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https://www.readbyqxmd.com/read/29017660/-rhythm-analysis-in-cpr
#1
Yingying Hu, Jun Xu, Xuezhong Yu
It's necessary to interrupt cardiopulmonary resuscitation (CPR) for a reliable automatic external defibrillator (AED) rhythm analysis, because the mechanical activity from the chest compressions introduces artifacts in the electrocardiogram (ECG) that substantially lower the capacity of an AED to judge cardio-electric rhythm. However, repeated interruptions of compression will reduce the quality of CPR, which in turn affect the prognosis of patients with cardiac arrest (CA). In order to improve the quality of CPR, reduce the interruptions of chest compression and implement accurate defibrillation, people have made many efforts on identifying ECG rhythm in CPR...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28988159/chest-compression-during-sustained-inflation-versus-3-1-chest-compression-ventilation-ratio-during-neonatal-cardiopulmonary-resuscitation-a-randomised-feasibility-trial
#2
Georg M Schmölzer, Megan O Reilly, Caroline Fray, Sylvia van Os, Po-Yin Cheung
BACKGROUND: Current neonatal resuscitation guidelines recommend 3:1 compression:ventilation (C:V) ratio. Recently, animal studies reported that continuous chest compressions (CC) during a sustained inflation (SI) significantly improved return of spontaneous circulation (ROSC). The approach of CC during SI (CC+SI) has not been examined in the delivery room during neonatal resuscitation. HYPOTHESIS: It is a feasibility study to compare CC+SI versus 3:1 C:V ratio during neonatal resuscitation in the delivery room...
October 7, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28807986/a-turbine-driven-ventilator-improves-adherence-to-advanced-cardiac-life-support-guidelines-during-a-cardiopulmonary-resuscitation-simulation
#3
Scott G Allen, Lara Brewer, Erik S Gillis, Nathan L Pace, Derek J Sakata, Joseph A Orr
BACKGROUND: Research has shown that increased breathing frequency during cardiopulmonary resuscitation is inversely correlated with systolic blood pressure. Rescuers often hyperventilate during cardiopulmonary resuscitation (CPR). Current American Heart Association advanced cardiac life support recommends a ventilation rate of 8 -10 breaths/min. We hypothesized that a small, turbine-driven ventilator would allow rescuers to adhere more closely to advanced cardiac life support (ACLS) guidelines...
August 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28754527/ultrasound-use-during-cardiopulmonary-resuscitation-is-associated-with-delays-in-chest-compressions
#4
Maite A Huis In 't Veld, Michael G Allison, David S Bostick, Kiondra R Fisher, Olga G Goloubeva, Michael D Witting, Michael E Winters
AIM: High-quality chest compressions are a critical component of the resuscitation of patients in cardiopulmonary arrest. Point-of-care ultrasound (POCUS) is used frequently during emergency department (ED) resuscitations, but there has been limited research assessing its benefits and harms during the delivery of cardiopulmonary resuscitation (CPR). We hypothesized that use of POCUS during cardiac arrest resuscitation adversely affects high-quality CPR by lengthening the duration of pulse checks beyond the current cardiopulmonary resuscitation guidelines recommendation of 10s...
July 25, 2017: Resuscitation
https://www.readbyqxmd.com/read/28521022/management-of-untreatable-ventricular-arrhythmias-during-pharmacologic-challenges-with-sodium-channel-blockers-for-suspected-brugada-syndrome
#5
Stefano Poli, Mauro Toniolo, Massimo Maiani, Davide Zanuttini, Luca Rebellato, Igor Vendramin, Ermanno Dametto, Guglielmo Bernardi, Flavio Bassi, Carlo Napolitano, Ugolino Livi, Alessandro Proclemer
Pharmacologic challenge with sodium channel blockers is part of the diagnostic workout in patients with suspected Brugada syndrome. The test is overall considered safe but both ajmaline and flecainide detain well known pro-arrhythmic properties. Moreover, the treatment of patients with life-threatening arrhythmias during these diagnostic procedures is not well defined. Current consensus guidelines suggest to adopt cautious protocols interrupting the sodium channel blockers as soon as any ECG alteration appears...
