Two rescuer resuscitation—Mission impossible? : A pilot study using a manikin setting

SummaryObjectiveAdvanced life support (ALS) in a cardiac arrest is usually performed by a team consisting of three people. The medical team of a Helicopter Emergency Medical Service (HEMS) often consists of two rescuers only. Due to that reason an algorithm was developed to provide ALS with two people. During the initial phase the rescuer in the over-the-head position provides one man CPR while the second rescuer prepares all advanced measures. When all preparations are complete both rescuers are able to provide ALS.Material and methodsA computer controlled manikin (Ambu Mega Code Simulator System MCS®) with online documentation was used to test the entire medical staff during 10 min of persistent VF.ResultsThe 20 teams were tested. Following data were recorded: no-flow-time 96.4 ± 11 s (16.1 ± 1.8%), chest compression frequency 120.1 ± 5.1 min−1, ventilation frequency = 9 min−1, number of chest compressions per session 1013.7 ± 45.9, depth of chest compressions 46.6 ± 2.5 mm, total number of chest compressions = 20,274, total number of ventilations = 1893. For ALS measures the following data were recorded: tracheal intubation (TI) was finished after 60.7 ± 9.8 s, duration of TI maneouver = 15.7 ± 4.4 s, end of initial phase = 188.9 ± 26.3 s, i.v. administration of adrenaline after 387.7 ± 33.6 s, i.v. administration of amiodarone after 507.9 ± 36.9 s and four shocks after: 138.0 ± 15.9, 266.8 ± 16.1, 398.0 ± 20.1 and 526.8 ± 23.6 s.ConclusionWe proved the feasibility of the algorithm in a manikin setting. Further observations have to prove the algorithm in real CPR situations.