Creating Coronary Care Units and Empowering Nurses

2015 ◽  
Author(s):  
W. Bruce Fye
Keyword(s):  
Cardiac Arrest ◽  
Health Care Providers ◽  
Vital Role ◽  
Care Providers ◽  
Vulnerable Patients ◽  
Life Saving ◽  
Life Threatening ◽  
Coronary Care ◽  
Infarction Heart ◽  
Coronary Care Units

The coronary care unit (CCU) concept was proposed in 1961 as a strategy to save the lives of patients hospitalized after an acute myocardial infarction (heart attack). The notion was to place vulnerable patients in an area where their heartbeats were monitored continuously and where specially trained nurses could initiate cardiopulmonary resuscitation (CPR) if a patient had a cardiac arrest. Cardiac defibrillators and temporary pacemakers, technologies developed in the 1950s to treat life-threatening heart rhythms, were combined with CPR in 1960 in an attempt save patients’ lives. Nurses played a vital role in CCUs, and the new care model transformed the traditional nurse-doctor relationship. Nurses were trained to initiate life-saving treatments without a physician being present. The resulting empowerment of nurses had significant implications for their status as health care providers. The CCU movement also contributed to the development of cardiac arrest teams and paramedic-staffed, defibrillator-equipped ambulances.

Effectiveness of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program Developed by the Thailand National Institute of Emergency Medicine (NIEMS)

2021 ◽  
pp. 1-6
Author(s):  
Chuenruthai Angkoontassaneeyarat ◽  
Chaiyaporn Yuksen ◽  
Chetsadakon Jenpanitpong ◽  
Pemika Rukthai ◽  
Marisa Seanpan ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Health Care Providers ◽  
Care Providers ◽  
Chest Compressions ◽  
Threatening Condition ◽  
Life Threatening

Abstract Background: Out-of-hospital cardiac arrest (OHCA) is a life-threatening condition with an overall survival rate that generally does not exceed 10%. Several factors play essential roles in increasing survival among patients experiencing cardiac arrest outside the hospital. Previous studies have reported that implementing a dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) program increases bystander CPR, quality of chest compressions, and patient survival. This study aimed to assess the effectiveness of a DA-CPR program developed by the Thailand National Institute for Emergency Medicine (NIEMS). Methods: This was an experimental study using a manikin model. The participants comprised both health care providers and non-health care providers aged 18 to 60 years. They were randomly assigned to either the DA-CPR group or the uninstructed CPR (U-CPR) group and performed chest compressions on a manikin model for two minutes. The sequentially numbered, opaque, sealed envelope method was used for randomization in blocks of four with a ratio of 1:1. Results: There were 100 participants in this study (49 in the DA-CPR group and 51 in the U-CPR group). Time to initiate chest compressions was statistically significantly longer in the DA-CPR group than in the U-CPR group (85.82 [SD = 32.54] seconds versus 23.94 [SD = 16.70] seconds; P <.001). However, the CPR instruction did not translate into better performance or quality of chest compressions for the overall sample or for health care or non-health care providers. Conclusion: Those in the CPR-trained group applied chest compressions (initiated CPR) more quickly than those who initiated CPR based upon dispatch-based CPR instructions.

scholarly journals Caregiver Burden: Caregiving Workshops Have a Positive Impact on Those Caring for Individuals With Dementia in Arkansas

2021 ◽  
Vol 8 ◽  
pp. 237437352110180
Author(s):  
Robin E. McAtee ◽  
Laura Spradley ◽  
Leah Tobey ◽  
Whitney Thomasson ◽  
Gohar Azhar ◽  
...  
Keyword(s):  
Caregiver Burden ◽  
Health Care Providers ◽  
Positive Impact ◽  
Educational Programs ◽  
Vital Role ◽  
Complex Care ◽  
Care Providers ◽  
Dementia Caregivers ◽  
Before And After ◽  
Burden Scale

Millions of Americans live with dementia. Caregivers of this population provide countless hours of multifaceted, complex care that frequently cause unrelenting stress which can result in immense burden. However, it is not fully understood what efforts can be made to reduce the stress among caregivers of persons with dementia (PWD). Therefore, the aim of this pretest–posttest designed study was to evaluate changes in caregiver burden after providing an educational intervention to those caring for PWD in Arkansas. Forty-one participants completed the Zarit Caregiver Burden Scale before and after attending a 4-hour dementia-focused caregiving workshop. The analysis of the means, standard deviations, and paired t tests showed that there was an increase in the confidence and competence in caring for PWD 30 to 45 days after attending the workshop. Health care providers need to understand both the vital role caregivers provide in managing a PWD and the importance of the caregiver receiving education about their role as a caregiver. Utilizing caregiver educational programs is a first step.