May 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28499516/improving-cpr-performance
#6
REVIEW
Boulos S Nassar, Richard Kerber
Cardiac arrest continues to represent a public health burden with most patients having dismal outcomes. CPR is a complex set of interventions requiring leadership, coordination, and best practices. Despite the widespread adoption of new evidence in various guidelines, the provision of CPR remains variable with poor adherence to published recommendations. Key steps health-care systems can take to enhance the quality of CPR and, potentially, to improve outcomes, include optimizing chest compressions, avoiding hyperventilation, encouraging intraosseous access, and monitoring capnography...
May 10, 2017: Chest
https://www.readbyqxmd.com/read/28459305/advanced-airway-type-and-its-association-with-chest-compression-interruptions-during-out-of-hospital-cardiac-arrest-resuscitation-attempts
#7
Angela F Jarman, Christy L Hopkins, J Nicholas Hansen, Jonathan R Brown, Christopher Burk, Scott T Youngquist
OBJECTIVE: To assess interruptions in chest compressions associated with advanced airway placement during cardiopulmonary resuscitation (CPR) of out-of-hospital cardiac arrest (OHCA) victims. METHODS: The method used was observational analysis of prospectively collected clinical and defibrillator data from 339 adult OHCA victims, excluding victims with <5 minutes of CPR. Interruptions in CPR, summarized by chest compression fraction (CCF), longest pause, and the number of pauses greater than 10 seconds, were compared between patients receiving bag valve mask (BVM), supraglottic airway (SGA), endotracheal intubation (ETI) via direct laryngoscopy (DL), and ETI via video laryngoscopy (VL)...
September 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28349529/continuous-chest-compression-versus-interrupted-chest-compression-for-cardiopulmonary-resuscitation-of-non-asphyxial-out-of-hospital-cardiac-arrest
#8
REVIEW
Lei Zhan, Li J Yang, Yu Huang, Qing He, Guan J Liu
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a major cause of death worldwide. Cardiac arrest can be subdivided into asphyxial and non asphyxial etiologies. An asphyxia arrest is caused by lack of oxygen in the blood and occurs in drowning and choking victims and in other circumstances. A non asphyxial arrest is usually a loss of functioning cardiac electrical activity. Cardiopulmonary resuscitation (CPR) is a well-established treatment for cardiac arrest. Conventional CPR includes both chest compressions and 'rescue breathing' such as mouth-to-mouth breathing...
March 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28241962/a-method-to-differentiate-between-ventricular-fibrillation-and-asystole-during-chest-compressions-using-artifact-corrupted-ecg-alone
#9
Guang Zhang, Taihu Wu, Zongming Wan, Zhenxing Song, Ming Yu, Dan Wang, Liangzhe Li, Feng Chen, Xinxi Xu
In recent years, numerous adaptive filtering techniques have been developed to suppress the chest compression (CC) artifact for reliable analysis of the electrocardiogram (ECG) rhythm without CC interruption. Unfortunately, the result of rhythm diagnosis during CCs is still unsatisfactory in many studies. The misclassification between corrupted asystole (ASY) and corrupted ventricular fibrillation (VF) is generally regarded as one of the major reasons for the poor performance of reported methods. In order to improve the diagnosis of VF/ASY corrupted by CCs, a novel method combining a least mean-square (LMS) filter and an amplitude spectrum area (AMSA) analysis was developed based only on the analysis of the surface of the corrupted ECG episode...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28113258/an-enhanced-adaptive-filtering-method-for-suppressing-cardiopulmonary-resuscitation-artifact
#10
Yushun Gong, Peng Gao, Liang Wei, Chenxi Dai, Lei Zhang, Yongqin Li
Cardiopulmonary resuscitation (CPR) must be interrupted for reliable rhythm analysis in current automatic external defibrillators (AEDs) because of artifacts produced by chest compressions. However, interruptions in CPR adversely affect the restoration of spontaneous circulation (ROSC) and survival. Suppressing CPR artifacts by digital signal processing techniques is a promising method to enable rhythm analysis during chest compressions, which would eliminate CPR interruptions for rhythm analysis. Although numerous methods have been developed to suppress CPR artifacts, the accuracy of rhythm analysis is still inadequate due to the residual artifact components in the filtered signal...
