Recent discussions
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David Symes
It would seem and feel right to continue the uniform approach of compression first for lay public or non specifically trained professionals. There is evidence that this group may be reluctant to undertake ventilation, especially if no barrier equipment is available,, thus prolonging the time before resuscitative efforts are commenced. The accepted ABC approach for those appropriately trained and equipped remains I believe the optimum response for this group. -
Leonard McFarlan
Because of the covid pandemic , Hospitals are giving their staff a over extended break from taking refresher courses in basic cpr . It’s the wrong time to look at increasing Instructor competence with the health system being so fragile . -
Luvir Salac
If the cause of cardiac arrest in drowning is V fib then, CAB will be of great importance. -
Kelly Martinez
Drowning protocol needs to focus on ventilations first. 5 or more initial breaths should be the standard before compressions. -
Scott Ruddle
I agree that whether chest compressions come first or the resuscitation is started with ventilations likely makes little difference as shown by the manikin study. (The delay to set up ventilation equipment may change the time to first ventilation.) It would make instructing the procedure to lay rescuers easier if there was just one procedure advocated, CAB order of approach. However, education that drowning is a hypoxic event should be reinforced. Ventilations, preferably with supplemental oxygen, should be encouraged. Explain that compression only CPR may be less effective in this circumstance, since it does not address the hypoxia. Explain that ROSC can frequently occur without defibrillation since reversing the hypoxia corrects the lack of cardiac output. -
Leonard McFarlan
I would think extra energy or priority should be made to get the person out of the water ,other than stopping to give a breath .. Then a breath could be given . -
Shinichiro Ohshimo
Congratulations on the completion of this systematic review! I highly appreciate your systematic review. This systematic review has provided important recommendations for the use of AEDs in pediatric patients with non-traumatic cardiopulmonary arrest. My only concern is that the articles used in the systematic review were all published by the same research team in Philadelphia. Furthermore, the entry periods for these studies largely overlapped. Therefore, I think that the number of patients calculated in the systematic review may have been counted in duplicate. -
ALS Task Force
We thank the commenters and provide a response at https://we.tl/t-M4JcwWRIO3 -
ALS Task Force
Thank you for your feedback. The average time to reach target temperature in the TTM study was similar to other published studies including where there have been no delays due to trial recruitment and randomisation – we have addressed this issue in previous responses. Our systematic review did not identify any sub populations where hypothermia was beneficial. -
ALS Task Force
We thank Professor Nichol for his detailed feedback and provide a point by point response at https://we.tl/t-FpHoQ6S2Co.