Practice Of Cardiopulmonary Resuscitation Research Articles

Self-confidence and level of knowledge after cardiopulmonary resuscitation training in 14 to 18-year-old schoolchildren: A randomised-interventional controlled study in secondary schools in Germany.

Education of schoolchildren in cardiopulmonary resuscitation (CPR) is a strategic goal for improvement of bystander CPR in society. The primary objective was to analyse the impact of CPR training on the resuscitation knowledge and self-confidence of secondary schoolchildren. In addition, independent predictors of improved CPR knowledge and self-confidence were investigated. Randomised-interventional controlled study. Four secondary schools in Germany. Four hundred and twenty-four schoolchildren aged from 14 to 18 years were included into the study. Fifty-one percent were female, and 33% had an immigrant background. The intervention group received a 90-min CPR training session, whereas controls had no intervention. Levels of knowledge and self-confidence in initiating CPR were analysed by a study questionnaire before (t0), 90 min after (t1) and 6 months after training (t2). Based on the evaluation of study questionnaires, the primary endpoint was to determine the development of resuscitation knowledge and self-confidence in initiating cardiopulmonary resuscitation at survey time-points t0, t1 and t2. Schoolchildren in the intervention group (n=207) showed a significantly higher level of knowledge (P < 0.001) and self-confidence (P < 0.001) at t1 and t2 compared with controls (n=217). Age was a predictor for long-term self-confidence [odds ratio (OR), 1.20; 95% confidence interval (95% CI), 1.02 to 1.41; P = 0.032]. The long-term benefit in the level of knowledge and self-confidence were significantly higher in native compared with immigrant schoolchildren: (OR, 1.79; 95% CI, 1.14 to 2.82; P = 0.011) and (OR, 1.67; 95% CI, 1.07 to 2.60; P = 0.024), respectively. Guideline compliant (90 min) theoretical and practical CPR training improves the level of knowledge and self-confidence in 14 to 18-year-old schoolchildren. Older schoolchildren are more likely to have increased self-confidence with respect to initiating CPR. Schoolchildren with an immigrant background showed a significantly lower increase in their level of knowledge and self-confidence compared with native children. Adaptation and simplification of teaching materials and further research on educational methods for CPR are urgently needed to enable a sustainable approach to teaching CPR, which also produces a long-lasting effect in the entire population.

How Ventilation Is Delivered During Cardiopulmonary Resuscitation: An International Survey.

Recommendations regarding ventilation during cardiopulmonary resuscitation (CPR) are based on a low level of scientific evidence. We hypothesized that practices about ventilation during CPR might be heterogeneous and may differ worldwide. To address this question, we surveyed physicians from several countries on their practices during CPR. We used a Web-based opinion survey. Links to the survey were sent by e-mail newsletters and displayed on the Web sites of medical societies involved in CPR practice from December 2013 to March 2014. 1,328 surveys were opened, and 548 were completed (41%). Responses came from 54 countries, but 64% came from 6 countries. Responders were mostly physicians (89%). From this group, 97% declared following specific CPR guidelines. Regarding practices, 28% declared always or frequently adopting only continuous chest compressions without additional ventilation. With regard to mechanical chest compression devices, 38% responded that such devices were available to them; when used, 28% declared always or frequently experiencing problems with ventilation such as frequent alarms. During bag-mask ventilation in intubated patients, 18% declared stopping chest compression during insufflation, and 39% applied > 10 breaths/min, which conflicts with international CPR guidelines. When a ventilator was used, the volume controlled mode was the most common strategy cited, but there was heterogeneity regarding ventilator settings for PEEP, trigger, FIO2 , and breathing frequency. SpO2 and end-tidal CO2 were the 2 most monitored variables cited. Physicians indicated heterogeneous practices that often differ significantly from international CPR guidelines. This may reflect the low level of evidence and a lack of detailed recommendations concerning ventilation during CPR.

Extracorporeal Cardiopulmonary Resuscitation in the Pediatric Cardiac Population: In Search of a Standard of Care.

