scholarly journals Effect of Chest Compression Position Depending on the Rescuer’s Hip Joint Angle During Basic CPR

2020 ◽  
Vol 34 (2) ◽  
pp. 103-109
Author(s):  
Jae-Min Lee ◽  
Hyeong-Wan Yun
Keyword(s):  
Chest Compression ◽  
Hip Joint ◽  
Joint Angle ◽  
Chest Compressions ◽  
Compression Speed ◽  
Compression Time ◽  
Significant Difference ◽  
Cpr Quality ◽  
And Control

This study aims to investigate the improvement in basic CPR quality on the basis of the hip joint angle of the rescuer among students in the Department of Emergency Medical Technology who completed a basic CPR curriculum. In this study, we carried out a comparative analysis using SimPad SkillReporter and Resusci Anne® QCPR® to measure the quality of CPR (depth of chest compressions, full relaxation, compression speed, and more) on the basis of the rescuer’s hip joint angle in accordance with the 2015 AHA Guidelines and conducted chest compressions and CPR 5 times in a 30:2 ratio. It was found that maintenance of the rescuer’s hip joint angle at 90 degrees while compressing and relaxing the chest made a statistically significant difference in both the experimental and control groups. Moreover, this indicated that the closer the hip joint angle was to 90 degrees, the better was the quality of basic CPR. However, there was no significant difference in the hip joint angle, degree of CPR, depth of chest compressions, chest compression speed, chest compression and relaxation percentages (%), accuracy of chest compressions, hands-off time during CPR, and percentage of chest compression time (p > 0.05). Maintaining the hip joint angle at 90 degrees for basic CPR was not significantly different from not maintaining this angle. Nonetheless, good results have been obtained at moderate depth and 100% recoil. Therefore, good outcome and high-quality CPR are expected.

scholarly journals Impact of Postshock Transcutaneous Pacing on Chest Compression Quality during Resuscitation: A Simulation-Based Pilot Study

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Wojciech Telec ◽  
Tomasz Kłosiewicz ◽  
Radosław Zalewski ◽  
Julia Żukowska-Karolak ◽  
Artur Baszko ◽  
...  
Keyword(s):  
Chest Compression ◽  
Control Group ◽  
High Fidelity Simulation ◽  
Chest Compressions ◽  
Current Output ◽  
Significant Difference ◽  
Simulation Based ◽  
Transcutaneous Pacing ◽  
And Control

Background. Successful defibrillation is commonly followed by a transient nonperfusing state. To provide perfusion in this stagnant phase, chest compressions are recommended irrespective of arrhythmia termination. Implantable cardioverters-defibrillators (ICD) used immediately after delivery of the shock are capable of pacing the heart, and this feature is commonly activated in these devices. Potential utility of external, transcutaneous postshock pacing in patients with SCA in shockable rhythms has not been determined. This study aimed at presenting an impact of a short-term external postshock pacing (ePSP) on a quality of chest compressions (CC) without compromising them. Methods. The study was designed as a high-fidelity simulation study. Twenty triple-paramedic teams were invited. Participants were asked to take part in a 10-minute adult cardiac arrest scenario with ventricular fibrillation. In the first simulation, paramedics had to resume compressions after each shock (control group). In the second, simultaneous with compressions, one of the rescuers started transcutaneous pacing (TCP) with a current output of 200 mA and a pacer rate of 80 ppm. TCP was finished after 30 seconds (experimental group). The primary outcomes were chest compression fraction (CCF), mean depth and rate of compressions, percent of fully recoiled compressions, and percent of compressions of correct depth and their rate. Results. In both experimental and control group, CCF, mean depth, and rate were similar (84.65 ± 3.67 vs. 85.45 ± 4.95, p = 0.54 ; 55.75 ± 3.40 vs. 55.25 ± 2.73, p = 0.63 ; 122.70 ± 4.92 vs. 120.80 ± 6.00, p = 0.25 , respectively). In turn, percent of CC performed in correct depth, rate, and recoil was unsatisfactory in both groups (51.00 ± 17.40 vs. 52.60 ± 18.72, p = 0.76 ; 122.70 ± 4.92 vs. 120.80 ± 6.00, p = 0.25 , respectively). Small differences were not statistically significant. Moreover, appropriate hand-positioning was observed more frequently in the control group, and this was the only significant difference (95.60 ± 5.32 vs. 99.30 ± 1.59, p = 0.006 ). Conclusion. This difference was statistically significant ( p < 0.01 ). Introducing an ePSP does not influence relevantly the quality of CC.

