Suporte avançado de vida em cardiologia: análise comparativa entre os resultados da avaliação teórica pré e pós-curso

2009 ◽  
Vol 3 (3) ◽  
pp. 573
Author(s):  
Erika Azevedo Massimo ◽  
Daclé Vilma Carvalho ◽  
Talline Arêdes Hang-Costa ◽  
Danilo Ulisses Oliveira
Keyword(s):  
Exploratory Study ◽  
Life Support ◽  
Advanced Life Support ◽  
Advanced Cardiac Life Support ◽  
Minas Gerais ◽  
Theoretical Evaluation ◽  
Significant Difference ◽  
Cross Training ◽  
Terapia Intensiva ◽  
Belo Horizonte

ABSTRACTObjective: to analyze comparatively the results obtained by students in the theoretical evaluations pre and post course provider of Advanced Life Support in Cardiology (SAVC) in Belo Horizonte. Method: this was an exploratory study, descriptive and cross-training conducted at the center of the Mining Society of Intensive Care (miserly) in Belo Horizonte, Minas Gerais. The sample consisted of 92 evaluations of pre-tests and an equal number of post-tests, data were obtained from the database of the training center in accordance with Resolution 196/96. Results: the results of this study were presented in the form of tables showing a comparison between the scores obtained in the theoretical evaluation pre and post-course. Were established concepts that refer to intervals of notes ranging from zero to 100 points and was calculated by the average of the scores obtained by students concepts. Statistical analysis was performed on the average scores obtained in both evaluations. Conclusion: there was significant difference of evaluation results between theoretical pre-and post-course, showing a differentiation or acquisition of theoretical knowledge by the students during the course, even with this, practical. Descriptors: cardiopulmonary resuscitation; education, continuing; advanced cardiac life support; teaching; evaluation.RESUMOObjetivo: analisar comparativamente os resultados obtidos pelos alunos nas avaliações teóricas pré e pós-curso de provedor de Suporte Avançado de Vida em Cardiologia (SAVC) em Belo Horizonte. Método: trata-se de um estudo exploratório, descritivo e transversal realizado no centro de treinamento da Sociedade Mineira de Terapia Intensiva (SOMITI) em Belo Horizonte, Minas gerais. A amostra foi constituída de 92 avaliações de pré-testes e igual número de pós-testes, os dados foram obtidos do banco de dados do referido centro de treinamento em conformidade com a Resolução 196/96. Resultados: os resultados deste estudo foram apresentados em forma de tabelas havendo uma comparação entre as notas obtidas na avaliação teórica pré e pós-curso. Foram estabelecidos conceitos que se referem a intervalos de notas que variam de zero a 100 pontos e foi calculada a média das notas por conceitos obtidos pelos alunos. A análise estatística também foi realizada com base na média das notas obtidas nas duas avaliações. Conclusão: houve diferença significativa dos resultados das avaliações teóricas entre pré e pós-curso, apontando para uma diferenciação ou incorporação de conhecimento teórico pelos alunos, durante o curso, mesmo sendo este, prático. Descritores: ressuscitação cardiopulmonar; educação continuada; suporte vital cardíaco avançado; ensino; avaliação.RESUMENObjetivo: analizar comparativamente los resultados obtenidos por los estudiantes en las evaluaciones teóricas de la pre y post curso proveedor de Apoyo Avanzado de Vida en Cardiología (SAVC) en Belo Horizonte. Método: este es un estudio exploratorio, descriptivo y transversal que tuvo lugar en el centro de formación de la Sociedad Minera de Cuidados Intensivos (miserable) en Belo Horizonte, Minas Gerais. La muestra de 92 evaluaciones de los ensayos preliminares y un número igual de después de los ensayos, los datos se obtuvieron de la base de datos del Centro de formación de conformidad con la Resolución 196/96. Resultados: los resultados de este estudio fueron presentados en forma de cuadros que muestran una comparación entre los resultados obtenidos en la evaluación teórica pre y post-curso. Se establecieron los conceptos que se refieren a los intervalos de las notas que van de cero a 100 puntos y se calculó la media de las puntuaciones obtenidas por los estudiantes conceptos. El análisis estadístico se realizó en la media de las puntuaciones obtenidas en las dos avaliações. Conclusão: hubo diferencia significativa de los resultados de la evaluación teórica entre pre y post-curso, que muestra una diferenciación o la adquisición de conocimientos teóricos de los alumnos durante el curso, aunque esto, prático. Descriptores: resucitación cardiopulmonar; educación continua; apoyo vital cardíaco avanzado; evaluación.

