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Sudden cardiac arrest (SCA) remains a major healthcare issue worldwide with gloomy outcomes due to poor perfusion of cardiopulmonary resuscitation (CPR), deemed unsuitable for hemostatic conditions, cardiotorsal anatomy, electrophysiology, and thoracic biomechanics. Alternatively, we propose a new management, implementing rational exploitation of the stagnant blood masses: manually with a novel technique of cardiac massage and mechanically with a circulatory flow restoration (CFR) device. Methods: Simulated chest compressions were performed through the 5th intercostal space in professional Lifeguards volunteers, placed in the left lateral decubitus position with raised legs and abdominal compression. Results: Bypassing the sternal barrier, refilling the heart, and then compressing the chest with a recoil-rebound maneuver (3R / CPR) can significantly promote return of spontaneous circulation (ROSC). The effectiveness of the CFR device versus CPR has previously been demonstrated in the literature. Conclusion: Unlike current CPR, the 3R/CPR adapts human morphology and provides adequate myocardial perfusion promoting ROSC safely, under all circumstances. Preclinical computational models can confirm the effectiveness of the technique.
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Objective:To evaluate the outcome of the patients receiving dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) delivered by first-responders who witnessed the out-of-hospital cardiac arrest (OHCA) before the Emergency Medical Service (EMS) arrived.Methods:We performed a search of the relevant literature exploring major scientific databases. We assessed the quality of the included cohort study according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Meta-analysis was performed on three outcome indicators (recovery of spontaneous circulation survival to hospital discharge and survival with favourable neurologic outcome) using the Revman5.3 software.Results:A total of 21 studies with 349 822 patients were selected for the meta-analysis, including 182 125 patients in the DA-CPR group and 167 697 in the CPR-only group. The meta-analysis showed no significant difference between the DA-CPR and CPR-only groups in ROSC [ RR=1.10, 95% confidence interval ( CI): 0.94-1.29, P=0.24], survival to hospital discharge ( RR=1.10, 95% CI: 0.90-1.34, P=0.34) and survival with favourable neurologic outcome ( RR=1.01, 95% CI: 0.79-1.28, P=0.97) of the patients in America, Japan and Korea. However, there was a significant difference between the DA-CPR and the CPR-only groups in ROSC ( RR=2.61, 95% CI:1.53-4.46, P=0.0005), survival to hospital discharge( RR=6.08, 95% CI: 1.84-20.04, P=0.003), and survival with favourable neurologic outcome( RR=9.76, 95% CI: 1.87-51.02, P=0.007) of the patients in China. Conclusions:The overall effect of DA-CPR is significantly different for each country. In detail, DA-CPR offers a survival advantage (Return of spontaneous circulation, survival to hospital discharge and survival with favourable neurologic outcome) over CPR alone in China but no advantage in developed countries.
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@#Introduction: Vaccination is a biological process that improves immunity level of an individual towards certain diseases. Vaccination is generally given to all newborn and kids. Most countries oblige their citizens to be vaccinated as early as new-born age. The aim of this research is to study the perception on vaccination intake and the associated factors that lead to its refusal among parents in east coast and west coast peninsular Malaysia. Methods: Primary data were collected using self-administered questionnaire and were distributed to assess the study objectives. Total 240 questionnaires were distributed equally in west coast and east coast study area. Questionnaire consists of demographic data, perception aspects and factors that may lead to the negative perceptions. Results: There is significant association between perception and religion, education level and side effect factor in east coast with majority of the respondents are Muslims (40.83%) while there is no significant association between education level and side effect factor (p>0.1) in west coast with majority of respondents are Muslims (51.67%) too. This study found that perception regarding vaccination is influenced by the religion restrictions in east coast of peninsular Malaysia and not in west coast region. The other factors associated with vaccination refusal varies according to education level, and regional basis. Conclusion: Most of the respondents who have negative perception regarding vaccination are from East Coast region as they are more prone into Islamic teachings. All the possible factors of vaccination refusal are accepted by the respondents but varies in its prevalence as the leading factor determined that caused the vaccination refusal are religion restriction and the least percentage for the factor is time restriction.
