Leitlinienadhärenz bei frustran verlaufenden Reanimationen mit automatischen Reanimationsgeräten

Ondruschka, Benjamin; Baier, Christina; Hartwig, Thomas; Gräwert, Stephanie; Böhm, Lennert; Dreßler, Jan; Bernhard, Michaël

doi:10.1055/a-0669-9207

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…Wenn diese Zeitintervalle berücksichtigt werden und insbesondere, wenn bereits Totenflecken als sicheres Todeszeichen auftreten, ist das Auftreten des "Lazarus-Phänomens", die plötzliche Rückkehr eines Spontankreislaufs nach Beendigung von Reanimationsmaßnahmen, sicher vermeidbar [22]. Statistisch wird unter ACCD-Anwendung länger reanimiert als bei alleiniger manueller Thoraxkompression [15].…”

Section: Verletzungsfolgen Nach Accdbzw Mcc-reanimationenunclassified

Automatische externe Reanimationsgeräte

Ondruschka¹,

Bayer²,

Bernhard³

et al. 2019

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ZusammenfassungIn der Reanimationssituation müssen die professionellen Helfer trotz hoher Stresslevel und Zeitknappheit schnell, ressourceneffizient und zielführend Entscheidungen im Sinne des Patienten treffen: grundlegend dabei ist etwa das Abwägen zwischen dem Einsatz einer automatischen externen Reanimationshilfe zur kontinuierlichen, gleichmäßigen und ermüdungsfreien Durchführung der Thoraxkompressionen bis zum Wiedererreichen eines Eigenkreislaufs oder dem Abbruch der Maßnahmen.

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Section: Verletzungsfolgen Nach Accdbzw Mcc-reanimationenunclassified

Automatische externe Reanimationsgeräte

Ondruschka¹,

Bayer²,

Bernhard³

et al. 2019

Notarzt

Self Cite

View full text Add to dashboard Cite

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Early in-hospital course of critically ill nontrauma patients in a resuscitation room of a German emergency department (OBSERvE2 study)

et al. 2021

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Background Management of critically ill nontrauma (CINT) patients in the resuscitation room of the emergency department (ED) is very challenging. Detailed data describing the patient characteristics and management of this population are lacking. This observational study describes the epidemiology, management and outcome in CINT ED patients in the resuscitation room. Methods This prospective, single center observational study included all adult patients who were consecutively admitted to the ED resuscitation room during 2 periods of 1 year (September 2014–August 2015 vs. September 2017– August 2018). Patient characteristics, out-of-hospital/in-hospital treatment, admission-related conditions, time intervals for diagnostics and interventions and outcome were recorded using a self-developed questionnaire. Results A total of 34,303 patients in the first and 35,039 patients in the second study period were admitted to the ED, of whom 532 and 457 patients, respectively, were admitted to the nontrauma resuscitation room due to acute life-threatening conditions. The patient characteristics did not differ significantly between the study periods (male: 58% vs. 59%, age: 68 ± 17 years vs. 65 ± 17 years). Time intervals for diagnostic and therapeutic interventions were similar. The CINT patients during the second study period were treated faster compared to the first study period (end of ED management: 53 ± 33 min vs. 41 ± 24 min, p < 0.0001). The 30-day all-cause mortality was comparable (34.0% vs. 36.3%). Conclusion Observation of critically ill patient management in the ED resuscitation room showed reliable results between both study periods. Structured ED management guidelines for CINT patients may provide comparable results at one institution.

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Chest compression-associated injuries in cardiac arrest patients treated with manual chest compressions versus automated chest compression devices (LUCAS II) – a forensic autopsy-based comparison

Ondruschka

Baier

Bayer

et al. 2018

Forensic Sci Med Pathol

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The aim of this autopsy study was to investigate chest-compression associated injuries to the trunk in out-of-hospital and in-hospital non-traumatic cardiac arrest patients treated with automated external chest compression devices (ACCD; all with LUCAS II devices) versus exclusive manual chest compressions (mCC). In this retrospective single-center study, all forensic autopsies between 2011 and 2017 were included. Injuries following cardiopulmonary resuscitation (CPR) in patients treated with mCC or ACCD were investigated and statistically compared using a bivariate logistic regression. In the seven-year period with 4433 autopsies, 614 were analyzed following CPR (mCC vs. ACCD: n = 501 vs. n = 113). The presence of any type of trunk injury was correlated with longer resuscitation intervals (30 ± 15 vs. 44 ± 25 min, p < 0.05). In comparison with mCC, treatment with ACCD led to more frequent skin emphysema (5 vs 0%, p = 0.012), pneumothorax (6 vs. 1%, p = 0.008), lung lesions (19 vs. 4%, p = 0.008), hemopericardium (3 vs 1%, p = 0.025) and liver lesions (10 vs. 1%, p = 0.001), all irrespective of confounding aspects. Higher age and longer CPR durations statistically influenced frequency of sternal and rib fractures (p < 0.001). The mean number of fractured ribs did not vary significantly between the groups (6 ± 3 vs. 7 ± 2, p = 0.09). In this cohort with unsuccessful CPR, chest compression-related injuries were more frequent following ACCD application than in the mCC group, but with only minutely increased odds ratios. The severity of injuries did not differ between the groups, and no iatrogenic injury was declared by the forensic pathologist as being fatal. In the clinical routine after successful return of spontaneous circulation a computed tomography scan for CPR-associated injuries is recommended as soon as possible.

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Leitlinienadhärenz bei frustran verlaufenden Reanimationen mit automatischen Reanimationsgeräten

Cited by 3 publications

References 14 publications

Automatische externe Reanimationsgeräte

Automatische externe Reanimationsgeräte

Early in-hospital course of critically ill nontrauma patients in a resuscitation room of a German emergency department (OBSERvE2 study)

Chest compression-associated injuries in cardiac arrest patients treated with manual chest compressions versus automated chest compression devices (LUCAS II) – a forensic autopsy-based comparison

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