Evaluation of a novel method of performing cardiopulmonary resuscitation in microgravity

1
Evaluation of a novel method of performing
cardiopulmonary resuscitation in microgravity

• Simon N Evetts PhD, Lisa Evetts RGN,
• Thais Russomano MD PhD,
• João Castro MD and John Ernsting MBBS PhD.
• Microgravity Laboratory, PUCRS, Porto Alegre,
  Brazil.
• Human Physiology and Aerospace Medicine Group,
  Kings College London.

2
Background

• Can Cardiopulmonary Resuscitation be performed
  by anyone, anywhere when off planet?

3
Background

• Can Cardiopulmonary Resuscitation be performed
  by anyone, anywhere when off planet?
• Current unrestrained Basic Life Support methods,
  i.e. unaided, single person CPR.

4
Background

• Can Cardiopulmonary Resuscitation be performed
  by anyone, anywhere when off planet?
• Current unrestrained Basic Life Support methods,
  i.e. unaided, single person CPR.
• Hand stand method

5
Background

• Can Cardiopulmonary Resuscitation be performed
  by anyone, anywhere when off planet?
• Current unrestrained Basic Life Support methods,
  i.e. unaided, single person CPR.
• Hand stand method
• Reverse bear-hug (Heimlich).

6
Background

• Can Cardiopulmonary Resuscitation be performed
  by anyone, anywhere when off planet?
• Current unrestrained Basic Life Support methods,
  i.e. unaided, single person CPR.
• Hand stand method
• Reverse bear-hug (Heimlich).
• Limitations.

7
Background

• Can Cardiopulmonary Resuscitation be performed
  by anyone, anywhere when off planet?
• Current unrestrained Basic Life Support methods,
  i.e. unaided, single person CPR.
• Hand stand method
• Reverse bear-hug (Heimlich).
• Limitations.

• Can a method of CPR (with fewer limitations than
  current methods) be performed by anyone, anywhere
  when off planet?

8
Aim

• The aim of the study was to ascertain the
  viability and effectiveness of performing a new
  method of unaided, single person CPR in
  microgravity.

9
Recent and current CPR guidelines

• European Resuscitation Council 1998
• Mouth-to-mouth ventilation requiring tidal
  volumes of 400 600 ml.
• Chest compression depth of 40 50 mm.
• Chest compression rate of 100
  compressions.min-1.

10
Recent and current CPR guidelines

• European Resuscitation Council 1998
• Mouth-to-mouth ventilation requiring tidal
  volumes of 400 600 ml.
• Chest compression depth of 40 50 mm.
• Chest compression rate of 100
  compressions.min-1.

• European Resuscitation Council 2001
• Tidal volumes of 700 1000 ml.
• Chest compression depth of 40 50 mm.
• Chest compression rate in excess of 100 min-1.

11
ER CPR method chest compression potential.
12
ER method ventilation potential.
13
Manikin trials.

• 4 ? 2 Subjects/investigators.

• Laerdal adapted CPR manikin

14
Manikin trials.

• Pre post flight 1Gz measures.

15
Results
16
Results
17
Results

• P lt 0.05

18
Results
19
Results
20
Discussion

• Reasons for insufficient rate of chest
  compression and greater variation of measures in
  microgravity.

21
Discussion

• Reasons for insufficient rate of chest
  compression and greater variation of measures in
  microgravity.
• Novelty of environment.

22
Discussion

• Reasons for insufficient rate of chest
  compression and greater variation of measures in
  microgravity.
• Novelty of environment.
• Variable acceleration forces and shortness of
  microgravity exposure.

23
Discussion

• Reasons for insufficient rate of chest
  compression and greater variation of measures in
  microgravity.
• Novelty of environment.
• Variable acceleration forces and shortness of
  microgravity exposure.
• Use of 1Gz manikin (albeit adapted for
  microgravity use).

24
Discussion

• ER compared to other methods of performing CPR
  in microgravity.

25
Discussion

• Jay, Lee, Goldsmith, Battat, Maurer and Suner,
  2003. CPR effectiveness in microgravity
  Comparisons of thee positions and a mechanical
  device. Aviat Space Environ Med, 74(11) 1183-9

26
Discussion
27
Discussion
28
Discussion
29
Discussion
30
Recommendations and Conclusion

• Effectiveness of the ER method for all
  populations will need to be ascertained before it
  can be considered a viable method for universal
  use.

31
Recommendations and Conclusion

• Effectiveness of the ER method for all
  populations will need to be ascertained before it
  can be considered a viable method for universal
  use.

• Strength
• Anthropometric indeces
• Cardiovascular fitness

32
Recommendations and Conclusion

• Effectiveness of the ER method for all
  populations will need to be ascertained before it
  can be considered a viable method for universal
  use.
• Strength
• Anthropometric indeces
• Cardiovascular fitness
• Indications are that ER CPR should be possible
  for almost anyone, anywhere off planet.

33
Thank you for your timeAny questions?
34
Our thanks to-Laerdal Uk LtdVARIG

• E-mail address
• snevetts_at_btopenworld.com
• or
• simon.evetts_at_kcl.ac.uk