Abstract 19242: No Difference in Skill Acquisition and Retention When Teaching Laypersons Recovery Position Using Four-stage and Two-stage Teaching Technique: A Randomized Comparison

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Katrine Bjørnshave ◽  
Lise Q Krogh ◽  
Svend B Hansen ◽  
Mette A Nebsbjerg ◽  
Stinne E Rasmussen ◽  
...  
Keyword(s):  
Skill Acquisition ◽  
Head Tilt ◽  
European Resuscitation Council ◽  
Two Stage ◽  
Airway Patency ◽  
Resuscitation Guidelines ◽  
Teaching Technique ◽  
Separate Step ◽  
Spontaneously Breathing ◽  
Total Average

Introduction: Resuscitation guidelines recommend that unconscious and spontaneously breathing persons are placed in the recovery position to secure airway patency. Techniques for teaching the recovery position require evaluation. Aim: To evaluate acquisition and retention of recovery position skills among laypersons taught using a four-stage and two-stage teaching technique. Methods: Laypersons were randomized to a standardized European Resuscitation Council (ERC) courses in BLS/AED including training in recovery position using a four-stage teaching technique compared to modified course with the same content using a two-stage teaching technique. Participants were tested immediately after training and three months (±five days) later to assess acquisition and retention of recovery position skills. Tests were video recorded and reviewed by two assessors blinded to teaching technique. A skill checklist in accordance with the ERC guidelines representing the eight steps of the recovery position was used. The primary endpoint was passing the test (8 out of 8 skills). Result: In total, 160 participants were included. Total average number of steps of eight performed correctly was 7.3±1.0 (n=70) vs 7.1±1.1 (n=72) (p=0.5) immediately after the course and 4.1 ±2.3 (n=64) vs 3.8 ±2.3 (n=64) (p=0.4) three month later when using the four-stage and the two-stage technique, respectively. Correct final recovery position was obtained by 91% vs 93% immediately after the course and 49% vs 42% three month later. Each separate step of the recovery position is shown in Table 1. Conclusion: There was no difference in skill acquisition and retention when teaching laypersons recovery position using the four-stage and two-stage teaching technique. There was a marked decrease in skill level three months after training, particularly keeping the airway patent by head tilt and checking breathing regularly in both groups.

Abstract 19197: No Difference in Retention of BLS/AED Skills When Teaching Laypersons Using Four-stage and Two-stage Teaching Technique: A Randomized Comparison

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Katrine Bjørnshave ◽  
Lise Q Krogh ◽  
Svend B Hansen ◽  
Mette A Nebsbjerg ◽  
Troels Thim ◽  
...  
Keyword(s):  
Chest Compression ◽  
Health Care Professionals ◽  
Pass Rate ◽  
Two Stage ◽  
Compression Depth ◽  
Training Technique ◽  
Resuscitation Training ◽  
Compression Cycle ◽  
Teaching Technique ◽  
Total Average

Introduction: The ability of laypersons to perform BLS/AED increases immediately after resuscitation training. Studies indicate that resuscitation skills rapidly decay after initial training, however it is unknown whether teaching technique influence retention of skill. Aim: To study the retention of BLS/AED skills three months after training when teaching laypersons using a four-stage and two-stage teaching technique. Methods: Laypersons (exclusion: health care professionals/students) were randomized to a standardized ERC BLS/AED courses using the four-stage teaching technique or to courses with the same content but modified to a two-stage teaching technique. Participants were tested in a simulated cardiac arrest scenario three months (±five days) after their course to assess retention of BLS/AED. Tests were video recorded and reviewed by two independent assessors blinded to training technique. Skills were assessed using the ERC BLS/AED assessment form. The primary endpoint was passing the test (17 out of 17 skills adequately performed). Results: A total of 160 participants were included in the study. No difference was found in pass rate immediately after training (diff. -1.6%; 95%CI -17.9%; 14.6%). There was no statistical difference in retention of BLS/AED skills (pass rate: both 11%, diff. -0.4%; 95%CI -28%-27%) three months after training . Total average skills adequately performed (of 17) were 13.7 versus 13.3 among laypersons trained with the four-stage (n=64) and the two-stage technique (n=64). No difference was found in number of chest compressions delivered per compression cycle (29±2.8 vs 30±3.1), chest compression rate (107±17 vs 108±19 minute-1), chest compression depth (46±11 vs 43±12 mm), number of effective rescue breaths between compression cycles (1.6±0.7 vs 1.6±0.5) and tidal volume (0.6±0.4 0.7±0.4 L). Conclusion: We found no difference in retention of BLS/AED skills among laypersons taught using a four-stage teaching technique compared to a two-stage teaching technique.

