Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest
Lars Wik,Jo Kramer-Johansen,Helge Myklebust,Hallstein Sørebø,Leif Svensson,Bob Fellows,Petter Andreas Steen +6 more
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TLDR
In this study of CPR during out-of-hospital cardiac arrest, chest compressions were not delivered half of the time, and most compressions was too shallow.Abstract:
ContextCardiopulmonary resuscitation (CPR) guidelines recommend target values
for compressions, ventilations, and CPR-free intervals allowed for rhythm
analysis and defibrillation. There is little information on adherence to these
guidelines during advanced cardiac life support in the field.ObjectiveTo measure the quality of out-of-hospital CPR performed by ambulance
personnel, as measured by adherence to CPR guidelines.Design and SettingCase series of 176 adult patients with out-of-hospital cardiac arrest
treated by paramedics and nurse anesthetists in Stockholm, Sweden, London,
England, and Akershus, Norway, between March 2002 and October 2003. The defibrillators
recorded chest compressions via a sternal pad fitted with an accelerometer
and ventilations by changes in thoracic impedance between the defibrillator
pads, in addition to standard event and electrocardiographic recordings.Main Outcome MeasureAdherence to international guidelines for CPR.ResultsChest compressions were not given 48% (95% CI, 45%-51%) of the time
without spontaneous circulation; this percentage was 38% (95% CI, 36%-41%)
when subtracting the time necessary for electrocardiographic analysis and
defibrillation. Combining these data with a mean compression rate of 121/min
(95% CI, 118-124/min) when compressions were given resulted in a mean compression
rate of 64/min (95% CI, 61-67/min). Mean compression depth was 34 mm (95%
CI, 33-35 mm), 28% (95% CI, 24%-32%) of the compressions had a depth of 38
mm to 51 mm (guidelines recommendation), and the compression part of the duty
cycle was 42% (95% CI, 41%-42%). A mean of 11 (95% CI, 11-12) ventilations
were given per minute. Sixty-one patients (35%) had return of spontaneous
circulation, and 5 of 6 patients discharged alive from the hospital had normal
neurological outcomes.ConclusionsIn this study of CPR during out-of-hospital cardiac arrest, chest compressions
were not delivered half of the time, and most compressions were too shallow.
Electrocardiographic analysis and defibrillation accounted for only small
parts of intervals without chest compressions.read more
Citations
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Journal ArticleDOI
European Resuscitation Council Guidelines for Resuscitation 2010 Section 4 Adult advanced life support
Charles D. Deakin,Jerry P. Nolan,Jasmeet Soar,Kjetil Sunde,Rudolph W. Koster,Gary B. Smith,Gavin D. Perkins +6 more
TL;DR: Cardiothoracic anesthetic, Southampton General Hospital, Southampton, UK Anesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK Anaesthesia and intensive care medicine, Southmead Hospital, Bristol, UK Surgical ICU, Oslo University Hospital Ulleval, Oslo, Norway Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands Critical Care and Resuscitation, University of Warwick, Warwick Medical School, Warwick, UK
Journal ArticleDOI
Part 14: Pediatric Advanced Life Support 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Monica E. Kleinman,Leon Chameides,Stephen M. Schexnayder,Ricardo A. Samson,Mary Fran Hazinski,Dianne L. Atkins,Marc D. Berg,Allan R. de Caen,Ericka L. Fink,Eugene B. Freid,Robert W. Hickey,Bradley S. Marino,Vinay M. Nadkarni,Lester T. Proctor,Faiqa Qureshi,Kennith Sartorelli,Alexis A. Topjian,Elise W. van der Jagt,Arno Zaritsky +18 more
TL;DR: In contrast to adults, cardiac arrest in infants and children does not usually result from a primary cardiac cause, more often it is the terminal result of progressive respiratory failure or shock, also called an asphyxial arrest.
Journal ArticleDOI
European Resuscitation Council Guidelines for Resuscitation 2010 Section 2. Adult basic life support and use of automated external defibrillators.
Rudolph W. Koster,Michael Baubin,Leo Bossaert,Antonio Caballero,Pascal Cassan,Maaret Castrén,Cristina Granja,Anthony J. Handley,Koenraad G. Monsieurs,Gavin D. Perkins,Violetta Raffay,Claudio Sandroni +11 more
TL;DR: This section contains the guidelines for adult BLS by lay rescuers and for the use of an automated external defibrillator (AED), which includes recognition of sudden cardiac arrest, the recovery position and management of choking.
Journal ArticleDOI
Post-cardiac arrest syndrome: Epidemiology, pathophysiology, treatment, and prognostication ☆ ☆☆ ★: A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke
Jerry P. Nolan,Robert W. Neumar,Christophe Adrie,Mayuki Aibiki,Robert A. Berg,Bernd W. Böttiger,Clifton W. Callaway,Robert S B Clark,Romergryko G. Geocadin,Edward C. Jauch,Karl B. Kern,Ivan Laurent,W. T. Longstreth,Raina M. Merchant,Peter T. Morley,Laurie J. Morrison,Vinay M. Nadkarni,Mary Ann Peberdy,Emanuel P. Rivers,Antonio Rodriguez-Nunez,Frank W. Sellke,Christian Spaulding,Kjetil Sunde,Terry L. Vanden Hoek +23 more
TL;DR: A growing body of knowledge suggests that the individual components of the post-cardiac arrest syndrome are potentially treatable.
Journal ArticleDOI
Post–Cardiac Arrest Syndrome
Robert W. Neumar,Jerry P. Nolan,Christophe Adrie,Mayuki Aibiki,Robert A. Berg,Bernd W. Böttiger,Clifton W. Callaway,Robert S B Clark,Romergryko G. Geocadin,Edward C. Jauch,Karl B. Kern,Ivan Laurent,W. T. Longstreth,Raina M. Merchant,Peter T. Morley,Laurie J. Morrison,Vinay M. Nadkarni,Mary Ann Peberdy,Emanuel P. Rivers,Antonio Rodriguez-Nunez,Frank W. Sellke,Christian Spaulding,Kjetil Sunde,Terry L. Vanden Hoek +23 more
TL;DR: This scientific statement outlines current understanding and identifies knowledge gaps in the pathophysiology, treatment, and prognosis of patients who regain spontaneous circulation after cardiac arrest to provide a resource for optimization of post–cardiac arrest care.
References
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Mary Ann Peberdy,William Kaye,Joseph P. Ornato,Gregory Luke Larkin,Vinay M. Nadkarni,Mary E. Mancini,Robert A. Berg,Graham Nichol,Tanya Lane-Trultt +8 more
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Journal ArticleDOI
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Journal ArticleDOI
Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the ‘Utstein style’
Douglas Chamberlain,Richard O. Cummins,N. Abramson,M. Allen,Peter Baskett,Lance B. Becker,Leo Bossaert,Herman H Delooz,Wolfgang Dick,Mickey Eisenberg,Thomas Evans,Stig Holmberg,Richard E. Kerber,A. Mullie,Joseph P. Ornato,Eric Sandoe,Andreas Skulberg,Hugh Tunstall-Pedoe,Richard Swanson,William H. Thies +19 more