Resuscitation Council UK Research Articles

Becoming an instructor in advanced life support

Being an approved instructor for the Resuscitation Council UK can be rewarding, fun, and a good way to learn teaching skills and keep your knowledge of resuscitation up to date. Whether you're interested in advanced life support (ALS) or advanced paediatric life support (APLS), here are some tips The first step is to be put forward by the relevant course faculty …

Nurses and health support workers' views on cardiopulmonary resuscitation in a hospice setting.

This paper reports on a study which took place in a 15-bed hospice and provides an account of the views of registered nurses (n = 12) and health support workers (n = 10) in relation to cardiopulmonary resuscitation (CPR) within a hospice setting. The study was part of a larger ethnographic research project being conducted in the hospice when the British Medical Association/Royal College of Nursing and the Resuscitation Council UK (Resuscitation Council UK, 2001) published guidelines urging all establishments that face decisions about attempting CPR to develop local policies. The guidelines provided the impetus for the present study, the aim of which was to explore staff responses to the introduction of a CPR policy in the hospice. Semi-structured interviews were conducted on a purposive sample of hospice staff. The findings raise issues about the implementation of CPR in a context where it was felt that the patient should be allowed to die a natural death.

The Resuscitation Council UK Immediate Life Support Course

Recognising and intervening in the early stages of critical illness, basic life support and defibrillation are essential for improving outcome from inhospital cardiac arrest [1,2]. The Resuscitation Council (UK) http://www.resus.org.uk launched the Immediate Life Support Course (ILS) in January 2002. This multiprofessional 1-day resuscitation course provides tuition on the knowledge and skills required by a first responder to manage a patient in cardiac arrest for the short time before the arrival of a cardiac arrest team. ILS also introduces healthcare professionals to the role of a cardiac arrest team member. Recognition and intervention in the acutely unwell patient prior to cardiac arrest, basic airway skills and rapid safe defibrillation using either manual or automated external defibrillators (AEDs) are the prime objectives of the course. The course includes lectures, skill stations and cardiac arrest scenarios. ILS has standardised much of the life support training that already takes place in hospitals in the UK. In the first year, 14,409 candidates attended ILS courses in 122 course centres. The backgrounds of the participants are summarised in Table ​Table1.1. Participants are continually assessed during the course and those that demonstrate satisfactory performance are awarded a certificate valid for 12 months. During the first year the majority (99%) of participants successfully achieved the course objectives. The preliminary results presented here show a promising start for the new ILS course. The challenge now is opening up the course in more centres while maintaining the quality of teaching. Table 1

Advanced Cardiac Life Support A Practical Guide Advanced Cardiac Life Support A Practical Guide

The title of this book took me back to the time four years ago when I was taking my advance cardiac life support examination and was sent a huge manual by the UK resuscitation council. I had to learn every bit of it for my exam. How I would have loved to have this handy little volume with me then.

Continuing Professional Development. Anaphylactic shock.

The causes of anaphylactic shock and presenting features are not clearly understood. In addition, the treatment of people suffering from anaphylactic or anaphylactoid reactions has not always been effectively provided. This article aims to rectify some of the current areas of concern, especially highlighting the recent work carried out by the Resuscitation Council (UK) on this subject (Resuscitation Council UK 1999/2001). After reading this article you should be able to: Explain the circulation of the blood and changes that occur during an anaphylactic reaction. Summarise the antigen/antibody mechanism especially in relation to allergic reactions. Describe the difference between anaphylactic and anaphylactoid reactions. Recognise the presenting signs and symptoms of anaphylaxis and shock. Describe the assessment and appropriate intervention for a patient suffering from an anaphylactic reaction. Explain what prevention/support services are available to suffers.

Defibrillators in public places: the introduction of a national scheme for public access defibrillation in England

