Abstract 274: Verbal Prompts During Pediatric Cardiopulmonary Resuscitation in Emergency Department: A Report From the Videography in Pediatric Emergency Resuscitation (VIPER) Collaborative

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Ichiro Watanabe ◽  
Richard S Hanna ◽  
Sage R Myers ◽  
Benjamin Kerrey ◽  
Mary Frey ◽  
...  
Keyword(s):  
Age Groups ◽  
Pediatric Emergency ◽  
Ventilation Rate ◽  
Chest Compressions ◽  
Video Review ◽  
Study Sites ◽  
Verbal Prompts ◽  
Monitor Device ◽  
Monitoring Devices

Introduction: The quality of chest compressions (CC) is crucial for good outcomes for pediatric cardiac arrest. Verbal prompts from resuscitation leader or CPR coach may help to optimize it. The objective of this study is to describe the frequency of appropriate verbal prompts during pediatric CPR. We hypothesized that verbal prompts for CC would be given less frequently to infants compared to children. Methods: A report from the Videography In Pediatric Emergency Resuscitation (VIPER) Collaborative, a prospective observational database from three tertiary PEDs from December 2016 to April 2018. All study sites videorecord and review resuscitations and use a pressure sensor/monitor device during CPR. All events where chest compressions (CC) were performed under videorecorded conditions with the monitor device in use were eligible for inclusion. Events where real-time feedback from monitoring devices for CC was available were excluded (ages > 8). Data on CPR performance was collected by a combination of video review and monitor device; CC rate and depth and ventilation rate were extracted in time periods corresponding to individual CPR providers. Data on verbal prompts (time, who gave prompts, what prompt consisted of) were identified during video review. Results: There were 21 cases with total 182 providers included in database during study periods (infants: n=15, children: n=6). Verbal prompts for compression rate and depth were given in 14/21 (67%) of cases. 19/80 (24%) came from the resuscitation leader; 32/80 (40%) and from a CPR coach. 7 (3.9%) providers doing CC watched ZOLL monitor for feedback. Appropriate verbal prompts for CC rate were given to 4.2 % of providers in infants and 8.8 % in children (p=0.024). And 9.2% in infants and 10.5 % in children (p=0.064) were given to providers for CC depth. After adjusting by confounders, there weren’t any significant differences between age groups for both CC rate: OR1.22 (95%CI 0.49-3.05, P=0.670) and depth: OR 2.82 (95%CI 0.73-10.9, P=0.134). Conclusions: Verbal prompts frequency for CC rate and depth during pediatric CPR was described. There weren’t any significant differences between infants and children under 8 years old.

Abstract 109: Pediatric CPR in the Emergency Department: Initial Findings From the Videography in Pediatric Emergency Research Collaborative

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Karen J O’Connell ◽  
Benjamin T Kerrey ◽  
Sage R Myers ◽  
Alexis B Sandler ◽  
Richard Hanna ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Pediatric Emergency ◽  
Ventilation Rate ◽  
Older Children ◽  
High Quality ◽  
Video Review ◽  
Cpr Quality ◽  
The Impact ◽  
Monitor Device

