1
|
Fernández-Méndez M, Barcala-Furelos R, Otero-Agra M, Bierens J. Increasing ventilation in drowning resuscitation - A cross-over randomized simulation study of ventilation during automated external defibrillator analysis pauses. Resusc Plus 2024; 19:100674. [PMID: 38873276 PMCID: PMC11170470 DOI: 10.1016/j.resplu.2024.100674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/09/2024] [Accepted: 05/19/2024] [Indexed: 06/15/2024] Open
Abstract
Objective The aim of this study was to analyze the feasibility of a new resuscitation strategy in which breaths are provided during automated external defibrillator (AED) rhythm analysis, and to evaluate its impact on chest compressions (CC) quality and the peri-analysis time. Method A randomized simulation study, comparing two cardiopulmonary resuscitations strategies, has been conducted: the standard strategy (S1) with strategy involving ventilation during AED analysis (S2). Thirty lifeguards have performed both strategies in a cross-over study design during 10 min of CPR. Results The number of ventilations per 10 min increases from 47 (S1) to 72 (S2) (p < 0.001). This results in the delivery of an additional 17.1 L of insufflated air in S2 compared to S1 (p < 0.001). There have been no significant changes in frequency and total number of CC. These findings correspond to a reduction of the non-ventilation period from 176 s (S1) to 48 s (S2). Conclusions This simulation study suggests that it is feasible to increase the number of ventilations during resuscitation following drowning, without affecting the quantity and quality of chest compressions. The results of this study may serve as a foundation for further investigation into optimal ventilation strategies in this context.
Collapse
Affiliation(s)
- María Fernández-Méndez
- Faculty of Education and Sport Sciences, REMOSS Research Group, Universidade de Vigo, Pontevedra, Spain
- CLINURSID Research Group, Nursing Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- School of Nursing, Universidade de Vigo, Pontevedra, Spain
| | - Roberto Barcala-Furelos
- Faculty of Education and Sport Sciences, REMOSS Research Group, Universidade de Vigo, Pontevedra, Spain
- CLINURSID Research Group, Nursing Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Faculty of Education and Sports Sciences, University of Vigo, Pontevedra, Spain
| | - Martín Otero-Agra
- Faculty of Education and Sport Sciences, REMOSS Research Group, Universidade de Vigo, Pontevedra, Spain
- School of Nursing, Universidade de Vigo, Pontevedra, Spain
| | - Joost Bierens
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, UK
| |
Collapse
|
2
|
Ko YC, Lin HY, Chiang WC, Yang CW, Hsieh MJ, Ma MHM. Comparing the effects of blended learning and traditional instruction on basic life support for laypersons: A randomized controlled trial. J Formos Med Assoc 2024; 123:687-692. [PMID: 37996323 DOI: 10.1016/j.jfma.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/26/2023] [Accepted: 10/19/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND/PURPOSE Blended learning offers the advantages of both instructor-led and self-instruction methods in basic life support (BLS). Our study aims to compare the effects of blended learning with those of traditional instructor-led methods on the performance of laypersons taking BLS courses. METHODS A total of 108 participants were randomly assigned to three groups: traditional instruction (group A, n = 36), blended learning with two rounds of practice (group B, n = 36), and blended learning with three rounds of practice (group C, n = 36). Group A received a 90-min lecture and a 30-min hands-on practice session using a manikin and a metronome. Participants in groups B and C received 18-min standardized online video lessons and performed hands-on practice twice and thrice, respectively. The primary outcome was chest compression at a correct speed (100-120 compressions per min) after the training course. Secondary outcomes included knowledge test scores, attitudes and confidence, and individual skill performance after training. RESULTS Patient characteristics were similar between the groups. Blended learning with practicing thrice resulted in the highest compressions at a correct speed (group A vs. B vs. C, 68.09 vs 80.03 vs 89.42, p = 0.015) and the shortest average hands-off time (group A vs. B vs. C, 1.12 vs 0.86 vs 0.17 s, p = 0.015). Both blended groups performed better in confirming environmental safety (p < 0.001). No differences in scores of the knowledge test, attitude, or confidence were noted among the three groups. CONCLUSION Blended learning with three rounds of hands-on practice may be considered an alternative teaching method.
Collapse
Affiliation(s)
- Ying-Chih Ko
- Section of Emergency Medicine, Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Hao-Yang Lin
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Chu Chiang
- Department of Emergency Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan
| | - Chih-Wei Yang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Ju Hsieh
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Matthew Huei-Ming Ma
- Department of Emergency Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan
| |
Collapse
|
3
|
Schwartze JT, Das S, Suggitt D, Baxter J, Tunstall S, Ronan N, Stannard H, Rezgui A, Jafar W, Baxter DN. Ward-based in situ simulation: lessons learnt from a UK District General Hospital. BMJ Open Qual 2024; 13:e002571. [PMID: 38749539 PMCID: PMC11097843 DOI: 10.1136/bmjoq-2023-002571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 03/02/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION In situ simulation (ISS) enables multiprofessional healthcare teams to train for real emergencies in their own working environment and identify latent patient safety threats. This study aimed to determine ISS impact on teamwork, technical skill performance, healthcare staff perception and latent error identification during simulated medical emergencies. MATERIALS AND METHODS Unannounced ISS sessions (n=14, n=75 staff members) using a high-fidelity mannequin were conducted in medical, paediatric and rehabilitation wards at Stepping Hill Hospital (Stockport National Health Service Foundation Trust, UK). Each session encompassed a 15 min simulation followed by a 15 min faculty-led debrief. RESULTS The clinical team score revealed low overall teamwork performances during simulated medical emergencies (mean±SEM: 4.3±0.5). Linear regression analysis revealed that overall communication (r=0.9, p<0.001), decision-making (r=0.77, p<0.001) and overall situational awareness (r=0.73, p=0.003) were the strongest statistically significant predictors of overall teamwork performance. Neither the number of attending healthcare professionals, their professional background, age, gender, degree of clinical experience, level of resuscitation training or previous simulation experience statistically significantly impacted on overall teamwork performance. ISS positively impacted on healthcare staff confidence and clinical training. Identified safety threats included unknown location of intraosseous kits, poor/absent airway management, incomplete A-E assessments, inability to activate the major haemorrhage protocol, unknown location/dose of epinephrine for anaphylaxis management, delayed administration of epinephrine and delayed/absence of attachment of pads to the defibrillator as well as absence of accessing ALS algorithms, poor chest compressions and passive behaviour during simulated cardiac arrests. CONCLUSION Poor demonstration of technical/non-technical skills mandate regular ISS interventions for healthcare professionals of all levels. ISS positively impacts on staff confidence and training and drives identification of latent errors enabling improvements in workplace systems and resources.
Collapse
Affiliation(s)
- Julian Tristan Schwartze
- Stroke Medicine, National Hospital for Neurology and Neurosurgery, London, UK
- Medical Education, Stepping Hill Hospital, Stockport, UK
| | - Souvik Das
- Emergency Department, Stepping Hill Hospital, Stockport, UK
| | | | | | - Simon Tunstall
- Department of Anaesthetics, Stepping Hill Hospital, Stockport, UK
| | - Nicholas Ronan
- Royal Stoke University Hospital Acute Medical Unit, Stoke-on-Trent, UK
| | | | - Amina Rezgui
- Acute Medicine, Stepping Hill Hospital, Stockport, UK
| | - Wisam Jafar
- Gastroenterology, Stepping Hill Hospital, Stockport, UK
| | | |
Collapse
|
4
|
Glassman J, Yahoodik S, Samuel S, Young J, Knodler MK, Zhang T, Zafian T, Fisher DL, Yamani Y. Booster Dose of Attention Training Program for Young Novice Drivers: A Longitudinal Driving Simulator Evaluation Study. HUMAN FACTORS 2024; 66:933-953. [PMID: 35763588 DOI: 10.1177/00187208221109993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE We examined the effectiveness of a second exposure to ACCEL, a novel driving training program, on latent hazard anticipation (HA) performance several months after their first exposure. BACKGROUND Past research has demonstrated that PC-based driver training programs can improve latent HA performance in young novice drivers, but these improvements are below the ceiling level. METHOD Twenty-five participants were randomly assigned to either the Placebo group, the ACCEL-1 group, or the ACCEL-2 group. Following the completion of the assigned training program, participants drove a series of eighteen scenarios incorporating latent hazards in a high-fidelity driving simulator with their eyes tracked. Participants returned two to six months following the first session and completed either the placebo program (ACCEL-1 and Placebo groups), or a second dose of training program (ACCEL-2 group), again followed by simulated evaluation drives. RESULTS The ACCEL-2 group showed improved HA performance compared to the ACCEL-1 and Placebo groups in the second evaluation. CONCLUSION ACCEL enhances young novice drivers' latent HA performance. The effectiveness of ACCEL is retained up to 6 months, and a second dose further improves HA performance. APPLICATION Policy makers should consider requiring such training before the completion of graduate driver license programs. Young novice drivers that do not show successful latent HA performance could be required to complete additional training before being allowed to drive without restrictions.
Collapse
Affiliation(s)
| | | | | | - Jared Young
- Volpe National Transportation Systems Center, Cambridge, USA
| | | | | | | | - Donald L Fisher
- Volpe National Transportation Systems Center, Cambridge, USA
| | | |
Collapse
|
5
|
Steffen R, Burri S, Roten FM, Huber M, Knapp J. Impact of teaching on use of mechanical chest compression devices: a simulation-based trial. Int J Emerg Med 2024; 17:26. [PMID: 38408897 PMCID: PMC10895751 DOI: 10.1186/s12245-024-00611-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/22/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The use of mechanical chest compression devices on patients in cardiac arrest has not shown benefits in previous trials. This is surprising, given that these devices can deliver consistently high-quality chest compressions without interruption. It is possible that this discrepancy is due to the no-flow time (NFT) during the application of the device. In this study, we aimed to demonstrate a reduction in no-flow time during cardiopulmonary resuscitation (CPR) with mechanical chest compression devices following 10 min of structured training in novices. METHODS 270 medical students were recruited for the study. The participants were divided as a convenience sample into two groups. Both groups were instructed in how to use the device according to the manufacturer's specifications. The control group trained in teams of three, according to their own needs, to familiarise themselves with the device. The intervention group received 10 min of structured team training, also in teams of three. The participants then had to go through a CPR scenario in an ad-hoc team of three, in order to evaluate the training effect. RESULTS The median NFT was 26.0 s (IQR: 20.0-30.0) in the intervention group and 37.0 s (IQR: 29.0-42.0) in the control group (p < 0.001). In a follow-up examination of the intervention group four months after the training, the NFT was 34.5 s (IQR: 24.0-45.8). This represented a significant deterioration (p = 0.015) and was at the same level as the control group immediately after training (p = 0.650). The position of the compression stamp did not differ significantly between the groups. Groups that lifted the manikin to position the backboard achieved an NFT of 35.0 s (IQR: 27.5-42.0), compared to 41.0 s (IQR: 36.5-50.5) for the groups that turned the manikin to the side (p = 0.074). CONCLUSIONS This simulation-based study demonstrated that structured training can significantly reduce the no-flow time when using mechanical resuscitation devices, even in ad-hoc teams. However, this benefit seems to be short-lived: after four months no effect could be detected.
Collapse
Affiliation(s)
- Richard Steffen
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, 3010, Switzerland
| | - Simon Burri
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, 3010, Switzerland
| | - Fredy-Michel Roten
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, 3010, Switzerland
- Valais Cantonal Rescue Organization, Sierre, Switzerland
| | - Markus Huber
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, 3010, Switzerland
| | - Jürgen Knapp
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, 3010, Switzerland.
