How can a single rescuer adequately deliver tidal volume with a manual resuscitator? An improved device for delivering regular tidal volume

Jeung

et al. 2019

Clin Exp Pharma Physio

Pralidoxime is a common antidote for organophosphate poisoning; however, studies have also reported pralidoxime's pressor effect, which may facilitate the restoration of spontaneous circulation (ROSC) after cardiac arrest by improving coronary perfusion pressure (CPP). We investigated the immediate cardiovascular effects of pralidoxime in anaesthetised normal rats and the effects of pralidoxime administration during cardiopulmonary resuscitation (CPR) in a pig model of cardiac arrest. To evaluate the immediate cardiovascular effects of pralidoxime, seven anaesthetised normal rats received saline or pralidoxime (20 mg/kg) in a randomised crossover design, and the responses were determined using the conductance catheter technique. To evaluate the effects of pralidoxime administration during CPR, 22 pigs randomly received either 80 mg/kg of pralidoxime or an equivalent volume of saline during CPR. In the rats, pralidoxime significantly increased arterial pressure than saline (P = .044). The peak effect on arterial pressure was observed in the first minute. In a pig model of cardiac arrest, CPP during CPR was higher in the pralidoxime group than in the control group (P = .002). ROSC was attained in three animals (27.3%) in the control group and nine animals (81.8%) in the pralidoxime group (P = .010). Three animals (27.3%) in the control group and eight animals (72.2%) in the pralidoxime group survived the 6‐hour period (P = .033). In conclusion, pralidoxime had a rapid onset of pressor effect. Pralidoxime administered during CPR led to significantly higher rates of ROSC and 6‐hour survival by improving CPP in a pig model.

Section: Methodsmentioning

confidence: 99%

Section: Study To Investigate the Effects Of Pralidoxime Administermentioning

confidence: 99%

Pralidoxime administered during cardiopulmonary resuscitation facilitates successful resuscitation in a pig model of cardiac arrest

Jung

Jeung

et al. 2019

Clin Exp Pharma Physio

“…To reduce bias caused by inconsistent squeezing volumes, ventilation was provided using a volumemarked BVM procedure devised by Cho et al 16 Cho et al indicated that the volume-marked BVM procedure delivered a constant volume of approximately 500-600 mL. 16 Briefly, the volume-marked bag is a conventional self-inflatable bag device (total volume 1600 mL; Laerdal, Stavanger, Norway) with an imaginary axis grid and fingertip-location guide.…”

Section: Population and Settingmentioning

confidence: 99%

“…16 Briefly, the volume-marked bag is a conventional self-inflatable bag device (total volume 1600 mL; Laerdal, Stavanger, Norway) with an imaginary axis grid and fingertip-location guide. The participants were instructed to place a thumb correctly and to squeeze the bag with one hand so as to touch the middle finger to the thumb slightly, as previously described by Cho et al 16 In the present study, a transparent Laerdal silicone mask No. 4-5+ with a multifunction mask cover (Laerdal) served as the SM, whereas a medium-sized hospital full face mask (ResMed) served as the ResMed CM.…”

Section: Population and Settingmentioning

confidence: 99%

The Performances of Standard and ResMed Masks During Bag–Valve–Mask Ventilation

Jeung

Prehospital Emergency Care

et al. 2012

“…The recommended tidal volume is 400-600 mL. If BMV is used, it is recommended that the user should compress the bag by about one-third, (22) suffi cient to produce a chest rise over one second.…”

Section: Ventilations In Cprmentioning

confidence: 99%

Advanced Cardiac Life Support: 2016 Singapore Guidelines

Ching

Leong

Chua

et al. 2017

smedj

Public access defibrillation PAD is another key intervention to improve the time to defi brillation for shockable rhythms in OHCA, through increasing the availability of automated external defi brillators (AEDs) in public places. Patients with shockable rhythms who received bystander defibrillation had 5.8 times the odds of survival compared to those who did not. Emergency ambulance response Prehospital emergency medical services should optimise the rapid dispatch of fi rst-responders who are trained in Basic Cardiac Life Support (BCLS) and AED use, as well as paramedics trained in advanced life support protocols, to the scene within eight minutes. This can be achieved through strategic preplacement of ambulances and related vehicular assets, as well as stratifi ed levels of responses for calls of different priority levels.Survival in OHCA is critically dependent on prompt institution of the fi rst three links of the chain of survival. Prehospital factors, including witnessed arrests, initial shockable rhythms, bystander defi brillation and emergency ambulance response times within eight minutes of collapse, have been ABSTRACT The main areas of emphasis in the Advanced Cardiac Life Support (ACLS) guidelines are: early recognition of cardiac arrest and call for help; good-quality chest compressions; early defi brillation when applicable; early administration of drugs; appropriate airway management ensuring normoventilation; and delivery of appropriate post-resuscitation care to enhance survival. Of note, it is important to monitor the quality of the various care procedures. The resuscitation team needs to reduce unnecessary interruptions to chest compressions in order to maintain adequate coronary perfusion pressure during the ACLS drill. In addition, the team needs to continually look out for reversible causes of the cardiac arrest.