ACLS Ventilation Skills-Education Effect of Compression Adjusted Ventilation: A Manikin Study

PURPOSE: Previous study demonstrated that compression adjusted ventilation (CAV) is helpful in maintaining an adequate ventilation rate during cardiopulmonary resuscitation (CPR). We conducted this study in order to verify that CAV is also a useful educational method for maintenance of an adequate ventilation rate. METHODS: Volunteers who received education on CPR guidelines were randomly assigned to two groups. In the conventional ventilation (CV) group, participants performed ventilation in accordance with conventional guidelines. In the CAV group, the ventilation rate was adjusted in line with the compression rate (one ventilation per 12 chest compressions). Then, participants performed CPR using a cardiac arrest model with an advanced airway. They performed chest compression and ventilation. All participants performed CPR immediately after their instruction (test 1) and performed it again after four weeks (test 2). RESULTS: Data were collected from 60 participants. In the CAV group, proportion of adequacy of ventilation rates was higher compared with the CV group in both test 1 (CV: 18.8% vs. CAV: 57.1%, p=0.001) and test 2 (CV: 25.0% vs. CAV: 71.4%, p<0.001). In addition, no significant difference was observed between the compression rates of the two groups in test 1. However, in test 2, a significant decline was observed in the CV group (p=0.003). CONCLUSION: CAV is a more useful educational method for maintenance of an adequate ventilation rate.

Effect of Intravenous Fat Emulsion on Glyphosate Surfactant Herbicide-Induced Shock in a Rat Model: A Preliminary Study

PURPOSE: Decontamination and supportive care are general types of treatment for glyphosate surfactant herbicide (GlySH) intoxication. However, no particular treatment for refractory shock has been established as a conventional therapy. Therefore, this study examined whether intravenous fat emulsion therapy (IFE) is effective on GlySH-induced shock. METHODS: This preliminary study was conducted on 10 rats. After anesthesia and catheterization, shock was induced by GlySH infusion. After a stabilization period, animals were randomized to receive intravenous normal saline (Group 1) or 20% lipid emulsion (Group 2). RESULTS: In the shock state, there was no significant difference between the two groups for systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP). In the post-management state, there was no significant difference between the two groups for SBP and MAP. However, there was a significant difference for DBP (Group 1, median 72.5 (IQR 52.8-74.6) mmHg; Group 2, median 77.6 (IQR 74.8-98.3) mmHg, p=0.016), SBP variation (Group 1, median 5.5 (IQR 1.6-11.1) mmHg; Group 2, median 25.6 (IQR 15.5-42.9) mmHg, p=0.008); DBP variation (Group 1, median -1.02 (IQR -4.69-11.0) mmHg; Group 2, median 21.1 (IQR 14.0-43.2) mmHg, p=0.008); MAP variation (Group 1, median 1.15 (IQR -2.6-11.0) mmHg; Group 2, median 23.2 (IQR 14.2-42.8) mmHg, p=0.008). CONCLUSION: The IFE increased blood pressure when shock was induced using GlySH. However, further studies are required to determine what components induced the shock and permitted a response to the IFE.