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@#Introduction: There is global support for the teaching of cardiopulmonary resuscitation (CPR) in schools, and teachers are expected to play a leading role in a medical emergency. For effective resuscitation, retention of CPR knowledge after training is paramount. This study aimed at assessing the retention of CPR knowledge among student teachers at pre-, post-immediate, 8th-, and 14th-week post-training. Method: A quasi-experimental study using non-probability convenience sampling was conducted to select 41 respondents from the Department of Physical and Health Education, Faculty of Education (UiTM). A validated American Heart Association's 2015 Basic Life Support (BLS) multiple-choice questions (MCQ) were utilised to measure the retention of knowledge among the participants. Results: This study demonstrated a significant lack of CPR knowledge during pre-test with the mean scores of M=8.02 despite half of the participants had prior knowledge in CPR. Nevertheless, the paired t-test revealed a significant improvement in the post-scores following the intervention at M=16.20, t(40) = -18.56, p < 0.001, and d=3.91. The one-way RM-ANOVA results showed a decline in the retention rate at the 8th week (M=13.06; p < 0.001) and an improvement at the 14th weeks (M= 5.74; p < 0.001). Conclusion: The knowledge of CPR among the student teachers following the intervention program was appropriate, but the deterioration of retention suggested that all student teachers should undergo comprehensive routine CPR courses to avoid the immediate loss of CPR knowledge and skills. The governing bodies in Malaysia should implement CPR training as part of the curriculum for teachers.
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Background: Current state of practice of medical imaging now encompasses advancesupportive care to patient, in addition to the supportive care offered for the stabilization of patient before radiologic procedures. Advance supportive care, such as Cardiopulmonary Resuscitation (CPR) is offered to patient who may have cardiopulmonary arrests.Objective: To assess the knowledge of cardiopulmonary resuscitation (CPR) among clinical radiography students of a tertiary institution in Sokoto. Methods:A cross section study employing a semi-structured and self-administered questionnaire, consisting of two section, designed with the aim of the study were distributed among 82 clinical radiography students (300 –500 level), in the 2017/2018 academy session of the tertiary institution (Usmanu Danfodiyo University) in Sokoto. The data were extracted using SPSS version 20 and analysed using descriptive and inferential statistics.Results: A total of 75 questionnaire were returned, yielding a response rate of 91.5%. Respondents comprised 53 male and 22 female aged 20 to 34 years with mean age of 27 years. It was observed that 68% of the students had never had a CPR training and about 4% of the respondents knew the recommended compression to ventilation ratio during a CPR. While 1.3% knew the recommended chest compression to be performed each minute when giving CPR. Majority of the respondents (94.7%) were of the opinion, that CPR training should be made mandatory for all clinical radiography students.Conclusion:Base on the evidence presented within this study, there is knowledge gap in the practice of cardiopulmonary resuscitation (CPR) among clinical radiography students, as majority of the students do not have adequate knowledge on the practice of CPR.
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OBJECTIVES: The purpose of this study was factors affecting self-efficacy of cardiopulmonary resuscitation (CPR) in adults. Therefore, the provide basic data for strategy development to improve the performance rate of bystander CPR. METHODS: The data were collected from 164,165 adults of the 2016 Korean Community Health Survey. The survey method was 1:1 interview with households, and the survey period was from August 16, 2016 to October 31, 2016. The survey variables were as follows: self-efficacy of CPR, awareness of CPR, training experience of CPR, demographic characteristics, medical characteristics, health promoting behaviors, and safety practices. RESULTS: The rate of self-efficacy of CPR in adults was 60.6%. Factors affecting self-efficacy of CPR were age, sex, residence, education level, occupation, marital status, any CPR training, CPR training within the last 2 years, CPR training with manikin within the last 2 years, emergency room visit within the last 1 year, physical activity status, drive a bicycle, seat belts on rear seat, seat belts when riding a bus were statistically significant. CONCLUSIONS: In conclusion, in order to improve the self-efficacy of CPR in adults, the recent experience rate of CPR education, the practice rate of health promotion behavior, and the practice rate of safety behavior should be improved. The government should expand the provision of education programs to improve the self-efficacy of CPR and actively prepare national-level public advertisements strategies.
