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Mechanical chest compressions

Roger W Nightingale, Cameron R Bass, Barry S Myers
BACKGROUND: Cervical bilateral facet dislocations are among the most devastating spine injuries in terms of likelihood of severe neurological sequelae. More than half of patients with tetraparesis had sustained some form of bilateral facet fracture dislocation. They can occur at any level of the sub-axial cervical spine, but predominate between C5 and C7. The mechanism of these injuries has long been thought to be forceful flexion of the chin towards the chest. This "hyperflexion" hypothesis comports well with intuition and it has become dogma in the clinical literature...
March 8, 2018: Clinical Biomechanics
John P Lichtenberger, Andrew M Kim, Dane Fisher, Peter S Tatum, Brian Neubauer, P Gabriel Peterson, Brett W Carter
Introduction: Combat-related thoracic trauma is a significant contributor to morbidity and mortality of the casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Penetrating, blunt, and blast injuries were the most common mechanisms of trauma. Imaging plays a key role in the management of combat-related thoracic trauma casualties. This review discusses the imaging manifestations of thoracic injuries from penetrating trauma, emphasizing epidemiology and diagnostic clues seen during OEF and OIF...
March 1, 2018: Military Medicine
Grace Koo, Neha Goyal, Jeanne M DeCara, Roberto M Lang, Karima Addetia
Good-quality chest compressions improve outcomes in cardiac arrest. While manual chest compressions are suboptimal in this regard, the LUCAS device has been shown to improve the effectiveness of chest compressions during cardiopulmonary resuscitation (CPR). The complication rate associated with mechanical CPR, however, has not been adequately studied. Limited evidence suggests no difference in internal injury between manual and mechanical CPR. We report the case of a patient on anticoagulation who developed a mediastinal hematoma post mechanical CPR and on whom subtle findings on initial echocardiography could have alerted the clinician to this complication early during the clinical course...
March 6, 2018: Echocardiography
Daniela de Melo Miranda Gonçalves, Gustavo Falbo Wandalsen, Ana Sílvia Scavacini, Fernanda Cordoba Lanza, Ana Lucia Goulart, Dirceu Solé, Amélia Miyashiro Nunes Dos Santos
BACKGROUND: Pulmonary function in former preterm infants may be compromised during childhood. OBJECTIVES: To assess pulmonary function in very-low-birth-weight preterm infants at 6-12 months of corrected age and analyze the factors associated with abnormal pulmonary function. METHODS: Cross-sectional study with preterm infants at 6-12 months of corrected age with birth weight <1500 g. Children with malformations or affected by neuromuscular and respiratory diseases were excluded...
March 2018: Respiratory Medicine
Rebecca Maria Hasler, Sandra Stucky, Heinz Bähler, Aristomenis K Exadaktylos, Frank Neff
OBJECTIVE: Most deaths occur in the pre-hospital setting, whereas mortality in the emergency department (ED) is low (<1%). However, our clinical impression is that some patients are being transported to hospital in devastating conditions with no likelihood of survival, but demanding extensive hospital resources. The decision on whether to transport a dying person to hospital or not is a difficult task for emergency medical services (EMS) personnel. As there is little epidemiological data about these patients, this paper aims to describe this special population...
2018: PloS One
Russell D MacDonald
No abstract text is available yet for this article.
March 2018: Air Medical Journal
Jakob Wollborn, Eva Ruetten, Bjoern Schlueter, Joerg Haberstroh, Ulrich Goebel, Martin A Schick
AIM: Standardized modeling of cardiac arrest and cardiopulmonary resuscitation (CPR) is crucial to evaluate new treatment options. Experimental porcine models are ideal, closely mimicking human-like physiology. However, anteroposterior chest diameter differs significantly, being larger in pigs and thus poses a challenge to achieve adequate perfusion pressures and consequently hemodynamics during CPR, which are commonly achieved during human resuscitation. The aim was to prove that standardized resuscitation is feasible and renders adequate hemodynamics and perfusion in pigs, using a specifically designed resuscitation board for a pneumatic chest compression device...
