Assessing the quality of CPR performed by a single lifeguard, two lifeguards and a lifeguard with a bystander after water rescue: a quasi-experimental trial

BackgroundHigh-quality cardiopulmonary resuscitation (CPR) could improve survival of drowning victims. The purpose of the study is to assess the impact of fatigue caused by water rescue on subsequent CPR quality and the influence of a bystander’s participation on CPR quality in a lifeguard rescue.MethodsThis was a simulated quasi-experimental study with a sample of 14 lifeguards and 13 laypersons. Each lifeguard performed 2 min single-rescuer CPR as baseline measurement. In three separate trials, a single lifeguard swam 50 m to perform a water rescue in a pool and returned with the manikin another 50 m. After each rescue, 10 min of CPR was performed by a single lifeguard, two lifeguards or a lifeguard with a layperson with no CPR training. Paired t-test and repeated analysis of variance were used to analyse CPR quality variables.ResultsBaseline CPR quality was adequate for most measures except compression depth and re-expansion. After water rescue, the single lifeguard trial showed no significant differences compared with baseline. CPR score and ventilation score of the single-lifeguard trial was higher than that of the lifeguard-bystander trial (p=0.027, p<0.001). Both the two-lifeguard trial (p=0.025), and lifeguard-bystander trial (p=0.010) had a lower percentage of breaths with correct ventilation volume and higher percentage of breaths with excessive ventilation volume (p=0.007, p=0.011, respectively) than the single-lifeguard trial. No-flow time of the lifeguard-bystander trial was longer than other trials (p<0.001).ConclusionsAlthough CPR given by the lifeguard was not optimal, fatigue generated by a water rescue has no impact on the quality of subsequent CPR performed by a trained lifeguard for 10 min. Untrained bystanders assisting in CPR in a drowning event is unlikely to be helpful.

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Assessing Ventilation Skills by Nursing Students in Paediatric and Adult Basic Life Support: A Crossover Randomized Simulation Study Using Bag-Valve-Mask (BMV) vs Mouth-to-Mouth Ventilation (MMV)

10.22514/sv.2020.16.0072 ◽

2020 ◽

Cited By ~ 1

Keyword(s):

Nursing Students ◽

Basic Life Support ◽

Life Support ◽

Age Groups ◽

Training Session ◽

The Other ◽

Quasi Experimental ◽

Cpr Quality ◽

Cpr Training

To evaluate nursing students’ CPR skills using mouth-to-mouth (MMV) and bag-valve-mask (BMV) ventilation techniques on manikin simulators for infant and adult victims after practical and theoretical training. A quasi-experimental randomised cross-over design study with 44 nursing students was carried out. The participants attended a 5-hour theoretical and practical CPR training session using MMV and BMV on adult and infant manikins. A month later, four 4-minute CPR tests were performed in pairs. Two tests were performed on the infant manikin and two on the adult, using the two ventilation techniques (MMV and BMV). No significant differences between the tests were observed in the quality of chest compression (p > 0.008). Significantly higher values of effective ventilations were observed with MMV as compared with BMV in both age groups: Adult (MMV: 98 ± 7% / BMV: 84 ± 17% / p = 0.003) and Infant (MMV: 97 ± 11% / BMV: 76 ± 26% / p = 0.001). CPR quality was significantly higher when using MMV on the infant (68 ± 16%; p < 0.001) than in the other tests. The nursing students did not manage to master BMV with either victim. New complementary strategies to help them grasp the necessary BMV skills will be required.

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LO67: The impact of CPR quality during entire resuscitation episode on survival from cardiac arrest

CJEM ◽

10.1017/cem.2017.129 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S51

Author(s):

I. Drennan ◽

A.K. Taher ◽

S. Cheskes ◽

C. Zhan ◽

A. Byers ◽

...

