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Abstract
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I would like to thank Joost Bierens,1 Gary Payinda and Jonathon Webber2 for their comments on my recent editorial on chest-compression-only for cardiac arrest following drowning.3
The authors of both letters quite rightly draw attention to the disparity between the elderly patients in Fukunda’s study4 and the youth of the typical drowning victim. This is not the only weakness of the study, as Fukunda et al admitted in their paper, which was presented as a stimulus to comment and future research.
I also agree entirely with Joost Bierens, that the logical initial management of a hypoxic cardiac arrest, such as that following drowning, is to attempt to re-oxygenate the blood. The problem is that, as yet, there is no good, published, objective research that confirms this. I wait eagerly, therefore, for the study noted by Payinda and Webber, which is due for imminent publication in Pre-hospital and Disaster Medicine. Hopefully, it will be available in time for consideration by those reviewing the resuscitation guidelines for 2020.
In the meantime, however, it should be remembered that chest-compression-only is not considered the optimum management for all cases of cardiac arrest, but a compromise particularly for dispatcher-directed CPR or when the rescuer is untrained in rescue breathing. A similar compromise would seem reasonable for victims of drowning ...
Language: en |