Cristian Abelairas-Gómez

The effect of strength training on quality of prolonged basic cardiopulmonary resuscitation

BACKGROUND Providing high-quality chest compressions and rescue breaths are key elements in the effectiveness of cardio-pulmonary resuscitation. AIM To investigate the effects of a strength training programme on the quality of prolonged basic cardiopulmonary resuscitation on a manikin. METHODS This was a quasi-experimental trial. Thirty-nine participants with prior basic life support knowledge were randomised to an experimental or control group. They then performed a test of 10 min of chest compressions and mouth-to-mouth ventilation on manikins equipped with a skill reporter tool (baseline or test 1). The experimental group participated in a four-week strength training programme focused on the muscles involved in chest compressions. Both groups were subsequently tested again (test 2). RESULTS After training, the experimental group significantly increased the mean depth of compression (53.7 ± 2.3 mm vs. 49.9 ± 5.9 mm; p = 0.003) and the correct compression fraction (68.2 ± 21.0% vs. 46.4 ± 29.1%; p = 0.004). Trained subjects maintained chest compression quality over time better than the control group. The mean tidal volume delivered was higher in the experimental than in the control group (701.5 ± 187.0 mL vs. 584.8 ± 113.6 mL; p = 0.040) and above the current resuscitation guidelines. In test 2, the percentage of rescue breaths with excessive volume was higher in the experi-mental group than in the controls (31.5 ± 19.6% vs. 15.6 ± 13.0%; p = 0.007). CONCLUSIONS A simple strength training programme has a significant impact on the quality of chest compressions and its maintenance over time. Additional training is needed to avoid over-ventilation of potential patients.

Can surf-lifeguards perform a quality cardiopulmonary resuscitation sailing on a lifeboat? A quasi-experimental study

Purpose Drowning is a high-priority public health problem around the world. The European Resuscitation Council Guidelines for Resuscitation 2015 put special emphasis on special environments like open waters. Stopping the drowning process as soon as possible and starting an early cardiopulmonary resuscitation (CPR) improve survival. Inflatable rescue boats (IRBs) are used around the world in the water rescue of drowning victims. Our objective was to test the quality of CPR performed by surf-lifeguards while sailing on an IRB. Methods A quasi-experimental simulation trial was conducted in Tenerife (Canary Islands—Spain) on September 2015. Ten surf-lifeguards were asked to perform a 2 min CPR on manikins in four different scenarios: (1) onshore, (2) on adrift boat, (3) on a boat sailing at 5 knots and (4) on a boat sailing at 10 knots. CPR was performed individually and was measured by means of CPRmeter (Laerdal, Norway) located on the standard manikin. Repeated measures analysis of variance was used in order to analyse the differences between scenarios. Results The composite of all CPR variables was over 84% in all conditions, but it was lower when CPR was performed on board: onshore (96.49±3.58%) versus adrift (91.80±3.56, p=0.04), sailing at 5 knots (88.65±5.54, p=0.03) and sailing at 10 knots (84.74±5.56, p=0.001). Conclusion Surf-lifeguards are able to deliver good-quality CPR even on a moving IRB, but their performance is lower than onshore. This fact should be considered in real cases to balance the risk and benefits of CPR on board.

Teachers’ Perceptions of Preschool Children’s Psychomotor Development in Spain:

This study analyzed the psychomotor profiles of preschool stage students and to determine how these data agreed with the students’ teachers’ subjective assessment. We also correlated these data with other variables such as age, gender, and family influence. A total of 211 children aged 3 to 6 years, in the second cycle of preschool from 30 classes of 10 schools in Spain participated. Additionally, 30 preschool teachers from these classes participated. Study results revealed serious teacher misperceptions regarding their students’ psychomotor development, with low agreement rates between students and teachers in the motor dimension and slight agreement rates in communicative, cognitive, and social areas. The reasons for and implications of these misperceptions are discussed.

