scholarly journals MP20: Evaluation of the disruptors during advanced life support in emergency departments

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S49-S49
Author(s):  
J. Truchot ◽  
D. Michelet ◽  
D. Drummond ◽  
P. Plaisance
Keyword(s):  
Emergency Departments ◽  
Exploratory Study ◽  
Online Survey ◽  
Life Support ◽  
Medical Curriculum ◽  
Real Life ◽  
Advanced Life Support ◽  
Cross Sectional ◽  
Phone Calls ◽  
Ed Overcrowding

Introduction: Simulation is used as a teaching technique in the medical curriculum, and especially for advanced life support (ALS). However, simulated ALS can differ greatly from real life ALS. The aim of this exploratory study was to identify the different disruptors associated with real life ALS. Methods: We conducted a cross-sectional, anonymous, online survey that included 32 items. It was distributed by email to emergency physicians from five emergency departments in Paris. The aim of this online survey was to identify the elements perceived as disruptors during ALS. Other aspects of the survey explored the perceived differences between simulated ALS and real life ALS. Descriptive statistics of percentage, mean and standard deviation were used to analyse the data. Results: Among 100 surveyed physicians, 43 (43%) answers were analysed. 53% were women with a mean age of 32 ± 3 years old. The identified disruptors from real life ALS were task interruptions mainly from non-medical staff (n = 16; 37%), patient's siblings (n = 5; 12%), other specialists (n = 5; 12%) and the phone calls (n = 2; 5%). The situation of ED overcrowding (n = 12; 28%) was also mentioned as a potential disruptor. Overall, physicians reported that some technical and non-technical tasks were harder to perform in real life compared to simulated sessions. Conclusion: This exploratory study allowed the identification of disruptors encountered in real life cases of ALS, and may be used for future simulation-based teaching to enhance realism during sessions

scholarly journals Parada cardiorrespiratória pré-hospitalar: avaliação dos atendimentos segundo o utstein style*

2019 ◽  
Vol 13 ◽  
Author(s):  
Robson Cristiano Zandomenighi ◽  
Eleine Aparecida Penha Martins
Keyword(s):  
Life Support ◽  
Cardiopulmonary Arrest ◽  
Advanced Life Support ◽  
Venous Access ◽  
Orotracheal Intubation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Epinephrine Administration ◽  
Peripheral Venous Access ◽  
Utstein Style

Objetivo: analisar as ocorrências, respostas e desfechos da parada cardiorrespiratória pré-hospitalar segundo o Utstein Style e identificar os fatores associados à sobrevida. Método: trata-se de um estudo quantitativo, documental e transversal, com vítimas de parada cardiorrespiratória atendidas nas unidades de suporte avançado de vida, no ano de 2015. Coletaram-se os dados a partir dos relatórios de atendimento do socorrista, organizando-os e analisando-os de acordo com o Utstein Style. Apresentaram-se os resultados em forma de tabelas. Resultados: verificaram-se 163 atendimentos, predominando o sexo masculino, não havendo associação entre idade e os desfechos. Identificou-se a maioria das PCRs como sendo de causa clínica, na residência e em assistolia, sendo entubação orotraqueal, acesso venoso periférico e administração de adrenalina os procedimentos mais frequentes. Constatou-se que as ocorrências presenciadas por espectadores leigos e o tempo-resposta da ambulância demonstraram uma associação com o desfecho sobrevida. Calculou-se a taxa de sobrevida em 25,1%. Conclusão: avaliou-se o serviço por meio da análise das ocorrências segundo o Utstein Style e verificaram-se associações entre o desfecho e as lacunas no atendimento, havendo a necessidade de intervenções em cada elo da corrente de sobrevivência. Descritores: Parada Cardíaca Extra-Hospitalar; Ressuscitação Cardiopulmonar; Serviços Médicos de Emergência; Ambulâncias; Emergências; Avaliação de Resultados. ABSTRACTObjective: to analyze the occurrences, responses and outcomes of prehospital cardiopulmonary arrest according to Utstein Style and to identify factors associated with survival. Method: this is a quantitative, documentary and cross-sectional study with victims of cardiopulmonary arrest treated at the advanced life support units in 2015. Data were collected from the rescuer's care reports and organized. and analyzing them according to Utstein Style. Results were presented in tables. Results: 163 cases were observed, predominantly male, with no association between age and outcomes. Most CRPs were identified as being of clinical cause, at home and in asystole, with orotracheal intubation, peripheral venous access and epinephrine administration being the most frequent procedures. It was found that the occurrences witnessed by lay spectators and the ambulance response time demonstrated an association with the survival outcome. The survival rate was calculated at 25.1%. Conclusion: the service was evaluated by analyzing the occurrences according to the Utstein Style and there were associations between the outcome and the gaps in care, requiring interventions in each link of the survival chain. Descriptors:  Out-of-Hospital Cardiac Arrest; Cardiopulmonary Resuscitation; Emergency Medical Services; Ambulances; Emergencies; Outcome Assessment. RESUMENObjetivo: analizar las ocurrencias, las respuestas y los resultados del paro cardiopulmonar prehospitalario según el Utstein Style e identificar los factores asociados con la supervivencia. Método: este es un estudio cuantitativo, documental y transversal con víctimas de paro cardiopulmonar tratadas en las unidades de soporte vital avanzado en 2015. Los datos se recopilaron de los informes de atención del rescatista, organizándolos y analizándolos según el Utstein Style. Los resultados se presentaron en tablas. Resultados: se observaron 163 casos, predominantemente masculinos, sin asociación entre la edad y los resultados. La mayoría de las PCRs se identificaron como de causa clínica, en el hogar y en la asistolia, siendo los procedimientos más frecuentes la intubación orotraqueal, el acceso venoso periférico y la administración de adrenalina los procedimientos más frecuentes. Se descubrió que las ocurrencias presenciadas por espectadores legos y el tiempo de respuesta de la ambulancia demostraron una asociación con el resultado de supervivencia. La tasa de supervivencia se calculó en 25.1%. Conclusión: el servicio se evaluó analizando las ocurrencias según el Utstein Style y hubo asociaciones entre el resultado y las brechas en la atención, lo que requiere intervenciones en cada eslabón de la cadena de supervivencia. Descriptores: Paro Cardíaco Extra-Hospitalario; Reanimación Cardiopulmonar; Servicios Médicos de Urgencia; Ambulancias, Urgencias Médicas, Evaluación de Resultado. 

