Chest compression efficacy determines blood flow in cardiopulmonary resuscitation (CPR) and relies on body mechanics, so resuscitator weight matters. Individuals of insufficient weight are incapable of generating a sufficient downward chest compression force using traditional methods.
This study investigated how a resuscitator's weight affects chest compression efficacy, determined the minimum weight required to perform chest compressions and, for children and adults below this minimum weight, examine alternate means to perform chest compressions.
Volunteers aged 8 years and above were enrolled to perform video-recorded, music-facilitated, compression-only CPR on an audible click-confirming manikin for 2 minutes, following brief training. Subjects who failed this proceeded to alternate modalities: chest compressions by jumping on the lower sternum; and squat-bouncing (bouncing the buttocks on the chest). These methods were assessed via video review.
There were 57 subjects. The 30 subjects above 40kg were all able to complete nearly 200 compressions in 2 minutes. Success rates declined in those who weighed less than 40kg. Below 30 kg, only one subject (29.9 kg weight) out of 14 could achieve 200 effective compressions. Nearly all of the 23 subjects who could not perform conventional chest compressions were able to achieve effective chest compressions using alternate methods.
A weight below 40kg resulted in a declining ability to perform standard chest compressions effectively. For small resuscitators, the jumping and squat-bouncing methods resulted in sufficient compressions most of the time; however, chest recoil and injuries are concerns.
The purpose of this theoretical concept article is to spark a dialogue on the use of organisational behaviour theory to address emergency responder retention. In the United States, emergency medical services (EMS) appear to be burdened with continuing problems of retaining staff. Poor responder retention affects the ability of EMS to deliver high-quality services; without trained, educated and experienced first responders, the EMS system struggles, and what suffers is the ability to provide medical care. The authors set out to construct a pathway for addressing the underlying issues leading to the exodus of professionals using organisational behaviour theory. To develop the idea, an inductive logic approach was used to address underlying negative factors influencing poor retention and discuss the promise of organisational behaviour theory in improving the retention of responders.
Paramedic independent prescribing offers an opportunity to improve patient access to medications. However, incomplete, unclear or incorrectly written prescriptions can cause harm to patients. This article in the Prescribing Paramedic series considers: the legal requirements a prescription must meet for prescription-only medicines and controlled drugs; common errors that may occur during prescription writing and potential solutions; and best practice recommendations for prescribers to follow when writing a prescription to minimise errors. The advantages and disadvantages of electronic prescribing are discussed.
In her last NQP column, Mahdiyah Bandali reflects on her surprise foray into paramedicine, her journey thus far, and what keeps her motivated to carry on in the face of various obstacles
In this month's Paramedic Roles, Mitchell Brown shares his experience shadowing an ACP in A&E
Publishing an academic paper and going through the submission process can be unfamiliar and daunting. This article will provide a basic overview of where to start, how to search and scrutinise journals to find the right one for your work, checking guidelines and the finer things such as whether or not to pay for your publication, getting everything ready, what to expect during the process of submission, how your manuscript is reviewed and how a decision is made. Familiarising yourself with the basics of the submission process will make it less intimidating as you will know what to expect and how to prepare.