Abstract 92: Evaluation Of Knowledge And Practice Of Cardiopulmonary Resuscitation Of Children And Infants By An Out-of-hospital Emergency Care Team

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Nathalie S Goddet ◽  
François Dolveck ◽  
Alexis Descatha ◽  
Noella Lode ◽  
Jean-Louis Chabernaud ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Emergency Care ◽  
Life Support ◽  
Prehospital Emergency Care ◽  
Emergency Response System ◽  
First Aid Training ◽  
Life Threatening ◽  
Prehospital Emergency ◽  
Job Title ◽  
Knowledge And Practice

Introduction The French emergency response system in life threatening situations is the deployment of fully equipped ambulances with paramedic, nurse and emergency physician. The 2005 ILCOR and ERC guidelines concerning cardiopulmonary resuscitation (CPR) have led to significant changes, especially in terms of basic life support (BLS). We aimed to review fundamental knowledge and practice by our personnel concerning CPR in children and infants to determine current training needs for our teams. Materials and methods Paper questionnaires were filled out by our personnel and immediately collected. Inclusion criteria: physicians, nurses, and paramedics (refusals to fill out questionnaire were not included). We recorded: profile of personnel, knowledge of 2005 guidelines, basic CPR and advanced CPR parameters. Majors results were compared based on job title. Results Sixty-one questionnaires were filled out (25 paramedics, 13 nurses, and 23 physicians). Personnel was mostly aged under 40 (70,5%, n=43), with over 2 years experience in prehospital emergency care(75,4%, n=46); 47,5% (n=\29) had no training in pediatrics; 68,9% (n=42) had BLS certification and 31,1% (n=19) reported regular participation in first aid training programs. A minority of subjects declared knowing the 2005 Guidelines (11,5%, n=7), even among physician (17,4%, n=4). Table 1 shows major results about CPR parameters according to job title. Conclusion This study emphasizes the lack of knowledge and the repeated changes witch require more frequent and more extensive training for entire personnel on the team, focusing on basic CPR for physicians and advanced CPR for paramedics and nurses. Table 1: Answers according to job title AED : Automatic External Defibrillator

scholarly journals Which health-related reasons lead to prehospital emergency care and how does subjective emergency status connect to subsequent care?

2021 ◽  
Author(s):  
Silke Piedmont ◽  
Anna Katharina Reinhold ◽  
Jens-Oliver Bock ◽  
Enno Swart ◽  
Bernt-Peter Robra
Keyword(s):  
Health Insurance ◽  
Emergency Care ◽  
Third Party ◽  
Insurance Companies ◽  
Prehospital Emergency Care ◽  
Health Related ◽  
Life Threatening ◽  
Prehospital Emergency ◽  
Health Insurance Companies ◽  
Reported Data

Abstract Objectives/Background In many countries, the use of emergency medical services (EMS) increases steadily each year. At the same time, the percentage of life-threatening complaints decreases. To redesign the system, an assessment and consideration of the patients’ perspectives is helpful. Methods We conducted a paper-based survey of German EMS patients who had at least one case of prehospital emergency care in 2016. Four health insurance companies sent out the questionnaire to 1312 insured persons. We linked the self-reported data of 254 respondents to corresponding claims data provided by their health insurance companies. The analysis focuses a.) how strongly patients tend to call EMS for themselves and others given different health-related scenarios, b.) self-perceived health complaints in their own index case of prehospital emergency care and c.) subjective emergency status in combination with so-called “objective” characteristics of subsequent EMS and inpatient care. We report principal diagnoses of (1) respondents, (2) 57,240 EMS users who are not part of the survey and (3) all 20,063,689 inpatients in German hospitals. Diagnoses for group 1 and 2 only cover the inpatient stay that started on the day of the last EMS use in 2016. Results According to the survey, the threshold to call an ambulance is lower for someone else than for oneself. In 89% of all cases during their own EMS use, a third party called the ambulance. The most common, self-reported complaints were pain (38%), problems with heart and circulation (32%), and loss of consciousness (17%). The majority of respondents indicated that their EMS use was due to an emergency (89%). We could detect no or only weak associations between patients’ subjective urgency and different items for objective care. Conclusion Dispatchers can possibly optimize or reduce the disposition of EMS staff and vehicles if they spoke directly to the patients more often. Nonetheless, there is need for further research on how strongly the patients’ perceived urgency may affect the disposition, rapidness of the service and transport targets.

