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Latsios G, Leopoulou M, Synetos A, Karanasos A, Papanikolaou A, Bounas P, Stamatopoulou E, Toutouzas K, Tsioufis K. Cardiac arrest and cardiopulmonary resuscitation in "hostile" environments: Using automated compression devices to minimize the rescuers' danger. World J Cardiol 2023; 15:45-55. [PMID: 36911750 PMCID: PMC9993930 DOI: 10.4330/wjc.v15.i2.45] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/25/2023] [Accepted: 02/15/2023] [Indexed: 02/21/2023] Open
Abstract
Mechanical automated compression devices are being used in cardiopulmonary resuscitation instead of manual, "hands-on", rescuer-delivered chest compressions. The -theoretical- advantages include high-quality non-stop compressions, thus freeing the rescuer performing the compressions and additionally the ability of the rescuer to stand reasonably away from a potentially "hazardous" victim, or from hazardous and/or difficult resuscitation conditions. Such circumstances involve cardiopulmonary resuscitation (CPR) in the Cardiac Catheterization Laboratory, especially directly under the fluoroscopy panel, where radiation is well known to cause detrimental effects to the rescuer, and CPR during/after land or air transportation of cardiac arrest victims. Lastly, CPR in a coronavirus disease 2019 patient/ward, where the danger of contamination and further serious illness of the health provider is very existent. The scope of this review is to review and present literature and current guidelines regarding the use of mechanical compressions in these "hostile" and dangerous settings, while comparing them to manual compressions.
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Affiliation(s)
- George Latsios
- 1 University Department of Cardiology, "Hippokration" University Hospital, Athens Medical School, Athens 11527, Greece.
| | - Marianna Leopoulou
- 1 Cardiology Clinic, 'Hippokration' University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 11527, Greece
- Department of Cardiology, "Elpis" Athens General Hospital, Athens 11522, Greece
| | - Andreas Synetos
- 1 Department of Cardiology, Athens Medical School, University Athens, Hippokrat Hospital, Athens 11527, Greece
| | - Antonios Karanasos
- 1 University Department of Cardiology, "Hippokration" University Hospital, Athens Medical School, Athens 11527, Greece
| | - Angelos Papanikolaou
- 1 Cardiology Department Athens Medical School, Hippokration General Hospital, Athens 11527, Greece
| | - Pavlos Bounas
- Department of Cardiology, "Thriasio" General Hospital, Thriasio General Hospital, Elefsina 19600, Greece
| | - Evangelia Stamatopoulou
- CathLab, 2 Department of Cardiology, Medical School, National and Kapodistrian University of Athens, "Attikon" University Hospital, Attikon University Hospital, Athens 12462, Greece
| | | | - Kostas Tsioufis
- 1 Department of Cardiology, Medical School, National and Kapodistrian University of Athens, "Hippokration" General Hospital, "Hippokration" University Hospital, Athens 11527, Greece
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Exploring the Feelings of Nurses during Resuscitation—A Cross-Sectional Study. Healthcare (Basel) 2021; 10:healthcare10010005. [PMID: 35052169 PMCID: PMC8774964 DOI: 10.3390/healthcare10010005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/17/2022] Open
Abstract
Cardiopulmonary resuscitation (CPR) is one of the most stressful situations in emergency medicine. Nurses involved in performing basic and advanced resuscitation procedures are therefore exposed to a certain amount of stress. The purpose of this study was to determine the stressors and the level of stress experienced by nurses during resuscitation. A cross-sectional quantitative study was done. The sample consisted of 457 nurses who worked in emergency units. First demographic data were collected, followed by a questionnaire regarding the effect of different situations that occur during and after resuscitation on nurses including Post-Code Stress Scale questionnaire. The most disturbing situations for respondents were resuscitation of young person (MV = 3.7, SD = 1.4), when they fail to establish an intravenous pathway (MV = 3.5, SD = 1.4), chaotic situation during resuscitation (MV = 3.4, SD = 1.4) and making decision about termination of resuscitation (MV = 3.1, SD = 1.5). Research has shown that nurses are exposed to a certain amount of stress during resuscitation, but most of them manage to compensate for stress effectively.
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Latsios G, Leopoulou M, Synetos A, Karanasos A, Melidi E, Toutouzas K, Tsioufis K. The role of automated compression devices in out-of- and in- hospital cardiac arrest. Can we spare rescuers’ hands? EMERGENCY CARE JOURNAL 2021. [DOI: 10.4081/ecj.2021.9525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Research regarding the use of mechanical compressions in the setting of a cardiac arrest, either outside of or inside the hospital environment has produced mixed results. The debate whether they can replace manual compressions still remains. The aim of this review is to present current literature contemplating the application of mechanical compressions in both settings, data comparing them to manual compressions as well as current guidelines regarding their implementation in everyday clinical use. Currently, their implementation in the resuscitation protocol seems to benefit the victims of an in-hospital cardiac arrest rather than the victims that sustain a cardiac arrest outside of the hospital.
