Cardiopulmonary resuscitation chest compressions

Chandra, N.C., Rudikoff, M., and Weisfeldt, M.L. Simultaneous chest compression and ventilation at high airway pressure during cardiopulmonary resuscitation. Lancet, 1,175-178,1980. 

Barranco, E, Lesmes, A., Irles, J.A., Blasco, J., Leal, J., Rodriquez, J., and Leon, C. Cardiopulmonary resuscitation with simultaneous chest and abdominal compression comparative study in humans. Resuscitation, 20,67-77,1990. 

Lafeunte-Lafuente, C. and Melero-Bascones, M. Active chest compression-decompression for cardiopulmonary resuscitation. Cochrane Database Syst. Rev., 2, CD002751,2004. 

First-aid training. Training in the initial care, including cardiopulmonary resuscitation (which includes chest compressions, rescue breathing, and, as appropriate, other heart and lung resuscitation techniques), performed by a person who is not a medical practitioner, of a sick or injured person until definitive medical treatment can be administered. 

Fig. H-7. Revival of a person whose heart has stopped. This procedure is called cardiopulmonary resuscitation (CPR). It involves (1) rhythmically pressing down the lower part of the breastbone against the heart 60 to 80 times per minute so as to pump blood to the tissues, and (2) mouth-to-mouth breathing 15 to 20 times per minute so as to force oxygenated air into the lungs of the victim. When resuscitation is attempted by only one person, every 15 chest compressions should be alternated with two respirations.

An essential part of the AED process, Cardiopulmonary Resuscitation (CPR) has evolved since its first implementation in 1740, when the Paris Academy of Sciences officially recommended mouth-to-mouth resuscitation for drowning victims (chest compressions weren t added until the late 19th century). 

Halperin, H.R., Paradis, N., Ornato, J.P. et al. 2004. Cardiopulmonary resuscitation with a novel chest compression device in a porcine model of cardiac arrest Improved hemodynamics and mechanisms./. Am. Coll. Cardiol. 44(11) 2214-2220. 

Jung, E., Babbs, G.F., Lenhart, S., Protopopescu, A. 2006. Optimal strategy for cardiopulmonary resuscitation with continuous chest compression. Acad. Emerg. Med. 13 715-721. 

You, Y. 2009. Optimum location for chest compressions during two-rescuer infant cardiopulmonary resuscitation. Resuscitation 80(12) 1378-1381. 

Looks like a nearly flat line on a rhythm strip except during chest compressions with cardiopulmonary resuscitation. 

Supporting this view is a report from the Tokyo subway terrorist incident of 1995. One hospital received two casualties who were apneic with no heartbeat. With vigorous resuscitation, cardiac activity was established in both. One resumed spontaneous respiration and walked out of the hospital several days later, and the other did not start breathing spontaneously and died days later. These anecdotes suggest that when circumstances permit, resuscitation should be attempted. In a contaminated area where resources, including personnel, are limited, the use of ventilatory support and closed chest cardiac compression must be balanced against other factors (see above), but the immediate administration of diazepam and additional atropine requires little effort and can be very rewarding in the casualty who still has apparent cardiopulmonary function. Cyanide... 

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