CPR with restricted patient access using alternative rescuer positions: a randomised cross-over manikin study simulating the CPR scenario after avalanche burial
Autor: | Bernd Wallner, Giacomo Strapazzon, Gabriel Putzer, Luca Moroder, Markus Falk, Stefanie Wallner, Hermann Brugger, Hannah Salchner, Peter Mair |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Cross over
Resuscitation Pocket mask business.industry Decompression RC86-88.9 medicine.medical_treatment Confined space Medical emergencies. Critical care. Intensive care. First aid Critical Care and Intensive Care Medicine Ventilation law.invention Asphyxia law Anesthesia Ventilation (architecture) Emergency Medicine Medicine Cardiopulmonary resuscitation Gastric insufflation Atypical rescuer position business Tidal volume Original Research |
Zdroj: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 29, Iss 1, Pp 1-8 (2021) Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
ISSN: | 1757-7241 |
Popis: | Background The aim of this manikin study was to evaluate the quality of cardiopulmonary resuscitation (CPR) with restricted patient access during simulated avalanche rescue using over-the-head and straddle position as compared to standard position. Methods In this prospective, randomised cross-over study, 25 medical students (64% male, mean age 24) performed single-rescuer CPR with restricted patient access in over-the-head and straddle position using mouth-to-mouth ventilation or pocket mask ventilation. Chest compression depth, rate, hand position, recoil, compression/decompression ratio, hands-off times, tidal volume of ventilation and gastric insufflation were compared to CPR with unrestricted patient access in standard position. Results Only 28% of all tidal volumes conformed to the guidelines (400–800 ml), 59% were below 400 ml and 13% were above 800 ml. There was no significant difference in ventilation parameters when comparing standard to atypical rescuer positions. Participants performed sufficient chest compressions depth in 98.1%, a minimum rate in 94.7%, correct compression recoil in 43.8% and correct hand position in 97.3% with no difference between standard and atypical rescuer positions. In 36.9% hands-off times were longer than 9 s. Conclusions Efficacy of CPR from an atypical rescuer position with restricted patient access is comparable to CPR in standard rescuer position. Our data suggest to start basic life-support before complete extrication in order to reduce the duration of untreated cardiac arrest in avalanche rescue. Ventilation quality provided by lay rescuers may be a limiting factor in resuscitation situations where rescue ventilation is considered essential. |
Databáze: | OpenAIRE |
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