scholarly journals The Barriers to the Success of Cardiopulmonary Resuscitation from the Perspectives of Emergency Medical Services Providers

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ayob Akbari ◽  
Ahmad Nasiri ◽  
Mohammad Azim Mahmodi
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Emergency Care ◽  
Simple Random Sampling ◽  
Public Access ◽  
Prehospital Emergency Care ◽  
Cross Sectional ◽  
Significant Difference ◽  
Prehospital Emergency ◽  
The Mean ◽  
Cpr Training

Background: Cardiopulmonary resuscitation (CPR) is an integral part of prehospital emergency care. Addressing the barriers to successful CPR may help improve the quality of CPR in the future. Objectives: The present study aimed to identify the barriers to successful CPR from the perspective of EMS providers. Methods: This cross-sectional analytical study was conducted from May 2015 to Jan 2016. One hundred sixty EMS providers who were employed at EMS affiliated to Birjand University of Medical Sciences (Iran) were selected through simple random sampling. To assess barriers to the success of CPR, data were collected using a researcher-made questionnaire (60 questions) categorized in six subscales. Study data were analyzed by SPSS v.16, descriptive (frequency, mean, and standard deviation), and inferential statistics (t-test and ANOVA). Results: Among the subscales of barriers to successful CPR from the perspective of EMS providers, the EMS structure subscale was the most important (3.06 ± 0.38, out of a 0 - 4 range). In this subscale, public inaccessibility automated external defibrillator (AED) (3.59 ± 0.49) and Lack of telephone-CPR advice by the dispatcher (3.58 ± 0.55) were the most important barriers, respectively. There was a significant difference between the mean score of barriers to successful CPR and educational status, which increased in EMS providers with BS degree (P = 0.003). There was no significant difference between the mean score of barriers to successful CPR compared to the other demographic characteristics of EMS providers (P > 0.05). Conclusions: EMS providers perceived public inaccessibility AED and Lack of telephone-CPR training as the most important barriers to success CPR in prehospital emergency care. Therefore, public access to AED must be emphasized to promote immediate response and improve CPR's outcome in EMS. Moreover, telephone-CPR training by dispatchers should be recommended to help increase the success of CPR.

scholarly journals Implementation of a National 5‐Year Plan for Prehospital Emergency Care in Singapore and Impact on Out‐of‐Hospital Cardiac Arrest Outcomes From 2011 to 2016

2020 ◽  
Vol 9 (21) ◽  
Author(s):  
Andrew Fu Wah Ho ◽  
Nurun Nisa Amatullah De Souza ◽  
Audrey L. Blewer ◽  
Win Wah ◽  
Nur Shahidah ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Care ◽  
Survival Rates ◽  
Prehospital Emergency Care ◽  
Shockable Rhythm ◽  
Automated External Defibrillation ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Prehospital Emergency ◽  
Hospital Cardiac Arrest

Background Outcomes of patients from out‐of‐hospital cardiac arrest (OHCA) vary widely globally because of differences in prehospital systems of emergency care. National efforts had gone into improving OHCA outcomes in Singapore in recent years including community and prehospital initiatives. We aimed to document the impact of implementation of a national 5‐year Plan for prehospital emergency care in Singapore on OHCA outcomes from 2011 to 2016. Methods and Results Prospective, population‐based data of OHCA brought to Emergency Departments were obtained from the Pan‐Asian Resuscitation Outcomes Study cohort. The primary outcome was Utstein (bystander witnessed, shockable rhythm) survival‐to‐discharge or 30‐day postarrest. Mid‐year population estimates were used to calculate age‐standardized incidence. Multivariable logistic regression was performed to identify prehospital characteristics associated with survival‐to‐discharge across time. A total of 11 465 cases qualified for analysis. Age‐standardized incidence increased from 26.1 per 100 000 in 2011 to 39.2 per 100 000 in 2016. From 2011 to 2016, Utstein survival rates nearly doubled from 11.6% to 23.1% ( P =0.006). Overall survival rates improved from 3.6% to 6.5% ( P <0.001). Bystander cardiopulmonary resuscitation rates more than doubled from 21.9% to 56.3% and bystander automated external defibrillation rates also increased from 1.8% to 4.6%. Age ≤65 years, nonresidential location, witnessed arrest, shockable rhythm, bystander automated external defibrillation, and year 2016 were independently associated with improved survival. Conclusions Implementation of a national prehospital strategy doubled OHCA survival in Singapore from 2011 to 2016, along with corresponding increases in bystander cardiopulmonary resuscitation and bystander automated external defibrillation. This can be an implementation model for other systems trying to improve OHCA outcomes.

