What is the best position to place and re-evaluate an unconscious but normally breathing victim? A randomised controlled human simulation trial on children

Current resuscitation guidelines endorse placing the unconscious and normally breathing victims in the recovery position (RP), but this technique might hinder breathing evaluation. To compare breathing evaluation and cardiac arrest detection: placing the victim in RP and checking breathing regularly...

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Bibliographic Details
Published in:Resuscitation 2019-01, Vol.134, p.104-109
Main Authors: Navarro-Patón, Rubén, Freire-Tellado, Miguel, Fernández-González, Noel, Basanta-Camiño, Silvia, Mateos-Lorenzo, Javier, Lago-Ballesteros, Joaquín
Format: Article
Language:English
Subjects:
Breathing assessment
Cardiopulmonary Resuscitation - education
Child
CPR
Female
Head
Head-tilt and chin-lift
Humans
Male
Out-of-hospital cardiac arrest
Out-of-Hospital Cardiac Arrest - diagnosis
Patient Positioning - standards
Recovery position
Respiration
Schoolchildren
Simulation Training - methods
Unconsciousness - diagnosis
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Summary:Current resuscitation guidelines endorse placing the unconscious and normally breathing victims in the recovery position (RP), but this technique might hinder breathing evaluation. To compare breathing evaluation and cardiac arrest detection: placing the victim in RP and checking breathing regularly, placing the victim in RP while re-evaluating breathing every minute, and placing the victim on his back, maintaining an open airway with the head-tilt-chin-lift technique and continuously checking breathing. Schoolchildren aged 10–12 with no previous cardiopulmonary resuscitation (CPR) training, from three different primary schools were randomly allocated into groups to receive a CPR course involving one of the three strategies. Then a human simulation took place. 192 schoolchildren (64 per group) were randomly selected and received one of the courses. 182 participants who correctly assessed the victim were compared: 16 (26.2%) out of the 59 participants using RP and checking breathing regularly detected cardiac arrest before the end of the simulation, compared to 41 (67.20%) out of 61 using RP re-evaluating breathing every minute, and 56 (90.3%) out of 62 using head-tilt-chin-lift. Statistically significant differences were found between the RP groups (p 
ISSN:0300-9572
1873-1570
DOI:10.1016/j.resuscitation.2018.10.030