INFLUENCE OF DIFFERENT TYPES OF RECOVERY POSITIONS ON PERFUSION INDEXES OF THE FOREARM

Background: Basic life support guidelines of the European Resuscitatio n Council (ERC) suggest a modified type of recovery position compared to that recommended by the American Heart Association (AHA). However, anecdotal reports and the results of a small study by Fulstow and Smit h (Resuscitation 1993; 26: 89-91) gave evidence that the new ERC posit ion may cause an impairment of perfusion of the lower forearm. The aim of our study was to evaluate the effects of different recovery positi ons on arterial perfusion and venous drainage of the forearm. Methods: We placed 20 young healthy volunteers randomly in either ERC or AHA p osition for 15 min first, and in the other position thereafter. Before and between volunteers were positioned supine. In a second series 10 volunteers were positioned according to the same protocol in semiprone positions as described by Morrison, Mirakhur and Craig (MMC), and Rau tek's position, respectively. Forearm perfusion indices of the depende nt arm were continuously assessed by photoplethysmographic pulsatility change, photoplethysmographic volume change, invasive peripheral veno us pressure and non-invasive blood pressure amplitude. Subjective disc omfort was assessed non-qualitatively. Results: All indices of arteria l perfusion demonstrated an impairment of arterial inflow in ERC, MMC and Rautek's position as well as venous congestion in these three posi tions. On the contrary, AHA position was associated with no significan t changes of arterial flow and only moderate, insignificant signs of v enous congestion. Conclusion: The results of this study suggest that A HA position causes less circulatory disturbances than the ERC, MMC and Rautek's positions.