Quality and efficiency of bystander CPR

Hoeyweghen, Raf J. Van; Bossaert, Leo; Mullie, A.; Calle, Paul; Martens, Patrick; Buylaert, Walter; Delooz, Herman

doi:10.1016/0300-9572(93)90162-j

Cited by 388 publications

(65 citation statements)

References 7 publications

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“…Not surprisingly, once again this study confirmed that successful resuscitation and neurological outcome are comparable after CC or CCϩRB for VF cardiac arrest. [5][6][7][8][9][10][11][12][13][14] More importantly, this investigation highlights the hemodynamic importance of continuous chest compressions during CPR.…”

Section: Discussionmentioning

confidence: 67%

“…[1][2][3][4] Numerous animal investigations and 2 clinical studies suggest that bystander CPR with chest compressions alone (CC) is as effective as chest compressions plus rescue breathing (CCϩRB) for VF cardiac arrest. [5][6][7][8][9][10][11][12][13][14] This technique is attractive because it is simpler than standard CPR and easier to teach, learn, remember, and perform. [2][3][4]14 Hypoxia and hypercarbia, however, are important mediators of poor outcome from VF.…”

mentioning

confidence: 99%

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Adverse Hemodynamic Effects of Interrupting Chest Compressions for Rescue Breathing During Cardiopulmonary Resuscitation for Ventricular Fibrillation Cardiac Arrest

et al. 2001

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Background-Despite improving arterial oxygen saturation and pH, bystander cardiopulmonary resuscitation (CPR) with chest compressions plus rescue breathing (CCϩRB) has not improved survival from ventricular fibrillation (VF) compared with chest compressions alone (CC) in numerous animal models and 2 clinical investigations. Methods and Results-After 3 minutes of untreated VF, 14 swine (32Ϯ1 kg) were randomly assigned to receive CCϩRB or CC for 12 minutes, followed by advanced cardiac life support. All 14 animals survived 24 hours, 13 with good neurological outcome. For the CCϩRB group, the aortic relaxation pressures routinely decreased during the 2 rescue breaths. Therefore, the mean coronary perfusion pressure of the first 2 compressions in each compression cycle was lower than those of the final 2 compressions (14Ϯ1 versus 21Ϯ2 mm Hg, PϽ0.001). During each minute of CPR, the number of chest compressions was also lower in the CCϩRB group (62Ϯ1 versus 92Ϯ1 compressions, PϽ0.001). Consequently, the integrated coronary perfusion pressure was lower with CCϩRB during each minute of CPR (PϽ0.05 for the first 8 minutes). Moreover, at 2 to 5 minutes of CPR, the median left ventricular blood flow by fluorescent microsphere technique was 60 mL · 100 g Ϫ1 · min Ϫ1 with CCϩRB versus 96 mL · 100 g Ϫ1 · min Ϫ1 with CC, PϽ0.05. Because the arterial oxygen saturation was higher with CCϩRB, the left ventricular myocardial oxygen delivery did not differ. Conclusions-Interrupting chest compressions for rescue breathing can adversely affect hemodynamics during CPR for

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Section: Discussionmentioning

confidence: 67%

mentioning

confidence: 99%

Adverse Hemodynamic Effects of Interrupting Chest Compressions for Rescue Breathing During Cardiopulmonary Resuscitation for Ventricular Fibrillation Cardiac Arrest

et al. 2001

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“…The fact that the rescuer does not wish to perform mouth-to-mouth ventilation when blood is visible does not remove the responsibility to call for help, open the airway 205 , and perform chest compression. Provision of sternal compressions without mouth-to-mouth ventilation is far better than not perform resuscitation at all 198 . In the event that the rescuer decides to follow international guidelines and carry out mouth-to-mouth ventilation 1,203,204 , it is necessary to accompany the victim after initiation of advanced life support to check out the presence of contagious diseases that require postexposure prophylaxis.…”

Section: Arq Bras Cardiolmentioning

confidence: 99%

“…In this regard, numerous are the articles with animal models, but rare are the studies in humans. In an observational study, long term survival of those treated with chest compression plus mouth-to-mouth ventilation and those treated with chest compression alone was comparable (16% and 15%, respectively) 198,199 . Notwithstanding the praiseworthy initiative of the authors, the study does not have a definitive design, and it is subjected to criticism.…”

Section: Arq Bras Cardiolmentioning

confidence: 99%

Transmission of infectious diseases through mouth-to-mouth ventilation: evidence-based or emotion-based medicine?

Arend¹

2000

Arq. Bras. Cardiol.