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Kapoor MC, Rao SC, Dewan R, Böttiger BW. A survey of cardiopulmonary resuscitation in COVID-19 patients. J Anaesthesiol Clin Pharmacol 2021; 37:47-50. [PMID: 34103822 PMCID: PMC8174426 DOI: 10.4103/joacp.joacp_36_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/27/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Aims: The novel coronavirus 2 (SARS-CoV-2) pandemic has placed severe resource constraints on hospitals. High mortality rates of the COVID-19 have overwhelmed the resuscitation services. The constant fear of virus infection during cardiopulmonary resuscitation (CPR) has placed severe restrictions on the resuscitation services. Reports of poor outcomes after CPR further dampened the spirits of CPR providers. Hence we surveyed CPR practices for COVID -19 patients across hospitals in India by health care providers. Material and Methods: An online survey using Google Forms was initiated to collect data on performance of CPR in diagnosed cases of COVID-19 after in-hospital cardiac arrest. The survey's web-link was publicized using social media, and participation sought of all personnel involved in CPR delivery in COVID-19 patients. The responses received were analyzed. The main outcome measured were determination of the percentage of COVID-19 patients discharged home who were administered CPR. Results: There were 248 responses from different parts of India. At the time of cardiac arrest, 194 victims had diffuse lung infiltrates, 22 had mild lung disease, while 32 had no documented lung lesion. Twenty-five victims had evidence of pulmonary embolism, 39 had cardiac involvement, and 3 had brain involvement. Return of spontaneous circulation (ROSC) was achieved in 59.27% of cases but ROSC sustained in only 22.59%. 7.25% of patients, who received CPR, could be discharged home. Conclusion: The survey has shown reasonable survival rates after CPR administration in COVID-19 patients suffering from IHCA. We should not ignore the need to maximize live outcomes after CPR, even in COVID-19 patients.
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Affiliation(s)
| | - Ssc Chakra Rao
- Indian Resuscitation Council, Kakinada, Andhra Pradesh, India
| | - Rasesh Dewan
- National Course Director, Indian Resuscitation Council, Ahmedabad, Gujarat, India
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Latsios G, Synetos A, Mastrokostopoulos A, Vogiatzi G, Bounas P, Nikitas G, Papanikolaou A, Parisis C, Kanakakis I, Goudevenos J. CardioPulmonary Resuscitation in patients with suspected or confirmed Covid-19. A consensus of the Working group on CardioPulmonary Resuscitation of the Hellenic Society of Cardiology. Hellenic J Cardiol 2021; 62:24-28. [PMID: 32949726 PMCID: PMC7495187 DOI: 10.1016/j.hjc.2020.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/25/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022] Open
Abstract
The unprecedented for modern medicine pandemic caused by the SARS-COV-2 virus ("coronavirus", Covid-19 disease) creates in turn new data on the management and survival of cardiac arrest victims, but mainly on the safety of CardioPulmonary Resuscitation (CPR) providers. The Covid-19 pandemic resulted in losses of thousands of lives, and many more people were hospitalized in simple or in intensive care unit beds, both globally and locally in Greece. More specifically, in victims of cardiac arrest, both in- and out- of hospital, the increased mortality and high contagiousness of the SARS-CoV-2 virus posed new questions, of both medical and moral nature/ to CPR providers. What we all know in resuscitation, that we cannot harm the victim and therefore do the most/best we can, is no longer the everyday reality. What we need to know and incorporate into decision-making in the resuscitation process is the distribution of limited human and material resources, the potentially very poor outcome of patients with Covid-19 and cardiac arrest, and especially that a potential infection of health professionals can lead in the lack of health professionals in the near future. This review tries to incorporate the added skills and precautions for CPR providers in terms of both in- and out- hospital CPR.
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Affiliation(s)
- George Latsios
- 1st University Department of Cardiology, National and Kapodistrian University of Athens, "Hippocratio" General Hospital, Athens, Greece.
| | - Andreas Synetos
- 1st University Department of Cardiology, National and Kapodistrian University of Athens, "Hippocratio" General Hospital, Athens, Greece
| | | | - Georgia Vogiatzi
- 3rd University Department of Cardiology, National and Kapodistrian University of Athens, "Sotiria" General Hospital, Athens, Greece
| | - Pavlos Bounas
- General Hospital of Elefsina "Thriasio", Elefsina, Greece
| | - Georgios Nikitas
- Department of Cardiology, Konstantopoulio General Hospital, Athens, Greece
| | - Aggelos Papanikolaou
- 1st University Department of Cardiology, National and Kapodistrian University of Athens, "Hippocratio" General Hospital, Athens, Greece
| | | | - Ioannis Kanakakis
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
| | - John Goudevenos
- Department of Cardiology, University of Ioannina Medical School, Greece
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Somri M, Gaitini L, Galante D, Sanallah M, Hossein J, Gómez-Ríos MÁ. A simple method to prevent aerosol dispersion during Cardiopulmonary Resuscitation using supraglottic airway devices. Resuscitation 2020; 159:35-37. [PMID: 33359415 PMCID: PMC7834422 DOI: 10.1016/j.resuscitation.2020.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 12/09/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Mostafa Somri
- Anesthesiology Department Bnai Zion Medical Center, Faculty of Medicine Technion, Institute of Technology, Haifa, Israel
| | - Luis Gaitini
- Anesthesiology Department Bnai Zion Medical Center, Faculty of Medicine Technion, Institute of Technology, Haifa, Israel
| | - Dario Galante
- Department of Anesthesia and Intensive Care, Ospedali Riuniti University Hospital, Foggia, Italy
| | - Mhfod Sanallah
- Anesthesiology Department Bnai Zion Medical Center, Faculty of Medicine Technion, Institute of Technology, Haifa, Israel
| | - Jalaa Hossein
- Anesthesiology Department Bnai Zion Medical Center, Faculty of Medicine Technion, Institute of Technology, Haifa, Israel
| | - Manuel Ángel Gómez-Ríos
- Department of Anesthesia and Perioperative Medicine, Complejo Hospitalario Universitario de A Coruña, A Coruña, Galicia, Spain.
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