Introduction: Cardiopulmonary resuscitation (CPR) is frequently performed in a manner inconsistent with American Heart Association (AHA) guidelines. Published studies on CPR quality during pediatric cardiac arrest using chest compression (CC) monitor devices have reported data in aggregate form from entire CPR events. The addition of video review allows precise measurement of CPR quality at the level of individual providers. Hypothesis: To measure individual healthcare providers’ (HCP) CPR quality during pediatric cardiac arrest events in actual patients in the emergency department (PED) and describe adherence to AHA guidelines. Methods: A report from the Videography in Pediatric Emergency Resuscitation (VIPER) Collaborative, a prospective observational database from three tertiary PEDs. All study sites videorecord and review resuscitations and use a pressure sensor/monitor device during CPR. All events where chest compressions (CC) were performed under videorecorded conditions with the monitor device in use were eligible for inclusion. Data on CPR performance was collected by a combination of video review and monitor device; CC rate and depth and ventilation rate were extracted in time periods corresponding to individual CPR providers. CPR segments were defined as ‘high-quality’ if all AHA guidelines were achieved (CC rate 100-120 cpm; CC depth >= 1.5 inches for infants or >= 2 inches for children; ventilation rate 8-12 bpm, no pauses > 10 seconds). Results: Between August 2016 and April 2018, complete data was available for 31 events (infants: n=5; older children: n=6). 279 compression segments were analyzed. Median CC rate was 119 cpm (IQR 110 – 129); median depth was 1.0 inches in infants (IQR 0.85 – 1.2) and 2.1 inches in older children (IQR 1.4 – 2.4). Median ventilation rate was 15 bpm (IQR 10 - 30). 22/279 (8%) compression segments met all criteria for high-quality CPR. Conclusions: PED HCPs infrequently met AHA guidelines for CPR quality. Future studies using video review and CC monitor data collection should examine the impact of specific training strategies on provider-level CPR performance during pediatric cardiac arrest.

Abstract 107: The Effects of Hand Placement on Chest Compression Quality in the Pediatric Emergency Department: Findings From the Videography in Pediatric Emergency Research Collaborative

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Alexis B Sandler ◽  
Karen O’Connell ◽  
Ichiro Watanabe ◽  
Richard Hanna ◽  
Benjamin T Kerrey ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Young Patients ◽  
Pediatric Emergency ◽  
Hand Position ◽  
Pediatric Emergency Department ◽  
Emergency Research ◽  
Chest Compressions ◽  
Patient Demographics

Introduction: Guidelines for infant cardiopulmonary resuscitation (CPR) recommend two finger (2F) technique for one-rescuer chest compressions (CCs) and a two-thumb encircling (2T) for two-rescuers CCs. Pediatric guidelines recommend either a one-handed (1H) or two-handed (2H) technique based on provider judgement. Previous small, single site studies suggest that 2T compressions are more effective for infant CPR than 2F and 1H. Hypothesis: To combine video review and monitor-defibrillator CC analysis to determine the effects of hand placement on CC quality in a pediatric emergency department (PED). Methods: Data was obtained from the Videography in Pediatric Emergency Resuscitation (VIPER) Collaborative, a prospective observational resuscitation database from 3 tertiary PEDs. Participating sites review resuscitations for quality, safety, and research purposes. Rate and depth for continuous CC segments delivered by a single compressor (epoch) were obtained from Zoll R-series monitor-defibrillator, epoch duration and hand position from video, and patient demographics from medical records. Epochs with analyzable video and CC data were eligible for inclusion. Quality of CC rate and depth were evaluated for adherence to 2015 AHA standards. Results: A total of 248 minutes of CCs for 19 patients [14 infants ≤1 year; 5 toddlers 2-4 years] were analyzed. Median CC rates were adherent to AHA standards for toddlers but not infants, where CCs were often too fast (Table 1). CC depth was inadequate in both infant and toddlers. The 2T technique in infants was significantly associated with adherence to AHA standards for rate ( X 2 =4.97; X 2 =3.64) (Table 1). Conclusions: Infant CC rate and depth and toddler CC depth were not adherent to AHA standards. Performing CCs on infants using the 2T technique was most likely to produce CCs at the recommended rate. Further understanding and implementation of techniques to assist with providing high-quality CCs in young patients is needed.

The impact of the use of a footrest on the quality of chest compressions. A prospective, randomized, cross-sectional study

2018 ◽  
Vol 31 (3) ◽  
Author(s):  
Jolanta Majer ◽  
Sandra Pyda ◽  
Jerzy Robert Ladny ◽  
Antonio Rodriguez-Nunez ◽  
Lukasz Szarpak
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Chest Compressions ◽  
Cross Sectional ◽  
The Impact

Leukemia Support Groups: How Are They Doing?