Acute muscle fatigue and CPR quality assisted by visual feedback devices: A randomized-crossover simulation trial

Objective To analyse the acute muscular fatigue (AMF) in triceps brachii and rectus abdominis during compression-only and standard cardiopulmonary resuscitation (CPR) performed by certified basic life support providers. Methods Twenty-six subjects were initially recruited and randomly allocated to two study groups according to the muscles analysed; eighteen finally met the inclusion criteria (nine in each group). Both groups carried out two CPR tests (compression-only and standard CPR) of 10 min divided into five 2-min intermittent periods. The ventilation method was freely chosen by each participant (mouth-to-mouth, pocket-mask or bag-valve-mask). CPR feedback was provided all the time. AMF was measured by tensiomyography at baseline and after each 2-min period of the CPR test, in triceps brachii or rectus abdominis according to the study group. Results Rectus abdominis’ contraction time increased significantly during the fifth CPR period (p = 0.020). Triceps brachii’s radial muscle belly displacement (p = 0.047) and contraction velocity (p = 0.018) were lower during compression-only CPR than during standard CPR. Participants who had trained previously with feedback devices achieved better CPR quality results in both protocols. Half of participants chose bag-valve-mask to perform ventilations but attained lower significant ventilation quality than the other subjects. Conclusions Compression-only CPR induces higher AMF than standard CPR. Significantly higher fatigue levels were found during the fifth CPR test period, regardless of the method. Adequate rescuer’s strength seems to be a requisite to take advantage of CPR quality feedback devices. Training should put more emphasis on the quality of ventilation during CPR.

Nueva técnica de masaje cardíaco en lactantes

OBJECTIVE To compare the quality of chest compressions performed according to the classical technique (MT) versus a new technique (NM) (compression with 2thumbs with closed fists) in an infant manikin. DESIGN A controlled, randomized cross-over study was carried out in professionals assisting pediatric patients. SETTING A University Hospital with a Pediatric ICU in the north of Spain. PARTICIPANTS Residents and nurses in Pediatrics who had completed a basic and an advanced pediatric cardiopulmonary resuscitation course. INTERVENTIONS Quantitative analysis of the variables referred to chest compression quality in a 2-minute cardiopulmonary resuscitation scenario in infants. Laerdals SimPad® with SkillReporter™ system was used. MAIN VARIABLES OF INTEREST Mean rate and percentage of compressions in the recommended rate range, mean depth and percentage of compressions within the depth range of recommendations, percentage of compressions with adequate decompression, and percentage of compressions performed with the fingers in the center of the chest. RESULTS Global quality of the compressions (NM: 84.2±23.7% vs. MT: 80.1±25.4% [p=0.25; p=ns]), percentage of compressions with correct depth (NM: 59.9±35.8% vs. MT: 59.5±35.7% [p=0.76; p=ns]), mean depth reached (NM: 37.3±3.8mm vs. MT: 36±5.3mm [p=0.06; p=ns]), percentage of complete re-expansion of the chest (NM: 94.4±9.3% vs. MT: 92.4±18.3% [p=0.58; p=ns]), and percentage of compressions with the recommended rate (NM: 62.2±34.6% vs. MT: 51±37.2% [p=0.13; p=ns]) proved similar with both methods. CONCLUSIONS The quality of chest compressions with the new method (thumbs with closed fists) is similar to that afforded by the traditional method.

Down syndrome people capable of learning and performing foreign body airway obstruction treatment algorithm

Please cite this article as: Cristian Abelairas-Gómez, Candela Gómez-González, Pilar Leboráns-Iglesias, Sergio Álvarez-Pérez, Andrea Corrales, Sergio López-García, Antonio Rodríguez-Núñez , Are Down syndrome people capable of learning and performing foreign body airway obstruction treatment algorithm? Yes, they are!. The address for the corresponding author was captured as affiliation for all authors. Please check if appropriate. Yajem(2017), doi:10.1016/j.ajem.2018.03.044

What biomechanical factors are more important in compression depth for children lifesavers? A randomized crossover study

Objective: To evaluate the biomechanical aspects involved in Cardiopulmonary Resuscitations compression depth by children. Methods: A randomized crossover study with 196 children between 9 and 14 years‐old was conducted. The children performed four CPR hands‐only tests of 1 min in four different heights (floor, 5 cm, 10 cm, and 15 cm). Anthropometric, angulation and quality of CPR variables were registered during the tests. Results: CPR quality was sub‐optimal in all tests. Tests with the simulated victim placed on the floor had the best compression quality. Children that made deeper compressions had significantly higher values in all anthropometric variables. Analysis gives more discriminatory power to the anthropometric variables than angulation variables on compression depth. Conclusion: Chest compression depth obtained by children depends more on their anthropometric characteristics than on their body position. The approximate age to perform compressions with an acceptable quality is 12 years‐old. The use of steps increased arm angle, getting it closer to 90° but did not increase quality CPR when compared with performance on the floor.