scholarly journals Comparison of standard and over-the-head method of chest compressions during cardiopulmonary resuscitation - a simulation study

2019 ◽  
Author(s):  
Michał Ćwiertnia ◽  
Marek Kawecki ◽  
Tomasz Ilczak ◽  
Monika Mikulska ◽  
Mieczysław Dutka ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Artificial Ventilation ◽  
Hand Position ◽  
Chest Compressions ◽  
Confined Spaces ◽  
Medical Response ◽  
Significant Difference ◽  
Emergency Interventions

Abstract Background: Maintaining highly effective cardiopulmonary resuscitation (CPR) can be particularly difficult when artificial ventilation using a bag-valve-mask device, combined with chest compression have to be carried out by one person. The aim of the study is to compare the quality of CPR conducted by one paramedic using chest compression from the patient’s side with compression conducted from the ‘over-the-head’ position. Methods: The subject of the study were two methods of CPR – ‘standard’ (STD) and ‘over-the-head’ (OTH). The STD method consisted of cycles of 30 chest compressions from the patient’s side, and two attempts at artificial ventilation after moving round to behind the patient’s head. In the OTH method, both compression and ventilation were conducted from behind the patient’s head. Results: Both CPR methods were conducted by 38 paramedics working in medical response teams. Statistical analysis was conducted on the data collected, giving the following results: the average time of the interruptions between compression cycles (STD 9.184 s, OTH 7.316 s, p < 0.001); the depth of compression 50–60 mm (STD 50.65%, OTH 60.22%, p < 0.001); the rate of compression 100–120/min. (STD 46.39%, OTH 53.78%, p < 0.001); complete chest wall recoil (STD 84.54%, OTH 91.46%, p < 0.001); correct hand position (STD 99.32%, OTH method 99.66%, p < 0.001). A statistically significant difference was demonstrated in the results to the benefit of the OTH method in the above parameters. The remaining parameters showed no significant differences in comparison to reference values. Conclusions: The demonstrated higher quality of CPR in the simulated research using the OTH method conducted by one person justifies the use of this method in a wider range of emergency interventions than only for CPR conducted in confined spaces.

scholarly journals Real-Time Chest Compression Quality Measurements by Smartphone Camera

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Øyvind Meinich-Bache ◽  
Kjersti Engan ◽  
Tonje Søraas Birkenes ◽  
Helge Myklebust
Keyword(s):  
Cardiac Arrest ◽  
Real Time ◽  
Chest Compression ◽  
Quality Measurement ◽  
Smartphone Application ◽  
Average Error ◽  
Compression Rate ◽  
Chest Compressions ◽  
Compression Time ◽  
Cpr Quality

Out-of-hospital cardiac arrest (OHCA) is recognized as a global mortality challenge, and digital strategies could contribute to increase the chance of survival. In this paper, we investigate if cardiopulmonary resuscitation (CPR) quality measurement using smartphone video analysis in real-time is feasible for a range of conditions. With the use of a web-connected smartphone application which utilizes the smartphone camera, we detect inactivity and chest compressions and measure chest compression rate with real-time feedback to both the caller who performs chest compressions and over the web to the dispatcher who coaches the caller on chest compressions. The application estimates compression rate with 0.5 s update interval, time to first stable compression rate (TFSCR), active compression time (TC), hands-off time (TWC), average compression rate (ACR), and total number of compressions (NC). Four experiments were performed to test the accuracy of the calculated chest compression rate under different conditions, and a fifth experiment was done to test the accuracy of the CPR summary parameters TFSCR, TC, TWC, ACR, and NC. Average compression rate detection error was 2.7 compressions per minute (±5.0 cpm), the calculated chest compression rate was within ±10 cpm in 98% (±5.5) of the time, and the average error of the summary CPR parameters was 4.5% (±3.6). The results show that real-time chest compression quality measurement by smartphone camera in simulated cardiac arrest is feasible under the conditions tested.

scholarly journals Comparison of standard and over-the-head method of chest compressions during cardiopulmonary resuscitation - a simulation study

2019 ◽  
Author(s):  
Michał Ćwiertnia ◽  
Marek Kawecki ◽  
Tomasz Ilczak ◽  
Monika Mikulska ◽  
Mieczysław Dutka ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Artificial Ventilation ◽  
Hand Position ◽  
Chest Compressions ◽  
Medical Response ◽  
Single Person ◽  
Significant Difference ◽  
Emergency Interventions