scholarly journals Comparing the usability of paediatric weight estimation methods: a simulation study

2018 ◽  
Vol 104 (2) ◽  
pp. 121-123 ◽  
Author(s):  
Robin D Marlow ◽  
Dora L B Wood ◽  
Mark D Lyttle
Keyword(s):  
Simulation Study ◽  
Exploratory Study ◽  
Life Support ◽  
Estimation Methods ◽  
Weight Estimation ◽  
Cognitive Stress ◽  
Reference Table ◽  
Online Simulation ◽  
Significant Difference ◽  
Recent Version

ObjectiveEstimating weight is essential in order to prepare appropriate sized equipment and doses of resuscitation drugs in cases where children are critically ill or injured. Many methods exist with varying degrees of complexity and accuracy. The most recent version of the Advanced Paediatric Life Support (APLS) course has changed their teaching from an age-based calculation method to the use of a reference table. We aimed to evaluate the potential implications of this change.MethodUsing a bespoke online simulation platform we assessed the ability of acute paediatric staff to apply different methods of weight estimation. Comparing the time taken, rate and magnitude of errors were made using the APLS single and triple age-based formulae, Best Guess and reference table methods. To add urgency and an element of cognitive stress, a time-based competitive component was included.Results57 participants performed a total of 2240 estimates of weight. The reference table was the fastest (25 (22–28) vs 35 (31–38) to 48 (43–51) s) and most preferred, but errors were made using all methods. There was no significant difference in the percentage accuracy between methods (93%–97%) but the magnitude of errors made was significantly smaller using the three APLS formulae 10% (6.5–21) compared with reference table (69% (34–133)) mainly from month/year table confusion.ConclusionIn this exploratory study under psychological stress none of the methods of weight estimation were free from error. Reference tables were the fastest method and also had the largest errors and should be designed to minimise the risk of picking errors.

Resuscitation on the field: basic and advanced life support and automatic external defibrillators

2019 ◽  
pp. 403-410
Author(s):  
Mark S. Link ◽  
Mark Estes III
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Basic Life Support ◽  
Life Support ◽  
Action Plan ◽  
Advanced Life Support ◽  
Advanced Cardiac Life Support ◽  
Screening Strategy ◽  
Automated External Defibrillators ◽  
Playing Field

Resuscitation on the playing field is at least as important as screening in the prevention of death. Even if a screening strategy is largely effective, individuals will suffer sudden cardiac arrests. Timely recognition of a cardiac arrest with rapid implementation of cardiopulmonary resuscitation (CPR) and deployment and use of automated external defibrillators (AEDs) will save lives. Basic life support, including CPR and AED use, should be a requirement for all those involved in sports, including athletes. An emergency action plan is important in order to render advanced cardiac life support and arrange for transport to medical centres.

scholarly journals Effects of Erythropoietin Administration on Adrenal Glands of Landrace/Large White Pigs after Ventricular Fibrillation

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Armando Faa ◽  
Gavino Faa ◽  
Apostolos Papalois ◽  
Eleonora Obinu ◽  
Giorgia Locci ◽  
...  
Keyword(s):  
Ventricular Fibrillation ◽  
Adrenal Glands ◽  
Life Support ◽  
Advanced Life Support ◽  
Spontaneous Circulation ◽  
Control Group ◽  
Swine Model ◽  
Protective Effects ◽  
Large White ◽  
Significant Difference