Objective: To implement a government-led project—the ‘Defibrillators in Public Places’ Initiative—to deploy Automated External Defibrillators (AEDs) in public places. Background: A Defibrillator Advisory Committee (DAC) was formed to assist the government with the implementation of the project. Its particular tasks were to: recommend criteria for the selection, training and assessment of those individuals likely to use the devices; procure the equipment necessary for the implementation of the project; procure the training services required for the implementation of the project; ensure the AEDs are sited where they are most likely to be of benefit; establish a mechanism to audit the use of this equipment and the outcome of this initiative. To co-ordinate this project a National Project Manager was appointed. Consultation with Ambulance Services NHS Trusts established the places where cardiac arrest occurred under circumstance where the availability of a defibrillator might be most likely to be effective. Defibrillators were procured under the direction of the NHS Purchasing and Supply Agency in conjunction with medical advisors. Devices that were reliable, safe, simple in operation and with good data retrieval systemes were selected. Training contracts were awarded under the direction of the NHS Purchasing and Supply Agency in conjunction with medical and educational advisors. Organisations with accredited training experience and possessing the appropriate administrative and data handling abilities were selected. The ability to undertake training in an area concordant with current NHS regions was an essential requirement. In the first stage of implementation, pilot trials were successfully established at sites where persons were willing to be trained in the use of automated defibrillators. Arrangements for national progress of the project were made on the basis of the experience gained at pilot sites. A robust system for monitoring the outcome of the project has been established in partnership with the Resuscitation Council UK. The long-term success of this innovative project requires: Continuing central administrative support in the short to medium term. Central audit and data collection. The results of this project should contribute to national databases being established by the Resuscitation Council UK. Continuing adequate funding. The recognition that the provision of defibrillation to the victims of cardiac arrest is a key feature of the NHS.

Variability in the assessment of advanced life support skills

The number of short ‘life support’ and emergency care courses available are increasing. Variability in examiner assessments has been reported previously in more traditional types of examinations but there is little data on the reliability of the assessments used on these newer courses. This study evaluated the reliability and consistency of instructor marking for the Resuscitation Council UK Advanced Life Support Course. Twenty five instructors from 15 centres throughout the UK were shown four staged video recorded defibrillation tests (one repeated) and three cardiac arrest simulation tests in order to assess inter-observer and intra-observer variability. These tests form part of the final assessment of competence on an Advanced Life Support course. Significant levels of variability were demonstrated between instructors with poor levels of agreement of 52–80% for defibrillation tests and 52–100% for cardiac arrest simulation tests. There was evidence of differences in the observation/recognition of errors and rating tendencies of instructors. Four instructors made a different pass/fail decision when shown defibrillation test 2 for a second time leading to only moderate levels of intra-observer agreement ( κ=0.43). In conclusion there is significant variability between instructors in the assessment of advanced life support skills, which may undermine the present assessment mechanisms for the advanced life support course. Validation of the assessment tools for the rapidly growing number of life support courses is required with urgent steps to improve reliability where required.

An audit of basic life support skills amongst general practitioner principals: is there a need for regular training?

Objective: to determine what proportion of general practitioner (GP) principals in Herefordshire health authority are able to perform basic life support according to current guidelines. Design: prospective cohort study. Setting: Herefordshire Health Authority area. Subjects: 53 general practitioner (GP) principals, based in 18 surgeries. Main outcome measures: basic life support (BLS) skills were assessed using the 1997 UK Resuscitation Council guidelines in checklist form as a process criterion. An assessments of each doctor was made before and after teaching of BLS skills. Results: 50% of GP principals ( n=53) in Herefordshire Health Authority took part in the audit. Of these 90.6% (48) were unable to perform BLS according to current guidelines on initial appraisal. After a practical teaching session 98% were competent in BLS skills. Conclusion: without regular teaching, BLS skills amongst GPs are likely to fall below an acceptable standard. Even short teaching periods can produce significant improvement in skills.

Neuroophthalmology, Volume 8

<h3>Background</h3> Out-of-hospital cardiac arrest survival rates in the UK are poor, and non-medically trained individuals have been identified to perform substandard cardiopulmonary resuscitation (CPR). Millions watch televised medical dramas and, for many, these comprise their only education on CPR. This study aims to investigate the quality of CPR portrayed on these programmes and whether this has an effect on public knowledge. <h3>Methods</h3> Prospective observational study of 30 consecutive episodes of three popular medical dramas. Public knowledge of CPR and viewing habits were assessed with a survey of non-medically trained personnel. <h3>Results</h3> 90 episodes were reviewed with 39 resuscitation attempts shown. Chest compression rates varied from 60 to 204 compressions per minute with a median of 122 (95% CI 113 to 132). Depth varied from 1.5 to 7.5 cm with a median of 3 (3.15–4.31). Rate and depth were significantly different from the UK Resuscitation Council Guidelines (2010) (p&lt;0.05, t-test). Survey participants (n=160, 80% response rate) documented what they thought was the correct rate and depth of chest compressions and were scored accordingly. Those who documented watching medical dramas regularly scored significantly worse than those who watched occasionally (p&lt;0.05, Mann-Whitney test). <h3>Conclusion</h3> Televised medical dramas depict CPR inaccurately and laypersons may be less well informed about the correct technique the more they tune into these programmes. While there may be other confounding variables, given the popularity of television medical dramas, the poor depiction may be significantly contributing to poor public CPR knowledge and represent a potential new avenue of public education.