Although clinical and pharmacologic guidelines exist for the practice of cardiopulmonary resuscitation in children (Pediatric Advanced Life Support), the practice of extracorporeal cardiopulmonary resuscitation in pediatric cardiac patients remains without universally accepted standards. We aim to explore variation in extracorporeal cardiopulmonary resuscitation procedures by surveying clinicians who care for this high-risk patient population. A 28-item cross-sectional survey was distributed via a web-based platform to clinicians focusing on cardiopulmonary resuscitation practices and extracorporeal membrane oxygenation team dynamics immediately prior to extracorporeal membrane oxygenation cannulation. Pediatric hospitals providing extracorporeal mechanical support services to patients with congenital and/or acquired heart disease. Critical care/cardiology specialist physicians, cardiothoracic surgeons, advanced practice nurse practitioners, respiratory therapists, and extracorporeal membrane oxygenation specialists. None. Survey web links were distributed over a 2-month period with critical care and/or cardiology physicians comprising the majority of respondents (75%). Nearly all respondents practice at academic/teaching institutions (97%), 89% were from U.S./Canadian institutions and 56% reported less than 10 years of clinical experience. During extracorporeal cardiopulmonary resuscitation, a majority of respondents reported adherence to guideline recommendations for epinephrine bolus dosing (64%). Conversely, 19% reported using only one to three epinephrine bolus doses regardless of extracorporeal cardiopulmonary resuscitation duration. Inotropic support is held after extracorporeal membrane oxygenation cannulation "most of the time" by 58% of respondents and 94% report using afterload reducing/antihypertensive agents "some" to "most of the time" after achieving full extracorporeal membrane oxygenation support. Interruptions in chest compressions are common during active cannulation according to 77% of respondents. The results of this survey identify wide variability in resuscitative practices during extracorporeal cardiopulmonary resuscitation in the pediatric cardiac population. The deviations from established Pediatric Advanced Life Support CPR guidelines support a call for further inquiry into the pharmacologic and logistical care surrounding extracorporeal cardiopulmonary resuscitation.

Analisis Pengaruh Pelatihan Resusitasi Jantung Paru RJP Dewasa terhadap Retensi Pengetahuan dan Ketrampilan RJP pada Mahasiswa Keperawatan di Yogyakarta

&lt;p&gt;&lt;strong&gt;ABSTRACT &lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Cardiac arrest is a major public health problem affecting thousands of individuals each year in both out-of-hospital and in-hospital setting. High quality of cardiopulmonary resuscitation (CPR) provide return of spontaneous after cardiac arrest, but majority of nursing students feel unconfident to practice CPR. The aim of the study was to assess the effect of CPR training program on knowledge and practices of nursing students in Yogyakarta. The study design was quasi-experimental and one group pretest – posttest&lt;em&gt; &lt;/em&gt;design. A questionnaire was applied to the students before CPR training, then the student were informed about adult CPR by the researchers and all of the students practice CPR on a Resusci-Anne manikin. One months after this training the same questionnaire and skills checklist of CPR were apllied. Sixty five students of nursing participated in this study. This study show CPR training significantly positive impact cognitive and skills performance in nursing students. While the average CPR knowledge score of these students was 44,43%, before CPR training, this average increased to 89,64% after CPR training and decreased to 77,54% after one month CPR training. Skill score of the students one month after the CPR skill training was 70,61%. Nursing students tend to forget theoretical and applied CPR training after one month. Hence there is a need for continuous CPR training and education and repeating the skills at regular intervals ever after they have graduated to ensure sustainability in the CPR skills.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Keywords :&lt;/strong&gt; cardiopulmonary resuscitation, bystander CPR, training&lt;/p&gt;&lt;p&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;ABSTRAK&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Henti jantung merupakan penyebab kematian utama pada kasus kegawatdaruratan kardiovaskuler, baik pada setting prehospital (OHCA) maupun intrahospital. RJP yang berkualitas dapat mengoptimalkan &lt;em&gt;return of spontaneous circulation &lt;/em&gt;pada OHCA, tetapi banyak mahasiswa keperawatan tidak percaya diri dalam melakukan prosedur ini sehingga mereka membutuhkan pelatihan RJP&lt;em&gt;, &lt;/em&gt;agar dapat berespon cepat, tanggap dan akurat dalam memberikan pertolongan pada korban OHCA. Penelitian ini menguji pengaruh pelatihan RJP dewasa terhadap retensi pengetahuan dan ketrampilan RJP pada mahasiswa keperawatan di Yogyakarta. Jenis penelitian &lt;em&gt;quasi experimental&lt;/em&gt; dengan design &lt;em&gt;one group pretest – posttest&lt;/em&gt;. &lt;em&gt;Posttest&lt;/em&gt; diberikan dua kali, yaitu sesaat sesudah pelatihan dan sebulan sesudah pelatihan. Jumlah sampel yaitu 65 orang. Analisa data menggunakan &lt;em&gt;pair t-test&lt;/em&gt;. Hasilnya,&lt;strong&gt; &lt;/strong&gt;pelatihan RJP berpengaruh positif terhadap pengetahuan dan ketrampilan &lt;em&gt;bystander &lt;/em&gt;RJP dengan p-value 0,000 (&amp;lt;0,001). Rerata skor awal&lt;em&gt; &lt;/em&gt;pengetahuan 44,43%, rerata skor sesaat sesudah pelatihan 89,64% dan rerata skor sebulan sesudah pelatihan adalah 77,54%.&lt;strong&gt; &lt;/strong&gt;Rata-rata skor ketrampilan sebelum pelatihan adalah 35,55%, rerata skor sesaat setelah pelatihan 91,80% dan rerata skor sebulan setelah pelatihan 70,61%. Penurunan retensi pengetahuan dan ketrampilan mahasiswa sebulan sesudah pelatihan RJP kemungkinan disebabkan karena mahasiswa kurang terpapar kasus pasien dengan henti jantung yang membutuhkan tindakan RJP.&lt;/p&gt;&lt;strong&gt;Kata Kunci: &lt;/strong&gt;resusitasi jantung paru, pelatihan, &lt;em&gt;bystander&lt;/em&gt; RJP&lt;strong&gt;&lt;/strong&gt;