- Swiss Air Rescue, Rega, Zurich, Switzerland.
| |
Collapse
|
6
|
Marquis A, Douillet D, Morin F, Chauvat D, Sechet A, Lacour H, Poiroux L, Savary D. Comparison of chest compression quality between the overlapping hands and interlocking hands techniques: A randomised cross-over trial. Am J Emerg Med 2023; 74:9-13. [PMID: 37729735 DOI: 10.1016/j.ajem.2023.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/06/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Performing quality chest compressions is fundamental to the management of cardiopulmonary arrest. The aim of this study was to compare the efficacy of two hand positions: overlapping versus interlocking for performing chest compressions during cardiopulmonary arrest. METHODS The HP2C (for Hands Position and Chest Compression) was a prospective, randomised, open-label, cross-over, single-centre study. Participants were recruited from the Emergency Medical Service (EMS) teams and the prehospital firefighter teams. They were randomised to start chest compressions either with overlapping or interlocking hands and then performed the other technique after a washout period. The judgement criteria were the overall chest compressions success score generated by software in accordance with ILCOR recommendations, the quality of compression, release, rate and subjective intensity measured with the Borg scale. RESULTS A total of 100 participants were included in the study. The mean age of the caregivers was 38 ± 9.3 years. The median CPR score was 79.5% IQR [48.5-94.0] in the overlapping hands group and 71% IQR [38.0-92.8] in the interlocking hands group (p-value = 0.37). There was no significant difference for the other criteria, especially no difference in term of intensity of effort. However, there was a trend towards better results with overlapping hands. CONCLUSIONS This study failed to demonstrate a difference in effectiveness between overlapping and interlocking hand chest compressions during cardiopulmonary resuscitation.
Collapse
Affiliation(s)
- Aurélien Marquis
- Centre for Emergency Care Teaching (CESU 49), Angers University Hospital, Angers, France
| | - Delphine Douillet
- Centre for Emergency Care Teaching (CESU 49), Angers University Hospital, Angers, France; Emergency Department, Angers University Hospital, Avenue de l'Hôtel Dieu, 49100 Angers, France; UMR MitoVasc CNRS 6215 INSERM 1083, University of Angers, 49100 Angers, France.
| | - François Morin
- Emergency Department, Angers University Hospital, Avenue de l'Hôtel Dieu, 49100 Angers, France
| | - Damien Chauvat
- Centre for Emergency Care Teaching (CESU 49), Angers University Hospital, Angers, France; Emergency Department, Angers University Hospital, Avenue de l'Hôtel Dieu, 49100 Angers, France
| | - Aurélien Sechet
- Centre for Emergency Care Teaching (CESU 49), Angers University Hospital, Angers, France; Emergency Department, Angers University Hospital, Avenue de l'Hôtel Dieu, 49100 Angers, France
| | - Hélène Lacour
- Centre for Emergency Care Teaching (CESU 49), Angers University Hospital, Angers, France; Emergency Department, Angers University Hospital, Avenue de l'Hôtel Dieu, 49100 Angers, France
| | - Laurent Poiroux
- Delegation to Clinical Research and Innovation, Angers University Hospital, 49100 Angers, France
| | - Dominique Savary
- Emergency Department, Angers University Hospital, Avenue de l'Hôtel Dieu, 49100 Angers, France; Inserm, EHESP, University of Rennes, Irset (Institut de Recherche en Santé, environnement et travail), UMR_S 1085, 49000 Angers, France
| |
Collapse
|
7
|
Bharne P, Kelly E, Rajkumar S, Iglesias A, Ponnapalli S, Haslund-Gourley B, Gadegbeku A. Temporal Reinforcement of Naloxone Training Results in Significant Retention of Anti-bias and Overdose-Response Knowledge. Cureus 2023; 15:e45415. [PMID: 37854753 PMCID: PMC10581504 DOI: 10.7759/cureus.45415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The opioid epidemic is an increasingly severe problem affecting public health and leading to significant economic burdens on healthcare systems. Overdose reversal training and de-stigmatization efforts are common strategies used to combat this epidemic. Nevertheless, healthcare professionals report a lack of confidence in administering naloxone and high stigmatization levels toward people with opioid use disorder (OUD). While one-time educational training reduces stigma and improves naloxone administration confidence, we previously demonstrated that knowledge retention at a three-month follow-up is reduced among a cohort of medical students. This study aimed to improve the effectiveness of opioid overdose awareness and reversal training (OOART) with a three-month follow-up abbreviated OOART (aOOART) booster video. METHODS Voluntary OOART was offered to first-year medical students (M1) at the Drexel University College of Medicine in 2022. At this training, 82 students completed a pre-training survey to establish a baseline knowledge and attitude toward people with OUD and their familiarity with the steps to reverse an opioid overdose. Following the hour-long training, 64 of 82 (79%) participants completed the post-training survey to measure the immediate retention of training information. After 2.5 months, students were randomly selected to receive a 6.5-minute aOOART booster video or serve as an unboosted control. Students in the booster and non-booster cohorts then completed a three-month follow-up survey. RESULTS Students who received the aOOART booster had significantly increased opioid reversal knowledge scores compared to non-boosted control students at the three-month follow-up. The aOOART booster resulted in a retention of the lowered stigma, and participants expressed a higher willingness to respond to an opioid overdose compared to participants who did not receive the booster video at the three-month follow-up. CONCLUSIONS This study shows that an aOOART booster method improves knowledge retention following initial OOART. Further, the aOOART booster video served to maintain participants' reduced stigma toward people with OUD and maintained participants' willingness to respond to an opioid overdose. These results support the incorporation of an abbreviated, periodic OOART reinforcement video into opioid overdose response training nationwide. We believe this "booster video" approach is a novel and effective method to improve healthcare professionals' and medical student preparedness to render appropriate care to people with OUD.
Collapse
Affiliation(s)
| | - Erin Kelly
- College of Medicine, Drexel University, Philadelphia, USA
| | - Sujay Rajkumar
- College of Medicine, Drexel University, Philadelphia, USA
| | | | | | | | | |
Collapse
|
8
|
Suzuki R, Kanai M, Oya K, Harada Y, Horie R, Sekiguchi H. A prospective randomized study to compare standard versus intensive training strategies on long-term improvement in critical care ultrasonography proficiency. BMC MEDICAL EDUCATION 2022; 22:732. [PMID: 36280812 PMCID: PMC9594969 DOI: 10.1186/s12909-022-03780-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Critical care ultrasonography (CCUS) has become a daily diagnostic tool for intensivists. While the effective training measures for ultrasound novices are discussed widely, the best curriculum for the novices to retain a long-term proficiency is yet to be determined. METHODS Critical care medicine fellows who underwent an introductory CCUS workshop were randomly allocated into the standard training (ST) or the intensive training (IT) group. The IT group received an 8-h training besides the standardized fellowship education that the ST group received. Participant improvement in CCUS proficiency tests (maximum score, 200) after a 6-month training intervention was compared between the groups. CCUS examinations performed in patient care were observed over 2 years. RESULTS Twenty-one fellows were allocated into the ST (n = 10) or the IT (n = 11) group. No statistically significant difference was observed in the median (interquartile range [IQR]) improvement in CCUS proficiency tests between the ST group and the IT group: 18 (3.8-38) versus 31 (21-46) (P = .09). Median (IQR) test scores were significantly higher in postintervention than preintervention for both groups: ST, 103 (87-116) versus 124 (111-143) (P = .02), and IT, 100 (87-113) versus 143 (121-149) (P < .01). Participating fellows performed 226 examinations over the 2 years of observation. CONCLUSIONS Fellows improved their CCUS proficiency significantly after 6-month training intervention. However, an additional 8-h training did not provide further benefits.
Collapse
Affiliation(s)
- Reina Suzuki
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, 55905, USA
- Department of Critical Care Medicine, Mayo Clinic, Phoenix, AZ, 85054, USA
| | - Mio Kanai
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kazumasa Oya
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Yohei Harada
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Ryohei Horie
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Hiroshi Sekiguchi
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, 55905, USA.
- Department of Critical Care Medicine, Mayo Clinic, Phoenix, AZ, 85054, USA.
| |
Collapse
|
9
|
Lin L, Ni S, Liu Y, Xue J, Ma B, Xiong D, Zhao Y, Jin X. Effect of peer videorecording feedback CPR training on students' practical CPR skills: a randomized controlled manikin study. BMC MEDICAL EDUCATION 2022; 22:484. [PMID: 35733183 PMCID: PMC9215097 DOI: 10.1186/s12909-022-03563-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The aim of this study was to compare one-month acquisition and half-a-year quality retention of cardiopulmonary resuscitation (CPR) skills after initial training of medical students between peer videorecording feedback training (PVF) and traditional peer verbal feedback training (TVF). METHODS Participants were randomly assigned to the PVF group (n = 62) and the TVF group (n = 65). All participants received a 45-min CPR training program performed by an American Heart Association basic life support-certified instructor, and then they began two hours of practice in groups. During interactive peer learning, students cooperated in couples of a doer and a helper to realize maximization of each other's learning. In the PVF group, training performance feedback came from peers based on practice videorecording. In the TVF group, feedback came from peers verbally without videorecording. CPR quality was tested at 1 and 6 months after training. RESULTS After 1 month of initial training, the PVF group had a better presentation of CPR skills acquisition than the TVF group. Compared to the TVF group, the PVF group had significantly higher total scores, compression depth, appropriate compression depth, and complete chest recoil (p < 0.05). Moreover, compression interruption was a significantly positive change in the PVF group compared to the TVF group (p < 0.05). However, after 6 months, proportions of appropriate compression depth in the PVF group were better than those in the TVF group (p < 0.05). The differences in total scores, compression depth, appropriate compression depth, complete chest recoil and compression interruption were non-significant (all p > 0.05). CONCLUSIONS Compared to TVF, PVF is more effective in enhancing CPR skill acquisition at 1 month. After half a year, CPR skill quality was obviously reduced in both groups, and no difference in CPR quality was found between the two groups.
Collapse
Affiliation(s)
- Lian Lin
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Hubei, 430071, Wuhan, China
| | - Shaozhou Ni
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Hubei, 430071, Wuhan, China
- Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei, China
| | - Yaqi Liu
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Hubei, 430071, Wuhan, China
- The Second Clinical College of Wuhan University, Wuhan, 430071, Hubei, China
| | - Jingyi Xue
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Hubei, 430071, Wuhan, China
| | - Binyu Ma
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Hubei, 430071, Wuhan, China
| | - Dan Xiong
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Hubei, 430071, Wuhan, China
- Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei, China
| | - Yan Zhao
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Hubei, 430071, Wuhan, China.
- Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei, China.
| | - Xiaoqing Jin
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Hubei, 430071, Wuhan, China.
- Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei, China.
| |
Collapse
|
10
|
Training and certification in first responder care among mountaineering practitioners in east Africa. Afr J Emerg Med 2022; 12:129-134. [PMID: 35388356 PMCID: PMC8971314 DOI: 10.1016/j.afjem.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/05/2022] [Accepted: 02/23/2022] [Indexed: 11/21/2022] Open
Abstract
In mountaineering, within East Africa, medical care may be very far away from the emergency scenes, and hence the tier one emergency care system may be offered by the mountaineering practitioners. There is limited research in the first responder care programmes in the mountaineering wilderness environments in Africa. Competency in first responder care through training and certification is part of safety promotion, a factor that can offer more confidence and appeal to tourists towards participation in mountaineering activities in Africa.
Introduction Mountaineering activities have potential risks for injuries and illnesses. Extreme weather conditions, high altitude, limited resources and accessibility to transport and definitive medical services calls for mountaineering practitioners to be well prepared through training and certification in first responder care. This is useful in cases when they have an injured climber and need to offer support in the tier-one emergency system care before accessing further care in a medical facility. The study sought to establish the first responder care training status of mountaineering practitioners and the associations of mountaineering practitioners’ first responder care training levels and gender, age, years of work experience, and designation. Methods The study used cross-sectional analytical research design with a purposive sample of one hundred and thirty six (136) mountaineering practitioners in East Africa. Snowball sampling procedure was used to identify the respondents since there were no records indicating the population size or specific location of these mountaineering practitioners. A self-administrated questionnaire was used to collect data on whether they were trained or not; status of their up-to-date certification; institutions where they did their training and recertification; and their training levels in first responder care, which would cover the aim of the study. Results Majority of mountaineering practitioners (91.2%) had received some form of training. However, 47.1% had received training in basic first aid, which did not involve mountain related components. Outdoor practitioners’ up-to-date training was dependent on their age (p = 0.005), and years of work experience (p= 0.014). Discussion There is need for mountaineering practitioners to have standardized minimum training in wilderness specific first responder care. The study recommends that the training and recertification should be undertaken on a regular basis by the mountaineering practitioners in East Africa.
