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> Hey Guys, > Just thought I would drop in my two cents worth. The actual benifit from= the > abdominal thrust (not actually a Heimlich as its not done standing) is to > reduce gastric destintion leading to vomitus and aspiration. This is > reguardless of wet or dry drowning. A study was being done with a three = man > CPR to evaluate the effectiveness of continued abdominal thrust during > rescitation but I haven't seen any follow up on the article I read which = leads > me to believe that it was either ineffective or out comes were below stan= drd. Actually what you are referring to is a new approach in CPR called "Interposd Abdominal Compression-CPR" or, simply "IAC-CPR". The main goal o= f this approach was not to prevent regurgitation but to maximize the thoracic pump effect by forcing blood in the thoracic compartment during the upstrok= e of the thoracic compression by using a downstroke abdominal compression. As a side effect (and rather a beneficial one), the maneuver relieved gastric distension and prevented regurgitation (and subsequent aspiration of gastri= c content into the airways). The papers I have read so far seem promising since the technique had a positive effect on hemodynamics. For practical reasons (technique more difficult to learn and to do, not easy to find 3 trained rescuers on the streets - at least not here in Canada, etc...), however, I do not believe that it will become standard anytime soon for out-of-hospital situations. You can read the following to get more info: Halperin HR, Chandra NC, Levin HR, Rayburn BK, Tsitlik JE: Newer methods of improving blood flow during CPR. Annals of emergency medicine 1996;27:553-562. Babbs CF: Interposed abdominal compression-CPR: A case study in cardiac arrest research. Annals of emergency medicine 1993;22:24-32. Howard M, Carrubba C, Guiness M, Foss F, Hogan B: Interposed abdominal compression CPR: its effects on coronary perfusion pressure in human subjects. Annals of emergency medicine 1984;13:989-990. Ward KR, Sullivan RJ, Zelenak RR, Summer WR: A comparison of interposed abdominal CPR and standard CPR by monitoring of end-tidal PCO2. Annals of emergency medicine 1989;18:831-837. Babbs CF, Sack JB, Fern KB: Interposed abdominal compression as an adjunct to cardiopulmonary resuscitation. The American hearth journal 1994;127:412-421. Sack JB, Kesselbrenner MB, Bregman D: Survival from in-hospital cardiac arrest with interposed abdominal counterpulsation during cardiopulmonary resuscitation. JAMA 1992;267:379-385. You will probably find more recent papers if you search a little... > In Any case it has been my experince (Both as an EMS provide and working = in > the ER) that it is irelivant wheahter the drowning is wet or dry. After > initial ventalation the lung tend to clear them selves of most water. At= htis > point as rescuers the best we can do is continue to maintian a clear airw= ay > while performing CPR and haul ass to the hospital. I totally agree with you on this. The use of abdominal thrusts alone often delays the administration of rescue breathing and chest compressions which are much needed to provide some level of tissue oxygenation. Clearing the lungs becomes useless if brain damage occurs because of the prolonged anoxia. =C9tienne **************************************************************** *Etienne Beaule, sauvetage@ge*.co* * **** * *B. Sc. Physiology * **** * *First aid/CPR instructor * ********** * *Search and rescue consultant * ********** * *Nitrox diver * **** * *http://www.geocities.com/~sauvetage * **** * **************************************************************** ICQ# 13589258 -- Send mail for the `techdiver' mailing list to `techdiver@aquanaut.com'. Send subscribe/unsubscribe requests to `techdiver-request@aquanaut.com'.
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