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At least 55 records · Page 3Linked to original sources
PubMed1997

Poor correlation of mouth-to-mouth ventilation skills after basic life support training and 6 months later.

The purpose of the present study was to evaluate the cardiopulmonary resuscitation (CPR) skills of medical students after a 2-h basic life support class (n = 129) and 6 months later (n = 113). Mean +/- SD written test score decreased from 6.4 +/- 0.7 to 6.2 +/- 0.8 (P = 0.03). Mean +/- SD breaths delivered before CPR decreased from 2.9 +/- 0.6 to 2.2 +/- 1.2 (P = 0.0001), ventilation rate increased from 12.2 +/- 1.9 to 14.3 +/- 5.0 breaths/min (P = 0.0001), tidal volume increased from 0.75 +/- 0.2 to 0.8 +/- 0.31 (P = 0.11), minute ventilation from 9.1 +/- 2.6 to 10.8 +/- 3.61 (P = 0.0001), and stomach inflation from 13 +/- 22 to 18 +/- 27% of CPR breaths (P = 0.11). Mean +/- SD chest compression/min decreased from 56 +/- 9 to 54 +/- 12 (P = 0.34), depth of chest compression increased from 41 +/- 6 to 46 +/- 7 mm (P = 0.0001), hands held incorrectly on the thorax increased from 22 +/- 27 to 23 +/- 32% (P = 0.59), and leaning on the chest from 4 +/- 12 to 18 +/- 28% of compressions (P < 0.0001). In summary, ventilation skills were unpredictable; there was only a 5% chance that a given student would achieve the same mouth-to-mouth ventilation performance in both the BLS class and 6 months later. Despite the respiratory mechanics of the CPR manikin which prevented stomach inflation much better than an unconscious patient with an unprotected airway, stomach inflation occurred repeatedly. Teachers of basic life support classes need to consider the respiratory mechanics of the CPR manikin being used to assure clinically realistic and appropriate mouth-to-mouth ventilation skills.

Adult↗
PubMedDate not supplied

Mouth-to-mouth ventilation of cardiac arrested humans using a barrier mask.

INTRODUCTION: Concern for possible disease transmission during mouth-to-mouth resuscitation has decreased the incidence of bystander cardiopulmonary resuscitation (CPR). Barrier masks have become available that may be effective in CPR as well as protective against cross-contamination. HYPOTHESIS: A silicone rubber barrier mask incorporating a one-way-valved airway (Kiss of Life [KOL]) designed to prevent contamination of the rescuer, permits satisfactory mouth-to-mouth ventilation of victims of cardiopulmonary arrest. METHODS: Ten adult patients who did not survive non-traumatic cardiac arrest were ventilated with exhaled room air using a KOL barrier mask while external cardiac massage continued. Arterial blood gases were obtained every two minutes for a maximum of 10 minutes. The operator was blinded to the results of these blood tests. RESULTS: Eight men and two women with ages from 55 to 99 years were studied. Four patients were edentulous and two of these had marked mandibular atrophy. The two patients with mandibular atrophy were poorly ventilated with the barrier mask. One other patient was not ventilated successfully. This patient had undergone multiple attempts at endotracheal intubation and had transtracheal needle ventilation performed prior to use of the barrier mask. One patient had elevated PaCO2 despite being well-ventilated clinically. Six patients were ventilated well clinically and had satisfactory PaCO2 and PaO2 values. CONCLUSION: The barrier mask studied appears to be an effective aid to ventilation in CPR. Patients without facial support, as in edentulous patients with mandibular atrophy, are not ventilated well with this device.

Aged↗
PubMed2006

Bystander mouth-to-mouth ventilation and regurgitation during cardiopulmonary resuscitation.

