scholarly journals Parada cardiorrespiratória pré-hospitalar: avaliação dos atendimentos segundo o utstein style*

2019 ◽  
Vol 13 ◽  
Author(s):  
Robson Cristiano Zandomenighi ◽  
Eleine Aparecida Penha Martins
Keyword(s):  
Life Support ◽  
Cardiopulmonary Arrest ◽  
Advanced Life Support ◽  
Venous Access ◽  
Orotracheal Intubation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Epinephrine Administration ◽  
Peripheral Venous Access ◽  
Utstein Style

Objetivo: analisar as ocorrências, respostas e desfechos da parada cardiorrespiratória pré-hospitalar segundo o Utstein Style e identificar os fatores associados à sobrevida. Método: trata-se de um estudo quantitativo, documental e transversal, com vítimas de parada cardiorrespiratória atendidas nas unidades de suporte avançado de vida, no ano de 2015. Coletaram-se os dados a partir dos relatórios de atendimento do socorrista, organizando-os e analisando-os de acordo com o Utstein Style. Apresentaram-se os resultados em forma de tabelas. Resultados: verificaram-se 163 atendimentos, predominando o sexo masculino, não havendo associação entre idade e os desfechos. Identificou-se a maioria das PCRs como sendo de causa clínica, na residência e em assistolia, sendo entubação orotraqueal, acesso venoso periférico e administração de adrenalina os procedimentos mais frequentes. Constatou-se que as ocorrências presenciadas por espectadores leigos e o tempo-resposta da ambulância demonstraram uma associação com o desfecho sobrevida. Calculou-se a taxa de sobrevida em 25,1%. Conclusão: avaliou-se o serviço por meio da análise das ocorrências segundo o Utstein Style e verificaram-se associações entre o desfecho e as lacunas no atendimento, havendo a necessidade de intervenções em cada elo da corrente de sobrevivência. Descritores: Parada Cardíaca Extra-Hospitalar; Ressuscitação Cardiopulmonar; Serviços Médicos de Emergência; Ambulâncias; Emergências; Avaliação de Resultados. ABSTRACTObjective: to analyze the occurrences, responses and outcomes of prehospital cardiopulmonary arrest according to Utstein Style and to identify factors associated with survival. Method: this is a quantitative, documentary and cross-sectional study with victims of cardiopulmonary arrest treated at the advanced life support units in 2015. Data were collected from the rescuer's care reports and organized. and analyzing them according to Utstein Style. Results were presented in tables. Results: 163 cases were observed, predominantly male, with no association between age and outcomes. Most CRPs were identified as being of clinical cause, at home and in asystole, with orotracheal intubation, peripheral venous access and epinephrine administration being the most frequent procedures. It was found that the occurrences witnessed by lay spectators and the ambulance response time demonstrated an association with the survival outcome. The survival rate was calculated at 25.1%. Conclusion: the service was evaluated by analyzing the occurrences according to the Utstein Style and there were associations between the outcome and the gaps in care, requiring interventions in each link of the survival chain. Descriptors:  Out-of-Hospital Cardiac Arrest; Cardiopulmonary Resuscitation; Emergency Medical Services; Ambulances; Emergencies; Outcome Assessment. RESUMENObjetivo: analizar las ocurrencias, las respuestas y los resultados del paro cardiopulmonar prehospitalario según el Utstein Style e identificar los factores asociados con la supervivencia. Método: este es un estudio cuantitativo, documental y transversal con víctimas de paro cardiopulmonar tratadas en las unidades de soporte vital avanzado en 2015. Los datos se recopilaron de los informes de atención del rescatista, organizándolos y analizándolos según el Utstein Style. Los resultados se presentaron en tablas. Resultados: se observaron 163 casos, predominantemente masculinos, sin asociación entre la edad y los resultados. La mayoría de las PCRs se identificaron como de causa clínica, en el hogar y en la asistolia, siendo los procedimientos más frecuentes la intubación orotraqueal, el acceso venoso periférico y la administración de adrenalina los procedimientos más frecuentes. Se descubrió que las ocurrencias presenciadas por espectadores legos y el tiempo de respuesta de la ambulancia demostraron una asociación con el resultado de supervivencia. La tasa de supervivencia se calculó en 25.1%. Conclusión: el servicio se evaluó analizando las ocurrencias según el Utstein Style y hubo asociaciones entre el resultado y las brechas en la atención, lo que requiere intervenciones en cada eslabón de la cadena de supervivencia. Descriptores: Paro Cardíaco Extra-Hospitalario; Reanimación Cardiopulmonar; Servicios Médicos de Urgencia; Ambulancias, Urgencias Médicas, Evaluación de Resultado. 

