Automatic compression improves adherence to advanced life support protocol in two-paramedic team. A randomized simulation study

2020 ◽  
Keyword(s):  
Human Error ◽  
Life Support ◽  
Advanced Life Support ◽  
Supraglottic Airway ◽  
Control Group ◽  
Delivery Time ◽  
Chest Compressions ◽  
Adherence To Guidelines ◽  
Experimental Group

Introduction: The use of protocols reduces the risk of human error and increases healthcare professionals’ adherence to guidelines. In a team of only two providers, following Advanced Life Support (ALS) protocol might be challenging. Automated Chest Compressions Devices (ACCD) may increase the quality of chest compressions. The aim of this study was to evaluate if the use of ACCD in resuscitation by a two-paramedic crew improves adherence to the ALS protocol. Materials and Methods: This study was designed as a prospective randomized high-fidelity cross-over simulation trial. Fifty-two doubleperson teams were enrolled. Each team performed two full resuscitation scenarios: one with ACCD (the experimental group-ACC) and one with manual compressions (the control group-MAN). Results: ACC achieved shorter mean durations of resuscitation loops, being less prolonged in relation to recommended durations than MAN (13 vs. 23 sec over recommended respectively, P = 0.0003). ACC also achieved mean times for supraglottic airway completion significantly faster than MAN: 224 ± 66 s vs 122 ± 35 s (P < 0.0001). In ACC, the intravenous line was obtained earlier then in MAN (162 ± 35 s vs 183 ± 45 s, P = 0.0111). Moreover, the first and second doses of adrenaline (epinephrine) were administered earlier 272± 58 s vs 232 ± 57 s (P = 0.0014) for the first and 486 ± 96 s vs 424 ± 69 s (P = 0.0007) for the second doses, respectively. Mean chest compression fraction (CCF) in MAN group was significantly lower (74 ± 4%) than in ACC group (83 ± 2%) (P < 0.0001). Conclusions: In a simulated setting, ACCD used by two-person paramedic teams yielded earlier achievement of resuscitation endpoints and improved delivery time of compressions. which may have implications for effective clinical resuscitation.

scholarly journals Quality of Chest Compressions on A Dental Chair -- A Randomized Simulation Trial as Observation in Support of A Procedure Proposal

2020 ◽  
Keyword(s):  
Control Group ◽  
Crucial Importance ◽  
Chest Compressions ◽  
Dental Patients ◽  
Dental Chair ◽  
Dental Office ◽  
Efficient Performance ◽  
Medical Emergencies ◽  
Experimental Group

Background: Although medical emergencies among dental patients are not frequent, several factors may provoke sudden cardiac arrests. Early initiation of high-quality chest compressions (CC) is of crucial importance for the safety and effectiveness of cardiopulmonary resuscitation (CPR). Aims: We aimed to evaluate the quality of chest compressions performed on a dental chair for the proposed procedure in case of cardiac arrest in a dental office. Methods: We designed a prospective, randomized, crossover simulation study. Sixty paramedic students were randomly assigned to the control group, in which resuscitation was performed on the floor (n = 30) or to the experimental group, in which compressions were performed on a dental unit (n = 30). We used a simulator that recorded number of compressions, rate, depth of compressions and chest recoil. Results: There were no significant differences in numbers, rate, depth of chest compressions or in chest recoil between groups. Conclusions: We proved that performing chest compressions on a dental chair might be as effective as on the floor. On this basis, we propose a procedure for safe and efficient performance of CPR in a dental office.

scholarly journals Cardiopulmonary resuscitation (CPR) during spaceflight - a guideline for CPR in microgravity from the German Society of Aerospace Medicine (DGLRM) and the European Society of Aerospace Medicine Space Medicine Group (ESAM-SMG)

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Jochen Hinkelbein ◽  
Steffen Kerkhoff ◽  
Christoph Adler ◽  
Anton Ahlbäck ◽  
Stefan Braunecker ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Airway Management ◽  
Life Support ◽  
Advanced Life Support ◽  
Medical Emergency ◽  
Supraglottic Airway ◽  
Chest Compressions ◽  
Aerospace Medicine ◽  
International Group ◽  
The Earth