OBJECTIVES: To determine whether there is an association between bystander mouth-to-mouth ventilation and regurgitation in prehospital cardiac arrest patients. DESIGN: Prospectively conducted observational study. SETTING: Data were collected from patients treated by the emergency medical service (EMS) systems in three middle-sized or large Finnish urban communities, the Tampere District EMS and the physician-staffed Helicopter EMSs in the Helsinki and Turku areas in southern Finland. SUBJECTS: The study population consisted of 529 consecutive prehospital cardiac arrest patients with attempted resuscitation. Exclusion criteria were cardiac arrest due to trauma or drug overdose. MAIN OUTCOME MEASURES: Regurgitation in prehospital cardiac arrest patients documented by EMS personnel on the scene. RESULTS: Regurgitation occurred in a fourth of patients. Bystander cardiopulmonary resuscitation (CPR) with mouth-to-mouth ventilation was associated with a significantly increased risk of regurgitation compared with no CPR (P < 0.013) and CPR without ventilations (P < 0.01). CONCLUSIONS: The mode and role of bystander CPR in cardiac arrest needs to be further evaluated.

Aged↗
PubMed1990

Prevention of transmission of infection during mouth-to-mouth resuscitation.

The risk of infection transmitted during mouth-to-mouth or mouth-to-nose resuscitation procedures is difficult to define but is possibly quite low. However, the perceived risk is sufficient to cause serious concern for many individuals, including trained hospital personnel as well as the general public, and may preclude prompt and effective action. A novel airway device was evaluated for the retention of infective droplets and fluid permeability under simulated resuscitation conditions using a cardiopulmonary resuscitation training manikin. Retention of a 0.5-5.0 micron aerosol of Staphylococcus aureus cells was greater than 80% at flow rates of 6 l/min while under simulated resuscitation conditions the trapping of bacteria, originating predominantly from saliva, was over 90%. These data suggest that this device may afford significant protection against transmission of infection during exhaled air resuscitation manoeuvres.

Bacterial Infections↗
PubMedDate not supplied

[Mouth care in intubated patients with nothing-by-mouth diet in an in tensive care unit].

The objective of this study is to value the effectiveness of a care plan of mouth care and at the same time, compare the effects of the use of two different solutions: physiologic serum and non-diluted hexetidine (Oraldine). The sample studied was formed by 40 intubated patients or patients with an absolute oral diet who were in the Intensive Care Unit of the University Clinic. 50% of the patients underwent oral hygiene with physiological serum, following the established protocol and the other 50% were treated with non-diluted hexetidine with a frequency of five times a day. The mouth status was checked at the moment of admission and then daily: lips, tongue, gums, palate, presence of residua and saliva characteristics. Also, a series of factors which could alter the buccal integrity were registered: oxygenotherapy, orotraqueal intubation, anemia, plaquetopenia, medicines, etc. Bacteriological controls of traqueal secretion were performed periodically. From the analysis of the results we can conclude that the care plan established is efficient, although it is not enough for patients with coagulation alterations (plaquetopenia). From the solutions used for oral hygiene we can say that although there have not been significant differences, the physiologic serum is the chosen product, as it maintains the mouth status better and helps to keep the oral microbiota.

Adolescent↗
PubMed2002

Foot-and-mouth disease: susceptibility of domestic poultry and free-living birds to infection and to disease--a review of the historical and current literature concerning the role of birds in spread of foot-and-mouth disease viruses.

Ruminants and pigs are the dominant natural hosts of food-and-mouth disease (FMD) viruses. Approximately 70 additional mammalian species are found to be susceptible under natural or experimental conditions. Reptilia, amphibia, and fish are probably naturally resistant to infection. According to the reviewed literature, domestic birds (chickens, turkeys, guinea fowl, ducks and geese) have been experimentally infected with some strains of FMD viruses and may develop lesions suggestive of FMD such as vesicular lesions on the comb, wattles, eye lids, and feet. Since chickens are to some extent coprophagous, chickens get infected by ingestion of virus under conditions of natural exposure or their plumage gets contaminated in an infectious environment. Thus, domestic birds kept in free-run systems may serve as virus vectors for short distances. Free-living birds, especially starlings (Sturnus vulgaris), sea gulls (Larus canus), house-sparrows (Passer domesticus) have been successfully experimentally infected and developed vesicular lesions on the skin and mucosal membranes of the mouth. During epizootics of FMD the plumage of these free-living birds can be contaminated with FMD viruses and the virus is spread over long distances during migration periods in spring and autumn. Thus migrating birds may assume an active role in long distance dissemination of FMD viruses.

