Nedas Jasinskas

Magical manoeuvre: a 5-s instructor's intervention helps lightweight female rescuers achieve the required chest compression depth.

Background Adequate chest compression (CC) depth is crucial for resuscitation outcomes. Lightweight rescuers, particularly women, are often unable to achieve the required 5–6 cm CC depth. This nonrandomized cohort study investigated new strategies to improve CC performance. Objective To evaluate the effects of a 5-s instructor’s intervention on the depth of CCs performed by female rescuers during standard video self-instruction basic life support training. Methods Data were prospectively collected from January 2011 to January 2012 from 336 female medical and pharmacy students undergoing cardiopulmonary resuscitation (CPR) training at the Lithuanian University of Health Sciences. During the training process, the instructors performed a simple 5-s intervention (Andrew’s manoeuvre) with all of the rescuers in the study group. The instructor pushed 10 times on the shoulders of each trainee while she performed CCs to achieve the maximal required compression depth. Immediately after training, the participants were asked to perform a 6-min basic life support test on a manikin that was connected to a PC with Skill Reporter System software; the quality of the participants’ CPR skills was then evaluated. Results The CC depth in the study group increased by 6.4 mm (P<0.001) compared with the control group (52.9 vs. 46.6 mm). A regression analysis showed that Andrew’s manoeuvre increased the depth of the CCs among women by 14.87×(1−0.01×weight) mm. Conclusion A simple 5-s instructor’s intervention during the CPR training significantly improved the performance of the female rescuers and helped them achieve the CC depth required by 2010 resuscitation guidelines. Andrew’s manoeuvre is most effective among the women with the lowest body weight.

Evaluation of volume status in a prehospital setting by ultrasonographic measurement of inferior vena cava and aorta diameters

Objectives The aim of this study was to evaluate the utility of ultrasonographic measurement of the diameter of the inferior vena cava (IVCD) and abdominal aorta (AAD) for assessing volume status. Material and methods This was a prospective, observational study. A total of 23 volunteers participated in the study. Each participant was selected randomly. All participants completed the 2016 Kaunas Marathon. Participants filed out a brief survey about their fluid intake (in standardised glasses) in the 24 h before the race and during the race. Participants underwent ultrasound measurements 10–40 min before the start of the race and 3–15 min after finishing the race. To visualize respiratory variation, M-mode was used, with the beam crossing the IVCD 2 cm from the right atrium. The AAD was measured 1 cm above the celiac trunk. IVCD in expiration (IVCDexp)/AAD was calculated by dividing the value of IVCDexp by the value of AAD. The findings were compared with difference in body mass index. Results The mean weight lost after the marathon was 2.93 kg (p < 0.001). Mean IVCD in inspiration (IVCDins) after the run was lower by 0.39 cm (p < 0.001) then before the run. Mean IVCDexp/AAD after the run was 0.24 cm lower than before the run (p = 0.03). Before and after the marathon, there was a statistically significant negative correlation in weight difference, with mean IVCDexp difference (p = 0.047). There was no statistically significant difference in caval index before and after running. Conclusion Ultrasonographic assessment of IVCDexp could be useful in the evaluation of volume status.