Podcasts about mcpr

After the bumper double paper review episode, we fit two months of blog content into one episode. Iain and Simon discuss the management of the patient with chronic liver disease who has an acute decompensation, global health connections, whether mechanical CPR is more effective than human CPR and the potential effects on elderly patients staying in the ED overnight. References Conor Crowley, Justin Salciccioli, Wei Wang, Tomoyoshi Tamura, Edy Y. Kim, Ari Moskowitz, The association between mechanical CPR and outcomes from in-hospital cardiac arrest: An observational cohort study, Resuscitation, 2024, 110142, ISSN 0300-9572, https://doi.org/10.1016/j.resuscitation.2024.110142. Roussel M, Teissandier D, Yordanov Y, Balen F, Noizet M, Tazarourte K, Bloom B, Catoire P, Berard L, Cachanado M, Simon T, Laribi S, Freund Y; FHU IMPEC-IRU SFMU Collaborators; FHU IMPEC−IRU SFMU Collaborators. Overnight Stay in the Emergency Department and Mortality in Older Patients. JAMA Intern Med. 2023 Dec 1;183(12):1378-1385. doi: 10.1001/jamainternmed.2023.5961. PMID: 37930696; PMCID: PMC10628833. Recommended Conferences Premier Conference - 11th-12th June 2024, Winchester Tactical Trauma 24 - 7th-9th October, Sundsvall, Sweden RCEM Annual Scientific Conference

Melissa Chefec, is the founder of MCPR Public Relations, a firm specializing in publicity for doctors and wellness experts.MCPR has been promoting its clients for media interviews and resulting publicity for over 25 years. Ms. Chefec is expert in media relations and content development about health, fitness, beauty, mental health and nutrition topics.As an entrepreneur and business leader, she oversees a team of 4 public relations specialists, managing all aspects of the business including pr planning, strategy development, media relations with journalist, tracking for published articles and health/medical writing. Melissa, speaks about how to get PR for your medical practice https://mcprpublicrelations.com/ --------------- Dr. Sharon Mclaughlin is board certified plastic surgeon. She is founder of the Female Physician Entrepreneurs Network and Business Program where she empowers women physicians by helping them turn their idea into profitable businesses so that they can have the freedom to live their best life. She is also the founder of Mind Lull, which helps others slow down by providing tools and journals which help small business owners improve their focus and have more fulfillment. Her latest book, Thriving After Burnout, is a compilation of stories from women physicians who share tips and strategies on what helped them during burnout. Thriving After Burnout Thriving After Burnout: A Compilation of Real Stories and Strategies to Reduce Female Physician Burnout For women physicians https://fpestrong.com You can find Dr Mclaughlin's planners here Journal and Business Planner For Entrepreneurs and Small Business Owners: Intention and Gratitude Journal For Entrepreneurs Her website https://sharonmclaughlinmd.com You can reach her at sharon@sharonmclaughlinmd.com

Melissa Chefec, is the founder of MCPR Public Relations, a firm specializing in publicity for doctors and wellness experts.MCPR has been promoting its clients for media interviews and resulting publicity for over 25 years. Ms. Chefec is expert in media relations and content development about health, fitness, beauty, mental health and nutrition topics.As an entrepreneur and business leader, she oversees a team of 4 public relations specialists, managing all aspects of the business including pr planning, strategy development, media relations with journalist, tracking for published articles and health/medical writing. Melissa, speaks about how to get PR for your medical practice https://mcprpublicrelations.com/ --------------- Dr. Sharon Mclaughlin is board certified plastic surgeon. She is founder of the Female Physician Entrepreneurs Network and Business Program where she empowers women physicians by helping them turn their idea into profitable businesses so that they can have the freedom to live their best life. She is also the founder of Mind Lull, which helps others slow down by providing tools and journals which help small business owners improve their focus and have more fulfillment. Her latest book, Thriving After Burnout, is a compilation of stories from women physicians who share tips and strategies on what helped them during burnout. Thriving After Burnout Thriving After Burnout: A Compilation of Real Stories and Strategies to Reduce Female Physician Burnout For women physicians https://fpestrong.com You can find Dr Mclaughlin's planners here Journal and Business Planner For Entrepreneurs and Small Business Owners: Intention and Gratitude Journal For Entrepreneurs Her website https://sharonmclaughlinmd.com You can reach her at sharon@sharonmclaughlinmd.com

