Creating a drowning chain of survival

Szpilman, David; Webber, Jonathon; Quan, Linda; Bierens, Joost J.L.M.; Morizot-Leite, Luiz; Langendorfer, Stephen J.; Beerman, Stephen; Løfgren, Bo

doi:10.1016/j.resuscitation.2014.05.034

Cited by 93 publications

(91 citation statements)

References 9 publications

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“…Lifeguards often act as bystanders, and therefore adequate training in high-quality CPR and use of adequate equipment by lifeguards is essential. The recently proposed drowning chain of survival clearly indicates that stopping the drowning process and starting CPR as early as possible are the key elements for improving the patient's outcome [7].…”

Section: Introductionmentioning

confidence: 99%

The impact of the use of a CPRMeter monitor on quality of chest compressions: a prospective randomised trial, cross-simulation

Iskrzycki¹,

Smereka²,

Núñez³

et al. 2018

Kardiol Pol

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A b s t r a c tBackground: Drowning is a common issue at many pools and beaches, and in seas all over the world. Lifeguards often act as bystanders, and therefore adequate training in high-quality cardiopulmonary resuscitation (CPR) and use of adequate equipment by lifeguards is essential. Aim:The aim of this study was to evaluate the impact of the recently introduced CPRMeter (Laerdal, Stavanger, Norway) on quality of CPR, if used by moderately experienced CPR providers. In particular, we tested the hypothesis that using the CPRMeter improves quality of chest compression by lifeguards compared to standard non-feedback CPR. Methods:The study was designed as prospective, randomised, cross-over manikin trial. Fifty lifeguards of the Volunteer Water Rescue Service (WOPR), a Polish nationwide association specialised in water rescue, participated in this study. Participants were randomly assigned 1:1 to one of two groups: a feedback group and a non-feedback group. Participants swim a distance of 25 m in the pool, and then they were asked to haul a manikin for the second 25 m, simulating rescuing a drowning victim. Once participants finished the second 25-m distance, participants were asked to initiate 2-min basic life support according to the randomisation. Results:The median quality of CPR score for the 2-min CPR session without feedback was 69 (33-77) compared to 84 (55-93) in the feedback group (p < 0.001). Compression score, mean depth, rate of adequate chest compressions/min, and overall mean rate during the CPR session improved significantly in the feedback group, compared to the non-feedback group. Conclusions:Using the visual real-time feedback device significantly improved quality of CPR in our relatively unexperienced CPR providers. Better quality of bystander CPR is essential for clinical outcomes, and therefore feedback devices should be considered. Further clinical studies are needed to assess the effect of real-time visual devices, especially in bystander-CPR.

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Section: Introductionmentioning

confidence: 99%

The impact of the use of a CPRMeter monitor on quality of chest compressions: a prospective randomised trial, cross-simulation

Iskrzycki¹,

Smereka²,

Núñez³

et al. 2018

Kardiol Pol

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“…The "drowning chain of survival" [6] refers to a series of water safety interventions that, when put into action by laypeople or professionals, reduce the mortality associated with drowning ( figure 1). …”

Section: Drowning Chain Of Survivalmentioning

confidence: 99%

“…A drowning risk assessment identifies a person at high risk of drowning by a near vertical body position, ineffective downward arm movements, ineffective pedalling or kicking leg actions and little or no forward progress in water. Sending someone to call for help upon recognising a person in water distress is a key element that ensures early activation of professional rescue service and emergency medical services [6]. Provide flotation to stop the process of drowning The next priority is to interrupt the drowning process by providing flotation to the victim as an interim measure to reduce the risk of airways submersion [6].…”

Section: Recognise Distress and Call For Helpmentioning

confidence: 99%

“…In one report of rescues by bystanders, almost 30% of persons rescued from drowning required CPR [5], which demonstrates that a delay in intervention may lead to a more severe drowning picture than if lifeguards are on duty. The bias produced by not accounting for the real drowning figures gives the false impression that every drowning requires CPR and that to know how to resuscitate is the most important tool to save people from drowning [6]. For every person who dies from drowning, at least another four receive care in the emergency department for nonfatal drowning [1].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is essential that health professionals are aware of the complete sequence of steps towards survival in drowning [6].…”