Keyword(s):

Cardiac Arrest ◽

Chest Compression ◽

Patient Survival ◽

P Value ◽

High Quality ◽

Compression Depth ◽

Entire Duration ◽

Cpr Quality ◽

The Impact

Introduction: High-quality cardiopulmonary resuscitation (CPR) is essential for patient survival. Typically, CPR quality is only measured during the first 10 minutes of resuscitation. There is limited research examining the quality of CPR over the entire duration of resuscitation.Objective: To examine the quality of CPR over the entire duration of resuscitation and correlate the quality of CPR to patient survival. Methods: This was a retrospective observational study using data from the Toronto RescuNET Epistry-Cardiac Arrest database. We included consecutive, adult (>18) OHCA treated by EMS between January 1, 2014 and September 30, 2015. High-quality CPR was defined, in accordance with 2015 AHA Guidelines, as a chest compression rate of 100-120/min, depth of 5.0-6.0 cm and chest compression fraction (ccf) of >0.80. We further categorized high-quality resuscitation as meeting benchmarks >80% of the time, moderate-quality between 50-80% and low-quality meeting benchmarks <50% of the resuscitation. We used multivariable logistic regression to determine association between variables of interest, including CPR quality metrics, and survival to hospital discharge. Results: A total of 5,208 OHCA met our inclusion criteria with a survival rate of 8%. The median (IQR) duration of resuscitation was 23.0 min (15.0,32.7). Overall CPR quality was considered high-quality for ccf in 81% of resuscitation episodes, 41% for rate, and 7% for depth. The percentage of resuscitations meeting the quality benchmarks differed between survivors and non-survivors for both depth (15% vs 6%) and ccf (61% vs 83%) (P value <0.001). After controlling for Utstein variables maintaining a chest compression depth within recommendations for >80% showed a trend towards improved survival (OR 1.68, 95% CI 0.96, 2.92). Other variables associated with survival were public location, initial CPR by EMS providers or bystanders, witnessed cardiac arrest (EMS or bystander), and initial shockable rhythm. Increasing age and longer duration of resuscitation were associated with decreased survival. Conclusion: Overall, EMS providers were not able to maintain rate or depth within guideline recommendations for the majority of the duration of resuscitation. Maintaining chest compression depth for greater than 80% of the resuscitation showed a trend towards increased survival from OHCA.

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158087 ◽

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.

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Impact of a Series of Educational Talks Taught by Health Professionals to Promote Healthy Snack Choices among Children

Children ◽

10.3390/children8030203 ◽

2021 ◽

Vol 8 (3) ◽

pp. 203

Author(s):

Víctor Arufe Giráldez ◽

Javier Puñal Abelenda ◽

Rubén Navarro-Patón ◽

Alberto Sanmiguel-Rodríguez

Keyword(s):

Nutritional Quality ◽

Positive Impact ◽

Total Sample ◽

Overweight And Obesity ◽

Healthy Habits ◽

Quasi Experimental ◽

Nutrition And Dietetics ◽

Future Work ◽

The Impact

Background: One of the great challenges facing today’s society is the need to combat overweight and obesity in schoolchildren. This study aimed to analyze the impact of a cycle of didactic talks—given to families by a specialist in pediatrics, a specialist in nutrition and dietetics and a specialist in physical exercise—on childrens’ snack choices and nutrition quality. Methods: A longitudinal, quasi-experimental and quantitative investigation was designed, working with a total sample of 50 students divided into control and experimental groups. The nutritional quality of daily snacks was recorded during the month before and the month after the cycle of talks given by health experts. Results: An increase in the nutritional quality of the snacks was observed in the days after the talk—but, after a week, values returned to normal. Conclusions: The giving of educational talks to promote healthy habits may have a positive impact on the nutritional quality of school snacks in the days immediately following the talks. However, some forgetfulness was detected over time, which reduced the nutritional quality of the snacks once more. For future work, it is recommended that researchers measure the impact produced by giving regular talks.

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

10.22514/sv.2020.16.0005 ◽

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.