Aim.To evaluate the effects of erythropoietin administration on the adrenal glands in a swine model of ventricular fibrillation and resuscitation.Methods. Ventricular fibrillation was inducedviapacing wire forwarded into the right ventricle in 20 female Landrace/Large White pigs, allocated into 2 groups: experimental group treated with bolus dose of erythropoietin (EPO) and control group which received normal saline. Cardiopulmonary resuscitation (CPR) was performed immediately after drug administrationas perthe 2010 European Resuscitation Council (ERC) guidelines for Advanced Life Support (ALS) until return of spontaneous circulation (ROSC) or death. Animals who achieved ROSC were monitored, mechanically ventilated, extubated, observed, and euthanized. At necroscopy, adrenal glands samples were formalin-fixed, paraffin-embedded, and routinely processed. Sections were stained with hematoxylin-eosin.Results.Oedema and apoptosis were the most frequent histological changes and were detected in all animals in the adrenal cortex and in the medulla. Mild and focal endothelial lesions were also detected. A marked interindividual variability in the degree of the intensity of apoptosis and oedema at cortical and medullary level was observed within groups. Comparing the two groups, higher levels of pathological changes were detected in the control group. No significant difference between the two groups was observed regarding the endothelial changes.Conclusions. In animals exposed to ventricular fibrillation, EPO treatment has protective effects on the adrenal gland.

scholarly journals Methodology of Specialist Physicians Training: From Traditional to e-Learning

2020 ◽  
Vol 17 (20) ◽  
pp. 7681
Author(s):  
Juan Chaves ◽  
Antonio A. Lorca-Marín ◽  
Emilio José Delgado-Algarra
Keyword(s):  
Life Support ◽  
Medical Training ◽  
Advanced Life Support ◽  
Sample Volume ◽  
Mixed Methodology ◽  
Face To Face ◽  
Significant Difference ◽  
The Face ◽  
E Learning ◽  
The Impact

Different studies show that mixed methodology can be effective in medical training. However, there are no conclusive studies in specialist training on advanced life support (ALS). The main objective of this research is to determine if, with mixed didactic methodology, which includes e-learning, similar results are produced to face-to-face training. The method used was quasi-experimental with a focus on efficiency and evaluation at seven months, in which 114 specialist doctors participated and where the analysis of the sociodemographic and pre-test variables points to the homogeneity of the groups. The intervention consisted of e-learning training plus face-to-face workshops versus standard. The results were the performance in knowledge and technical skills in cardiac arrest scenarios, the perceived quality, and the perception of the training. There were no significant differences in immediate or deferred performance. In the degree of satisfaction, a significant difference was obtained in favour of the face-to-face group. The perception in the training itself presented similar results. The main limitations consisted of sample volume, dropping out of the deferred tests, and not evaluating the transfer or the impact. Finally, mixed methodology including e-learning in ALS courses reduced the duration of the face-to-face sessions and allowed a similar performance.

scholarly journals MP20: Evaluation of the disruptors during advanced life support in emergency departments

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S49-S49
Author(s):  
J. Truchot ◽  
D. Michelet ◽  
D. Drummond ◽  
P. Plaisance
Keyword(s):  
Emergency Departments ◽  
Exploratory Study ◽  
Online Survey ◽  
Life Support ◽  
Medical Curriculum ◽  
Real Life ◽  
Advanced Life Support ◽  
Cross Sectional ◽  
Phone Calls ◽  
Ed Overcrowding