Section: Introductionmentioning

confidence: 99%

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Sports related to drowning

Szpilman¹,

Orlowski

2016

Eur Respir Rev

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Aquatic sports are included in the top list of risky practices as the environment per se carries a possibility of death by drowning if not rescued in time. Not only are aquatic sports related to a high risk of death, but also all sports practiced on the water, over the water and on ice. Whatever the reason a person is in the water, drowning carries a higher possibility of death if the individual is unable to cope with the water situation, which may simply be caused by an inability to stay afloat and get out of the water or by an injury or disease that may lead to physical inability or unconsciousness. The competitive nature of sports is a common pathway that leads the sports person to exceed their ability to cope with the environment or simply misjudge their physical capability. Drowning involves some principles and medical interventions that are rarely found in other medical situations as it occurs in a deceptively hostile environment that may not seem dangerous. Therefore, it is essential that health professionals are aware of the complete sequence of action in drowning. This article focuses on the pulmonary injury in sports and recreational activities where drowning plays the major role. @ERSpublications Drowning involves rarely seen interventions: it is essential health professionals are aware of the drowning sequence

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Resuscitation of Drowned Persons During the COVID-19 Pandemic

et al. 2022

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IMPORTANCE Resuscitation is a niche example of how the COVID-19 pandemic has affected society in the long term. Those trained in cardiopulmonary resuscitation (CPR) face the dilemma that attempting to save a life may result in their own harm. This is most of all a problem for drowning, where hypoxia is the cause of cardiac arrest and ventilation is the essential first step in reversing the situation. OBJECTIVETo develop recommendations for water rescue organizations in providing their rescuers with safe drowning resuscitation procedures during the COVID-19 pandemic. EVIDENCE REVIEW Two consecutive modified Delphi procedures involving 56 participants from 17 countries with expertise in drowning prevention research, resuscitation, and programming were performed from March 28, 2020, to March 29, 2021. In parallel, PubMed and Google Scholar were searched to identify new emerging evidence relevant to each core element, acknowledge previous studies relevant in the new context, and identify knowledge gaps. FINDINGS Seven core elements, each with their own specific recommendations, were identified in the initial consensus procedure and were grouped into 4 categories: (1) prevention and mitigation of the risks of becoming infected, (2) resuscitation of drowned persons during the COVID-19 pandemic, (3) organizational responsibilities, and (4) organizations unable to meet the recommended guidelines. The common measures of infection risk mitigation, personal protective equipment, and vaccination are the base of the recommendations. Measures to increase drowning prevention efforts reduce the root cause of the dilemma. Additional infection risk mitigation measures include screening all people entering aquatic facilities, defining criteria for futile resuscitation, and avoiding contact with drowned persons by rescuers with a high-risk profile. Ventilation techniques must balance required skill level, oxygen delivery, infection risk, and costs of equipment and training.Bag-mask ventilation with a high-efficiency particulate air filter by 2 trained rescuers is advised. Major implications for the methods, facilities, and environment of CPR training have been identified, including nonpractical skills to avoid being infected or to infect others. Most of all, the organization is responsible for informing their members about the impact of the COVID-19 pandemic and taking measures that maximize rescuer safety. Research is urgently needed to better understand, develop, and implement strategies to reduce infection transmission during drowning resuscitation. CONCLUSIONS AND RELEVANCEThis consensus document provides an overview of recommendations for water rescue organizations to improve the safety of their rescuers during the COVID-19 pandemic and balances the competing interests between a potentially lifesaving intervention and risk to the rescuer. The consensus-based recommendations can also serve as an example for other volunteer organizations and altruistic laypeople who may provide resuscitation.

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Creating a drowning chain of survival

Cited by 93 publications

References 9 publications

The impact of the use of a CPRMeter monitor on quality of chest compressions: a prospective randomised trial, cross-simulation

The impact of the use of a CPRMeter monitor on quality of chest compressions: a prospective randomised trial, cross-simulation

Sports related to drowning

Resuscitation of Drowned Persons During the COVID-19 Pandemic

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