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UpdateCardiopulmonary arrest is the interruption of the heart's mechanical activity confirmed by unconsciousness, apnea, and absence of central pulse 1 . The basic technical knowledge for management of this medical emergency by way of cardiopulmonary resuscitation (CPR) should be part of the training curriculum for health care workers and is highly recommended for the general public. However, concern about the transmission of diseases appears to have created substantial barriers for the use of CPR, both in and out of the hospital setting. The idea that the intention of saving a person's life could result in the death of the rescuer is intimidating and reduces peoples' desire and availability to help cardiopulmonary arrest victims [2][3][4][5] . The outcome of reduced use of CPR is reflected in the increase in the morbidity and mortality of the event 6-8 . Studies carried out by Brenner report that about 50% of physicians would refuse to carry out mouth-to-mouth ventilation in strangers and 7-14% would not perform mouth-to-mouth ventilation on victims with AIDS [9][10][11] . Another study reports that, although 68% of the interviewees would perform chest compressions on an unknown victim of cardiopulmonary arrest, only 15% would perform mouth-to-mouth ventilation 12 . A number of other papers report similar findings [13][14][15][16][17] . In the great majority of cases, the reason for the reluctance to immediately start CPR is the fear of catching transmissible diseases, especially HIV 12,18 . The objective of this article is to review the literature on infectious diseases transmitted through mouth-tomouth ventilation. The search for available scientific evidence for pre-and post-exposure prophylaxis has been made through searching the Medline database of articles published between 1990-1999. In addition to this, all the articles published between 1966-1999 in journals indexed to Index Medicus with the key word mouth to mouth ventilation or mouth-to-mouth ventilation, and cardiopulmonary resuscitation were reviewed. Conclusions were also based on a personal collection of articles, posters and relevant notes collected over the last few years.

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“…Furthermore, ERC highlights the importance of CPR quality, including compression depth and frequency which is often found to be inadequate 14, 15, 16, 17. The use of AEDs providing feedback on CPR, either in the form of AV‐feedback with verbal prompts and visual indication of compression depth and frequency or a metronome, could be a useful strategy to improve CPR quality,18, 19 and is recommended by the Danish Health Authority and ERC 5, 20…”

mentioning

confidence: 99%

Return of spontaneous circulation and long‐term survival according to feedback provided by automated external defibrillators

Agerskov

Hansen

Nielsen

et al. 2017

Acta Anaesthesiol Scand

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BackgroundWe aimed to investigate the effect of automated external defibrillator (AED) feedback mechanisms on survival in out‐of‐hospital cardiac arrest (OHCA) victims. In addition, we investigated converting rates in patients with shockable rhythms according to AED shock waveforms and energy levels.MethodsWe collected data on OHCA occurring between 2011 and 2014 in the Capital Region of Denmark where an AED was applied prior to ambulance arrival. Patient data were obtained from the Danish Cardiac Arrest Registry and medical records. AED data were retrieved from the Emergency Medical Dispatch Centre (EMDC) and information on feedback mechanisms, energy waveform and energy level was downloaded from the applied AEDs.ResultsA total of 196 OHCAs had an AED applied prior to ambulance arrival; 62 of these (32%) provided audio visual (AV) feedback while no feedback was provided in 134 (68%). We found no difference in return of spontaneous circulation (ROSC) at hospital arrival according to AV‐feedback; 34 (55%, 95% confidence interval (CI) [13–67]) vs. 72 (54%, 95% CI [45–62]), P = 1 (odds ratio (OR) 1.1, 95% CI [0.6–1.9]) or 30‐day survival; 24 (39%, 95% CI [28–51]) vs. 53 (40%, 95% CI [32–49]), P = 0.88 (OR 1.1 (95% CI [0.6–2.0])). Moreover, we found no difference in converting rates among patients with initial shockable rhythm receiving one or more shocks according to AED energy waveform and energy level.ConclusionsNo difference in survival after OHCA according to AED feedback mechanisms, nor any difference in converting rates according to AED waveform or energy levels was detected.

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Quality and efficiency of bystander CPR

Cited by 388 publications

References 7 publications

Adverse Hemodynamic Effects of Interrupting Chest Compressions for Rescue Breathing During Cardiopulmonary Resuscitation for Ventricular Fibrillation Cardiac Arrest

Adverse Hemodynamic Effects of Interrupting Chest Compressions for Rescue Breathing During Cardiopulmonary Resuscitation for Ventricular Fibrillation Cardiac Arrest

Transmission of infectious diseases through mouth-to-mouth ventilation: evidence-based or emotion-based medicine?

Return of spontaneous circulation and long‐term survival according to feedback provided by automated external defibrillators

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