Twenty-two female Yorkshire pigs were sedated, intubated, ventilated and secured on a table designed to tilt the whole body according to the position required. This systematic review sets out to determine if heads-up CPR (HUPCPR) improves patient survival to discharge and neurological outcomes in OHCA by critically analysing the supporting literature of the HUPCPR technique.Įxamines potential benefits of HUT positioning compared to SUP and HDT positioning during CPR respectively. While this abstract offers little in terms of tangible research or evidence to critique, the possibility of doubling survival rates in OHCA patients is certainly worthy of further investigation. NHS England (2018) measure success rates in OHCA by ‘survival to discharge from hospital’ and measure the quality of discharge by neurological outcome. However, this information is provided in abstract only and no subsequent data have been released disclosing further information on this doubling of survival rates neither has ‘increased survival’ been given a more exact definition, nor is ‘all cause’ OHCA specified to include traumatic cardiac arrest. (2016) explain that this process decreases intracranial and intrathoracic pressures, thereby increasing cerebral and coronary perfusion pressure, and are claiming an increase in survival of all-cause OHCA from 17.4% to 36% across 2014–2015. This process is accompanied by intubating the patient, affixing an impedance threshold device (ITD) to the end of the endotracheal tube and delivering chest compressions through an active compression–decompression (ACD) device that implements active chest recoil. (2016) delivered a seminar at a conference describing a resuscitation technique known as ‘heads-up’ CPR, described as a process by which a patient in OHCA in placed on an orthopaedic scoop elevated at the head end by approximately 30° by being placed on a large pelican case. However, this systematic review aims to identify a novel approach to CPR that emergency medical services (EMS) in Florida, United States, have reportedly implemented to good effect. Two such areas may be increased public education in cardiopulmonary resuscitation (CPR) and publicly accessible defibrillators ( Bækgaard, Viereck, Møller, Ersbøll, & Lippert, 2017 Song et al., 2018), both of which require large systematic changes in public education through collaboration between emergency services and local government services. (2016) identified a number of countries with better survival to discharge rates than the United Kingdom, meaning that there are current ongoing techniques and systems in place that UK ambulance services either need to start or need to do more effectively. The earliest available comparable statistics from NHS England (2011) show OHCA survival to discharge rates have remained largely unchanged over the last seven years, and it is clear that more research is needed to identify areas of improvement for treatment of OHCA by ambulance services.Ī prospective one-month meta-analysis of 27 European countries by Gräsner et al. Despite these changes, data from NHS England (2018) show that in August of that year, the survival to discharge of all-cause OHCA patients treated by UK ambulance services was 10.4%, with even fewer than this discharged with favourable neurological outcome (exact percentage unlisted within these statistics). Paramedics in the United Kingdom have been trained in the delivery of advanced life support (ALS) since 1979, with techniques being refined and updated over time in an attempt to improve survival to discharge for out-of-hospital cardiac arrest (OHCA) patients ( College of Paramedics, 2015).
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