scholarly journals CPR with restricted patient access using alternative rescuer positions: a randomised cross-over manikin study simulating the CPR scenario after avalanche burial

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Bernd Wallner ◽  
Luca Moroder ◽  
Hannah Salchner ◽  
Peter Mair ◽  
Stefanie Wallner ◽  
...  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Limiting Factor ◽  
Hand Position ◽  
Patient Access ◽  
Compression Depth ◽  
Standard Position ◽  
Manikin Study ◽  
Significant Difference

Abstract Background The aim of this manikin study was to evaluate the quality of cardiopulmonary resuscitation (CPR) with restricted patient access during simulated avalanche rescue using over-the-head and straddle position as compared to standard position. Methods In this prospective, randomised cross-over study, 25 medical students (64% male, mean age 24) performed single-rescuer CPR with restricted patient access in over-the-head and straddle position using mouth-to-mouth ventilation or pocket mask ventilation. Chest compression depth, rate, hand position, recoil, compression/decompression ratio, hands-off times, tidal volume of ventilation and gastric insufflation were compared to CPR with unrestricted patient access in standard position. Results Only 28% of all tidal volumes conformed to the guidelines (400–800 ml), 59% were below 400 ml and 13% were above 800 ml. There was no significant difference in ventilation parameters when comparing standard to atypical rescuer positions. Participants performed sufficient chest compressions depth in 98.1%, a minimum rate in 94.7%, correct compression recoil in 43.8% and correct hand position in 97.3% with no difference between standard and atypical rescuer positions. In 36.9% hands-off times were longer than 9 s. Conclusions Efficacy of CPR from an atypical rescuer position with restricted patient access is comparable to CPR in standard rescuer position. Our data suggest to start basic life-support before complete extrication in order to reduce the duration of untreated cardiac arrest in avalanche rescue. Ventilation quality provided by lay rescuers may be a limiting factor in resuscitation situations where rescue ventilation is considered essential.

scholarly journals Comparison of extended reality and conventional methods of basic life support training: protocol for a multinational pragmatic clinical trial (XR BLS trial)

2021 ◽  
Author(s):  
Chang Woo Im ◽  
Dong Keon Lee ◽  
You Hwan Jo ◽  
Todd Chang ◽  
Joo Lee Song ◽  
...  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Hand Position ◽  
Compression Depth ◽  
Pragmatic Clinical Trial ◽  
Training Video ◽  
Cpr Training ◽  
To Receive

Abstract BackgroundConventional cardiopulmonary resuscitation (CPR) training for the general public involves the use of a manikin and a training video, which has limitations of lack of realism and immersion. To overcome these limitations, virtual reality and extended reality technologies are being used in the field of medical education. The aim of this study is to explore the efficacy and safety of the extended reality (XR)-based basic life support (BLS) training.MethodsThis study is a prospective, multinational, multicentre, randomized controlled study. Four institutions in 4 countries will participate in the study. A total of 154 participants will be randomly assigned to either the XR group or the conventional group stratified by institution and sex (1:1 ratio). Each participant who is allocated to either group will be sent to a separate room to receive training with an XR BLS module or conventional CPR training video. All participants will perform a test on a CPR manikin after the training. The primary outcome will be mean compression depth. The secondary outcome will be overall BLS performances, including compression rate, correct hand position, compression and full release and hands-off time. DiscussionUsing VR to establish a virtual educational environment can give trainees a sense of realism. In the XR environment, which combines the virtual world with the real world, trainees can more effectively learn various skills. This trial will provide evidence of the usefulness of XR in CPR education.Trial registrationClinicalTrials.gov NCT04736888. Registered on 29 January 2021

scholarly journals (A153) Analysis of Chest Compressions: Measured Using the Quality Compression Index and Performance Disparities among Demographic Characteristics

2011 ◽  
Vol 26 (S1) ◽  
pp. s43-s44
Author(s):  
J.H. Schwab ◽  
A.L. Williams ◽  
M.L. Birnbaum ◽  
Z.T. Emberts ◽  
P.D. Padjen ◽  
...  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Healthcare Providers ◽  
Hand Position ◽  
Compression Index ◽  
Chest Compressions ◽  
Male Sex ◽  
And Performance ◽  
Over Time