Medical skills training for undergraduate dental students

Context: Medical emergencies can happen at any time; dentists and dental students as the members of the health-care system are expected to play an effective role in these situations. All dental schools in Iran provide dental students with the dental emergency management course, but the course is theoretical, and students do not find the opportunity to practice different maneuvers, especially airway management maneuvers, injection, and cardiopulmonary resuscitation (CPR). Aims: In this study, we investigated the necessity of learning medical skills, including injection, establishing intravenous line access, practical CPR, and first aid, on undergraduate dental students using a questionnaire. Settings and Design: In this cross-sectional study, 84 dental students were enrolled to fill out a questionnaire about the necessity of learning certain clinical skills; they subsequently participated in a 1-day-long practical medical skills training workshop. Materials and Methods: We enrolled 84 dental students in our study to fill out a questionnaire, and then we held a 1-day-long practical medical skills training workshop for 2 days to study if workshops are effective to achieve the desired educational goals or not. Statistical Analysis Used: SPSS software version 20 (Chicago, IL, USA) was used to analyze the data. Descriptive measures were used for the assessment of the categorical data. Results: Almost all students agreed on the necessity of learning mentioned skills, including blood pressure measurement, injection, CPR, and first aid. Most of them believed that medical skills training for students would enhance their knowledge. Conclusions: Our results showed that most of the students believed that learning mentioned skills in the dentistry educational curriculum is necessary and should be included in the educational program. We suggest that dental students be introduced to these educations throughout their professional curriculum. Our pilot evaluation suggests that workshops would be effective to achieve the desired goals.

European cardiovascular nurses’ and allied professionals’ knowledge and practical skills regarding cardiopulmonary resuscitation

