Effective Cardiopulmonary Resuscitation Research Articles

Online training to improve BLS performance with dispatcher assistance? Results of a cluster-randomised controlled simulation trial

BackgroundThe prognosis for patients improves significantly with effective cardiopulmonary resuscitation (CPR) performed by bystanders. Current research indicates that individuals who receive CPR from trained bystanders have a greater likelihood of survival compared to those who receive dispatcher-assisted CPR from untrained laypersons. This cluster-randomised controlled trial assessed the impact of a 30-min online training session prior to a simulated cardiac arrest situation with dispatcher-assisted CPR (DA-CPR) on enhancing Basic Life Support (BLS) performance.MethodsThis study was performed in 2018 in Hamburg, Germany. The primary outcome was the practical BLS skills of high school students in simulated out-of-hospital cardiac arrest scenarios with dispatcher assistance. The intervention group participants underwent a 30-min online BLS training session, while the control group did not receive an intervention. It was hypothesized that the average practical BLS scores of the intervention group would be 1.5 points higher than those of the control group.ResultsBLS assessments of 286 students of 16 different classes were analysed. The estimated mean BLS score in the intervention group was 7.60 points (95% CI: 6.76 to 8.44) compared to 6.81 (95% CI: 5.97 to 7.65) in the control group adjusted for BLS training and class. Therefore, the estimated mean difference between the groups was 0.79 (95% CI: -0.40 to 1.97) and not significantly different (p-value: 0.176). Based on a logistic regression analysis the intervention had only a significant effect on the chance to pass the item “vertically above the chest” (OR = 4.99; 95% CI: 1.46 to 17.12) adjusted for BLS training and class.ConclusionPrior online training exhibits beneficial impacts on the BLS performance of bystanders during DA-CPR. To maximise the effect size, online training should be incorporated into a set of interventions that are mutually complementary and specifically designed for the target participants.Trial registrationDRKS00033531. "Kann online Training Laien darauf vorbereiten Reanimationsmaßnahmen unter Anleitung der Leitstelle adäquat durchzuführen? " Registered on January 29, 2024.

Диспетчерское сопровождение оказания первой помощи очевидцами события при внегоспитальной остановке кровообращения у пострадавшего: реалии и перспективы

Summary. Purpose of the study. The purpose of this work is to analyze the practical experience of remote support of first aid in out-of-hospital circulatory arrest using the example of the State Budgetary Institution of Health “Emergency Station of the Gelendzhik Resort City” of the Ministry of Health of the Krasnodar Territory. Material and methods. The empirical basis of the scientific research was the analytical material on dispatching support for the provision of first aid in case of out-of-hospital circulatory arrest, contained in the works of Russian and foreign scientists. A study was made of the regulations governing the organization of first aid, including dispatching support for its provision. Research results and their analysis. The experience of the GBUZ “Emergency Station of the Resort City of Gelendzhik” of the Ministry of Health of the Krasnodar Territory showed that the effectiveness of cardiopulmonary resuscitation in cases of circulatory arrest before the arrival of an ambulance, when eyewitnesses provided first aid during dispatching support (the proportion of successful resuscitations – 8.6%), was similar to that in cases of circulatory arrest in the presence of emergency medical professionals (7.4%). In this regard, one of the options for increasing the frequency and quality of CPR by eyewitnesses of the incident may be to accompany the CPR by a telephone emergency dispatcher.

Effectiveness of Feedback with Mobile Devices for Quality Measure of CPR Training: A Systematic Review

Cardiopulmonary resuscitation (CPR) is a life-saving skill that can significantly increase survival rates in an emergency. Medical professionals, health students, and trained lay people must all perform high-quality CPR. As an outcome, effective CPR training using instruments that support the achievement of high-quality CPR is essential. Objective: This systematic review aimed to evaluate the effectiveness of feedback provided via mobile devices in measuring the quality of CPR training. Method: Design used systematic review with reference to the PRISMA Statement Guidelines 2020. Search results through database of ScienceDirect (778 articles), Wiley Online Library (765 articles), PubMed (55 articles), and ResearchGate (73 articles). The research designs of articles analyzed was randomized controlled trial which published from 2013 to 2023 with the keywords cardiopulmonary resuscitation, CPR training, mobile devices. The sample in this study was taken from five articles that match the inclusion criteria. JBI's critical assessment tool for assessing bias risk in randomly controlled 2023 checklist tests is used to critically evaluate the instruments used for the selected article. Results: The primary results that five publications were based on CPR quality metrics such as chest compression depth and speed, as well as the proportion of acceptable chest compression depth. Conclusions: This review discovered evidence that mobile devices have an effect on the effectiveness of real-time feedback on CPR quality in CPR training. CPR trainees received effective instant guidance from a variety of mobile devices, including smartphones and smart watches equipped with sensors.

