The prevalence of chest compression leaning during in-hospital cardiopulmonary resuscitation

Fried, David A.; Leary, Marion; Smith, D.; Sutton, Robert M.; Niles, Dana; Herzberg, Daniel L.; Becker, Lance B.; Abella, Benjamin S.

doi:10.1016/j.resuscitation.2011.02.032

Cited by 71 publications

(47 citation statements)

References 23 publications

(34 reference statements)

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“…[46][47][48] Human studies show that a majority of rescuers often lean during CPR and do not allow the chest to recoil fully. 49,50 Therefore, the expert panel agrees that leaning should be minimized.…”

Section: Full Chest Recoil: No Residual Leaningmentioning

confidence: 97%

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Meaney¹,

Bobrow²,

Mancini³

et al. 2013

Circulation

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837

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The "2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" increased the focus on methods to ensure that high-quality cardiopulmonary resuscitation (CPR) is performed in all resuscitation attempts. There are 5 critical components of high-quality CPR: minimize interruptions in chest compressions, provide compressions of adequate rate and depth, avoid leaning between compressions, and avoid excessive ventilation. Although it is clear that high-quality CPR is the primary component in influencing survival from cardiac arrest, there is considerable variation in monitoring, implementation, and quality improvement. As such, CPR quality varies widely between systems and locations. Victims often do not receive high-quality CPR because of provider ambiguity in prioritization of resuscitative efforts during an arrest. This ambiguity also impedes the development of optimal systems of care to increase survival from cardiac arrest. This consensus statement addresses the following key areas of CPR quality for the trained rescuer: metrics of CPR performance; monitoring, feedback, and integration of the patient’s response to CPR; team-level logistics to ensure performance of high-quality CPR; and continuous quality improvement on provider, team, and systems levels. Clear definitions of metrics and methods to consistently deliver and improve the quality of CPR will narrow the gap between resuscitation science and the victims, both in and out of the hospital, and lay the foundation for further improvements in the future.

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Section: Full Chest Recoil: No Residual Leaningmentioning

confidence: 97%

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Meaney¹,

Bobrow²,

Mancini³

et al. 2013

Circulation

Self Cite

837

521

View full text Add to dashboard Cite

show abstract

“…67,68 Observational studies indicate that leaning is common during CPR in adults and children. 69,70 2015 Summary of Evidence There are no human studies reporting the relationship between chest wall recoil and clinical outcomes. The evidence is derived from 2 animal studies and a pediatric study of patients not in cardiac arrest.…”

Section: S420 Circulationmentioning

confidence: 99%

Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality

Kleinman¹,

Brennan²,

Goldberger³

et al. 2015

Circulation

778

311

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“…142,143 Observational studies indicate that leaning is common during CPR in adults and children. 143,144 This question sought to examine the effect of chest wall leaning during standard manual CPR on outcome.…”

Section: Introductionmentioning

confidence: 99%

Part 3: Adult Basic Life Support and Automated External Defibrillation

Travers¹,

Perkins²,

Berg³

et al. 2015

Circulation

234

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Introduction This Part of the 2015 International Consensus on Cardiopul monary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Science With Treatment Recommendations (CoSTR) presents the consensus on science and treatment recommendations for adult basic life support (BLS) and automated external defibrillation (AED). After the publication of the 2010 CoSTR, the Adult BLS Task Force developed review questions in PICO (population, intervention, comparator, outcome) format.1 This resulted in the generation of 36 PICO questions for systematic reviews. The task force discussed the topics and then voted to prioritize the most important questions to be tackled in 2015. From the pool of 36 questions, 14 were rated low priority and were deferred from this round of evidence evaluation. Two new questions were submitted by task force members, and 1 was submitted via the public portal. Two of these (BLS 856 and BLS 891) were taken forward for evidence review. The third question (368: ForeignBody Airway Obstruction) was deferred after a preliminary review of the evidence failed to identify compelling evidence that would alter the treatment recommendations made when the topic was last reviewed in 2005. 2 Each task force performed a systematic review using detailed inclusion and exclusion criteria, based on the recommendations of the Institute of Medicine of the National Academies.3 With the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).Reviewers were unable to identify any relevant evidence for 3 questions (BLS 811, BLS 373, and BLS 348), and the evidence review was not completed in time for a further question (BLS 370). A revised PICO question was developed for the opioid question (BLS 891). The task force reviewed 23 PICO questions for the 2015 consensus on science and treatment recommendations, including BLS 811, BLS 373, and BLS 348. The PICO flow is summarized in Figure 1.Using the methodological approach proposed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group, 4 the reviewers for each question created a reconciled risk-of-bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 5 Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 for studies of diagnostic accuracy, 6 and GRADE for observational studies that inform both therapy and prognosis questions.7 GRADE evidence profile tables 8 were then created to facilitate an evaluation of the evidence in support of each of the critical and important outcomes. Critical outcomes were defined as neurologically favorable outcome (level 9), survival (level 8), and return of spontaneous circulation (ROSC; level 7). Given the heterogeneity of time points evaluated in the studies related to BLS/AED, time intervals were pooled across outcomes. For neurologic outcome and survival, we considered the outcomes at discharge,...

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The prevalence of chest compression leaning during in-hospital cardiopulmonary resuscitation

Cited by 71 publications

References 23 publications

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality

Part 3: Adult Basic Life Support and Automated External Defibrillation

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