Cardiopulmonary resuscitation (CPR) remains a cornerstone in the treatment of cardiac arrest, and is directly linked to survival rates. Nurses are often first responders and need to be skilled in the performance of cardiopulmonary resuscitation. As cardiopulmonary resuscitation skills deteriorate rapidly, the purpose of this study was to investigate whether there was an association between participants' cardiopulmonary resuscitation training and their practical cardiopulmonary resuscitation test results. This comparative study was conducted at the 2014 EuroHeartCare meeting in Stavanger ( n=133) and the 2008 Spring Meeting on Cardiovascular Nursing in Malmö ( n=85). Participants performed cardiopulmonary resuscitation for three consecutive minutes CPR training manikins from Laerdal Medical®. Data were collected with a questionnaire on demographics and participants' level of cardiopulmonary resuscitation training. Most participants were female (78%) nurses (91%) from Nordic countries (77%), whose main role was in nursing practice (63%), and 71% had more than 11 years' experience ( n=218). Participants who conducted cardiopulmonary resuscitation training once a year or more ( n=154) performed better regarding ventilation volume than those who trained less (859 ml vs. 1111 ml, p=0.002). Those who had cardiopulmonary resuscitation training offered at their workplace ( n=161) also performed better regarding ventilation volume (889 ml vs. 1081 ml, p=0.003) and compression rate per minute (100 vs. 91, p=0.04) than those who had not. Our study indicates a positive association between participants' performance on the practical cardiopulmonary resuscitation test and the frequency of cardiopulmonary resuscitation training and whether cardiopulmonary resuscitation training was offered in the workplace. Large ventilation volumes were the most common error at both measuring points.

Effectiveness of hands-on cardiopulmonary resuscitation practice with self-debriefing for healthcare providers: A simulation-based controlled trial

Introduction: The psychomotor skill of cardiopulmonary resuscitation emphasized the importance of high-quality chest compression. This investigation examined the effect of self-debriefing and the different materials of debriefing during hands-on cardiopulmonary resuscitation practice for healthcare providers. Methods: This was a randomized controlled trial of a cardiopulmonary resuscitation training program involving emergency medical technicians in northern Taiwan. Participants were blinded to the study purpose and were allocated randomly using the black envelope method. All participants completed a 2-min pre-test of hands-only cardiopulmonary resuscitation using a manikin. Those who were allocated to the control group received self-debriefing with knowledge of pre-test result. Those who were allocated to the experimental group received self-debriefing with an additional biomechanical information of performance of chest compression. A post-test was performed 30 min after the pre-test. Results: A total of 88 participants were enrolled with 44 in each group. There was significant difference of cardiopulmonary resuscitation quality after self-debriefing among all participants (pre- vs post-test adequate rate, 54.7% vs 67.5%, p = 0.028; adequate depth, 41.2% vs 69.5%, p &lt; 0.001; full recoil, 35.9% vs 54.5%, p = 0.001). The analysis of effects of self-debriefing with additional knowledge of performance revealed no significant difference in any of the measurements (improvement in adequate rate, 11.3% vs 14.2%, p = 0.767; adequate depth, 29.6% vs 27.0%, p = 0.784; full recoil, 23.0% vs 14.1%, p = 0.275). Conclusion: Self-debriefing improved hands-only cardiopulmonary resuscitation quality whether or not biomechanical information of performance of chest compression was given.

Ventilation during cardiopulmonary resuscitation in children: a survey on clinical practice.

This study aimed to investigate the ventilation practice during cardiopulmonary resuscitation (CPR) and after return of spontaneous circulation (ROSC) in children. An online survey of CPR practices was designed and sent to healthcare professionals treating children. A total of 477 healthcare professionals from 46 countries responded to this survey; 92.7% were physicians and 64.2% worked in pediatric intensive care units. Specific CPR guidelines were used by 97.7% of respondents. The respiratory rate most frequently used for children over 12 months was 13 to 20 respirations per minute (rpm) (46% in intubated and 41.8% in non-intubated). For infants under 12 months, the most frequently used respiratory rate was 21 to 30 rpm in intubated patients (37.3%): in non-intubated infants, 13 to 20 rpm (26.5%) and 21 to 30 rpm (26.5%) were used with the same frequency. In North America, the respiratory rate most widely used was 7 to 12 rpm; higher rates (13 to 20 rpm and 21 to 30 rpm) were used in Europe and Latin America (P<0.001). After ROSC, no significant differences in the respiratory rates used were found between the continents. More than 40% of healthcare professionals had a target oxygen saturation below 94%; more than 10% used a target arterial PCO2 below 35 mmHg and more than 13% above 45 mmHg. There is considerable variation in the management of ventilation of children in cardiac arrest, and international recommendations are not being followed in a high percentage of cases.

