Sergio López-García

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.

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.

Cardiopulmonary Resuscitation Quality by Helicopter Rescue Swimmers While Flying.

OBJECTIVE Our objective was to assess the cardiopulmonary resuscitation (CPR) quality by helicopter rescue swimmers (HRSs) while flying. METHODS Twenty HRSs from the Spanish Maritime Safety took part in this study. The research protocol included 2 phases: a baseline test (5 minutes of CPR on land) and a challenge test (5 minutes of CPR on a Sikorsky S-61N helicopter in-flight). A Laerdal Resusci Anne mannequin with Laerdal PC Skill Reporting (Stavanger, Norway) was used to register CPR variables. RESULTS CPR quality on land versus in-flight was not significantly different. The mean chest compression (CC) depth (52.6 mm on land vs. 51.9 mm in-flight) was inside the recommended range, but mean CC rate (133 vs. 132 per minute), tidal volume (752 vs. 888 mL), and hands-off time (9 per cycle in both tests) were above the 2015 recommended goal. Incomplete chest re-expansion was observed in 19% of on land and 26% in-flight CCs. CPR quality was maintained throughout the 5-minute challenges. CONCLUSION HRSs are able to perform CPR in a flying helicopter with similar quality to CPR on land. They need additional training to avoid excessive CC rates, tidal volumes, and hands-off times and to permit chest re-expansion.