scholarly journals Implementation of a National 5‐Year Plan for Prehospital Emergency Care in Singapore and Impact on Out‐of‐Hospital Cardiac Arrest Outcomes From 2011 to 2016

2020 ◽  
Vol 9 (21) ◽  
Author(s):  
Andrew Fu Wah Ho ◽  
Nurun Nisa Amatullah De Souza ◽  
Audrey L. Blewer ◽  
Win Wah ◽  
Nur Shahidah ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Care ◽  
Survival Rates ◽  
Prehospital Emergency Care ◽  
Shockable Rhythm ◽  
Automated External Defibrillation ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Prehospital Emergency ◽  
Hospital Cardiac Arrest

Background Outcomes of patients from out‐of‐hospital cardiac arrest (OHCA) vary widely globally because of differences in prehospital systems of emergency care. National efforts had gone into improving OHCA outcomes in Singapore in recent years including community and prehospital initiatives. We aimed to document the impact of implementation of a national 5‐year Plan for prehospital emergency care in Singapore on OHCA outcomes from 2011 to 2016. Methods and Results Prospective, population‐based data of OHCA brought to Emergency Departments were obtained from the Pan‐Asian Resuscitation Outcomes Study cohort. The primary outcome was Utstein (bystander witnessed, shockable rhythm) survival‐to‐discharge or 30‐day postarrest. Mid‐year population estimates were used to calculate age‐standardized incidence. Multivariable logistic regression was performed to identify prehospital characteristics associated with survival‐to‐discharge across time. A total of 11 465 cases qualified for analysis. Age‐standardized incidence increased from 26.1 per 100 000 in 2011 to 39.2 per 100 000 in 2016. From 2011 to 2016, Utstein survival rates nearly doubled from 11.6% to 23.1% ( P =0.006). Overall survival rates improved from 3.6% to 6.5% ( P <0.001). Bystander cardiopulmonary resuscitation rates more than doubled from 21.9% to 56.3% and bystander automated external defibrillation rates also increased from 1.8% to 4.6%. Age ≤65 years, nonresidential location, witnessed arrest, shockable rhythm, bystander automated external defibrillation, and year 2016 were independently associated with improved survival. Conclusions Implementation of a national prehospital strategy doubled OHCA survival in Singapore from 2011 to 2016, along with corresponding increases in bystander cardiopulmonary resuscitation and bystander automated external defibrillation. This can be an implementation model for other systems trying to improve OHCA outcomes.

scholarly journals A Comparison Between Differently Skilled Prehospital Emergency Care Providers in Major-Incident Triage in South Africa

2018 ◽  
Vol 33 (6) ◽  
pp. 575-580 ◽  
Author(s):  
Annet Ngabirano Alenyo ◽  
Wayne P. Smith ◽  
Michael McCaul ◽  
Daniel J. Van Hoving
Keyword(s):  
South Africa ◽  
Emergency Care ◽  
Life Support ◽  
Major Incident ◽  
Prehospital Emergency Care ◽  
Care Providers ◽  
Publication Type ◽  
Cross Sectional ◽  
Prehospital Emergency ◽  
Level Of Training