Enhancing Dispatch Systems for Out-of-Hospital Cardiac Arrest: A Proposal for Improved Survival Outcomes

Early and effective cardiopulmonary resuscitation (CPR) is critical for survival and neurological recovery in cases of out-of-hospital cardiac arrest (OHCA). This commentary proposes a novel approach involving the use of a CPR instructional video tailored for laypersons. It also recommends a three-phase approach for the implementation of this strategy, including a trial period, agreements with telecom and dispatch system providers, and a public health campaign to raiseawareness and improve compliance with instructions. This proposal aims to enhance the dispatch process for OHCA, ultimately improving survival rates and neurological outcomes.

Abstract 185: Regional Oxygen Saturation and Capnography Monitoring During Resuscitation After Cardiac Arrest in a Swine Pediatric ARDS Model

Introduction: Survival and outcomes after cardiac arrest (CA) depend largely on the effectiveness of cardiopulmonary resuscitation (CPR). Traditional invasive methods of monitoring CPR can be challenging out-of-hospital and are lacking in more than 50% of in-hospital pediatric CA. Regional oxygen saturation (rSO 2 ) monitoring with Near Infrared Spectroscopy (NIRS) and volumetric capnography offers a noninvasive approach that could potentially overcome these challenges. Aim: To determine the feasibility and effectiveness of NIRS and volumetric capnography monitoring in a swine model of pediatric hypoxia induced CA. Approach: Juvenile pigs were sedated and mechanically ventilated. Mild to moderate Acute Respiratory Distress Syndrome (ARDS) was induced by continuous oleic acid infusion. Respiratory and hemodynamic variables were monitored using invasive and noninvasive (NIRS and capnography) monitoring to assess efficacy of CPR. Animals were randomized into one of the two groups: High-quality CPR (hqCPR) to achieve coronary perfusion pressure of 25-30 mmHg and low-quality CPR (lqCPR) to achieve coronary perfusion pressure of 10-15 mmHg. Trajectories over time were analyzed using regression analyses. The discriminatory ability to distinguish between groups based on trajectories were analyzed using receiver operating characteristics curve (ROC) analysis. Results: 39 animals (23±3 kg) were included in our study. In the hqCPR group, there are generally higher values for cerebral and renal rSO 2 , ETCO 2 , volume of CO 2 elimination (VCO 2 ), and carotid blood flow, compared to the lqCPR group (p<0.0001). Cerebral and renal rSO 2 values increase over time, while ETCO 2 , VCO 2 , and carotid flow values decrease in the hqCPR group. Cerebral rSO2 had a ROC AUC of 0.76 (95% CI: 0.58-0.94), whereas renal rSO2 had a ROC AUC of 0.54 (95% CI: 0.22-0.87) representing nearly no discrimination ability. ETCO 2 had a ROC AUC of 0.66 (95% CI: 0.49-0.84), whereas VCO 2 had a ROC AUC of 0.62 (95% CI: 0.38-0.85). Conclusions: Higher mean cerebral rSO2 values during CPR might be used to assess quality of CPR effectiveness and provide real-time adjustments as needed. This could guide healthcare providers in optimizing CPR quality and improving outcomes for cardiac arrest patients.