Introduction: Simulation is used as a teaching technique in the medical curriculum, and especially for advanced life support (ALS). However, simulated ALS can differ greatly from real life ALS. The aim of this exploratory study was to identify the different disruptors associated with real life ALS. Methods: We conducted a cross-sectional, anonymous, online survey that included 32 items. It was distributed by email to emergency physicians from five emergency departments in Paris. The aim of this online survey was to identify the elements perceived as disruptors during ALS. Other aspects of the survey explored the perceived differences between simulated ALS and real life ALS. Descriptive statistics of percentage, mean and standard deviation were used to analyse the data. Results: Among 100 surveyed physicians, 43 (43%) answers were analysed. 53% were women with a mean age of 32 ± 3 years old. The identified disruptors from real life ALS were task interruptions mainly from non-medical staff (n = 16; 37%), patient's siblings (n = 5; 12%), other specialists (n = 5; 12%) and the phone calls (n = 2; 5%). The situation of ED overcrowding (n = 12; 28%) was also mentioned as a potential disruptor. Overall, physicians reported that some technical and non-technical tasks were harder to perform in real life compared to simulated sessions. Conclusion: This exploratory study allowed the identification of disruptors encountered in real life cases of ALS, and may be used for future simulation-based teaching to enhance realism during sessions

scholarly journals LO38: Does spaced instructional design result in improved retention of pediatric resuscitation skills? A randomized education study

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S20-S20
Author(s):  
C. Patocka ◽  
A. Cheng ◽  
M. Sibbald ◽  
J. Duff ◽  
A. Lai ◽  
...  
Keyword(s):  
Rating Scales ◽  
Life Support ◽  
Spacing Effect ◽  
Advanced Life Support ◽  
Course Completion ◽  
Skill Learning ◽  
Global Rating ◽  
Procedural Skills ◽  
Pediatric Resuscitation ◽  
Significant Difference

Introduction: Survival from cardiac arrest has been linked to the quality of resuscitation care. Unfortunately, healthcare providers frequently underperform in these critical scenarios, with a well-documented deterioration in skills weeks to months following advanced life support courses. Improving initial training and preventing decay in knowledge and skills are a priority in resuscitation education. The spacing effect has repeatedly been shown to have an impact on learning and retention. Despite its potential advantages, the spacing effect has seldom been applied to organized education training or complex motor skill learning where it has the potential to make a significant impact. The purpose of this study was to determine if a resuscitation course taught in a spaced format compared to the usual massed instruction results in improved retention of procedural skills. Methods: EMS providers (Paramedics and Emergency Medical Technicians (EMT)) were block randomized to receive a Pediatric Advanced Life Support (PALS) course in either a spaced format (four 210-minute weekly sessions) or a massed format (two sequential 7-hour days). Blinded observers used expert-developed 4-point global rating scales to assess video recordings of each learner performing various resuscitation skills before, after and 3-months following course completion. Primary outcomes were performance on infant bag-valve-mask ventilation (BVMV), intraosseous (IO) insertion, infant intubation, infant and adult chest compressions. Results: Forty-eight of 50 participants completed the study protocol (26 spaced and 22 massed). There was no significant difference between the two groups on testing before and immediately after the course. 3-months following course completion participants in the spaced cohort scored higher overall for BVMV (2.2 ± 0.13 versus 1.8 ± 0.14, p=0.012) without statistically significant difference in scores for IO insertion (3.0 ± 0.13 versus 2.7± 0.13, p= 0.052), intubation (2.7± 0.13 versus 2.5 ± 0.14, p=0.249), infant compressions (2.5± 0.28 versus 2.5± 0.31, p=0.831) and adult compressions (2.3± 0.24 versus 2.2± 0.26, p=0.728) Conclusion: Procedural skills taught in a spaced format result in at least as good learning as the traditional massed format; more complex skills taught in a spaced format may result in better long term retention when compared to traditional massed training as there was a clear difference in BVMV and trend toward a difference in IO insertion.

scholarly journals O cotidiano no alojamento materno, das mães de crianças internadas em uma Unidade de Terapia Intensiva Neonatal

2008 ◽  
Vol 8 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Erika da Silva Dittz ◽  
Joaquim Antônio César Mota ◽  
Roseni Rosângela de Sena
Keyword(s):  
Minas Gerais ◽  
Terapia Intensiva ◽  
Belo Horizonte

