Vaillancourt, 2017). Several studies (Kim & Shin, 2019;Lactona & Suryanto, 2021;Magid et al., 2018) found key obstacles to CPR education, beginning with substantial funds for external teachers and special training materials must be available. ...
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... 4.5% of temperature research was performed in South America, and in 2.2% in Australia or New Zealand and in equal percentage in Africa ( figure 1and figure 2). thermology OR thermography OR "infrared thermal imaging" OR "infrared imaging" OR "thermal imaging" AND year 2017 3750 836 thermology OR thermography OR "infrared thermal imaging" OR "infrared imaging" OR "thermal imaging" OR thermometry AND year 2017 4490 1024 thermology OR thermography OR "infrared thermal imaging" OR "infrared imaging" OR "thermal imaging" OR thermometry OR "temperature measurement" AND year 2017 7349 1828 thermology OR thermography OR "infrared thermal imaging" OR "infrared imaging" OR "thermal imaging" OR thermometry OR "temperature measurement" AND year 2017 limited to medicine (humans in Embase) 902 942 thermology OR thermography OR "infrared thermal imaging" OR "infrared imaging" OR "thermal imaging" OR thermometry OR "temperature measurement" AND year 2017 limited to medicine (humans in Embase) AND ('article'/it OR 'editorial'/it OR 'letter'/it OR 'note'/it OR 'review'/it OR 'short survey'/it) 803 726 ...
Medical Thermology 2017 - A computer-assisted literature survey
Article
  • Aug 2018
The literature survey 2017 is based on 803 papers found in Scopus, 235 articles in Embase and 15 additional notes or abstracts detected in the journal "Thermology international "with the keywords "thermography" OR "infrared imaging" OR "thermology" OR "temperature measurement" OR "thermometry" AND "published in 2016" and restricted to "medicine". The papers were analysed with respect to the origin of authors, the language and the publication source. Similar as in the surveys of previous years, a detailed description is provided of publications related to Raynaud's phenomenon, Complex Regional Pain Syndrome, Breast diseases and fever measurement. Most of the publications on breast thermography originate from Asia and many authors of these papers are primarily trained in engineering science.
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2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardio pulmonary Resuscitation and Emergency Cardiovascular Care
Article
Full-text available
  • Nov 2017
Cardiopulmonary resuscitation is a lifesaving technique for victims of sudden cardiac arrest. Despite advances in resuscitation science, basic life support remains a critical factor in determining outcomes. The American Heart Association recommendations for adult basic life support incorporate the most recently published evidence and serve as the basis for education and training for laypeople and healthcare providers who perform cardiopulmonary resuscitation.
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The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial
Article
Full-text available
  • Oct 2013
Previous research has demonstrated significant relationships between peri-shock pause and survival to discharge from out-of hospital shockable cardiac arrest (OHCA). To determine the impact of peri-shock pause on survival from OHCA during the ROC PRIMED randomized controlled trial. We included patients in the ROC PRIMED trial who suffered OHCA between June 2007and November 2009, presented with a shockable rhythm and had CPR process data for at least one shock. We used multivariable logistic regression to determine the association between peri-shock pause duration and survival to hospital discharge. Among 2006 patients studied, the median (IQR) shock pause duration was: pre-shock pause 15seconds (8, 22); post-shock pause 6seconds (4, 9); and peri-shock pause 22.0seconds (14, 31). After adjusting for Utstein predictors of survival as well as CPR quality measures, the odds of survival to hospital discharge were significantly higher for patients with pre-shock pause <10seconds (OR: 1.52, 95% CI: 1.09, 2.11) and peri-shock pause<20seconds (OR: 1.82, 95% CI: 1.17, 2.85) when compared to patients with pre-shock pause ≥20seconds and peri-shock pause ≥40seconds. Post-shock pause was not significantly associated with survival to hospital discharge. Results for neurologically intact survival (Modified Rankin Score ≤3) were similar to our primary outcome. In patients with cardiac arrest presenting in a shockable rhythm during the ROC PRIMED trial, shorter pre- and peri-shock pauses were significantly associated with higher odds of survival. Future cardiopulmonary education and technology should focus on minimizing all peri-shock pauses.