Animals↗
PubMed1997

Effects of simulated mouth-to-mouth ventilation during external cardiac compression or active compression-decompression in a swine model of witnessed cardiac arrest.

STUDY OBJECTIVE: To assess the effects of simulated mouth-to-mouth (MTM) ventilation on blood gases, gas exchange, and minute ventilation during external cardiac compression (ECC) or active compression-decompression (ACD) in a swine model of witnessed cardiac arrest and bystander CPR. METHODS: Twenty swine were anesthetized, intubated, ventilated with room air, and monitored for aortic and right atrial pressure and blood gas sampling. After 1 minute of ventricular fibrillation cardiac arrest, ECC or ACD was manually performed at a rate of 100 per minute for 12 minutes. Animals in the room air group had their endotracheal tubes open to air, whereas those in the MTM group were mechanically ventilated with a gas mixture of 16% oxygen and 4% carbon dioxide. Arterial and venous PO2, PCO2, and pH values; oxygen consumption (VO2); carbon dioxide production (VCO2); and minute ventilation (VE) were measured at baseline and 1, 5, 9, and 13 minutes after induction of cardiac arrest. RESULTS: MTM ventilation did not alter arterial or venous PO2 values in comparison with room air but did result in higher arterial PCO2 values at 5 and 9 minutes (although the mean PCO2 was 40 mm Hg or less [5.3 kPa] in all groups) and significant central venous hypercarbic acidosis at 9 and 13 minutes. Arterial PO2 values were greater in the ACD than the ECC groups at 5, 9, and 13 minutes, although all groups maintained acceptable PO2 (mean values > or = 60 mm Hg [8.0 kPa]) through 9 minutes of CPR and through 13 minutes in all but the ECC-room air group. PCO2 values were lower in the ACD groups beyond 1 minute, with the ACD-room air group showing extreme hyperventilation (mean PCO2 < or = 20 mm Hg [2.7 kPa]). MTM ventilation resulted in negative VO2 and VCO2 for the first few minutes, reflecting changes in pulmonary gas stores. As equilibrium was approached, VO2 and VCO2 approached zero in all groups, reflecting low cardiac output. MTM ventilation did not improve VE over room air at any time during ACD. It did improve VE during ECC, but only at the 12th interval. CONCLUSION: In this swine model of witnessed CPR, simulated MTM ventilation was not beneficial for blood gases, gas exchange, or ventilation during ECC or ACD CPR.

Animals↗
PubMed1995

[Examinations with DNA cytometry of mouth and oropharyngeal lavage fluid as a screening method in diagnosis of malignancies of the mouth cavity and oropharynx].

BACKGROUND: Due to a high rate of false negative results, cytologic examinations of scrapings are currently not very common in diagnosing squamous cell carcinomas of the upper aerodigestive tract. The purpose of the present study was to determine whether cytometric and cytologic examinations are suitable in diagnosing squamous cell carcinomas of the oral cavity and oropharynx. METHODS: Cytologic and cytometric examinations of rinsing fluid from the mouth and throat were performed in 14 patients with histologically confirmed squamous cell carcinomas of the oral cavity and oropharynx. The patients were asked to rinse their mouth and throat with 10 ml of Ringer's solution. The rinsing fluid was centrifuged and fixed. The sediment was then smeared onto glass slides and stained according to the technique of Feulgen. Quantitative DNA measurements were then performed using a TV-based image analysis system. The DNA indices, 2 c DI, 5 c EE, and DNA entropy were determined from the single-cell measurements. RESULTS: The results of the carcinoma patient group were compared to those obtained in 19 patients without any evidence of cancer (control group). With this method, malignant and benign cells could be distinguished in all cases, i.e., all patients with a carcinoma could be identified as positive by this examination, whereas patients without evidence of cancer were identified as negative in all cases. CONCLUSIONS: The results of this pilot study show that quantitative DNA measurements might be a suitable tool for non-invasive screening of patients who are at high risk for developing a carcinoma in the upper aerodigestive tract and for follow-up of patients in order to detect tumor recurrence after successful initial treatment.