The effect of a national web course \u201cHelp-Brain-Heart\u201d as a supplemental learning tool before CPR training: a cluster randomised trial

BackgroundThe effectiveness of cardiopulmonary resuscitation (CPR) learning methods is unclear. Our aim was to evaluate whether a web course before CPR training, teaching the importance of recognition of symptoms of stroke and acute myocardial infarction (AMI) and a healthy lifestyle, could influence not only theoretical knowledge but also practical CPR skills or willingness to act in a cardiac arrest situation.MethodsClasses with 13-year-old students were randomised to CPR training only (control) or a web course plus CPR training (intervention). Data were collected (practical test and a questionnaire) directly after training and at 6 months. CPR skills were evaluated using a modified Cardiff test (12–48 points). Knowledge on stroke symptoms (0–7 points), AMI symptoms (0–9 points) and lifestyle factors (0–6 points), and willingness to act were assessed by the questionnaire. The primary endpoint was CPR skills at 6 months. CPR skills directly after training, willingness to act and theoretical knowledge were secondary endpoints. Training and measurements were performed from December 2013 to October 2014.ResultsFour hundred and thirty-two students were included in the analysis of practical skills and self-reported confidence. The mean score for CPR skills was 34 points after training (control, standard deviation [SD] 4.4; intervention, SD 4.0; not significant [NS]); and 32 points at 6 months for controls (SD 3.9) and 33 points for intervention (SD 4.2; NS). At 6 months, 73% (control) versus 80% (intervention; P = 0.05) stated they would do compressions and ventilation if a friend had a cardiac arrest, whereas 31% versus 34% (NS) would perform both if the victim was a stranger. One thousand, two hundred and thirty-two students were included in the analysis of theoretical knowledge; the mean scores at 6 months for the control and intervention groups were 2.8 (SD 1.6) and 3.2 (SD 1.4) points (P < 0.001) for stroke symptoms, 2.6 (SD 2.0) and 2.9 (SD 1.9) points (P = 0.008) for AMI symptoms and 3.2 (SD 1.2) and 3.4 (SD 1.0) points (P < 0.001) for lifestyle factors, respectively.DiscussionUse of online learning platforms is a fast growing technology that increases the flexibility of learning in terms of location, time and is available before and after practical training.ConclusionsA web course before CPR training did not influence practical CPR skills or willingness to act, but improved the students’ theoretical knowledge of AMI, stroke and lifestyle factors.

Knowledge, attitude and practice study on cardiopulmonary resuscitation among medical and nursing interns

Background: Cardiac arrest is a substantial public health problem estimated to account for 15–20% of all death. It is documented that a timely performed cardiopulmonary resuscitation (CPR) can largely prevent sudden death. Being important members of the health care delivery team, medical professionals and nursing staff are deemed to pass the basic skills and expertise which are needed to perform CPR. The principle objectives of the research project are to assess knowledge and attitude of CPR and to compare knowledge regarding CPR among medical and nursing students.Methods: It was a cross sectional study for duration of 2 month from March 2013 to April 2013, conducted among 100 nursing and medical interns of a tertiary care institute in Vijayawada (A.P). Pre tested structured questionnaire of 2010 American health association guidelines for CPR and basic life support (BLS) Practice Test of National Health Care Provider Solutions of 30 questions were used to assess the knowledge, attitude and practice among study participants. Results: The median for knowledge score of MBBS interns was 6 with inter-quartile range 2 and the median for the knowledge score of nursing interns was 6 with inter-quartile range 1. The median for the practice score for MBBS interns was 5 with inter-quartile range of 2.25 and median for practice score in case of nursing interns was 4 with inter-quartile range 2. 36% of MBBS interns had poor knowledge score and 46% of nursing interns had poor knowledge score. Conclusions: The present study identified the knowledge and practice score of BLS or CPR which is poor in both medical and nursing students, even though they have positive and good attitude towards it. BLS training should be the part of the curriculum to solve this issue.

Effect of two additional interventions, test and reflection, added to standard cardiopulmonary resuscitation training on seventh grade students’ practical skills and willingness to act: a cluster randomised trial

ObjectivesThe aim of this research is to investigate if two additional interventions, test and reflection, after standard cardiopulmonary resuscitation (CPR) training facilitate learning by comparing 13-year-old students’ practical skills and...