Abstract Background With the “Artemis”-mission mankind will return to the Moon by 2024. Prolonged periods in space will not only present physical and psychological challenges to the astronauts, but also pose risks concerning the medical treatment capabilities of the crew. So far, no guideline exists for the treatment of severe medical emergencies in microgravity. We, as a international group of researchers related to the field of aerospace medicine and critical care, took on the challenge and developed a an evidence-based guideline for the arguably most severe medical emergency – cardiac arrest. Methods After the creation of said international group, PICO questions regarding the topic cardiopulmonary resuscitation in microgravity were developed to guide the systematic literature research. Afterwards a precise search strategy was compiled which was then applied to “MEDLINE”. Four thousand one hundred sixty-five findings were retrieved and consecutively screened by at least 2 reviewers. This led to 88 original publications that were acquired in full-text version and then critically appraised using the GRADE methodology. Those studies formed to basis for the guideline recommendations that were designed by at least 2 experts on the given field. Afterwards those recommendations were subject to a consensus finding process according to the DELPHI-methodology. Results We recommend a differentiated approach to CPR in microgravity with a division into basic life support (BLS) and advanced life support (ALS) similar to the Earth-based guidelines. In immediate BLS, the chest compression method of choice is the Evetts-Russomano method (ER), whereas in an ALS scenario, with the patient being restrained on the Crew Medical Restraint System, the handstand method (HS) should be applied. Airway management should only be performed if at least two rescuers are present and the patient has been restrained. A supraglottic airway device should be used for airway management where crew members untrained in tracheal intubation (TI) are involved. Discussion CPR in microgravity is feasible and should be applied according to the Earth-based guidelines of the AHA/ERC in relation to fundamental statements, like urgent recognition and action, focus on high-quality chest compressions, compression depth and compression-ventilation ratio. However, the special circumstances presented by microgravity and spaceflight must be considered concerning central points such as rescuer position and methods for the performance of chest compressions, airway management and defibrillation.

scholarly journals Effects and Retention of Self-Re-Learning Using Video Recording of Advanced Life Support (ALS) On Nursing Students’ Knowledge, Self-Efficacy, and Skills Performance

2020 ◽  
Author(s):  
Kyeongmin Jang ◽  
Sung Hwan Kim ◽  
Ja Young Oh ◽  
Ji Yeon Mun
Keyword(s):  
Cardiac Arrest ◽  
Nursing Students ◽  
Self Efficacy ◽  
Life Support ◽  
Video Recording ◽  
Advanced Life Support ◽  
Control Group ◽  
Control Group Design ◽  
Hospital Deaths ◽  
Experimental Group

Abstract Background In-hospital cardiac arrests account for 80% of hospital deaths, and the survival rate is not significantly different from that of pre-hospitalized cardiac arrest patients. The nurses would presumably be the first to see an in-hospital cardiac arrest patient. This study proposed to measure nursing students’ knowledge, self-efficacy, and skills performance of advanced life support (ALS) 6 months after the training by sending their videos taken during the final skills test after the ALS training.Methods This is an experimental study with a randomized control group design. The participants’ knowledge, self-efficacy, and skill performance of ALS were evaluated immediately after the training and participants were videotaped during the final skills test. Thereafter, we sent the video to the experimental group through the mobile phone messenger application once a month from the third month after training. Approximately six months after the training day, we conducted a follow-up test of the measured variables using the blinded method.Results Six months after the ALS training, knowledge scores decreased significantly in both groups (p<0.001). Self-efficacy decreased by about 3 from 50.55 to 47.18 in the experimental group (p = 0.089), while it decreased by 10 in the control group from 50.67 to 39 (p<0.001). The skills performance decreased from 27.5 to 26.68 in the experimental group, while it decreased significantly from 27.95 to 16.9 in the control group (p< 0.001).Conclusion Self-study with videos taken during an ALS skills test helps enhance the sustainable effects of training, such as knowledge, self-efficacy, and skills performance.