scholarly journals Perbedaan Hemoglobin Terglikosilasi (Hba1c) terhadap Profil Lipid Pasien Rumah Sakit Islam Surabaya

2021 ◽  
Vol 5 (1) ◽  
pp. 8
Author(s):  
Dwi - Kuswanto ◽  
Hari Basuki Notobroto ◽  
Rachmah Indawati
Keyword(s):  
Blood Glucose ◽  
Random Sampling ◽  
Ldl Cholesterol ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean ◽  
Hba1c Levels ◽  
Diabetes Melitus

ABSTRAK Latar Belakang : Diabetes melitus merupakan penyakit metabolik dengan karakteristik hiperglikemia sebagai akibat kelainan sekresi insulin maupun kerja insulin. Diabetes sebagai salah satu penyebab dislipidemia sekunder, sehingga pengelolaan glukosa darah merupakan pencegahan primer timbulnya komplikasi penyakit kardiovaskular. Hasil Riskesdas tahun 2018, prevalensi diabetes melitus yang didiagnosis dokter pada penduduk di semua umur sebesar 3,4% di Kota Surabaya.Tujuan : Penelitian ini untuk mengetahui perbedaan profil lipid pada level HbA1C normal, prediabetes dan diabetes melitus.Metode : Penelitian cross sectional, teknik pengambilan sampel dengan simple random sampling dari data rekam medis pasien rawat jalan di Rumah Sakit Islam Surabaya  dari 1 Januari tahun 2018 sampai dengan 31 Desember 2019 berusia 35-80 tahun dan mendapat pemeriksaan HbA1c, kolesterol, trigliserida dan LDL-kolesterol pada waktu yang sama dan terdokumentasi lengkap pertama sekali sehingga diperoleh besar sampel 73 data pasien. Uji Anova one way digunakan untuk mengetahui perbedaan rata-rata kolesterol, trigliserida dan LDL-kolesterol berdasarkan HbA1C.Hasil : Hasil penelitian menunjukkantidakada perbedaan yang signifikan rata-rata kolesterol, dan LDL-kolesterol dengan tingkatan HbA1C (p>0,05), ada perbedaan yang signifikan rata-rata trigliserid dengan HbA1C normal, prediabetes, dan diabetes (p=0,01). Hasil multiple comparison dengan metode Tukey HSD menunjukkan perbedaan signifikan rata-rata trigliserid  pada HbA1C normal dengan diabetes (p=0,039) dan prediabetes dengan diabetes (p=0,044).Kesimpulan :Perbedaan rata-rata trigliserida signifikanpada HbA1Ckategorinormal dan prediabetes dengan diabetes, pentingnya mengendalikanglukosa darah untuk mencegahkomplikasi kardiovaskuler pada penderita diabetes melitus yang dapat dilakukan melalui pemantauan mandiri glukosa darah, pola hidup sehat, aktivitas fisik secara teratur, terapi nutrisi medis sesuai kebutuhan, menurunkan berat badan bagi yang mengalami obesitas, tidak merokokdan intervensi obat anti hiperglikemia jika dibutuhkan.Kata Kunci : diabetes, HbA1C, kolesterol, trigliserid, LDL-kolesterol. ABSTRACT  Background :Diabetes melitus is a metabolic disease characterized by hyperglicemia as a result of abnormal insulin secretion and insulin action. Diabetes is a cause of secondary dislipidemia, so that diabetes melitus monitoring is a primary deterrent to cardiovascular complication. Riskesdas 2018 said that the prevalence of doctors' diagnosed diabetes in the population at all age 3.4% in Surabaya.Objective : This study is to find out the difference in lipid profiles on normal HbA1Clevels, pre-diabetes and diabetes mellitusMethod: Cross-sectional study, the sampling technique used was simple random sampling fromoutpatient medical recordsthe Surabaya Islamic hospital's from 1st of January 2018 to 31st December 2019 aged 35-80 years and checked for HbA1C, cholesterol, triglyceride and LDL-cholesterol at the same and firsttime documented. Sample sizes of 73 data analized with One Way Anova test was used to identify differences in mean cholesterol, triglyceride and LDL-cholesterol based Hba1C.Results :The results showed that there was no significant difference mean cholesterol and mean LDL-cholesterol with HbA1C levels (p> 0.05), there were significant differences mean the triglyceride with normal HbA1C levels, pre-diabetes, and diabetes (p= 0.01). Multiple comparason results using Tukey HSD methods showed that there was significant differences mean the triglycerid on normal HbA1C levels with diabetes (p= 0.039) and the mean triglyceride ebetween hba1c prediabetesand diabetes (p= 0.044).Conclusions: The mean difference trigliseride signifnificant in normal HbA1C levels and pre-diabetes with diabetes.The importantce of controlling blood glucose to prevent cardiovasculer complication in people with diebetes mellitus can be done through education on independent monitoring of blood glucose, healthy lifestyle, reguler physical activity, medical nutrition therapy according to the needs, lost weight for those who are obese, do not smoke and  anti-hyperglicemia drug intervention if needed.

