Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality

Kleinman, Monica E.; Brennan, Erin; Goldberger, Zachary D.; Swor, Robert A.; Terry, Mark A.; Bobrow, Bentley J.; Gazmuri, Raúl J.; Travers, Andrew H.; Rea, Thomas D.

doi:10.1161/cir.0000000000000259

Cited by 780 publications

(346 citation statements)

References 147 publications

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“…Recent European Resuscitation Council (ERC) and AHA guidelines recommend a CC rate between 100 and 120 per minute (cpm) [23,24]. According to the literature, the strong consensus about the target CC depth and CC rate has not yet been reached [25,26].…”

Section: Both European and American Guidelines For Resuscitationmentioning

confidence: 99%

Factors influencing high-quality chest compressions during cardiopulmonary resuscitation scenario, according to 2015 American Heart Association Guidelines

et al. 2018

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A b s t r a c tBackground and aim: Recent American Heart Association guidelines from 2010 and 2015 stressed the importance of high-quality chest compression and defined standards for compression rate, depth, recoil, and maximal acceptable time for interruptions. High-quality cardiopulmonary resuscitation (CPR) is the "cornerstone" of a system of care that can optimise outcomes beyond the return of spontaneous circulation. Methods:One hundred medical students were enrolled to the study. Study participants, after attending a Basic Life Support Course according to American Heart Association 2015 guidelines, performed 2-min CPR on a Resusci Anne ® QCPR Manikin. The following data were collected: age, sex, and health status. The study made use of a Tanita MC-980 MA for body composition analysis.Results: Mean height of participants was 170.2 ± 8.3 cm, and mean weight was 65 ± 11.8 kg. Mean body mass index was 22.1 ± 2.7, and mean fat-free mass (FFM) was 50.1 ± 10.5 kg. The mean fat mass (FAT%) was 22.9 ± 7.6. Basal metabolic rate, FFM, trunk muscle mass, left arm muscle mass, and right arm muscle mass were positively correlated with compression depth (all p for trend < 0.05). Mean compression depth was 49.7 ± 8.4 (for female 48.7 ± 7.9 mm, for male 42.4 ± 9.5 mm; p = 0.144). Compression rate for males and females was the same, at 114 ×/min (p = 0.769). Conclusions:In our study, basal metabolic rate, FFM, trunk muscle mass, and left and right arm muscle mass were positively correlated with compression depth. Moreover, an arm muscle mass rise of 1 kg caused a rise of compression depth parameter of 7.3 mm, while when chest compression was performed by females, a fall of compression depth of 3.3 mm was seen.

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Section: Both European and American Guidelines For Resuscitationmentioning

confidence: 99%

Factors influencing high-quality chest compressions during cardiopulmonary resuscitation scenario, according to 2015 American Heart Association Guidelines

et al. 2018

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“…1 This study showed that patient survival to hospital discharge was highest when compressions were between 100 and 120 per minute, 1 which is reflected in the latest update of the resuscitation guideline from the American Heart Association. 2 …”

Section: Chest Compressions During Cardiopulmonary Resuscitation Shoumentioning

confidence: 99%

Cardiopulmonary resuscitation

Khan¹,

Weston²

2014

Medicine

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Chest compressions during cardiopulmonary resuscitation should be fast pushesIn adult patients with out-of-hospital cardiac arrest, a large multicentre prospective observational study reported that more than 50% of rescuers performing cardiopulmonary resuscitation (CPR) provided chest compressions faster than the recommended rate of 100 per minute. 1 This study showed that patient survival to hospital discharge was highest when compressions were between 100 and 120 per minute, 1 which is reflected in the latest update of the resuscitation guideline from the American Heart Association. 2 2 Perishock pauses should be limited to improve survival Perishock pauses are pauses before and after defibrillatory shock. In a recent large observational study on the impact of perishock pauses in patients with out-of-hospital cardiac arrest, survival to hospital discharge was significantly higher for those patients who received preshock pauses of less than 10 seconds and total perishock pauses of less than 20 seconds during CPR. 3 Perishock pauses are strong independent predictors of survival from out-of-hospital cardiac arrest; they should be minimized during CPR by performing compressions while the defibrillator is charging. Rescuers may adopt an interrupted or continuous CPR strategyBystander CPR is the most important predictor of survival from cardiac arrest. Any interruptions in chest compressions are associated with reduced blood flow and worse survival. For this reason, and because ventilation is a difficult skill to acquire for those who are not health care professionals, the guideline update recommends that members of the public provide uninterrupted continuous chest compressions. 2 Trained rescuers should provide 30 chest compressions that are interrupted by no more than 10 seconds to provide two ventilations. 2 Vasopressin offers no advantage over epinephrine in cardiac arrestThere is limited evidence to suggest that vasopressin and epinephrine can similarly improve return of spontaneous circulation and survival to hospital discharge. Because simplicity is important during resuscitation efforts, the guideline update specifically recommends that epinephrine be administered as soon as possible following onset of cardiac arrest. 4 5 A target temperature should be maintained in the postcardiac arrest period All adult patients who are comatose with return of spontaneous circulation following cardiac arrest should receive targeted temperature management. The guideline update recommends selecting and achieving a single target temperature between 32°C and 36°C, which should be maintained constantly for at least 24 hours. 5 PRACTICE | FIVE THINGS TO KNOW ABOUT

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“…The current application of S-CPR is based on the technique of "external chest compression" that was defined by Kouwenhoven in 1960 and comprises the phases of active compression and passive decompression. Despite the evolution of resuscitation medicine, the limited improvement in survival rates following cardiac arrest has led researchers to explore the possibility of different CPR techniques and also to develop devices that support ventilation and circulation (2)(3)(4)(5)(6). This manuscript was prepared to review the experimental and clinical studies conducted on the historical progress and effectiveness of mechanical chest compression devices (MCCD).…”

Section: Introductionmentioning

confidence: 99%