Sudden cardiac arrest pharmacotherapy with prefilled syringes improves adherence to Advanced Life Support protocol in understaffed resuscitation pre-hospital care teams

2020 ◽  
Keyword(s):  
Cardiac Arrest ◽  
Simulation Study ◽  
Life Support ◽  
Sudden Cardiac Arrest ◽  
Advanced Life Support ◽  
Control Group ◽  
Performance Quality ◽  
Prefilled Syringes ◽  
The Impact

Every procedural facilitation or a change in available equipment in treatment of out-of-hospital arrest (OHCA) by two-person teams may significantly enhance their performance quality. The aim of this study was to assess the impact of adrenaline in prefilled syringes on improving the adherence to Advanced Life Support protocol by understaffed teams. The research was based on a randomized cross-over high-fidelity simulation study. Two-person teams took part in two 10-minute simulation scenarios featuring sudden cardiac arrest in ventricular fibrillation (VF). The control group (group C) had at its disposal standard ampoules, whereas the experimental group (group E) prefilled syringes. The execution times of CPR start, defibrillation shocks, intravenous (IV) access, epinephrine and amiodarone doses were measured. Additionally, the chest compression fraction (CCF) was calculated. The designed two-minute loops were considerably prolonged in group C. Nineteen teams (31.1%) in group C but 49 (80.3%) in group E carried out the fifth defibrillation (P < 0.001). After two minutes of CPR nobody in group C switched to perform chest compressions. IV access was obtained significantly earlier in group E (114.7 ± 52.2 sec) than in group C (150.2 ± 68.6 sec)(P = 0.002). Two doses of adrenaline were administered in group E, whereas its second dose only by 12 teams in group C. The simulation study has proved that for understaffed teams a use of prefilled syringes not only did enhance the flow of ALS procedure, but it also improved the quality of cardiopulmonary resuscitation.

scholarly journals Effectiveness of self-re-learning using video recordings of advanced life support on nursing students’ knowledge, self-efficacy, and skills performance

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kyeongmin Jang ◽  
Sung Hwan Kim ◽  
Ja Young Oh ◽  
Ji Yeon Mun
Keyword(s):  
Nursing Students ◽  
Self Efficacy ◽  
Life Support ◽  
Statistical Significance ◽  
Advanced Life Support ◽  
Rank Test ◽  
Control Group ◽  
Bulletin Board ◽  
Post Intervention ◽  
Experimental Group

Abstract Background Nurses are presumably the first to see an in-hospital cardiac arrest patient. This study proposed measuring nursing students’ knowledge, self-efficacy, and skills performance in advanced life support (ALS), 6 months after training, by sending videos taken during their final skills test after the ALS training. Methods This is an experimental study using a randomised control group design. This study was conducted from June to December 2018, and the subjects of the study were 4th year students, recruited through a bulletin board at a nursing university. The participants’ knowledge, self-efficacy, and skill performance in ALS were evaluated immediately after the training, and participants were videotaped during the final skills test. Thereafter, the videos were sent to the experimental group through a mobile phone messenger application, once a month, from the third month after training. Approximately six months after training day, a follow-up test was conducted for the measured variables using a blinded method. The paired t-test and Wilcoxon signed-rank test were used to compare the two groups pre-and post-intervention. The statistical significance level was set at p < .05. Results Six months after the ALS training, knowledge scores decreased significantly in both groups (p < 0.001). Self-efficacy decreased by about 3 points from 50.55 to 47.18 in the experimental group (p = 0.089), while it decreased by 10 points in the control group, from 50.67 to 39 (p < 0.001). The skills performance decreased from 27.5 to 26.68 in the experimental group, while it decreased significantly from 27.95 to 16.9 in the control group (p < 0.001). Conclusion Self-study with videos taken during an ALS skills test helps enhance the sustainable effects of training such as knowledge, self-efficacy, and skills performance.

scholarly journals Effectiveness of an Exercise Program Designed for Persons with Osteoporosis and Osteopenia on Pain Management and Quality of Life

2014 ◽  
Vol 4 (3) ◽  
pp. 169-179
Author(s):  
María José Ponce Darós ◽  
Nuria Sempere Rubio ◽  
Sara Cortés Amador
Keyword(s):  
Quality Of Life ◽  
Life Support ◽  
Physical Therapist ◽  
Exercise Program ◽  
Control Group ◽  
Paired Samples ◽  
Perceived Satisfaction ◽  
Final Score ◽  
Experimental Group