IntroductionCardiopulmonary resuscitation (CPR) guidelines throughout the world stress the importance of high quality chest compressions soon after cardiac arrest as the most significant factor in determining survival. Little evidence exists, internationally, documenting the quality of compressions provided by healthcare providers. In this study investigators sought to determine the quality of chest compressions delivered by rescuers. It was hypothesized that greater variably in compression quality exists between rescuers than variability in individual rescuers over time.MethodsIn this observational pilot study, basic life support (BLS) providers from prehospital and in-hospital settings were invited to participate in the investigation. Ten minutes of continuous chest compressions were recorded on the Resusci Anne and the Laerdal PC Skillreporting System. An adequate compression was defined as a compression with depth > 38mm, full chest recoil, and correct hand position. The Quality Compression Index (QCI) was developed to factor rate into the characteristics of an adequate compression. QCI is a scaled performance index calculated every 30 seconds.ResultsProviders came from a variety of clinical backgrounds, aged 35.5 ± 11.0 years. Of the 103 total participants, 94 (91.3%) completed 10 minutes of compressions. The most significant degradation in the quality of compressions occurred within the first two minutes. There was greater variability between different rescuers than the variability over time. Mean Square Error (MSE) due to subjects was comparatively greater than the MSE due to time (63.2 vs. 7.68). Performance of CPR, male sex, < 45 years of age, and prehospital background, correlated with higher quality. Time since last BLS certification and the number of times a rescuer completed a BLS class did not correlate with the quality.ConclusionsGreater variability in the quality of compressions exists between different rescuers than a rescuer over time. Some participants were not able to deliver ideal compressions from the start, when the effects of fatigue were minimal.

scholarly journals Basic Life-Support Learning in Undergraduate Students of Sports Sciences: Efficacy of 150 Minutes of Training and Retention after Eight Months

2019 ◽  
Vol 16 (23) ◽  
pp. 4771 ◽  
Author(s):  
Silvia Aranda-García ◽  
Ernesto Herrera-Pedroviejo ◽  
Cristian Abelairas-Gómez
Keyword(s):  
Undergraduate Students ◽  
Basic Life Support ◽  
Life Support ◽  
Training Session ◽  
Skills Training ◽  
Hand Position ◽  
Professional Groups ◽  
Sports Science ◽  
Sports Sciences

Several professional groups, which are not health professionals, are more likely to witness situations requiring basic life support (BLS) due to the nature of their job. The aim of this study was to assess BLS learning after 150 min of training in undergraduate students of sports science and their retention after eight months. Participants trained on BLS (150-min session: 30 theory, 120 practice). After training (T1) and after 8 months (T2), we evaluated their performance of the BLS sequence and two minutes of cardiopulmonary resuscitation (CPR). At T1, the 23 participants presented a mean score of 72.5 ± 21.0% in the quality of the CPRs (compressions: 78.6 ± 25.9%, ventilation: 69.9 ± 30.1%). More than 90% of the participants acted correctly in each step of the BLS sequence. At T2, although the overall quality of the CPR performed did not decrease, significant decreases were observed for: correct hand position (T1: 98.2 ± 8.8, T2: 77.2 ± 39.7%), compression depth (T1: 51.4 ± 7.9, T2: 56.0 ± 5.7 mm), and compression rate. They worsened opening the airway and checking for breathing. In conclusions, participants learned BLS and good-quality CPR after the 150-min training session. At eight months they had good retention of the BLS sequence and CPR skills. Training on airway management and the position of the hands during CPR should be reinforced.

scholarly journals Performing Simulated Basic Life Support without Seeing: Blind vs. Blindfolded People

2021 ◽  
Vol 18 (20) ◽  
pp. 10724
Author(s):  
Santiago Martínez-Isasi ◽  
Cristina Jorge-Soto ◽  
Roberto Barcala-Furelos ◽  
Cristian Abelairas-Gómez ◽  
Aida Carballo-Fazanes ◽  
...  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Training Session ◽  
Practical Training ◽  
Blind People ◽  
Compression Depth ◽  
Feedback Training ◽  
Simulation Scenario ◽  
Quasi Experimental

