scholarly journals P116: A randomized cross-over trial of conventional bimanual versus single elbow (Koch) chest compression quality in a height-restricted aeromedical helicopter

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S98-S98
Author(s):  
N. Pompa ◽  
D. O’Dochartaigh ◽  
M. J. Douma ◽  
P. Jaggi ◽  
S. Ryan ◽  
...  
Keyword(s):  
External Validation ◽  
Compression Rate ◽  
Limited Data ◽  
Compression Technique ◽  
Compression Depth ◽  
Restricted Environment ◽  
The Mean ◽  
Preliminary Study ◽  
Aeromedical Transport

Introduction: Aeromedical helicopters and fixed wing aircraft are used across Canada to transfer patients to definitive care. Given height limitation in aeromedical transport, CPR performance can be affected. An adapted manual compression technique has been proposed by H. Koch (pron. Cook) that uses the elbow to compress the sternum rather than the conventional hand. This preliminary study evaluated the quality of Koch compressions versus conventional bimanual compressions. Methods: Paramedics (5), registered nurses (3) and a physician (1) were recruited. Each participant performed a 2 minute cycle of each technique, were randomized to determine which technique was performed first, and rested 5 minutes between compression cycles. A Resusci Anne SkillReporter manikin atop a stretcher in a BK117 helicopter was used. The compressors performed without feedback or prompting. Outcomes include compression rate, depth, recoil, and fatigue. Results: The mean conventional compression rate was (bpm) 118 +/− 13 versus 111 +/− 10 in the Koch scenario (p=0.02) (target 100 to 120). Mean conventional compression depth (mm) was 44 +/− 9 versus 49 +/− 7 in the Koch scenario (p=0.01) (target 50 to 60). The mean percentage of compressions with complete release in the conventional scenario was 86 +/− 20 versus 84 +/− 22 in the Koch scenario (p=0.9) (target 100%). Using a Modified Borg Scale of 1 to 10, mean provider fatigue after conventional CPR was 7 (+/− 1.6) versus 3 (+/− 1.2) using Koch technique (p<0.001). On average, Koch technique improved the percentage of compressions at target rate by 26%, the percentage at correct depth by 9%, overall compression quality score by 13% and were more less fatiguing. Conclusion: Using an elbow in a height-restricted environment improved compression depth and reduced provider fatigue. From our limited data, Koch compressions appear to improve compression quality. Further study and external validation are required.

scholarly journals Impact of a Smart-Ring-Based Feedback System on the Quality of Chest Compressions in Adult Cardiac Arrest: A Randomized Preliminary Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5408
Author(s):  
Chiwon Ahn ◽  
Seungjae Lee ◽  
Jongshill Lee ◽  
Jaehoon Oh ◽  
Yeongtak Song ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Feedback System ◽  
Controlled Study ◽  
Feedback Group ◽  
Compression Depth ◽  
System Usability Scale ◽  
The Mean ◽  
Preliminary Study ◽  
The Ideal

This study aimed to assess the effectiveness of a novel chest compression (CC) smart-ring-based feedback system in a manikin simulation. In this randomized, crossover, controlled study, we evaluated the effect of smart-ring CC feedback on cardiopulmonary resuscitation (CPR). The learnability and usability of the tool were evaluated with the System Usability Scale (SUS). Participants were divided into two groups and each performed CCs with and without feedback 2 weeks apart, using different orders. The primary outcome was compression depth; the proportion of accurate-depth (5–6 cm) CCs, CC rate, and the proportion of complete CCs (≤1 cm of residual leaning) were assessed additionally. The feedback group and the non-feedback group showed significant differences in compression depth (52.1 (46.3–54.8) vs. 47.1 (40.5–49.9) mm, p = 0.021). The proportion of accurate-depth CCs was significantly higher in the interventional than in the control condition (88.7 (30.0–99.1) vs. 22.6 (0.0–58.5%), p = 0.033). The mean SUS score was 83.9 ± 8.7 points. The acceptability ranges were ‘acceptable’, and the adjective rating was ‘excellent’. CCs with smart-ring feedback could help achieve the ideal range of depth during CPR. The smart-ring may be a valuable source of CPR feedback.

scholarly journals Effect of the Use of Metronome Feedback on the Quality of Pediatric Cardiopulmonary Resuscitation