1997 ◽  
Vol 4 (5) ◽  
pp. 407-412
Author(s):  
Donna Corwin Moss
Keyword(s):  
Quality Of Life ◽  
Support Groups ◽  
Age Groups ◽  
Cancer Treatments ◽  
Future Directions ◽  
Course Of Illness ◽  
New Concepts ◽  
Sources Of Support ◽  
Practical Impact

Background Support groups help their participants to cope with the emotional and practical impact of their illnesses. Methods The effectiveness of the Leukemia Society of America support groups in enhancing the quality of life for their participants is reviewed. The groundwork, purpose, and structure of such groups, as well as alternate sources of support, are presented. Evaluation and future directions for oncology groupwork are discussed. Results Support groups complement the therapies provided by clinical practitioners and scientists by addressing the additional needs of cancer patients over the course of illness and survival. Conclusions New concepts and methods that address the needs of specific age-groups and incorporate the newly generated data on cancer treatments will further enhance the benefits provided by support groups.

scholarly journals Children’s Understanding of Informed Assents in Research Studies

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 871
Author(s):  
Hortense Cotrim ◽  
Cristina Granja ◽  
Ana Sofia Carvalho ◽  
Carlos Cotrim ◽  
Rui Martins
Keyword(s):  
Health Care ◽  
Positive Relationship ◽  
Age Groups ◽  
High Capacity ◽  
Decision Making Process ◽  
Objective Understanding ◽  
Level Of Understanding ◽  
Age And Sex ◽  
Acceptance Of Health Care

The assent procedure reflects an effort to enable the minor to understand, to the degree they are capable of, what their participation in the decision making process would involve. Aims: To evaluate the minors’ ability to understand the information provided to them when obtaining assent and to evaluate the opinion of the parents regarding the importance of asking the child’s assent. Methods: The sample included a total of 52 minors aged between 10 and 17 years who underwent exercise echocardiogram. The Quality of Informed Consent is divided into two parts: Part A was used to measure objective understanding and part B to measure subjective understanding. Results: The results show that the minors have a high capacity to understand the information given to them when asking for assent. A positive relationship was found between the two parts of the questionnaire. No statistically significant relationship was found between age and sex and part A and part B or between both age groups (<14 years old and ≥14 years old) and the measure. In the case of the parents, 96.6% of parents consider assent as an advantage for the child’s acceptance of health care. The opinion of the parents is not related to the age, sex or level of schooling. Conclusion: Minors showed a substantial level of understanding regarding the information provided to them. The parents considered the implementation of assent fundamental to the child’s acceptance of health care.

scholarly journals Modelling the Quality of Bathing Waters in the Adriatic Sea

Water ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 1525
Author(s):  
Christian Ferrarin ◽  
Pierluigi Penna ◽  
Antonella Penna ◽  
Vedrana Spada ◽  
Fabio Ricci ◽  
...  
Keyword(s):  
Adriatic Sea ◽  
Management Tool ◽  
Negative Consequences ◽  
Sea Temperature ◽  
Bathing Water Directive ◽  
Bathing Waters ◽  
Diffusion Dynamics ◽  
Study Sites

The aim of this study is to develop a relocatable modelling system able to describe the microbial contamination that affects the quality of coastal bathing waters. Pollution events are mainly triggered by urban sewer outflows during massive rainy events, with relevant negative consequences on the marine environment and tourism and related activities of coastal towns. A finite element hydrodynamic model was applied to five study areas in the Adriatic Sea, which differ for urban, oceanographic and morphological conditions. With the help of transport-diffusion and microbial decay modules, the distribution of Escherichia coli was investigated during significant events. The numerical investigation was supported by detailed in situ observational datasets. The model results were evaluated against water level, sea temperature, salinity and E. coli concentrations acquired in situ, demonstrating the capacity of the modelling suite in simulating the circulation in the coastal areas of the Adriatic Sea, as well as several main transport and diffusion dynamics, such as riverine and polluted waters dispersion. Moreover, the results of the simulations were used to perform a comparative analysis among the different study sites, demonstrating that dilution and mixing, mostly induced by the tidal action, had a stronger effect on bacteria reduction with respect to microbial decay. Stratification and estuarine dynamics also play an important role in governing microbial concentration. The modelling suite can be used as a beach management tool for improving protection of public health, as required by the EU Bathing Water Directive.