Establishing a Quality Improvement Program for Pediatric In-hospital Cardiac Arrest

Background: Pediatric In-hospital Cardiac Arrest (IHCA) is a rare event with a 50-55% mortality rate. Techniques of Cardiopulmonary Resuscitation (CPR), medication and electrical therapy timing, team dynamics, simulation and debriefing programs are associated with improved outcomes. This study aimed to improve outcomes after IHCA by describing and implementing quality improvement processes that cross and coordinate among traditional siloed pediatric resuscitation team structures. Methods: We chose three outcome measures: (1) return of spontaneous circulation (ROSC), (2) 24-hour survival after IHCA, and (3) survival to hospital discharge. Process outcomes include (1) hot debriefs performed with a standardized form, (2) code documentation using a revised form, and (3) formal code team review presented to a central Emergency Management Committee, using a standardized form. Results: One hundred and thirty-two patients experienced 176 events during the 36-month study period. Survival to hospital discharge increased from 33% during year 1 to 60% during year 2 (P < 0.05) but decreased to 45% in year 3. Both hot debrief performance and code documentation process methods did not demonstrate widespread adoption, but formal code team review was documented in 80% of events quite rapidly. Conclusions: There are common traits inherent to effective CPR team response. Ensuring optimal performance of these common tasks and techniques in every pediatric IHCA event in our hospital is being addressed by committee reorganization, task simplification, new technology acquisition and enhanced feedback loops. Early outcome analysis shows initial improvement in survival to hospital discharge after pediatric IHCA.

327 The undergraduate perception's on cardiopulmonary resuscitation effectiveness by virtual and by standard training

327 The undergraduate perception's on cardiopulmonary resuscitation effectiveness by virtual and by standard training

Extracorporeal cardiopulmonary resuscitation for refractory OHCA: lessons from three randomized controlled trials-the trialists' view.

Extracorporeal cardiopulmonary resuscitation is a promising treatment for refractory out-of-hospital cardiac arrest. Three recent randomized trials (ARREST trial, Prague OHCA study, and INCEPTION trial) that addressed the clinical benefit of extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest yielded seemingly diverging results. The evidence for extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest, derived from three recent randomized controlled trials, is not contradictory but rather complementary. Excellent results can be achieved with a very high level of dedication, provided that strict selection criteria are applied. However, pragmatic implementation of extracorporeal cardiopulmonary resuscitation does not necessarily lead to improved outcome of refractory out-of-hospital cardiac arrest. Centres that are performing extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest or aspire to do so should critically evaluate whether they are able to meet the pre-requisites that are needed to conduct an effective extracorporeal cardiopulmonary resuscitation programme.

Knowledge, attitude, and proficiency of healthcare providers in cardiopulmonary resuscitation in a public primary healthcare setting in Qatar.

Early and effective cardiopulmonary resuscitation (CPR) increases both survival rate and post-cardiac arrest quality of life. This study aims to assess the current knowledge and ability of physicians and nurses in health centers (HCs) operated by the Primary Health Care Corporation (PHCC) in Doha, Qatar, to perform CPR. This study consists of two parts. The first part is a descriptive cross-sectional survey using an online form targeting physicians and nurses working in all HCs to assess their CPR knowledge and attitude. The second part is a direct observation of CPR drills to evaluate the skills and competencies of code blue team members in a convenient sample of 14 HCs. A multivariate model was employed to test the independent effect of explanatory variables on the total knowledge score. A total of 569 physicians and nurses responded to the survey. Only one-half (48.7%) formally received training on basic life support within the last year. Furthermore, 62.7% have tried to revive a dying person with no pulse. All the participants recognize the importance of knowing how to revive a dying adult or child as part of their job. The study showed that being a nurse was the most important predictor of a higher knowledge score in both components. Attending more resuscitation courses (3-6 courses in the last 3 years) ranked second in importance, and a longer experience in clinical practice (5-10 and >10 years) ranked third in predictive power. In addition, the direct observation of CPR drill performance revealed a satisfactory outcome. The level of CPR knowledge and skills practice among healthcare providers in PHCC is deemed satisfactory as most providers reported having performed CPR in the past. Considering that PHCC is the first step to people's healthcare in Qatar, clinical staff should be certified and assessed regularly to ensure retention of resuscitation knowledge and skills.

The Effect of Cardiopulmonary Resuscitation (CPR) Education on the CPR Knowledge, Attitudes, Self-Efficacy, and Confidence in Performing CPR among Elementary School Students in Korea.

