An 84-year-old male patient collapsed outside. A passer-by witnessed the incident, notified emergency services and commenced CPR. The time between call and arrival of the fire service was eight minutes. Initial rhythm strip analysis demonstrated asystole. The resuscitator was attached immediately to a facemask by a firefighter (Figure 7 ).\nThe patient received a ventilation rate of 100 breaths per minute. This rate corresponds with the MCCD frequency, and ventilation was being triggered in each decompression phase. The drop in the ventilation rate in the initial part was due to a leak in the airway circuit. During the period of automatic ventilation, oxygen saturation was between 80 and 90%. Thus, the patient was adequately ventilated. The etCO2 ranged between 22–30 mmHg from the beginning of the recording till 23:28 minutes after, suggesting good-quality CPR with adequate circulation. During resuscitation, the patient received intravenous epinephrine. After 23:28 min there was an increase in etCO2 up to 43 mmHg, an early indicator of ROSC. The steep decrease afterwards was due to the cessation of ventilation and chest compressions, and hence a cessation in CO2 exhalation. The patient had an ROSC after 25 minutes and was transported to a nearby hospital.
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.