scholarly journals A Comparison Between Differently Skilled Prehospital Emergency Care Providers in Major-Incident Triage in South Africa

2018 ◽  
Vol 33 (6) ◽  
pp. 575-580 ◽  
Author(s):  
Annet Ngabirano Alenyo ◽  
Wayne P. Smith ◽  
Michael McCaul ◽  
Daniel J. Van Hoving
Keyword(s):  
South Africa ◽  
Emergency Care ◽  
Life Support ◽  
Major Incident ◽  
Prehospital Emergency Care ◽  
Care Providers ◽  
Publication Type ◽  
Cross Sectional ◽  
Prehospital Emergency ◽  
Level Of Training

AbstractIntroductionMajor-incident triage ensures effective emergency care and utilization of resources. Prehospital emergency care providers are often the first medical professionals to arrive at any major incident and should be competent in primary triage. However, various factors (including level of training) influence their triage performance.Hypothesis/ProblemThe aim of this study was to determine the difference in major-incident triage performance between different training levels of prehospital emergency care providers in South Africa utilizing the Triage Sieve algorithm.MethodsThis was a cross-sectional study involving differently trained prehospital providers: Advanced Life Support (ALS); Intermediate Life Support (ILS); and Basic Life Support (BLS). Participants wrote a validated 20-question pre-test before completing major-incident training. Two post-tests were also completed: a 20-question written test and a three-question face-to-face evaluation. Outcomes measured were triage accuracy and duration of triage. The effect of level of training, gender, age, previous major-incident training, and duration of service were determined.ResultsA total of 129 prehospital providers participated. The mean age was 33.4 years and 65 (50.4%) were male. Most (n=87; 67.4%) were BLS providers. The overall correct triage score pre-training was 53.9% (95% CI, 51.98 to 55.83), over-triage 31.4% (95% CI, 29.66 to 33.2), and under-triage 13.8% (95% CI, 12.55 to 12.22). Post-training, the overall correct triage score increased to 63.6% (95% CI, 61.72 to 65.44), over-triage decreased to 17.9% (95% CI, 16.47 to 19.43), and under-triage increased to 17.8% (95% CI, 16.40 to 19.36). The ALS providers had both the highest likelihood of a correct triage score post-training (odds ratio 1.21; 95% CI, 0.96-1.53) and the shortest duration of triage (median three seconds, interquartile range two to seven seconds; P=.034). Participants with prior major-incident training performed better (P=.001).ConclusionAccuracy of major-incident triage across all levels of prehospital providers in South Africa is less than optimal with non-significant differences post-major-incident training. Prior major-incident training played a significant role in triage accuracy indicating that training should be an ongoing process. Although ALS providers were the quickest to complete triage, this difference was not clinically significant. The BLS and ILS providers with major-incident training can thus be utilized for primary major-incident triage allowing ALS providers to focus on more clinical roles.AlenyoAN, SmithWP, McCaulM, Van HovingDJ. A comparison between differently skilled prehospital emergency care providers in major-incident triage in South Africa. Prehosp Disaster Med. 2018;33(6):575–580.

scholarly journals Clinical and obstetric situation of pregnant women who require prehospital emergency care

2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Vívien Cunha Alves de Freitas ◽  
Glauberto da Silva Quirino ◽  
Rogério Pinto Giesta ◽  
Ana Karina Bezerra Pinheiro
Keyword(s):  
Pregnant Women ◽  
Emergency Care ◽  
Cross Sectional Study ◽  
Prehospital Emergency Care ◽  
Cross Sectional ◽  
Significance Level ◽  
Care Services ◽  
Prehospital Emergency ◽  
Brazilian Northeast ◽  
Emergency Care Services