January 22, 2018: American Journal of Emergency Medicine
Huaqin Liu, Zhui Yu, Ying Li, Bin Xu, Baihui Yan, Wulf Paschen, David S Warner, Wei Yang, Huaxin Sheng
Experimental cardiac arrest (CA) in aging research is infrequently studied in part due to the limitation of animal models. We aimed to develop an easily performed mouse CA model to meet this need. A standard mouse KCl-induced CA model using chest compressions and intravenous epinephrine for resuscitation was modified by blood withdrawal prior to CA onset, so as to decrease the requisite KCl dose to induce CA by decreasing the circulating blood volume. The modification was then compared to the standard model in young adult mice subjected to 8 min CA...
February 2018: Aging and Disease
Keith Couper, Rochelle M Velho, Tom Quinn, Anne Devrell, Ranjit Lall, Barry Orriss, Joyce Yeung, Gavin D Perkins
OBJECTIVES: To evaluate the effect of training strategy on team deployment of a mechanical chest compression device. DESIGN: Randomised controlled manikin trial. SETTING: Large teaching hospital in the UK. PARTICIPANTS: Twenty teams, each comprising three clinicians. Participating individuals were health professionals with intermediate or advanced resuscitation training. INTERVENTIONS: Teams were randomised in a 1:1 ratio to receive either standard mechanical chest compression device training or pit-crew device training...
February 1, 2018: BMJ Open
M E M Vester, R A C Bilo, H G T Nijs, R R van Rijn
We present two cases of infants who died under suspicious circumstances. After clinical and legal investigations, non-accidental constrictive asphyxia inflicted by one of the parents was established. The first case presents a to date not yet reported, unique mechanism of trauma. In order to stop his daughter from crying, the father admitted that he sometimes sat on his baby while she was lying on the bed. Occasionally increasing his force by pulling with his hands on the bottom of the bed. In the second case tight swaddling and encircling chest compression was the causative mechanism...
January 10, 2018: Forensic Science International
Nicolas Newell, A Phillip Pearce, Edward Spurrier, Iain Gibb, Claire E Webster, Spyros D Masouros, Jonathan C Clasper
BACKGROUND: A range of devastating blast injuries have been sustained by personnel during recent conflicts. Previous studies have focused on severe injuries, including to the spine, however, no study has specifically focused on the most common spinal injury; transverse process (TP) fractures. Although their treatment usually requires limited intervention, analysis of TP fractures may help determine injury mechanisms. METHODS: Data was collected from victims with spinal fractures injured in Improvised Explosive Device (IED) attacks, from the UK's Joint Theatre Trauma Registry...
January 24, 2018: Journal of Trauma and Acute Care Surgery
Tae Han Kim, Yu Jin Lee, Eui Jung Lee, Young Sun Ro, KyungWon Lee, Hyeona Lee, Dayea Beatrice Jang, Kyoung Jun Song, Sang Do Shin, Helge Myklebust, Tonje Søraas Birkenes
INTRODUCTION: For cardiac arrests witnessed at home, the witness is usually a middle-aged or older housewife. We compared the quality of cardiopulmonary resuscitation (CPR) performance of bystanders trained with the newly developed telephone-basic life support (T-BLS) program and those trained with standard BLS (S-BLS) training programs. METHODS: Twenty-four middle-aged and older housewives without previous CPR education were enrolled and randomized into two groups of BLS training programs...
February 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Ryan Newberry, Ted Redman, Elliot Ross, Rachel Ely, Clayton Saidler, Allyson Arana, David Wampler, David Miramontes
INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is a major cause of death and morbidity in the United States. Quality cardiopulmonary resuscitation (CPR) has proven to be a key factor in improving survival. The aim of our study was to investigate the outcomes of OHCA when mechanical CPR (LUCAS 2 Chest Compression System™) was utilized compared to conventional CPR. Although controlled trials have not demonstrated a survival benefit to the routine use of mechanical CPR devices, there continues to be an interest for their use in OHCA...
January 18, 2018: Prehospital Emergency Care
Emmanuel Charbonney, Stéphane Delisle, Dominique Savary, Gilles Bronchti, Marceau Rigollot, Adrien Drouet, Bilal Badat, Paul Ouellet, Patrice Gosselin, Alain Mercat, Laurent Brochard, Jean-Christophe M Richard
BACKGROUND: Studying ventilation and intrathoracic pressure (ITP) induced by chest compressions (CC) during Cardio Pulmonary Resuscitation is challenging and important aspects such as airway closure have been mostly ignored. We hypothesized that Thiel Embalmed Cadavers could constitute an appropriate model. METHODS: We assessed respiratory mechanics and ITP during CC in 11 cadavers, and we compared it to measurements obtained in 9 out-of-hospital cardiac arrest patients and to predicted values from a bench model...