Basic life support awareness level among medical students in Jordan: a cross-sectional study

2021 ◽  
Author(s):  
Ebraheem Albazee ◽  
Mohammad Alnifise ◽  
Lina Almahmoud ◽  
Ahmed Alsaeedi ◽  
Mohammed Al-balawi ◽  
...  
Keyword(s):  
Medical Students ◽  
Basic Life Support ◽  
Life Support ◽  
Cardiopulmonary Arrest ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grade Point ◽  
Validated Questionnaire ◽  
Awareness Level

Objective: Performing basic life support (BLS) in patients with cardiopulmonary arrest decreases mortality and morbidity. In addition, BLS knowledge is a prerequisite for medical graduation. The present study was conducted to determine the awareness level of undergraduate medical students in Jordan regarding BLS and background knowledge. Methods: This cross-sectional study was conducted between 17 April 2021 and 12 May 2021. A validated questionnaire was used as an online Google form and was posted in all medical student groups and Jordanian universities through various social medias. We categorized level of awareness into two groups: adequate awareness for those who got 60% or more, and inadequate awareness for those who got less than 60% in BLS test. Chi-square test was used to compare different variables. Results: A total of 886 students with a mean age of 21.5 (± 2.2) years completed the survey, including 552 females (62.3%). Among participated students, only 281 (31.7%) had adequate awareness, whereas 605 (68.3%) had inadequate awareness, with a mean score of 10 (± 3.8) out of 20. Surprisingly, there was no statistically significant correlation (P=0.210) between grade point average (GPA) and awareness level among participated students. On the contrary, we detected statistically significant relationships (P<0.001) between various variables and awareness level. Conclusion: Overall, we found that awareness of BLS among medical students in Jordan is not adequate. We can improve the awareness of medical students in this regard through obligating them to educate the general population, especially school students, as a volunteer campaign.

Abstract 19658: Physicians on Cardiac Arrest Teams are Most Often Non-specialists With Limited Clinical Experience

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kasper G Lauridsen ◽  
Anders S Schmidt ◽  
Philip Caap ◽  
Rasmus S Aagaard ◽  
Bo Løfgren
Keyword(s):  
Cardiac Arrest ◽  
Clinical Experience ◽  
Life Support ◽  
Clinical Skills ◽  
Advanced Life Support ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Telephone Interviews ◽  
Cpr Training ◽  
Erc Guidelines

Introduction: The quality of in-hospital resuscitation is poor and may be affected by clinical experience and cardiopulmonary resuscitation (CPR) training. This study aimed to investigate the clinical experience, self-perceived skills, CPR training, and knowledge of guidelines on when to abandon resuscitation among physicians on cardiac arrest teams. Methods: This is a nationwide cross-sectional study in Denmark. Telephone interviews were performed with physicians on cardiac arrest teams in public somatic hospitals. Telephone interviews were performed using a structured questionnaire. Results: In total, 93 physicians (53% male) from 45 hospitals participated. Median age was 34 interquartile range (30-39) years. Participants were medical students working as locum physicians (5%), residents and fellows (79%), chief physicians (16%), and median postgraduate clinical experience was 48 (19-87) months. Most physicians (92%) felt confident in treating a cardiac arrest, while less felt confident in performing intubation (41%) and focused cardiac ultrasound (39%) during cardiac arrest. Median time since last CPR training was 4 months (2-10) and 48% had attended a European Resuscitation Council (ERC) Advanced Life Support (ALS) course. The majority (84%) felt confident in terminating resuscitation however only 9% were able to state ERC guidelines on when to abandon resuscitation. Conclusions: Physicians on Danish cardiac arrest teams are most often non-specialists with four or less years of clinical experience. Several physicians are not able to perform important clinical skills during resuscitation. Less than half of physicians have attended an ERC ALS course. Only very few physicians know the ERC guidelines on when to abandon resuscitation.

