Mouth-to-mouth ventilation and/or chest compression in basic life support: The debate continues

Resuscitation ◽  
2008 ◽  
Vol 77 (3) ◽  
pp. 283-285 ◽  
Author(s):  
R.W. Koster
2018 ◽  
Vol 1 (1) ◽  
pp. 14-19
Author(s):  
Upendra Yadav ◽  
RS Mehta

Introduction: Lack of resuscitation skills of nurses in basic life support (BLS) and advanced life support (ALS) has been identified as a contributing factor to poor outcomes of cardiac arrest victims.Objective: To assess the effectiveness of education intervention programme to improve the knowledge of, and thereby the quality of Emergency service; especially in the area of Basic Life Support, Advance Life Support and Triage system.Method: Pre-experimental research design was used to conduct the study among the nurses working in Emergency units of B. P. Koirala Institute of Health Sciences where CPR is very commonly performed. Using convenient sampling technique, a total of 24 nurses agreed to participate and to give consent were included in the study. The theoretical, demonstration and re-demonstration sessions were arranged, involving the trained doctors and nurses during the three hours educational programme. Post-test was carried out after education intervention programme. The 2010 BLS and ALS guidelines were used as guide for the study contents. The collected data were analyzed using SPSS-15 software.Result: It was found that there is significant increase in knowledge after education intervention in the components of life support measures (BLS/ALS) i.e. ratio of chest compression to ventilation in BLS (P= 0.001), correct sequence of CPR (p< 0.001), rate of chest compression in ALS (P= 0.001), the depth of chest compression in adult CPR (p< 0.001), and position of chest compression in CPR (P= 0.016). The participating nurses well appreciated the programme and requested to continue in future for all the nurses.Conclusion: The workshop certainly improves the knowledge of the working nurses, and thereby the quality of Emergency service; especially in the areas of Basic Life Support, Advance Life Support and Triage System.Journal of BP Koirala Institute of Health Sciences, Vol. 1, No. 1, 2018, page: 14-19


Author(s):  
Helene Bylow ◽  
Thomas Karlsson ◽  
Margret Lepp ◽  
Andreas Claesson ◽  
Jonny Lindqvist ◽  
...  

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


2018 ◽  
Vol 26 (2) ◽  
pp. 106-110 ◽  
Author(s):  
Yoshiaki Takahashi ◽  
Takeji Saitoh ◽  
Misaki Okada ◽  
Hiroshi Satoh ◽  
Toshiya Akai ◽  
...  

Background: Conventional hands-on chest compression, in cardiopulmonary resuscitation, is often inadequate, especially when the rescuers are weak or have a small physique. Objectives: This study aimed to investigate the potential of leg-foot chest compression, with and without a footstool, during cardiopulmonary resuscitation. Methods and Results: We prospectively enrolled 21 medical workers competent in basic life support. They performed cardiopulmonary resuscitation on a manikin for 2 min using conventional hands-on compression (HO), leg-foot compression (LF), and leg-foot compression with a footstool (LF + FS). We analyzed the compression depths, changes in the rescuers’ vital signs, and the modified Borg scale scores after the trials. The compression depth did not differ between the cases using HO and LF. In the case of LF + FS, compression depths ⩾5 cm were more frequently observed (median, inter-quartile range: 93%, 81%–100%) than in HO (9%, 0%–57%, p < 0.01) and LF (28%, 11%–47%, p < 0.01). The increase in the heart rate or modified Borg scale scores, after the trials, did not differ between the HO and LF group; however, the values were the lowest in the case of LF + FS (49 ± 18 beats/min and 5 (4–7) in HO, 46 ± 18 and 6 (5–7) in LF, and 32 ± 11 and 2 (1–3) in LF + FS, respectively, p < 0.01). However, the increase in blood pressure, SpO2, and respiratory rate were not different among each group. The increases in the heart rate and modified Borg scale scores negatively were correlated with the rescuers’ body size, in the case of HO and LF, but not LF + FS. Conclusion: LF can be used as an alternative to HO, when adequate HO is difficult. LF + FS could be used when rescuers are weak or have a small physique and when the victims are bigger than the rescuers.


2016 ◽  
Vol 45 ◽  
pp. 163-166 ◽  
Author(s):  
Matthew Johnson ◽  
Amanda Peat ◽  
Leanne Boyd ◽  
Tanya Warren ◽  
Kathryn Eastwood ◽  
...  

