scholarly journals Web-based Compared to Personal Automated External Defibrillator Assisted Cardiopulmonary Resuscitation Training for Dental Students: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Antonia Postina ◽  
Jürgen Hoffmann ◽  
Till Sebastian Mutzbauer
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Tidal Volume ◽  
Chest Compression ◽  
Dental Students ◽  
Basic Knowledge ◽  
Web Based ◽  
The Web ◽  
Personal Tutor

BACKGROUND Cardiopulmonary resuscitation (CPR) is rarely performed by dental staff. The availability of automated external defibrillators (AED) is increasing. Personal tutor training with a manikin is the most common way to teach CPR. But internet-learning approaches, such as video-based teaching, are gaining popularity. OBJECTIVE This pilot study has been designed to compare the performance of CPR after two teaching methods in a simulated cardiac arrest situation. A personal tutor demonstration was compared with a web-based video demonstration. The main hypothesis was that more than 70% of the participants of the tutor-instructed group would start CPR within 10 seconds (s), while only up to 30% of the participants of the web-based video-instructed group would start within this time. METHODS One group of dental students received a 5.5 minutes (min) AED-CPR demonstration by a tutor on a manikin (T-/control group n=23 teams of two). A second group watched a 7min web-based AED-CPR instruction video (W-/intervention group n=23 teams of two). No repetition was offered, no questions or practice allowed. CPR performance was video-recorded and analyzed by two examiners. RESULTS No differences concerning the onset and quality of CPR were found. Students started CPR after detection of cardiac arrest with a minimum delay (median=6s (T)/6s (W); IQR=5/7; P=.52). Tidal volume and chest compression depths were insufficient in both groups (tidal volume: median=14 milliliters (ml) (T)/58ml (W); IQR=218.5/148.5; P=.9; depths: median=30 millimeters (mm) (T)/20mm (W); IQR=12.5/10; P=.02). Tutor-instructed teams compressed deeper, but both groups did not meet the recommended standard. Chest compression rate was in the recommended interval (median=113 (T)/111 compressions/minute (W); IQR=24.5/20; P=.46). More students of the web-based video-instructed group had problems using the AED (T=7 teams; W=14; P=.04) but all except one team continued CPR. They did not focus on the problems with the AED and were able to trigger a shock (T=21 teams; W=19; P=.38). Restart of CPR after the shock within 10s was achieved at almost equal time intervals (median=5s (T)/6s (W); IQR=3/4; P=.54). CONCLUSIONS Dental students can acquire basic knowledge in AED-assisted CPR in similar quality by a short web-based video simulation compared with a short demonstration by a tutor. Contrary to expectations, most parameters of CPR and AED performance quality of web-based video-instructed group were not different to students of the tutor-instructed group. The recommended tidal volume had not been achieved in both groups. Chest compression depth seems to be a parameter that has been more difficult to teach to the web-based video-instructed group. No delays of standard CPR measures were observed after detection of cardiac arrest in both groups. The use of the AED did not distract the attention of the rescuers from the simulated patient. CLINICALTRIAL DRKS00012404

Abstract 17534: The Most Appropriate Number of Personnel Needed for Chest Compressions for In-hospital Cardiac Arrest: A Randomized, Crossover Manikin Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Shunsuke Yamanaka ◽  
Kei Nishiyama ◽  
Hiroyuki Hayashi ◽  
Ji Young Huh
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Healthcare Providers ◽  
Preliminary Evaluation ◽  
Chest Compressions ◽  
Rescue Team ◽  
Manikin Study ◽  
Hospital Cardiac Arrest

Background: Effective chest compression (CC) is vital in cardiopulmonary resuscitation (CPR), and rescuer’s fatigue negatively affects quality of CPR. However, there is no consensus on the appropriate number of personnel needed for CC to avoid rescuer’s fatigue. Objective: We determined the appropriate number of personnel needed for 30-min CPR in a rescue-team in a hospital. Methods: We conducted a preliminary randomized, crossover, manikin trial on healthcare providers. We divided them into Groups A to D according to the intervals between the 2-min CC and assigned a different interval to each group. Groups A, B, C, and D performed CCs at 2-, 4-, 6-, and 8-min intervals as in 2, 3, 4, and 5 personnel, respectively. All participants performed CCs for 30 min with different intervals depending on the assigned group; participants allocated to Groups A, B, C, and D performed 8, 5, 4, and 3 cycles, respectively. We compared the differences between first cycle and the second to the last cycle Results: We enrolled 42 participants (age: 25.2±4.2, men 47.6%) for the preliminary evaluation. We used Kruskal-Wallis for the analysis. Participants in the less interval Groups A and B performed faster (A: -24.28±15.18, B: -7.90±13.49, C: -11.27±17.01, D: -2.38±3.31, P=0.03) and shallower CCs (A: -4.42±6.92, B: -3.18±5.43, C: -0.18±5.74, D: -1.23±4.10, P=0.62). Women-rescuers performed faster (A: -27.25±12.23, B: -7.00±13.97, C: -8.16±19.26, D: 3.16±4.66, P= 0.05) and shallower CCs (A: -6.25±7.54, B: -3.00±6.89, C: -3.66±3.32, D: -0.16±4.35, P=0.58). However, CCs of men-rescuers were not faster (A: -20.33±20.65, B: -9.00±14.44, C: -15.00±15.11, D: -7.14±16.70, P= 0.60) or shallower (A: -2.00±6.55 B: -3.40±3.78, C: 4.00±5.33, D: -2.14±3.98, P=0.06). Conclusion: At least four rescuers (Group C) may be needed to reduce rescuer’s fatigue for 30-min CPR. If the team only includes women, more personnel would be needed as women experience fatigue faster.