Adult↗
PubMed1976

[Method of correction of microstomia and deviation of the mouth angles by rotation of trapeziform and triangular flaps of the mouth mucosa].

In the paper, the author suggests an essentially new method of dilation of the oral orifice and elimination of mouth angles deviations basing on the principle of new redistribution of local tissues by means of rotation of a trapeziform graft of the mucosa with its submucous layer from the buccal and adoral region. In this method one uses more adequate tissues, which reserves in case of microstomia are located in the buccal and adoral region. The successful utilization in 60 patients of the suggested method of elimination of microstomia arising due to different causes enabled the author to recommend it widely for reparative surgery.

Humans↗
PubMed1990

A model for evaluation of gas exchange: mouth to mouth ventilation of infants by emergency medical technicians.

We describe a model for evaluating techniques of infant ventilation during resuscitation. The utility of the model is illustrated by testing performance of emergency medical technicians in mouth to mouth ventilation of a model 4 kg infant. Ventilation was generally adequate with mean (+/- S.D.) frequency 22 +/- 9 breaths per minute and tidal volume 40 +/- 13 ml. Gas delivered to the model consisted of PICO2 7 +/- 6 mmHg and FIO2 0.20 +/- 0.007. Assuming normal metabolic rate and respiratory dead space, alveolar gas composition resulting from the simulated resuscitations would be PACO2 = 31 +/- 20 and PAO2 = 110 +/- 19 mmHg. Nine of ten rescuers would have achieved satisfactory PACO2 less than or equal to 50 and PAO2 greater than or equal to 100. However, the rescuers' exhaled oxygen concentration is not adequate to correct hypoxemia if associated with hypoventilation or a wide alveolar to arterial oxygen gradient.

Emergencies↗
PubMed1994

Willingness of male homosexuals to perform mouth-to-mouth resuscitation.

