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      Increasing ventilation in drowning resuscitation − A cross-over randomized simulation study of ventilation during automated external defibrillator analysis pauses

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          Abstract

          Objective

          The aim of this study was to analyze the feasibility of a new resuscitation strategy in which breaths are provided during automated external defibrillator (AED) rhythm analysis, and to evaluate its impact on chest compressions (CC) quality and the peri-analysis time.

          Method

          A randomized simulation study, comparing two cardiopulmonary resuscitations strategies, has been conducted: the standard strategy (S1) with strategy involving ventilation during AED analysis (S2). Thirty lifeguards have performed both strategies in a cross-over study design during 10 min of CPR.

          Results

          The number of ventilations per 10 min increases from 47 (S1) to 72 (S2) ( p < 0.001). This results in the delivery of an additional 17.1 L of insufflated air in S2 compared to S1 ( p < 0.001). There have been no significant changes in frequency and total number of CC. These findings correspond to a reduction of the non-ventilation period from 176 s (S1) to 48 s (S2).

          Conclusions

          This simulation study suggests that it is feasible to increase the number of ventilations during resuscitation following drowning, without affecting the quantity and quality of chest compressions. The results of this study may serve as a foundation for further investigation into optimal ventilation strategies in this context.

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          Most cited references23

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          European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances

          These European Resuscitation Council (ERC) Cardiac Arrest in Special Circumstances guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the modifications required to basic and advanced life support for the prevention and treatment of cardiac arrest in special circumstances; specifically special causes (hypoxia, trauma, anaphylaxis, sepsis, hypo/hyperkalaemia and other electrolyte disorders, hypothermia, avalanche, hyperthermia and malignant hyperthermia, pulmonary embolism, coronary thrombosis, cardiac tamponade, tension pneumothorax, toxic agents), special settings (operating room, cardiac surgery, catheter laboratory, dialysis unit, dental clinics, transportation (in-flight, cruise ships), sport, drowning, mass casualty incidents), and special patient groups (asthma and COPD, neurological disease, obesity, pregnancy).
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            European Resuscitation Council Guidelines 2021: Basic Life Support

            The European Resuscitation Council has produced these basic life support guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include cardiac arrest recognition, alerting emergency services, chest compressions, rescue breaths, automated external defibrillation (AED), CPR quality measurement, new technologies, safety, and foreign body airway obstruction.
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              European Resuscitation Council Guidelines for Resuscitation 2015: Section 4. Cardiac arrest in special circumstances.

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                Author and article information

                Contributors
                Journal
                Resusc Plus
                Resusc Plus
                Resuscitation Plus
                Elsevier
                2666-5204
                30 May 2024
                September 2024
                30 May 2024
                : 19
                : 100674
                Affiliations
                [a ]Faculty of Education and Sport Sciences, REMOSS Research Group, Universidade de Vigo, Pontevedra, Spain
                [b ]CLINURSID Research Group, Nursing Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
                [c ]School of Nursing, Universidade de Vigo, Pontevedra, Spain
                [d ]Faculty of Education and Sports Sciences, University of Vigo, Pontevedra, Spain
                [e ]Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, UK
                Author notes
                [* ]Corresponding author at: School of Nursing, Pontevedra. University of Vigo, C/Joaquín Costa 41, 36004 Pontevedra, Spain. maria.jose.fernandez.mendez@ 123456gmail.com maria.jose.fernandez.mendez@ 123456uvigo.gal
                Article
                S2666-5204(24)00125-5 100674
                10.1016/j.resplu.2024.100674
                11170470
                38873276
                22f8877d-c1dd-45ba-9140-66a6d267b317
                © 2024 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 19 February 2024
                : 9 May 2024
                : 19 May 2024
                Categories
                Short Paper

                automatic external defibrillator (aed),cardiopulmonary resuscitation (cpr),drowning,hypoxia,strategy,ventilation

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