scholarly journals New guidelines for resuscitation in adults

Medicina ◽  
2006 ◽  
Vol 43 (1) ◽  
pp. 79
Author(s):  
Dinas Vaitkaitis ◽  
Vidas Pilvinis ◽  
Andrius Pranskūnas ◽  
Nedas Jasinskas ◽  
Paulius Dobožinskas
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Sudden Cardiac Arrest ◽  
Heart Association ◽  
European Resuscitation Council ◽  
Resuscitation Guidelines ◽  
New Guidelines ◽  
Cardiovascular Care ◽  
Foreign Body Airway Obstruction ◽  
External Defibrillator

Five years after the last issue of the guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, in 2005 American Heart Association and European Resuscitation Council published new guidelines. In this review, basic life support (BLS) technique, indications for use of an automated external defibrillator (AED), recognition of sudden cardiac arrest, and management of choking (foreign-body airway obstruction) are presented according to the “Resuscitation Guidelines 2005.”

scholarly journals The Combibag: An Evaluation of a New Self-Inflating Resuscitator

1986 ◽  
Vol 14 (1) ◽  
pp. 66-69 ◽  
Author(s):  
T. Cramond ◽  
J. P. O'Callaghan
Keyword(s):  
Safety Valve ◽  
Valve Design ◽  
Two Stage ◽  
Inadequate Ventilation ◽  
Spontaneously Breathing

The Combibag self-inflating resuscitator incorporates an adult and a paediatric segment as well as a two-stage pressure limiting safety valve. The resuscitator is not without problems. A sizeable forward leak of gas can occur beyond the patient valve. The patient valve design is such that a spontaneously breathing patient draws his inspired gas entirely from room air. Problems can also occur with the valve either sticking or being blown forward off its seating, thereby making the resuscitator inoperable and dangerous. The use of a two-stage pressure-limiting safety valve should prevent unnecessary barotrauma but could well lead to unrecognised venting with inadequate ventilation when used by inexperienced personnel.

Thoracic influence on upper airway patency

1988 ◽  
Vol 65 (5) ◽  
pp. 2124-2131 ◽  
Author(s):  
W. B. Van de Graaff
Keyword(s):  
Muscle Activity ◽  
Upper Airway ◽  
Constant Flow ◽  
Airway Patency ◽  
Anesthetized Dogs ◽  
Measured Resistance ◽  
Flow Through ◽  
Phrenic Nerves ◽  
Tracheostomy Tubes ◽  
Spontaneously Breathing

Patency of the upper airway (UA) is usually considered to be maintained by the activity of muscles in the head and neck. These include cervical muscles that provide caudal traction on the UA. The thorax also applies caudal traction to the UA. To observe whether this thoracic traction can also improve UA patency, we measured resistance of the UA (RUA) during breathing in the presence and absence of UA muscle activity. Fifteen anesthetized dogs breathed through tracheostomy tubes. RUA was calculated from the pressure drop of a constant flow through the isolated UA. RUA decreased 31 +/- 5% (SEM) during inspiration. After hyperventilating seven of these dogs to apnea, we maximally stimulated the phrenic nerves to produce paced diaphragmatic breathing. Despite absence of UA muscle activity, RUA fell 51 +/- 11% during inspiration. Graded changes were produced by reduced stimulation. In six other dogs we denervated all UA muscles. RUA still fell 25 +/- 7% with inspiration in these spontaneously breathing animals. When all caudal ventrolateral cervical structures mechanically linking the thorax to the UA were severed, RUA increased and respiratory fluctuations ceased. These findings indicate that tonic and phasic forces generated by the thorax can improve UA patency. Inspiratory increases in UA patency cannot be attributed solely to activity of UA muscles.

