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cpr interrupted

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 Saf Case Rep
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)...
October 1, 2016: Resuscitation
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...
August 10, 2016: American Journal of Emergency Medicine
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
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
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
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
Preethi William, Prashant Rao, Uday B Kanakadandi, Alejandro Asencio, Karl B Kern
Cardiac arrest, though not common during coronary angiography, is increasingly occurring in the catheterization laboratory because of the expanding complexity of percutaneous interventions (PCI) and the patient population being treated. Manual chest compression in the cath lab is not easily performed, often interrupted, and can result in the provider experiencing excessive radiation exposure. Mechanical cardiopulmonary resuscitation (CPR) provides unique advantages over manual performance of chest compression for treating cardiac arrest in the cardiac cath lab...
May 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
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
Takashi Cho, Nobuyasu Komasawa, Kazuo Hattori, Ryosuke Mihara, Toshiaki Minami
BACKGROUND: Recent guidelines for infant cardiopulmonary resuscitation emphasize that all rescuers should minimize interruption of chest compression, even for endotracheal intubation. OBJECTIVE: We compared the utility of application of a gum-elastic bougie (GEB) plus Miller laryngoscope (Mil) with the Mil alone during chest compression on an infant mannequin. METHODS: Sixteen anesthesiologists with more than 2 years of experience performed tracheal intubation on an infant mannequin using the Mil or Mil plus 6Fr GEB, with or without chest compression...
July 2016: Journal of Emergency Medicine
David A Pearson, R Darrell Nelson, Lisa Monk, Clark Tyson, James G Jollis, Christopher B Granger, Claire Corbett, Lee Garvey, Michael S Runyon
BACKGROUND: Team-focused CPR (TFCPR) is a choreographed approach to cardiopulmonary resuscitation (CPR) with emphasis on minimally interrupted high-quality chest compressions, early defibrillation, discourages endotracheal intubation and encourages use of the bag-valve-mask (BVM) and/or blind-insertion airway device (BIAD) with a ventilation rate of 8-10 breaths/min to minimize hyperventilation. Widespread incorporation of TFCPR in North Carolina (NC) EMS agencies began in 2011, yet its impact on outcomes is unknown...
August 2016: Resuscitation
Jong Won Kim, Sang O Park, Kyeong Ryong Lee, Dae Young Hong, Kwang Je Baek, Young Hwan Lee, Jeong Hun Lee, Pil Cho Choi
AIM: This study compared endotracheal intubation (ETI) performance during cardiopulmonary resuscitation (CPR) between direct laryngoscopy (DL) and video laryngoscopy (VL) (GlideScope(®)) by experienced intubators (>50 successful ETIs). METHODS: This was a prospective randomized controlled study conducted in an emergency department between 2011 and 2013. Intubators who used DL or VL were randomly allocated to ETI during CPR. Data were collected from recorded video clips and rhythm sheets...
August 2016: Resuscitation
Gabriel Putzer, Patrick Braun, Giacomo Strapazzon, Martha Toferer, Miriam Mulino, Bernhard Glodny, Markus Falk, Hermann Brugger, Peter Paal, Raimund Helbok, Peter Mair
BACKGROUND AND AIM: Limited data are available concerning the impact of CPR interventions on cerebral oxygenation during hypothermic cardiac arrest. We therefore studied cerebral perfusion pressure (CPP), brain tissue oxygen tension (PbtO2), cerebral venous oxygen saturation (ScvO2) and regional cerebral oxygen saturation (rSO2) in an animal model of hypothermic CPR. We also assessed the correlation between rSO2 and CPP, PbtO2 and ScvO2 to clarify whether near-infrared spectroscopy (NIRS) may be used to non-invasively monitor changes in cerebral oxygenation during hypothermic CPR...
July 2016: Resuscitation
Charles D Deakin, Rudolph W Koster
PURPOSE OF REVIEW: This article summarizes current knowledge of the causes and consequences of interruption of chest compressions during cardiopulmonary resuscitation. RECENT FINDINGS: Pauses in chest compressions occur during analysis of the heart rhythm, delivery of ventilation, interventions such as intubation, and gaining intravenous access, but pauses may also be unprompted. Pauses related to defibrillation are because of preshock pauses for rhythm analysis and charging, and postshock pauses to evaluate the outcome of the shock...
June 2016: Current Opinion in Critical Care
Roberta Affatato, Yongqin Li, Giuseppe Ristagno
PURPOSE OF REVIEW: Automated external defibrillators require preshock interruptions in cardiopulmonary resuscitation (CPR) to perform rhythm analysis. Artifact filtering technology may provide the opportunity to visualize the underlying ECG trace during CPR. Moreover, a continuous ventricular fibrillation analysis may be performed such to prioritize CPR interventions, that is, chest compression or defibrillation. RECENT FINDINGS: Different ECG filtering techniques and ventricular fibrillation analysis algorithms to predict defibrillation outcome have been developed...
June 2016: Current Opinion in Critical Care
Andreas Bohn, Stephan Seewald, Jan Wnent
Witnesses of a sudden cardiac arrest play a key-role in resuscitation. Lay-persons should therefore be trained to recognize that a collapsed person who is not breathing at all or breathing normally might suffer from cardiac arrest. Information of professional emergency medical staff by lay-persons and their initiation of cardio-pulmonary-resuscitation-measures are of great importance for cardiac-arrest victims. Ambulance-dispatchers have to support lay-rescuers via telephone. This support includes the localisation of the nearest Automatic External Defibrillator (AED)...
March 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Marc R Wong, Matt J Reggio, Freddy R Morocho, Monica M Holloway, Jose C Garcia-Blanco, Constance Jenkins, Arthur D Johnson
BACKGROUND: Interruptions in cardiopulmonary resuscitation (CPR) to obtain vascular access reduces blood flow to vital organs. Tibial intraosseous (TIO) access may be a faster alternative to intravenous (IV) access for delivery of vasoactive medications. The purpose of this study was to examine the differences in pharmacokinetics and pharmacodynamics of TIO- and IV-delivered epinephrine. MATERIALS AND METHODS: A prospective, between subjects, experimental design comparing Cmax, Tmax, return of spontaneous circulation (ROSC), and time to ROSC...
April 2016: Journal of Surgical Research
Emma Wallace, Maike J M Uijen, Barbara Clyne, Atieh Zarabzadeh, Claire Keogh, Rose Galvin, Susan M Smith, Tom Fahey
OBJECTIVES: Following appropriate validation, clinical prediction rules (CPRs) should undergo impact analysis to evaluate their effect on patient care. The aim of this systematic review is to narratively review and critically appraise CPR impact analysis studies relevant to primary care. SETTING: Primary care. PARTICIPANTS: Adults and children. INTERVENTION: Studies that implemented the CPR compared to usual care were included...
2016: BMJ Open
Simon Gates
No abstract text is available yet for this article.
March 24, 2016: New England Journal of Medicine
Jean-Jacques Parienti
No abstract text is available yet for this article.
March 24, 2016: New England Journal of Medicine
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