Abstract P163: Accuracy to Diagnose Cardiac Arrest and Quickness to Start Chest Compression in Different BLS Algorithms; a Comparative Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tomoko Tamura ◽  
Koichi Tanigawa ◽  
Shinji Kusunoki ◽  
Takuma Sadamori ◽  
Tadatsugu Otani ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Medical Students ◽  
Health Care Providers ◽  
Chest Compression ◽  
Loss Of Consciousness ◽  
Care Providers ◽  
Clinical Experiences ◽  
European Resuscitation Council ◽  
The Subject ◽  
Erc Guidelines

Background; BLS algorithms for health care providers or experience personnel recommended by AHA, European Resuscitation Council (ERC), and Japanese Resuscitation Council (JPN) differ with respect to the sequence of assessment and procedures. The differences may affect accuracy to diagnose cardiac arrest and quickness to start chest compression. We compared BLS algorithms recommended by these organizations with respect to accuracy of respiratory/circulatory assessment, and quickness to start chest compression using a computed manikin model. Methods; Thirty three subjects (16 physicians and 17 medical students) were enrolled. The Sim-Man (Laerdal) was used to develop 2 scenarios (no pulse/no breathing, with pulse 60/min and breathing 10/min). The three algorithms and 2 scenarios were randomly assigned to the subject, and the accuracy to diagnose cardiac arrest and the time from confirmation of loss of consciousness to starting chest compression were evaluated. Results; The rates of incorrect assessment of respiratory/circulatory status were AHA;9.8% (13 out of 132), ERC;9.1%(12 out of 132) and JPN;6.8%(9 out of 132)(n.s. among algorithms). When the results were analyzed with respect to clinical experiences of the subjects, i.e. physicians vs. medical students, significant differences were found between the groups: AHA;17.2% (11 out of 64), ERC;15.6% (10 out of 64), JPN;12.5% (8 out of 64) in students, whereas AHA;2.9% (2 out of 68), ERC;2.9% (2 out of 68), JPN;1.5% (1 out of 68) in physicians* (* p<0.05 vs. students). The time to starting chest compression were AHA;27.8±5.1 sec, ERC;18.6±3.2** sec, JPN;23.7±4.2 sec (**p<0.05 vs. AHA and JPN), and no significant differences were found between physicians and students. Conclusions; No differences were found in accuracy of respiratory and circulatory assessment among the algorithms, although it may be influenced by clinical experiences of evaluators. The BLS algorithm starting CPR from chest compression such as ERC guidelines may reduce the time of no-flow status in cardiac arrest.

History and experience of a volunteer ambulance first responder scheme in London

2021 ◽  
Vol 13 (8) ◽  
pp. 344-348
Author(s):  
Saman Al-Sahab ◽  
Aditi Nijhawan ◽  
Tim Kirkby ◽  
Shadman Aziz
Keyword(s):  
Cardiac Arrest ◽  
Blue Light ◽  
Response Times ◽  
Ambulance Service ◽  
First Responder ◽  
Emergency Responders ◽  
Life Saving ◽  
Wide Range ◽  
Life Threatening ◽  
Set Up

Emergency responders (ERs) are volunteers who attend category 1 (immediately life-threatening) and category 2 (emergency) 999 calls on behalf of the London Ambulance Service NHS Trust (LAS). ERs aim to arrive first on scene to these incidents to provide essential life-saving interventions prior to the arrival of further ambulance resources. ERs come from a wide range of backgrounds and undergo a thorough selection, training and mentorship process before advancing to working in a two-person ER crew. Compared to most traditional volunteer first responder schemes, the LAS ER scheme, which was set up in 2008, involves an enhanced skillset, dispatch to medical and traumatic emergencies in addition to cardiac arrest, and the use of blue-light vehicles to reduce response times. Over a period of 13 years, the scheme has grown in scope and size, and now operates with more than 120 volunteers based at seven ambulance stations across London.