Cardiopulmonary resuscitation (CPR) education for schoolchildren is emphasized, as bystander CPR is a vital key to increasing the survival rate of out-of-hospital cardiac arrest (OHCA) victims. This study was conducted to verify the effect of CPR education on knowledge, attitudes, self-efficacy, and confidence of Korean elementary school students in performing CPR. Data were collected through structured questionnaires before and after CPR education and analyzed using descriptive statistics, T-tests, and hierarchical regression. Significant improvements in CPR knowledge, attitudes, self-efficacy, and confidence in performing CPR were found after CPR education, with the greatest increase observed in confidence (p = 0.000). The influencing factors on confidence in performing CPR were school grade, attitude, and self-efficacy. Although a significant increase in schoolchildren's CPR knowledge after education was shown, knowledge did not affect confidence in performing CPR. Therefore, early CPR education which focuses on improving confidence in performing CPR is recommended. CPR education might raise attitude and self-efficacy leading to increased confidence in performing bystander CPR. In conclusion, early and regular CPR education for elementary school students is crucial and should be conducted repeatedly.

Effectiveness of Cardiopulmonary Resuscitation at the Workplace.

Out-of-Hospital Cardiac Arrest (OHCA) is a medical emergency whose chances of survival can be increased by rapid Cardiopulmonary Resuscitation (CPR) and early use of Public Access Defibrillators (PAD). Basic Life Support (BLS) training became mandatory in Italy to spread knowledge of resuscitation maneuvers in the workplace. Basic Life Support (BLS) training became mandatory according to the DL 81/2008 law. To improve the level of cardioprotection in the workplace, the national law DL 116/2021 increased the number of places required to be provided with PADs. The study highlights the possibility of a Return to spontaneous circulation in OHCA in the workplace. A multivariate logistic regression model was fitted to the data to extrapolate associations between ROSC and the dependent variables. The associations' robustness was evaluated through sensitivity analysis. The chance to receive CPR (OR 2.3; 95% CI:1.8-2.9), PAD (OR 7.2; 95% CI:4.9 - 10.7), and achieve Return to spontaneous circulation (ROSC) (crude OR 2.2; 95% CI:1.7-3.0, adjusted OR 1.6; 95% CI:1.2-2.2) is higher in the workplace compared to all other places. The workplace could be considered cardioprotective, although further research is necessary to understand the causes of missed CPRs and identify the best places to increase BLS and defibrillation training to help policymakers implement correct programming on the activation of PAD projects.

Diagnosis and treatment of sepsis-induced cardiomyopathy using hemosorption therapy: a case report

Introduction. Sepsis is a life-threatening organ failure caused by the body’s dysregulated response to infection. The prevalence of sepsis-induced cardiomyopathy (SICM) in patients with sepsis ranges from 10 to 70%, while there are no special sections on SICM in the known resuscitation manuals. There is also a lack of large clinical trials evaluating the effectiveness of SICM treatment.Case. A 59-year-old patient was urgently hospitalized in the intensive care unit with shock of unknown origin. Emergency coronary angiography revealed no coronary obstruction. Two hours after admission, asystole was recorded with effective cardiopulmonary resuscitation, mechanical ventilation, infusion of inotropic and vasopressor drugs. The patient was diagnosed with leukocytosis up to 19*109/l, procalcitonin >0,5 ng/ml. Subsequently, stage 2 acute kidney injury, pneumonia, acute respiratory distress syndrome, sepsis, SICM, combined shock (cardiogenic, septic) were diagnosed. Antibiotic and hemosorption therapy using a CytoSorb column were started. On the 6th day, there was a improvement of hemodynamic parameters, a decrease in the rate of vasopressor infusion, and normalization of the left ventricular ejection fraction. The condition has stabilized with further favorable changes.Discussion. Despite the wide prevalence and high mortality in SICM, this condition is not well described in the literature, and there are no clear diagnostic criteria and treatment algorithms. This case demonstrates the effective treatment of SICM at the stage when the prognosis of patients becomes extremely unfavorable, reaching 90% mortality.Conclusion. This case demonstrates the effective treatment of SICM as an element of multiple organ failure, in the outcome of sepsis, using efferent methods, when the prognosis becomes extremely unfavorable. Personalized approach and management of these patients is critical to improve disease outcomes.

Using computed tomography to evaluate proper chest compression depth for cardiopulmonary resuscitation in Thai population: A retrospective cross-sectional study.

