Objective: To evaluate the effect of strategies to reduce the spread of simulated aerosol during chest compressions on manikin and cadaver experimental models.Methods: To evaluate aerosol-spread we nebulized ultraviolet sensitive detergents into the artificial airway of a resuscitation dummy and performed CPR. The spread of the visualized aerosol was documented by a camera. In a further approach we applied nebulized detergents into the airways of human cadavers and detected the simulated spread on the same way. Among others we did recordings with undergoing compression-only-CPR, with a surgical mask or an oxygen mask on the patients face and with an inserted supraglottic airway device with and without a connected airway filter.Results: Most aerosol-spread at the direction of the provider was visualized during compression-only-CPR. The use of a surgical mask and of an oxygen mask on the patient's face deflected the spread. Inserting a supraglottic airway device connected to an airway filter lead to a remarkable reduction of aerosol-spread. Conclusion:The early insertion of a supraglottic airway device connected to an airway filter before starting chest compression may be beneficial for staff protection during CPR.

Supplemental Digital Content is available in the text.

Objective: To evaluate aerosol-spread in cardiopulmonary resuscitation (CPR) using different methods of airway management. Knowledge about Aerosol spread is vital during the SARS-CoV-2-Pandemic. Methods: To evaluate feasibility we nebulized ultraviolet sensitive detergents into the artificial airway of a resuscitation dummy and performed CPR. The spread of the visualized aerosol was documented by a camera. In a second approach we applied nebulized detergents into human cadavers by an endotracheal tube and detected aerosol- spread during chest compressions the same way. We did recordings with undergoing compression- only-CPR, with a surgical mask and with an inserted laryngeal tube with and without a connected airway filter. Results: Most aerosol-spread at the direction of the provider was visualized during compression-only-CPR. The use of a surgical mask deflected the spread. Inserting a laryngeal tube connected to an airway filter lead to a remarkable reduction of aerosol-spread. Conclusion: The early insertion of a laryngeal tube connected to an airway filter before starting chest compression may be good for two Things: the treatment of hypoxemia as the likeliest cause of cardiac arrest and for staff protection during CPR.

Objective: To evaluate leg-heel chest compression without previous training as an alternative for medical professionals and its effects on distance to potential aerosol spread during chest compression. Methods: 20 medical professionals performed standard manual chest compression followed by leg-heel chest compression after a brief instruction on a manikin. We compared percentage of correct chest compression position, percentage of full chest recoil, percentage of correct compression depth, average compression depth, percentage of correct compression rate and average compression rate between both methods. In a second approach, potential aerosol spread during chest compression was visualized. Results: There was no significant difference between manual and leg-heel compression. The distance to potential aerosol spread could have been increased by leg-heel method. Conclusion: Under special circumstances like COVID-19-pandemic, leg-heel chest compression may be an effective alternative without previous training compared to manual chest compression while markedly increasing the distance to the patient.

Background and aims: Aerosols and droplets are the main vectors in transmission of highly contagious SARS-Cov-2. Invasive diagnostic procedures like upper airway and gastrointestinal endoscopy have been declared as aerosol generating procedures. Protection of health care workers is crucial in times of COVID-19 pandemic. Methods: We simulated aerosol and droplet spread during upper airway and gastrointestinal endoscopy with and without physico-mechanical barriers using a simulation model. Results: A clear plastic drape as used for central venous access markedly reduced visualized aerosol and droplet spread during endoscopy. Conclusion: A simple and cheap drape has the potential to reduce aerosol and droplet spread during endoscopy. In terms of health care worker protection, this may be important particularly in low- or moderate-income countries.

No abstract

Kinderreanimation, an?sthesiologische Zwischenf?lle oder Komplikationen w?hrend der Geburt ? gerade in Ausnahmesituationen f?llt es schwer, einen k?hlen Kopf zu bewahren. Trainiert werden solche brenzligen Szenarien immer ?fter als ?Trocken?bung? im Patientensimulator. Denn was in der Luftfahrt schon zur Routine geh?rt, findet auch bei vielen Klinikchefs immer mehr Beachtung. Schlie?lich ist das Prinzip ganz einfach: den Ernstfall proben, bevor er eintrifft.

No abstract