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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

CPR represents the primary intervention used during cardiac arrest for maintaining perfusion and extending the potential resuscitation period. Effective CPR, however, requires careful attention to detail by the resuscitation team, including (1) effective control of the airway using manual maneuvers or airway adjuncts, (2) delivery of effective ventilation that assures adequate oxygenation, while reducing the chance for gastric inflation, and (3) chest compressions delivered at the appropriate depth and rate using a duty cycle of 50% compression and 50% release. During the resuscitation effort team leaders should closely monitor the performance of CPR, rotate rescuers frequently to avoid fatigue, and provide continuous feedback based upon direct (transmitted pulse, chest rise) and indirect (end-tidal CO2) measures of effectiveness. A careful and measured approach to CPR performance, combined with a strong chain of survival, provides victims of cardiac arrest the best chance for survival.
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PMID:Basic life support cardiopulmonary resuscitation. 1184 37

Prolonged use of the CardioPump can cause fatigue and may impair performing the ACD-CPR maneuver accurately. We applied a lever mechanism to lessen the fatigue. The fixed part of the lever consists of a 40 cm metal pipe, 2 cm in diameter, mounted vertically to a rectangular metal base plate (45 cm x 20 cm) placed under the patient when the device is used. The fulcrum of the lever is positioned at any height on the vertical tube. One end of the 65 cm lever was connected to a pin-joint hub at the fulcrum. The height of the fulcrum is adjusted for each patient according to the anterior-posterior dimension of the thorax. The Cardio-Pump is mounted in a frame which is movable along the shaft of the lever between the fulcrum and the handle at the operator end of the lever. ACD-CPR is performed by lowering and raising the handle. The range of motion is controlled for safety by observing the movement of the chest wall of the patient from the side. We were able to maintain ACD-CPR with this device for more than 30 minutes without significant fatigue.
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PMID:[Lever type push-pull device for ACD-CPR]. 1496 12

There is debate as to whether chest compression-only cardiopulmonary resuscitation (CC-CPR) or standard 30:2 CPR should be taught to laypersons. Equivalence in outcomes between standard CPR and CC-CPR has been amply demonstrated in communities with short ambulance response times of about five minutes. Depriving oxygen from a collapsed patient beyond six minutes results in poorer outcomes. Communities with prolonged ambulance travel times have seen improved outcomes with CPR than CC-CPR. While healthcare workers demonstrate a reluctance to perform mouth-to-mouth ventilation, laypersons generally show a willingness to do so. Rescuer fatigue also argues against the use of CC-CPR for more than a few minutes. For communities with relatively long ambulance transport times, the best approach appears to be standard CPR, with emphasis on good quality compression. For dispatcher-assisted CPR, communication issues suggest that CC-CPR is advisable. Public CPR training should include teaching of mouth-to-mouth ventilation alternating with chest compressions.
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PMID:Chest compression-only CPR or good quality 30:2 CPR. 2187 15

We introduce a new method of external chest compression (ECC), an essential part of cardiopulmonary resuscitation, using a thumb and index finger method (TIFM) on infants, and compares, this with two standard methods of the two finger method (TFM) and the two-thumb encircling hands method (TTEM). Sixty trained PALS (Pediatric Advanced Life Support) providers were randomly assigned into three groups and provided one-rescuer ECC for a period of five continuous minutes. Results without coaching or feedback were recorded on a recording CPR simulator (Laerdal, Inc). ECC was performed according to the BLS recommendations of the International Liaison Committee on Resuscitation (ILCOR). The quality of ECC in the TFM group deviated considerably from guideline recommendations. The same parameters in the TTEM and new TIFM groups during this study were in accordance with the parameters recommended by the guidelines. Thus, our new TIFM technique of chest compression, in infants was shown to be better than the currently TFM, especially for achieving adequate compression depth and avoiding fatigue, and is equally as effective as the TTEM. We propose this new method (TIFM) should be considered as the method of choice in single rescuer situations.
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PMID:New method of chest compression for infants in a single rescuer situation: thumb-index finger technique. 2389 82

In order to provide early intervention for coronary artery lesion (CAL) caused by Kawasaki Disease (KD), we analyzed clinical characteristics of typical and incomplete KD cases from 1998 to 2008 in Northwest and Central China. A total of 383 patients included 298 cases of typical KD and 85 cases of incomplete KD. The morbidity of incomplete KD was 28.5%, a percentage significantly lower than that of typical KD. The occurrence of bulbar conjunctiva congestion, erythra, crissum red, film-like decrustation, lip red, rhagades, raspberry tongue, bilateral toe-end decrustation, limb sclerosis, cervical lymph nodes enlargement, agitation and irritability in incomplete KD group was lower than that in the group of typical KD (p < 0.05); however, the occurrence of unilateral toe-end decrustation, scar reappearance erythema, malaise, fatigue, liver incidence was significant higher in incomplete KD group (p < 0.05). Based on lab assays and inspection index comparisons, the incomplete KD cases whose C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly increased, had significantly higher reduction in blood platelet (PLT). Interestingly, the KD patients with CPR higher than 30 mg/L, ESR higher than 40 mm/h, hepatomegaly and IVIG ineffectiveness, had higher incidence of CAL development. Altogether, our data have indicated differential clinical characteristics between incomplete KD and typical KD, and have identified several high risk factors of KD for CAL, such as hepatomegaly.
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PMID:Retrospective analysis of risk factors associated with Kawasaki disease in China. 2890 47

Background: Rescuer fatigue during neonatal CPR can affect CPR quality leading to reduced cerebral and myocardial perfusion. Aim: To investigate rescuer fatigue during simulated neonatal CPR using both objective (heart rate and cardiac output) and subjective measures. Methods: A randomized crossover manikin study performed. Nineteen doctors working in neonatology were randomized to (a) two-thumb term, (b) two-finger term, (c) two-thumb preterm, or (d) two-finger preterm group. Cardiac output and heart rate were measured with a non-invasive cardiac output monitor. A Likert scale assessed participants' level of perceived exertion. Results: In the preterm group, the mean change in HR from rest to 5 min in the TT group was 11.58 bpm (SD 6.22) vs. 9.94 bpm (SD 8.48), (p-value 0.36). There was no difference in change in CO, 2.10 (SD 1.15) in the TT group vs. 1.39 (SD 1.63) in TF group (p value 0.23). There was no difference in BORG RPE rating. In the term group, the mean change in HR from rest to 5 min was 15 bpm (SD 8.40) in TT group and 13 bpm (SD 7.86) in TF group, (p-value 0.416). The median change in CO from rest to 5 min was 1.50 (0.78 to 2.42 IQR) in TT group vs. 1.60 (0.65 to 3.0 IQR) in TF group. Conclusion: Providing chest compressions is associated with an increase in both heart rate and cardiac output. We did not identify difference between objective and subjective measures of fatigue between either technique in a preterm or term model.
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PMID:Rescuer Exertion and Fatigue Using Two-Thumb vs. Two-Finger Method During Simulated Neonatal Cardiopulmonary Resuscitation. 3230 May 78