Collapse
|
11
|
Hu Y, Zheng B, Zhu L, Tang S, Lu Q, Song Q, Zhang N, Zhong Y. The effectiveness of emergency knowledge training of pediatric medical workers based on the knowledge, skills, simulation model: a quasi-experimental study. BMC MEDICAL EDUCATION 2022; 22:213. [PMID: 35351112 PMCID: PMC8966279 DOI: 10.1186/s12909-022-03267-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Basic life support and advanced life support are essential emergency management skills for medical workers, and pediatricians' first aid skills can be improved through emergency knowledge training. METHODS A controlled pre-post-intervention quasi-experimental study design was used. The study setting was a tertiary children's hospital in China. In November 2019, a KSS model of emergency knowledge learning was developed and tested, and pediatric medical workers (N = 1448) were trained with it. The outcome measures were based on an emergency knowledge questionnaire devised by the authors that measured the effectiveness of training by comparing the pre-and post-training scores of the particpants. RESULTS Pediatric medical workers scored significantly higher in total emergency knowledge after the training course than before [75.00 (62.50, 85.00) versus 100.00 (95.00, 100.00); P = 0.00]. Basic life support and advanced life support knowledge score significantly improved after training. Teamwork scores were significantly higher after the training than before [5.00 (5.00, 10.00) versus 10.00 (10.00, 10.00); P = 0.00]. Scores were significantly higher after the training (P < 0.001), especially for case analysis questions (P = 0.00). The attitudes of the medical workers towards the training were all positive and affirmative. CONCLUSION The KSS model was shown to be effective in improving the emergency knowledge of pediatric medical workers. Future research will be to explore the effectiveness of the model with different participants and at other hospitals or other institutions such as schools, encouraging more people to participate in and evaluate the model to promote its optimization. TRIAL REGISTRATION Hunan Children's Hospital, HCHLL-2018-03.
Collapse
Affiliation(s)
- Yaojia Hu
- Nursing Department, Hunan Children's Hospital, Changsha, China
| | - Bingya Zheng
- The School of Pediatrics, Hengyang Medical School, University of South China Hunan Children's Hospital, Changsha, China
| | - Lihui Zhu
- Nursing Department, Hunan Children's Hospital, Changsha, China
| | - Shuo Tang
- Medical Department Emergency Office, Hunan Children's Hospital, Changsha, China
| | - Qi Lu
- Medical Department Emergency Office, Hunan Children's Hospital, Changsha, China
| | - Qingqing Song
- Department of Cardiology, Hunan Children's Hospital, Changsha, China
| | - Na Zhang
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Yan Zhong
- Child Health Care Center, Hunan Children's Hospital, Changsha, China.
| |
Collapse
|
12
|
Diaz MCG, Werk LN, Crutchfield JH, Handy LK, Franciosi JP, Dent J, Villanueva R, Antico E, Taylor A, Wysocki T. A Provider-Focused Intervention to Promote Optimal Care of Pediatric Patients With Suspected Elbow Fracture. Pediatr Emerg Care 2021; 37:e1663-e1669. [PMID: 29369265 DOI: 10.1097/pec.0000000000001417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Emergency department (ED) and urgent care (UC) physicians' accurate assessment of the neurovascular and musculoskeletal (NV/MSK) examination in pediatric patients with suspected elbow fracture is crucial to the early recognition of neurovascular compromise. Our objective was to determine the impact of computer-based simulation (CBS) and computerized clinical decision support systems (CCDSS) on ED and UC physicians' assessment of the NV/MSK examination of pediatric patients with elbow fracture as noted in their documentation. METHODS All ED UC physician participants received CBS training about management of pediatric patients with suspected elbow fracture. Participants were then randomized to receive CCDSS (intervention arm) when an eligible patient was seen or no further intervention (comparison arm.) Participants received feedback on the proportion of patients with discharge diagnosis of elbow fracturewith proper examination elements documented. RESULTS Twenty-eight ED and UC physicians were enrolled - 14 in each arm. Over the span of 16 weeks, 50 patients with a discharge diagnosis of elbow fracture were seen - 25 in each arm. Twenty-two of 25 (88%) patients seen by intervention arm participants had a complete NV/MSK examination documented. Six of 25 (24%) patients seen by comparison arm participants had a complete NV/MSK examination documented. Elements most commonly missed in the comparison arm included documentation of ulnar pulse as well as radial, median, and ulnar nerve motor functions. CONCLUSIONS Compared with single CBS training alone, repeated exposure to CCDSS after CBS training resulted in improved documentation of the NV/MSK status of pediatric patients with elbow fracture.
Collapse
Affiliation(s)
- Maria Carmen G Diaz
- From the Nemours Institute for Clinical Excellence, Nemours/Alfred I. du Pont Hospital for Children, Wilmington, DE
| | - Lloyd N Werk
- Office of Quality and Safety, Nemours Children's Hospital
| | | | - Lori K Handy
- Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA
| | - James P Franciosi
- Division of Gastroenterology, Hepatology and Nutrition, Nemours Children's Hospital, Orlando, FL
| | - Joanne Dent
- Nemours Biomedical Research, Nemours/Alfred I. du Pont Hospital for Children, Wilmington, DE
| | | | | | - Alex Taylor
- Nemours Center for Health Care Delivery Science, Jacksonville, FL
| | - Tim Wysocki
- Nemours Center for Health Care Delivery Science, Jacksonville, FL
| |
Collapse
|
13
|
Abelairas-Gómez C, Martinez-Isasi S, Barcala-Furelos R, Varela-Casal C, Carballo-Fazanes A, Pichel-López M, Fernández Méndez F, Otero-Agra M, Sanchez Santos L, Rodriguez-Nuñez A. Training frequency for educating schoolchildren in basic life support: very brief 4-month rolling-refreshers versus annual retraining-a 2-year prospective longitudinal trial. BMJ Open 2021; 11:e052478. [PMID: 34848519 PMCID: PMC8634240 DOI: 10.1136/bmjopen-2021-052478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/25/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To compare the effectiveness of 4-month rolling-refreshers and annual retraining in basic life support (BLS) on a sample of schoolchildren. DESIGN Prospective longitudinal trial. SETTING AND PARTICIPANTS Four hundred and seventy-two schoolchildren (8-12 years old). INTERVENTIONS Schoolchildren were instructed in BLS and then split into the following three groups: control group (CG), standard group (SG) and rolling-refresher group (RRG). Their BLS skills were assessed within 1 week (T1) and 2 years later (T2). Moreover, CG did not receive any additional training; SG received one 50 min retraining session 1 year later; RRG participated in very brief (5 min) rolling-refreshers that were carried out every 4 months. PRIMARY AND SECONDARY OUTCOMES Hands-on skills of BLS sequence and cardiopulmonary resuscitation. RESULTS BLS sequence performance was similar in all groups at T1, but SG and RRG followed the steps of the protocol in more proportion than CG at T2. When compared at T2, RRG showed higher proficiency than SG in checking safety, checking response, opening the airway and alerting emergency medical services. In addition, although the mean resuscitation quality was low in all groups, RRG participants reached a higher percentage of global quality cardiopulmonary resuscitation (CG: 16.4±24.1; SG: 25.3±28.8; RRG: 29.9%±29.4%), with a higher percentage of correct chest compressions by depth (CG: 3.9±11.8; SG: 10.8±22.7; RRG: 15.5±26.1 mm). CONCLUSIONS In 8-to-12-year-old schoolchildren, although annual 50 min retraining sessions help to maintain BLS performance, 4-month very brief rolling-refreshers were shown to be even more effective. Thus, we recommend implementing baseline BLS training at schools, with subsequently brief rolling-refreshers.
Collapse
Affiliation(s)
- Cristian Abelairas-Gómez
- Simulation and Intensive Care Unit of Santiago (SICRUS), Health Research Institute of Santiago, University Hospital of Santiago de Compostela- CHUS, Santiago Compostela, Spain
- Faculty of Education Sciences, Universidade de Santiago de Compostela, Spain, Santiago Compostela, Spain
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Santiago Martinez-Isasi
- Simulation and Intensive Care Unit of Santiago (SICRUS), Health Research Institute of Santiago, University Hospital of Santiago de Compostela- CHUS, Santiago Compostela, Spain
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, University of Santiago de Compostela, Santiago de Compostela, Spain
- Faculty of Nursing, Universidade de Santiago de Compostela, Santiago Compostela, Spain
| | - Roberto Barcala-Furelos
- REMOSS Research Group, Faculty of Education and Sport Sciences, University of Vigo, Vigo, Spain
- Faculty of Education and Sport Sciences, Universidad de Vigo, Vigo, Spain
| | - Cristina Varela-Casal
- REMOSS Research Group, Faculty of Education and Sport Sciences, University of Vigo, Vigo, Spain
- Faculty of Education and Sport Sciences, Universidad de Vigo, Vigo, Spain
| | - Aida Carballo-Fazanes
- Simulation and Intensive Care Unit of Santiago (SICRUS), Health Research Institute of Santiago, University Hospital of Santiago de Compostela- CHUS, Santiago Compostela, Spain
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, University of Santiago de Compostela, Santiago de Compostela, Spain
- Faculty of Nursing, Universidade de Santiago de Compostela, Santiago Compostela, Spain
| | - María Pichel-López
- REMOSS Research Group, Faculty of Education and Sport Sciences, University of Vigo, Vigo, Spain
| | - Felipe Fernández Méndez
- REMOSS Research Group, Faculty of Education and Sport Sciences, University of Vigo, Vigo, Spain
| | - Martín Otero-Agra
- REMOSS Research Group, Faculty of Education and Sport Sciences, University of Vigo, Vigo, Spain
| | - Luis Sanchez Santos
- Pediatric, Health area of Santiago de Compostela-Barbanza, Santiago de Compostela, Spain
| | - Antonio Rodriguez-Nuñez
- Simulation and Intensive Care Unit of Santiago (SICRUS), Health Research Institute of Santiago, University Hospital of Santiago de Compostela- CHUS, Santiago Compostela, Spain
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, University of Santiago de Compostela, Santiago de Compostela, Spain
- Faculty of Nursing, Universidade de Santiago de Compostela, Santiago Compostela, Spain
- Pediatric Intensive Care Unit, University Hospital of Santiago de Compostela-CHUS, Santiago de Compostela, Spain
| |
Collapse
|
14
|
Sand K, Guldal AU, Myklebust TÅ, Hoff DAL, Juvkam PC, Hole T. Cardiopulmonary resuscitation retention training for hospital nurses by a self-learner skill station or the traditional instructor led course: A randomised controlled trial. Resusc Plus 2021; 7:100157. [PMID: 34467255 PMCID: PMC8384897 DOI: 10.1016/j.resplu.2021.100157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/01/2021] [Accepted: 08/01/2021] [Indexed: 10/26/2022] Open
Abstract
Introduction Intrahospital cardiac arrest has a steep mortality and high-quality cardiopulmonary resuscitation (CPR) is essential for favourable outcome. Instructor led (IL) CPR training is resource demanding and instructor free, feedback providing CPR skill stations (SS) could provide a means to enable the needed frequent retraining. The main objective of this study was to test the hypothesis that there was no difference between IL and SS training. Methods A total of 129 hospital nurses were randomised to CPR retraining in three groups; skill station with retraining at 2 months (SS-R), skill station without retraining (SS) and instructor led training (IL). Participants were tested at baseline, 2 and 8 months. The skill station groups were combined (c-SS) for analysis at baseline and 2 months when comparing to IL. Results Baseline characteristics for the three groups differed significantly, however c-SS and IL groups performed equally at baseline and testing at 2 months. At 8 months the SS group performed 71% correct ventilations compared to 54% in the IL group (p = 0.04), but CPR quality was otherwise equal. Longitudinal analysis showed SS-R performed 3.4 mm deeper compressions at final evaluation compared to baseline (p = 0.02) and 2.8 mm deeper compared to 2-month test (p = 0.02). No effects of retraining at 2 months could be detected at final comparison of SS-R and SS groups. Conclusion CPR training using a skill station led to equal performance at 2 and 8 months compared to instructor led training. Feedback-providing skill stations could be a feasible tool for required frequent retraining.
