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Anesth Analg 2005;101:200-205
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000154305.70984.6B


CRITICAL CARE AND TRAUMA

Over-the-Head Cardiopulmonary Resuscitation Improves Efficacy in Basic Life Support Performed by Professional Medical Personnel with a Single Rescuer: A Simulation Study

Michael Hüpfl, MD*{dagger}, Andreas Duma, MD*{dagger}, Thomas Uray, MD{dagger}, Christina Maier{dagger}, Nikolaus Fiegl{dagger}, Norbert Bogner{dagger}, and Peter Nagele, MD*{ddagger}

*Department of Anesthesia and General Intensive Care, Medical University; {dagger}St. John's Ambulance, Vienna, Austria; and {ddagger}Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri

Address correspondence and reprint requests to Peter Nagele, MD, Department of Anesthesia and General Intensive Care, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. Address e-mail to peter.nagele{at}meduniwien.ac.at.

Two-rescuer cardiopulmonary resuscitation (CPR) is considered the best method for professional basic life support (BLS). However, in many prehospital cardiac arrest situations, one rescuer has to begin CPR alone while the other performs additional tasks. In theory, over-the-head CPR is a suitable alternative in this situation, with the added benefit of allowing the single rescuer to use a self-inflating bag for ventilation. In this trial, we compared standard single-rescuer CPR with over-the-head CPR in manikins. We planned this study using a crossover study design where each participant administered both CPR techniques in a randomized order. Ventilation and chest compression data were collected with analysis software during a 2-min CPR test for each technique. Sixty-seven emergency medical technician students participated in this trial. Over-the-head CPR allowed for superior ventilation compared to standard CPR (number of correct ventilations: 330 of 760 versus 279 of 779; P = 0.002). The quality of delivered chest compressions did not differ between the two groups (correct chest compressions: 4293 of 6304 versus 4313 of 6395; P = 0.44). In conclusion, our study has shown that over-the-head CPR may be an effective alternative BLS technique when a single professional rescuer has to perform CPR, likely offering superior ventilation and comparable chest compression quality compared with standard BLS.




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Anesth. Analg.Home page
P. Nagele and M. Hupfl
Over-the-Head CPR
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.