BACKGROUND: Providing mouth-to-mouth resuscitation (MMR) during cardiopulmonary resuscitation (CPR) is a proven effective lifesaving procedure. However, the perceived risk to the rescuer of contracting infectious diseases, especially acquired immunodeficiency syndrome (AIDS), by performing MMR on a possibly human immunodeficiency virus (HIV) positive individual is probably affecting the number of people willing to perform MMR. Physicians and nurses constitute a major part of citizen cardiopulmonary resuscitation (CPR) responders and serve as CPR educators and resource personnel. Currently, the fear of physicians and nurses of contracting infectious disease has dampened their willingness to perform MMR, and thus has reduced the number of strangers who will receive MMR. Homosexual males, like the medical community, have an increased perceived risk of acquiring infectious diseases, especially AIDS, and have been the target of intense educational efforts concerning the transmission of HIV. By (a) determining the willingness of various groups to perform MMR, (b) elucidating the factors which affect their willingness to perform MMR, and (c) comparing this willingness to the actual, not perceived, risk of acquiring HIV by performing MMR, either appropriate changes can be made to educate people in the performance of MMR, by informing them of the actual risks of contracting infectious diseases, or alternative methods of resuscitation, involving 'lay-on' masks, can be recommended. Thus the willingness of homosexual males to perform MMR was determined and compared to the previously determined actual reluctance of the medical community to perform MMR in similar hypothetical scenarios. METHODS: During interviews, 200 male homosexuals in Los Angeles were asked to assume that they knew how to perform CPR and MMR and to indicate how they would respond to four hypothetical cardiac arrest scenarios. These scenarios included cardiac arrests of a child, a trauma victim, a young man in a gay neighbourhood, and a victim of unknown history. Demographical data concerning the respondents was also obtained. RESULTS: Of the homosexual men surveyed, 93 and 85% stated they would perform MMR on a stranger of unknown history, if they, the rescuer, were HIV negative or positive, respectively, (P < 0.001). Similarly, a high percentage of the presumed HIV negative and HIV positive respondents stated a high willingness to perform MMR in response to hypothetical cardiac arrest scenarios involving a trauma victim, a child, and a young man in a gay neighbourhood. CONCLUSIONS: The willingness of male homosexuals to perform MMR is high, in contrast to the general reluctance of internists and medical nurses to perform MMR in the same outpatient scenarios. The different perceived risks of male homosexuals and physicians acquiring infectious diseases by performing MMR is probably responsible for the difference in willingness of these two groups to perform MMR. The high perceived risk of acquiring infectious diseases due to performance of MMR currently held by physicians in general may be lowered by increasing educational efforts. CPR courses should (a) discuss actual and perceived risks of acquiring infectious diseases by MMR, (b) discuss and weigh a small, and possibly not valid, risk of contracting an infectious disease while performing MMR on a victim, and (c) emphasize techniques involving 'lay-on' barrier masks. The availability of effective 'lay-on' barrier masks' should also be increased.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Comparison of the reluctance of house staff of metropolitan and suburban hospitals to perform mouth-to-mouth resuscitation.

BACKGROUND: Although performing mouth-to-mouth resuscitation (MMR) during cardiopulmonary resuscitation (CPR) is an effective lifesaving procedure, both the general public and physicians are often unwilling to perform CPR. Fear of contracting infectious diseases, especially AIDS, is often stated as the reason for this reluctance. However, the likelihood of saving a life usually outweighs the chance of contracting an infectious disease, especially when victims are considered to be at low risk for being HIV+ and are in communities with low incidences of HIV antibodies. METHODS: The entire housestaff (58 residents) in the Department of Internal Medicine of a suburban hospital responded to a questionnaire of hypothetical cardiac arrest scenarios in both inpatient and outpatient settings. Their responses were compared to those previously obtained from the housestaff (82 residents) of a hospital in a large metropolitan area with a high incidence of HIV positive patients. RESULTS: The willingness of the suburban housestaff (residents) to perform MMR in the inpatient scenario of a patient with an unknown risk for communicable infections was 43%, with trauma was 12%, with a perceived high risk for being HIV+ was 14%, and in the elderly was 29%, compared to 45, 16, 7 and 39%, respectively of the house staff of the metropolitan hospital. In outpatient scenarios, the willingness of the suburban housestaff to perform MMR on a victim with an unknown risk for communicable infections was 50%, with trauma was 33%, with a perceived high risk for being HIV+ was 34%, in the elderly was 26%, and in a child was 86%, compared to 54, 36, 21, 65, and 99%, respectively, of the metropolitan residents. Overall, the suburban male residents were more likely to be willing to perform MMR than the female ones, as were residents actively practising a religion or having graduated from medical schools in the United States. Suburban residents under 30 years of age seemed more willing to perform MMR in the majority of the scenarios than those over 30 years of age. Of the 31 suburban residents that stated they would be unwilling to perform MMR in at least one of the given scenarios, all stated that their unwillingness was due to fear of becoming infected with HIV or other infectious agents. In 1994, the percentage of known HIV positive individuals admitted to the suburban hospital was approximately five times less than that of the metropolitan hospital whose house staff was interviewed (P < 0.001). CONCLUSIONS: Patients perceived to be at high risk for HIV were less likely to receive MMR than those at low risk. The reluctance of house staff to perform MMR in a suburban community hospital with a low incidence of HIV+ patients is similar to that of house staff in a large metropolitan community with a much higher incidence of infected patients. This reluctance, which was largely due to fear of contracting HIV infections, is not influenced by frequent contact with patients infected with HIV but is based on perceived rather than actual risks of contracting HIV. To increase the willingness of physicians, other medical personnel, and the lay public to perform MMR on victims of cardiac and respiratory arrests, the negligible risk of contracting infectious diseases while performing MMR should be emphasized. Use of portable barrier masks while performing MMR and an increase in their availability would decrease the minimal risks even further, and is recommended by the authors.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Effectiveness of mouth-to-mouth resuscitation performed by young adolescents on a mannequin.

