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Multiple Life-Saving Procedures Performed Simultaneously are Less Effective Than When Performed Individually Suggest University of Pittsburgh Researchers

Findings to be presented at Society for Academic Emergency Medicine Annual Meeting

ORLANDO, May 19, 2004 For patients in respiratory distress and in need of basic life support, it may be beneficial for them to receive rescue breathing, cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED) through a more automated and precise system in order to receive optimal care, suggest emergency medicine researchers at the University of Pittsburgh. Results of their study were presented today at the Society for Academic Emergency Medicine Annual Meeting in Orlando, Fla.

This study examined the effectiveness of artificial ventilation by prehospital care providers using basic life support techniques, which is the basic level of care provided by first responders, paramedics and emergency medical technicians (EMTs).

Through this study, we found that as resuscitation complexity increases, basic life-saving performance decreases, said study author Jon Rittenberger, M.D., a second-year resident in the affiliated residency in emergency medicine at the University of Pittsburgh School of Medicine.

Using full-torso mannequins, 36 prehospital care providers were tested in pairs and randomly completed three sets of six-minute scenarios. These scenarios included a non-breathing patient with a pulse and a pulseless patient with and without an AED. The mannequins, which were programmed to generate a carotid pulse, were connected to a computer to record the number of ventilations, ventilation rates and capacity of air exchange, number of chest compressions and compression depth.

At the completion of the experiment, the researchers found that rescue breathing alone provided more correct ventilations than CPR or CPR plus AED. The researchers also noted that fewer ventilations were also delivered during CPR and CPR plus AED. Eight pairs incorrectly treated the non-breathing patient by providing CPR instead of rescue breathing and were excluded from the ventilation analysis. More compressions were delivered with CPR alone versus CPR plus AED. The researchers suggest that further decrements might occur when advanced life-saving skills enter into resuscitation.

This research is compelling in that it demonstrates how basic life-saving skills may need to be redefined in order for patients to receive the best possible care, says Donald M. Yealy, M.D., professor and vice-chair of emergency medicine at the University of Pittsburgh School of Medicine and current president of the Society for Academic Emergency Medicine.

The department of emergency medicine at the University of Pittsburgh School of Medicine, under the direction of Paul M. Paris, M.D., F.A.C.E.P., is one of the largest academic departments in the United States, where roughly 40,000 patients are treated each year. Department faculty are recognized authorities in many specialty areas of emergency medicine, including prehospital care, pain management, decision guidelines, airway management, toxicology, resuscitation medicine, disaster planning and injury prevention.

The Society of Academic Emergency Medicine is the largest academic emergency medicine physician organization in the world, with more than 5,000 members. The societys mission is to foster emergency medicine's academic environment in research, education and health policy through forums, publications, inter-organizational collaboration, policy development and consultation services for teachers, researchers and students.

Collaborating with Dr. Rittenberger on this study were or are, Dave Hostler, Ph.D, research director, Guy Guimond, NREMT-P, and Tom Platt, M.Ed., NREMT-P, all from the University of Pittsburgh and Western Pennsylvania Center for Emergency Medicine.

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