AbstractIntroductionMajor-incident triage ensures effective emergency care and utilization of resources. Prehospital emergency care providers are often the first medical professionals to arrive at any major incident and should be competent in primary triage. However, various factors (including level of training) influence their triage performance.Hypothesis/ProblemThe aim of this study was to determine the difference in major-incident triage performance between different training levels of prehospital emergency care providers in South Africa utilizing the Triage Sieve algorithm.MethodsThis was a cross-sectional study involving differently trained prehospital providers: Advanced Life Support (ALS); Intermediate Life Support (ILS); and Basic Life Support (BLS). Participants wrote a validated 20-question pre-test before completing major-incident training. Two post-tests were also completed: a 20-question written test and a three-question face-to-face evaluation. Outcomes measured were triage accuracy and duration of triage. The effect of level of training, gender, age, previous major-incident training, and duration of service were determined.ResultsA total of 129 prehospital providers participated. The mean age was 33.4 years and 65 (50.4%) were male. Most (n=87; 67.4%) were BLS providers. The overall correct triage score pre-training was 53.9% (95% CI, 51.98 to 55.83), over-triage 31.4% (95% CI, 29.66 to 33.2), and under-triage 13.8% (95% CI, 12.55 to 12.22). Post-training, the overall correct triage score increased to 63.6% (95% CI, 61.72 to 65.44), over-triage decreased to 17.9% (95% CI, 16.47 to 19.43), and under-triage increased to 17.8% (95% CI, 16.40 to 19.36). The ALS providers had both the highest likelihood of a correct triage score post-training (odds ratio 1.21; 95% CI, 0.96-1.53) and the shortest duration of triage (median three seconds, interquartile range two to seven seconds; P=.034). Participants with prior major-incident training performed better (P=.001).ConclusionAccuracy of major-incident triage across all levels of prehospital providers in South Africa is less than optimal with non-significant differences post-major-incident training. Prior major-incident training played a significant role in triage accuracy indicating that training should be an ongoing process. Although ALS providers were the quickest to complete triage, this difference was not clinically significant. The BLS and ILS providers with major-incident training can thus be utilized for primary major-incident triage allowing ALS providers to focus on more clinical roles.AlenyoAN, SmithWP, McCaulM, Van HovingDJ. A comparison between differently skilled prehospital emergency care providers in major-incident triage in South Africa. Prehosp Disaster Med. 2018;33(6):575–580.

scholarly journals The Barriers to the Success of Cardiopulmonary Resuscitation from the Perspectives of Emergency Medical Services Providers

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ayob Akbari ◽  
Ahmad Nasiri ◽  
Mohammad Azim Mahmodi
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Emergency Care ◽  
Simple Random Sampling ◽  
Public Access ◽  
Prehospital Emergency Care ◽  
Cross Sectional ◽  
Significant Difference ◽  
Prehospital Emergency ◽  
The Mean ◽  
Cpr Training

Background: Cardiopulmonary resuscitation (CPR) is an integral part of prehospital emergency care. Addressing the barriers to successful CPR may help improve the quality of CPR in the future. Objectives: The present study aimed to identify the barriers to successful CPR from the perspective of EMS providers. Methods: This cross-sectional analytical study was conducted from May 2015 to Jan 2016. One hundred sixty EMS providers who were employed at EMS affiliated to Birjand University of Medical Sciences (Iran) were selected through simple random sampling. To assess barriers to the success of CPR, data were collected using a researcher-made questionnaire (60 questions) categorized in six subscales. Study data were analyzed by SPSS v.16, descriptive (frequency, mean, and standard deviation), and inferential statistics (t-test and ANOVA). Results: Among the subscales of barriers to successful CPR from the perspective of EMS providers, the EMS structure subscale was the most important (3.06 ± 0.38, out of a 0 - 4 range). In this subscale, public inaccessibility automated external defibrillator (AED) (3.59 ± 0.49) and Lack of telephone-CPR advice by the dispatcher (3.58 ± 0.55) were the most important barriers, respectively. There was a significant difference between the mean score of barriers to successful CPR and educational status, which increased in EMS providers with BS degree (P = 0.003). There was no significant difference between the mean score of barriers to successful CPR compared to the other demographic characteristics of EMS providers (P > 0.05). Conclusions: EMS providers perceived public inaccessibility AED and Lack of telephone-CPR training as the most important barriers to success CPR in prehospital emergency care. Therefore, public access to AED must be emphasized to promote immediate response and improve CPR's outcome in EMS. Moreover, telephone-CPR training by dispatchers should be recommended to help increase the success of CPR.