장애인활동보조인의 심폐소생술 실습교육 효과

Purpose This study was conducted to identify the effects of cardiopulmonary resuscitation (CPR) practice education on CPR knowledge, attitude, confidence, learning satisfaction and performance of the personal assistants for the disabled. Methods This is a quasi-experimental study with a non-equivalent control group. The participants were 62 personal assistants for the disabled. Thirty-one subjects were assigned to an experimental group and the remaining subjects were assigned to a control group. The date collected were analyzed using the IBM SPSS Statistics 20.0 program by descriptive statistics, χ²-test, Fisher’s exact test, and t-test. Results CPR practice education was found to have a meaningful effect on CPR knowledge (p<.001), learning satisfaction (p<.001), and performance (p<.001) of the personal assistants for the disabled. Conclusion Considering these results, it would be useful to develop CPR practice curriculum to enhance CPR knowledge, attitude, confidence, learning satisfaction and performance of the personal assistants for the disabled. Keywords: Cardiopulmonary resuscitation, Attitude, Knowledge, Satisfaction 주요어: ì‹¬íì†Œìƒìˆ , 태도, 지식, 만족도

Cardiopulmonary resuscitation knowledge among nursing students: a questionnaire study.

Objective:Nurses are usually first witnesses to in-hospital sudden cardiac arrests. Training of nurses has an impact on the efficiency and outcome of cardiopulmonary resuscitation (CPR), and thus, assessment of CPR knowledge among undergraduate nurses is very important to improve training program.Methods:The questionnaire comprised of three parts about CPR knowledge: the first dealing with general questions to understand the importance of CPR in clinical practice; the second comprising the main goal and accuracy of CPR intervention; and the last consisting of questions targeting the indications, methods, and effectiveness of CPR. Descriptive statistics and multiple response analyses were done by IBM SPSS version 20.Results:The students had good knowledge about the importance of CPR in clinical practice and stood average in knowing its indications and effectiveness. The mean score was 64.62±17.84 out of 100 points. While only 11% of them were completely aware about the universal compression ventilation ratio, 16.2% were aware of the current compression depth. In addition, 21.8% of participants have only indicated the order of CPR being compression, airway, and breathing.Conclusion:Knowledge of CPR is good among the nursing students. However, skills of CPR have to be improved by current training programs at regular intervals. Their knowledge and practical approach have to be updated with the current guidelines in CPR.

Chapter 32 - Neurology of cardiopulmonary resuscitation

This chapter aims to provide an up-to-date review of the science and clinical practice pertaining to neurologic injury after successful cardiopulmonary resuscitation. The past two decades have seen a major shift in the science and practice of cardiopulmonary resuscitation, with a major emphasis on postresuscitation neurologic care. This chapter provides a nuanced and thoughtful historic and bench-to-bedside overview of the neurologic aspects of cardiopulmonary resuscitation. A particular emphasis is made on the anatomy and pathophysiology of hypoxic-ischemic encephalopathy, up-to-date management of survivors of cardiopulmonary resuscitation, and a careful discussion on neurologic outcome prediction. Guidance to practice evidence-based clinical care when able and thoughtful, pragmatic suggestions for care where evidence is lacking are also provided. This chapter serves as both a useful clinical guide and an updated, thorough, and state-of-the-art reference on the topic for advanced students and experienced practitioners in the field.

Implementing Cardiopulmonary Resuscitation Training Programs in High Schools: Iowa's Experience

To understand perceived barriers to providing cardiopulmonary resuscitation (CPR) education, implementation processes, and practices in high schools. Iowa has required CPR as a graduation requirement since 2011 as an unfunded mandate. A cross-sectional study was performed through multiple choice surveys sent to Iowa high schools to collect data about school demographics, details of CPR programs, cost, logistics, and barriers to implementation, as well as automated external defibrillator training and availability. Eighty-four schools responded (26%), with the most frequently reported school size of 100-500 students and faculty size of 25-50. When the law took effect, 51% of schools had training programs already in place; at the time of the study, 96% had successfully implemented CPR training. Perceived barriers to implementation were staffing, time commitment, equipment availability, and cost. The average estimated startup cost was <$1000 US, and the yearly maintenance cost was <$500 with funds typically allocated from existing school resources. The facilitator was a school official or volunteer for 81% of schools. Average estimated training time commitment per student was <2 hours. Automated external defibrillators are available in 98% of schools, and 61% include automated external defibrillator training in their curriculum. Despite perceived barriers, school CPR training programs can be implemented with reasonable resource and time allocations.