scholarly journals A comparison of airway maintenance by cuffed Oropharyngeal airway (COPA) and laryngeal mask airway (LMA) in spontaneously breathing adult patients

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Ashraf Zia ◽  
Tahir Chaudhry ◽  
Riaz Hussain ◽  
Tafoorul Islam Ghalani
Keyword(s):  
Statistical Analysis ◽  
Laryngeal Mask Airway ◽  
Head Tilt ◽  
Adult Patients ◽  
Laryngeal Mask ◽  
Oropharyngeal Airway ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Spontaneously Breathing

In this study total hundred patients wee included. Fifty (group I) were subjected to COPA device for airway maintenance and in other fifty (group II) LMA was used. In this study first attempt successful insertion rate in group I was 90% while in group II it was 94%. However statistical analysis showed no significant different in both groups. Regarding maneuvers needed to maintain smooth breathing in group I head tilt was used in 2 %. It is significantly high in group I than in group II. Laboured breathing was seen in 6% in group I while 2% in group II. There was no significant difference in both groups. According to this study LMA is better in all respect as it is easier to insert and better fit in.

Anatomic consequences of intrinsic tongue muscle activation

2006 ◽  
Vol 101 (5) ◽  
pp. 1377-1385 ◽  
Author(s):  
E. Fiona Bailey ◽  
Yu-Hsien Huang ◽  
Ralph F. Fregosi
Keyword(s):  
Electrical Stimulation ◽  
Muscle Activation ◽  
Critical Role ◽  
Upper Airway ◽  
Pressure Source ◽  
Airway Patency ◽  
Tongue Muscle ◽  
Airway Pressures ◽  
Tongue Muscles ◽  
Spontaneously Breathing

We recently showed respiratory-related coactivation of both extrinsic and intrinsic tongue muscles in the rat. Here, we test the hypothesis that intrinsic tongue muscles contribute importantly to changes in velopharyngeal airway volume. Spontaneously breathing anesthetized rats were placed in a MRI scanner. A catheter was placed in the hypopharynx and connected to a pressure source. Axial and sagittal images of the velopharyngeal airway were obtained, and the volume of each image was computed at airway pressures ranging from +5.0 to −5.0 cmH2O. We obtained images in the hypoglossal intact animal (i.e., coactivation of intrinsic and extrinsic tongue muscles) and after selective denervation of the intrinsic tongue muscles, with and without electrical stimulation. Denervation of the intrinsic tongue muscles reduced velopharyngeal airway volume at atmospheric and positive airway pressures. Electrical stimulation of the intact hypoglossal nerve increased velopharyngeal airway volume; however, when stimulation was repeated after selective denervation of the intrinsic tongue muscles, the increase in velopharyngeal airway volume was significantly attenuated. These findings support our working hypothesis that intrinsic tongue muscles play a critical role in modulating upper airway patency.

A Randomized Controlled Trial Comparing the Cuffed Oropharyngeal Airway and the Laryngeal Mask Airway in Spontaneously Breathing Anesthetized Adults 

1998 ◽  
Vol 88 (4) ◽  
pp. 970-977 ◽  
Author(s):  
Robert S. Greenberg ◽  
Joseph MB Brimacombe ◽  
Alison Berry ◽  
Victoria Gouze ◽  
Steven Piantadosi ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Controlled Trial ◽  
Head Tilt ◽  
Ease Of Use ◽  
Laryngeal Mask ◽  
Oropharyngeal Airway ◽  
Average Total Number ◽  
Spontaneously Breathing ◽  
First Time ◽  
Better Than