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Family Empowerment Media: track record, cost-effectiveness, and main uncertainties, published by Rethink Priorities on June 12, 2023 on The Effective Altruism Forum. Editorial note and disclaimer This report assesses the nonprofit Family Empowerment Media (FEM). The project was commissioned and supported by a donor who wishes to remain anonymous. It was conducted in February 2023 over two weeks. This report attempts to estimate the cost-effectiveness of FEM, mainly relying on two existing cost-effectiveness analyses (from GiveWell and Founders Pledge). We were asked to look into the cost-effectiveness of the organization in an unbiased way, and we started the research without a prior for whether this organization would be cost-effective or not. In this report, we express cost-effectiveness as a function of the cost-effectiveness of cash transfers (like the original models mentioned above). We did not analyze the cost-effectiveness of any other family planning interventions, so we cannot and do not make any claims about how FEM compares to other family planning interventions. In addition to looking at the cost-effectiveness of FEM's program, we describe their track record to date, and try to determine the main uncertainties about the program and its (cost-)effectiveness. We relied on four expert interviews to attempt to answer some of the questions: We interviewed Anna Christina Thorsheim (Executive Director and cofounder of FEM), Andrew Martin (Senior Research Analyst at GiveWell), Rosie Bettle (Applied Researcher at Founders Pledge), and Dr. Mukhtar Muhammad (medically trained expert in social and behavior change communication with a historical focus on family planning programming). We have tried to flag major sources of uncertainty in the report and are open to revising our views as more information becomes available. We would like to mention that Melanie Basnak previously worked at Charity Entrepreneurship (CE), the nonprofit organization that incubated FEM. Melanie did not overlap with Anna Christina Thorsheim during her time at CE and believes she oversaw this research in an unbiased manner. Executive summary In a randomized controlled trial in Burkina Faso from 2016-2018, a family planning mass media campaign led by the nonprofit Development Media International (DMI) led to a 5.9 percentage point (20%) increase in the modern contraceptive prevalence rate (mCPR), leading the study authors to estimate a cost effectiveness of $7.70 per couple-year protection, albeit with uncertainty. The nonprofit Family Empowerment Media (FEM) ran a pilot family planning mass media campaign in Kano, Nigeria, and they observed a 6 percentage point (75%) increase in mCPR using less rigorous pre- and post-pilot data comparisons. GiveWell conducted a cost-effectiveness analysis (CEA) of DMI's intervention, finding it to be 1.1-5.4x the cost-effectiveness of cash transfers, depending on the context. FEM altered the model to pertain to its pilot intervention in Kano, finding that their intervention was ~27x the cost-effectiveness of cash transfers. Founders Pledge conducted a separate CEA, finding a cost-effectiveness of ~22x that of cash transfers, complete with a full (unpublished) report. We used the original models as a starting point to conduct our own cost-effectiveness estimation, tweaking certain values. In most cases, our adjustments would tend to increase these existing cost-effectiveness estimates, so we are confident that the cost-effectiveness of FEM's intervention beats that of cash transfers, and we believe that their cost-effectiveness might be higher than GiveWell's and Founders Pledge's estimates. However, we would like to see several remaining uncertainties resolved before we would feel confident putting a bound on cost-effectiveness, and we discuss these uncertainti...