Collapse
Affiliation(s)
- Kristoffer Sand
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.,Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | | | - Tor Åge Myklebust
- Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | - Dag Arne Lihaug Hoff
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.,Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | - Per Christian Juvkam
- Clinic of Emergency Medicine and Prehospital Care, St. Olav's University Hospital, Trondheim, Norway
| | - Torstein Hole
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway
| |
Collapse
|
15
|
Umuhoza C, Chen L, Unyuzumutima J, McCall N. Impact of structured basic life-support course on nurses' cardiopulmonary resuscitation knowledge and skills: Experience of a paediatric department in low-resource country. Afr J Emerg Med 2021; 11:366-371. [PMID: 34367898 PMCID: PMC8327485 DOI: 10.1016/j.afjem.2021.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/23/2021] [Accepted: 03/31/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The study aimed to assess the impact of a modified paediatric basic life support (BLS) training on paediatric nurses' knowledge and skills in the main tertiary level public hospital in Rwanda. METHODS A prospective, before-and-after educational intervention study was performed. Nurses working in the paediatric department at Centre Hospitalier Universitaire de Kigali (CHUK) were enrolled after consenting to the study. A modified BLS training was administered using didactic lectures, videos, case discussions, and simulations. Knowledge and skills were assessed before, immediately and six months after the training, using the American Heart Association (AHA) multiple-choice questions test and simulation scenarios. Ethical approval from the hospital's investigational review board was obtained before the start of the study. RESULTS Fifty-seven nurses working in paediatric department were included in the study, most with advanced nursing degrees. At baseline, only 3.5% scored above 80% on the knowledge test and none were able to perform high-quality one-rescuer CPR. Knowledge and high-quality one-rescuer CPR skills improved significantly immediately after the training, with 63.2% scoring above 80% and 63.2% capable of performing high-quality one-rescuer CPR (p < 0.01). Six months later, only 45.6% scored above 80% and 15.8% were capable of performing high-quality one-rescuer CPR (p < 0.01). Some skills, such as delivering breaths using bag-mask device, showed better retention. CONCLUSION In the paediatric department of the main public tertiary care hospital in Rwanda, nurses' baseline knowledge and skills in providing BLS was poor but can increase with focused BLS training. Due to the decline in knowledge and skills over six months, the use of debriefing and focused trainings following resuscitation events and improved implementation of yearly departmental refresher courses are recommended.
Collapse
Affiliation(s)
- Christian Umuhoza
- Paediatrics, University of Rwanda, Kigali City, Rwanda
- Paediatrics, Centre Hospitalier Universitaire de Kigali (CHUK), Kigali City, Rwanda
- Corresponding author.
| | - Lei Chen
- Paediatrics, Yale University, New Haven, CT, United States of America
| | | | - Natalie McCall
- Paediatrics, Yale University, New Haven, CT, United States of America
| |
Collapse
|
16
|
Fernández-Méndez M, Otero-Agra M, Fernández-Méndez F, Martínez-Isasi S, Santos-Folgar M, Barcala-Furelos R, Rodríguez-Núñez A. Analysis of Physiological Response during Cardiopulmonary Resuscitation with Personal Protective Equipment: A Randomized Crossover Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137093. [PMID: 34281042 PMCID: PMC8296930 DOI: 10.3390/ijerph18137093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/18/2021] [Accepted: 06/29/2021] [Indexed: 12/12/2022]
Abstract
The use of personal protective equipment (PPE) is required for the self-protection of healthcare workers during cardiopulmonary resuscitation (CPR) in patients at risk of aerosol transmission of infectious agents. The aim of this study was to analyze the impact of personal protective equipment on physiological parameters during CPR. A randomized, quasi-experimental, crossover design was used. The study was carried out in a training and simulation emergency box and the total sample consisted of 20 healthcare professionals. Two CPR tests were compared with the recommended sequence of 30 chest compressions and 2 ventilations. The duration of each test was 20 min. One of the CPR tests was carried out without using any PPE (CPR_control), i.e., performed with the usual clothing of each rescuer. The other test was carried out using a CPR test with PPE (i.e., CPR_PPE). The main variables of interest were: CPR quality, compressions, ventilations, maximum heart rate, body fluid loss, body temperature, perceived exertion index, comfort, thermal sensation and sweating. The quality of the CPR was similar in both tests. The maximum heart rate was higher in the active intervals (compressions + bag-valve-mask) of the test with PPE. CPR_PPE meant an increase in the perceived effort, temperature at the start of the thermal sensation test, thermal comfort and sweating, as opposed to CPR performed with usual clothing. Performing prolonged resuscitation with PPE did not influence CPR quality, but caused significant physiological demands. Rescuers were more fatigued, sweated more and their thermal comfort was worse. These results suggest that physical preparation should be taken into account when using PPE and protocols for physiological recovery after use should also be established.
Collapse
Affiliation(s)
- María Fernández-Méndez
- CLINURSID Research Group, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (M.F.-M.); (S.M.-I.); (R.B.-F.); (A.R.-N.)
- REMOSS Research Group, Faculty of Education and Sports Science, University of Vigo, 36005 Pontevedra, Spain; (M.O.-A.); (M.S.-F.)
- Pontevedra School of Nursing, University of Vigo, 36004 Pontevedra, Spain
- Santiago de Compostela’s Health Research Institute (IDIS), 15706 Santiago de Compostela, Spain
| | - Martín Otero-Agra
- REMOSS Research Group, Faculty of Education and Sports Science, University of Vigo, 36005 Pontevedra, Spain; (M.O.-A.); (M.S.-F.)
- Pontevedra School of Nursing, University of Vigo, 36004 Pontevedra, Spain
| | - Felipe Fernández-Méndez
- CLINURSID Research Group, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (M.F.-M.); (S.M.-I.); (R.B.-F.); (A.R.-N.)
- REMOSS Research Group, Faculty of Education and Sports Science, University of Vigo, 36005 Pontevedra, Spain; (M.O.-A.); (M.S.-F.)
- Pontevedra School of Nursing, University of Vigo, 36004 Pontevedra, Spain
- Santiago de Compostela’s Health Research Institute (IDIS), 15706 Santiago de Compostela, Spain
- Correspondence:
| | - Santiago Martínez-Isasi
- CLINURSID Research Group, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (M.F.-M.); (S.M.-I.); (R.B.-F.); (A.R.-N.)
- Santiago de Compostela’s Health Research Institute (IDIS), 15706 Santiago de Compostela, Spain
- Faculty of Nursing, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Myriam Santos-Folgar
- REMOSS Research Group, Faculty of Education and Sports Science, University of Vigo, 36005 Pontevedra, Spain; (M.O.-A.); (M.S.-F.)
- Pontevedra School of Nursing, University of Vigo, 36004 Pontevedra, Spain
- Department of Obstetrics, Complexo Hospitalario of Pontevedra, Sergas, 36001 Pontevedra, Spain
| | - Roberto Barcala-Furelos
- CLINURSID Research Group, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (M.F.-M.); (S.M.-I.); (R.B.-F.); (A.R.-N.)
- REMOSS Research Group, Faculty of Education and Sports Science, University of Vigo, 36005 Pontevedra, Spain; (M.O.-A.); (M.S.-F.)
- Santiago de Compostela’s Health Research Institute (IDIS), 15706 Santiago de Compostela, Spain
| | - Antonio Rodríguez-Núñez
- CLINURSID Research Group, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (M.F.-M.); (S.M.-I.); (R.B.-F.); (A.R.-N.)
- Santiago de Compostela’s Health Research Institute (IDIS), 15706 Santiago de Compostela, Spain
- Faculty of Nursing, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Pediatric Intensive Care Unit, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| |
Collapse
|
17
|
Training von Basisreanimationsmaßnahmen (Newborn Life Support, Paediatric Basic Life Support). Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-021-01223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
18
|
Lee MJ, Shin TY, Lee CH, Moon JD, Roh SG, Kim CW, Park HE, Woo SH, Lee SJ, Shin SL, Oh YT, Lim YS, Choe JY, Na SH, Hwang SO. 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 9. Education and system implementation for enhanced chain of survival. Clin Exp Emerg Med 2021; 8:S116-S124. [PMID: 34034453 PMCID: PMC8171173 DOI: 10.15441/ceem.21.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/28/2021] [Indexed: 02/07/2023] Open
Affiliation(s)
- Mi Jin Lee
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Tae-Yong Shin
- Department of Emergency Medicine, Asan Chungmu General Hospital, Asan, Korea
| | - Chang Hee Lee
- Department of Emergency Medical Technician, Namseoul University, Cheonan, Korea
| | - Jun Dong Moon
- Department of Emergency Medical Service, College of Health & Nursing, Kongju National University, Gongju, Korea
| | - Sang Gyun Roh
- Department of Emergency Medical Services, Sun Moon University, Asan, Korea
| | - Chan Woong Kim
- Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyo Eun Park
- Division of Cardiology, Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Seon Hee Woo
- Department of Emergency Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seung Joon Lee
- National Medical Emergency Center, National Medical Center, Seoul, Korea
| | - Seung Lyul Shin
- Department of Emergency Medicine, Inha University College of Medicine, Incheon, Korea
| | - Young Taeck Oh
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Su Lim
- Department of Emergency Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sang-Hoon Na
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Oh Hwang
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | | |
Collapse
|
19
|
Sturny L, Regard S, Larribau R, Niquille M, Savoldelli GL, Sarasin F, Schiffer E, Suppan L. Differences in Basic Life Support Knowledge Between Junior Medical Students and Lay People: Web-Based Questionnaire Study. J Med Internet Res 2021; 23:e25125. [PMID: 33620322 PMCID: PMC7943337 DOI: 10.2196/25125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/06/2021] [Accepted: 01/31/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Early cardiopulmonary resuscitation and prompt defibrillation markedly increase the survival rate in the event of out-of-hospital cardiac arrest (OHCA). As future health care professionals, medical students should be trained to efficiently manage an unexpectedly encountered OHCA. OBJECTIVE Our aim was to assess basic life support (BLS) knowledge in junior medical students at the University of Geneva Faculty of Medicine (UGFM) and to compare it with that of the general population. METHODS Junior UGFM students and lay people who had registered for BLS classes given by a Red Cross-affiliated center were sent invitation links to complete a web-based questionnaire. The primary outcome was the between-group difference in a 10-question score regarding cardiopulmonary resuscitation knowledge. Secondary outcomes were the differences in the rate of correct answers for each individual question, the level of self-assessed confidence in the ability to perform resuscitation, and a 6-question score, "essential BLS knowledge," which only contains key elements of the chain of survival. Continuous variables were first analyzed using the Student t test, then by multivariable linear regression. Fisher exact test was used for between-groups comparison of binary variables. RESULTS The mean score was higher in medical students than in lay people for both the 10-question score (mean 5.8, SD 1.7 vs mean 4.2, SD 1.7; P<.001) and 6-question score (mean 3.0, SD 1.1 vs mean 2.0, SD 1.0; P<.001). Participants who were younger or already trained scored consistently better. Although the phone number of the emergency medical dispatch center was well known in both groups (medical students, 75/80, 94% vs lay people, 51/62, 82%; P=.06), most participants were unable to identify the criteria used to recognize OHCA, and almost none were able to correctly reorganize the BLS sequence. Medical students felt more confident than lay people in their ability to perform resuscitation (mean 4.7, SD 2.2 vs mean 3.1, SD 2.1; P<.001). Female gender and older age were associated with lower confidence, while participants who had already attended a BLS course prior to taking the questionnaire felt more confident. CONCLUSIONS Although junior medical students were more knowledgeable than lay people regarding BLS procedures, the proportion of correct answers was low in both groups, and changes in BLS education policy should be considered.