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

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.

Effectiveness of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program Developed by the Thailand National Institute of Emergency Medicine (NIEMS)

2021 ◽  
pp. 1-6
Author(s):  
Chuenruthai Angkoontassaneeyarat ◽  
Chaiyaporn Yuksen ◽  
Chetsadakon Jenpanitpong ◽  
Pemika Rukthai ◽  
Marisa Seanpan ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Health Care Providers ◽  
Care Providers ◽  
Chest Compressions ◽  
Threatening Condition ◽  
Life Threatening

Abstract Background: Out-of-hospital cardiac arrest (OHCA) is a life-threatening condition with an overall survival rate that generally does not exceed 10%. Several factors play essential roles in increasing survival among patients experiencing cardiac arrest outside the hospital. Previous studies have reported that implementing a dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) program increases bystander CPR, quality of chest compressions, and patient survival. This study aimed to assess the effectiveness of a DA-CPR program developed by the Thailand National Institute for Emergency Medicine (NIEMS). Methods: This was an experimental study using a manikin model. The participants comprised both health care providers and non-health care providers aged 18 to 60 years. They were randomly assigned to either the DA-CPR group or the uninstructed CPR (U-CPR) group and performed chest compressions on a manikin model for two minutes. The sequentially numbered, opaque, sealed envelope method was used for randomization in blocks of four with a ratio of 1:1. Results: There were 100 participants in this study (49 in the DA-CPR group and 51 in the U-CPR group). Time to initiate chest compressions was statistically significantly longer in the DA-CPR group than in the U-CPR group (85.82 [SD = 32.54] seconds versus 23.94 [SD = 16.70] seconds; P <.001). However, the CPR instruction did not translate into better performance or quality of chest compressions for the overall sample or for health care or non-health care providers. Conclusion: Those in the CPR-trained group applied chest compressions (initiated CPR) more quickly than those who initiated CPR based upon dispatch-based CPR instructions.

Role of Dominant Hand Position during Chest Compression by Novice Rescuers: An Observational Simulation Study

2014 ◽  
Vol 21 (6) ◽  
pp. 382-386 ◽  
Author(s):  
Ch Jo ◽  
Jh Ahn ◽  
Yd Shon ◽  
Gc Cho
Keyword(s):  
Hong Kong ◽  
Cardiopulmonary Resuscitation ◽  
Training Program ◽  
Chest Compression ◽  
Simulation Study ◽  
Hand Position ◽  
Dominant Hand ◽  
Cpr Training

Introduction The aim of this study was to determine the effect of hand positioning on the quality of external chest compression (ECC) by novice rescuers. Methods This observational simulation study was conducted for 117 included participants. After completion of an adult cardiopulmonary resuscitation (CPR) training program for 3-h, the participants selected which of their hands would be in contact with the mannequin during ECC and performed 5 cycles of single rescuer CPR on a recording mannequin. The participants were assigned to 2 groups: the dominant hand group (DH; n=40) and the non-dominant hand group (NH; n=29). The depth and rate of ECC were analysed to compare the effectiveness of ECC between 2 groups. Results The rate of ECC was significantly faster in the DH group (mean, 117.3 ±11.4/min) than in the NH group (mean, 110.9±12.2/min) (p=0.028). However, the depth of ECC in the dominant hand group (mean, 52.4±5.9 mm) was not significantly different from that in the non-dominant hand group (mean, 50.8±6.0 mm) (p=0.287). Similarly, the portion of ECC with inadequate depth in the dominant hand group (mean, 1.8±4.3%) was not significantly different from that in the non-dominant hand group (mean, 5.3±15.6%) (p=0.252). Conclusions ECC can be performed with an acceptably higher rate of compressions when the dominant hand of the novice rescuer is placed in contact with the sternum. However, the position of the dominant hand does not affect the depth of ECC. (Hong Kong j.emerg.med. 2014;21:382-386)

scholarly journals An alternative method of chest compression from over-the-head during cardiopulmonary resuscitation