Transport of patients with ongoing CPR to the correct treatment center is a high risk but potentially lifesaving intervention. Mechanical CPR (mCPR) devices are recommended to reduce risk and maintain chest compression quality. However, such transports have inherent pitfalls to both patient and provider safety. This is a poorly studied field of our practice and no clear consensus for how this should be done exists. In this podcast episode, we are joined by Dr. Per Olav Berve to discuss the practical challenges of these missions, CPR physiology, hemodynamics, and hopefully some hard-earned advice on how to get a patient in cardiac arrest to hospital in a survivable physiologic state. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com Creative Commons Attribution 3.0 Unported License https://creativecommons.org/licenses/by/3.0/deed.en_US

This week, we are joined by Michael Corrigan of MCPR in Chicago. Michael is the founder and owner of MCPR. Michael has been gaining experience in PR for 15 years now with both agency and in house experience. Michael focuses on looking at marketing as storytelling to leverage the brand and help the brand grow. Michael works with both local and small brands as well as national and global brands! His services include marketing, content, and PR.

WAGRadio's Groovin' Blue is hosted and produced by DJZigZag 1.  (  :18)  WAGRadio GB 20-08 Intro 2.  (3:18)  "Luv Drug (2020 Vaxanation Vs Dinda (DJZigZag MashEdiT)" - JAY VEGAS, DJ OJI, DJ BISKIT, ORIGINAL MAN [Hot Stuff] / [POJI] 3.  (  :39)  WAGRadio FreeDumb Id 4.  (5:54)  "BRB (DJZigZag X10 Da Mix)" - MAHALIA [Warner] 5.  (7:17)  "A Real Mother For Ya (Ben Liebrand Old Skool Remix)" - JOHNNY GUITAR WATSON [High Fashion] 6.  (3:23)  "Jolene" - CHIQUIS RIVERA, BECKY G [UMG Recordings, Inc.] 7.  (7:09)  "Summertime" - BYRD OUTBACK [Smooth Agent Records 12" No. SAR1009] 2005 8.  (  :12)  WAGRadio Sumpin' Id 9.  (5:49)  "Skank (Bluckther Remix) Vs Long Way From Home (DJZigZag MashEdiT)" - FEDDE Le GRAND, FEDDE LeGRAND & SULTAN [Darklight] / [Ultra] 10.(  :30)  WAGRadio BraNNu Id 11.(4:04)  "You Gotta Do It All" - CeeLo GREEN [BMG Rights Management] 12.(3:27)  "Rock Steady" - ZOE [Orange Hill 45rpm No. RS 010904 ] 2004 Prod. Alborosie 13.(  :14)  DJZZiD 14.(3:27)  "No Strings Attached Vs Lollipop (DJZigZag MashEdiT)" - JACQUES RENAULT, VOZMEDIANO [Let's Play House] / [Monoside] 15.(  :12)  WAGRadio Ho Gai Id 16.(4:22)  "How Can I Get Next To You" - CHAPTER 8 [Beverly Glen Music 45rpm No. BG 2024] 1985 Prod. Michael J. Powell 17.(  :08)  WAGRadio BearTed Id 18.(4:10)  "Ooh!" - MARY J. BLIGE [Geffen 12" No. GEFR-26057-1] 2003 Prod. Sean "P. Diddy" Combs 19.( xxx)  "Rockstar (DJZigZag EdiT of the Kay Stafford Club Mix)" - DaBaby, RODDY RICCH [Interscope] 20.(  :32)  WAGRadio 2020 Gentlemen Id 21.(3:55)  "Orgastra (DJZigZag Piedra Dura EdiT)" - HP VINCE, DAVE LETHERMAN [Tropical Disco] 22.(4:30)  "If I" - JESSE POWELL [MCA 12" No. MCPR 25210-1] 2005 23.(  :22)  WAGRadio Montz Long Past Id 24.(2:50)  "Super Duper Party People (Alan Braxe Radio Remix)" - ALLIE X [Twin] 25.(3:21)  "The Way" - CeeLo GREEN [BMG Rights Management] 26.(  :12)  WAGRadio UniQua's Id 27.(4:49)  "Get Right Back Vs Inner City Blues (DJZigZag MashEdiT)" - DJ SHU-MA, DISCO TOWN, ANGELO FERRERI, MOON ROCKET [Tactical] / [Mood Funk] 79:31  