Death in emergency departments: a multicenter cross-sectional survey with analysis of withholding and withdrawing life support

2010 ◽  
Vol 36 (5) ◽  
pp. 765-772 ◽  
Author(s):  
Philippe Le Conte ◽  
David Riochet ◽  
Eric Batard ◽  
Christelle Volteau ◽  
Bruno Giraudeau ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Life Support ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Reconsidering How Successful Aging is Defined

2021 ◽  
Vol 20 (3) ◽  
pp. 694-708
Author(s):  
Barbra Teater ◽  
Jill Chonody
Keyword(s):  
Social Workers ◽  
Exploratory Study ◽  
Successful Aging ◽  
Online Survey ◽  
Community Dwelling ◽  
Financial Security ◽  
Cross Sectional ◽  
The Social ◽  
Aging Adults ◽  
Definition Of

Successful aging is a prominent framework within gerontology, yet an understanding of how aging adults define “successful aging” is often missing in the social work discourse around what it means to age well. This cross-sectional, exploratory study used an online survey to explore community-dwelling adults’ (aged 55+; n=471) definition of successful aging, the underlying components across all definitions, and any differences in components based on whether or not the adults identified as aging successfully. Summative content analysis yielded five main themes and 13 sub-themes for those who identified as aging successfully and five main themes and 11-sub-themes for those who identified as not aging successfully with elements of health constituting the largest percentage of responses across both groups. Bivariate analyses found participants in the “not aging successfully” group mentioned elements of Being Healthy and Financial Security more than those in the aging successfully group, and elements of Sustain Participation, Curiosity, and Learning less than those in the “aging successfully” group. The findings illustrate the extent to which aging adults view successful aging as the presence of health and ability. Social workers should be mindful to the ways in which adults view successful aging and the elements they believe to contribute to successful aging in order to provide and tailor programs, services, and resources that are supportive of aging adults’ needs and wishes.

Physical Education Teachers’ Embracement of Alternative Environment Activities

2020 ◽  
Vol 39 (4) ◽  
pp. 508-517
Author(s):  
Nathan Hall ◽  
Brent Bradford ◽  
José da Costa ◽  
Daniel B. Robinson
Keyword(s):  
Professional Development ◽  
Physical Education ◽  
Exploratory Study ◽  
Online Survey ◽  
Descriptive Statistics ◽  
Physical Education Teachers ◽  
Cross Sectional ◽  
Teachers Experiences ◽  
Outdoor Environments ◽  
Teachers Professional Development

Background and Purpose: Despite widespread evidence suggesting the numerous benefits from being active in outdoor environments, children in many Western nations have recently been spending less time outdoors. This cross-sectional exploratory study provides a descriptive examination of physical education teachers’ embracement of alternative environment activities (AEAs) in physical education programs. Method: Data were collected from 225 current physical education teachers in Alberta and Manitoba, Canada, through an online survey. Data were analyzed using descriptive statistics, factor analysis, Levene’s tests, and independent t tests. Results: Significant differences were found in relation to teachers’ experiences, or lack thereof, with professional development in relation to the extent to which teachers embraced AEAs. Furthermore, cost was discovered to be the greatest perceived barrier to teaching AEAs. Discussion and Conclusions: This study reveals an established need for teachers’ professional development in teaching AEAs and for discovering ways to decrease cost barriers for teaching AEAs.