Abstract Background: Maintaining highly effective cardiopulmonary resuscitation (CPR) can be particularly difficult when artificial ventilation using a bag-valve-mask device, combined with chest compression have to be carried out by one person. The aim of the study is to compare the quality of CPR conducted by one paramedic using chest compression from the patient’s side with compression conducted from the ‘over-the-head’ position. Methods: The subject of the study were two methods of CPR – ‘standard’ (STD) and ‘over-the-head’ (OTH). The STD method consisted of cycles of 30 chest compressions from the patient’s side, and two attempts at artificial ventilation after moving round to behind the patient’s head. In the OTH method, both compressions and ventilations were conducted from behind the patient’s head. Results: Both CPR methods were conducted by 38 paramedics working in medical response teams. Statistical analysis was conducted on the data collected, giving the following results: the average time of the interruptions between compression cycles (STD 9.184 s, OTH 7.316 s, p < 0.001); the depth of compression 50–60 mm (STD 50.65%, OTH 60.22%, p < 0.001); the rate of compression 100–120/min. (STD 46.39%, OTH 53.78%, p < 0.001); complete chest wall recoil (STD 84.54%, OTH 91.46%, p < 0.001); correct hand position (STD 99.32%, OTH method 99.66%, p < 0.001). A statistically significant difference was demonstrated in the results to the benefit of the OTH method in the above parameters. The remaining parameters showed no significant differences in comparison to reference values. Conclusions: The higher quality of CPR in the simulated research using the OTH method by a single person justifies the use of this method in a wider range of emergency interventions.

Abstract 333: End-Tidal Carbon Dioxide, CPR Quality and ROSC During Pediatric Cardiac Arrests in a Large Academic Children’s Hospital, 2013-2018

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Jill L Sorcher ◽  
Elizabeth A Hunt ◽  
Donald H Shaffner ◽  
Justin Jeffers ◽  
Heather Newton ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Chest Compression ◽  
Chest Compressions ◽  
Significant Difference ◽  
End Tidal Carbon Dioxide ◽  
Study Population ◽  
Cpr Quality ◽  
Data Files ◽  
Pediatric Populations ◽  
End Tidal

Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} Little evidence exists to guide end-tidal carbon dioxide (ETCO 2 ) use during cardiac arrest events in pediatric populations. Despite this, integrating physiologic feedback, including ETCO 2 , into resuscitation optimization is recognized as an important component to precision resuscitation. This was a prospective observational study of ETCO 2 , CPR quality and ROSC. The study population included any pediatric patient who received chest compressions from January 1, 2013 through July 10, 2018 in the Johns Hopkins Children’s Center. During this time, 457 arrest events of any length requiring chest compressions occurred. Of these events, 274 utilized ETCO 2 in some capacity and 198 recorded ETCO 2 on a Zoll R Series® defibrillator. Data files from 145 of these events that contained both chest compression and ETCO 2 data were successfully obtained. These 145 events contained 2200 minutes of ETCO 2 data and 2156 minutes of both chest compression and ETCO 2 data; values are reported as median [IQR]. The average ETCO 2 for all events was 21 mmHg [15-32]. ETCO 2 by age category was (0-1: 12 [0-29]; 1-8: 20 [2-35]; 8+: 10.15 [0-21]). When comparing patients who achieved ROSC > 20 minutes to those who did not, we observed a significant difference in ETCO 2 between those who survived and those who did not (ROSC: 25 [15-30] vs. NO ROSC: 15 [9-22]; p<0.001). Analysis to assess associations between ROSC and chest compression depth, rate, and fraction are underway. In this analysis of the largest set of pediatric ETCO 2 and resuscitation data, our findings suggest that a difference may exist in survival associated with an ETCO 2 difference between 15 and 20 mmHg.

scholarly journals Comparison of standard and over-the-head method of chest compressions during cardiopulmonary resuscitation - a simulation study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Michał Ćwiertnia ◽  
Marek Kawecki ◽  
Tomasz Ilczak ◽  
Monika Mikulska ◽  
Mieczysław Dutka ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Artificial Ventilation ◽  
Hand Position ◽  
Chest Compressions ◽  
Medical Response ◽  
Single Person ◽  
Significant Difference ◽  
Emergency Interventions