Einen spannende Sonderfolge über Reanimation mit Justus von dasFoam.org ! Wir diskutieren aktuelle Evidenz und erweiterte Maßnahmen und am Ende gibt es noch eine kleine Überraschung! Rein- und durchhören lohnt sich ! Evidenz-Grade: Empfehlungsgrade: Quellen beide Abbildungen: AHA Top-Artikel von dasFOAM: MUST READ FÜR ALLE:https://dasfoam.org/2018/08/18/kreislaufstillstand-eine-videoanalyse/Pulscheck-Artikel von Justus:https://dasfoam.org/2019/11/24/der-tod-des-pulschecks/Smartwatch:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367979/ Die weiteren Quellen findet Ihr dann in den jeweiligen Artikeln von dasFOAM Quellen […] Der Beitrag "Sonderfolge" Reanimation – Was die Leitlinien uns (nicht) sagen erschien zuerst auf pin-up-docs - don't panic.

First, there are two proposed mechanisms of CPR, brilliantly summarized in this paper: Cardiac Pump Mechanism: “blood is squeezed from the heart into the arterial and pulmonary circulations, with closure of the mitral and tricuspid valves, preventing retrograde blood flow, and opening of the aortic and pulmonary valves in response to forward blood flow. Air is thought to move freely in and out of the lungs, so that the intrathoracic pressures do not significantly rise and the pulmonary circulation is not adversely affected by chest compressions. With the relaxation of chest compression, the heart fills with blood and air passively returns to the lungs.” Thoracic Pump Mechanism: “With each chest compression the intrathoracic pressure rises because of the collapse of the airways; the thoracic pump theory. This theory presumes that the rise in the intrathoracic pressures results in collapse of the pulmonary airways, thereby reducing the movement of air out of the lungs and reducing the size of the intrathoracic structures, but not necessary equally. The collapse of venous structures at the thoracic inlet was postulated to prevent retrograde venous blood flow and with each relaxation of chest compressions, the intrathoracic pressure falls with return of venous blood.” It is likely that both mechanisms are at play: …In patients with an average chest configuration and those with so‐called “barrel chests,” secondary to emphysema or other causes, the lateral chest roentgenogram often shows a significant distance between the anterior chest‐wall and the heart. In such patients it is nearly inconceivable that sternal compressions of the chest during CPR could result in cardiac compression. Rather, the mechanism of blood flow from chest compressions is probably secondary to the rhythmic alterations of the intrathoracic pressure and releases, for example, the “thoracic pump” theory. Is there any evidence that M-CPR Devices improve outcomes – since they’re marketed as “life saving devices”? A Meta Analysis from Gates et. al. concluded: Existing studies do not suggest that mechanical chest compression devices are superior to manual chest compression, when used during resuscitation after out of hospital cardiac arrest. However, if there’s no difference in survival, and it’s not WORSE than manual CPR, why not use it to cognitively offload tasks? Because, it may be worse. Gonzales