2021 ◽  
Vol 18 (15) ◽  
pp. 8087
Author(s):  
Dongjun Yang ◽  
Wongyu Lee ◽  
Jehyeok Oh
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Healthcare Providers ◽  
Compression Rate ◽  
Audio Feedback ◽  
Simple Method ◽  
Compression Depth ◽  
Pediatric Resuscitation ◽  
Cpr Quality

Although the use of audio feedback with devices such as metronomes during cardiopulmonary resuscitation (CPR) is a simple method for improving CPR quality, its effect on the quality of pediatric CPR has not been adequately evaluated. In this study, 64 healthcare providers performed CPR (with one- and two-handed chest compression (OHCC and THCC, respectively)) on a pediatric resuscitation manikin (Resusci Junior QCPR), with and without audio feedback using a metronome (110 beats/min). CPR was performed on the floor, with a compression-to-ventilation ratio of 30:2. For both OHCC and THCC, the rate of achievement of an adequate compression rate during CPR was significantly higher when performed with metronome feedback than that without metronome feedback (CPR with vs. without feedback: 100.0% (99.0, 100.0) vs. 94.0% (69.0, 99.0), p < 0.001, for OHCC, and 100.0% (98.5, 100.0) vs. 91.0% (34.5, 98.5), p < 0.001, for THCC). However, the rate of achievement of adequate compression depth during the CPR performed was significantly higher without metronome feedback than that with metronome feedback (CPR with vs. without feedback: 95.0% (23.5, 99.5) vs. 98.5% (77.5, 100.0), p = 0.004, for OHCC, and 99.0% (95.5, 100.0) vs. 100.0% (99.0, 100.0), p = 0.003, for THCC). Although metronome feedback during pediatric CPR could increase the rate of achievement of adequate compression rates, it could cause decreased compression depth.

scholarly journals Metronome Use Positively Affect Cardiopulmonary Resuscitation Parameters: Prospective Observational Multicenter Manikin Study

2020 ◽  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Minute Ventilation ◽  
Heart Association ◽  
High Volume ◽  
Compression Rate ◽  
Compression Depth ◽  
Manikin Study ◽  
Volume Ventilation ◽  
Cpr Quality

Objective: Clinical studies have shown that eliminating performer errors is important to ensure high quality cardiopulmonary resuscitation (CPR). Literature on the effects of metronome use on the quality of CPR is scarce. This study aimed to investigate the effect of metronome use on the quality of cardiopulmonary resuscitation. Methods: Thirty volunteer emergency physicians who were divided into 15 groups participated in this prospective, observational, multi-center, manikin study. Firstly, each participant performed conventional CPR on a manikin, and then performed metronome-guided CPR after a short break. Parameters affecting CPR quality were evaluated based on the recommendations of the 2015 American Heart Association CPR and Emergency Cardiovascular Care Guideline. In addition, the fatigue levels of participants were evaluated using the Borg Fatigue Index. Results: Metronome-guided CPR significantly improved the chest compression rate (median (Interquartile Range-IQR); 128 (22) compressions/min vs. 110 (2) compressions/min; 95%CI, p < 0.001), deep compression rate (median (IQR); 95.25 (80) compressions/min vs. 72.63 (105) compressions/min; 95%CI, p < 0.001), compression depth (median (IQR); 62.50 (11) mm vs. 60.25 (14) mm; 95%CI, p = 0.016), ventilation number (median (IQR); 11.25 (6) ventilations/min vs. 9.50 (1) ventilations/min; 95%CI, p = 0.001), high-volume ventilation count (median (IQR); 10.13 (6) ventilations/min vs. 9.50 (1) ventilations/min; 95%CI, p = 0.026), minute ventilation volume (median (IQR); 11.75 (10) L/min vs. 8.03 (3) L/min; 95%CI, p < 0.05), and fatigue levels (median (IQR); 3 (2) vs. 2 (2); in 95%CI, p < 0.05). Conclusions: Our study showed that metronome is a useful device for reaching effective CPR. Metronome guidance may change the CPR parameters positively. This study is in accordance with previous studies which have investigated the effect of metronome-guided CPR on survival.

scholarly journals Incidence and trends of ophthalmic cancer in Singapore: Data from Singapore Cancer Registry

2021 ◽  
Vol 50 (4) ◽  
pp. 297-305
Author(s):  
Chin Sheng Teoh ◽  
Preethi Jeyabal ◽  
Stephanie M Young ◽  
Vivien SY Lim
Keyword(s):  
Quality Of Life ◽  
Cancer Registry ◽  
Ciliary Body ◽  
Age Of Onset ◽  
Improve Quality ◽  
Limited Data ◽  
Specific Frequency ◽  
The Mean ◽  
Implementing Strategies

