Inter-rater reliability and comfort in the application of a basic life support termination of resuscitation clinical prediction rule for out of hospital cardiac arrest

Background: Out-of-hospital cardiac arrest is an important cause that leads to hospital admission and death. Improving lay people’s knowledge and skills in basic life support (BLS) may lead to reduced death associated with out-of-hospital cardiac arrest. “BLS NU KKU” is a BLS training program developed from up-to-date literature as a smartphone application used to train lay people in the community. Objective: To evaluate BLS-related knowledge and skills of participants before and after BLS training. Materials and Methods: A one group pretest-posttest design was used to implement the present study in Khon Kaen, Thailand. Participants were 350 individuals age 18 and older. An 8-hour BLS training session was offered to 10 groups of 35 participants over the period of 10 months between November 2018 and August 2019. Self-administered questionnaires were used to assess BLS knowledge and Cardiopulmonary resuscitation (CPR) skills. Results: The mean score for BLS-related knowledge significantly increased after the BLS training (mean = 15.05, SD = 2.51) compared to the scores before the training (mean = 10.47, SD = 3.43) (p<0.05). BLS skills improved from 0% to 100% (p<0.001) will all skills rated with mostly “excellent” and “good”. Satisfaction with the training program was also rated mostly with “excellent” and “good”. Conclusion: The BLS training program effectively improved participants’ knowledge and skills for basic life support. This program should be disseminated to train lay people in other settings. Keywords: Basic life support, Cardiac arrest, Mobile application

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2019 American Heart Association Focused Update on Pediatric Basic Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Circulation ◽

10.1161/cir.0000000000000736 ◽

2019 ◽

Vol 140 (24) ◽

Author(s):

Jonathan P. Duff ◽

Alexis A. Topjian ◽

Marc D. Berg ◽

Melissa Chan ◽

Sarah E. Haskell ◽

...

Keyword(s):

Systematic Review ◽

Cardiac Arrest ◽

American Heart Association ◽

Basic Life Support ◽

Life Support ◽

American Heart ◽

Heart Association ◽

Liaison Committee ◽

Bystander Cpr ◽

Hospital Cardiac Arrest

This 2019 focused update to the American Heart Association pediatric basic life support guidelines follows the 2019 systematic review of the effects of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) on survival of infants and children with out-of-hospital cardiac arrest. This systematic review and the primary studies identified were analyzed by the Pediatric Task Force of the International Liaison Committee on Resuscitation. It aligns with the International Liaison Committee on Resuscitation’s continuous evidence review process, with updates published when the International Liaison Committee on Resuscitation completes a literature review based on new published evidence. This update summarizes the available pediatric evidence supporting DA-CPR and provides treatment recommendations for DA-CPR for pediatric out-of-hospital cardiac arrest. Four new pediatric studies were reviewed. A systematic review of this data identified the association of a significant improvement in the rates of bystander CPR and in survival 1 month after cardiac arrest with DA-CPR. The writing group recommends that emergency medical dispatch centers offer DA-CPR for presumed pediatric cardiac arrest, especially when no bystander CPR is in progress. No recommendation could be made for or against DA-CPR instructions when bystander CPR is already in progress.

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Meta-analysis of the accuracy of termination of resuscitation rules for out-of-hospital cardiac arrest

Emergency Medicine Journal ◽

10.1136/emermed-2018-207833 ◽

2019 ◽

Vol 36 (8) ◽

pp. 479-484 ◽

Cited By ~ 5

Author(s):

Mark H Ebell ◽

Akke Vellinga ◽

Siobhan Masterson ◽

Phillip Yun

Keyword(s):

Cardiac Arrest ◽

Basic Life Support ◽

Life Support ◽

Meta Analysis ◽

Advanced Life Support ◽

Study Quality ◽

European Resuscitation Council ◽

Comprehensive Search ◽

Hospital Cardiac Arrest ◽

Low Rate

BackgroundOur objective was to perform a systematic review of studies reporting the accuracy of termination of resuscitation rules (TORRs) for out-of-hospital cardiac arrest (OHCA).MethodsWe performed a comprehensive search of the literature for studies evaluating the accuracy of TORRs, with two investigators abstracting relevant data from each study regarding study design, study quality and the accuracy of the TORRs. Bivariate meta-analysis was performed using the mada procedure in R.ResultsWe identified 14 studies reporting the performance of 9 separate TORRs. The sensitivity (proportion of eventual survivors for whom the TORR recommends resuscitation and transport) was generally high: 95% for the European Resuscitation Council (ERC) TORR, 97% for the basic life support (BLS) TORR and 99% for the advanced life support (ALS) TORR. The BLS and ERC TORR were more specific, which would lead to fewer futile transports, and all three of these TORRs had a miss rate of ≤0.13% (defined as a case where a patient is recommended for termination but survives). The pooled proportion of patients for whom each rule recommends TOR was much higher for the ERC and BLS TORRs (93.5% and 74.8%, respectively) than for the ALS TORR (29.0%).ConclusionsThe BLS and ERC TORRs identify a large proportion of patients who are candidates for termination of resuscitation following OHCA while having a very low rate of misclassifying eventual survivors (<0.1%). Further prospective validation of the ERC TORR and direct comparison with BLS TORR are needed.

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