Pre-filled syringes with adrenaline during cardiopulmonary resuscitation in nonshockable rhythms. Pilot randomised crossover simulation study

Robak, Oliver; Pruc, Michał; Małysz, Marek; Smereka, Jacek; Szarpak, Łukasz; Bielski, Karol; Ładny, Jerzy Robert; Ludwin, Kobi

doi:10.5603/demj.a2020.0025

Cited by 6 publications

(6 citation statements)

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“…Correct medications, time to critical interventions No difference in the hands-off time when using prototype CPR assist device compared to standard equipment. Robak (2020) 27 Paramedics ( n = 40) ALS/CPR with pre-filled medication syringes Time to critical interventions The use of pre-filled adrenaline syringes: shorter time to intraosseous access, shorter time to adrenaline. Robakowska (2022) 22 Paramedics ( n = 463) Team size comparison CC quality, time to critical interventions 3-member teams: critical interventions faster, quality of CC comparable.…”

Section: Resultsmentioning

confidence: 99%

Efficiency of two-member crews in delivering prehospital advanced life support cardiopulmonary resuscitation: A scoping review

Keselica,

Peřan,

Renza

et al. 2024

Resuscitation Plus

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Section: Resultsmentioning

confidence: 99%

Efficiency of two-member crews in delivering prehospital advanced life support cardiopulmonary resuscitation: A scoping review

Keselica,

Peřan,

Renza

et al. 2024

Resuscitation Plus

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“…It turned out that the first dose of adrenaline was administered faster by the paramedics who had prefilled syringes at their disposal. Additonally, the improvement of chest compressions parameters was observed, followed by visible better implementation of ALS protocol [19,22].…”

Section: Discussionmentioning

confidence: 95%

Sudden cardiac arrest pharmacotherapy with preﬁlled syringes improves adherence to Advanced Life Support protocol in understaffed resuscitation pre-hospital care teams

Zalewski¹,

Telec²,

Puslecki³

et al. 2020

Signa Vitae

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Every procedural facilitation or a change in available equipment in treatment of out-of-hospital arrest (OHCA) by two-person teams may significantly enhance their performance quality. The aim of this study was to assess the impact of adrenaline in prefilled syringes on improving the adherence to Advanced Life Support protocol by understaffed teams. The research was based on a randomized cross-over high-fidelity simulation study. Two-person teams took part in two 10-minute simulation scenarios featuring sudden cardiac arrest in ventricular fibrillation (VF). The control group (group C) had at its disposal standard ampoules, whereas the experimental group (group E) prefilled syringes. The execution times of CPR start, defibrillation shocks, intravenous (IV) access, epinephrine and amiodarone doses were measured. Additionally, the chest compression fraction (CCF) was calculated. The designed two-minute loops were considerably prolonged in group C. Nineteen teams (31.1%) in group C but 49 (80.3%) in group E carried out the fifth defibrillation (P < 0.001). After two minutes of CPR nobody in group C switched to perform chest compressions. IV access was obtained significantly earlier in group E (114.7 ± 52.2 sec) than in group C (150.2 ± 68.6 sec)(P = 0.002). Two doses of adrenaline were administered in group E, whereas its second dose only by 12 teams in group C. The simulation study has proved that for understaffed teams a use of prefilled syringes not only did enhance the flow of ALS procedure, but it also improved the quality of cardiopulmonary resuscitation.

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“…Return of spontaneous circulation is one of the basic outcomes of resuscitation, especially in the prehospital setting [34]. Pooled analysis showed that the use of adrenaline increases the chance of ROSC, which was evident in both RCTs and observational studies.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis appraising efficacy and safety of adrenaline for adult cardiopulmonary resuscitation

Ludwin¹,

Safiejko²,

Smereka

et al. 2021

Cardiol J.

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Background: There is a beneficial effect of adrenaline during adult cardiopulmonary resuscitation (CPR) from cardiac arrest but there is also uncertainty about its safety and effectiveness. The aim of this study was to evaluate the use of adrenaline versus nonadrenaline CPR. Methods: PubMed, ScienceDirect, Embase, CENTRAL (Cochrane Central Register of Controlled Trials) and Google Scholar databases were searched from their inception up to 1 st July 2020. Two reviewers independently assessed eligibility and risk of bias, with conflicts resolved by a third reviewer. Risk ratio (RR) or mean difference of groups were calculated using fixed or random-effect models. Results: Nineteen trials were identified. The use of adrenaline during CPR was associated with a significantly higher percentage of return of spontaneous circulation (ROSC) compared to non-adrenaline treatment (20.9% vs. 5.9%; RR = 1.87; 95% confidence interval [CI] 1.37-2.55; p < 0.001). The use of adrenaline in CPR was associated with ROSC at 19.4% and for non-adrenaline treatment-4.3% (RR = 3.23; 95% CI 1.89-5.53; p < 0.001). Survival to discharge (or 30-day survival) when using adrenaline was 6.8% compared to non-adrenaline treatment (5.5%; RR = 0.99; 95% CI 0.76-1.30; p = 0.97). However, the use of adrenaline was associated with a worse neurological outcome (1.6% vs. 2.2%; RR = 0.57; 95% CI 0.42-0.78; p < 0.001). Conclusions: This review suggests that resuscitation with adrenaline is associated with the return of spontaneous circulation and survival to hospital discharge, but no higher effectiveness was observed at discharge with favorable neurological outcome. The analysis showed higher effectiveness of ROSC and survival to hospital discharge in non-shockable rhythms. But more multicenter randomized controlled trials are needed in the future.

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Pre-filled syringes with adrenaline during cardiopulmonary resuscitation in nonshockable rhythms. Pilot randomised crossover simulation study

Cited by 6 publications

References 0 publications

Efficiency of two-member crews in delivering prehospital advanced life support cardiopulmonary resuscitation: A scoping review

Efficiency of two-member crews in delivering prehospital advanced life support cardiopulmonary resuscitation: A scoping review

Sudden cardiac arrest pharmacotherapy with preﬁlled syringes improves adherence to Advanced Life Support protocol in understaffed resuscitation pre-hospital care teams

Systematic review and meta-analysis appraising efficacy and safety of adrenaline for adult cardiopulmonary resuscitation

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