Gasping during cardiac arrest

Zuercher, Mathias; Ewy, Gordon A.

doi:10.1097/mcc.0b013e3283298e00

Cited by 28 publications

(18 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…13,23 In these situations, agonal breathing, a common event occurring in the first moments of cardiac arrest, 7 is often misleading and delays the initiation of bystander CPR. 24 As a consequence, the American Heart Association has claimed for a simplification of the procedures involved in the evaluation of normal breathing. 10 Such a simplified approach might significantly increase OHCA detection by telephone, 25 with few adverse effects in the case of CPR undertaken in patients who are not in cardiac arrest.…”

Section: Discussionmentioning

confidence: 99%

“…Among these, 115 met the inclusion criteria and were randomly distributed in the 4 study groups as depicted in Figure 1. According to the inclusion criteria, mean age was higher in the untrained groups (31 [24][25][26][27][28][29][30][31][32][33][34][35]years in U-NG and 27 [24-34.5]years in U-G) than in the previously trained groups (20.5 [20][21][22]years in T-NG and 21.5 [20][21][22][23][24]years in T-G), respectively (P < 0.001).…”

Section: Flow and Baseline Characteristics Of Volunteersmentioning

confidence: 99%

See 1 more Smart Citation

Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Using a French-Language Compression-Ventilation Pediatric Protocol

Peters¹,

Stipulante²,

Delfosse³

et al. 2017

Pediatr Emer Care

View full text Add to dashboard Cite

Objective: Out-of-hospital cardiac arrest (OHCA) in pediatrics is a devastating event associated with poor survival rates. Although telephone dispatcher-assisted cardiopulmonary resuscitation (CPR; T-CPR) instructions improve the frequency and quality of bystander CPR for OHCA in adults, this support remains undeveloped in children. Our objective was to assess the effectiveness of a pediatric T-CPR protocol in untrained and trained bystanders. Secondarily, we sought to determine the feasibility and the effectiveness of ventilation in such a protocol.Methods: Eligible adults with no CPR experience were recruited in a movie theater in Liege, as well as bachelor nursing students in Liege. All volunteers were randomly assigned either to T-CPR or to no-T-CPR using randomization. The volunteers were exposed to a pediatric manikin model cardiac arrest. On the basis of Cardiff evaluation test, data were collected to evaluate CPR performance.Results: A total of 115 volunteers were assigned to 4 groups: untrained nonguided group (n = 27), untrained guided group (n = 32), trained nonguided group (n = 26), and trained guided group (n = 30). We found an improvement in CPR performance in the guided groups. Most volunteers (81.2%) in untrained guided group and 83.3% in the trained guided group were able to give 2 ventilations after each compressions cycle. Conclusions:In a pediatric manikin model of OHCA, T-CPR instructions including mouth-to-mouth ventilations and chest compressions produced a significant increase in resuscitation performance not only among previously untrained but also among trained volunteers.Key Words: CPR, cardiac arrest, infant, manikin, telephone, prospective study (Pediatr Emer Care 2017;33: 00-00) A lthough uncommon in children, out-of-hospital cardiac arrest (OHCA) has devastating complications.1 Indeed, the survival rate at hospital discharge rarely exceeds 8% 2 despite care being conducted in accordance with chain of survival concept. In adults, early bystander-initiated cardiopulmonary resuscitation (CPR) has been related to better neurological outcomes and higher survival rates.4 However, regardless of population, most OHCAs still do not receive any CPR before the arrival of emergency medical services.1,5 As a consequence, only 37% of infants at best actually receive early bystander CPR, whereas most OHCAs occur at home. 3 The lack of CPR knowledge or skills has been advocated to explain this low rate of CPR and subsequent poorer prognosis for OHCA occurring in private places as compared with the ones taking place in public locations. 6,7 Besides, stress, reluctance to practice mouth-to-mouth ventilation, and fear of communicable disease are other major barriers for bystander CPR practice, although these bystanders are most frequently the parents.In adults, dispatcher-assisted compression-only CPR has been demonstrated to enhance the rate of CPR attempts. This observation was the rationale for current guidelines recommending bystander chest compression-only CPR in adults. 8 However, such recom...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Flow and Baseline Characteristics Of Volunteersmentioning

confidence: 99%

Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Using a French-Language Compression-Ventilation Pediatric Protocol