OBJETIVOS: conhecer o cotidiano no alojamento de mães, cujas crianças estão internadas em uma Unidade de Terapia Intensiva Neonatal. MÉTODOS: pesquisa qualitativa realizada no Hospital Sofia Feldman, em Belo Horizonte, Minas Gerais, Brasil. Os dados foram obtidos por meio de observação participante e grupo focal, e os instrumentos utilizados para registro dos dados foram os diários de campo, gravadores e fitas. Para análise dos dados utilizou-se a análise de conteúdo. RESULTADOS: ao decidir permanecer no alojamento materno a mãe se sente dividida entre atender as necessidades do filho hospitalizado, as demandas da família e as suas próprias necessidades. A vivência no ambiente hospitalar exige que a mãe se adapte a uma nova dinâmica, determinada pelas rotinas e normas institucionais. A permanência no alojamento materno, ao mesmo tempo em que surge como uma possibilidade das mães estabelecerem relações de amizade e solidariedade, é um espaço de relações conflituosas entre elas. CONCLUSÕES: na adaptação da mãe ao novo cotidiano, revelou-se importante a convivência entre as mães, a família e os profissionais de saúde. O estudo aponta para a importância do profissional de saúde aproximar-se da realidade vivenciada pelas mães, para facilitar sua adaptação.

scholarly journals Concord�ncia interavaliadores em avalia��o da c�rnea de pacientes cr�ticos

2017 ◽  
Vol 7 ◽  
Author(s):  
Diego Dias de Ara�jo ◽  
Andreza Werli-Alvarenga ◽  
Nat�lia Gherardi Almeida ◽  
Priscila Marinho Aleixo Silva ◽  
Tamara Gon�alves Rezende Macieira ◽  
...  
Keyword(s):  
Minas Gerais ◽  
Terapia Intensiva ◽  
Belo Horizonte

Objetivo: estabelecer o grau de concord�ncia interavaliadores na avalia��o da c�rnea de pacientes adultos, internados em unidade de terapia intensiva de um hospital p�blico, atrav�s do teste de fluoresce�na. M�todos: trata-se de um estudo transversal com abordagem descritiva, realizado com cinco avaliadores a partir do teste de concord�ncia na avalia��o da c�rnea de pacientes adultos internados em unidade de terapia intensiva de um hospital p�blico de Belo Horizonte, Minas Gerais. Oitenta e cinco pacientes foram avaliados, totalizando 170 c�rneas. O coeficiente kappa foi utilizado para a avalia��o do grau de concord�ncia interavaliadores e para esta an�lise o n�vel de signific�ncia adotado foi o valor p < 0,05. Resultados: verificou-se concord�ncia geral com varia��o do coeficiente kappa de 0,84 a 0,93 entre os avaliadores. Os �ndices obtidos indicam concord�ncias quase perfeitas. Conclus�o: a partir dos resultados, evidencia-se que os avaliadores ap�s capacita��o para avalia��o corneana est�o aptos a realizar o exame da c�rnea em pacientes adultos internados em unidade de terapia intensiva e que a concord�ncia interavaliadores � uma importante etapa de valida��o a ser utilizada na calibra��o de profissionais para avalia��es ou an�lises subsequentes.

Observational Study on the Effect of Duration from Pediatric Advanced Life Support (PALS) Certification on PALS Performance in Pediatric Interns in Simulated Cardiopulmonary Arrest

2021 ◽  
Author(s):  
Nancy M. Tofil ◽  
Stacy L. Gaither ◽  
Charli Cohen ◽  
Carrie Norwood ◽  
Jerry Lynn Zinkan ◽  
...  
Keyword(s):  
Life Support ◽  
Cardiopulmonary Arrest ◽  
Training Session ◽  
Advanced Life Support ◽  
Performance Score ◽  
Performance Skills ◽  
Score Following ◽  
Resuscitation Training ◽  
Significant Difference ◽  
Key Events