May 6, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28104427/novel-cpr-system-that-predicts-return-of-spontaneous-circulation-from-amplitude-spectral-area-before-electric-shock-in-ventricular-fibrillation
#11
Yoshihide Nakagawa, Mari Amino, Sadaki Inokuchi, Satoshi Hayashi, Tsutomu Wakabayashi, Tatsuya Noda
AIM: Amplitude spectral area (AMSA), an index for analysing ventricular fibrillation (VF) waveforms, is thought to predict the return of spontaneous circulation (ROSC) after electric shocks, but its validity is unconfirmed. We developed an equation to predict ROSC, where the change in AMSA (ΔAMSA) is added to AMSA measured immediately before the first shock (AMSA1). We examine the validity of this equation by comparing it with the conventional AMSA1-only equation. METHOD: We retrospectively investigated 285 VF patients given prehospital electric shocks by emergency medical services...
January 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/27942341/short-lessons-in-basic-life-support-improve-self-assurance-in-performing-cardiopulmonary-resuscitation
#12
Mario Kobras, Sascha Langewand, Christina Murr, Christiane Neu, Jeannette Schmid
BACKGROUND: There are several reasons why resuscitation measures may lead to inferior results: difficulties in team building, delayed realization of the emergency and interruption of chest compression. This study investigated the outcome of a new form of in-hospital cardiopulmonary resuscitation (CPR) training with special focus on changes in self-assurance of potential helpers when faced with emergency situations. METHODS: Following a 12-month period of CPR training, questionnaires were distributed to participants and non-participants...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#13
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27747683/difficulty-using-smart-pump-logs-to-recreate-a-patient-safety-event-case-study-and-considerations-for-pump-enhancements
#14
Andrew A M Ibey, Derek Andrews, Barb Ferreira
The authors present a case in which a physical anomaly with an infusion pump resulted in an unforeseen fault that the nurse's attempts to resolve unknowingly exacerbated. This case study presents the first report in the literature to detail the difficulty in recreating a patient safety event using smart pump logs, support server continuous quality improvement (CQI) data, and the drug order entry system to elucidate the clinical scenario. A 75-year-old male patient presented to a major teaching hospital and was admitted to the intensive care unit (ICU) with a massive gastrointestinal bleed and myocardial infarction, then stabilized...
December 2016: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27702580/short-ecg-segments-predict-defibrillation-outcome-using-quantitative-waveform-measures
#15
Jason Coult, Lawrence Sherman, Heemun Kwok, Jennifer Blackwood, Peter J Kudenchuk, Thomas D Rea
AIM: Quantitative waveform measures of the ventricular fibrillation (VF) electrocardiogram (ECG) predict defibrillation outcome. Calculation requires an ECG epoch without chest compression artifact. However, pauses in CPR can adversely affect survival. Thus the potential use of waveform measures is limited by the need to pause CPR. We sought to characterize the relationship between the length of the CPR-free epoch and the ability to predict outcome. METHODS: We conducted a retrospective investigation using the CPR-free ECG prior to first shock among out-of-hospital VF cardiac arrest patients in a large metropolitan region (n=442)...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27645811/hands-on-defibrillation-during-active-chest-compressions-eliminating-another-interruption
#16
REVIEW
William Brady, Joshua A Berlat
After decades of research, effective chest compressions have emerged as a key component of high-quality cardiopulmonary resuscitation (CPR) for cardiac arrest patients. Minimizing interruptions in chest compressions is garnering increasing attention as a method to improve CPR quality and outcomes. Hands-on defibrillation has been suggested as both a safe and effective means of reducing interruptions in chest compressions. This article discusses the safety and efficacy of a novel and controversial method to reduce interruptions: hands-on defibrillation...