Peters¹,

Stipulante²,

Delfosse³

et al. 2017

Pediatr Emer Care

View full text Add to dashboard Cite

show abstract

“…Gasping contributes to physiological ventilation—that is, ventilation associated with decreased intrathoracic pressures rather than artificial ventilation produced by MTM ventilation, which increase the intrathoracic pressures 51. Gasping during cardiac arrest provides adequate ventilation 35 52 53 54 55. Gasping has been reported in 40% of OHCA and 55% of witnessed arrests 34.…”

Section: Gasping Is Not Uncommon Early In Primary Cardiac Arrestmentioning

confidence: 99%

Rationale for continuous chest compression cardiopulmonary resuscitation

Ramaraj

Ewy

2009

Heart

View full text Add to dashboard Cite

Every year more than a million cardiac arrests are documented in the industrialised nations of the world, with the majority occurring in settings outside hospital. A major factor in survival after out-of-hospital cardiac arrest (OHCA) is early institution of bystander resuscitation efforts. Sadly, the majority of OHCAs do not receive bystander resuscitation for a variety of reasons. One of them is the requirement for mouth-to-mouth (MTM) ventilation. The 2008 American Heart Association recommendation for "hands only" or continuous chest compression cardiopulmonary resuscitation (CPR) for untrained lay people was a welcome change. However, evidence indicates that MTM and other forms of positive pressure ventilation should be eliminated for all bystanders responding to primary cardiac arrest (unexpected witnessed collapse in an unresponsive person). The requirement for MTM ventilation may well be indicated for patients with respiratory arrest but is detrimental during early resuscitation efforts by anyone providing CPR to patients with primary cardiac arrest. This article provides rationale for continuous chest compression CPR by all bystanders.

show abstract

“…It is the exclusive provider of primary prehospital emergency care in the Central Bohemian Region of the Czech Republic. The region includes both rural and urban populations, in total 1 315 299 inhabitants, covering an area of 11 015 km 2 . Data were recorded following Utstein protocol including the presence of gasping at the time of ambulance car arrival to the OHCA patient.…”

Section: Methodsmentioning

confidence: 99%

“…It may persist for several seconds to minutes and its presence has been found to be an independent positive predictor of return of spontaneous circulation (ROSC) (ref. [1][2][3] ). Gasping has also been highlighted in the recent guidelines as a phenomenon that Emergency Medical Service (EMS) dispatchers should be made aware of 4 .…”

Section: Introductionmentioning

confidence: 99%

The presence of gasping predicts long-term survival in out-of-hospital cardiac arrest patients

Knor¹,

Šeblová²,

Škulec³

et al. 2018

BIOMED PAP

View full text Add to dashboard Cite

Background. The presence of gasping in out-of-hospital cardiac arrest (OHCA) patients predicts short-term prognosis. We performed a retrospective study to evaluate whether the presence of gasping at the time of Emergency Medical Service (EMS) arrival in the case OHCA patients of presumed cardian origin has any impact on six-month survival and/ or sustained return of spontaneous circulation (ROSC). Methods. We collected and analyzed Utstein Style data for all patients resuscitated for OHCA of presumed cardiac origin by the EMS of the Central Bohemian Region from Results. During the data collection period, 565 cases of OHCA of presumed cardiac origin were reported. Gasping at the time of EMS arrival was identified in 23.9%. The presence of gasping was associated with a significantly increased frequency of sustained ROSC (48.1 versus 20.7%, P<0.001) and six-month survival (40.7 versus 16.7%, P<0.001) than in non-breathing patients. Presence of gasping upon EMS arrival has been found to be an independent positive predictor of sustained ROSC (OR 2.51, CI 95% 1. 59-3.98, P<0.001). The occurrence of gasping at the time of EMS arrival at the scene was significantly related to response time from EMS activation to arrival. Conclusion. The presence of gasping upon arrival of the EMS for the patient with OHCA of presumed cardiac origin predicts both improves short-term and long-term prognoses.

show abstract

Gasping during cardiac arrest

Abstract: Gasping frequently occurs during cardiac arrest. Public and emergency medical dispatchers must be more aware of its presence and significance.

Cited by 28 publications

References 27 publications

Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Using a French-Language Compression-Ventilation Pediatric Protocol

Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Using a French-Language Compression-Ventilation Pediatric Protocol

Rationale for continuous chest compression cardiopulmonary resuscitation

The presence of gasping predicts long-term survival in out-of-hospital cardiac arrest patients

Contact Info

Product

Resources

About