et. al. compared “pit crew” resuscitation with “scripted” mCPR implementation and found: In this EMS system with a standardized, “pit crew” approach to OHCA that prioritized initial high-quality initial resuscitative efforts and scripted the sequence for initiating mechanical CPR, use of mechanical CPR was associated with decreased ROSC and decreased survival to discharge. Why might this be the case? We know based off work by Hwang et. al. who showed that standard CPR (inter-nipple line) often results in compression or narrowing of the LVOT or the aortic root. In this study, the area of maximal compression was over the aorta in 59% of patients! In another study, anderson et. al. used transthoractic echo to mark the location of the aortic root and the left ventricle of animals, and randomized them to receive CPR at one of the two locations. As you can probably guess, aortic systolic and diastolic pressures as well as ETCO2 were higher in the LV group, and 9 of the LV group (69%) achieved ROSC and survived at least 60 minutes compared to none who received chest compressions over the aortic root.  All of these studies and more are explained in a wonderful video created by Felipe Teran: The folks at The Ultrasound Podcast also discuss using TEE to guide hand or device palcement for CPR: TEE to save lives, guide compressions, and guide interventions Pt 1. #FOAMED.  p.s. – checkout cabofest2018.com  But, how do we do we know that we’re compressing the LV without TEE? Well, we don’t exactly. However, Qvigstad E et. al. published a study in Resuscitation titled “Clinical pilot study of different hand positions during manual chest compressions monitored with capnography.” They compared how hand positioning at the inter-nipple line (INL), 2 cm below the INL, 2 cm below and to the left, and 2 cm below and to the right affect ETCO2. They found that there’s not “one superior hand position”, and that optimal positioning varies: How does this explain when we should place mCPR? It doesn’t really, but one argument against mCPR, specifically one based off of the cardiac pump mechanism, is that the device is consistent and doesn’t fatigue, yet this might be it’s downfall. It’s postulated, and demonstrated in the above videos that it may just be consistently compressing the aortic outflow tract, and not the left ventricle.  Are we applying mCPR too early? Poole et. al discuss this in a paper titled: Mechanical CPR: Who? When? How? In their paper they discuss how the device is frequently deployed early, even before defibrillating the patient. Others In clinical practice, published literature reports marked variability in the hands-off time during device deployment, with pauses in excess of 1 minute being reported. In the LINC trial, the median reported chest compression pause associated with device deployment was 36.0 s (IQR 19.5, 45.5) The authors continue and note that… subsequent improvement in flow-fraction following device deployment meant that the median flow-fraction over the first 10 minutes of the cardiac arrest was higher in the mechanical CPR arm (mechanical 0.84 (IQR 0.78, 0.91) vs manual 0.79 (IQR 0.70, 0.86), p 