“My Whole World Fell Apart”: Parents Discovering Their Child Has Anorexia Nervosa

2020 ◽  
Vol 30 (12) ◽  
pp. 1821-1832
Author(s):  
Emily P. Williams ◽  
Shelly Russell-Mayhew ◽  
Nancy J. Moules ◽  
Gina Dimitropoulos
Keyword(s):  
Health Care ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Health Care Providers ◽  
Family Dynamics ◽  
Vital Role ◽  
Care Providers ◽  
Critical Gap ◽  
Hermeneutic Inquiry ◽  
Difficult Times

This was the first study to examine the experience of parents who discover their child was living with anorexia nervosa (AN), thus fulfilling a critical gap in the eating disorder literature. Gadamerian hermeneutic inquiry was the guiding philosophy and method used to investigate this topic. Dialogues with parents revealed the ambiguity inherent within discovery; the isolation, betrayal, and loss felt by parents; and the complicated family dynamics occurring during the process of discovering one’s child has AN. As such, when discoveries are made, parents play a vital role in the development and functioning of the family’s response to the situation. This research offers health care providers a better understanding of the difficult times parents and caregivers experience when discovering their child has AN.

scholarly journals Cardiopulmonary resuscitation during the COVID-19 pandemic: a scientific statement on CPR management protocol of Kasr Al-Ainy University Hospital is presented

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Hesham S. Taha ◽  
Mirna M. Shaker ◽  
Mohamed M. Abdelghany
Keyword(s):  
Health Care ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Health Care Providers ◽  
University Hospital ◽  
Rapid Sequence Intubation ◽  
Main Body ◽  
Care Providers ◽  
Management Protocol ◽  
Scientific Statement

Abstract Background The COVID-19 pandemic poses a major burden to the healthcare system in Egypt, and in the face of a highly infective disease which can prove fatal, healthcare systems need to change their management protocols to meet these new challenges. Main body This scientific statement, developed by the cardiology department at Cairo University, emphasized 6 different aspects that are intended to guide healthcare providers during cardiopulmonary resuscitation (CPR) in the era of the COVID-19 pandemic. It highlighted the importance of dealing with all cardiac arrest victims, during the pandemic, as potential COVID-19 cases, and the use of appropriate personal protective equipment (PPE) by health care providers during the procedure. It also stated that the CPR procedure should be done in a separate room with the door closed and that the number of providers present during the procedure should be limited to only those who are essential for patient resuscitation. It also stressed that family members and accompanying personnel of patients with possible COVID-19 should not be in the vicinity of CPR site. The statement also pointed out that CPR procedure should be done in the standard manner with precautions to minimize spread of infection to the staff and accompanying people. Early intubation was prioritized, and the use of rapid sequence intubation with appropriate PPE was recommended. For delivery of CPR for the prone ventilated patient, delivery of chest compressions by pressing the patient’s back, while a team prepares to turn the patient supine, was recommended. During intra-hospital transport, it was emphasized that the receiving intensive care unit (ICU) should be notified about the possibility of the patient being COVID-19 positive, so that appropriate infection control precautions are taken. Conclusion Cardiopulmonary resuscitation of cardiac arrest patients in the COVID-19 era poses a significant challenge, and all health care providers should deal with any cardiac arrest victim presenting to the emergency department as potential COVID-19 suspects and should use the appropriate PPE.

Holding Secrets While Living With Life-Threatening Illness: Normalizing Patients’ Decisions to Reveal or Conceal

2019 ◽  
Vol 30 (5) ◽  
pp. 655-665 ◽  
Author(s):  
Anne Bruce ◽  
Rosanne Beuthin ◽  
Laurene Sheilds ◽  
Anita Molzahn ◽  
Kara Schick-Makaroff
Keyword(s):  
Health Care Providers ◽  
Narrative Analysis ◽  
Social Practice ◽  
Narrative Approach ◽  
Care Providers ◽  
Life Threatening Illness ◽  
Health And Illness ◽  
Life Threatening ◽  
Normative Practice

Communicating openly and directly about illness comes easily for some patients, whereas for others fear of disclosure keeps them silent. In this article, we discuss findings about the role of keeping secrets regarding health and illness. These findings were part of a larger project on how people with life-threatening illnesses re-story their lives. A narrative approach drawing on Frank’s dialogical narrative analysis and Riesman’s inductive approach was used. Interviews were conducted with 32 participants from three populations: chronic kidney disease, HIV/AIDS, and cancer. Findings include case exemplars which suggest keeping secrets is a social practice that acts along continuums of connecting–isolating, protecting–harming, and empowering–imprisoning. Keeping secrets about illness is a normative practice that is negotiated with each encounter. Findings call health-care providers to rethink the role of secrets for patients by considering patient privilege, a person’s right to take the lead in revealing or concealing their health and illness experience.