Abstract Background Maintaining highly effective cardiopulmonary resuscitation (CPR) can be particularly difficult when artificial ventilation using a bag-valve-mask device, combined with chest compression have to be carried out by one person. The aim of the study is to compare the quality of CPR conducted by one paramedic using chest compression from the patient’s side with compression conducted from the ‘over-the-head’ position. Methods The subject of the study were two methods of CPR – ‘standard’ (STD) and ‘over-the-head’ (OTH). The STD method consisted of cycles of 30 chest compressions from the patient’s side, and two attempts at artificial ventilation after moving round to behind the patient’s head. In the OTH method, both compressions and ventilations were conducted from behind the patient’s head. Results Both CPR methods were conducted by 38 paramedics working in medical response teams. Statistical analysis was conducted on the data collected, giving the following results: the average time of the interruptions between compression cycles (STD 9.184 s, OTH 7.316 s, p < 0.001); the depth of compression 50–60 mm (STD 50.65%, OTH 60.22%, p < 0.001); the rate of compression 100–120/min. (STD 46.39%, OTH 53.78%, p < 0.001); complete chest wall recoil (STD 84.54%, OTH 91.46%, p < 0.001); correct hand position (STD 99.32%, OTH method 99.66%, p < 0.001). A statistically significant difference was demonstrated in the results to the benefit of the OTH method in the above parameters. The remaining parameters showed no significant differences in comparison to reference values. Conclusions The higher quality of CPR in the simulated research using the OTH method by a single person justifies the use of this method in a wider range of emergency interventions.

Abstract 258: Did We Already Reach the Best Achievable Quality of Chest Compression in Vienna?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sebastian Zeiner
Keyword(s):  
Chest Compression ◽  
Spontaneous Circulation ◽  
Ambulance Service ◽  
Control Center ◽  
Significant Difference ◽  
Hands On ◽  
The One ◽  
High Level ◽  
And Control

INTRODUCTION: Annually ~45 citizens per 100,000 have no signs of circulation and are assessed by teams of the Vienna Ambulance Service. Only in 25 percent of these cases sustained return of spontaneous circulation (ROSC) is achieved and merely unsatisfying 11.3 percent leave the hospital again. The goal of this project is to follow up on chest compression performances of the ambulance crews in Vienna after the Circulation Improving Resuscitation Care (CIRC) Trial some years ago. METHODS: This observational trial assesses the quality of chest compression based on the guideline recommendations. Data are gathered from run-reports and written event recordings as described by the Utstein criteria including command and control center and emergency call records, ECG, thoracic impedance data, vital parameters as well as hospital records. During the collection of this data, the ambulance service of Vienna received standardized feedback on their CPR performance. RESULTS: From August 1, 2013 to April 30, 2014701 patients were registered. MedianCompression ratewas 108/min.Median fraction of time in which chest compression were given with the target rate of 100 to 120/min, per case is 75% and median hands on fraction was 82%.Mean percentage of minutes with a hands off fraction of 75 or higher is 72% (SD ± 24). Comparing the group who regained ROSC to those who did not no significant difference can be found in either hands on fraction as well as frequency. The confidence interval of hands on fraction within the group that regained ROSC is between 75% and 80% compared to 74% and 78% within the group that did not. CONCLUSION: The missing presence of any difference between the groups with regained ROSC and the one that did not leads to the conclusion that the quality of chest compression is on overall high level and further improvement is hardly possible and will most likely not lead to further more ROSC.

scholarly journals Over the head and lateral position technique for cardiopulmonary resuscitation: which one is better?

MEDISAINS ◽  
2020 ◽  
Vol 18 (2) ◽  
pp. 80
Author(s):  
Ivo Feorentina ◽  
Kuswantoro Rusca Putra ◽  
Suryanto Suryanto
Keyword(s):  
Chest Compression ◽  
Lateral Position ◽  
Head Position ◽  
Quality Score ◽  
High Rate ◽  
Compression Speed ◽  
Cpr Quality ◽  
Alternative Position ◽  
Better Than

Background: A high rate of cardiac arrest requires high-quality CPR. A valuable CPR rescuer has lower success than two or more rescuers, especially with the use of BVM. There is a complexity encountered with lateral CPR position as a commonly used position, which is the difficulty of position movement from compression to ventilation. On the other hand, Over the Head CPR position is used as an alternative position, which is considered more effective than a lateral position. It is also considered to be able to overcome the obstacles found in CPR with a single rescuer using BVM ventilation in the lateral position so that study is required to compare the quality of CPR between the two CPR positions.Technique: The quality of CPR between Over the Head position CPR and Lateral position CPR is compared. The technique testing was carried out on 24 students using a mannequin. CPR quality components include compression ratios: ventilation, speed, depth, hand placement, chest recoil, and the amount of time of chest compression interruption were observed strictly. The overall CPR quality score, particularly in terms of compression speed and the minimum interruption time of chest compression on Over the Head position, is better than lateral position CPR.Conclusion: Over the Head position, CPR significantly produces a better quality of CPR than Lateral position CPR.

