Über-Kopf-Reanimation

[Pr0st]

Morjen....

Die Über-Kopf-Reanimation wird ja von manchen als Teufelszeug verflucht, von manchen auch als sinnvolle Alternative zur Seitenmannrea.

Jetzt meine Frage, hat hier irgendjemand mal eine Studie zur Hand, die Auswurfleistung, Outcome etc. genauer unter die Lupe nimmt und was handfestes abliefert?


Edit: Falls jetzt jemand mit den Thieme-Abstracts der ersten drei Googleseiten für "Über-Kopf-Reanimation" kommt, danke danke, die kenn ich auch schon, bisschen ausführlicher und frischer wäre aber nett...

[RS-USER-emergency doc]

Da gibts glaub ich 'nen Comic von Daniel zu, aber sonst...

[Back to life machine]

Sie wünschen, wir spielen: Hier mal die 3 neuesten Artikel (bzw. die Abstracts), die bei einer pubmed-Suche ("chest compression AND position") geliefert wurden. Die aus Resuscitation bekommt man auch als Volltext. Bei Problemen bitte PN.

Bollig G, Steen PA, Wik L.
Standard versus over-the-head cardiopulmonary resuscitation during simulated advanced life support.
Prehosp Emerg Care. 2007 Oct-Dec;11(4):443-7.

BACKGROUND: Limited space can make rescuer position changes difficult during cardiopulmonary resuscitation (CPR). Over-the-head (OTH) CPR enables one rescuer to deliver chest compressions and ventilations without changing position. The aim of the present study was to evaluate quality of OTH versus standard CPR with bag-valve-mask (BVM) ventilation in a manikin model during advanced life support (ALS). METHOD: In a randomised double-crossover trial, eight paramedic students performed ALS using both OTH and standard CPR with BVM. Initial rhythm was asystole, converting to ventricular fibrillation after atropine, adrenaline, and CPR. Data collection was stopped after atropine and epinephrine had been given. Data are presented as means +/- SD or median with 25% and 75% percentile. RESULTS: There were no significant differences in ventilation or compression variables or any time factors with median total hands off times of 50% versus 52% for OTH and standard CPR respectively. CONCLUSION: OTH CPR is an alternative method during CPR.

Two rescuer resuscitation--mission impossible? A pilot study using a manikin setting.Brucke M, Helm M, Schwartz A, Lampl L.
German Armed Forces Medical Centre, Department of Anaesthesiology and Intensive Care Medicine, Ulm, Germany. [email protected]
Resuscitation. 2007 Aug;74(2):317-24. Epub 2007 Mar 23.

OBJECTIVE: Advanced life support (ALS) in a cardiac arrest is usually performed by a team consisting of three people. The medical team of a Helicopter Emergency Medical Service (HEMS) often consists of two rescuers only. Due to that reason an algorithm was developed to provide ALS with two people. During the initial phase the rescuer in the over-the-head position provides one man CPR while the second rescuer prepares all advanced measures. When all preparations are complete both rescuers are able to provide ALS. MATERIAL AND METHODS: A computer controlled manikin (Ambu Mega Code Simulator System MCS with online documentation was used to test the entire medical staff during 10 min of persistent VF. RESULTS: The 20 teams were tested. Following data were recorded: no-flow-time 96.4+/-11s (16.1+/-1.8%), chest compression frequency 120.1+/-5.1 min (-1), ventilation frequency=9 min (-1), number of chest compressions per session 1013.7+/-45.9, depth of chest compressions 46.6+/-2.5mm, total number of chest compressions=20,274, total number of ventilations=1893. For ALS measures the following data were recorded: tracheal intubation (TI) was finished after 60.7+/-9.8s, duration of TI : maneuver = 15.7+/-4.4s, end of initial phase=188.9+/-26.3s, i.v. administration of adrenaline after 387.7+/-33.6s, i.v. administration of amiodarone after 507.9+/-36.9s and four shocks after: 138.0+/-15.9, 266.8+/-16.1, 398.0+/-20.1 and 526.8+/-23.6s. CONCLUSION: We proved the feasibility of the algorithm in a manikin setting. Further observations have to prove the algorithm in real CPR situations.

A comparison between over-the-head and standard cardiopulmonary resuscitation.Perkins GD, Stephenson BT, Smith CM, Gao F.
Intensive Care Unit, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS, UK. [email protected]
Resuscitation. 2004 May;61(2):155-61

BACKGROUND: Standard cardiopulmonary resuscitation (CPR) is performed by kneeling adjacent to the side of the casualty. In certain circumstances it may be difficult or impossible to perform CPR in this position, for example in confined spaces such as a narrow corridor, aircraft or train gangway. The aim of this study was to investigate the technique of over-the-head CPR (OTH CPR), where the CPR provider kneels above the casualty and performs chest compressions OTH of the casualty. METHODS: Twenty volunteers were randomised to a cross over trial where they performed standard and OTH CPR at a 7-day interval. Compression and ventilation variables were recorded on the Laerdal Resusci Annie VAM system. RESULTS: Chest compression depth and ventilation volume declined over time (0-3 min P < 0.001). There was no difference in compression rate, depth, duty cycle or ventilation rate, inflation rate and ventilation volume between techniques. Hand position was incorrect more frequently in the standard compared to the OTH group (incorrect compressions 300 versus 76, respectively, P < 0.001) due principally to a greater proportion of low positioned compressions in the standard CPR group. CONCLUSION: OTH CPR appears equally effective as standard CPR with some marginal advantages in correct hand placement. We suggest that in situations where it is not possible to perform standard CPR, OTH CPR may be considered as a suitable alternative.

Alles Klar?

[Pr0st]

Oha, vielen lieben Merci!