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Effect of Acute Exposure to Altitude on the Quality of Chest Compression‐Only Cardiopulmonary Resuscitation in Helicopter Emergency Medical Services Personnel: A Randomized, Controlled, Single‐Blind Crossover Trial

Journal of the American Heart Association ◽

10.1161/jaha.121.021090 ◽

2021 ◽

Author(s):

Anna Vögele ◽

Michiel Jan van Veelen ◽

Tomas Dal Cappello ◽

Marika Falla ◽

Giada Nicoletto ◽

...

Keyword(s):

Emergency Medical Services ◽

Chest Compression ◽

Acute Exposure ◽

Medical Services ◽

Compression Depth ◽

Helicopter Emergency Medical Services ◽

Emergency Medical ◽

Emergency Medical Services Personnel ◽

Cpr Quality

Background Helicopter emergency medical services personnel operating in mountainous terrain are frequently exposed to rapid ascents and provide cardiopulmonary resuscitation (CPR) in the field. The aim of the present trial was to investigate the quality of chest compression only (CCO)‐CPR after acute exposure to altitude under repeatable and standardized conditions. Methods and Results Forty‐eight helicopter emergency medical services personnel were divided into 12 groups of 4 participants; each group was assigned to perform 5 minutes of CCO‐CPR on manikins at 2 of 3 altitudes in a randomized controlled single‐blind crossover design (200, 3000, and 5000 m) in a hypobaric chamber. Physiological parameters were continuously monitored; participants rated their performance and effort on visual analog scales. Generalized estimating equations were performed for variables of CPR quality (depth, rate, recoil, and effective chest compressions) and effects of time, altitude, carryover, altitude sequence, sex, qualification, weight, preacclimatization, and interactions were analyzed. Our trial showed a time‐dependent decrease in chest compression depth ( P =0.036) after 20 minutes at altitude; chest compression depth was below the recommended minimum of 50 mm after 60 to 90 seconds (49 [95% CI, 46–52] mm) of CCO‐CPR. Conclusions This trial showed a time‐dependent decrease in CCO‐CPR quality provided by helicopter emergency medical services personnel during acute exposure to altitude, which was not perceived by the providers. Our findings suggest a reevaluation of the CPR guidelines for providers practicing at altitudes of 3000 m and higher. Mechanical CPR devices could be of help in overcoming CCO‐CPR quality decrease in helicopter emergency medical services missions. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04138446.

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Influence of the perceived benefit of a social network-based sales promotion on the perceived quality of a heritage complex

Academia Revista Latinoamericana de Administración ◽

10.1108/arla-06-2021-0126 ◽

2022 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Esmeralda Crespo-Almendros ◽

M. Belén Prados-Peña ◽

Lucia Porcu ◽

Juan Miguel Alcántara-Pilar

Keyword(s):

Social Network ◽

Perceived Quality ◽

Sales Promotion ◽

Sales Promotions ◽

Content Type ◽

Heritage Sites ◽

Negative Effect ◽

Quasi Experimental ◽

The Impact

Purpose This study seeks to analyze the influence of the consumer's perceived benefits deriving from two different promotional incentives offered via social media on the perceived quality of the heritage complex.Design/methodology/approach A quasi-experimental study was carried out among online users, implementing two different promotional stimuli. Facebook was selected as the social network through which the promotional incentives were offered in the experiment. The sample was obtained via a panel of Internet users provided by Sondea Internet SL.Findings The results showed that the benefits perceived by the tourists will depend on the sales promotion type offered. On the one hand, free VIP pass was found to be mostly related to hedonic benefits that positively affect perceived quality. On the other hand, 2 × 1 offer would be perceived as a utilitarian benefit and is likely to exert a fairly negative effect on perceived quality.Practical implications Tourism managers and practitioners are encouraged to analyze the characteristics of certain types of sales promotions, as each promotional incentive bears different values and associated benefits. The findings of this study suggest managers and practitioners to implement non-monetary promotions to enhance brand equity and perceived quality. Thus, it is paramount for the managers of cultural institutions and heritage sites to trust in sales promotions which can be very helpful if they are designed carefully.Originality/value This study pioneers the analysis of the impact of the benefits associated with different typologies of sales promotions on social networks on the perceived quality of a heritage site.