Bystanders are reluctant to perform basic life support (BLS) because of fear of failure and of infection, especially with mouth-to-mouth resuscitation (MTM). A possibility to enhance willingness could be the giving of MTM or BLS instructions at a very early age to the potential rescuers. The study aimed to investigate the effectiveness of MTM with respect to ventilation and the time needed for performing 5 ventilations. In this study, MTM was performed on a mannequin by 57 children and adolescents aged 10 and 14 years. This study showed that 14-year-olds effectively perform MTM, reaching the recommended tidal volumes. Ten-year-old children have already developed sufficient motor skills for MTM with no significant time differences compared with the 14-year-olds. However, physical demands may be rather high at this age. Further long-term studies are needed to investigate clinical benefits of early teaching of MTM or BLS that may lead to international guidelines with low age limits.

Adolescent↗
PubMed1990

Attitudes of BCLS instructors about mouth-to-mouth resuscitation during the AIDS epidemic.

We surveyed 5,823 American Heart Association Virginia Affiliate basic cardiac life support (BCLS) instructors to assess the impact that the acquired immunodeficiency syndrome (AIDS) epidemic has had on their attitudes, beliefs, and behaviors with respect to the training and performance of mouth-to-mouth (MTM) ventilation. The response rate by those whose mail survey could be delivered to a valid address was 41% (women, 63%; men, 37%; mean age, 38 +/- 1 years; health care providers, 87%; laypersons, 11%; and public safety workers, 2%). Of those surveyed, 49% had performed CPR within the past three years. Of these, 40% reported having hesitated to provide MTM ventilation at least once. Of those who had hesitated, more than one half identified fear of exposure to disease as the reason for their hesitation. Forty percent of all respondents had witnessed another provider hesitate to provide MTM ventilation. When presented with mock rescue scenarios, the majority of respondents indicated that they would not perform or would hesitate to perform MTM ventilation on most adult strangers. More than half felt that there was some risk of contracting AIDS from ventilating a manikin, and 71% said that their attitudes about providing CPR to strangers had changed as a result of the AIDS epidemic. We conclude that concern about AIDS appears to be adversely affecting the attitudes, beliefs, and self-reported behaviors of BCLS instructors in Virginia regarding the use of MTM ventilation on strangers.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Reluctance of paramedics and emergency medical technicians to perform mouth-to-mouth resuscitation.

