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Trauma
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Danielle M. Prentice, Lauren A. Plante
Indications for beginning cardiopulmonary resuscitation (CPR) are no different in pregnant patients. Algorithms for treatment, including drugs and defibrillation, are unchanged by the fact of pregnancy [82]. After mid-pregnancy, left uterine displacement should be effected so as to avoid caval compression: this may be done with a wedge under the right hip, manual displacement of the uterus from above, or with a human wedge in which the patient's right hip is lifted onto a rescuer's knees. The 2015 American Heart Association (AHA) guidelines advocate manual uterine displacement in preference to the other techniques because of easier access for defibrillation and airway management and the potential for more effective chest compressions when the patient is not tilted [82]. Survival among pregnant patients undergoing CPR in the emergency department after traumatic injury has been reported as 17% in a national administrative dataset, worse than age-matched non-pregnant controls [83].
Recognition and management of cardiopulmonary arrest
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
CPR commences immediately after defibrillation without checking for a pulse. This is because, even if a perfusing rhythm has been restored, it is unlikely that a pulse will be felt immediately, and the delay will be harmful if the defibrillation has not been successful.
Drowning
Published in Mike Tipton, Adam Wooler, The Science of Beach Lifeguarding, 2018
As soon as the drowning person is removed from the water, lay and professional rescuers must recognize the drowning severity, especially if there is a life-threatening situation such as an isolated respiratory or full cardiopulmonary arrest, so that immediate care can be provided. If a rescuer is in doubt as to whether the person is alive or not, they should always start CPR as this gives the patient a much greater chance of survival [4].
Effect of Wearing N95 Mask on the Quality of Chest Compressions in Prehospital Emergency Personnel: A Cross-over Study
Published in Prehospital Emergency Care, 2023
Liang Chen, Yang Shen, Shuangmei Liu, Yanyan Cao, Zhe Zhu
Out-of-hospital cardiac arrest is a leading cause of global mortality (1). Cardiopulmonary resuscitation (CPR) is an important emergency technique for saving patients from cardiac arrest and is something that prehospital emergency personnel must be proficient in. CPR training is generally based on simulated scenarios, using simulators for practice. Because novel coronaviruses such as COVID-19 can be transmitted via respiratory droplets and aerosols, and because of the general susceptibility of the population, the latest American Heart Association (AHA) guidelines require rescuers to wear personal protective equipment (PPE) when performing CPR (2). Because of the high-risk scenario of respiratory exposure in prehospital emergencies, rescuers need to wear N95 masks. N95 masks may lead to discomfort for medical personnel due to better airtightness, resulting in increased breathing resistance and greater physical exertion for users during strenuous exercise (3–5). Early, high-quality chest compressions are critical to the implementation of CPR and are essential for circulatory recovery and survival after cardiac arrest (6). Previous studies have shown that the quality of chest compressions of medical staff using PPE is significantly decreased (7). This trial was planned to determine whether wearing N95 masks influenced the performance of chest compressions by prehospital emergency personnel and the rescuer's condition when compared to surgical masks.
A Novel Assessment Using a Panoramic Video Camera of Resuscitation Quality in Patients following Out-of-Hospital Cardiac Arrest
Published in Prehospital Emergency Care, 2023
Huai-Kuan Huang, Huei-Han Chen, Yu-Long Chen, Giou-Teng Yiang, Wen-Chu Chiang
The technical skills of individual team members were clearly assessable. Crucial CPR qualities, including the chest compression rate, the lung inflation rate, unnecessary no-chest compression intervals, and time to intubation, could all be monitored throughout the resuscitation. Teamwork during the resuscitation was also evaluated using an all-around view. We highlighted three important features of team resource management (TRM) and teamwork by editing Video 1 into three different video clips, namely A, B, and C. Video A, B and C were edited without the 360-degree video due to the online video legibility and data size. This illustrates the importance of the panoramic video camera and the SAC. Video clips A, https://youtu.be/O3xVQElvcOM, demonstrated the team leader’s leadership quality by assigning another team member to replace the person administering CPR before initiating a new cycle of CPR. Video clips B, https://youtu.be/YzUQwuZL5Jo, showed mutual support and synchronization of all the team members while checking rhythms. Video clips C, https://youtu.be/ZLeZo1lphwY, illustrated cross-monitoring and closed-loop communication, wherein the team leader reminded the person administering CPR to increase the chest compression rate after making the person aware that the compression rate was too slow. None of these features could be evaluated using quality-monitored chest pads.
Perimortem caesarean section in COVID-19 era
Published in Journal of Obstetrics and Gynaecology, 2022
Yudianto Budi Saroyo, Noroyono Wibowo, Damar Prasmusinto, Yuditiya Purwosunu, Rima Irwinda, Mohammad Adya Firmansha Dilmy, Angela Putri, Andrew Wijaya
Upon maternal cardiac arrest, resuscitation should follow Basic Life Support (BLS) and Advance Cardiac Life Support (ACLS) guidelines by AHA. Performing effective chest compression in a non-pregnant adult with cardiac arrest will give 30% of normal adult cardiac output. In pregnant woman lying in supine position, the acquired cardiac output is decreased by another 60% as the uterus compress the aorta and vena cava inferior (Katz 2012). As such, this pressure significantly influences the effectivity of cardiopulmonary resuscitation (CPR). Therefore, several adjustments are needed when performing CPR in a pregnant woman. Those adjustments include manual uterine displacement or put the mother into left lateral tilt position to an angle of 30° (Chu et al. 2018; Zelop et al. 2018). Furthermore, resuscitation in maternal cardiac arrest needs at least 2 intravenous (IV) lines. When the IV access cannot be established, intraosseous access or central line access should be done. As large uterus size cause compression of vena cava inferior, it is important to note that all the access should be done above the level of diaphragm to ensure quick entry of fluids into the circulation (Jeejeebhoy and Morrison 2013; Hu and Hong 2020).