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THE IMPACT OF RESPIRATORY MUSCLE FATIGUE ON THE QUALITY AND EFFICIENCY OF RESCUE ACTION

Journal of Kinesiology and Exercise Sciences ◽

10.5604/01.3001.0012.2311 ◽

2017 ◽

Vol 27 (80) ◽

pp. 65-75 ◽

Cited By ~ 1

Author(s):

Katarzyna Kucia ◽

Ewa Dybińska ◽

Tomasz Białkowski ◽

Tomasz Pałka

Keyword(s):

Muscle Fatigue ◽

Respiratory Muscle ◽

Body Height ◽

Heart Association ◽

Recording Instrument ◽

Respiratory Muscle Fatigue ◽

Stomach Inflation ◽

Water Rescue ◽

The Impact

INTRODUCTION The lifeguard is the person in charge of safety in water environments. After a rescue, it is possible that he has to execute a CPR. The European Resuscitation Council (ERC) as well as theAmerican Heart Association are currently encouraging a quality CPR performance. The lifeguard may be obliged to carry out a CPR during a long period of time as the response of the Emergency Medical Service takes 5–8 min on average and it can even reach 20 min. The normal respiratory muscle effort at maximal swimming intensity requires a significant fraction of cardiac output and causes leg blood flow to fall. The main objective of this paper was to determine respiratory muscle fatigue (RMF) level in swimming with different intensity on quality and efficiency rescu action in the water. MATERIAL AND METHODS The study involved eleven lifeguards male (9) and female (2); age: (24.25±1.5); body height( 176,27±7,88) and body mass (75.81±11,01)form University School of Physical Education, Cracow. Two tests were conducted: the first test involved the execution of 5 min of CPR (rested), and the second one in performing water rescue and subsequent CPR (exhausted) for 5 minutes. The quality of the CPR at rest and at fatigue condition was compared. The recording instrument was the Ambu Defib Trainer W (Wireless).The time and precision of the simulated water rescue was also registered. Two spirometry tests were performed the first test was set before swimming and the second after (exhausted). Maximal respiratory pressures (PImax, PEmax) were evaluated before and directly after swimming in different intensity.The quality of the respiratory muscle fatigue at rest and at fatigue condition was compared. The recording instrument was portable MicroLoop spirometer. RESULTS After e simulated water rescue significantly increase parameters such as: ventilation minute volume rested (3,06±22,10) exhausted (4,23 ±22,10. P < .001); ventilation rate rested (3.60±34.80) exhausted (4,80 ±34.80. P < .001); and stomach inflation rested (2,0±20,47) exhausted (5.80 ±20.47. P < .001). The greatest variation in the results of the respiratory muscle fatigue both before and after swimming with different intensity was observed only in two parameters: maximal ventilation index (MVV) and peak exhaust flow (PEF). CONCLUSIONS The accumulated fatigue during a simulated water rescue performed by lifeguards reduces the quality of compression depth and pause between compressions. The following respiratory parameters were found to have the strongest effect on the swimming: during maximum exercise intensity and FEV 1 (-0.77) rested and FEV 1 (-0.57) exhausted and FVC (-0.79) rested and FVC (-0.70) exhausted.

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Abstract 12065: CPR Prompting Devices: Unintended Consequences Impacting High Performers

Circulation ◽

10.1161/circ.132.suppl_3.12065 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Christie L Mulvey ◽

Sally J Rudy ◽

David L Rodgers ◽

Tammi J Bortner ◽

Elizabeth H Sinz ◽

...

