Newsgroup: it.sociale.primosoccorso
Titolo: Re. RCP nuova

Spero di contribuire a rispondere a qualche domanda con alcune voci
bibliografiche del tutto recenti (in inglese però), sul perchè ai laici (non
soccorritori) convenga indicare solo la compressione senza ventilazione e
sostanzialmente non nell'arresto asfittico, ma solo in quello cardiaco non
traumatico.
 Crit Care Med 2000 Nov;28(11 Suppl):N190-2
Dispatcher-assisted "phone" cardiopulmonary resuscitation by chest
compression alone or with mouth-to-mouth ventilation.
Hallstrom AP
Clinical Trial Center, University of Washington, Seattle 98105, USA.
Based on both animal studies and field studies of the process and
intermediate outcomes related to cardiopulmonary resuscitation (CPR), we
initiated a randomized trial of dispatcher-assisted CPR, with the
intervention arm receiving instructions for chest compression only and the
control arm receiving standard instructions for airway maintenance
ventilation, and chest compression. Of 241 patents randomized to chest
compression instructions only, 35 survived (14.6%) compared with 29 of 279
(10.4%) patients in the control arm (p = .09). These results may have
implications for future guidelines and teaching CPR.
e anche
Crit Care Med 2000 Nov;28(11 Suppl):N186-9
Cardiopulmonary resuscitation without ventilation.
Kern KB
Section of Cardiology, Sarver Heart Center, University of Arizona, Tucson,
85724, USA.
Current resuscitation methods, although occasionally effective, rarely
perform as well as initially anticipated. Some of the disappointment can be
attributed to the difficulty of the task for many, including both
professional and lay first responders. Significant attention has been paid
recently to the need to simplify both the technique and the teaching of
resuscitation. In considering simplification of the current resuscitation
scheme, a logical start is an honest reappraisal of the importance and
priorities of each of the once sacrosanct ABCs, specifically, establishment
of an Airway, artificial Breathing (mouth-to-mouth breathing), and chest
compressions for temporary Circulation. Experimental data continue to
accumulate indicating that most important within this triad is circulation.
Adequate oxygen exists within the blood during at least the first 10 mins of
cardiac arrest. If circulation is provided to distribute such oxygen, no
survival disadvantage results with chest compression-only basic life support
(BLS) efforts. Even a totally occluded airway during the first 6 mins of
cardiac arrest does not compromise survival if reasonable circulation is
provided with chest compressions. Clinical studies support the same
conclusion that what most influences survival in any BLS effort is
circulation, not ventilation. Belgium investigators have shown equal
survival rates among those treated with chest compressions plus ventilation
and those who received chest compressions alone. Telephone dispatcher-guided
BLS cardiopulmonary resuscitation (CPR) has likewise shown no survival
disadvantage to chest compression-only CPR when compared with
telephone-guided standard BLS CPR. Based on this reasoning, a new simplified
BLS method has been proposed. "Staged" CPR consists of a strategy to
initially teach laypersons a simplified approach to BLS, which requires only
chest compressions and not mouth-to-mouth breathing. "Bronze" CPR, in which
chest compression-only BLS is taught, was compared with the standard
European Resuscitation Council BLS course for laypersons. Manikin "exit
testing" at course completion has revealed significant advantages of the
simplified approach compared with standard CPR courses for the lay public

 ...
Domani, quando saro' + riposato me le rileggo (il mio inglese e' scarsino!),
quello che ho capito l'ho postato in risposta a Fabiano nel thread "RCP
nuova", ma lo riprendo in parte qui x evitare che tu non lo legga e non mi
possa rispondere (mi interessa sapere fino a che punto riesca a sparare
c%te!)....
Dicevo:
" x un certo numero di minuti primi (6?) il sangue e' sufficientemente
ossigenato e quindi il solo circolo e' sufficiente a mantenere il nutrimento
agli organi nobili;
. questo vale sia x il cittadino qualunque che presta un soccorso in attesa
dell'abz. (se si concentra sulla MCE la fara' tanto meglio e piu' a lungo
che se deve rispettare due ritmi diversi), . ma vale anche x l'equipaggio
BLS, che puo' far circolare sangue sufficientemente ossigenato per piu'
tempo prima di ossigenare nuovamente, ....credo che il rapporto 15:2 sia
dovuto al fatto che praticare MCE per 15 volte consucutive (15-20 sec. max,
non di piu') sia ragionevole anche per una persona non dotata di una gran
forza/resistenza "
...
Il mio riassunto e' corretto?
Thanks!
--
aldo martini
soccorritore volontario
croce verde cascine vica/rivoli to
**opinioni personali**

 ha scritto nel messaggio
news:%0t96.78108$eB2.6...@news.infostrada.it...
...cut...


 ....
Beh la mia non era proprio una traduzione letterale, ma una specie di
riassunto tra le varie cose che ho letto sul ng. al riguardo...
--
aldo martini
soccorritore volontario
croce verde cascine vica/rivoli to
coord. formazione ANPAs
-opinioni personali-