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Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality
Article
  • Nov 2015
As with other Parts of the 2015 American Heart Association (AHA) Guidelines Update for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC), Part 5 is based on the International Liaison Committee on Resuscitation (ILCOR) 2015 international evidence review process. ILCOR Basic Life Support (BLS) Task Force members identified and prioritized topics and questions with the newest or most controversial evidence, or those that were thought to be most important for resuscitation. This 2015 Guidelines Update is based on the systematic reviews and recommendations of the 2015 International Consensus on CPR and ECC Science With Treatment Recommendations , “Part 3: Adult Basic Life Support and Automated External Defibrillation.”1,2 In the online version of this document, live links are provided so the reader can connect directly to the systematic reviews on the ILCOR Scientific Evidence Evaluation and Review System (SEERS) website. These links are indicated by a combination of letters and numbers (eg, BLS 740). We encourage readers to use the links and review the evidence and appendix. As with all AHA Guidelines, each 2015 recommendation is labeled with a Class of Recommendation (COR) and a Level of Evidence (LOE). The 2015 Guidelines Update uses the newest AHA COR and LOE classification system, which contains modifications of the Class III recommendation and introduces LOE B-R (randomized studies) and B-NR (nonrandomized studies) as well as LOE C-LD (based on limited data) and LOE C-EO (consensus of expert opinion). The AHA process for identification and management of potential conflicts of interest was used, and potential conflicts for writing group members are listed at the end of each Part of the 2015 Guidelines Update. For additional information about the systematic review process or management of potential conflicts of interest, see “Part 2: Evidence Evaluation and Management of Conflicts of Interest” in this …
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Part 7: Adult Advanced Cardiovascular Life Support
Article
  • Nov 2015
Basic life support (BLS), advanced cardiovascular life support (ACLS), and post–cardiac arrest care are labels of convenience that each describe a set of skills and knowledge that are applied sequentially during the treatment of patients who have a cardiac arrest. There is overlap as each stage of care progresses to the next, but generally ACLS comprises the level of care between BLS and post–cardiac arrest care. ACLS training is recommended for advanced providers of both prehospital and in-hospital medical care. In the past, much of the data regarding resuscitation was gathered from out-of-hospital arrests, but in recent years, data have also been collected from in-hospital arrests, allowing for a comparison of cardiac arrest and resuscitation in these 2 settings. While there are many similarities, there are also some differences between in- and out-of-hospital cardiac arrest etiology, which may lead to changes in recommended resuscitation treatment or in sequencing of care. The consideration of steroid administration for in-hospital cardiac arrest (IHCA) versus out-of-hospital cardiac arrest (OHCA) is one such example discussed in this Part. The recommendations in this 2015 American Heart Association (AHA) Guidelines Update for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) are based on an extensive evidence review process that was begun by the International Liaison Committee on Resuscitation (ILCOR) after the publication of the ILCOR 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations 1 and was completed in February 2015.2 In this in-depth evidence review process, the ILCOR task forces examined topics and then generated prioritized lists of questions for systematic review. Questions were first formulated in PICO (population, intervention, comparator, outcome) format,3 and then a search strategy and inclusion and exclusion criteria were defined and a search for relevant articles was performed. The evidence was evaluated by using …
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Part 10: Special Circumstances of Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Article
  • Oct 2015
This Part of the 2015 American Heart Association (AHA) Guidelines Update for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) addresses cardiac arrest in situations that require special treatments or procedures other than those provided during basic life support (BLS) and advanced cardiovascular life support (ACLS). This Part summarizes recommendations for the management of resuscitation in several critical situations, including cardiac arrest associated with pregnancy (Part 10.1), pulmonary embolism (PE) (10.2), and opioid-associated resuscitative emergencies, with or without cardiac arrest (10.3). Part 10.4 provides recommendations on intravenous lipid emulsion (ILE) therapy, an emerging therapy for cardiac arrest due to drug intoxication. Finally, updated guidance for the management of cardiac arrest during percutaneous coronary intervention (PCI) is presented in Part 10.5. A table of all recommendations made in this 2015 Guidelines Update as well as those made in the 2010 Guidelines is contained in the Appendix. The special situations of resuscitation section (Part 12) of the 2010 AHA Guidelines for CPR and ECC 1 covered 15 distinct topic areas. The following topics were last updated in 2010: Additional information about drowning is presented in Part 5 of this publication, “Adult Basic Life Support and Cardiopulmonary Resuscitation Quality.” The recommendations in this 2015 Guidelines Update are based on an extensive evidence review process that was begun by the International Liaison Committee on Resuscitation (ILCOR) with the publication of the ILCOR 2010 International Consensus on CPR and ECC Science With Treatment …
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Chest Compression Rates and Survival Following Out-of-Hospital Cardiac Arrest
Article
  • Jan 2015
  • CRIT CARE MED
Guidelines for cardiopulmonary resuscitation recommend a chest compression rate of at least 100 compressions/min. A recent clinical study reported optimal return of spontaneous circulation with rates between 100 and 120/min during cardiopulmonary resuscitation for out-of-hospital cardiac arrest. However, the relationship between compression rate and survival is still undetermined. Prospective, observational study. Data is from the Resuscitation Outcomes Consortium Prehospital Resuscitation IMpedance threshold device and Early versus Delayed analysis clinical trial. Adults with out-of-hospital cardiac arrest treated by emergency medical service providers. None. Data were abstracted from monitor-defibrillator recordings for the first five minutes of emergency medical service cardiopulmonary resuscitation. Multiple logistic regression assessed odds ratio for survival by compression rate categories (<80, 80-99, 100-119, 120-139, ≥140), both unadjusted and adjusted for sex, age, witnessed status, attempted bystander cardiopulmonary resuscitation, location of arrest, chest compression fraction and depth, first rhythm, and study site. Compression rate data were available for 10,371 patients; 6,399 also had chest compression fraction and depth data. Age (mean ± SD) was 67 ± 16 years. Chest compression rate was 111 ± 19 per minute, compression fraction was 0.70 ± 0.17, and compression depth was 42 ± 12 mm. Circulation was restored in 34%; 9% survived to hospital discharge. After adjustment for covariates without chest compression depth and fraction (n = 10,371), a global test found no significant relationship between compression rate and survival (p = 0.19). However, after adjustment for covariates including chest compression depth and fraction (n = 6,399), the global test found a significant relationship between compression rate and survival (p = 0.02), with the reference group (100-119 compressions/min) having the greatest likelihood for survival. After adjustment for chest compression fraction and depth, compression rates between 100 and 120 per minute were associated with greatest survival to hospital discharge.
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American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
  • Jan 2015
  • CIRCULATION
  • 414-435
American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132:S414-35.