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2018 ; 11
(1
): 31-37
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Cardiopulmonary Resuscitation: Unusual Techniques for Unusual Situations
#MMPMID29628666
Bhatnagar V
; Jinjil K
; Dwivedi D
; Verma R
; Tandon U
J Emerg Trauma Shock
2018[Jan]; 11
(1
): 31-37
PMID29628666
show ga
BACKGROUND: The cardiopulmonary resuscitation (CPR) in prone position has been
dealt with in 2010 American Heart Association (AHA) guidelines but have not been
reviewed in 2015 guidelines. The guidelines for patients presenting with cardiac
arrest under general anesthesia in lateral decubitus position and regarding
resuscitation in confined spaces like airplanes are also not available in AHA
guidelines. This article is an attempt to highlight the techniques adopted for
resuscitation in these unusual situations. AIMS: This study aims to find out the
methodology and efficacy in nonconventional CPR approaches such as CPR in prone,
CPR in lateral position, and CPR in confined spaces. METHODS: We conducted a
literature search using MeSH search strings such as CPR + Prone position, CPR +
lateral Position, and CPR + confined spaces. RESULTS: No randomized controlled
trials are available. The literature search gives a handful of case reports, some
simulation- and manikin-based studies but none can qualify for class I evidence.
The successful outcome of CPR performed in prone position has shown compressions
delivered on the thoracic spine with the same rate and force as they were
delivered during supine position. A hard surface is required under the patient to
provide uniform force and sternal counter pressure. Two rescuer technique for
providing successful chest compression in lateral position has been documented in
the few case reports published. Over the head CPR and straddle (STR), CPR has
been utilized for CPR in confined spaces. Ventilation in operating rooms was
taken care by an advanced airway in situ. CONCLUSION: A large number of studies
of high quality are required to be conducted to determine the efficacy of CPR in
such positions.