• Resuscitation · Jan 2019

    Randomized Controlled Trial

    What is the best position to place and re-evaluate an unconscious but normally breathing victim? A randomised controlled human simulation trial on children.

    • Rubén Navarro-Patón, Miguel Freire-Tellado, Noel Fernández-González, Silvia Basanta-Camiño, Javier Mateos-Lorenzo, and Joaquín Lago-Ballesteros.
    • University of Santiago de Compostela, Faculty of Teacher Training, Avda. Ramón Ferreiro sn, C.P. 27001, Lugo, Spain. Electronic address: ruben.navarro.paton@usc.es.
    • Resuscitation. 2019 Jan 1; 134: 104-109.

    BackgroundCurrent resuscitation guidelines endorse placing the unconscious and normally breathing victims in the recovery position (RP), but this technique might hinder breathing evaluation.AimTo compare breathing evaluation and cardiac arrest detection: placing the victim in RP and checking breathing regularly, placing the victim in RP while re-evaluating breathing every minute, and placing the victim on his back, maintaining an open airway with the head-tilt-chin-lift technique and continuously checking breathing.MethodsSchoolchildren aged 10-12 with no previous cardiopulmonary resuscitation (CPR) training, from three different primary schools were randomly allocated into groups to receive a CPR course involving one of the three strategies. Then a human simulation took place.Result192 schoolchildren (64 per group) were randomly selected and received one of the courses. 182 participants who correctly assessed the victim were compared: 16 (26.2%) out of the 59 participants using RP and checking breathing regularly detected cardiac arrest before the end of the simulation, compared to 41 (67.20%) out of 61 using RP re-evaluating breathing every minute, and 56 (90.3%) out of 62 using head-tilt-chin-lift. Statistically significant differences were found between the RP groups (p < 0.001; OR = 5.766) as well as between the Head-tilt-chin-lift and both RP groups (p < 0.001; OR = 21.094), (p = 0.002; OR = 4.553).ConclusionThe strategy involving head-tilt-chin-lift significantly increased the likelihood of detecting cardiac arrest. Re-evaluating every minute when the RP was used significantly increased the likelihood of detecting cardiac arrest.Copyright © 2018 Elsevier B.V. All rights reserved.

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