ABSTRACT Objectives: to identify the clinical and obstetric situation of pregnant women who required emergency care, considering the adequacy of their requirement. Methods: this is a cross-sectional study, developed in the headquarters of the Mobile Emergency Care Services from a state in the Brazilian Northeast, through the analysis of 558 reports of obstetric patients attended in 2016. The magnitude of the associations was expressed by odds ratio and confidence intervals, considering a 5% significance level. Results: more than half (50.9%) requirements for emergency care were from women who went into labor (non-expulsive), especially among third trimester pregnant women (p < 0.000). Most clinical and obstetric parameters were normal. Conclusions: the inadequate demands for emergency care services reflect the excessive medicalization of the gestational process and shows how important it is to discuss the physiological symptoms that involve pregnancy, so that a more egalitarian and efficient urgency service can be offered.

scholarly journals Influence of Motivation on Academic Progression of Students: A Cross-sectional Study

2020 ◽  
Author(s):  
Ahmad K Alnemare
Keyword(s):  
Extrinsic Motivation ◽  
Academic Motivation ◽  
Learning Experience ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Vital Role ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean

Introduction: Motivation plays a vital role in learning and is a great enabler as it functions on multiple dimensions and paves way to conquer impediments in the path of success. An attempt has been made through this study to scrutinize the convictions related to motivation and the deployment of strategies in the learning process of students. Aim: To find the relation if any, between academic achievement and the motivation level with the students of College of Medicine, Majmaah University, Majmaah, Saudi Arabia. Materials and Methods: The cross-sectional study was carried out among pre-medical and medical students of Majmaah University. Academic Motivation Scale (AMS) questionnaire was distributed to 250 students who were selected based on simple random sampling. There were 233 students who participated in the study out of which there were 147 males and 86 females who completed the questionnaire. Motivation of student towards education was assessed in three domains, namely Intrinsic, Extrinsic and Amotivation. After ethical approval from institutional review board, questionnaire was distributed and results recorded in Statistical Package for the Social Sciences (SPSS) version 25. Qualitative variables were represented with frequencies and percentages and quantitative variables with mean and standard deviation. Student’s t-test and Analysis of Variance (ANOVA) were applied to compare the means. Results: Comparison of motivational scores between students in different years showed no significant difference in the mean scores across all dimensions of motivation except Extrinsic Motivation-Regulation. The mean score of 2nd year students was 16.63 and it increased over the years. The mean score at 6th year was 22.03 and it decreased during internship with mean score of 20.58. Conclusion: The study of various stimulators which affect the learning experience of the student provides good insight on motivation and its influence on academic performances.

scholarly journals FAMILY PRESENCE AND THE PRESS EFFECTS ON PREHOSPITAL CARDIOPULMONARY RESUSCITATION: ATTITUDES OF A GROUP OF EMERGENCY CAREGIVERS

2020 ◽  
Vol 21 (1) ◽  
pp. 102-116
Author(s):  
HASAN ERBAY
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Emergency Services ◽  
Negative Attitude ◽  
Significant Others ◽  
Prehospital Emergency Care ◽  
Family Presence ◽  
Descriptive Research ◽  
Significant Difference ◽  
The Press ◽  
Prehospital Emergency

There have been many studies regarding family presence during cardiopulmonary resuscitation and most of them are about emergency services or intensive care units. However, the issue has not been studied enough in terms of prehospital emergency medicine and the perspective of prehospital emergency caregivers. In this study, it is aimed to present the attitudes of a group of prehospital emergency care professionals to family presence and the press effects during prehospital cardiopulmonary resuscitation. The data for this descriptive research was collected from the participants of 63 prehospital caregivers in Afyonkarahisar. The data was collected using a questionnaire designed by the authors and the responses summarized by using frequencies and percentages. Descriptive statistics were used to characterize the sample and each of the survey items. The local ethics committee approval was obtained. Most participants were strongly opposed to family presence and the press during CPR. The highest mean in the phrases that “I don’t want any press member to be there when I perform CPR on a patient.” There is no significant difference in family presence during CPR between the role and year of the experience. Prehospital emergency caregivers mostly have negative attitude towards family presence and the press during CPR. They mostly think the presence of significant others and being watched adversely affects their CPR performance. Disturbing effect on caregivers is not only related to the presence of family members or to other significant others but also the press. Family presence and the press effect on prehospital cardiopulmonary resuscitation are crucial issues that need more attention.