Collapse
Affiliation(s)
- Ludovic Sturny
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Simon Regard
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Robert Larribau
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Marc Niquille
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Georges Louis Savoldelli
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - François Sarasin
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Eduardo Schiffer
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| |
Collapse
|
20
|
Bylow H, Karlsson T, Lepp M, Claesson A, Lindqvist J, Svensson L, Herlitz J. Learning Outcome After Different Combinations of Seven Learning Activities in Basic Life Support on Laypersons in Workplaces: a Cluster Randomised, Controlled Trial. MEDICAL SCIENCE EDUCATOR 2021; 31:161-173. [PMID: 34457876 PMCID: PMC8368380 DOI: 10.1007/s40670-020-01160-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND The goal for laypersons after training in basic life support (BLS) is to act effectively in an out-of-hospital cardiac arrest situation. However, it is still unclear whether BLS training targeting laypersons at workplaces is optimal or whether other effective learning activities are possible. AIM The primary aim was to evaluate whether there were other modes of BLS training that improved learning outcome as compared with a control group, i.e. standard BLS training, six months after training, and secondarily directly after training. METHODS In this multi-arm trial, lay participants (n = 2623) from workplaces were cluster randomised into 16 different BLS interventions, of which one, instructor-led and film-based BLS training, was classified as control and standard, with which the other 15 were compared. The learning outcome was the total score for practical skills in BLS calculated using the modified Cardiff Test. RESULTS Four different training modes showed a significantly higher total score compared with standard (mean difference 2.3-2.9). The highest score was for the BLS intervention including a preparatory web-based education, instructor-led training, film-based instructions, reflective questions and a chest compression feedback device (95% CI for difference 0.9-5.0), 6 months after training. CONCLUSION BLS training adding several different combinations of a preparatory web-based education, reflective questions and chest compression feedback to instructor-led training and film-based instructions obtained higher modified Cardiff Test total scores 6 months after training compared with standard BLS training alone. The differences were small in magnitude and the clinical relevance of our findings needs to be further explored. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03618888. Registered August 07, 2018-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03618888. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-020-01160-3.
Collapse
Affiliation(s)
- Helene Bylow
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Karlsson
- Health Metrics Unit, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margret Lepp
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Østfold University College, Halden, Norway
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | - Andreas Claesson
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institute, Stockholm, Sweden
| | | | - Leif Svensson
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institute, Stockholm, Sweden
| | - Johan Herlitz
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre of Registers Västra Götaland, Gothenburg, Sweden
- Prehospen-Centre of Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| |
Collapse
|
21
|
Greif R, Bhanji F, Bigham BL, Bray J, Breckwoldt J, Cheng A, Duff JP, Gilfoyle E, Hsieh MJ, Iwami T, Lauridsen KG, Lockey AS, Ma MHM, Monsieurs KG, Okamoto D, Pellegrino JL, Yeung J, Finn JC. Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2020; 142:S222-S283. [PMID: 33084395 DOI: 10.1161/cir.0000000000000896] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application.
Collapse
|
22
|
Cheng A, Magid DJ, Auerbach M, Bhanji F, Bigham BL, Blewer AL, Dainty KN, Diederich E, Lin Y, Leary M, Mahgoub M, Mancini ME, Navarro K, Donoghue A. Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S551-S579. [PMID: 33081527 DOI: 10.1161/cir.0000000000000903] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
23
|
Greif R, Bhanji F, Bigham BL, Bray J, Breckwoldt J, Cheng A, Duff JP, Gilfoyle E, Hsieh MJ, Iwami T, Lauridsen KG, Lockey AS, Ma MHM, Monsieurs KG, Okamoto D, Pellegrino JL, Yeung J, Finn JC, Baldi E, Beck S, Beckers SK, Blewer AL, Boulton A, Cheng-Heng L, Yang CW, Coppola A, Dainty KN, Damjanovic D, Djärv T, Donoghue A, Georgiou M, Gunson I, Krob JL, Kuzovlev A, Ko YC, Leary M, Lin Y, Mancini ME, Matsuyama T, Navarro K, Nehme Z, Orkin AM, Pellis T, Pflanzl-Knizacek L, Pisapia L, Saviani M, Sawyer T, Scapigliati A, Schnaubelt S, Scholefield B, Semeraro F, Shammet S, Smyth MA, Ward A, Zace D. Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2020; 156:A188-A239. [PMID: 33098918 DOI: 10.1016/j.resuscitation.2020.09.014] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application.
Collapse
|
24
|
Merchant RM, Topjian AA, Panchal AR, Cheng A, Aziz K, Berg KM, Lavonas EJ, Magid DJ. Part 1: Executive Summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S337-S357. [DOI: 10.1161/cir.0000000000000918] [Citation(s) in RCA: 190] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
25
|
Yeung J, Djarv T, Hsieh MJ, Sawyer T, Lockey A, Finn J, Greif R. Spaced learning versus massed learning in resuscitation - A systematic review. Resuscitation 2020; 156:61-71. [PMID: 32926969 DOI: 10.1016/j.resuscitation.2020.08.132] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/05/2020] [Accepted: 08/17/2020] [Indexed: 12/20/2022]
Abstract
AIM Skill decay is a recognised problem in resuscitation training. Spaced learning has been proposed as an intervention to optimise resuscitation skill performance compared to traditional massed learning. A systematic review was performed to answer 'In learners taking resuscitation courses, does spaced learning compared to massed learning improve educational outcomes and clinical outcomes?' METHODS This systematic review followed the PRISMA guidelines. We searched bibliographic databases (Embase, MEDLINE and the Cochrane Library (CENTRAL)) from inception to 2 December 2019. Randomised controlled trials and non-randomised studies were eligible for inclusion. Two reviewers independently scrutinized studies for relevance, extracted data and assessed quality of studies. Risk of bias of studies and quality of evidence were assessed using RoB, ROBINS-I tool and GRADEpro respectively. Educational outcomes studied were skill retention and performance 1 year after completion of training; skill performance between completion of training and 1 year; and knowledge at course conclusion. Clinical outcomes were skill performance at actual resuscitation, patient survival to discharge with favourable neurological outcome. This systematic review was registered in PROSPERO (CRD42019150358). RESULTS From 2,042 references, we included data from 17 studies (13 randomised studies, 4 cohort studies) in courses with manikins and simulation in the narrative synthesis. Eight studies reported results from basic life support training (with or without automatic external defibrillator); three studies reported from paediatric life support training; five were in neonatal resuscitation and one study reported results from a bespoke emergency medicine course which included resuscitation teaching. Fifteen out of seventeen studies reported improved performance with the use of spaced learning. The overall certainty of evidence was rated as very low for all outcomes primarily due to a very serious risk of bias. Heterogeneity across studies precluded any meta-analyses. There was a lack of data on the effectiveness of spaced learning on skill acquisition compared to maintaining skill performance and/or preventing skill decay. There was also insufficient data to examine the effectiveness of spaced learning on laypeople compared to healthcare providers. CONCLUSIONS Despite the very low certainty of evidence this systematic review suggests that spaced learning can improve skill performance at 1 year post course conclusion and skill performance between course conclusion and 1 year. There is a lack of data from this educational intervention on skill performance in clinical resuscitation and patient survival at discharge with favourable neurological outcomes.
Collapse
Affiliation(s)
- J Yeung
- Warwick Medical School, University of Warwick, United Kingdom.
| | - T Djarv
- Department of Medicine Solna, Karolinska Institutet, Sweden
| | - M J Hsieh
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - T Sawyer
- Division of Neonatology, University of Washington, USA
| | - A Lockey
- Department of Emergency Medicine, Calderdale and Huddersfield NHS Foundation Trust, United Kingdom
| | - J Finn
- Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia
| | - R Greif
- Department of Anesthesiology and Pain Therapy, Bern University Hospital, University of Bern, Bern, Switzerland; Sigmund Freud University Vienna, Medical School, Vienna, Austria
| | | |
Collapse
|
26
|
Barcala-Furelos R, Fernández-Méndez M, Cano-Noguera F, Otero-Agra M, Morán-Navarro R, Martínez-Isasi S. Measuring the physiological impact of extreme heat on lifeguards during cardiopulmonary resuscitation. Randomized simulation study. Am J Emerg Med 2020; 38:2019-2027. [PMID: 33142168 DOI: 10.1016/j.ajem.2020.06.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/13/2020] [Accepted: 06/13/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Lifeguard teams carry out their work in extremely hot conditions in many parts of the world. The aim of this study was to analyze the impact of high temperatures on physiological parameters during cardiopulmonary resuscitation (CPR). METHOD A randomized quasi-experimental cross-over design was used to test physiological lifesaving demands (50 min acclimatization +10 min CPR) in two different thermal environments: Thermo-neutral environment (25 °C) vs Hyperthermic environment (37 °C). RESULTS The data obtained from 21 lifeguards were included, this covers a total of 420 min of resuscitation. The CPR performance was constantly maintained during the 10 min. The Oxygen uptake (VO 2) ranged from 17 to 18 ml/min/kg for chest compressions (CC) and between 13 and 14 ml/min/kg for ventilations (V) at both 25 °C and 37 °C, with no significant difference between environments (p > 0.05). The percentage of maximum heart rate (%HR max) increased between 7% and 8% at 37 °C (p < 0.001), ranging between 75% and 82% of HR max. The loss of body fluids (LBF) was higher in the hyperthermic environment; LBF: (37 °C: 400 ± 187 g vs 25 °C: 148 ± 81 g, p < 0.001). Body temperature was 1 °C higher at the end of the test (p < 0.001). The perceived fatigue (RPE) increased by 37° an average of 2 points on a scale of 10 (p = 0.001). CONCLUSIONS Extreme heat is not a limiting factor in CPR performance with two lifeguards. Metabolic consumption is sustained, with an increase in CC, so V can serve as active rest. Nevertheless, resuscitation at 37 °C results in a higher HR, is more exhausting and causes significant loss of fluids due to sweating.
Collapse
Affiliation(s)
- Roberto Barcala-Furelos
- Faculty of Education and Sport Sciences, REMOSS Research Group, Universidade de Vigo, Pontevedra, Spain; CLINURSID Research Group, Nursing Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Santiago de Compostela's Health Research Institute (IDIS), Santiago de Compostela, Spain.
| | - María Fernández-Méndez
- CLINURSID Research Group, Nursing Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Santiago de Compostela's Health Research Institute (IDIS), Santiago de Compostela, Spain; School of Nursing, REMOSS Research Group, Universidade de Vigo, Pontevedra, Spain.
| | | | - Martín Otero-Agra
- Faculty of Education and Sport Sciences, REMOSS Research Group, Universidade de Vigo, Pontevedra, Spain.
| | | | - Santiago Martínez-Isasi
- CLINURSID Research Group, Nursing Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Santiago de Compostela's Health Research Institute (IDIS), Santiago de Compostela, Spain.
| |
Collapse
|
27
|
Chien CY, Fang SY, Tsai LH, Tsai SL, Chen CB, Seak CJ, Weng YM, Lin CC, Chien WC, Huang CH, Lin CY, Chaou CH, Liu PH, Tseng HJ, Chen JC, Peng SY, Cheng TH, Hsu KH, Ng CJ. Traditional versus blended CPR training program: A randomized controlled non-inferiority study. Sci Rep 2020; 10:10032. [PMID: 32572100 PMCID: PMC7308401 DOI: 10.1038/s41598-020-67193-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 06/03/2020] [Indexed: 11/09/2022] Open
Abstract
Cardiopulmonary resuscitation (CPR) training and its quality are critical in improving the survival rate of cardiac arrest. This randomized controlled study investigated the efficacy of a newly developed CPR training program for the public in a Taiwanese setting. A total of 832 adults were randomized to either a traditional or blended (18-minute e-learning plus 30-minute hands-on) compression-only CPR training program. The primary outcome was compression depth. Secondary outcomes included CPR knowledge test, practical test, quality of CPR performance, and skill retention. The mean compression depth was 5.21 cm and 5.24 cm in the blended and traditional groups, respectively. The mean difference in compression depth between groups was -0.04 (95% confidence interval -0.13 to infinity), demonstrating that the blended CPR training program was non-inferior to the traditional CPR training program in compression depth after initial training. Secondary outcome results were comparable between groups. Although the mean compression depth and rate were guideline-compliant, only half of the compressions were delivered with adequate depth and rate in both groups. CPR knowledge and skill retained similarly in both groups at 6 and 12 months after training. The blended CPR training program was non-inferior to the traditional CPR training program. However, there is still room for improvement in optimizing initial skill performance as well as skill retention. Clinical Trial Registration: NCT03586752; www.clinicaltrial.gov.
