Resuscitation
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Randomized Controlled Trial Comparative Study Clinical Trial
Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) compared with standard CPR in a manikin model--decompression force, compression rate, depth and duration.
During active compression-decompression cardiopulmonary resuscitation (ACD-CPR), the rescuer applies traction to the chest between compressions. Under experimental conditions, cardiac output increases, possibly through accentuated intrathoracal pressure fluctuations. ACD-CPR requires specific training and may be more complex to perform than standard CPR. ⋯ ACD-CPR when compared with standard CPR causes a consistent and significant reduction of compression rate, depth and duration. These are all factors of possible clinical significance. Training in ACD-CPR should address this issue, with special emphasis on optimal decompression force and ECC rate.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of three methods of bag valve mask ventilation.
A method of bag valve mask ventilation in which the resuscitator compresses the self inflating bag between their open palm and the side of their body was compared with conventional single and two resuscitator bag valve mask ventilation. Fifteen nurses each ventilated three patients for 4 min following the induction of general anaesthesia, using one method per patient in random order. ⋯ D.); 'open palm': 270 ml (160); single resuscitator: 260 ml (220); two resuscitators: 480 ml (210). Peak mask pressure (mmHg): mean (SD); 'open palm': 19 (8); single resuscitator: 17(9); two resuscitator: 28 (11).
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Randomized Controlled Trial Comparative Study Clinical Trial
Airway management training using the laryngeal mask airway: a comparison of two different training programmes.
Nurses without prior experience in the use of the laryngeal mask airway (LMA) were randomly allocated to one of two groups to be trained in the emergency technique of insertion of an LMA. Group A (32 nurses) were trained only on a manikin and group B (20 nurses) were trained on a manikin and with live anaesthetised patient practice in theatre (five successful insertions). Without further practice, both groups were asked to insert an LMA in a live patient in theatre 3 months after initial training. ⋯ Skill performance and retention were shown to be high following either training method, with no significant difference between the performance of either group (chi 2). We have shown that manikin-only training in the emergency technique for LMA insertion is as effective as live patient training. It is proposed that manikin training alone may be adopted as a future training modality if, as is expected, the use of the LMA in resuscitation becomes more commonplace.
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Randomized Controlled Trial Clinical Trial
Rescuer's work capacity and duration of cardiopulmonary resuscitation.
Specific training in the techniques of cardiopulmonary resuscitation (CPR) has been the major aim of CPR education for both health care professionals and lay people over the past few decades. We performed a randomized trial to evaluate individual physiological parameters of 12 professional rescuers influencing duration and quality of standard CPR and active compression-decompression CPR. CPR duration was assessed according to individual work capacity after grouping rescuers as untrained and trained individuals, according to their work capacity of up to and including 100% and over 100%. ⋯ No changes in the forces of compression and decompression were measured during active compression-decompression CPR, thus demonstrating maintenance of constant CPR quality. Duration of resuscitation was influenced by the CPR method performed and by the individual work capacity (P = 0.004 and P = 0.027, respectively). We conclude that the duration of CPR depends both on the method applied and the rescuers' individual work capacity and recommend improvement of work capacity by aerobic training especially for professional rescuers.
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Randomized Controlled Trial Clinical Trial
Active compression-decompression resuscitation: a prospective, randomized study in a two-tiered EMS system with physicians in the field.
Improved cardiopulmonary circulation with active compression-decompression cardiopulmonary resuscitation (ACD-CPR) has been demonstrated in studies using different animal models and a small number of humans in cardiac arrest (CA). However, prehospital studies have shown both positive and no extra benefit of ACD-CPR on return of spontaneous circulation (ROSC), hospital admission and discharge rates. The aim of our prospective study was to compare standard manual CPR (S-CPR) with ACD-CPR as the initial technique of resuscitating patients with out-of-hospital CA, with respect to survival rates and neurological outcome. ⋯ Concerning complications of CPR, there was no difference between the groups. In our two-tiered EMS system with physician-staffed ambulances, ACD-CPR neither improved nor impaired survival rates and neurological prognosis in patients with out-of-hospital cardiac arrest. The new CPR technique did not increase the complications associated with the resuscitation effort.