- How information can be used today
Article critique: Interruptions in Cardiopulmonary Resuscitation
From Paramedic Endotracheal Intubation by Henry E. Wang, Scott J. Simeone, Matthew D. Weaver, Clifton W. Callaway.
This article is related to fire prevention because fire fighters are first respondents be it a fire or another type of emergency/ disaster. As such, successfully articulating cardiopulmonary resuscitation is a fire prevention/intervention strategy since it prevents loss of life when a fire occurs. While it is not preventing a fire from destroying a building, ultimately saving lives becomes the priority of the fire fighter soon after arriving on the scene. Hence, proper training in cardiopulmonary resuscitations is imperative.
This study evaluated compliance emergency cardiac guideline interventions in cardiopulmonary arrest regarding continuous uninterrupted cardiopulmonary resuscitation (CPR) chest compressions. It was the researchers’ concern that paramedics in the United States perform endotracheal intubation. They measured frequency and duration of CPR chest compression interruptions in relation to paramedic endotracheal intubation while cardiopulmonary arrests resuscitations were done before reaching hospital (Wang, et.al, 2009).
Using cardiac monitors containing compression devices CPR chest compressions were continuously recorded. Also a digital audio channel recorded all resuscitation events. Measurement of CPR interruptions included assessment of airway suctioning, laryngoscopy, endotracheal tube placement, confirmation and adjustment, securing the tube in place, bag-valve-mask ventilation between intubation attempts, and alternate airway insertion(Wang, et.al, 2009). Finally, they identified frequency related to amount and duration of CPR interruptions linked to endotracheal intubation efforts (Wang, et.al, 2009).
100 cases from a total of 182 cardiopulmonary arrests sustained from an emergency fire environment were investigated. It was discovered that the median number of endotracheal intubations linked to CAPR interruption was 2. The median duration of the first endotracheal intubation–associated CPR interruption was 46.5 seconds (IQR 23.5 to 73 seconds; range 7 to 221 seconds); almost one third exceeded 1 minute’ (Wang, et.al, 2009). A total duration median of all endotracheal intubations linked to CPR interruptions was ‘109.5 seconds (IQR 54 to 198 seconds; range 13 to 446 seconds); one fourth exceeded 3 minutes’ (Wang, et.al, 2009). ‘Endotracheal intubations linked to CPR pauses recorded estimates as 22.8% (IQR 12.6-36.5%; range 1.0% to 93.4%) of all CPR interruptions’ (Wang, et.al, 2009).
These researchers concluded from this study that paramedic endotracheal intubation efforts before arriving at hospital were linked to multiple prolonged CPR interruptions (Wang, et.al, 2009).
These results re-emphasize the fact that, inevitably, fire prevention is not merely learning how to instruct the public regarding safety techniques in the home and work environment regarding how to avoid a fire. Importantly, it embraces responding to a fire since the emergencies always happen. Fire fighters/paramedics are among the first to be called to the scene. Means that fire prevention curriculum ought to include equal components in training in cardiopulmonary resuscitation. In class we do not practice enough CPR as a measure of fire prevention. As such this article shows where fire prevention training should embrace more contemporary fire prevention strategies as it relates to CPR training and techniques.
How information can be used today? The findings in this study can be very useful in evaluating the present fire prevention training in assessing if training prepares fire fighters to manage out-of-hospital endotracheal intubation efforts with fewer multiple prolonged CPR interruptions.
Wang, H. Scott, Weaver, M. Callaway, C. (2009). Interruptions in Cardiopulmonary Resuscitation from Paramedic Endotracheal Intubation. Annals of Emergency Medicine, 54 (5), Pages 645-652.