The effectiveness of cardiopulmonary resuscitation is determined by appropriate chest compression depth and rate. The American Heart Association recommended CC depth at 5-6 cm to indicate proper cardiac output during cardiac arrest. However, many studies showed the differences in the body builds between Caucasians and Asians. Therefore, this study aimed to determine heart compression fraction (HCF) in the Thai population by using contrast-enhanced computed tomography (CT) scan of the chest and a mathematical model. Consecutive contrast-enhanced CT scans of the chest performed at Ramathibodi Hospital were retrospectively reviewed from January to March 2018 by two independent radiologists. Patients' characteristics, including gender, age, weight, height, and pre-existing diseases, were recorded, and the chest parameters were measured from a CT scan. The heart compression fraction (HCF) was subsequently calculated. Of 306 subjects, there were 139 (45.4%) males, 148 (47.4%) lung diseases and 10 (3.3%) heart diseases. Mean age and BMI were 60.4 years old and 23.8 kg/m2, respectively. Chest diameter, heart diameter, and non-cardiac soft tissue were significantly smaller in females compared to males. Mean (SD) HCF proportional with 50 mm and 60 mm depth were 38.3% (13.3%) and 50% (14.3%), respectively. There were significant differences of HCF proportional by 50 mm and 60 mm depth between men and women (33.2% vs 42.6% and 44% vs 54.9%, respectively (P<0.001)). In addition, a decrease in HCF was significantly observed among higher BMI groups. The CT scan and mathematical model showed that 38% and 50% HCF proportions were generated by 50 mm and 60 mm CC depth. HCF proportions were significantly different between genders and among BMI groups. The recommended depth of 5-6 cm is likely to provide sufficient CC depth in the population of Thailand.

Nurses' Knowledge, Attitudes, and Practice of Cardiopulmonary Resuscitation at a Selected Training Hospital in Namibia: A Cross-Sectional Survey.

Nurses play a key role in cases of cardiopulmonary arrest by promptly attending to and initiating cardiopulmonary resuscitation. Effective cardiopulmonary resuscitation thus requires nurses to possess appropriate attitudes, competencies, and adherence to the best nursing practice. Cardiac arrests are a prevalent cause of fatalities, being responsible for approximately 30% of deaths worldwide. Despite this statistic, however, research in this specific field is lacking in Namibia. The objective of this research was to examine registered nurses' knowledge, attitudes toward, and practice with regard to cardiopulmonary resuscitation at a selected teaching hospital in Namibia. A cross-sectional survey design using a self-administered questionnaire was utilized to purposively recruit 158 registered nurses from the inpatient and outpatient departments of a teaching hospital in Namibia. Descriptive and chi-square tests were performed using SPSSv26. The results of the study indicate that a significant percentage of nurses have limited knowledge (14.7 ± 1.50), negative attitudes (36.2 ± 4.8), and poor practice (11.16 ± 1.18) when it comes to cardiopulmonary resuscitation. Their poor knowledge is strongly associated with poor practice (χ2 = 9.162, P = .002). The study further revealed a significant correlation between the departments in which the nurses worked and their practice of cardiopulmonary resuscitation, suggesting that the work environment is a crucial factor in determining a nurse's approach to emergency care. The findings of study indicate that the cardiopulmonary resuscitation practice in the selected hospital is unsafe due to the registered nurses' poor knowledge and negative attitudes. It is strongly recommended that hospital managers and policy-makers take steps to formulate guidelines that mandate regular cardiopulmonary resuscitation training at predetermined times.

Comparison of cardiopulmonary resuscitation quality performed by a single rescue with a bag-valve mask device: Over-the-head or lateral position?

IntroductionThe highest quality and effectiveness of Cardiopulmonary Resuscitation (CPR) will be difficult to achieve if ventilatory assistance is provided using a Bag-Valve Mask (BVM) device and combined with compression by a single rescue. This study aims to compare the different qualities of CPR between the over-the-head (OTH) position and the lateral position performed by a single rescue with a BVM device. MethodThis study was a comparative study, comparing the quality of CPR produced by lateral position and OTH position on mannequins. This study involved 100 respondents divided into two groups, namely 50 respondents had lateral position and 50 had OTH position. CPR quality assessment was guided by five CPR quality indicators referring to the American Heart Association (AHA). The statistical test used was Mann-Whitney. ResultsStatistical tests show CPR using the OTH position had higher quality than the lateral position (p = 0.004). Based on five CPR quality indicators, two indicators had a significant difference between the OTH and lateral positions, namely speed (p = 0.026), and interruption (p = 0.008). Meanwhile, the other three indicators did not have significant differences, namely depth (p = 0.427), hand placement (p = 1.000), and complete chest recoil (p = 1.185). ConclusionThe OTH position was more effective and had better quality when CPR used a single rescue with a BVM device compared to the lateral position.