scholarly journals Effects of ‘rescuer’ rotating time on the quality of chest compressions: 1-minute vs. 2-minute intervals

2019 ◽  
Vol 16 ◽  
Author(s):  
Farhad Gheibati ◽  
Mehdi Heidarzadeh ◽  
Mahmood Shamshiri ◽  
Fatemeh Sadeghpour
Keyword(s):  
Experimental Study ◽  
Chest Compression ◽  
Crossover Design ◽  
Compression Rate ◽  
Chest Compressions ◽  
Total Rate ◽  
Study Results ◽  
Significant Difference ◽  
Better Than

IntroductionFatigue can influence the quality of continuous chest compression cardiopulmonary resuscitation (CCC-CPR). This study was conducted to compare the effect of ‘rescuer’ rotating time on the quality of chest compressions at 1-minute and 2-minute intervals.MethodsThe present semi-experimental study was conducted on 70 non-professional ‘rescuers’ as 35 two-person teams using a crossover design. All teams performed eight 2-minute cycles of CCC-CPR with a rotation of 1 minute and 2 minutes. Quality metrics of the chest compression rate, appropriate depth of compression, and total rate of compressions at the end of eight 2-minute cycles were used to assess the quality of the chest compressions.ResultsThe study results showed that the number of chest compressions with an adequate depth performed by the non-professional rescuers in the 1- and 2-minute scenarios wererespectively 118.18 and 100.87. There was no significant difference in the number of chest compressions between the two scenarios at the end of the CCC-CPR, but the number of compressions with sufficient depth in the 1-minute scenario was better than that in the 2-minute scenario.ConclusionThe study showed that although the rate of chest compression had a downward trend in the 1-minute scenario, rescuers maintained 100 to 120 chest compressions after 16 minutes. This means that non-professional rescuers replacement after 1 minute can increase chest compression with sufficient depth.

scholarly journals Comparison of standard and over-the-head method of chest compressions during cardiopulmonary resuscitation - a simulation study

2019 ◽  
Author(s):  
Michał Ćwiertnia ◽  
Marek Kawecki ◽  
Tomasz Ilczak ◽  
Monika Mikulska ◽  
Mieczysław Dutka ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Artificial Ventilation ◽  
Hand Position ◽  
Chest Compressions ◽  
Medical Response ◽  
Single Person ◽  
Significant Difference ◽  
Emergency Interventions

Abstract Background: Maintaining highly effective cardiopulmonary resuscitation (CPR) can be particularly difficult when artificial ventilation using a bag-valve-mask device, combined with chest compression have to be carried out by one person. The aim of the study is to compare the quality of CPR conducted by one paramedic using chest compression from the patient’s side with compression conducted from the ‘over-the-head’ position. Methods: The subject of the study were two methods of CPR – ‘standard’ (STD) and ‘over-the-head’ (OTH). The STD method consisted of cycles of 30 chest compressions from the patient’s side, and two attempts at artificial ventilation after moving round to behind the patient’s head. In the OTH method, both compressions and ventilations were conducted from behind the patient’s head. Results: Both CPR methods were conducted by 38 paramedics working in medical response teams. Statistical analysis was conducted on the data collected, giving the following results: the average time of the interruptions between compression cycles (STD 9.184 s, OTH 7.316 s, p < 0.001); the depth of compression 50–60 mm (STD 50.65%, OTH 60.22%, p < 0.001); the rate of compression 100–120/min. (STD 46.39%, OTH 53.78%, p < 0.001); complete chest wall recoil (STD 84.54%, OTH 91.46%, p < 0.001); correct hand position (STD 99.32%, OTH method 99.66%, p < 0.001). A statistically significant difference was demonstrated in the results to the benefit of the OTH method in the above parameters. The remaining parameters showed no significant differences in comparison to reference values. Conclusions: The higher quality of CPR in the simulated research using the OTH method by a single person justifies the use of this method in a wider range of emergency interventions.

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