Introduction: Limited data are available on the incidence of primary ophthalmic cancers worldwide. We describe the incidence and trends of primary ophthalmic cancers in Singapore. Methods: Data on ophthalmic cancers diagnosed in Singapore from 1996 to 2016 were retrieved from the Singapore Cancer Registry for analysis. All were histologically proven primary ophthalmic cancers. Calculations of incidence and age-specific frequency of ophthalmic malignancy were made. Results: A total of 297 cases were included, with males constituting 59.9%. The race distribution was 78.5% Chinese, 16.5% Malay, 3.7% Indians and 1.3% others. There was an overall increase in ophthalmic malignancies. The mean age of onset was 47.4 years. The most common cancers were retinoblastoma (93.3%) in patients younger than 15 years, and lymphoma (71.3%) in patients aged 15 years and older. There has been an increase in lymphomas from 16.7% in 1968–1995 to 71.3% in 1996–2016 in those aged 15 years and older. The most common types of ophthalmic cancer according to location are lymphoma of the orbit, conjunctiva, cornea and lacrimal gland; retinoblastoma of the retina; and malignant melanoma of the choroid and ciliary body. Conclusion: Our study reported the incidence and trends of ophthalmic cancer in the Singapore population and showed an overall increase in ophthalmic malignancies in Singapore from 1996–2016. A substantial increase in lymphomas over the last 2 decades was noted. The data could aid clinicians, epidemiologists and policymakers in implementing strategies to address trends in ophthalmic cancers and spur aetiological research to improve quality of life in pa tients with such cancers. Keywords: Aetiology; epidemiology; malignancy; orbital cancers

Abstract 133: Electrical Insulating Gloves for Safe Hands-on Defibrillation Do Not Compromise the Quality of Chest Compressions

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Jakob E Thomsen ◽  
Martin Harpsø ◽  
Graham W Petley ◽  
Svend Vittinghus ◽  
Charles D Deakin ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Chest Compression ◽  
Electrical Insulation ◽  
Compression Rate ◽  
Chest Compressions ◽  
Compression Depth ◽  
Resuscitation Guidelines ◽  
Hands On ◽  
Class 1

Introduction: We have recently shown that Class 1 electrical insulating gloves are safe for hands-on defibrillation. Continuous chest compressions during defibrillation reduce the peri-shock pauses and increase the subsequent chance of successful defibrillation. In this study we have investigated the effect of these electrical insulation gloves on the quality of chest compressions, compared with normal clinical examination gloves. Methods: Emergency medical technicians trained in 2010 resuscitation guidelines delivered uninterrupted chest compressions for 6 min on a manikin, whilst wearing Class 1 electrical insulating gloves or clinical examination gloves. The order of gloves was randomized and each session of chest compressions was separated by at least 30 min to avoid fatigue. Data were collected from the manikin. Compression depth and compression rate were compared. Results: Data from 35 participants are shown in Figure 1. There was no statistically significant difference between Class 1 electrical insulating gloves in chest compression depth (median±range: 45 (28-61) vs 43 (28-61) p=0.69) and chest compression rate (113 (67-150) vs 113(72-145), p=0.87) when compared to clinical examination cloves. Conclusion: These preliminary data suggest that the use of Class 1 electrical insulation gloves does not reduce the quality of chest compressions during simulated CPR compared to clinical examination gloves.

Validity of The Fertility Quality of Life (FertiQol) Questionnaire in Indonesian Infertile Women

KnE Medicine ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. 202
Author(s):  
Muhammad D. Priangga ◽  
Gita Pratama ◽  
Mila Maidarti ◽  
Achmad K. Harzif ◽  
Budi Wiweko
Keyword(s):  
Quality Of Life ◽  
Statistical Analysis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Infertile Women ◽  
The Mean ◽  
Preliminary Study