Recently, a reluctance of lay and medical personnel to perform mouth-to-mouth resuscitation (MMR) in hospital and community settings has been documented, with 45% of respondents declining to perform MMR on a stranger. In the present study, we examined whether the perceived risk and fear of contracting infectious diseases diminishes the willingness of paramedics and emergency medical technicians (EMTs) to perform MMR. Seventy-seven EMTs and 27 paramedics responded to a questionnaire, administered by one of two physicians, containing mock cardiac arrest scenarios that were designed to assess willingness to perform MMR as a citizen responder. Faced with a situation in which an adult stranger required MMR, 57% of the participating EMTs and all of the paramedics stated that they would refuse to perform MMR. None of the paramedics and only 32.5% of the EMTs stated that they would perform MMR on a man in a gay neighborhood. In addition, 23% of the EMTs and 37% of the paramedics indicated that they would refuse to perform MMR on a child. White respondents were more willing than nonwhite respondents to perform MMR. Twenty-nine percent of the prehospital-care providers had been in situations requiring MMR in the community, and 40% either had walked away or did only external compression. Of those participating paramedics and EMTs who had performed MMR in emergency situations, only 45% indicated that they would do so again. The respondents indicated that they would not be willing to administer MMR because of the fear of contracting infectious agents, especially the human immunodeficiency virus. Despite the proven effectiveness of MMR in saving lives, paramedics and EMTs are highly reluctant to perform MMR as citizen responders. Their perceived risks of contracting infectious agents during MMR are high, despite the low actual risks. We recommend that instruction in cardiopulmonary resuscitation for providers of pre-hospital care, the medical community, and the general public should emphasize the benefits of providing MMR, the actual low risks of contracting infectious diseases during administration of MMR, and the use of widely available and effective barrier masks to minimize any risks due to administration of MMR.

Adult↗
PubMed2000

Determinants of physician reluctance to perform mouth-to-mouth resuscitation.

OBJECTIVES: Mouth-to-mouth resuscitation (MMR) is widely taught and promoted. The purpose of this study was to better characterize the observation that health professionals are reluctant to perform MMR and to identify determinants of this reluctance. METHODS: 324 residents and faculty at a New York City teaching hospital were anonymously surveyed regarding their reluctance to perform MMR. One year later, medical staff were resurveyed. RESULTS: Reluctance varied across scenarios: 70-80% of physicians were willing to perform MMR on a newborn or child, 40-50% for an unknown man, and 20-30% for a trauma victim or potentially gay man. Physicians reported very similar percentages for each scenario in the two surveys. Factors associated with MMR reluctance were female gender (OR = 2), resident physician (OR = 2), and higher perceived risk of contracting HIV from MMR (OR = 1.4 per unit on 5-point scale). In the year before the survey, 30% of all respondents witnessed an apneic patient who required MMR for whom ventilation was not provided for at least 2 minutes. CONCLUSIONS: Many physicians are reluctant to perform MMR. Marked delays in ventilation of apneic patients are occurring.

Adult↗
PubMedDate not supplied

EMS provider reluctance to perform mouth-to-mouth resuscitation.

OBJECTIVES: To assess the willingness of EMS providers to perform mouth-to-mouth resuscitation (MMR) both with and without a barrier device (e.g., face shield), while not on duty; and to determine the providers' perceived risk from performing MMR and the frequency with which they carry a barrier device. METHODS: A survey was mailed to 543 EMS providers presenting four scenarios describing a patient in respiratory arrest. The respondents were asked whether they would perform MMR in each scenario both with and without a barrier device. RESULTS: Of those surveyed, 342 (64%) responded. Strikingly few (< or =5%) of the respondents would perform MMR without a barrier on each of the cases, except for the case of a pediatric drowning (52%). The respondents were least likely to perform MMR on a patient with AIDS (< 1%). The respondents were much more likely to perform MMR in each case if a barrier device was available. The respondents were very concerned about the risk of contagion from MMR, yet 44% of the respondents rarely or never carried a barrier device with them. CONCLUSION: Emergency medical services providers are quite reluctant to perform MMR, and this is likely related to their perception of a high risk of contagion. The availability of barrier devices greatly decreases this reluctance, but EMS personnel carry such devices infrequently.

Adult↗
PubMed1983

Nursology of mouth care: preventing, comforting and seeking activities related to mouth care.

Mouth care across age groups, whether independently carried out or with assistance from a nurse, is frequently not considered in relation to the health of the mouth before commencement. This need for assessment and a schema as a baseline should dictate the most appropriate tools and the method of intervention. With a nursing model by Roper based on a model of living, nursing interventions are indicated across three age groups.

Activities of Daily Living↗