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Which technique for resuscitation physicians should use? Preliminary data

Published:September 03, 2018DOI:https://doi.org/10.1016/j.ajem.2018.09.001
      Sudden cardiac arrest is among the most serious health problems in both Europe and the United States [
      • Freund B.
      • Kaplan P.W.
      A review of the utility of a hypothermia protocol in cardiac arrests due to non-shockable rhythms.
      ,
      • Aleksandrowicz S.
      • Madziala M.
      • Iskrzycki L.
      • Truszewski Z.
      • Gawlowski P.
      Performance of chest compressions with the use of the new mechanical chest compression machine Lifeline ARM: a randomized crossover manikin study in novice physicians.
      ]. The ability to perform cardiopulmonary resuscitation is among the basic skills that should be possessed by medical personnel, including physicians, nurses, and paramedics [
      • Treptau J.
      • Ebnet J.
      • Akin M.
      • Tongers J.
      • Bauersachs J.
      • Brehm M.
      • et al.
      Angiographic detection of fatal acute aortic dissection Stanford type A under resuscitation.
      ,
      • Jorge-Soto C.
      • Abilleira-González M.
      • Otero-Agra M.
      • Barcala-Furelos R.
      • Abelairas-Gómez C.
      • Szarpak L.
      • et al.
      Schoolteachers as candidates to be basic life support trainers: a simulation trial.
      ,
      • Pakula R.J.
      • Wanat S.
      CPR in terms of maritime search and rescue service working conditions.
      ]. The current resuscitation guidelines emphasize minimizing interruptions in chest compressions as a key factor affecting resuscitation effectiveness and thus the return of spontaneous circulation. According to the current guidelines, high-quality chest compressions are characterized by an appropriate frequency of 100–120 compressions per minute (CPM), a corresponding compression depth of 50–60 mm, as well as complete chest relaxation after each compression [
      • Szarpak L.
      • Truszewski Z.
      • Czyzewski L.
      • Frass M.
      • Robak O.
      CPR using the lifeline ARM mechanical chest compression device: a randomized, crossover, manikin trial.
      ]. Performing chest compressions in this way determines the most effective perfusion pressure and increases the chances for the return of spontaneous circulation [
      • Evrin T.
      • Bielski K.T.
      Is there any difference between different infant chest compression methods?.
      ,
      • Czekajlo M.
      • Dabrowska A.
      In situ simulation of cardiac arrest.
      ]. According to many studies, though, the quality of resuscitation – even performed by medical personnel – is often insufficient. Paramedics perform chest compressions exceeding the recommended maximum rate and not reaching the recommendation for chest compression depth.
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