scholarly journals PREPAREDNESS OF CANADIAN PHYSICIAN OFFICES FOR PAEDIATRIC EMERGENCIES

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e5-e5
Author(s):  
Anushka Weeraratne ◽  
Dayae Jeong ◽  
Suhrata Verma ◽  
Marina Atalla ◽  
Mohammed Hassan-Ali ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Life Support ◽  
Advanced Life Support ◽  
Family Physicians ◽  
Care Staff ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Past ◽  
Paediatric Emergency ◽  
The Impact

Abstract BACKGROUND Studies in the US have demonstrated that many primary care staff and offices are inadequately prepared for paediatric emergencies. Although the Canadian Paediatric Society (CPS) recently reaffirmed their “Guidelines for Paediatric Emergency Equipment and Supplies for a Physician’s Office”, no evaluation has been made regarding the impact of publishing these recommendations, or on the state of preparedness for paediatric emergencies in family physician offices. OBJECTIVES The aim of this study was to evaluate awareness of and adherence of family physicians in Ontario to the CPS guidelines on preparedness for paediatric emergencies. DESIGN/METHODS We conducted a province-wide, cross-sectional survey of 749 randomly selected family physicians. Participants were asked to complete a 14-question survey regarding clinic characteristics, incidence of paediatric emergencies, and preparedness of the clinic in the case of a paediatric emergency. Ethics approval was obtained from the regional Ethics Review Board. RESULTS 94 physicians responded to our survey (response rate of 13.1%). 68.1% of respondents reported seeing more than 10 children per week, and 59.6% and had experienced at least one paediatric emergency in the past year. The proportion of physicians reporting paediatric emergencies within the last year increased with the number of children seen - 37.9% of physicians who saw fewer than 10 children per week reported an emergency, compared to 100.0% of those who saw more than 40 children per week. Only 4.3% respondents reported that they were unaware of the CPS guidelines on paediatric emergency preparedness. Although 85.1% of respondents were aware of the guidelines, only 10.6% of respondents had read them. Of the physicians who were aware of but had not read the guidelines, 2.5% engaged in mock code sessions, 27.8% were up-to-date on Paediatric Advanced Life Support (PALS), 1.3% had written protocols outlining safe transport of children to hospitals, and 41.8% stocked half or more of the recommended supplies. In comparison, of the physicians who had read the guidelines, 20.0% engaged in mock code sessions, 50.0% were up-to-date on PALS, 10.0% had written protocols, and 70.0% stocked half or more of the recommended supplies. CONCLUSION A large proportion of respondents had experienced at least one paediatric emergency in the past year, but were overall underprepared. There was a discrepancy between physicians who were aware of the CPS guidelines on emergency preparedness (85.1%), and those who have actually read them (10.6%), though offices with the latter were more adherent to the guidelines’ recommendations. It will be important for CPS to consider how to further advocate for paediatric emergency preparedness in clinics that see children regularly.

Abstract 19658: Physicians on Cardiac Arrest Teams are Most Often Non-specialists With Limited Clinical Experience

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kasper G Lauridsen ◽  
Anders S Schmidt ◽  
Philip Caap ◽  
Rasmus S Aagaard ◽  
Bo Løfgren
Keyword(s):  
Cardiac Arrest ◽  
Clinical Experience ◽  
Life Support ◽  
Clinical Skills ◽  
Advanced Life Support ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Telephone Interviews ◽  
Cpr Training ◽  
Erc Guidelines

Introduction: The quality of in-hospital resuscitation is poor and may be affected by clinical experience and cardiopulmonary resuscitation (CPR) training. This study aimed to investigate the clinical experience, self-perceived skills, CPR training, and knowledge of guidelines on when to abandon resuscitation among physicians on cardiac arrest teams. Methods: This is a nationwide cross-sectional study in Denmark. Telephone interviews were performed with physicians on cardiac arrest teams in public somatic hospitals. Telephone interviews were performed using a structured questionnaire. Results: In total, 93 physicians (53% male) from 45 hospitals participated. Median age was 34 interquartile range (30-39) years. Participants were medical students working as locum physicians (5%), residents and fellows (79%), chief physicians (16%), and median postgraduate clinical experience was 48 (19-87) months. Most physicians (92%) felt confident in treating a cardiac arrest, while less felt confident in performing intubation (41%) and focused cardiac ultrasound (39%) during cardiac arrest. Median time since last CPR training was 4 months (2-10) and 48% had attended a European Resuscitation Council (ERC) Advanced Life Support (ALS) course. The majority (84%) felt confident in terminating resuscitation however only 9% were able to state ERC guidelines on when to abandon resuscitation. Conclusions: Physicians on Danish cardiac arrest teams are most often non-specialists with four or less years of clinical experience. Several physicians are not able to perform important clinical skills during resuscitation. Less than half of physicians have attended an ERC ALS course. Only very few physicians know the ERC guidelines on when to abandon resuscitation.