Abstract 92: Evaluation Of Knowledge And Practice Of Cardiopulmonary Resuscitation Of Children And Infants By An Out-of-hospital Emergency Care Team

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Nathalie S Goddet ◽  
François Dolveck ◽  
Alexis Descatha ◽  
Noella Lode ◽  
Jean-Louis Chabernaud ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Emergency Care ◽  
Life Support ◽  
Prehospital Emergency Care ◽  
Emergency Response System ◽  
First Aid Training ◽  
Life Threatening ◽  
Prehospital Emergency ◽  
Job Title ◽  
Knowledge And Practice

Introduction The French emergency response system in life threatening situations is the deployment of fully equipped ambulances with paramedic, nurse and emergency physician. The 2005 ILCOR and ERC guidelines concerning cardiopulmonary resuscitation (CPR) have led to significant changes, especially in terms of basic life support (BLS). We aimed to review fundamental knowledge and practice by our personnel concerning CPR in children and infants to determine current training needs for our teams. Materials and methods Paper questionnaires were filled out by our personnel and immediately collected. Inclusion criteria: physicians, nurses, and paramedics (refusals to fill out questionnaire were not included). We recorded: profile of personnel, knowledge of 2005 guidelines, basic CPR and advanced CPR parameters. Majors results were compared based on job title. Results Sixty-one questionnaires were filled out (25 paramedics, 13 nurses, and 23 physicians). Personnel was mostly aged under 40 (70,5%, n=43), with over 2 years experience in prehospital emergency care(75,4%, n=46); 47,5% (n=\29) had no training in pediatrics; 68,9% (n=42) had BLS certification and 31,1% (n=19) reported regular participation in first aid training programs. A minority of subjects declared knowing the 2005 Guidelines (11,5%, n=7), even among physician (17,4%, n=4). Table 1 shows major results about CPR parameters according to job title. Conclusion This study emphasizes the lack of knowledge and the repeated changes witch require more frequent and more extensive training for entire personnel on the team, focusing on basic CPR for physicians and advanced CPR for paramedics and nurses. Table 1: Answers according to job title AED : Automatic External Defibrillator

scholarly journals Cancer Patients’ Prehospital Emergency Care: Post Hoc Analysis from the French Prospective Multicenter Study EPICANCER

2021 ◽  
Vol 10 (5) ◽  
pp. 1145
Author(s):  
Olivier Peyrony ◽  
Jean-Paul Fontaine ◽  
Eloïse Trabattoni ◽  
Lionel Nakad ◽  
Sylvain Charreyre ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cancer Patients ◽  
Multicenter Study ◽  
Emergency Care ◽  
Prehospital Emergency Care ◽  
Prospective Multicenter Study ◽  
Emergency Medical Dispatch ◽  
Cross Sectional ◽  
Prehospital Emergency

Background: Very little data are available concerning the prehospital emergency care of cancer patients. The objective of this study is to report the trajectories and outcomes of cancer patients attended by prehospital emergency services. Methods: This was an ancillary study from a three-day cross-sectional prospective multicenter study in France. Adult patients with cancer were included if they called the emergency medical dispatch center Service d’Aide Médicale Urgente (SAMU). The study was registered on ClinicalTrials.gov (NCT03393260, accessed on 8th January 2018). Results: During the study period, 1081 cancer patients called the SAMU. The three most frequent reasons were dyspnea (20.2%), neurological disorder (15.4%), and fatigue (13.1%). Among those patients, 949 (87.8%) were directed to the hospital, among which 802 (90.8%) were directed to an emergency department (ED) and 44 (5%) were transported directly to an intensive care unit (ICU). A mobile intensive care unit (MICU) was dispatched 213 (31.6%) times. The decision to dispatch an MICU seemed generally based on the patient’s reason for seeking emergency care and the presence of severity signs rather than on the malignancy or the patient general health status. Among the patients who were directed to the ED, 98 (16.1%) were deceased on day 30. Mortality was 15.4% for those patients directed to the ED but who were not admitted to the ICU in the next 7 days, 28.2% for those who were admitted to ICU in the next 7 days, and 56.1% for those patients transported by the MICU directly to the ICU. Conclusion: Cancer patients attending prehospital emergency care were most often directed to EDs. Patients who were directly transported to the ICU had a high mortality rate, raising the question of improving triage policies.

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