Collapse
Affiliation(s)
- Cheng-Yu Chien
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Ton-Yen General Hospital, Zhubei, 302, Taiwan
| | - Shao-Yu Fang
- Department of Emergency Medicine, Chang Gung Memorial Hospital Taipei Branch, Taipei, 105, Taiwan
| | - Li-Heng Tsai
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Shang-Li Tsai
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Chang Gung Memorial Hospital Taipei Branch, Taipei, 105, Taiwan
| | - Chen-Bin Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Chen-June Seak
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Yi-Ming Weng
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, 330, Taiwan
| | - Chi-Chun Lin
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Ton-Yen General Hospital, Zhubei, 302, Taiwan
| | - Wei-Che Chien
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Chang Gung Memorial Hospital Taipei Branch, Taipei, 105, Taiwan
| | - Chien-Hsiung Huang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, 330, Taiwan
| | - Cheng-Yu Lin
- Department of Emergency Medicine, Ton-Yen General Hospital, Zhubei, 302, Taiwan
| | - Chung-Hsien Chaou
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Peng-Huei Liu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Chang Gung Memorial Hospital Taipei Branch, Taipei, 105, Taiwan
| | - Hsiao-Jung Tseng
- Biostatistics Unit, Clinical Trial Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, 333, Taiwan
| | - Jih-Chang Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Emergency Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, 330, Taiwan
| | - Shu-Yuan Peng
- Department of nursing, Ton-Yen General Hospital, Zhubei, 302, Taiwan
| | - Tsung-Hsuan Cheng
- Department of nursing, Ton-Yen General Hospital, Zhubei, 302, Taiwan
| | - Kuang-Hung Hsu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.,Laboratory for Epidemiology, Chang Gung University, Taoyuan, 333, Taiwan.,Department of Urology, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Chip-Jin Ng
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
| |
Collapse
|
28
|
Diaz MCG, Dawson K. Impact of Simulation-Based Closed-Loop Communication Training on Medical Errors in a Pediatric Emergency Department. Am J Med Qual 2020; 35:474-478. [PMID: 32204598 DOI: 10.1177/1062860620912480] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Closed-loop communication (CLC) promotes a shared understanding of information. The authors hypothesized that simulation-based CLC training would improve staff perceptions of CLC ability and decrease medical errors. Participants experienced 2 hands-on CLC simulations one month apart. A retrospective chart review of Emergency Severity Index (ESI) 1 patients was conducted 4 months pre and post CLC simulation-based training. Seventy simulations were held over 13 weeks. Staff perceptions of CLC ability improved and were sustained after one month. Nine ESI 1 patients were seen pre CLC, and 9 post; 8/9 pre-CLC ESI 1 patients had medical errors, with 19 total errors noted; 5/9 post-CLC ESI 1 patients had medical errors, with 5 total errors noted (rate ratio [99% CI] = 3.8 [1.4, 10.2]; P = .008). This simulation-based CLC training curriculum improved staff perceptions of their CLC ability and was associated with a significant decrease in the number of medical errors in ESI 1 patients.
Collapse
|
29
|
Evaluation of a Multimodal Resuscitation Program and Comparison of Mouth-to-Mouth and Bag-Mask Ventilation by Relatives of Children With Chronic Diseases. Pediatr Crit Care Med 2020; 21:e114-e120. [PMID: 31834244 DOI: 10.1097/pcc.0000000000002204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Children with chronic critical illness are at higher risk for cardiopulmonary arrests. Before chronically ill children are discharged from hospital, family members receive training in basic life support at many institutions. We evaluated whether a multimodal training program is able to teach adherence to current resuscitation guidelines and whether laypersons can be trained to perform both bag-mask ventilation and mouth-to-mouth ventilation equally effective in infants. DESIGN Prospective observational study. SETTING Pediatric critical care unit of a tertiary referral center. SUBJECTS Relatives of children with chronic illness prior to discharge from hospital. INTERVENTIONS Multimodal emergency and cardiopulmonary resuscitation training program. MEASUREMENTS AND MAIN RESULTS Following participation in our cardiopulmonary resuscitation training program 56 participants performed 112 simulated cardiopulmonary resuscitations (56 with mouth-to-mouth ventilation, 56 with bag-mask ventilation). Nearly all participants checked for consciousness and breathing. Shouting for help and activation of the emergency response system was only performed in half of the cases. There was almost full adherence to the resuscitation guidelines regarding number of chest compressions, chest compression rate, compression depth, full chest recoil, and duration of interruption of chest compression for rescue breaths. The comparison of mouth-to-mouth ventilation and bag-mask ventilation revealed no significant differences regarding the rate of successful ventilation (mouth-to-mouth ventilation: 77.1% ± 39.6%, bag-mask ventilation: 80.4% ± 38.0%; p = 0.39) and the cardiopulmonary resuscitation performance. CONCLUSIONS A standardized multimodal cardiopulmonary resuscitation training program for family members of chronically ill children is effective to teach good cardiopulmonary resuscitation performance and adherence to resuscitation guidelines. Laypersons could be successfully trained to equally perform mouth-to-mouth and bag-mask ventilation technique.
Collapse
|
30
|
Cheng A, Nadkarni VM, Mancini MB, Hunt EA, Sinz EH, Merchant RM, Donoghue A, Duff JP, Eppich W, Auerbach M, Bigham BL, Blewer AL, Chan PS, Bhanji F. Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest: A Scientific Statement From the American Heart Association. Circulation 2019; 138:e82-e122. [PMID: 29930020 DOI: 10.1161/cir.0000000000000583] [Citation(s) in RCA: 189] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The formula for survival in resuscitation describes educational efficiency and local implementation as key determinants in survival after cardiac arrest. Current educational offerings in the form of standardized online and face-to-face courses are falling short, with providers demonstrating a decay of skills over time. This translates to suboptimal clinical care and poor survival outcomes from cardiac arrest. In many institutions, guidelines taught in courses are not thoughtfully implemented in the clinical environment. A current synthesis of the evidence supporting best educational and knowledge translation strategies in resuscitation is lacking. In this American Heart Association scientific statement, we provide a review of the literature describing key elements of educational efficiency and local implementation, including mastery learning and deliberate practice, spaced practice, contextual learning, feedback and debriefing, assessment, innovative educational strategies, faculty development, and knowledge translation and implementation. For each topic, we provide suggestions for improving provider performance that may ultimately optimize patient outcomes from cardiac arrest.
Collapse
|
31
|
Matsuzaki K, Taniguchi S, Inoue K, Kawamura T. Effectiveness of a healthcare retreat for male employees with cardiovascular risk factors. Prev Med Rep 2019; 13:170-174. [PMID: 30619665 PMCID: PMC6313817 DOI: 10.1016/j.pmedr.2018.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/03/2018] [Accepted: 12/15/2018] [Indexed: 12/30/2022] Open
Abstract
Lifestyle modification is the primary treatment strategy for obesity, hypertension, dyslipidemia, and hyperglycemia. Recently, the Japanese government designed a healthcare retreat program for persons with cardiovascular risk factors. However, the structure and effectiveness of this program has not been fully discussed. Employees of a company group with obesity and one or more other cardiovascular risk factors were enrolled in the study. The participants in the three-day retreat program were compared with those receiving a brochure-based advice for their subsequent changes in the annual health check-up data using the propensity score matching method. Among the 415 eligible employees, 220 underwent the intensive program and 195 received a brochure-based advice. In the propensity score-matched subjects, reduction in body weight (2.7 kg vs. 0.99 kg, p < 0.01), waist circumference (3.5 cm vs. 1.5 cm, p < 0.01), and non-HDL cholesterol (8.8 mg/dl vs. 1.3 mg/dl, p = 0.05) were significantly greater in the intensive care group one year later. The superiority of the intensive program, however, was gradually attenuted for subsequent two years later. This healthcare retreat with counseling and training program would improve body weight and waist circumference for one to two subsequent years. Lifestyle modification is the primary treatment strategy for cardiovascular disease. Based on the trans-theoretical model, healthcare retreat program was established. Mean 2.7 kg reduction in body weight after 1 year in healthcare retreat group Our healthcare retreat program may supersede conventional approach.
Collapse
Affiliation(s)
- Keiichi Matsuzaki
- Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan
| | - Shotaro Taniguchi
- Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan.,Miyazaki Prefectural Health Foundation, 1-1-2, Kirishima, Miyazaki City, Miyazaki 880-0032, Japan
| | - Kana Inoue
- Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan
| | - Takashi Kawamura
- Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan
| |
Collapse
|
32
|
Hinkelbein J, Böhm L, Braunecker S, Genzwürker HV, Kalina S, Cirillo F, Komorowski M, Hohn A, Siedenburg J, Bernhard M, Janicke I, Adler C, Jansen S, Glaser E, Krawczyk P, Miesen M, Andres J, De Robertis E, Neuhaus C. In-flight cardiac arrest and in-flight cardiopulmonary resuscitation during commercial air travel: consensus statement and supplementary treatment guideline from the German Society of Aerospace Medicine (DGLRM). Intern Emerg Med 2018; 13:1305-1322. [PMID: 29730774 DOI: 10.1007/s11739-018-1856-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 04/21/2018] [Indexed: 01/08/2023]
Abstract
By the end of the year 2016, approximately 3 billion people worldwide travelled by commercial air transport. Between 1 out of 14,000 and 1 out of 50,000 passengers will experience acute medical problems/emergencies during a flight (i.e., in-flight medical emergency). Cardiac arrest accounts for 0.3% of all in-flight medical emergencies. So far, no specific guideline exists for the management and treatment of in-flight cardiac arrest (IFCA). A task force with clinical and investigational expertise in aviation, aviation medicine, and emergency medicine was created to develop a consensus based on scientific evidence and compiled a guideline for the management and treatment of in-flight cardiac arrests. Using the GRADE, RAND, and DELPHI methods, a systematic literature search was performed in PubMed. Specific recommendations have been developed for the treatment of IFCA. A total of 29 specific recommendations for the treatment and management of in-flight cardiac arrests were generated. The main recommendations included emergency equipments as well as communication of the emergency. Training of the crew is of utmost importance, and should ideally have a focus on CPR in aircraft. The decision for a diversion should be considered very carefully.
Collapse
Affiliation(s)
- Jochen Hinkelbein
- Working group "guidelines, recommendations, and statements", German Society of Aviation and Space Medicine, Munich, Germany.
- Working group "emergency medicine and air rescue", German Society of Aviation and Space Medicine, Munich, Germany.
