Comparison of the Alternating Rescuer Method between Every Minute and Two Minutes During Continuous Chest Compression in Cardiopulmonary Resuscitation According to the 2010 Guidelines

PURPOSE: To maintain high quality cardiopulmonary resuscitation (CPR), optimal alternating rescuers is important. Stronger and faster chest compression has recently been emphasized in the 2010 guidelines. Therefore, this study compared and evaluated changes in the quality of chest compression in a 2-min scenario group and a 1-min scenario group. METHODS: Among the 88 participants, two-rescuer pairs were randomly allocated. After the training and a one-day break, participants were asked to perform continuous chest compressions for 2 min on a manikin and to take a one-day break, followed by continuous chest compression for 1 min. In all simulated CPRs, the total number of chest compressions and those with appropriate depth were counted. Chest compression quality index was calculated as the proportion of chest compressions with appropriate depth. RESULTS: The mean overall chest compression depth was lower in the 2-min scenario group, compared with the 1-min scenario group. In particular, compression rate (p=0.110), abnormal hand position (p=0.181), and chest recoil (p=0.892) showed no significant difference between the two groups. However, the quality index, mean depth (p=0.018) and too shallow compression depth (p=0.020) 1-min scenario was better than that of the 2-min scenario group. The difference in the CPR quality index reached statistical significance. CONCLUSION: Switching compressors at an interval of 2 min is reasonable for performance of CPR by a lay-bystander. However, alternating rescuers every 1 min may be an alternative method during continuous chest compression.

Clinical Profiles of Patients who Undergone Emergency Angiographic Embolization at Emergency Department

PURPOSE: Hemodynamically unstable pelvic fractures represent therapeutic challenges for the trauma team. The authors of this article have studied the clinical profiles of the angiographic intervention population at the emergency department during four years (2005~2009) to develop clinical guidelines for preventing deaths due to multiple trauma and for predicting the prognosis during initial evaluation. METHODS: We performed a retrospective review of 34 patients who had undergone angiographic interventions at the emergency department and compared the differences in clinical variables between survivors and non-survivors. RESULTS: Representative values were compared between survivors and non-survivors : RTS (revised trauma score) 7.006 (6.376~7.841) vs. 6.128 (4.298~6.494), PRC (packed red cell) units 5.5 (2.0~11.0) vs. 15 (8.0~18.5), and lactate (mmol/L) 3.0 (1.0~7.0) vs. 8.5 (3.5~10.5). RTS (p<0.01) and PRC units before angiographic interventions (p=0.01) and lactate (p=0.02) had correlations to the final outcomes. CONCLUSION: The availability of an angiographic suite and persistent hypotension after adequate fluid resuscitation for pelvic trauma are good indications of angiographic intervention for pelvic hemorrhage.