Previous pilot experience has shown the ability of visually impaired and blind people (BP) to learn basic life support (BLS), but no studies have compared their abilities with blindfolded people (BFP) after participating in the same instructor-led, real-time feedback training. Twenty-nine BP and 30 BFP participated in this quasi-experimental trial. Training consisted of a 1 h theoretical and practical training session with an additional 30 min afterwards, led by nurses with prior experience in BLS training of various collectives. Quantitative quality of chest compressions (CC), AED use and BLS sequence were evaluated by means of a simulation scenario. BP’s median time to start CC was less than 35 s. Global and specific components of CC quality were similar between groups, except for compression rate (BFP: 123.4 + 15.2 vs. BP: 110.8 + 15.3 CC/min; p = 0.002). Mean compression depth was below the recommended target in both groups, and optimal CC depth was achieved by 27.6% of blind and 23.3% of blindfolded people (p = 0.288). Time to discharge was significantly longer in BFP than BP (86.0 + 24.9 vs. 66.0 + 27.0 s; p = 0.004). Thus, after an adapted and short training program, blind people were revealed to have abilities comparable to those of blindfolded people in learning and performing the BLS sequence and CC.

scholarly journals The effectiveness of traditional Basic Life Support training and alternative technology-enhanced methods in high schools

2018 ◽  
Vol 26 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Arif Onan ◽  
Sevgi Turan ◽  
Melih Elcin ◽  
Bulent Erbil ◽  
Şule Çınar Bulut
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Basic Life Support ◽  
Life Support ◽  
The Other ◽  
Hand Position ◽  
Ability To Act ◽  
Resuscitation Training ◽  
Significant Difference ◽  
Group A ◽  
Teacher Assessments

Background: Implementation of resuscitation training in school programs is a promising approach to improve rates of cardiopulmonary resuscitation use by trained bystanders. Unfortunately, theoretical cardiopulmonary resuscitation instruction alone is not sufficiently effective in developing practical skills. Objectives: This study aimed to investigate the effectiveness of traditional Basic Life Support training and alternative instructional methods to achieve learning objectives of Basic Life Support education. Methods: This quasi-experimental study was conducted in a secondary school in Ankara, Turkey. Eighty-three voluntary students were randomly allocated to theoretical (Group A), video-based (Group B), and mobile-assisted video-based instructions (Group C). All groups were led by the course teacher. Assessments were conducted in training and again 1 week later. Assessments were based on Basic Life Support knowledge and confidence performance scores. Results: Statistically significant difference was found for the groups’ Confidence Scale scores (F(2, 73) = 3.513, p = 0.035, ηp2 = 0.088); Group C (6.76 ± 1.70) scored higher than Group A. The groups’ Basic Life Support checklist scores were statistically significant (F(2, 73) = 28.050, p = 0.000, ηp2 = 0.435); Group C (32.32 ± 3.84) scored higher than the other groups. Statistically significant difference was found for the groups’ measurable Basic Life Support scores (F(2, 73) = 13.527, p = 0.000, ηp2 = 0.270); and Group C (23.76 ± 3.98) scored higher than the other groups. Conclusion: Our findings showed that all instruction methods led to increased Basic Life Support knowledge scores. The mobile-assisted program significantly increased knowledge scores. Same-group high-quality cardiopulmonary resuscitation parameters were more positive than the other instruction groups except for hand position. Group C students expressed higher confidence in their ability to act in an emergency when witnessing a victim collapse.

Awareness of basic life support among undergraduate medical students in Syria, Iraq and Jordan: a cross sectional study

2021 ◽  
Author(s):  
Mohammad Nour Shashaa ◽  
Mohamad Shadi Alkarrash ◽  
Mohammad Nour Kitaz ◽  
Roaa Rhayim ◽  
Mohammed Ismail ◽  
...  
Keyword(s):  
Medical Students ◽  
Basic Life Support ◽  
Life Support ◽  
Clinical Stage ◽  
Sudden Cardiac Arrest ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background Sudden cardiac arrest considers one of the most leading cause for death in all over the world. It is important for all medical students to train basic life support. This study evaluated the awareness of basic life support among medical students. Methods An electronic questionnaire based cross sectional study was conducted in November 2020 among 2114 medical student in Syria, Iraq and Jordan. We evaluated BLS skills according to mean score. A chi-squared test was used to determine if there were differences between those who attended a basic life support course and those who did not. Results 1656 of the participants (78.3%) stated that they did not attend a basic life support course. There was a significant difference between the participants from different countries where the mean score in Syria, Jordan and Iraq was 18.3, 24.3 and 18.8 respectively (p < 0.05). The participants were divided into 3 level according to total score; low (0–12), moderate (13–24) and high (25–37). In total, 18.3%, 72.8% and 8.9% of participants had high, intermediate and low level respectively. Conclusions The overall knowledge of basic life support among medical students is not adequate and need significant improvements. This study showed that an attendance a basic life support course previously had an effect on knowledge level. Hence, there is an urgent need to apply basic life support courses into the pre-clinical stage at universities.