Time out! Pauses during advanced life support in high-fidelity simulation: A cross-sectional study

2021 ◽  
Author(s):  
Verónica V. Márquez-Hernández ◽  
Lorena Gutiérrez-Puertas ◽  
Alba García-Viola ◽  
José Miguel Garrido-Molina ◽  
Vanesa Gutiérrez-Puertas ◽  
...  
Keyword(s):  
Life Support ◽  
Advanced Life Support ◽  
Cross Sectional Study ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Time Out

Awareness of Basic Life Support & Advanced Life Support among Students in a Medical College in Kerala

2020 ◽  
Vol 7 (45) ◽  
pp. 2640-2644
Author(s):  
Sunil R ◽  
Praseetha V.K
Keyword(s):  
Medical Students ◽  
Nursing Students ◽  
Basic Life Support ◽  
Life Support ◽  
Advanced Life Support ◽  
Advanced Cardiac Life Support ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Cardio Pulmonary Resuscitation

BACKGROUND The knowledge and skills in Cardio-Pulmonary Resuscitation (CPR) is an essential part in the medical education. Resuscitation skills have undergone series of evolution into current protocol which involves Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS). We wanted to assess the awareness of Basic Life Support among medical students, nursing students and house surgeons in a Government Medical College in Kerala. METHODS A cross-sectional study was conducted by assessing responses to 24 selected basic questions regarding BLS and ACLS among the students. After excluding the incomplete response forms the data from 500 responders was analysed. Results were analysed using an answer key prepared with the use of the Advanced Cardiac Life Support manual of AHA (2015). RESULTS Out of 500 responders, 250 were medical students, 100 were nursing students and 150 were House Surgeons. No one among them had complete knowledge of BLS & ACLS. Awareness of BLS & ACLS among students of medical, and nursing colleges and doctors is poor. Regarding knowledge of BLS (9 questions) the analysis of results showed that mean percentage of correct responses were 75.67 % of house surgeons, 51.78 % of nursing students and 20.98 % of medical students. CONCLUSIONS Awareness of BLS among students of medical, and nursing colleges and house surgeons is inadequate. Proper training programs must be initiated to rectify this. KEYWORDS BLS & ACLS Awareness, Medical Students, CPR Questionnaire

Pediatric Intraosseous Placement

2021 ◽  
pp. 121-128
Author(s):  
Samuel C. Seiden
Keyword(s):  
American Heart Association ◽  
Life Support ◽  
Advanced Life Support ◽  
Emergency Situation ◽  
Heart Association ◽  
Venous Access ◽  
Intraosseous Access ◽  
Injured Child ◽  
American Academy Of Pediatrics ◽  
Peripheral Venous Access

Intraosseous access can be used to rapidly deliver fluids and medications when venous access is not feasible. The intraosseous space does not collapse (as can occur with large veins), making the intraosseous route particularly useful in a patient in whom venous access cannot be obtained readily by peripheral or central routes. In fact, the most recent American Heart Association/American Academy of Pediatrics guidelines for Pediatric Advanced Life Support state that in an emergency situation, “intraosseous (IO) access can be quickly established with minimal complications by providers with varied levels of training. Limit the time spent attempting to establish peripheral venous access in a critically ill or injured child.” Contraindications include underlying bone disease, infection at the site, or recent IO access in the same bone. Severe complications, including loss of bone or limb, have been reported; neonates are at higher risk for these complications. There are several options for devices for obtaining intraosseous access.

scholarly journals Accuracy of pediatric advanced life support method for predicting the depth of endotracheal tube in Indonesian children

2021 ◽  
Author(s):  
Andi Ade Wijaya Ramlan ◽  
Adhrie Sugiharto ◽  
Agus Mutakim
Keyword(s):  
Endotracheal Tube ◽  
Life Support ◽  
Elective Surgery ◽  
Advanced Life Support ◽  
Cross Sectional Study ◽  
Mean Difference ◽  
Internal Diameter ◽  
Age Group ◽  
Limits Of Agreement ◽  
Cross Sectional