Keyword(s):

High Performance ◽

Unintended Consequences ◽

Entire Group ◽

Chest Compressions ◽

Convenience Sample ◽

High Performers ◽

Cpr Quality ◽

The Impact ◽

Level Group

Introduction: Prompting devices for chest compressions have been advocated as a means of improving CPR quality in previous AHA guidelines. Studies have shown overall CPR quality improves with the use of these devices. Hypothesis: This study compared the impact of prompting devices on providers with varying levels of experience and proficiency. Methods: A convenience sample of 53 subjects with varying degrees of CPR experience, ranging from zero to frequent opportunities to perform CPR, were enrolled. Using a skills recording CPR manikin, data on each subject’s chest compression performance was obtained. All subjects performed an initial one-minute cycle of continuous chest compressions with no prompting device. After a brief rest, subjects were randomized to use one of two CPR prompting devices (Philips MRX with Q-CPR or Laerdal Medical CPRmeter). An additional one minute of CPR was conducted with the first device. Subjects were then crossed over to use the other prompting device after another brief rest. Results: Across the entire group, nearly all parameters significantly improved with the prompting devices, confirming previous studies on the efficacy of CPR prompting devices. However, when subjects’ results were examined by breaking the group into three performance levels (high, medium and low) based on the Overall CPR Score generated by the manikin software, there were differences in performance. Paired t -tests were conducted on the low and high performance groups. The low-level group significantly improved across 7 of 8 variables with both devices. The high-level group had only minor changes from baseline (both positive and negative) in most variables, but had significant or near significant decrease in proficiency in one variable - percent correctly released compressions ( p = 0.011 for Philips device; p = 0.052 for the Laerdal device). Conclusions: CPR prompting devices improve the overall quality of chest compressions. Individuals with existing high performance CPR skills could be distracted by the device, reducing the quality of compressions compared to using no device. When a CPR prompting device is introduced into a health care system, all providers, especially high performers, require practice with the device in order to acclimate to its use.

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Psychophysical functioning and quality of life in 94 patients affected by oropharyngeal cancer and treated with different therapeutic approaches.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.6039 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 6039-6039

Author(s):

Fulvia Pedani ◽

Mario Airoldi ◽

Massimiliano Garzaro ◽

Riccardo Torta ◽

Luca Raimondo ◽

...

Keyword(s):

Quality Of Life ◽

Psychological Functioning ◽

Depression Scale ◽

Stage Iv ◽

Stage Iii ◽

Lower Percentage ◽

Anxiety And Depression ◽

Anxiety Depression ◽

The Impact

6039 Background: The treatment of oropharyngeal squamous cell carcinomas (OSCC) may heavily affect patient’s quality of life (QoL). Aim of our study was the evaluation of the impact of different treatments on physical and psychological functioning and on QoL of patients affected by stage III-IV disease. Methods: The enrolled sample was composed by 94 OSCC patients divided into 3 subgroups based on treatment modalities: surgery + adjuvant radiotherapy (S + RT: 30 patients), exclusive concomitant chemo-radiotherapy (CT + RT: 30 patients) and exclusive chemotherapy (CT) in 34 patients not suitable for surgery and/or radiotherapy. Psycho-oncological assessment included: Hospital Anxiety Depression Scale (HADS), Montgomery-Asberg Depression Scale (MADRS), Mini-Mental Adjustment to Cancer scale (MINI-MAC), EORTC QLQ C-30 questionnaire with the specific module Head and Neck 35 (H&N35). Results: The 60 patients primarily treated with S + RT or CT + RT presented superimposeable clinical and tumour characteristics while those treated with exclusive CT were affected by stage IV disease and in the 90% of cases underwent to previous treatment exclusive or combined treatment such as surgery, radiotherapy and chemotherapy. In the following table, data about physical and psychological functioning and on QoL of the 3 subgroups of patients are summarized. Conclusions: In stage III-IV OSCC treatments have a strong influence on QoL and coping styles. Patients treated with CT + RT were characterized by a lower percentage of self-reported anxiety and depression and higher EORTC Global QoL score. More than one third of patients treated with S + RT had overt symptoms of anxiety and depression. Stage IV patients treated with palliative CT had elevated level of anxiety, depression and low quality of life. Auto-evaluation is less effective in depression assessment. The role of concomitant psychological supportive care should be evaluated in these patients treated with different approaches. [Table: see text]

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