scholarly journals Basic life support providers’ assessment of centre of the chest and inter-nipple line for hand position and their underlying anatomical structures

Resuscitation ◽  
2011 ◽  
Vol 82 (2) ◽  
pp. 190-194 ◽  
Author(s):  
Joyce Yeung ◽  
Thomas Butler ◽  
James W. Digby ◽  
John Hughes ◽  
David Higgie ◽  
...  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Hand Position ◽  
Support Providers ◽  
Anatomical Structures

scholarly journals Quality of Chest Compressions Differs over Time between Advanced and Basic Life Support

2015 ◽  
Vol 06 (12) ◽  
pp. 944-953
Author(s):  
Pär Lindblad ◽  
Annika Åström Victorén ◽  
Christer Axelsson ◽  
Bjarne Madsen Härdig
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Chest Compressions ◽  
Over Time

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

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.

scholarly journals Comparing Basic Life Support Serious Gaming Scores With Hands-on Training Platform Performance Scores: Pilot Simulation Study for Basic Life Support Training

10.2196/24166 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e24166
Author(s):  
Mehmet Emin Aksoy
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Performance Data ◽  
Serious Game ◽  
Sensor Data ◽  
Average Score ◽  
Compression Depth ◽  
Serious Gaming ◽  
Hands On ◽  
Depth Compression

Background Serious games enrich simulation-based health care trainings and improve knowledge, skills, and self-confidence of learners while entertaining them. Objective A platform which can combine performance data from a basic life support (BLS) serious game app and hands-on data based on the same scoring system is not available in the market. The aim of this study was to create such a platform and investigate whether performance evaluation of BLS trainings would be more objective compared to conventional Objective Structured Clinical Examination (OSCE) examinations if these evaluations were carried out with the platform which combines OSCE scoring criteria with sensor data retrieved from the simulator’s sensors. Methods Participants were 25 volunteers (11 men [44.0%] and 14 [56.0] women) among Acıbadem Mehmet Ali Aydınlar University students without prior knowledge of the BLS protocol. A serious game module has been created for teaching learners the European Resuscitation Council Basic Life Support 2015 protocol. A second module called the hands-on module was designed for educators. This module includes a checklist used for BLS OSCE examinations and can retrieve sensor data such as compression depth, compression frequency, and ventilation volume from the manikin (CPR Lilly; 3B Scientific GmbH) via Bluetooth. Data retrieved from the sensors of the manikin enable educators to evaluate learners in a more objective way. Performance data retrieved from the serious gaming module have been combined with the results of the hands-on module. Data acquired from the hands-on module have also been compared with the results of conventional OSCE scores of the participants, which were obtained by watching the videos of the same trainings. Results Participants were considered successful in the game if they scored 80/100 or above. Overall, participants scored 80 or above in an average of 1.4 (SD 0.65) trials. The average BLS serious game score was 88.3/100 (SD 5.17) and hands-on average score was 70.7/100 (SD 17.3), whereas the OSCE average score was 84.4/100 (SD 12.9). There was no statistically significant correlation between success on trials (score ≥80/100), serious game, hands-on training app, and OSCE scores (Spearman rho test, P>.05). The mean BLS serious game score of the participants was 88.3/100 (SD 5.17), whereas their mean hands-on training app score was 70.7/100 (SD 17.3) and OSCE score was 84.4/100 (SD 12.9). Conclusions Although scoring criteria for OSCE and hands-on training app were identical, OSCE scores were 17% higher than hands-on training app scores. After analyzing the difference of scores between hands-on training app and OSCE, it has been revealed that these differences originate from scoring parameters such as compression depth, compression frequency, and ventilation volume. These data suggest that evaluation of BLS trainings would be more objective if these evaluations were carried out with the modality, which combines visual OSCE scoring criteria with sensor data retrieved from the simulator’s sensors. Trial Registration ClinicalTrials.gov NCT04533893; https://clinicaltrials.gov/ct2/show/NCT04533893

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