2019 ◽  
Author(s):  
Michał Ćwiertnia ◽  
Marek Kawecki ◽  
Tomasz Ilczak ◽  
Monika Mikulska ◽  
Mieczyslaw Dutka ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Artificial Respiration ◽  
Hand Position ◽  
Chest Compressions ◽  
Confined Spaces ◽  
Medical Response ◽  
Emergency Interventions ◽  
The Subject

Abstract Background Maintaining highly effective cardiopulmonary resuscitation (CPR) can be particularly difficult when artificial respiration using a bag-valve-mask device, combined with chest compression have to be carried out by one person. The aim of the study is to compare the quality of CPR conducted by one paramedic using chest compression from the patient’s side, with compression carried out from behind the patient’s head. Methods The subject of the study were two methods of CPR – ‘standard’ (STD) and ‘over-the-head’ (OTH). The STD method consisted of 30 chest compressions from the patient’s side, and two attempts at artificial respiration after moving round to behind the patient’s head. In the OTH method, both compression and respiration were conducted from behind the patient’s head. Results Both CPR methods were conducted by 38 paramedics working in medical response teams. The average time of the interruptions between compression cycles (STD 9.184 s, OTH 7.316 s, p<0.001); the depth of compression 50–60 mm (STD 50.65%, OTH 60.22%, p<0.001); the rate of compression 100–120/min. (STD 46.39%, OTH 53.78%, p<0.001); complete chest wall recoil (STD 84.54%, OTH 91.46%, p<0.001); correct hand position (STD 99.32%, OTH method 99.66%, p<0.001). The remaining parameters showed no significant differences in comparison to reference values. Conclusions The demonstrated higher quality of CPR in the simulated research using the OTH method conducted by one person justifies the use of this method in a wider range of emergency interventions than only for CPR conducted in confined spaces.

scholarly journals Effectiveness of Mechanical Chest Compression Devices over Manual Cardiopulmonary Resuscitation: A Systematic Review with Meta-analysis and Trial Sequential Analysis

2021 ◽  
Vol 22 (4) ◽  
pp. 810-819
Author(s):  
Mack Sheraton ◽  
John Columbus ◽  
Salim Surani ◽  
Ravinder Chopra ◽  
Rahul Kashyap
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Relative Effectiveness ◽  
Sufficient Evidence ◽  
Mechanical Compression ◽  
Mechanical Chest Compression ◽  
Significant Difference ◽  
Bystander Cpr ◽  
Meta Regression

Introduction: Our goal was to systematically review contemporary literature comparing the relative effectiveness of two mechanical compression devices (LUCAS and AutoPulse) to manual compression for achieving return of spontaneous circulation (ROSC) in patients undergoing cardiopulmonary resuscitation (CPR) after an out-of-hospital cardiac arrest (OHCA). Methods: We searched medical databases systematically for randomized controlled trials (RCT) and observational studies published between January 1, 2000–October 1, 2020 that compared mechanical chest compression (using any device) with manual chest compression following OHCA. We only included studies in the English language that reported ROSC outcomes in adult patients in non-trauma settings to conduct random-effects metanalysis and trial sequence analysis (TSA). Multivariate meta-regression was performed using preselected covariates to account for heterogeneity. We assessed for risk of biases in randomization, allocation sequence concealment, blinding, incomplete outcome data, and selective outcome reporting. Results: A total of 15 studies (n = 18474), including six RCTs, two cluster RCTs, five retrospective case-control, and two phased prospective cohort studies, were pooled for analysis. The pooled estimates’ summary effect did not indicate a significant difference (Mantel-Haenszel odds ratio = 1.16, 95% confidence interval, 0.97 to 1.39, P = 0.11, I2 = 0.83) between mechanical and manual compressions during CPR for ROSC. The TSA showed firm evidence supporting the lack of improvement in ROSC using mechanical compression devices. The Z-curves successfully crossed the TSA futility boundary for ROSC, indicating sufficient evidence to draw firm conclusions regarding these outcomes. Multivariate meta-regression demonstrated that 100% of the between-study variation could be explained by differences in average age, the proportion of females, cardiac arrests with shockable rhythms, witnessed cardiac arrest, bystander CPR, and the average time for emergency medical services (EMS) arrival in the study samples, with the latter three attaining statistical significance. Conclusion: Mechanical compression devices for resuscitation in cardiac arrests are not associated with improved rates of ROSC. Their use may be more beneficial in non-ideal situations such as lack of bystander CPR, unwitnessed arrest, and delayed EMS response times. Studies done to date have enough power to render further studies on this comparison futile.

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