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PubMed · 12204455

Resuscitating an idea: prone CPR.

Abstract

Cardiopulmonary resuscitation (CPR) is widely recognized as an essential part of the medical response to cardiac arrest. Traditional ('basic') CPR has remained essentially unchanged for 40 years despite major problems with training and performance, and survival rates from out-of-hospital cardiac arrest remain disappointingly low, despite massive resources devoted to CPR training and public awareness. More than a decade ago, an article described an alternative method-prone CPR-which offered many potential advantages over traditional CPR, including much simpler training and increased likelihood of actual performance by bystanders. The article received little notice at the time; however, the method of prone CPR merits further consideration based on a number of subsequent supporting studies and case reports. Prone CPR may represent a superior alternative to traditional CPR; research into its effectiveness should be given high priority.

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BibTeXRIS

John A Stewart. 2002. Resuscitating an idea: prone CPR.. https://doi.org/10.1016/s0300-9572(02)00145-4

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Comparison of ventilation and chest compression performance by bystanders using the Impact Model 730 ventilator and a conventional bag valve with mask in a model of adult cardiopulmonary arrest.

"Bystanders" or lay persons are typically the first caregivers to attend to a victim of out-of-hospital cardiopulmonary arrest. Astronaut crew medical officers (CMO) play a similar role to bystanders aboard the International Space Station (ISS). Studies have demonstrated the importance of bystander cardiopulmonary resuscitation (BCPR) for patient survival before the arrival of emergency medical care. Recent apprehension from bystanders about the threat of contracting communicable diseases during BCPR, however, has led to the consideration of other ventilation systems such as the bag-valve mask (BVM) and automatic transport ventilators (ATV). BVM use is called for during CPR aboard the ISS. This study evaluated the ventilation and compression performance of 40 basic CPR-trained bystanders using either a BVM (adult-sized self-inflating bag with face mask) or an ATV (Model 730 ventilator (M730), Impact Instrumentation, Inc., West Caldwell, NJ). Each two-bystander team gave BCPR to a simulated cardiopulmonary arrest victim using the 2-breath/15-compression cycle for 4 min and then switched roles for another 4-min interval. Compared to BVM use, the M730 led to significantly (p<0.05) lower number of breaths, smaller tidal volumes, airway flows, airway pressures, volume of gas entering the stomach per breath and chest compressions for the 4-min period. The M730 also enabled a bystander to meet the recommendation of 4-breath and compression cycles per minute as per Guidelines 2000. Lastly, ease-of-use scores were significantly higher for the M730 compared to the BVM. Overall, the data suggest that the M730 improves the quality of performance for a bystander performing BCPR.

Cardiopulmonary Resuscitation↗