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Limitations of Abdominal Binding during CPR

Published online by Cambridge University Press:  28 June 2012

James K. Alifimoff
Affiliation:
Work performed as medical students.
Peter Safar
Affiliation:
From the Resuscitation Research Center and the Department of Anesthesiology/Critical Care Medicine, University of Pittsburgh, Pittsburgh PA 15260, USA.
Nicholas Bircher
Affiliation:
Work performed as medical students.

Extract

Sudden cardiac death is the number one killer in the western world. In the USA alone, CPR attempts are justified in 200,000 cases per year. Recovery of brain function requires immediate initiation and uninterrupted maintenance of artificial ventilation and circulation by basic life support (BLS) until restoration of spontaneous circulation (ROSC) is possible with advanced life support (ALS). Presently recommended standard CPR (SCPR) produces only 6–30% of normal common carotid blood flow. For this reason, a more effective method of prolonged CPR-BLS is necessary in the absence of ALS ambulance services, which is common in rural areas.

Augmentation of blood flow during CPR can be accomplished by intravenous fluid load and epinephrine, which are unavailable to BLS personnel. Sustained abdominal compression in dogs during CPR increases blood flow but produces a high incidence of hepatic trauma. The use of military anti-shock trousers (MAST) during short-term SCPR has been shown to increase common carotid blood flow (CCABF); this, however, has not been evaluated with a long-term model.

Type
Part II: Clinical Care Topics
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

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