HIGH QUALITY CPR PAUSES IN COMPRESSION FULL
HIGH QUALITY CPR PAUSES IN COMPRESSION TRIAL
HIGH QUALITY CPR PAUSES IN COMPRESSION PROFESSIONAL

Employing transesophogeal echo for assessment of compression quality, assessment of rhythm and reversible etiologies may be a superior approach as compression interruptions are unnecessary. The use of POCUS intra-arrest or of POCUS driven arrest care must be thoughtfully applied to reduce potentials for harm. Extending rhythm checks to obtain good US images is not acceptable. Regardless of whether POCUS is used intra-arrest or not, interruptions in compressions should be minimized. While this study is too small to show an effect on patient outcomes from prolonged interruptions, everything in the existing literature tells us that longer interruptions will lead to worse outcomes. The use of intra-arrest POCUS was associated with an increased length of rhythm checks and, thus, an increased length in compression interruptions.

HIGH QUALITY CPR PAUSES IN COMPRESSION TRIAL

“In this prospective cohort trial of 24 patients with CA, POCUS during CPR pauses was associated with longer interruptions in CPR.” Our Conclusions

Single center study reduces external validity.

Absence of explanation of pauses without rhythm check.

Small study and most of the cardiac arrests that occurred were not included due to absence of video.

Does not look at patient centered outcomes.

Adds to the scant literature on the topic of US impact on pauses during cardiac arrest care.

Performed analysis and recorded experience level of person performing US.

All video footage was reviewed by two data abstractors.

Prospective, cohort study with videotaped resuscitation removing recall bias and ensuring accurate times.

US fellowship trained attending associated with shorter CPR pause vs non-US fellowship trained: – 3.9 seconds (95% CI – 8.4 to 0.7).When resus leader also performed POCUS, association with 6.1 second longer CPR pause (95% CI 0.4 – 11.7).Duration of pulse check (primary outcome).Ultrasound used for any pulse check: 69% (59/86).110 CPR pauses with rhythm check in 86 of the pauses.24 cardiac arrest patients enrolled (out of a total of 82 arrest that were resuscitated in the time period).Real CPR Help provides visual and audio feedback that guides rescuers to deliver CPR compressions fast enough and deep enough to save a life.

HIGH QUALITY CPR PAUSES IN COMPRESSION PROFESSIONAL

The Real CPR Help ® technology on ZOLL’s AEDs (automated external defibrillators) and professional defibrillators assists lay rescuers and health care professionals alike in delivering high-quality CPR. Systems, both in and out of the hospital, that have focused on improving their CPR quality and have incorporated ZOLL technology, have doubled the odds of survival.3,4 Rescuers at every experience level need assistance when delivering CPR.

Avoid excessive ventilation (2 breaths/30 compressions without advanced airway 10 breaths/minute with advanced airway).

Minimize pauses in compressions (chest compression fraction > 60%).

HIGH QUALITY CPR PAUSES IN COMPRESSION FULL

Avoid leaning on the chest to allow for full recoil after each compression.Compression depth of 2–2.4 inches (5–6 centimeters).In its 2015 Guidelines, the American Heart Association and the European Resuscitation Council identify five critical components required to provide high-quality CPR: High quality means providing compressions at the proper depth and rate, making sure not to lean on the chest, and keeping interruptions to an absolute minimum. High-quality CPR improves survival from cardiac arrest, and rescuers need to “maximize the quality of CPR” to save more lives.

High quality cpr pauses in compression