The implementation of strategies to improve cardiopulmonary resuscitation practice in the hospital setting: A national survey

The implementation of strategies to improve cardiopulmonary resuscitation practice in the hospital setting: A national survey

A new method to detect ventricular fibrillation from CPR artifact-corrupted ECG based on the ECG alone

Abstract During cardiopulmonary resuscitation, chest compressions (CCs) introduce mechanical activity in the ECG and thus preclude a reliable electrocardiographic (ECG) rhythm diagnosis. To achieve a reliable rhythm analysis, chest compression must therefore be interrupted, and therefore, the probability of the restoration of spontaneous circulation (ROSC) is adversely affected. In recent years, a number of algorithms have been developed to distinguish ventricular fibrillation (VF) rhythm from normal sinus rhythm (SR) without chest compression (CC) interruptions. However, the implementation of most of these algorithms relies on the acquisition of reference signals that are strongly correlated with CC artifacts and makes additional hardware alteration inevitable. In the present work, a novel method (the enhanced LMS method) that effectively suppresses CPR artifacts and can easily use the corrupted ECG signal alone is developed for the reliable detection of the VF rhythm during uninterrupted CCs. The enhanced LMS method was tested using mixtures of CC artifacts and real out-of-hospital ECG recordings for different corruption levels, and it was compared with other established algorithms that use the corrupted ECG signal alone, including the morphology consistency evaluation algorithm and the adaptive stop-band filtering algorithm. The validation results indicate that the enhanced LMS method has superior performance in VF/SR rhythm classification under different artifact interference levels. It is shown that the VF rhythm can be reliably detected using only the corrupted ECG alone. The novel method proposed in this study is promising for identification VF from SR with no hardware alterations for clinical cardiopulmonary resuscitation practice.

Effect of mobile application-based versus DVD-based CPR training on students’ practical CPR skills and willingness to act: a cluster randomised study

ObjectivesThe aim was to compare students’ practical cardiopulmonary resuscitation (CPR) skills and willingness to perform bystander CPR, after a 30 min mobile application (app)-based versus a 50 min DVD-based training.SettingsSeventh...

Transition from NICU to Home: Are the Parents Ready to Manage Any Emergency? An Evidence-Based Project.

Transitioning the care of a previously critically ill infant to home poses many challenges for the parents. Prior to the infant's discharge, the parents undergo rigorous training to continue the care of their infants at home. Even after training, parents may feel overwhelmed by the thought of managing an emergency at home. This evidence-based practice project aims to provide parents with additional hands-on practice of cardiopulmonary resuscitation (CPR) prior to their infant's discharge. Based on this project, a program of teaching CPR regularly is established currently in the NICU at Nemours Alfred I. duPont Hospital for Children.

Assessment of cardiopulmonary resuscitation practices in emergency departments for out-of-hospital cardiac arrest victims in Lebanon.

Background:The survival rate of out-of-hospital cardiac arrest (OHCA) victims in Lebanon is low. A national policy on resuscitation practice is lacking. This survey explored the practices of emergency physicians related to the resuscitation of OHCA victims in Lebanon.Methods:A sample of 705 physicians working in emergency departments (EDs) was recruited and surveyed using the LimeSurvey software (Carsten Schmitz, Germany). Seventy-five participants responded, yielding 10.64% response rate.Results:The most important factors in the participants’ decision to initiate or continue resuscitation were presence of pulse on arrival (93.2%), underlying cardiac rhythm (93.1%), the physician’s ethical duty to resuscitate (93.2%), transport time to the ED (89%), and down time (84.9%). The participants were optimistic regarding the survival of OHCA victims (58.1% reporting > 10% survival) and reported frequent resuscitation attempts in medically futile situations. The most frequently reported challenges during resuscitation decisions were related to pressure or presence of victim’s family (38.8%) and lack of policy (30%).Conclusion:In our setting, physicians often rely on well-established criteria for initiating/continuing resuscitation; however, their decisions are also influenced by cultural factors such as victim’s family wishes. The findings support the need for a national policy on resuscitation of OHCA victims.