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Dung T Nguyen ◽  
Kasper G Lauridsen ◽  
Josephine Johnsen ◽  
Katrine B Bomholt ◽  
Bo Løfgren

Background: The European Resuscitation Council (ERC) 2015 basic life support (BLS) algorithm has been simplified compared with the ERC 2010 BLS algorithm. Simplification of resuscitation guidelines may facilitate learning and improve guidelines adherence. This study aimed to study BLS performance using ERC 2015 compared with ERC 2010 guidelines. Methods: This is an observational study including video recordings of laypersons being skill tested after participation in a standardized ERC BLS/AED course using either the simplified ERC 2015 or ERC 2010 guidelines. The endpoints were 1) performing all steps of the BLS/AED algorithm correctly, 2) remembering the sequence of actions of the BLS/AED algorithm, 3) time to emergency medical service call, 4) time to first chest compression and 5) time to first shock. Results: We analyzed videos of 100 laypersons (50 trained using the simplified 2015 guidelines and 50 trained using the 2010 guidelines). Overall, 78% and 62% correctly performed all of the steps of the 2015 and 2010 guidelines respectively (p=0.08), whereas 94% and 82% remembered the correct sequence of actions of the 2015 and 2010 algorithms, respectively (p=0.06). There was no significant difference between participants following the 2015 vs 2010 algorithms with respect to time to emergency medical service call (difference: 0 sec, (95% confidence interval (CI): -3; 2) P=0.70), time to first chest compression (difference: 0 sec, (95% CI: -3;3) P=1.00), and time to first shock (difference: 0 sec, (95% CI: -6; 7) P=0.90). Conclusion: Laypersons tends to better perform resuscitation and adhere to the BLS algorithm when using the simplified ERC 2015 guidelines compared to the 2010 Guidelines. There were however no differences in time to emergency medical service call, time to first chest compression and shock delivery.


2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Prabin Kumar Giri ◽  
Bishal Pokhrel ◽  
Prem Prasad Panta ◽  
Robin Khapung

Background: Cardiopulmonary resuscitation success rates depend on the knowledge and skills of Adult basic life support (BLS) and advanced life support. The objective of the study was to find the level of awareness on BLS and skills among health personnel working in different departments of a rural teaching hospital. Methods: This descriptive cross-sectional study was conducted in a tertiary care hospital of Karnali Academy of Health Sciences, Jumla, Nepal. The awareness level about BLS was assessed using a structured questionnaire. Health personnel’s previous exposure to BLS and the inclusion of BLS in their curriculum was also assessed. Results: Among 91 participants,74% (n=67) heard about BLS ,64% (n=58)have seen performing and 25%(n=23) have performed CPR. Only 8%(n=7) attended a workshop on BLS. 43% (n=39) answered 100 and 46%(n=42) answered 30 compression per minute in adult during CPR.71%(n=65) knew the ratio of chest compression to breath in adults. Only 41%(n=37) identified anatomy/area  mid-chest for chest compression. Only 40%(n=36)  are familiar to the Heimlich maneuver and  5.5%(n=5) were aware of the sequence of BLS which is Head tilt, chin lift, check the pulse. Seventy-eight percent (n=71) responded that BLS training should be a part of the medical curriculum. Mean awareness of general medicine is significantly lower than the other two groups (P<0.001). Conclusion: The level of awareness and knowledge regarding BLS is different among health personnel. Hospital staff and nursing students had better knowledge regarding BLS than general medicine students.


2014 ◽  
Vol 35 (6) ◽  
pp. 219-226
Author(s):  
Yeongtak Song ◽  
Minwoo Kim ◽  
Jinsung Kim ◽  
Jaehoon Oh ◽  
Youngjoon Chee

2019 ◽  
Vol 104 (8) ◽  
pp. 793-801 ◽  
Author(s):  
Jeyapal Kandasamy ◽  
Peter S Theobald ◽  
Ian K Maconochie ◽  
Michael D Jones

BackgroundPerforming high-quality chest compressions during cardiopulmonary resuscitation (CPR) requires achieving of a target depth, release force, rate and duty cycle.ObjectiveThis study evaluates whether ‘real time’ feedback could improve infant CPR performance in basic life support-trained (BLS) and lay rescuers. It also investigates whether delivering rescue breaths hinders performing high-quality chest compressions. Also, this study reports raw data from the two methods used to calculate duty cycle performance.MethodologyBLS (n=28) and lay (n=38) rescuers were randomly allocated to respective ‘feedback’ or ‘no-feedback’ groups, to perform two-thumb chest compressions on an instrumented infant manikin. Chest compression performance was then investigated across three compression algorithms (compression only; five rescue breaths then compression only; five rescue breaths then 15:2 compressions). Two different routes to calculate duty cycle were also investigated, due to conflicting instruction in the literature.ResultsNo-feedback BLS and lay groups demonstrated <3% compliance against each performance target. The feedback rescuers produced 20-fold and 10-fold increases in BLS and lay cohorts, respectively, achieving all targets concurrently in >60% and >25% of all chest compressions, across all three algorithms. Performing rescue breaths did not impede chest compression quality.ConclusionsA feedback system has great potential to improve infant CPR performance, especially in cohorts that have an underlying understanding of the technique. The addition of rescue breaths—a potential distraction—did not negatively influence chest compression quality. Duty cycle performance depended on the calculation method, meaning there is an urgent requirement to agree a single measure.


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