CPR with restricted patient access using alternative rescuer positions: a randomised cross-over manikin study simulating the CPR scenario after avalanche burial
- PMID: 34481521
- PMCID: PMC8418718
- DOI: 10.1186/s13049-021-00944-9
CPR with restricted patient access using alternative rescuer positions: a randomised cross-over manikin study simulating the CPR scenario after avalanche burial
Erratum in
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Correction to: CPR with restricted patient access using alternative rescuer positions: a randomised cross-over manikin study simulating the CPR scenario after avalanche burial.Scand J Trauma Resusc Emerg Med. 2021 Sep 29;29(1):143. doi: 10.1186/s13049-021-00957-4. Scand J Trauma Resusc Emerg Med. 2021. PMID: 34587979 Free PMC article. No abstract available.
Abstract
Background: The aim of this manikin study was to evaluate the quality of cardiopulmonary resuscitation (CPR) with restricted patient access during simulated avalanche rescue using over-the-head and straddle position as compared to standard position.
Methods: In this prospective, randomised cross-over study, 25 medical students (64% male, mean age 24) performed single-rescuer CPR with restricted patient access in over-the-head and straddle position using mouth-to-mouth ventilation or pocket mask ventilation. Chest compression depth, rate, hand position, recoil, compression/decompression ratio, hands-off times, tidal volume of ventilation and gastric insufflation were compared to CPR with unrestricted patient access in standard position.
Results: Only 28% of all tidal volumes conformed to the guidelines (400-800 ml), 59% were below 400 ml and 13% were above 800 ml. There was no significant difference in ventilation parameters when comparing standard to atypical rescuer positions. Participants performed sufficient chest compressions depth in 98.1%, a minimum rate in 94.7%, correct compression recoil in 43.8% and correct hand position in 97.3% with no difference between standard and atypical rescuer positions. In 36.9% hands-off times were longer than 9 s.
Conclusions: Efficacy of CPR from an atypical rescuer position with restricted patient access is comparable to CPR in standard rescuer position. Our data suggest to start basic life-support before complete extrication in order to reduce the duration of untreated cardiac arrest in avalanche rescue. Ventilation quality provided by lay rescuers may be a limiting factor in resuscitation situations where rescue ventilation is considered essential.
Keywords: Asphyxia; Atypical rescuer position; Confined space; Resuscitation; Ventilation.
© 2021. The Author(s).
Conflict of interest statement
The authors declare no competing interests.
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References
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- Brugger H, Durrer B, Elsensohn F, Paal P, Strapazzon G, Winterberger E, et al. Resuscitation of avalanche victims: Evidence-based guidelines of the international commission for mountain emergency medicine (ICAR MEDCOM): intended for physicians and other advanced life support personnel. Resuscitation. 2013;84(5):539–546. doi: 10.1016/j.resuscitation.2012.10.020. - DOI - PubMed
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