BACKGROUND The pediatric advanced life support (PALS) method can predict the depth of endotracheal tube (ETT) in pediatric patients easily, but it has limitations due to variations in the children’s characteristics, especially the racial consideration. This study compared the accuracy of ETT depth prediction based on the PALS methods in Indonesian children. METHODS Patients aged 0–12 years, who underwent elective surgery with oral intubation, were recruited consecutively based on their ages: 0–24 months and 25 months–12 years for this cross-sectional study in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from June to August 2014. Bland–Altman analysis was used to compare the two measurement methods: PALS method to predict the ETT depth accuracy and auscultation method to confirm the position of the ETT. Furthermore, correlation analysis was done to examine the relationship of age, weight, height, and ETT internal diameter with ETT depth. RESULTS 50 patients were recruited in each group. Bland–Altman test of ETT depth in the 0–24 months age group showed a 1.18 cm mean difference from confirmation using the auscultation method (limits of agreement −0.71 to 3.08). The 25 months–12 years age group showed a 1.11 cm mean difference with limits of agreement were −0.95 to 3.17 from confirmation using the auscultation method. Age and weight had the strongest correlation value to ETT depth in the 25 months–12 years age group (R2 = 62.3%). CONCLUSIONS The PALS method is inaccurate for predicting ETT depth in Indonesian children aged 0–12 years old compared with the auscultation method.

Justification for deployment of peripherally inserted central catheter (PICC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18257-e18257
Author(s):  
João Raphael Maia ◽  
Flavia Torrecillas ◽  
Marcio Borella
Keyword(s):  
Breast Cancer ◽  
Central Venous Access ◽  
Venous Access ◽  
Cross Sectional Study ◽  
Peripheral Vein ◽  
Central Venous ◽  
Cross Sectional ◽  
Peripheral Venous Access ◽  
Fast Start ◽  
The Relationship

e18257 Background: Is not practical in countries of Latin America the use of Central Venous Catheters - CL in Oncology due the difficulty of financing of this procedure. The PICC is a vascular access device inserted in peripheral vein infusion drugs with Center for a cost of no more than 20% when compared to use of a catheter fully deployed. Methods: We conducted a cross-sectional study, retrospective and quantitative data were collected from complication and pharmacovigilance of a private oncology outpatient clinic in Rio de Janeiro, in the care of patients undergoing treatment for breast cancer with Paclitaxel weekly in the Jan 2016 period the Dec 2016. Results: The study were performed with 98 patients, peripheral venous access 75.5% and 24.5% central venous access. Of patients with peripheral venous access, 47.3% had exclusive member to puncture. Of this group, 21.6% of patients achieved success on first CL in all infusions performed in the period and 78.4% needed more than one CL for Administration of paclitaxel in at least an infusion. 182 Pharmacovigilance notifications were made, being 38.5% for the flebogênicidade symptoms after use of paclitaxel. Conclusions: The study highlights the relationship between venous access safe and successful outpatient antineoplasic therapy. The data observed in analyzed period justifies the creation of deployment Protocol of PICC for patients with breast cancer to treatment with Paclitaxel weekly. It is hoped with this Protocol added convenience and safety for the patient, ensuring fast start of infusional therapy often delayed by the difficulty in accessing the patient's venous network, reducing and avoiding delays in cycles, with low rates of complications for the same and lower costs.

scholarly journals ANALYSIS OF NURSING CARE TO USERS OF PERIPHERAL VENOUS ACCESS

2018 ◽  
Vol 4 ◽  
Author(s):  
Alana Oliveira Porto ◽  
Carla Bianca De Matos Leal ◽  
Dieslley Amorim De Souza ◽  
Jéssica Lane Pereira Santos
Keyword(s):  
Nursing Care ◽  
Venous Catheter ◽  
Venous Access ◽  
Cross Sectional Study ◽  
Surgical Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Professional Identification ◽  
Peripheral Venous Catheter ◽  
Peripheral Venous Access

Objective: To analyze the nursing care provided to users of peripheral venous catheter. Method: Descriptive, cross-sectional study, performed at a mid-sized hospital situated in the high productive backcountry of Bahia, whose participants were surgical patients using peripheral venous catheters for more than 72 hours. Results: 103 patients were included; 15.5% of the bandages were dirty and/or wet, 40.8% had no date of insertion, 58.3% had no professional identification, 34.9% showed signs of infection, 50.4% did not have records on the chart and 33% presented bacterial growth. Conclusion: Nursing care to users of peripheral venous catheters has not been adequate, resulting in preventable complications when considering scientific recommendations for care with peripheral venous access.

scholarly journals Análise epidemiológica dos atendimentos de parada cardiorrespiratória