Efficacy of Cardiopulmonary Resuscitation Training Program on Knowledge and Practice of Nursing Students

Background: Cardiopulmonary Resuscitation (CPR) is a technique of providing BLS to restore the circulationand breathing of an individual in cardiac arrest. Effective CPR in first few minutes can improve the chance ofsurvival of arrest victims. Best results of cardiopulmonary skills can be achieved when resuscitation educationprepares students to perform it effectively. The aim of the study was to assess the effectiveness of CPR trainingprogram on nursing students and to find correlation between the knowledge and practice of nursing studentsregarding CPR.Methods: This study used a quantitative approach with one group pre-test post-test research design. Studywas conducted in a selected college, total 60 subjects were selected through random stratified sampling. Datacollection was done by knowledge questionnaire and observation checklist.Conclusion: Majority of the participants, 93.2% (55) were females and 6.8% (4) were males. Average meanknowledge score difference from pretest to posttest was 12.9 and average mean practice score was 9.2. There wasa weak positive correlation between the knowledge and practice scores of nursing students. It was concludedthat knowledge and practice of nursing students were significantly better after the training program.

DETERMINING THE EFFECTIVENESS OF CARDIOPULMONARY RESUSCITATION USING A MANIKIN

Objectives: Many studies have shown that people applying cardiopulmonary resuscitation (CPR) cannot make sustained and effective CPR due to fatigue, sweaty hands, broken ribs, inability to determine the correct area etc. Thus, this study aimed to determine the effectiveness and sustainability of CPR quality using a CPR manikin by following the 2015 CPR guidelines.Material and Method: This study was carried out with 153 student volunteers from seven different health sciences programmes at Izmir University of Economics. All students were trained in first aid and basic life support in the previous school academic year. The time and effectiveness of CPR applied on a CPR manikin (Ambu® Manikin) were measured. The students’ body positioning, blowing capacities, depth of pressures and effective pressure durations were evaluated and numerical data were analysed by t-test. P-value &amp;lt;0.05 was accepted as statistically significant. Data were analysed using SPSS version 21.Results: Of the 153 student volunteers, 60.1% were female and 39.9% were male. The average student age was 20.32 ± 03 years, the average height was 169.20 ± 26 cm and the average weight was 65.12 ± 42 kg. The average effective CPR duration was 2.95 ± 0.86 min, the average pressure depth was 4.33 cm and the average depth of pressures and effective pressure was 0.6 liters. The position of the arms was correct in 83% of the students. In 81% of the cases, the application site was correctly determined. Moreover, 68.6% of the students were able to sustain the pumping activity of the heart. In all parameters other than the arms position, male students had better results than female students. CPR is a very important live-saving method to increase the chance of survival. However, this practice is ineffective unless applied correctly and timely.Conclusion: This study showed that manual chest compression on the manikin became ineffective in both speed and effectiveness just within minutes. This shows that there is a very important deficiency in this area where human life depends on minutes. Thus, developing and commissioning auxiliary external chest compression device that can perform CPR, especially in pre-hospital setting, ambulance and emergency departments, is important.