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Cologne, 50937, Cologne, Germany.
| | - Lennert Böhm
- Emergency Department, University of Duesseldorf, Düsseldorf, Germany
| | - Stefan Braunecker
- Working group "guidelines, recommendations, and statements", German Society of Aviation and Space Medicine, Munich, Germany
- Working group "emergency medicine and air rescue", German Society of Aviation and Space Medicine, Munich, Germany
- Department of Critical Care, King's College Hospital, London, UK
| | | | - Steffen Kalina
- Working group "emergency medicine and air rescue", German Society of Aviation and Space Medicine, Munich, Germany
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Cologne, 50937, Cologne, Germany
| | - Fabrizio Cirillo
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Cologne, 50937, Cologne, Germany
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - Matthieu Komorowski
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Andreas Hohn
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Cologne, 50937, Cologne, Germany
| | | | - Michael Bernhard
- Emergency Department, University of Duesseldorf, Düsseldorf, Germany
| | - Ilse Janicke
- Working group "emergency medicine and air rescue", German Society of Aviation and Space Medicine, Munich, Germany
- Department for Cardiology and Angiology, Heart Center Duisburg, Evangelisches Klinikum Niederrhein, Duisburg, Germany
| | - Christoph Adler
- Department of Internal Medicine III, Heart Center of the University of Cologne, Cologne, Germany
| | - Stefanie Jansen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Eckard Glaser
- Working group "guidelines, recommendations, and statements", German Society of Aviation and Space Medicine, Munich, Germany
- Working group "emergency medicine and air rescue", German Society of Aviation and Space Medicine, Munich, Germany
- , Gerbrunn, Germany
| | - Pawel Krawczyk
- Department of Anaesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Cracow, Poland
| | | | - Janusz Andres
- Department of Anaesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Edoardo De Robertis
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - Christopher Neuhaus
- Working group "guidelines, recommendations, and statements", German Society of Aviation and Space Medicine, Munich, Germany
- Working group "emergency medicine and air rescue", German Society of Aviation and Space Medicine, Munich, Germany
- Department of Anaesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
33
|
Pichel López M, Martínez-Isasi S, Barcala-Furelos R, Fernández-Méndez F, Vázquez Santamariña D, Sánchez-Santos L, Rodríguez-Nuñez A. Un primer paso en la enseñanza del soporte vital básico en las escuelas: la formación de los profesores. An Pediatr (Barc) 2018; 89:265-271. [DOI: 10.1016/j.anpedi.2017.11.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 11/02/2017] [Accepted: 11/09/2017] [Indexed: 12/11/2022] Open
|
34
|
Pichel López M, Martínez-Isasi S, Barcala-Furelos R, Fernández-Méndez F, Vázquez Santamariña D, Sánchez-Santos L, Rodríguez-Nuñez A. A first step to teaching basic life support in schools: Training the teachers. An Pediatr (Barc) 2018. [DOI: 10.1016/j.anpede.2018.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
35
|
Public knowledge, attitudes and willingness regarding bystander cardiopulmonary resuscitation: A nationwide survey in Taiwan. J Formos Med Assoc 2018; 118:572-581. [PMID: 30190091 DOI: 10.1016/j.jfma.2018.07.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/11/2018] [Accepted: 07/23/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND A low bystander cardiopulmonary resuscitation (CPR) rate is one of the factors associated with low cardiac arrest survival. This study aimed to assess knowledge, attitudes, and willingness towards performing CPR and the barriers for implementation of bystander-initiated CPR. METHODS Telephone interviews were conducted using an author-designed and validated structured questionnaire in Taiwan. After obtaining a stratified random sample from the census, the results were weighted to match population data. The factors affecting bystander-initiated CPR were analysed using logistic regression. RESULTS Of the 1073 respondents, half of them stated that they knew how to perform CPR correctly, although 86.7% indicated a willingness to perform CPR on strangers. The barriers to CPR performance reported by the respondents included fear of legal consequences (44%) and concern about harming patients (36.5%). Most participants expressed a willingness to attend only an hour-long CPR course. Respondents who were less likely to indicate a willingness to perform CPR were female, healthcare providers, those who had no cohabiting family members older than 65 years, those who had a history of a stroke, and those who expressed a negative attitude toward CPR. CONCLUSION The expressed willingness to perform bystander CPR was high if the respondents possessed the required skills. Attempts should be made to recruit potential bystanders for CPR courses or education, targeting those respondent subgroups less likely to express willingness to perform CPR. The reason for lower bystander CPR willingness among healthcare providers deserves further investigation.
Collapse
|
36
|
Diaz MCG, Wysocki T, Crutchfield JH, Franciosi JP, Werk LN. Provider-Focused Intervention to Promote Comprehensive Screening for Adolescent Idiopathic Scoliosis by Primary Care Pediatricians. Am J Med Qual 2018; 34:182-188. [PMID: 30095983 DOI: 10.1177/1062860618792667] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Screening can detect adolescent idiopathic scoliosis (AIS). The objective was to determine if computer-based simulation (CBS) and computerized clinical decision-support systems (CCDSS) would improve primary care providers' AIS screening exams as noted in their documentation. All participants received AIS screening CBS training. Participants were then randomized to receive either CCDSS when an eligible patient was seen (intervention arm) or no further intervention (comparison arm). Eligible patients' documentation was analyzed looking for a complete AIS screening exam. Over the span of 17 weeks, 1051 eligible patients were seen; 468 by providers in the intervention arm, 583 in the comparison arm. In all, 292/468 (62%) of eligible patients seen in the intervention arm and 0/583 (0%) in the comparison arm had a complete AIS screening exam documented. Compared with single CBS training alone, repeated exposure to CCDSS after CBS training resulted in improved documentation of the screening exam for AIS.
Collapse
Affiliation(s)
| | - Tim Wysocki
- 2 Nemours Center for Health Care Delivery Science, Jacksonville, FL
| | | | | | | |
Collapse
|
37
|
Abelsson A, Lundberg L. Cardiopulmonary resuscitation quality during CPR practice versus during a simulated life-saving event. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2018; 24:652-655. [PMID: 30059279 DOI: 10.1080/10803548.2018.1502962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION As a part of the emergency medical services, the Swedish fire brigade can increase the survival rate in out-of-hospital cardiac arrests. AIM To compare the quality of cardiopulmonary resuscitation (CPR) performed by firefighters at a routine CPR practice versus when involved in a simulated life-saving event. METHODS In this study, 80 firefighters divided into two groups performed CPR according to guidelines: one group indoors during a routine training session; the other group outdoors during a smoke diving exercise wearing personal protective clothing and self-contained breathing apparatus. Descriptive and inferential statistics were used to analyze the data. RESULTS The results showed a tendency for the outdoor group to perform CPR with better ventilation and compression quality, as compared to the indoor group. The ventilation of the manikin was not hampered by the firefighters wearing personal protective clothes and self-contained breathing apparatus, as the Swedish firefighters remove their facial mask and ventilate the patient with their mouth using a pocket mask. CONCLUSIONS Overall, the results in both groups showed a high quality of CPR which can be related to the fire brigade training and education traditions. CPR training is regularly performed, which in turn helps to maintain CPR skills.
Collapse
Affiliation(s)
- Anna Abelsson
- a School of Health Sciences , Jönköping University , Sweden
| | - Lars Lundberg
- b Centre for Defence Medicine , Swedish Armed Forces , Sweden.,c PreHospen - Centre for Prehospital Research , University of Borås , Sweden
| |
Collapse
|
38
|
Priftanji D, Cawley MJ, Finn LA, Hollands JM, Morel DW, Siemianowski LA, Bingham AL. Performance and retention of basic life support skills improve with a peer-led training program. CURRENTS IN PHARMACY TEACHING & LEARNING 2018; 10:744-749. [PMID: 30025775 DOI: 10.1016/j.cptl.2018.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 12/08/2017] [Accepted: 03/02/2018] [Indexed: 05/06/2023]
Abstract
BACKGROUND AND PURPOSE Pharmacy students' performance and retention of Basic Life Support (BLS) skills were evaluated 120 days after completion of a peer-led BLS training program. EDUCATIONAL ACTIVITY AND SETTING This was a single-center, parallel group, observational study. Doctor of pharmacy (PharmD) students in their third professional year completed a peer-led BLS training program (n = 148) and participated in a high-fidelity mannequin simulation activity 120 days later. Students were randomly assigned to rapid response teams (n = 24) of five to six members and the American Heart Association's standardized form for BLS assessment was used to assess BLS skills performance. The performance of skills was compared to that of students two years prior to the implementation of the peer-led BLS program. FINDINGS AND DISCUSSION Students who received peer-led BLS training demonstrated retention of BLS skills 120 days after the BLS training program. The teams also displayed significant improvement of the skills evaluated when compared to student teams prior to implementation of the peer-led training (n = 22). Improvement was demonstrated for assessment of responsiveness (96% vs. 41%, p < 0.001), assessment for breathing (100% vs. 32%, p < 0.001), assessment for pulse (96% vs. 36%, p < 0.001), and administration of appropriate ventilation (100% vs. 32%, p < 0.001). Numerical superiority was exhibited for high-quality cardiopulmonary resuscitation (CPR) initiation by teams who received peer-led training (100% vs. 86%, p = 0.101). SUMMARY Students who received peer-led BLS training demonstrated significant improvement in BLS skills performance and retention 120 days after the training program. Data suggests that peer-led BLS training can improve student BLS skills performance and retention.
Collapse
Affiliation(s)
- Dorela Priftanji
- Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy University of the Sciences, Philadelphia, PA, United States.
| | - Michael J Cawley
- Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy University of the Sciences, Philadelphia, PA, United States.
| | - Laura A Finn
- Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy University of the Sciences, Philadelphia, PA, United States.
| | - James M Hollands
- Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy University of the Sciences, Philadelphia, PA, United States.
| | - Diane W Morel
- Associate Dean for Academic Affairs and Assessment, South College School of Pharmacy, 400 Goody's Lane, Knoxville, TN, United States.
| | - Laura A Siemianowski
- Department of Pharmacy, Hospital of the University of Pennsylvania, 3400 Spruce Street- Ground Rhoads, Philadelphia, PA, United States.
| | - Angela L Bingham
- Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy University of the Sciences, Philadelphia, PA, United States.
| |
Collapse
|
39
|
Chauvin A, Truchot J, Bafeta A, Pateron D, Plaisance P, Yordanov Y. Randomized controlled trials of simulation-based interventions in Emergency Medicine: a methodological review. Intern Emerg Med 2018; 13:433-444. [PMID: 29147942 DOI: 10.1007/s11739-017-1770-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/10/2017] [Indexed: 11/27/2022]
Abstract
The number of trials assessing Simulation-Based Medical Education (SBME) interventions has rapidly expanded. Many studies show that potential flaws in design, conduct and reporting of randomized controlled trials (RCTs) can bias their results. We conducted a methodological review of RCTs assessing a SBME in Emergency Medicine (EM) and examined their methodological characteristics. We searched MEDLINE via PubMed for RCT that assessed a simulation intervention in EM, published in 6 general and internal medicine and in the top 10 EM journals. The Cochrane Collaboration risk of Bias tool was used to assess risk of bias, intervention reporting was evaluated based on the "template for intervention description and replication" checklist, and methodological quality was evaluated by the Medical Education Research Study Quality Instrument. Reports selection and data extraction was done by 2 independents researchers. From 1394 RCTs screened, 68 trials assessed a SBME intervention. They represent one quarter of our sample. Cardiopulmonary resuscitation (CPR) is the most frequent topic (81%). Random sequence generation and allocation concealment were performed correctly in 66 and 49% of trials. Blinding of participants and assessors was performed correctly in 19 and 68%. Risk of attrition bias was low in three-quarters of the studies (n = 51). Risk of selective reporting bias was unclear in nearly all studies. The mean MERQSI score was of 13.4/18.4% of the reports provided a description allowing the intervention replication. Trials assessing simulation represent one quarter of RCTs in EM. Their quality remains unclear, and reproducing the interventions appears challenging due to reporting issues.
Collapse
Affiliation(s)
- Anthony Chauvin
- Service d'Accueil des Urgences, Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 Rue Ambroise Paré, 75010, Paris, France.
- Faculté de Médecine, Université Diderot, Paris, France.