Objective: To study if an exercise program designed for patients with osteoporosis and osteopenia can be decrease the pain and improve quality of life. Method: 84 patients between 50 and 83 years old was participated at the study, 42 persons in the experimental group and 42 persons in the control group. The study was made in Puçol CEAM (Valencia) for 9 months on the experimental group was performed exercises supervised by the physical therapist 2 days a week for 1 hour. In this period of time, pain, quality of life, support and service satisfaction was measured. Results: After performing paired samples t test, shows how the experimental group decreased their pain and improve their quality of life from the initial to the final score. By contrast, the control group worsened. After testing regression is statistically significant relationship between pain, quality of life and assistance exercises. The perceived satisfaction by patients in the experimental group was very good, and 100% of them would like to continue doing the exercise program. Conclusions: The implementation of a specific exercise program for patients with osteoporosis and osteopenia reduces pain and improves quality of life of participants.

scholarly journals Effectiveness of an Exercise Program Designed for Persons with Osteoporosis and Osteopenia on Pain Management and Quality of Life

2014 ◽  
Vol 4 (3) ◽  
pp. 169-179
Author(s):  
María José Ponce Darós ◽  
Nuria Sempere Rubio ◽  
Sara Cortés Amador
Keyword(s):  
Quality Of Life ◽  
Life Support ◽  
Physical Therapist ◽  
Exercise Program ◽  
Control Group ◽  
Paired Samples ◽  
Perceived Satisfaction ◽  
Final Score ◽  
Experimental Group

Objective: To study if an exercise program designed for patients with osteoporosis and osteopenia can be decrease the pain and improve quality of life. Method: 84 patients between 50 and 83 years old was participated at the study, 42 persons in the experimental group and 42 persons in the control group. The study was made in Puçol CEAM (Valencia) for 9 months on the experimental group was performed exercises supervised by the physical therapist 2 days a week for 1 hour. In this period of time, pain, quality of life, support and service satisfaction was measured. Results: After performing paired samples t test, shows how the experimental group decreased their pain and improve their quality of life from the initial to the final score. By contrast, the control group worsened. After testing regression is statistically significant relationship between pain, quality of life and assistance exercises. The perceived satisfaction by patients in the experimental group was very good, and 100% of them would like to continue doing the exercise program. Conclusions: The implementation of a specific exercise program for patients with osteoporosis and osteopenia reduces pain and improves quality of life of participants.

Abstract 101: Top Quality of Ventilation During Out-of-Hospital Cardiac Arrest Is Hard to Reach

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Philip Datler ◽  
Patrick Sulzgruber ◽  
Michael Poppe ◽  
Markus Keferböck ◽  
Sebastian Zeiner ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Advanced Life Support ◽  
Ventilation Rate ◽  
Spontaneous Circulation ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Feedback Form ◽  
Hospital Cardiac Arrest

INTRODUCTION: With an incidence of ~45patients with out-of hospital cardiac arrest (OHCA) /100.000 inhabitants per year and thus over 700 cases annually, but a survival rate as low as 10%, OHCA remains still a challenge the chain of survival. Recently ventilation has gained less importance for BLS and thus the question arises, if this attitude was mirrored during ALS measures provided by ambulance crews. Therefore our analysis assessed the quality of ventilation during out of hospital cardiac arrests. METHODS: Over a period of 9 months, from August 1st 2013 until April 30th 2014, all patients suffering from an OHCA, aged 18 years and above and treated by the emergency medical service crews in Vienna, Austria were included in this study. A collective of 701 consecutive cases have been analyzed using the ECG- and impedance data recorded by the defibrillators used. On the basis of this data, the abidance of the quality standards of ventilation was examined using the current guidelines of the European Resuscitation Council of 2010 as gold standard. After the evaluation of each case, the responding EMS-teams were informed about the quality of the resuscitation via a feedback form. RESULTS: Endotracheal intubation was accomplished in 338 patients (47%). Ventilation was performed in accordance to the ERC guidelines in 49% (CI: 46-52) of total recorded ventilation minutes. Patients who had restoration of spontaneous circulation (ROSC) (n=135) after being intubated were ventilated with 9 (CI: 9-11; variance: 11) ventilations per minute. In patients not achieving ROSC (n=203) 10 (CI: 9-11; variance: 25) ventilations per minute were administered. Patients that were ventilated with a supraglottic airway device or a bag valve and mask received 6(SD±4) ventilations per minute. CONCLUSION: The high ventilation rate standard deviations within the compliance to guidelines suggest that there are numerous cases in which ventilation standards are not met. Therefore further analysis will be necessary to find out, what influence this might have on outcome and if it will be necessary to put more emphasis in upcoming discussions on the quality of ventilation at least during advanced life support.

