A 65-year-old male patient was found collapsed. The case was initially managed by a paramedic ambulance team. Manual CPR was performed for nine minutes, and a laryngeal mask was inserted. Initial rhythm analysis showed ventricular fibrillation, and the patient was defibrillated three times. Upon arrival of the fire service, an MCCD and a resuscitator were attached. SpO2 and etCO2 were measured and recorded.\nFigure 1 illustrates the first three minutes of resuscitation by the fire service prior to the attachment of the MCCD. In this initial period, ventilation was matched to manual chest compression. The respiration frequency varied with the manual CPR, ranging between 75 and 100 breaths per minute. EtCO2 was 20 mmHg for the first 30 seconds and then increased to 40 mmHg for the remainder of the recording. After 25 minutes of CPR, return of spontaneous circulation (ROSC) occurred and the patient was transported to a nearby hospital.
A 64-year-old unconscious male patient with cardiac arrest. The time between EMS notification and arrival of the fire service was eight minutes. An MCCD and a facemask together with a resuscitator were attached, and CPR was commenced.\nFigure 2 illustrates fifteen minutes of continuous CPR. Interruptions in the recording reflect interruptions in CPR during heart rhythm analysis and endotracheal intubation. The oxygen saturation ranged between 80–97%; however recordings included accidental removal of the pulse oximeter finger clip, poor circulatory status, hypothermia and vasoconstrictive medications. The etCO2 remained between 20 and 30 mmHg, which suggests sufficient CPR. EtCO2 increased after each interruption in CPR, as the CO2 accumulates due to decreased exhalation and lack of blood circulation. Defibrillation was not indicated, and upon arrival of the physician-staffed ambulance service, the patient was intubated and epinephrine administered. After 27 minutes, CPR was discontinued and the patient was declared deceased.