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel-Dieu Hospital, Paris, France.
| | - Jennifer Truchot
- Service d'Accueil des Urgences, Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 Rue Ambroise Paré, 75010, Paris, France
- Faculté de Médecine, Université Diderot, Paris, France
- Ilumens Simulation Department, Paris Descartes University, 45 rue des Saint Pères, 75006, Paris, France
| | - Aida Bafeta
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel-Dieu Hospital, Paris, France
| | - Dominique Pateron
- Sorbonne Universités, UPMC Paris Univ-06, Paris, France
- Service des Urgences-Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Patrick Plaisance
- Service d'Accueil des Urgences, Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 Rue Ambroise Paré, 75010, Paris, France
- Faculté de Médecine, Université Diderot, Paris, France
| | - Youri Yordanov
- INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), METHODS Team, Hotel-Dieu Hospital, Paris, France
- Sorbonne Universités, UPMC Paris Univ-06, Paris, France
- Service des Urgences-Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| |
Collapse
|
40
|
Empfehlungen der S2e-Leitlinie der Deutschen Gesellschaft für Luft- und Raumfahrtmedizin zu Herz-Kreislauf-Stillstand und kardiopulmonaler Reanimation während Linienflügen. Notf Rett Med 2018. [DOI: 10.1007/s10049-017-0395-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
41
|
Karam N, Narayanan K, Bougouin W, Benameur N, Beganton F, Jost D, Lamhaut L, Perier MC, Cariou A, Celermajer DS, Marijon E, Jouven X. Major regional differences in Automated External Defibrillator placement and Basic Life Support training in France: Further needs for coordinated implementation. Resuscitation 2017; 118:49-54. [DOI: 10.1016/j.resuscitation.2017.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 06/20/2017] [Accepted: 07/04/2017] [Indexed: 11/12/2022]
|
42
|
Clebone A, Burian BK, Watkins SC, Gálvez JA, Lockman JL, Heitmiller ES. The Development and Implementation of Cognitive Aids for Critical Events in Pediatric Anesthesia: The Society for Pediatric Anesthesia Critical Events Checklists. Anesth Analg 2017; 124:900-907. [PMID: 28079584 DOI: 10.1213/ane.0000000000001746] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event. Committee members, who represented children's hospitals from across the nation, used the recent literature and established guidelines (where available) and incorporated the expertise of colleagues at their institutions to develop these checklists, which included relevant factors to consider and steps to take in response to critical events. Human factors principles were incorporated to enhance checklist usability, facilitate error-free accomplishment, and ensure a common approach to checklist layout, formatting, structure, and design.The checklists were made available in multiple formats: a PDF version for easy printing, a mobile application, and at some institutions, a Web-based application using the anesthesia information management system. After the checklists were created, training commenced, and plans for validation were begun. User training is essential for successful implementation and should ideally include explanation of the organization of the checklists; familiarization of users with the layout, structure, and formatting of the checklists; coaching in how to use the checklists in a team environment; reviewing of the items; and simulation of checklist use. Because of the rare and unpredictable nature of critical events, clinical trials that use crisis checklists are difficult to conduct; however, recent and future simulation studies with adult checklists provide a promising avenue for future validation of the SPA checklists. This article will review the developmental steps in producing the SPA crisis checklists, including creation of content, incorporation of human factors elements, and validation in simulation. Critical-events checklists have the potential to improve patient care during emergency events, and it is hoped that incorporating the elements presented in this article will aid in successful implementation of these essential cognitive aids.
Collapse
Affiliation(s)
- Anna Clebone
- From the *Department of Anesthesia and Critical Care, University of Chicago, Chicago, Illinois; †NASA Ames Research Center, Moffett Field, California; ‡Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; §Department of Anesthesiology & Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania; and ‖Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Health System, Washington, DC
| | | | | | | | | | | | | |
Collapse
|
43
|
Nishiyama C, Shimamoto T, Kiyohara K, Kawamura T, Kitamura T, Sakamoto T, Iwami T. Effectiveness of a One-minute Self-retraining for Chest Compression-only Cardiopulmonary Resuscitation: Randomized Controlled Trial. AEM EDUCATION AND TRAINING 2017; 1:200-207. [PMID: 30051035 PMCID: PMC6001494 DOI: 10.1002/aet2.10034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 02/27/2017] [Accepted: 03/09/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Although cardiopulmonary resuscitation (CPR) skills decay after training, little is known about appropriate retraining methods. Our aim was to evaluate the effectiveness of a 1-minute self-retraining (with automated assessment and feedback) at 3 months after the initial 45-minute chest compression-only CPR training in a simulated randomized controlled trial. METHODS After the initial 45-minute chest compression-only CPR training, participants were randomly assigned to either a 1-minute self-retraining group or a control group. Three months after the initial training, the self-retraining group individually attended the 1-minute self-retraining with a self-training device. The participants' resuscitation skills were evaluated by a 2-minute case-based scenario test 6 months after the initial training. The primary outcome was the number of correct chest compressions with appropriate depth. RESULTS A total of 109 subjects participated in this study. With regard to the primary outcome, the number of chest compressions performed at the appropriate depth, there was not a statistically significant difference between groups (136.5 [39.8-204.5] in the self-retraining group versus 88.0 [8.5-162.0] in the control group, p = 0.66). The number of total chest compressions in the self-retraining group was 214.0 (186.5-236.0), which was significantly greater (p = 0.01) than that of the control group (177.0 [117.5-215.0]). The time without chest compressions was significantly shorter in the self-retraining group (0 [0-5.3] seconds vs. 23.0 [0.5-47.0] seconds, p = 0.01). CONCLUSIONS The 1-minute self-retraining program with hands-on practice appears to help preserve certain chest compression skills. Further efforts to provide methods to maintain CPR skills should be considered.
Collapse
Affiliation(s)
- Chika Nishiyama
- Department of Critical Care NursingKyoto University Graduate School of Human Health ScienceKyotoJapan
| | | | - Kosuke Kiyohara
- Department of Public HealthTokyo Women's Medical UniversityTokyoJapan
| | | | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population SciencesDepartment of Social and Environmental MedicineGraduate School of MedicineOsaka UniversityOsakaJapan
| | - Tetsuya Sakamoto
- Department of Emergency MedicineTeikyo University School of MedicineTokyoJapan
| | - Taku Iwami
- Kyoto University Health ServiceKyotoJapan
| |
Collapse
|
44
|
Kim YJ, Cho Y, Cho GC, Ji HK, Han SY, Lee JH. Retention of cardiopulmonary resuscitation skills after hands-only training versus conventional training in novices: a randomized controlled trial. Clin Exp Emerg Med 2017; 4:88-93. [PMID: 28717778 PMCID: PMC5511957 DOI: 10.15441/ceem.16.175] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 02/17/2017] [Accepted: 02/28/2017] [Indexed: 11/30/2022] Open
Abstract
Objective Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study is to compare the retention rate of CPR skills in laypersons after hands-only or conventional CPR training. Methods Participants were randomly assigned to 1 of 2 CPR training methods: 80 minutes of hands-only CPR training or 180 minutes of conventional CPR training. Each participant’s CPR skills were evaluated at the end of training and 3 months thereafter using the Resusci Anne manikin with a skill-reporting software. Results In total, 252 participants completed training; there were 125 in the hands-only CPR group and 127 in the conventional CPR group. After 3 months, 118 participants were randomly selected to complete a post-training test. The hands-only CPR group showed a significant decrease in average compression rate (P=0.015), average compression depth (P=0.031), and proportion of adequate compression depth (P=0.011). In contrast, there was no difference in the skills of the conventional CPR group after 3 months. Conclusion Conventional CPR training appears to be more effective for the retention of chest compression skills than hands-only CPR training; however, the retention of artificial ventilation skills after conventional CPR training is poor.
Collapse
Affiliation(s)
- Young Joon Kim
- Department of Emergency Medicine, Kang Dong Sacred Heart Hospital, Hallym University School of medicine, Seoul, Korea
| | - Youngsuk Cho
- Department of Emergency Medicine, Kang Dong Sacred Heart Hospital, Hallym University School of medicine, Seoul, Korea
| | - Gyu Chong Cho
- Department of Emergency Medicine, Kang Dong Sacred Heart Hospital, Hallym University School of medicine, Seoul, Korea
| | - Hyun Kyung Ji
- Department of Emergency Medical Technology, Baekseok University, Cheonan, Korea
| | - Song Yi Han
- Department of Emergency Medical Technology, Baekseok University, Cheonan, Korea
| | - Jin Hyuck Lee
- Department of Emergency Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| |
Collapse
|
45
|
Simulation and Web-based learning increases utilization of Bier block for forearm fracture reduction in the pediatric emergency department. CAN J EMERG MED 2016; 19:434-440. [PMID: 27866507 DOI: 10.1017/cem.2016.392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Bier block (BB) is a safe and effective alternative to procedural sedation for analgesia during forearm fracture reductions, yet remains infrequently used in the pediatric emergency department (PED). No standardized methods of BB training have previously been described. The objective of this study was to determine whether a multimodal instructional course increases comfort with BB and translates to increased use of this technique. METHODS A novel interdisciplinary simulation and Web-based training course was developed to teach the use of BB for forearm fracture reduction at a tertiary PED. Participants were surveyed pre-/post-training, and at 2 and 6 months regarding their comfort with BB. In parallel, we prospectively assessed the clinical use of BB for children ages 6 to 18 years requiring closed reduction of forearm fractures during the 24-month post-course period. RESULTS Course participation included 26 physicians and 12 nurses. Survey response rate was 100%. Course participation increased both comfort (10% pre-training v. 89% post-training, p<0.001) and the willingness to use BB (51% pre-training v. 95% post-training, p<0.001), an effect sustained at 6 months post-course (66% and 92%, respectively, p<0.001 for both). In clinical practice, there were no BBs performed prior to course administration. We observed a consistent and sustained increase in clinical use among the BB-trained physicians, with 37% of all forearm reductions performed using BB at 24 months post-course completion. CONCLUSIONS A novel combined simulation and Web-based training course increased comfort and willingness to use BB and was associated with increased use of this technique for forearm fracture reduction in the PED.
Collapse
|
46
|
Bhanji F, Donoghue AJ, Wolff MS, Flores GE, Halamek LP, Berman JM, Sinz EH, Cheng A. Part 14: Education: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2016; 132:S561-73. [PMID: 26473002 DOI: 10.1161/cir.0000000000000268] [Citation(s) in RCA: 202] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
47
|
Kobras M, Langewand S, Murr C, Neu C, Schmid J. Short lessons in basic life support improve self-assurance in performing cardiopulmonary resuscitation. World J Emerg Med 2016; 7:255-262. [PMID: 27942341 DOI: 10.5847/wjem.j.1920-8642.2016.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There are several reasons why resuscitation measures may lead to inferior results: difficulties in team building, delayed realization of the emergency and interruption of chest compression. This study investigated the outcome of a new form of in-hospital cardiopulmonary resuscitation (CPR) training with special focus on changes in self-assurance of potential helpers when faced with emergency situations. METHODS Following a 12-month period of CPR training, questionnaires were distributed to participants and non-participants. Those non-participants who intended to undergo the training at a later date served as control group. RESULTS The study showed that participants experienced a significant improvement in self-assurance, compared with their remembered self-assurance before the training. Their self-assurance also was significantly greater than that of the control group of non-participants. CONCLUSION Short lessons in CPR have an impact on the self-assurance of medical and non-medical personnel.
Collapse
Affiliation(s)
- Mario Kobras
- Department of Anaesthesiology, Intensive Care and Emergency Medicine, Asklepios Western Clinical Centre, 20 Suurheid, City of Hamburg 22559, Federal Republic of Germany
| | - Sascha Langewand
- Academy of the Rescue Service Cooperation in Schleswig-Holstein, 50 Esmarch Street, City of Heide 25746, Federal Republic of Germany
| | - Christina Murr
- Academy of the Rescue Service Cooperation in Schleswig-Holstein, 50 Esmarch Street, City of Heide 25746, Federal Republic of Germany
| | - Christiane Neu
- Regio Clinical Center GmbH, Sana Group, 71-75 Ramskamp, Elmshorn 25337, County of Pinneberg, Federal Republic of Germany
| | - Jeannette Schmid
- Executive Committee of the Goethe University, Frankfurt a.M., City of Frankfurt 60323, Federal Republic of Germany
| |
Collapse
|
48
|
Bakhbakhi D, Gamaleldin I, Siassakos D. Cardiopulmonary resuscitation of pregnant women. Resuscitation 2015; 91:A5-6. [PMID: 25840142 DOI: 10.1016/j.resuscitation.2015.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 03/23/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Danya Bakhbakhi
- Chilterns, Women's Health, Southmead Hospital, Bristol BS10 5NB, UK.
| | - Islam Gamaleldin
- Chilterns, Women's Health, Southmead Hospital, Bristol BS10 5NB, UK.
| | | |
Collapse
|