Time out! Pauses during advanced life support in high-fidelity simulation: A cross-sectional study

2021 ◽  
Author(s):  
Verónica V. Márquez-Hernández ◽  
Lorena Gutiérrez-Puertas ◽  
Alba García-Viola ◽  
José Miguel Garrido-Molina ◽  
Vanesa Gutiérrez-Puertas ◽  
...  
Keyword(s):  
Life Support ◽  
Advanced Life Support ◽  
Cross Sectional Study ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Time Out

Awareness of Basic Life Support & Advanced Life Support among Students in a Medical College in Kerala

2020 ◽  
Vol 7 (45) ◽  
pp. 2640-2644
Author(s):  
Sunil R ◽  
Praseetha V.K
Keyword(s):  
Medical Students ◽  
Nursing Students ◽  
Basic Life Support ◽  
Life Support ◽  
Advanced Life Support ◽  
Advanced Cardiac Life Support ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Cardio Pulmonary Resuscitation

BACKGROUND The knowledge and skills in Cardio-Pulmonary Resuscitation (CPR) is an essential part in the medical education. Resuscitation skills have undergone series of evolution into current protocol which involves Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS). We wanted to assess the awareness of Basic Life Support among medical students, nursing students and house surgeons in a Government Medical College in Kerala. METHODS A cross-sectional study was conducted by assessing responses to 24 selected basic questions regarding BLS and ACLS among the students. After excluding the incomplete response forms the data from 500 responders was analysed. Results were analysed using an answer key prepared with the use of the Advanced Cardiac Life Support manual of AHA (2015). RESULTS Out of 500 responders, 250 were medical students, 100 were nursing students and 150 were House Surgeons. No one among them had complete knowledge of BLS & ACLS. Awareness of BLS & ACLS among students of medical, and nursing colleges and doctors is poor. Regarding knowledge of BLS (9 questions) the analysis of results showed that mean percentage of correct responses were 75.67 % of house surgeons, 51.78 % of nursing students and 20.98 % of medical students. CONCLUSIONS Awareness of BLS among students of medical, and nursing colleges and house surgeons is inadequate. Proper training programs must be initiated to rectify this. KEYWORDS BLS & ACLS Awareness, Medical Students, CPR Questionnaire

scholarly journals 104 Management of sports-related concussion in UK emergency departments: a multi-centre study

2020 ◽  
Vol 37 (12) ◽  
pp. 822.2-822
Author(s):  
Haroon Rashid ◽  
Nick Dobbin ◽  
Smarak Mishra
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Return To Play ◽  
Cross Sectional ◽  
Multi Centre Study ◽  
North West ◽  
The North ◽  
Consensus Statements

Aims/Objectives/BackgroundIt is necessary for those working in emergency departments to have adequate knowledge and delivery of current sport-related concussion (SRC) management protocols including identifying patients with concussion, managing their symptoms, giving appropriate advice with regards to return to play and referring those at risk of further injuries to an appropriate service.This study aimed to establish the current practice, knowledge base and views towards SRC management of emergency department clinicians who have trained or are currently training in emergency medicine in the North West of England.Methods/DesignThis study was a multi centre, cross sectional study of 111 emergency department clinicians (EDCs) working across 15 centres in the North West of England A 21 item online survey was issued. The key questions focused on the advice given to patients on discharge, the importance of cognitive and physical rest, and knowledge of GRTP.Results/ConclusionsApproximately, 37% of the population responded to the invitation, with 111 responses included in this study. Only 27% of total respondents were aware of the Consensus Statements of Concussion in Sport guidelines, whilst 45% were unaware of any SRC guidelines. 57% of respondents had heard of a graded return to play (GRTP) protocol. Physical rest following an SRC was advised by 95% of respondents with 61% advising concomitant cognitive rest and 42% of respondents providing specific written advice. 90% of clinicians had not received any SRC training.There is a lack of knowledge amongst EDCs in the North West of England in managing and providing discharge advice according to recommendations for patients with SRC. This is likely a consequence of the limited training that these clinicians have received in managing SRC and suggests further work needs to be undertaken to educate EDCs on current SRC management guidance to ensure appropriate care and discharge advice is given to patients.

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