Background The cuffed oropharyngeal airway (COPA), a modified Guedel airway, was compared with the laryngeal mask airway (LMA) during spontaneous breathing anesthesia. Specifically examined were ease of use, physiologic tolerance, and the frequency of problems. Methods Adult patients consented to random (2:1) assignment to either COPA (n = 302) or LMA (n = 151) for airway management during anesthesia with propofol, nitrous oxide, and oxygen. Results Ease of insertion was similar, but the first-time successful insertion rate was higher with the LMA (COPA, 81% compared with LMA, 89%; P = 0.05). More brief manipulations (head tilt, chin lift, jaw thrust) were reported in the COPA group (average total number of manipulations: COPA, 1.1 +/- 1.6 compared with LMA, 0.1 +/- 0.2; P < 0.001). Continuous airway support was used more frequently in the COPA group (COPA, 30% compared with LMA, 0%; P < 0.0005). The incidences of aspiration, regurgitation, laryngospasm, wheezing, succinylcholine administration, oxygen saturation (SpO2) < 92%, failed use, and minor intraoperative problems were similar. When the airways were removed, blood was detected on the COPA less frequently than on the LMA (COPA, 5.8% compared with LMA, 15.3%; P = 0.001). The incidence of early and late sore throat was greater with the LMA (early: COPA, 4.7% compared with LMA, 21.9% [P = 0.001]; late: COPA, 8.4% compared with LMA, 16.1%; P = 0.01). The LMA did better than the COPA when anesthetists analyzed the technical aspects of the two devices. Conclusions Although the COPA and LMA are equivalent devices in terms of physiologic alterations and overall clinical problems associated with their use, the LMA was associated with a higher first-time insertion rate and fewer manipulations, suggesting that it is easier to use. The COPA was associated with less blood on the device and fewer sore throats, suggesting it may cause less pharyngeal trauma. Ultimately, both devices were similar in establishing a safe and effective airway for spontaneously breathing anesthetized adults.

Upper airway obstruction in the unconscious patient

1959 ◽  
Vol 14 (5) ◽  
pp. 760-764 ◽  
Author(s):  
Peter Safar ◽  
Lourdes A. Escarraga ◽  
Francis Chang
Keyword(s):  
Upper Airway ◽  
Posterior Pharyngeal Wall ◽  
Muscle Relaxants ◽  
The Unconscious ◽  
Pharyngeal Wall ◽  
Airway Patency ◽  
Forward Displacement ◽  
Oropharyngeal Airway ◽  
Spontaneously Breathing ◽  
Head Neck

Airway patency was studied in 80 anesthetized, spontaneously breathing patients, who received no muscle relaxants. With the neck flexed (chin towards chest) the airway was obstructed in all patients, both in the supine and prone positions, with and without an artificial oropharyngeal airway in place. With extension at the atlanto-occipital joint (chin up) in the supine position approximately 50% of the patients had an open airway. The other 50% required, in addition to extension of the neck, forward displacement of the mandible or the insertion of an oropharyngeal airway or both. Roentgenograms demonstrated that the tongue is pushed against the posterior pharyngeal wall when the neck is flexed and the mandible is not held forward. The incidence and degree of obstruction was similar in the prone and supine positions, with comparable positions of the head, neck and mandible. Submitted on December 19, 1958

scholarly journals Singapore Paediatric Resuscitation Guidelines 2021

2021 ◽  
Vol 62 (08) ◽  
pp. 372-389 ◽  
Author(s):  
GYK Ong ◽  
◽  
N Ngiam ◽  
LP Tham ◽  
YH Mok ◽  
...  
Keyword(s):  
Clinical Practice ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Treatment Recommendations ◽  
European Resuscitation Council ◽  
Liaison Committee ◽  
Local Setting ◽  
Resuscitation Guidelines ◽  
Consensus Statements

We present the 2021 Singapore Paediatric Resuscitation Guidelines. The International Liaison Committee on Resuscitation’s Pediatric Taskforce Consensus Statements on Science and Treatment Recommendations, which was published in October 2020, and the updated resuscitation guidelines from the American Heart Association and European Resuscitation Council, were reviewed and discussed by the committee. These recommendations were derived after deliberation of peer-reviewed evidence updates on paediatric resuscitation and took into consideration the local setting and clinical practice.

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