The Implementation of Learning Materials Based on Local Wisdom of Agricultural in Binjai to Improve the Students Problem Solving Abilities

2019 ◽  
Author(s):  
Nur Tsalits Fahman Mughni
Keyword(s):  
Problem Solving ◽  
Control Group ◽  
School Grade ◽  
Teaching Materials ◽  
Quasi Experimental ◽  
Equivalent Control ◽  
The Subject ◽  
And Control ◽  
Experimental Group

Teaching materials by integrating local culture makes easier for students to understand the subject matter in the learning process. The aims of the study is to measure the effectiveness of teaching materials based on local wisdom of agriculture in Binjai in improving the students problem solving abilities. The research method was a quasi experimental which use non equivalent control group in the pretest posttest design. The sample of study were students of Senior High School grade X in Binjai that consisted of experiment group which used teaching materials based on local wisdom of agriculture in Binjai and control group that used student handbooks. Teaching materials are tested by material experts and technology experts to ensure the quality of teaching materials. Data collection was conducted through test. The results showed that the teaching materials based on local wisdom of agriculture in Binjai effective in improving students problem solving abilities in the experimental group students based on the results of N gain value was 0.67 which has medium criteria. It means teaching materials based on agricultural local wisdom of agriculture in Binjai can be used as one of the teaching materials in learning activities.

The use of poly additive Nabicat in the feeding of laying hens

2020 ◽  
pp. 44-55
Author(s):  
S. Nikolaev ◽  
L. Andreenko
Keyword(s):  
Laying Hens ◽  
Optimal Dose ◽  
Control Group ◽  
Nutrient Metabolism ◽  
Volgograd Region ◽  
Mineral Components ◽  
Environmentally Safe ◽  
Experimental Group ◽  
Poultry Farming

In modern poultry farming the most urgent tasks are to search for and test new environmentally safe feed and economically justifi ed additives that stimulate productivity, positively aff ect the health of poultry, and consequently increase the livability of livestock and other important zootechnical traits. In order to maintain physiologically normal processes of life, metabolism and increase the level of productivity of poultry it needs mineral components and their chelated compounds. The purpose of this work was to increase the egg productivity of poultry by using the silicon-containing poly additive Nabicat in feeding young hens and laying hens. The researches have been carried out on the poultry cross Highsex Brown under the environments in CJSC “Poultry Farm “Volzhskaya” in the Sredneakhtubinsky area in the Volgograd region. In this paper, The optimal dose of the introduction of the silicon-containing poly additive Nabicat in the diets of young and laying hens of the cross Highsex Brown has been scientifi cally justifi ed and the biological value of using an organic form of silicon has been determined. The positive infl uence of the optimal dose of poly additive on growth, consumption, and digestibility, nutrient metabolism in the poultry body, as well as egg productivity and quality of the resulting egg has been revealed. Thus, the average egg productivity per 1 hen in the control group during the experiment period was 321,3 pcs., and in the 1st, 2nd and 3rd experimental groups it was 322,6 pcs., 325,8 and 325,7 pcs., which was higher than in the control group by 0,40 %, 1,40 and 1,37 %, respectively. The average egg weight in the 1st experimental group exceeded the control by 0,43 g or 0,68 %, in the 2nd experimental group by 1,16 g or 1,84 %, in the 3rd experimental group by 0,81 g or 1,28 %. The economic eff ectiveness of using the organic silicon additive in the composition of Nabicat poly additive in the feeding of laying hens has been proved. The economic eff ect due to the use of diff erent doses of the introduction of silicon-containing poly additive Nabicat in compound feed for laying hens of the 1st experimental group was 141,66 rubles, the 2nd experimental group 962,76 rubles, and the 3rd experimental group 821,89 rubles.

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