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In practice, nurses, physicians, and paramedics often perform cardiopulmonary resuscitation (CPR) inadequately. Two recent studies revealed that in the heat of an emergency, nurses, physicians, and other health care workers usually don't stick to American Heart Association and international CPR guidelines. Typical problems included chest compressions given without enough force and artificial breaths delivered too frequently, either mouth-to-barrier device or via endotracheal tubes.
These studies are the first to use a novel monitor/defibrillator with sensing capabilities to evaluate CPR performance during real emergencies. The device's maker, Laerdal Medical Corp., helped fund the studies.
One study involved 67 patients who experienced inhospital cardiac arrest at the University of Chicago Hospitals in Chicago, Ill., during a 16-month period. The researchers found that rescuers failed to follow at least one CPR guideline 80% of the time, and failure to follow several guidelines was common. One of the researchers commented, "Patients who had [CPR] perfectly done were in the distinct minority."
The second study involved 176 European adults experiencing out-of-hospital cardiac arrest. These researchers found that paramedics and nurse-anesthetists providing CPR delivered chest compressions only half the time, and most chest compressions were too shallow.
Researchers urge revising and simplifying CPR guidelines so they're more readily applied in the real world.
Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest, JAMA, BS Abella, et al., January 19, 2005; Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest, JAMA, L Wik, et al., January 19, 2005.
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