The first time you see it, there can be any number of emotions.  On some patients, it looks like their chest is being caved in by a machine.  On other patients, it feels like a smooth and controlled aspect of an otherwise difficult resuscitation.  There are many opinions and stories about mechanical cardiopulmonary resuscitation (mCPR), but the evidence may surprise you and lead to the question: does it work?

Murray has worked in music industry PR for over 30 years representing names like Kylie, the Petshop Boys, Coldplay, Yoko Ono and many more. He's been running MCPR for 10 years now and has decided to make the move back to Dundee to start a new chapter in his career. Murray talks about growing up in Lochee and always being part of an alternative scene and some of the difficulties that come with that. Eventually, the pull of the music scene in London became too great. He ended up living between squats and making ends meet however possible just to be part of an amazing time in the city's history. Through a friend's prison stint Murray ended up being persuaded to get into music PR. Off the back of that, he built a 30+ year career with 20 years at EMI records and then 10 running his own company. Now he has decided to take a different direction and move back to Dundee to work with Jennie Patterson. It's brilliant to see the lure of Dundee's changes bringing people like Murray back and hopefully he is one of many. Murray's website - http://murraychalmers.com/

Larry McDonald is a Jamaican percussionist, born in Port Maria in Jamaica in 1939. Larry first started to play congas with #Carlos Malcolm band in the 1960s and also with Toots Hibbert of the Grammy Award winning band Toots and the Maytals as well as the Count Ossie Band. He plays a wide variety of traditional percussion instruments.McDonald has a nearly 50 year history of recording and performing with a wide variety of artists, such as #GilScott-Heron, and Taj Mahal. In 2009, McDonald released his first solo album "Drumquestra" on which he united many of his former band mates from across his career, in an orchestra of drummers, including Sly DunbarUziah Thompson a.k.a. "Sticky" of Bob Marley and the Wailers and the former Count Ossie drummers under their later mantle "Mystic Revelation Of Rastafari" drummers. Drumquestra also featured former frontmen from bands Larry performed and recorded with, including Toots Hibbert, Bob Andy, #Mutabaruka, Stranger Cole and Dollarman. The album was recorded at a live session at Harry J Studios in Kingston Jamaica by Steel Pulse producer Sidney Mills for Malik Al Nasir's MCPR label in the UAE, who released the album in 2009. MCRP also released two singles off the album the same year, "Head Over Heels" Featuring Dollarman and Sly Dunbar and "Set The Children Free" Featuring Toots Hibbert, the latter of which was subsequently re-mixed for dance-floors by Lenny B. Shortly after the album was released, Larry was honoured in July 2011, at the 14th annual 'Tributes to the Greats' award ceremony in Jamaica, with a lifetime achievement award for his 50 year contribution to Jamaican music. On Friday 22 March 2013 Larry took to the stage at The UN General Assembly in NYC with Steel Pulse as part of the UNESCO's International Slavery 

Larry McDonald is a Jamaican percussionist, born in Port Maria in Jamaica in 1939. Larry first started to play congas with #Carlos Malcolm band in the 1960s and also with Toots Hibbert of the Grammy Award winning band Toots and the Maytals as well as the Count Ossie Band. He plays a wide variety of traditional percussion instruments.McDonald has a nearly 50 year history of recording and performing with a wide variety of artists, such as #GilScott-Heron, and Taj Mahal. In 2009, McDonald released his first solo album "Drumquestra" on which he united many of his former band mates from across his career, in an orchestra of drummers, including Sly DunbarUziah Thompson a.k.a. "Sticky" of Bob Marley and the Wailers and the former Count Ossie drummers under their later mantle "Mystic Revelation Of Rastafari" drummers. Drumquestra also featured former frontmen from bands Larry performed and recorded with, including Toots Hibbert, Bob Andy, #Mutabaruka, Stranger Cole and Dollarman. The album was recorded at a live session at Harry J Studios in Kingston Jamaica by Steel Pulse producer Sidney Mills for Malik Al Nasir's MCPR label in the UAE, who released the album in 2009. MCRP also released two singles off the album the same year, "Head Over Heels" Featuring Dollarman and Sly Dunbar and "Set The Children Free" Featuring Toots Hibbert, the latter of which was subsequently re-mixed for dance-floors by Lenny B. Shortly after the album was released, Larry was honoured in July 2011, at the 14th annual 'Tributes to the Greats' award ceremony in Jamaica, with a lifetime achievement award for his 50 year contribution to Jamaican music. On Friday 22 March 2013 Larry took to the stage at The UN General Assembly in NYC with Steel Pulse as part of the UNESCO's International Slavery 

