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An assessment of the feasibility and effectiveness of a method of performing cardiopulmonary resuscitation during microgravity. Simon N Evetts, Lisa M Evetts, T Russomano, J Castro and J Ernsting CB OBE. Microgravity Laboratory, PUCRS, Porto Alegre, Brazil.
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An assessment of the feasibility and effectiveness of a method of performing cardiopulmonary resuscitation during microgravity. Simon N Evetts, Lisa M Evetts, T Russomano, J Castro and J Ernsting CB OBE. Microgravity Laboratory, PUCRS, Porto Alegre, Brazil. Human Physiology and Aerospace Medicine Group, King’s College London.
Background • CPR in microgravity. • Current procedures • Restrained. • Unrestrained. • Need for effective unaided, single person CPR in space.
Recent and current CPR guidelines • European Resuscitation Council 1998: • Mouth-to-mouth ventilation requiring tidal volumes of 400 – 500 ml. • Chest compression depth of 40 – 50 mm. • Chest compression rate of ~ 100 compressions.min-1. • European Resuscitation Council 2001: • Tidal volumes of 700 – 1000 ml. • Chest compression depth of 40 – 50 mm. • Chest compression rate in excess of 100 min-1.
Evetts, Russomano, Castro CPR Method. Human subject in microgravity (position only).
ERC Method. Human subject in microgravity (position only).
ERC Method. Manikin use in microgravity (position and CPR).
Study Method • Subjects/investigators. • Laerdal CPR Manikin adaptation. • Pre & post flight procedures. • In flight procedures. • Measurements.
Measure +1GZ Microgravity Chest Compressions Depth (mm) 43.6 ± 0.59 41.3 ± 1.03 Range (min-max, mm) 40.4 – 47.1 27.6 – 51.2 Rate (compressions.min-1) 97.1 ± 3.0 80.2 ± 3.4 Percent correct (depth) 90% 60% n 225 672 Volume Volume (ml) 507.6 ± 11.5 491 ± 50.4 Range (min-max, ml) 423 – 570 284 - 891 Percent correct 87% 69% n 30 32 Results
Measure +1GZ Microgravity Chest Compressions Depth (mm) 43.6 ± 0.59 41.3 ± 1.03 Range (min-max, mm) 40.4 – 47.1 27.6 – 51.2 Rate (compressions.min-1) 97.1 ± 3.0 80.2 ± 3.4 Percent correct (depth) 90% 60% n 225 672 Volume Volume (ml) 507.6 ± 11.5 491 ± 50.4 Range (min-max, ml) 423 – 570 284 - 891 Percent correct 87% 69% n 30 32 Results
Measure +1GZ Microgravity Chest Compressions Depth (mm) 43.6 ± 0.59 41.3 ± 1.03 Range (min-max, mm) 40.4 – 47.1 27.6 – 51.2 Rate (compressions.min-1) 97.1 ± 3.0 * 80.2 ± 3.4 * Percent correct (depth) 90% 60% n 225 672 Volume Volume (ml) 507.6 ± 11.5 491 ± 50.4 Range (min-max, ml) 423 – 570 284 - 891 Percent correct 87% 69% n 30 32 Results * P < 0.05
Measure +1GZ Microgravity Chest Compressions Depth (mm) 43.6 ± 0.59 41.3± 1.03 Range (min-max, mm) 40.4 – 47.1 27.6 – 51.2 Rate (compressions.min-1) 97.1 ± 3.0 * 80.2 ± 3.4 * Percent correct (depth) 90% 60% n 225 672 Volume Volume (ml) 507.6 ± 11.5 491± 50.4 Range (min-max, ml) 423 – 570 284 - 891 Percent correct 87% 69% n 30 32 Results
Discussion • Reasons for insufficient rate of chest compression and greater variation of measures in microgravity. • Novelty of environment. • Variable acceleration forces. • Shortness of microgravity exposure. • Degree of manikin reliability.
Discussion • ERC compared to other methods of performing CPR in microgravity. • Current unpublished findings. • Further research required: • Effects of training and expertise. • Effects of strength. • Effects of anthropometric indices.
Conclusion • Effectiveness of the ERC method for all populations will need to be ascertained before it can be considered a viable method. • CPR of this nature is more difficult than at +1GZ and will therefore require appropriate pre-mission training. • Preliminary results indicate that the ERC method of unaided, single person CPR in microgravity is likely to be viable for use in space.