scholarly journals Odour, dust and non-methane volatile organic-compound emissions from tunnel-ventilated layer-chicken sheds: a case study of two farms

2013 ◽  
Vol 53 (12) ◽  
pp. 1309 ◽  
Author(s):  
Mark Dunlop ◽  
Zoran D. Ristovski ◽  
Erin Gallagher ◽  
Gavin Parcsi ◽  
Robin L. Modini ◽  
...  
Keyword(s):  
Dust Emission ◽  
Ventilation Rate ◽  
Gas Chromatography Mass Spectrometry ◽  
Emission Rates ◽  
Layer Chicken ◽  
Volatile Organic ◽  
Different Seasons ◽  
Odour Emissions ◽  
Cleaning Cycle ◽  
Study Sites

An observational study was undertaken to measure odour and dust (PM10 and PM2.5) emission rates and identify non-methane volatile organic compounds (NMVOCs) and odorants in the exhaust air from two tunnel-ventilated layer-chicken sheds that were configured with multi-tiered cages and manure belts. The study sites were located in south-eastern Queensland and the West Gippsland region of Victoria, Australia. Samples were collected in summer and winter on sequential days across the manure-belt cleaning cycle. Odour emissions ranged from 58 to 512 ou/s per 1000 birds (0.03–0.27 ou/s.kg) and dust emission rates ranged 0.014–0.184 mg/s per 1000 birds for PM10 and 0.001–0.190 mg/s per 1000 birds for PM2.5. Twenty NMVOCs were identified, including three that were also identified as odorants using thermal desorption–gas chromatography–mass spectrometry/olfactometry analysis. Odour emission rates were observed to vary with the amount of manure accumulation on the manure belts, being lowest 2–4 days after removing manure. Odour emission rates were also observed to vary with diurnal and seasonal changes in ventilation rate. Dust emissions were observed to increase with ventilation rate but not with manure accumulation. Some NMVOCs were identified at both farms and in different seasons whereas others were observed only at one farm or in one season, indicating that odorant composition was influenced by farm-specific practices and season.

scholarly journals Oral Health Related Quality of Life and Prosthetic Status among Institutionalized Elderly from the Bucharest Area: A Pilot Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6663
Author(s):  
Laura Iosif ◽  
Cristina Teodora Preoteasa ◽  
Elena Preoteasa ◽  
Ana Ispas ◽  
Radu Ilinca ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Age Groups ◽  
Health Related Quality ◽  
Institutionalized Elderly ◽  
Related Quality ◽  
Health Related ◽  
Prosthetic Status ◽  
The Impact

The aim of the study was to assess the oral health related quality of life (OHRQoL) of elderly in care homes, one of Romania’s most vulnerable social categories, to correlate it to sociodemographic, oral health parameters, and prosthodontic status. Therefore, a cross-sectional study was performed on 58 geriatrics divided into 3 age groups, who were clinically examined and answered the oral health impact profile (OHIP-14) questionnaire. Very high rates of complete edentulism in the oldest-old subgroup (bimaxillary in 64.3%; mandibular in 64.3%; maxillary in 85.7%), and alarming frequencies in the other subgroups (middle-old and youngest-old), statistically significant differences between age groups being determined. The OHIP-14 mean score was 14.5. Although not statistically significant, females had higher OHIP-14 scores, also middle-old with single maxillary arch, single mandibular arch, and bimaxillary complete edentulism, whether they wore dentures or not, but especially those without dental prosthetic treatment in the maxilla. A worse OHRQoL was also observed in wearers of bimaxillary complete dentures, in correlation with periodontal disease-related edentulism, in those with tertiary education degree, and those who came from rural areas. There were no statistically significant correlations of OHRQoL with age, total number of edentulous spaces or edentulous spaces with no prosthetic treatment. In conclusion, despite poor oral health and prosthetic status of the institutionalized elderly around Bucharest, the impact on their wellbeing is comparatively moderate.

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