January 6, 2018: Resuscitation
Kathleen Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, John Berger, George Ofori-Amanfo, Christopher J L Newth, J Michael Dean, Frank W Moler
OBJECTIVE: To investigate clinical characteristics associated with 12-month survival and neurobehavioural function among children recruited to the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital trial. METHODS: Children (n = 329) with in-hospital cardiac arrest who received chest compressions for ≥2 min, were comatose, and required mechanical ventilation after return of circulation were included. Neurobehavioural function was assessed using the Vineland Adaptive Behaviour Scales, second edition (VABS-II) at baseline (reflecting pre-arrest status) and 12 months post-arrest...
January 6, 2018: Resuscitation
Zhengfei Yang, Qingyu Liu, Guanghui Zheng, Zhifeng Liu, Longyuan Jiang, Qing Lin, Rui Chen, Wanchun Tang
Background: A compression-ventilation (C:V) ratio of 30:2 is recommended for adult cardiopulmonary resuscitation (CPR) by the current American Heart Association (AHA) guidelines. However, continuous chest compression (CCC) is an alternative strategy for CPR that minimizes interruption especially when an advanced airway exists. In this study, we investigated the effects of 30:2 mechanical CPR when compared with CCC in combination with regular ventilation in a porcine model. Methods: Sixteen male domestic pigs weighing 39±2 kg were utilized...
September 2017: Journal of Thoracic Disease
Lixiang Wang, Wei Song, Sisen Zhang
Chest compression cannot be effectively applied under certain situations, such as chest wall deformity, rib fracture, or hemopneumothorax. Active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) could reach better resuscitation outcomes in certain cardiac arrest (CA) patients. AACD-CPR can strengthen the high quality of cardiopulmonary resuscitation (CPR) in "2015 American Heart Association for cardiopulmonary resuscitation and emergency cardiovascular care update guide"...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Javier J Lasa, Parag Jain, Tia T Raymond, Charles G Minard, Alexis Topjian, Vinay Nadkarni, Michael Gaies, Melania Bembea, Paul A Checchia, Lara S Shekerdemian, Ravi Thiagarajan
OBJECTIVES: Although clinical and pharmacologic guidelines exist for the practice of cardiopulmonary resuscitation in children (Pediatric Advanced Life Support), the practice of extracorporeal cardiopulmonary resuscitation in pediatric cardiac patients remains without universally accepted standards. We aim to explore variation in extracorporeal cardiopulmonary resuscitation procedures by surveying clinicians who care for this high-risk patient population. DESIGN: A 28-item cross-sectional survey was distributed via a web-based platform to clinicians focusing on cardiopulmonary resuscitation practices and extracorporeal membrane oxygenation team dynamics immediately prior to extracorporeal membrane oxygenation cannulation...
February 2018: Pediatric Critical Care Medicine
Jorge López, Sarah N Fernández, Rafael González, María J Solana, Javier Urbano, Blanca Toledo, Jesús López-Herce
AIMS: Chest compressions (CC) during cardiopulmonary resuscitation are not sufficiently effective in many circumstances. Mechanical CC could be more effective than manual CC, but there are no studies comparing both techniques in children. The objective of this study was to compare the effectiveness of manual and mechanical chest compressions with Thumper device in a pediatric cardiac arrest animal model. MATERIAL AND METHODS: An experimental model of asphyxial cardiac arrest (CA) in 50 piglets (mean weight 9...
2017: PloS One
Torben K Becker, Aric W Berning, Arjun Prabhu, Clifton W Callaway, Francis X Guyette, Christian Martin-Gill
AIM OF THE STUDY: Mechanical chest compression (MCPR) devices are considered equivalent to manual compressions in patient outcomes in out-of-hospital cardiac arrest (OHCA). However, recent data suggest possible harm in patients with a supraglottic airway device (SGA) during MCPR. The aim of this study was to evaluate differences in direct and indirect markers of ventilation and perfusion in patients with cardiac arrest receiving MCPR and who had their airway managed with an endotracheal tube (ETT) or SGA...
January 2018: Resuscitation
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