Two rescuer resuscitation--mission impossible? A pilot study using a manikin setting

Area of Science:

• Emergency Medicine
• Cardiology
• Resuscitation Science

Background:

• Standard advanced life support (ALS) typically requires a three-person team.
• Helicopter Emergency Medical Services (HEMS) often operate with only two rescuers.
• This limitation necessitates adapted ALS protocols for smaller teams.

Purpose of the Study:

• To develop and evaluate a novel algorithm for two-rescuer advanced life support (ALS).
• To assess the feasibility of this algorithm in a simulated cardiac arrest scenario.
• To optimize ALS delivery within the constraints of Helicopter Emergency Medical Services (HEMS) staffing.

Main Methods:

• A computer-controlled manikin (Ambu Mega Code Simulator System MCS) was utilized for testing.
• Twenty medical teams were evaluated during a 10-minute simulated persistent ventricular fibrillation (VF).
• Key performance metrics including no-flow time, compression rate, ventilation rate, and ALS procedure timings were recorded.

Main Results:

• The algorithm demonstrated feasibility in a manikin setting with specific performance data recorded.
• Chest compression frequency averaged 120.1/min, with a depth of 46.6mm.
• Advanced interventions like tracheal intubation, drug administration, and defibrillation shocks were timed.

Conclusions:

• The developed two-rescuer ALS algorithm is feasible in a simulated environment.
• The study provides quantitative data on performance metrics during simulated cardiac arrest.
• Further validation in real-world cardiopulmonary resuscitation (CPR) situations is recommended.