Chemotherapy Acute Infusion Reactions: A Qualitative Report of the Perspectives of Patients With Cancer

2018 ◽  
Vol 35 (11) ◽  
pp. 1384-1389
Author(s):  
David J. Bartlett ◽  
Daniel S. Childs ◽  
Carmen Radecki Breitkopf ◽  
Megan E. Grudem ◽  
Jessica L. Mitchell ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Antineoplastic Agents ◽  
Qualitative Methodology ◽  
Infusion Reaction ◽  
Care Providers ◽  
Patients With Cancer ◽  
Life Threatening ◽  
Infusion Reactions

Objective: A growing number of cancer antineoplastic agents can cause life-threatening acute infusion reactions. Because previous studies have not studied these reactions from the perspective of patients, this study was undertaken with that objective in mind. Methods: Patients who had an acute infusion reaction were interviewed based on the Leventhal model. Once saturation of content was achieved, interviews were transcribed and analyzed with qualitative methodology. Results: Twenty-one patients were enrolled. Most were women (n = 15); the median age was 58 years, and paclitaxel was the most common inciting agent. Three themes emerged. First, these reactions are frightening; patients made remarks such as “I was just thinking oh my God, I am dying.” Second, prior education about these reactions seemed to mitigate this fear, “Basically everything the nurses told me potentially could happen, like happened. So, I was prepared.” Third, when health-care providers were prompt and attentive during the reaction, patients described less fear with future chemotherapy, “So no, I’m really not fearful about going in tomorrow because I know they’ll be there and they’ll be watching me.” Conclusion: These reactions evoke fear which can be mitigated with education prior to and with prompt responsiveness during the acute infusion reaction.

scholarly journals Mitigating the Twin Threats of Climate-Driven Atlantic Hurricanes and COVID-19 Transmission

2020 ◽  
Vol 14 (4) ◽  
pp. 494-503 ◽  
Author(s):  
James M. Shultz ◽  
James P. Kossin ◽  
Attila Hertelendy ◽  
Fredrick Burkle ◽  
Craig Fugate ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Care Providers ◽  
Protective Measures ◽  
Rapid Acquisition ◽  
Atlantic Hurricane ◽  
Hygiene Practices ◽  
Emergency Managers ◽  
Life Saving ◽  
Atlantic Hurricanes ◽  
Timely Warning

ABSTRACTThe co-occurrence of the 2020 Atlantic hurricane season and the ongoing coronavirus disease 2019 (COVID-19) pandemic creates complex dilemmas for protecting populations from these intersecting threats. Climate change is likely contributing to stronger, wetter, slower-moving, and more dangerous hurricanes. Climate-driven hazards underscore the imperative for timely warning, evacuation, and sheltering of storm-threatened populations – proven life-saving protective measures that gather evacuees together inside durable, enclosed spaces when a hurricane approaches. Meanwhile, the rapid acquisition of scientific knowledge regarding how COVID-19 spreads has guided mass anti-contagion strategies, including lockdowns, sheltering at home, physical distancing, donning personal protective equipment, conscientious handwashing, and hygiene practices. These life-saving strategies, credited with preventing millions of COVID-19 cases, separate and move people apart. Enforcement coupled with fear of contracting COVID-19 have motivated high levels of adherence to these stringent regulations. How will populations react when warned to shelter from an oncoming Atlantic hurricane while COVID-19 is actively circulating in the community? Emergency managers, health care providers, and public health preparedness professionals must create viable solutions to confront these potential scenarios: elevated rates of hurricane-related injury and mortality among persons who refuse to evacuate due to fear of COVID-19, and the resurgence of COVID-19 cases among hurricane evacuees who shelter together.

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