Roman-Patrik Lukas

Universitätsklinikum Münster, Muenster, North Rhine-Westphalia, Germany

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Publications (5)11.1 Total impact

  • Notfallmedizin up2date 02/2014; 9(01):33-44. DOI:10.1055/s-0033-1357885
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    ABSTRACT: Cardiopulmonary resuscitation is one of the most vital therapeutic options for patients with cardiac arrest. Sufficient chest compression depth turned out to be of utmost importance to increase the likelihood of a return of spontaneous circulation. Furthermore, the use of real-time feedback-systems for resuscitation is associated with improvement of compression quality. The European Resuscitation Council changed their recommendation about minimal compression depth from 2005 (40mm) to 2010 (50mm). The aim of the present study was to determine whether this recommendation of the new guidelines was implemented successfully in an Emergency medical service using a real-time feedback-system and to what extend a guideline-based CPR training leads to a "change in behaviour" of rescuers, respectively. The electronic resuscitation data of 294 patients were analysed retrospectively within two observational periods regarding fulfilment of the corresponding chest compression guideline requirements: ERC 2005 (40mm) 01.07.2009-30.06.2010 (n=145) and ERC 2010 (50mm) 01.07.2011-30.06.2012 (n=149). The mean compression depth during the first period was 47.1mm (SD 11.1) versus 49.6mm (SD 12.0) within the second period (p<0.001). With respect to the corresponding ERC Guidelines 2005 and 2010, the proportion of chest compressions reaching the minimal depth decreased (73.9% vs. 49.1%) (p<0.001). There was no correlation between compression depth and patient age, sex or duration of resuscitation. The present study was able to show a significant increase in chest compression depth after implementation of the new ERC guidelines. Even by using a real-time feedback system we failed to sustain chest compression quality at the new level as set by ERC guidelines 2010. In consequence, the usefulness of a fixed chest compression depth should be content of further investigations.
    Resuscitation 01/2014; 85(4). DOI:10.1016/j.resuscitation.2013.12.030 · 3.96 Impact Factor
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    ABSTRACT: Sudden cardiac arrest is a major contributor to avoidable deaths in Europe. Immediate start of basic life support (BLS) by laypersons is among the most successful strategies in the treatment of cardiac arrest patients. Despite the fact that more than half of all cardiac arrests in Germany are witnessed by a bystander, only in one fifth of all arrests layperson resuscitation is initiated. One strategy to enhance bystander BLS is to establish cardiac resuscitation tuition in schools. BLS instructions for pupils have been proven to be successfully implemented independent from children's age or physical ability. Although an age-adjusted curriculum seems reasonable even usage of automatic external defibrillators (AED) can be taught effectually. The earlier in the life of a student BLS-instruction begins, the more successful the training is. However a national German curriculum for BLS-training in schools has yet to be established in Germany.
    ains · Anästhesiologie · Intensivmedizin 09/2013; 48(9):552-7. DOI:10.1055/s-0033-1355236 · 0.39 Impact Factor
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    ABSTRACT: CONTEXT: The 2010 Resuscitation Guidelines require high-quality chest compression and rapid defibrillation for patients with ventricular fibrillation with rhythm analysis and defibrillation repeated every 2 min. A lack of adherence to the guidelines by medical students was observed during simulated resuscitation training. OBJECTIVES: To assess whether real-time cardiopulmonary resuscitation guidance, including an audiovisual countdown timer, a metronome, a display of the chest compression quality and voice prompts, might improve adherence to the guidelines by medical students. DESIGN: Prospective, randomised, cross-over simulation study. SETTING: Studienhospital Münster, Faculty of Medicine University Münster, Germany PARTICIPANTS: One hundred and forty-one medical students (fifth year) in 47 teams. INTERVENTION: Simulated resuscitation with and without real-time cardiopulmonary resuscitation guidance. MAIN OUTCOME MEASURES: The preshock pause, postshock pause, fraction of time without chest compression and defibrillation intervals. Observed quality parameters were chest compression depth and chest compression rate. RESULTS: With real-time cardiopulmonary resuscitation guidance, there were improved mean (SD) chest compression rates (105 ± 8 vs. 121 ± 12 bpm; P < 0.005), fewer inappropriate shock intervals [median (interquartile range) 0 (1 to 5) vs. 4 (1 to 7); P < 0.005], a smaller fraction of time without chest compression (18.9 ± 4.4 vs. 22.5 ± 7.0%; P < 0.005) and shorter postshock pauses (2.3 ± 0.9 vs. 3.4 ± 1.2 s; P < 0.005). CONCLUSION: Real-time cardiopulmonary resuscitation guidance significantly increased adherence to the guidelines by medical students treating simulated out-of-hospital cardiac arrest. Using a simple tool such as a countdown timer makes it possible to reduce the number of inappropriate shock intervals and time without chest compression.
    European Journal of Anaesthesiology 05/2013; DOI:10.1097/EJA.0b013e328362147f · 2.79 Impact Factor
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    ABSTRACT: Investigating the effects of any intervention during cardiac arrest remains difficult. The ROSC after cardiac arrest score was introduced to facilitate comparison of rates of return of spontaneous circulation (ROSC) between different ambulance services. To study the influence of chest compression quality management (including training, real-time feedback devices, and debriefing) in comparison with conventional cardiopulmonary resuscitation (CPR), a matched-pair analysis was conducted using data from the German Resuscitation Registry, with the calculated ROSC after cardiac arrest score as the baseline. Matching for independent ROSC after cardiac arrest score variables yielded 319 matched cases from the study period (January 2007-March 2011). The score predicted a 45% ROSC rate for the matched pairs. The observed ROSC increased significantly with chest compression quality management, to 52% (P=0.013; 95% CI, 46-57%). No significant differences were seen in the conventional CPR group (47%; 95% CI, 42-53%). The difference between the observed ROSC rates was not statistically significant. Chest compression quality management leads to significantly higher ROSC rates than those predicted by the prognostic score (ROSC after cardiac arrest score). Matched-pair analysis shows that with conventional CPR, the observed ROSC rate was not significantly different from the predicted rate. Analysis shows a trend toward a higher ROSC rate for chest compression quality management in comparison with conventional CPR. It is unclear whether a single aspect of chest compression quality management or the combination of training, real-time feedback, and debriefing contributed to this result.
    Resuscitation 03/2012; 83(10):1212-8. DOI:10.1016/j.resuscitation.2012.03.027 · 3.96 Impact Factor