AbstractPediatric advanced life support (PALS) training is critical for pediatric residents. It is unclear how well PALS skills are developed during this course or maintained overtime. This study evaluated PALS skills of pediatric interns using a validated PALS performance score following their initial PALS certification. All pediatric interns were invited to a 45-minute rapid cycle deliberate practice (RCDP) training session following their initial PALS certification from July 2017 to June 2019. The PALS score and times for key events were recorded for participants prior to RCDP training. We then compared performance scores for those who took PALS ≥3 months, between 3 days to 3 months and 3 days after PALS. There were 72 participants, 30 (of 30) in 3 days, 18 in 3 days to 3 months, and 24 in ≥3 months groups (42 total of 52 residents, 81%). The average PALS performance score was 53 ± 20%. There was no significant difference between the groups (3 days, 53 ± 15%; 3 days–3 months, 51 ± 19%; ≥3 months, 54 ± 26%, p = 0.922). Chest compressions started later in the ≥3 months groups compared with the 3 days or ≤3 months groups (p = 0.036). Time to defibrillation was longer in the 3 days group than the other groups (p = 0.008). Defibrillation was asked for in 3 days group at 97%, 73% in 3 days to 3 months and 68% in ≥3 months groups. PALS performance skills were poor in pediatric interns after PALS certification and was unchanged regardless of when training occurred. Our study supports the importance of supplemental resuscitation training in addition to the traditional PALS course.

Abstract 326: Practice Variation in the Transition from Weight-based to Flat Dosing of Epinephrine During Cardiopulmonary Resuscitation in Pediatric Intensive Care Units

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Martha Kienzle ◽  
Ryan W Morgan ◽  
Maya Dewan ◽  
Ken Tegtmeyer ◽  
Vijay Srinivasan ◽  
...  
Keyword(s):  
Life Support ◽  
Advanced Life Support ◽  
Pediatric Intensive Care ◽  
Ideal Body Weight ◽  
Practice Variation ◽  
Free Standing ◽  
Chi Square ◽  
Actual Weight ◽  
Significant Difference ◽  
Fellowship Programs

Introduction: Pediatric Advanced Life Support (PALS) guidelines include weight-based epinephrine dosing recommendations (0.01 mg/kg with a maximum dose of 1mg), but do not specify the age or weight at which adult (flat) dosing should be provided. Hypothesis: We hypothesized that there would be considerable practice variation in the transition from weight-based to flat dosing of epinephrine in pediatric ICUs (PICUs) and that more providers would prioritize weight than age in making this decision. Methods: We performed an IRB-exempt, multi-institution, internet-based survey. Recipients were U.S. PICU attending physicians (one per institution) involved in resuscitation system oversight. Proportions across categories were compared using Chi-square testing. Results: Of 137 institutions surveyed, 68 (50%) responded. Most responding institutions are children’s hospitals (free-standing or dedicated pediatric hospitals within combined hospitals) (67; 99%) and academic (55; 81%); 41 (60%) have PICU fellowship programs. Thirteen (19%) respondents are PICU medical directors, 16 (24%) are resuscitation committee members and 21 (31%) are PICU attendings with an interest in resuscitation. When choosing between weight-based and flat dosing, a significantly higher proportion of providers consider weight (64/68; 94%) vs. age (23/68; 34%) (p <0.01). Among those using age, there were no significant differences in the proportion of providers transitioning at 12 to <14 years of age (0, 0%), 14 to <16 (4, 17%), 16 to <18 (5, 22%) or ≥18 (6, 26%; p=0.82). Among those prioritizing weight, there was a significant difference between the proportion of providers transitioning at 50 to <60kg (28, 44%), 60 to <80kg (17, 27%), 80 to <100kg (5, 8%) or ≥100kg (8, 13%; p< 0.01). Twenty-nine (43%) institutions use an ideal body weight that is less than the patient’s actual weight when dosing epinephrine in obese patients. Conclusions: There is considerable practice variation in the transition from weight-based to flat epinephrine dosing during CPR in PICUs with most institutions using patient weight. Given the potential for large variation in amount of epinephrine delivered to these patients, prospective study is warranted to inform PALS guidelines.

Sign in / Sign up

Export Citation Format

Share Document