Prehospital Emergency Medicine at the Beach: What Is the Effect of Fins and Rescue Tubes in Lifesaving and Cardiopulmonary Resuscitation After Rescue?

OBJECTIVE To analyze the influence of fins and rescue tube use in a water rescue, assessed by time and distance to salvage position, physiological parameters, and cardiopulmonary resuscitation (CPR). METHODS Twenty professional lifeguards (10 men, 10 women) conducted 3 tests: a baseline test of 5 minutes of CPR and 2 water rescues, 1 without rescue equipment (NRE), and the other with fins and rescue tube (FRT). They also had to perform 5 minutes of CPR after each rescue. Time and distance of the rescues, physiological parameters (blood lactate concentration and heart rate), and quality of CPR were analyzed. RESULTS CPR quality worsened by 26 to 28% (P < .001) after rescue. However, there were no differences using FRT. The use of rescue equipment reduced the time (FRT: 216±57 seconds; NRE: 319±127 seconds; P < .001) and distance covered (FRT: 265±52 m; NRE: 326±41 m; P < .001). No differences were found in lactate levels between FRT and NRE just after the rescues, but there were some after 5 minutes of subsequent CPR (FRT: 10.7±2.2 mmol/L; NRE: 12.6±1.8 mmol/L; P < .001). Comparing women with men, we found significant differences in lactate concentrations only in FRT (women: 9.6±1.4 mmol/L; men: 8.1±1.2 mmol/L; P = .031). CONCLUSIONS The use of fins and rescue tube provides a comprehensive benefit in an aquatic emergency. However, FRT did not have any effect on the quality of the postrescue CPR.

Utilidad de un dispositivo luminoso simple para mejorar el aprendizaje del masaje cardiaco

INTRODUCTION The recommendations on cardiopulmonary resuscitation (CPR) emphasize the quality of the manoeuvres, especially chest compressions (CC). Audiovisual feedback devices could improve the quality of the CC during CPR. The aim of this study was to evaluate the usefulness of a simple lighting device as a visual aid during CPR on a mannequin. MATERIAL AND METHODS Twenty-two paediatricians who attended an accredited paediatric CPR course performed, in random order, 2min of CPR on a mannequin without and with the help of a simple lighting device, which flashes at a frequency of 100 cycles per minute. The following CC variables were analyzed using a validated compression quality meter (CPRmeter®): depth, decompression, rate, CPR time and percentage of compressions. RESULTS With the lighting device, participants increased average quality (60.23±54.50 vs. 79.24±9.80%; P=.005), percentage in target depth (48.86±42.67 vs. 72.95±20.25%; P=.036) and rate (35.82±37.54 vs. 67.09±31.95%; P=.024). CONCLUSIONS A simple light device that flashes at the recommended frequency improves the quality of CC performed by paediatric residents on a mannequin. The usefulness of this CPR aid system should be assessed in real patients.

Implantación de programas educativos para prevenir ahogamientos. ¿Qué se puede hacer desde la escuela infantil?

Drowning is regarded as a ‘‘global killer’’ that has not received the attention it requires. In Spain, drowning is responsible for 13% of global childhood mortality due to injuries and is the second most frequent cause of accidental death, after traffic accidents. Drowning is preventable, and recommendations of demonstrated efficacy have been established, such as the supervision of children, the presence of lifeguards, adequate information and signaling, the protection of aquatic spaces and the use of adequate flotation devices such as life vests. In countries with a strong public safeguarding tradition such as Australia, educational programs have been shown to offer positive results in terms of learning and prevention. However, to the best of our knowledge, no studies in Spain have analyzed the most appropriate contents and methodology for introducing the prevention of drowning in school education. We thus sought to evaluate