<p><strong>Introduction</strong></p><p>Infertility in Indonesia has an estimated prevalence as high as 22.3%, with the nature of the problem and its treatment could be devastating, it could affect quality of life and vice versa influence successful of the treatment. The Fertility Quality of Life (FertiQol) Questionnaire was specifically designed for infertility couples and has been demonstrated to have good properties. Studies in several countries has showed consistency in validity and reliability of the questionnaire. Precedently there has been no published study about Fertiqol in Indonesia, this preliminary study is to measure validity and reliability of FertiQol questionnaire among Indonesian infertility women.</p><p><br /> <strong>Material &amp; Methods</strong></p><p>This is a cross-sectional study, a written Fertiqol Questionnaire Indonesian version (www.Fertiqol.org) were distribute to Infertility clinic in Cipto Mangunkusumo General Hospital, total of 129 women completed the questionnaire. Statistical analysis used SPSS version 23.0. The questionnaire were tested for validity with Pearson’s correlation with two tailed and Cronbach α coefficient for reliability.<br /> <strong></strong></p><p><strong>Results</strong></p><p>FertiQol were completed by 129 women with infertility problem. The mean of total FertiQol score was 70.49±11.44, score for emotional, mind/body, relational, environment and tolerability was respectively 63.79±18.86; 66.05±18.22; 75.19.±15.11; 68.99±18.63; 75.64±16.55; 66.23±19.17. Reliability of Fertiqol was high (Cronbach a &gt; 0.70) with every item of questionnaires was valid ( r&gt; 0.1729).<br /> <strong></strong></p><p><strong>Conclusion</strong></p><p>This study showed that FertiQol Indonesian version are valid and reliable in measured quality of life among infertility women in Indonesia.</p>

scholarly journals Two year data from a preliminary study of double lesion site MRgFUS treatment of Essential Tremor targeting the thalamus and the posterior subthalamic area

2021 ◽  
Author(s):  
Ayesha Jameel ◽  
Wladyslaw Gedroyc ◽  
Dipankar Nandi ◽  
Bryn Jones ◽  
Olga Kirmi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Essential Tremor ◽  
Focused Ultrasound ◽  
Rating Scale ◽  
Severity Scores ◽  
The Mean ◽  
Preliminary Study ◽  
Clinical Rating Scale

AbstractBackgroundMR-guided focused ultrasound (MRgFUS) is an effective treatment for essential tremor (ET). However, the optimal intracranial target sites remain to be determined.ObjectiveTo assess MRgFUS induced sequential lesions in (anterior-VIM/VOP nuclei) the thalamus and then posterior subthalamic area (PSA) performed during the same procedure for alleviating ET.Methods14 patients had unilateral MRgFUS lesions placed in anterior-VIM/VOP then PSA. Bain-Findley Spirals were collected during MRgFUS from the treated arm (BFS-TA) and throughout the study from the treated (BFS-TA) and non-treated (BFS-NTA) arms and scored by blinded assessors. Although, the primary outcome was change in the BFS-TA from baseline to 12 months we have highlighted the 24 month data.Secondary outcomes included the Clinical Rating Scale for Tremor (CRST), Quality of Life for ET (QUEST) and PHQ-9 depression scores.ResultsThe mean improvement in the BFS-TA from baseline to 24 months was 41.1% (p<0.001) whilst BFS-NTA worsened by 8.8% (p<0.001). Intra-operative BFS scores from the targeted arm showed a mean 27.9% (p<0.001) decrease after anterior-VIM/VOP ablation and an additional 30.1% (p<0.001) reduction from post anterior-VIM/VOP to post-PSA ablation.Mean improvements at 24 month follow-up in the CRST-parts A, B and C were 60.7%, 30.4% and 65.6% respectively and 37.8% in QUEST-tremor score (all p<0.05). Unilateral tremor severity scores decreased in the treated arm (UETTS-TA) 72.9% (p=0.001) and non-treated arm (UETTS-NTA) 30.5% (p=0.003). At 24 months residual adverse effects were slight unsteadiness (n=1) and mild hemi-chorea (n=1).ConclusionUnilateral anterior-VIM/VOP and PSA MRgFUS significantly diminished contralateral arm tremor with improvements in arm function, tremor related disability and quality of life, with an acceptable adverse event profile.

scholarly journals Prevalence of Provocative Seizures in Persons with Epilepsy: A Longitudinal Study at Khon Kaen University Hospital, Thailand

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Nutthaya Vongkasamchai ◽  
Sunee Lertsinudom ◽  
Acharawan Topark-Ngarm ◽  
Udomlack Peansukwech ◽  
Kittisak Sawanyawisuth ◽  
...  
Keyword(s):  
Medical Records ◽  
Causative Factor ◽  
University Hospital ◽  
Limited Data ◽  
Asian Populations ◽  
Khon Kaen ◽  
The Mean ◽  
One Year ◽  
Seizure Attacks