Developing a Lay First Responder Program in Chad: A 12-Month Follow-Up Evaluation of a Rural Prehospital Emergency Care Program

2020 ◽  
Vol 35 (5) ◽  
pp. 546-553 ◽  
Author(s):  
Canaan J. Hancock ◽  
Peter G. Delaney ◽  
Zachary J. Eisner ◽  
Eric Kroner ◽  
Issa Mahamet-Nuur ◽  
...  
Keyword(s):  
Knowledge Acquisition ◽  
Emergency Care ◽  
Prehospital Emergency Care ◽  
Voluntary Participation ◽  
First Responder ◽  
Taxi Drivers ◽  
Post Test ◽  
Prehospital Emergency ◽  
Motorcycle Taxi

AbstractIntroduction:The World Health Organization (WHO; Geneva, Switzerland) recommends lay first responder (LFR) programs as a first step toward establishing formal Emergency Medical Services (EMS) in low- and middle-income countries (LMICs) to address injury. There is a scarcity of research investigating LFR program development in predominantly rural settings of LMICs.Study Objective:A pilot LFR program was launched and assessed over 12 months to investigate the feasibility of leveraging pre-existing transportation providers to scale up prehospital emergency care in rural, low-resource settings of LMICs.Methods:An LFR program was established in rural Chad to evaluate curriculum efficacy, using a validated 15-question pre-/post-test to measure participant knowledge improvement. Pre-/post-test score distributions were compared using a Wilcoxon Signed-Rank test. For test evaluation, each pre-test question was mapped to its corresponding post-test analog and compared using McNemar’s Chi-Squared Test to examine knowledge acquisition on a by-question basis. Longitudinal prehospital care was evaluated with incident reports, while program cost was tracked using a one-way sensitivity analysis. Qualitative follow-up surveys and semi-interviews were conducted at 12 months, with initial participants and randomly sampled motorcycle taxi drivers, and used a constructivist grounded theory approach to understand the factors motivating continued voluntary participation to inform future program continuity. The consolidated criteria for reporting qualitative research (COREQ) checklist was used to guide design, analysis, and reporting the qualitative results.Results:A total of 108 motorcycle taxi participants demonstrated significant knowledge improvement (P <.001) across three of four curricular categories: scene safety, airway and breathing, and bleeding control. Lay first responders treated 71 patients over six months, encountering five deaths, and provided patient transport in 82% of encounters. Lay first responders reported an average confidence score of 8.53/10 (n = 38). In qualitative follow-up surveys and semi-structured interviews, the ability to care for the injured, new knowledge/skills, and the resultant gain in social status and customer acquisition motivated continued involvement as LFRs. Ninety-six percent of untrained, randomly sampled motorcycle taxi drivers reported they would be willing to pay to participate in future training courses.Conclusion:Lay first responder programs appear feasible and cost-effective in rural LMIC settings. Participants demonstrate significant knowledge acquisition, and after 12 months of providing emergency care, report sustained voluntary participation due to social and financial benefits, suggesting sustainability and scalability of LFR programs in low-resource settings.

Nurse’s experiences of the caring encounter as single responder in prehospital emergency care

2021 ◽  
Vol 58 ◽  
pp. 101051
Author(s):  
Veronica Vicente ◽  
Lenny Bergqvist ◽  
Moa Kvist ◽  
Rebecka Rubenson Wahlin ◽  
Helena Sjölin
Keyword(s):  
Emergency Care ◽  
Prehospital Emergency Care ◽  
Prehospital Emergency
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