DETERMINANTS OF EFFECTIVE CARDIOPULMONARY RESUSCITATION PERFORMED BY MEDICAL PERSONNEL

Aim: The aim of this paper is an attempt to analyse the determinants of effective cardiopulmonary resuscitation (CPR) performed by medical personnel over a five-year span. Material and methods: An original research questionnaire was used to collect and process data for the purposes of this retrospective observational study. The research sample consisted of 167 patients aged between 16 and 102 who had in-hospital sudden cardiac arrest (SCA) and underwent cardiopulmonary resuscitation (CPR). Results: The most common causes of SCA in the study group of patients were cardiovascular diseases, and the mechanism of asystole was responsible for half of the recorded sudden cardiac arrests. While performing CPR, chest compressions were the most frequently applied procedure, whereas defibrillation or the Esmarch (jaw-thrust) maneuver were used less often. The effectiveness of resuscitation in almost a half of the cases was unsatisfactory, whereas the average time of performing resuscitation was 27,83 minutes. Pronouncement of death was made with regard to patients on whom resuscitation was performed for the longest time. On the other hand, among patients who were resuscitated for less than 20 minutes, breathing, blood circulation and con¬sciousness were restored, or only breathing and circulation were restored. Conclusions: The main cause of sudden cardiac arrest in the study period were non-shockable heart rhythms, whereas the restoration of spontaneous cir¬culation and breathing was achieved in the cases when resuscitation was performed for less than 20 minutes. The survival rate after successful resuscitation is comparable to the results obtained in other hospitals in Poland and Europe, as well as statistical data from scientific publications.

Pilot Study on the Knowledge and Attitude of Providing Bystander Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest in Phalga, Rivers State

Background: Sudden cardiac death is a principal cause of death for millions of people yearly worldwide. The survival chances of an out of cardiac arrest are significantly increased by the provision of prompt and effective bystander cardiopulmonary resuscitation (CPR).&#x0D; Methodology: A descriptive cross-sectional study was conducted among 61 respondents in PHALGA. SPSS version 2.0 was used for the data analysis.&#x0D; Results: Finding from the study provided evidence for a good test-retest reliability and an acceptable Cronbach alpha value.&#x0D; Conclusion: The majority of the community members have poor knowledge of cardiopulmonary resuscitation and only a few of them have a positive attitude toward providing bystander CPR. The positive or negative attitude towards cardiopulmonary resuscitation is influenced by their knowledge on cardiopulmonary resuscitation. The study showed that the majority had a negative attitude toward administering cardiopulmonary resuscitation. Health education, dissemination of information, and community training on CPR are needed to improve knowledge and positive attitude toward bystander CPR administration.

Abstract 219: Cerebral Oximetry Shows The Cardiopulmonary Resuscitation Leading To Return Of Spontaneous Circulation

Purpose: Effectiveness of cardiopulmonary resuscitation (CPR) is associated to return of spontaneous circulation (ROSC), but the alignment of the characteristics of compressions (rate and depth) to AHA recommendations has not been proven to improve outcome. In this study the power of the near infrared spectroscopy to discriminate productive CPR, i.e. chest compression sequences leading to ROSC, was evaluated. Material and methods: The cerebral oxygen saturation (rSO 2 ) measured in both cerebral lobules was recorded with the Nonin SenSmart 100X oximeter by Emergentziak-Osakidetza, the emergency service of the Basque Country, in the out-of-hospital cardiac arrest (OHCA). Concurrently, the ECG and bioimpedance were recorded by the Lifepak 15 desfibrillator. Chest compressions were delivered by Lucas 2 &amp; Lucas 3 devices. Sequences of compressions longer than 30 s were extracted, and changes in the left (rSO 2,L ) and right (rSO 2,R ) lobes were automatically computed by signal processing. The increase of rSO2, measured every 4 s during the CPR-sequence, was adjusted with linear regression and compared for ROSC/no-ROSC patients as registered in the emergency department (ED). Results: Chest compression intervals were identified in the bioimpedance, and 403 CPR-segments were extracted from 115 patients (80 from 43 patients with ED-ROSC) with a mean(std) duration of 2.46(1.07) min. The median(IQR) increase of brain saturation per patient, rSO 2,L and rSO 2,R , were 2.1(1.1-5.5) and 1.9(0.9-3.8) points. The figure shows the linear adjustment of the evolutions for both ROSC/no-ROSC groups, with slopes of: 1.81 vs 1.23 min -1 for ΔrSO 2,L (p&gt;0.05), 1.78 vs 0.95 min -1 (p&lt;0.05) for ΔrSO 2,R, and 2.03 vs 1-08 min -1 (p&lt;0.05) for the combination of both. Conclusions: Cerebral oximetry showed different evolution during mechanical chest compressions for patients with ED-ROSC. Significantly higher slopes in the rSO 2 evolution were observed for patients who achieved ROSC in OHCA.