2018 ◽  
Vol 12 (7) ◽  
pp. 1912
Author(s):  
Robson Cristiano Zandomenighi ◽  
Eleine Aparecida Penha Martins
Keyword(s):  
Diabetes Mellitus ◽  
Cardiopulmonary Resuscitation ◽  
Central Region ◽  
Life Support ◽  
Advanced Life Support ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Effective Response ◽  
Microsoft Office ◽  
Epidemiological Characteristics

Robson Cristiano Zandomenighi1, Eleine Aparecida Penha Martins2RESUMOObjetivo: analisar as características epidemiológicas das vítimas e ocorrências de parada cardiorrespiratória em ambiente pré-hospitalar e seus desfechos. Método: estudo quantitativo, epidemiológico e transversal, com as vítimas atendidas pelas unidades de suporte avançado de vida, submetidas à reanimação cardiopulmonar. Coletados os dados no relatório de atendimento do socorrista e realizada análise estatística a partir do Microsoft Office Excel e do Software SPSS 20.0.   Resultados: houve 163 atendimentos, mediana de idade de 65 anos, predominando o sexo masculino, com hipertensão arterial e diabetes mellitus. A causa clínica e a assistolia foram mais prevalentes, havendo mais ocorrências na região central, durante o outono, no período noturno. O tempo-resposta da ambulância foi menor na região central. A duração do atendimento demonstrou associação com o desfecho, sendo maior entre os sobreviventes. O principal destino dos sobreviventes foram hospitais terciários. A taxa de sobrevida imediata foi de 25,1%. Conclusão: idosos com comorbidades foram as principais vítimas, havendo elevada taxa de mortalidade. Verificou-se a importância de uma resposta rápida e eficaz do serviço de emergência. Descritores: Parada Cardíaca Extra-Hospitalar; Reanimação Cardiopulmonar; Epidemiologia; Serviços Médicos de Emergência; Ambulâncias. ABSTRACT Objective: to analyze the epidemiological characteristics of victims and occurrences of cardiorespiratory arrest cases in a prehospital environment and their outcomes. Method: this is a quantitative, epidemiological and cross-sectional study with victims assisted in advanced life support units and submitted to cardiopulmonary resuscitation. Data were collected from the report of the rescue team. The the Microsoft Office Excel and SPSS 20.0 software were used for statistical analyses. Results: there were 163 cases, the median age of the victims was 65 years, they were predominantly male, and presented hypertension and diabetes mellitus. Clinical cause and asystole were more prevalent, with more occurrences in the central region, during the fall, at night. The ambulance response time was lower in the central region. The duration of care was associated with the outcome, being higher among survivors. The main destination of survivors was tertiary hospitals. The immediate survival rate was 25.1%. Conclusion: elderly patients with comorbidities were the main victims, with a high mortality rate. It was verified the importance of a rapid and effective response from the emergency service. Descriptors: Extra-Hospital Cardiac Arrest; Cardiopulmonary resuscitation; Epidemiology; Emergency Medical Services; Ambulances.RESUMEN Objetivo: analizar las características epidemiológicas de las víctimas y ocurrencias de parada cardiorrespiratoria en ambiente pre-hospitalario y sus desenlaces. Método: estudio cuantitativo, epidemiológico y transversal, con las víctimas atendidas por las unidades de soporte avanzado de vida, sometidas a la reanimación cardiopulmonar. Los datos fueron recogidos en el informe de atención del socorrista y fue realizado el análisis estadístico a partir del Microsoft Office Excel y del Software SPSS 20.0.   Resultados: hubo 163 atendimientos, mediana de edad de 65 años, predominando el sexo masculino, con hipertensión arterial y diabetes mellitus. La causa clínica y la asistolia fueron más prevalentes, habiendo más ocurrencias en la región central, durante el otoño, en el período nocturno. El tiempo-respuesta de la ambulancia fue menor en la región central. La duración del atendimiento demostró asociación con el desenlace, siendo mayor entre los sobrevivientes. El principal destino de los sobrevivientes fueron hospitales terciarios. La tasa de sobrevida inmediata fue de 25,1%. Conclusión: ancianos con comorbilidades fueron las principales víctimas, habiendo elevada tasa de mortalidad. Se verifico la importancia de una respuesta rápida y eficaz del servicio de emergencia. Descriptores: Paro Cardíaco Extra-Hospitalario; Reanimación Cardiopulmonar; Epidemiología; Servicios Médicos de Urgencia; Ambulancias.  

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