Basic life support ventilation in mountain rescue. Official recommendations of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).
Cardiopulmonary resuscitation in the mountains usually has to be performed under difficult and hostile circumstances and sometimes for extended periods of time. Therefore, mountain rescuers should have the ability and the appropriate equipment to perform prolonged, efficient, and safe ventilation. Members of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) discussed the results of a literature review, focusing on the advantages and disadvantages of common ventilation techniques in basic life support and their training methods with specific respect to use in mountain rescue, and recommendations were proposed. Bystanders fear the potential risk of infection and lack the willingness to perform mouth-to-mouth ventilation, though the risk of infection is low. Mouth-to-mouth ventilation remains the standard technique for bystander ventilation and, in the absence of a barrier device, bystanders should not hesitate to ventilate a patient by this technique. For mountain rescue teams, we encourage the use of a barrier device for artificial ventilation. Mouth-to-mask ventilation devices are most likely to fulfill the requirements of being safe, simple, and efficient in the hands of a basic-trained rescuer. The use of a mouth-to-mask ventilation device is recommended for out-of-hospital ventilation in the mountains and should be part of the mountain rescuer's standard equipment. Bag-valve-mask ventilation is efficient, if performed by well-trained rescuers, but it leads to a low ventilation quality in the hands of a less experienced rescuer. It should be emphasized that regular training every 6 to 12 months is necessary to perform proper ventilation.
Paal
Peter
P
Department of Anesthesiology and Division of General and Surgical Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria. peter.paal@i-med.ac.at
Ellerton
John
J
Sumann
Günther
G
Demetz
Florian
F
Mair
Peter
P
Brugger
Hermann
H
D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D004632:Emergency Medical Services / Q000458:organization & administration*; D004634:Emergency Medical Technicians / Q000458:organization & administration*; D004635:Emergency Medicine / Q000458:organization & administration; D004869:Equipment Safety; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D007391:International Cooperation; D008397:Masks / Q000592:standards*; D009051:Mountaineering / Q000293:injuries; D010100:Oxygen / Q000627:therapeutic use; D017410:Practice Guidelines as Topic / Q000592:standards*; D018635:Rescue Work / Q000458:organization & administration; D012107:Research Design; D012121:Respiration, Artificial / Q000592:standards*
D010100:Oxygen