Background and Objective. Provocative factors are one causative factor of seizure attacks in persons with epilepsy (PWE). There are limited data of prevalence and major provocative factors in Asian populations.Methods. This study was performed at the Epilepsy Clinic, Khon Kaen University Hospital. The patients who aged 15 years or over, who had been treated at least 3 months with at least one antiepileptic drug, and who were followed up for at least one year were included. Data of seizure control and triggers were collected retrospectively from medical records. Data analysis was performed to identify independent provocative factors.Results. A total of 382 PWE met the study criteria. The mean age was40.4±0.8years. Approximately 44% of the patients had at least one provocative factor. By multivariate analysis, the independent provocative factors with the first three highest adjusted odds ratios were sleep deprivation (adjustedOR=8.64, 95% CI 3.73–19.99), alcohol consumption (adjustedOR=6.76, 95% CI 1.44–31.78), and feeling stressful (adjustedOR=2.97, 95% CI 1.29–6.86).Conclusion. Almost half of seizure attacks may be caused by provocative factors in Thai PWEs and some factors may be preventable. Avoidance of these factors should be emphasized to epilepsy patients for improving clinical outcomes and quality of life.

scholarly journals Frei-Chen bases based lossy digital image compression technique

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mahmood Al-khassaweneh ◽  
Omar AlShorman
Keyword(s):  
Image Compression ◽  
Compression Rate ◽  
High Quality ◽  
Compression Technique ◽  
Average Value ◽  
Second Stage ◽  
Compression Factor ◽  
Digital Image Compression ◽  
And Performance

In the big data era, image compression is of significant importance in today’s world. Importantly, compression of large sized images is required for everyday tasks; including electronic data communications and internet transactions. However, two important measures should be considered for any compression algorithm: the compression factor and the quality of the decompressed image. In this paper, we use Frei-Chen bases technique and the Modified Run Length Encoding (RLE) to compress images. The Frei-Chen bases technique is applied at the first stage in which the average subspace is applied to each 3 × 3 block. Those blocks with the highest energy are replaced by a single value that represents the average value of the pixels in the corresponding block. Even though Frei-Chen bases technique provides lossy compression, it maintains the main characteristics of the image. Additionally, the Frei-Chen bases technique enhances the compression factor, making it advantageous to use. In the second stage, RLE is applied to further increase the compression factor. The goal of using RLE is to enhance the compression factor without adding any distortion to the resultant decompressed image. Integrating RLE with Frei-Chen bases technique, as described in the proposed algorithm, ensures high quality decompressed images and high compression rate. The results of the proposed algorithms are shown to be comparable in quality and performance with other existing methods.

scholarly journals THE EFFECTIVENESS OF APPLYING ESA METHOD TOWARDS STUDENTS’ ENGLISH VOCABULARY MASTERY

2019 ◽  
Vol 6 (2) ◽  
pp. 76
Author(s):  
Rully May Vikasari
Keyword(s):  
Foreign Language ◽  
Junior High School ◽  
Mixed Method ◽  
Target Language ◽  
Writing Class ◽  
Post Test ◽  
Quasi Experimental ◽  
The Mean ◽  
Preliminary Study

Inspired by difficulties of grade 8 students of SMPN 4 Praya, Central Lombok in increasing their vocabulary mastery, the current study applied ESA (Engage Study Active) method to overcome the situation. The fundamental contribution of vocabulary in learning a foreign language encouraged the researcher to find a way to improve students’ vocabulary mastery. In an attempt to find the solution, the study was designed as a quasi-experimental study at SMPN (public junior high school) 4 Praya. To conduct the study, the researcher had conducted a preliminary study to collect information from the class to identify problems occurred in the school during vocabulary learning. By applying mixed method, this study was aimed to find the effectiveness of ESA method using the quantitative method and to see the improvement on the students’ mastery qualitatively by conducting classroom observation to see the quality of interaction in the class using English as the target language. Throughout the study, quantitative data showed increase in students’ vocabulary mastery after being treated using ESA method, in which the mean score of the pre-test of 53 increased in the post-test of 75. The result was found using descriptive statistic analysis towards students’ pretest and posttest results. Qualitatively, the observers’ notes also indicated increase in terms of students’ vocabulary mastery by viewing students’ engagements during classroom interactions. It can be concluded that ESA method may increase students’ English vocabulary mastery in writing class.

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