November 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27366508/does-video-laryngoscopy-offer-advantages-over-direct-laryngoscopy-during-cardiopulmonary-resuscitation
#17
Ayten Saraçoğlu, Olgaç Bezen, Türker Şengül, Egin Hüsnü Uğur, Sibel Şener, Fisun Yüzer
OBJECTIVE: Interruption of chest compressions should be minimized because of its negative effects on survival. This randomized, controlled, cross-over study aimed to analyze the effectiveness of Macintosh, Miller, McCoy and McGrath laryngoscopes during with or without chest compressions in the scope of a simulated cardiopulmonary resuscitation scenario. METHODS: The time required for successful tracheal intubation, number of attempts, dental trauma severity and the need for optimization manoeuvres were recorded during cardiopulmonary resuscitation with and without chest compressions...
August 2015: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27349359/impact-of-a-feedback-device-on-chest-compression-quality-during-extended-manikin-cpr-a-randomized-crossover-study
#18
RANDOMIZED CONTROLLED TRIAL
Clément Buléon, Julie Delaunay, Jean-Jacques Parienti, Laurent Halbout, Xavier Arrot, Jean-Louis Gérard, Jean-Luc Hanouz
PURPOSES: Chest compressions require physical effort leading to increased fatigue and rapid degradation in the quality of cardiopulmonary resuscitation overtime. Despite harmful effect of interrupting chest compressions, current guidelines recommend that rescuers switch every 2 minutes. The impact on the quality of chest compressions during extended cardiopulmonary resuscitation has yet to be assessed. BASIC PROCEDURES: We conducted randomized crossover study on manikin (ResusciAnne; Laerdal)...
September 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27228145/airtraq-laryngoscope-versus-the-conventional-macintosh-laryngoscope-during-pediatric-intubation-performed-by-nurses-a-randomized-crossover-manikin-study-with-three-airway-scenarios
#19
Łukasz Szarpak, Katarzyna Karczewska, Łukasz Czyżewski, Zenon Truszewski, Andrzej Kurowski
OBJECTIVES: We hypothesized that the Airtraq laryngoscope (Airtraq LLC, Bonita Springs, Fla) is beneficial for intubation of pediatric manikins while performing cardiopulmonary resuscitation (CPR). In the present study, we evaluated the effectiveness of the Macintosh (MAC) laryngoscope (HEINE Optotechnik, Munich, Germany) and Airtraq in 3 simulated CPR scenarios. METHODS: A randomized crossover simulation trial was designed. Eighty-three nurses intubated the trachea of a PediaSIM CPR training manikin (FCAE HealthCare, Sarasota, Fla) using the MAC and Airtraq in a normal airway scenario, normal airway with chest compression scenario, and difficult airway with chest compression scenario...
May 25, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27195693/hands-off-time-for-endotracheal-intubation-during-cpr-is-not-altered-by-the-use-of-the-c-mac-video-laryngoscope-compared-to-conventional-direct-laryngoscopy-a-randomized-crossover-manikin-study
#20
COMPARATIVE STUDY
Philipp Schuerner, Bastian Grande, Tobias Piegeler, Martin Schlaepfer, Leif Saager, Matthew T Hutcherson, Donat R Spahn, Kurt Ruetzler
INTRODUCTION: Sufficient ventilation and oxygenation through proper airway management is essential in patients undergoing cardio-pulmonary resuscitation (CPR). Although widely discussed, securing the airway using an endotracheal tube is considered the standard of care. Endotracheal intubation may be challenging and causes prolonged interruption of chest compressions. Videolaryngoscopes have been introduced to better visualize the vocal cords and accelerate intubation, which makes endotracheal intubation much safer and may contribute to intubation success...
2016: PloS One
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