Ziel der hier vorgelegten Arbeit ist es, vor einer möglichen flächendeckenden Einführung im bayerischen Rettungsdienst, zum einen durch eine strukturierte Literaturrecherche zu klären, ob durch den Einsatz mechanischer Thoraxkompressionsgeräte eine Verbesserung des Gesamtüberlebens im Sinne eines guten neurologischen Behandlungsergebnisses zu erreichen ist; zum anderen soll über eine Umfrage in allen bayerischen Rettungsdienstbereichen (RDB) geklärt werden, wie viele mechanische Thoraxkompressionsgeräte bereits vorgehalten werden, wie deren Einsatz koordiniert wird und ob es ein Qualitätsmanagement zur mCPR gibt. Ein klarer Überlebensvorteil im Sinne eines guten neurologischen Outcomes konnte für die mechanischen Thoraxkompressionsgeräte bisher nicht eindeutig nachgewiesen werden. Das Erreichen eines Spontankreislaufes (ROSC) scheint dagegen durch den Einsatz von mechanischen Thoraxkompressionsgeräte mitunter besser zu gelingen, ohne das sich daraus aber ein besseres neurologisches Behandlungsergebnis ableiten lässt oder das Überleben der Patienten insgesamt verbessert wird. So erfüllt die mCPR aktuell am ehesten die Kriterien eines vielversprechenden Therapieansatzes, für den ein klarer Wirksamkeitsnachweis aussteht. Vorteile ergeben sich vermutlich aber in Situationen, in denen eine manuelle Thoraxkompression nicht qualitativ hochwertig durchgeführt werden kann wie es beispielsweise während des Transportes an Bord von Rettungshubschraubern und Rettungswagen oder auch beim Transport des Patienten über enge Treppenhäuser oder Feuerwehrdrehleitern der Fall sein kann. Hinzu kommt hier auch noch ein erheblicher Sicherheitsaspekt für das eingesetzte Personal, das ohne mCPR gezwungen ist im fahrenden Rettungswagen eine kontinuierliche Herzdruckmassage sicherzustellen, ohne durch eine entsprechendes Rückhaltesystem (Sicherheitsgurt) gesichert sein zu können. Eine einheitliche Handlungsempfehlung für die Einbindung mechanischer Thoraxkompressionsgeräte in den Reanimationsalgorithmus des ERC 2010 liegt nicht vor. Ebenso fehlen Vorgaben für die Durchführung der Beatmung unter mCPR. Eine spezielle, intensive Schulung des Personals ist für die sichere Anwendung der mCPR und die Verkürzung der No-Flow-Zeiten entscheidend und so wird es auch von den Leitlinien zur cardiopulmonalen Reanimation aus dem Jahr 2010 von ERC und AHA in ihren jeweiligen Ausführungen zu mechanischen Thoraxkompressionsgeräten gefordert; nämlich dass mechanische Thoraxkompressionsgeräte nur in den Händen speziell trainierter Teams sinnvoll eingesetzt werden sollten. Da mCPR eine qualitativ hochwertige Herzdruckmassage gewährleisten kann, wird Sie in der Praxis der cardiopulmonalen Reanimation mittlerweile häufig auch im bayerischen Rettungsdienst eingesetzt. Dies geschieht bis heute auf Eigeninitiativen zur Anschaffung und ohne einheitliches Konzept. Der tatsächliche Nutzen ist dadurch möglicherweise nicht gegeben. Denn für den Einsatz der angeschafften Geräte im bayerischen Rettungsdienst fehlen bis dato nicht nur klar definierte Anwendungsindikationen, sondern vor allem auch die von den Leitlinien geforderten speziellen Schulungen um die mechanischen Thoraxkompressionsgeräte im geforderten Zeitrahmen von einer maximalen Unterbrechung der Thoraxkompressionen von 10 Sekunden sicher zu erreichen. Des Weiteren gibt es kein einheitliches Qualitätsmanagement das eine Auswertung der durchgeführten Reanimationen beschreibt und vornimmt. Damit werden die Geräte nach Vorgaben des Notarztes eingesetzt, was bei den vorliegenden Daten der aktuellen Studienlage, vor allem aus den randomisiert-kontrollierten Studien, zwar keine Verschlechterung der Reanimationsergebnisse zwingend zur Folge hätte, aber auch keine Verbesserung. Zusätzlich besteht die Gefahr, dass es zu unethischen Entscheidungen kommt, indem jede einmal begonnene Reanimation in eine Klinik transportiert wird; ungeachtet einer potentiellen Aussichtslosigkeit. Damit wird lediglich die Entscheidung zu Therapieeinstellung in die Hände des Klinikarztes gelegt, erzeugt dabei allerdings erheblichen Mehraufwand und - kosten. Daher ist unbedingt zu fordern, dass vor der in Dienstbringung von mechanischen Thoraxkompressionsgeräten die Indikationen, Kontraindikationen und Abbruchkriterien klar formuliert werden. Des Weiteren ist zu fordern ein Beatmungskonzept für die mCPR zu erstellen um potentielle Lungenschäden zu vermeiden.