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Adult , Humans , Cardiopulmonary Resuscitation , Education , Emergency Service, Hospital , Family Characteristics , Health Promotion , Health Surveys , Manikins , Marital Status , Motor Activity , Occupations , Seat Belts , Surveys and QuestionnairesABSTRACT
Objective • To investigate the effects of levosimendan on kidney injury in the rat model of cardiopulmonary resuscitation. Methods • Twentyfive healthy adult male SD rats were randomly divided into three groups, which were sham group (S group, n=5), levosimendan group (L group, n=10) and control group (C group, n=10). Cardiac arrest and cardiopulmonary resuscitation procedure were created in L group and C group by inducing ventricular fibrillation. L group was treated with levosimendan during and after resuscitation, while C group and S group were given equivalent volume of saline solution. S group was not induced into cardiac arrest and resuscitation. Serum interleukin-6 (IL-6), IL-10, tumor necrosis factor-α (TNF-α), creatinine (SCr), blood urea nitrogen (BUN) and cystatin-C (CysC) levels were compared between L group and C group at 1, 4 and 6 h after resuscitation.Three groups of rats were sacrificed, and the pathological changes of kidney tissues were observed at 6 h after resuscitation. Results • All rats were resuscitated successfully. No differences were found between the three groups about baseline data. After resuscitation, compared with S group, the levels of serum inflammatory cytokines and kidney function indicators increased dramatically (all P<0.05) in the other two groups. In resuscitation after 1, 4 and 6 h, the levels of IL-6 and TNF-α in L group were lower than those in C group, but IL-10 levels were higher in L group (P=0.000, P=0.002, P=0.036) than those in C group, and there were significant differences between the two groups (all P=0.000). In resuscitation after 1, 4 and 6 h, the levels of SCr (P=0.001, P=0.007, P=0.472), BUN (P=0.001, P=0.004, P=0.122) and CysC (P=0.493, P=0.001, P=0.175) were lower in L group than those in C group. Only 1 and 4 hours after resuscitation, the differences in the levels of SCr and BUN were significant, and only 4 hours after resuscitation, the difference in the level of CysC was significant between L group and C group. Both L and C group showed pathological characteristics of severe acute kidney injury, and the pathological injury scores of L group were alleviated compared with those of C group (all P=0.000). Conclusion • Levosimendan can improve kidney injury of cardiac arrest and cardiopulmonary resuscitation model rats.
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Background and Objectives: The role of effective basic life support (BLS) and cardiopulmonary resuscitation (CPR) is established. Reports on CPR knowledge assessment in Nepal are few and underline the gross lack of CPR knowledge.Material and Methods: A cross-sectional descriptive study was conducted among residents, students, and teachers in a few Nepalese health institutions. A questionnaire based on BLS guidelines 2010 was used, incorporating total 30 questions.Results: Total 145 complete responses (63 females, 82 males) were obtained and analyzed. Mean and median of correct answers was 18 out of 30 (60%, range 3-26); 9% could identify the correct sequence of action from a given set of 7 CPR steps. By ANOVA, score correlated significantly with the background of person (scores highest 19 in ‘clinical’ group and 18 in ‘dentistry’ to 16.38 in ‘nursing’ and 15.09 in ‘non-clinical’; p=0.000) but not with other variables (sex, age, designation, academic degree, institution, and previous CPR training).Conclusion: Lack in CPR knowledge and awareness are reported worldwide. Findings of this study are similar. Although those with clinical background had better knowledge, poor correlations with other variables indicate lack of importance being given to CPR knowledge and skill by most people, even those working in big health institutions of the country.
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Objective By taking cardiopulmonary resuscitation (CPR) resident standardization training skills practice as an example,to explore how to improve the ability of resident operating on the clinical skills.Methods 58 resident physicians in the hospital standardized training were selected,and through training and assessment of cardiopulmonary resuscitation skill training,the result was compared,and statistical analysis was made on the overall pass rate,the performance after the training,and the pass rate of operation.Result Comparison of the data was done by the t test,and pass rate by chi square result 48 people passed the training and examination,and the pass rate was 82.76％.The operation scores before and after training were:General (78.5 ± 6.44) vs.(89.2 ± 6.12),Department of gynecology and Obstetrics (74.3 ± 6.54) vs.(87.0 ± 6.34) of (70.6 ± 6.78) vs.(87.3 ± 6.31),rehabilitation medicine (70.2 ± 6.81) vs.(85.6 ± 6.77),Department of Stomatology (69.80 ± 7.07) vs.(82.80 ± 6.89),psychiatric (69.4 ± 7.19) vs.(80.4 ± 6.91),Department of medical imaging (69.30 ± 7.20) vs.(78.80 ± 6.94),(64.00 ± 7.25 test vs.) (76.5 ± 6.99),and the differences were statistically significant.After the training,the average score of the general professional training was 89.2,the highest score,while the average score of students trained in professional inspection department was 76.5 points,the lowest score.Chest compressions and artificial respiration,electrode plate installation project operation were the worst.Students pressed 80 times/min before but now increased to 90 seconds;as for artificial respiration,students often extended more than 30 seconds;the electrode plate installation project operation,extended more than 25 seconds.Conclusion The pass rate of different professional training and the performance before and after professional training have differences,so theory and practice need to be combined to carry out scientific and reasonable training so as to improve the train-ing residents' clinical skills.
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Objective The purpose of our study was to assess the onset effect of bystander CPR assisted by a smart phone APP or by a dispatcher.Methods 74 volunteers,without any experience in basic life support measures,was randomly divided into three groups:no-assisted group (n=13),dispatcher-assisted group (n=34) and smart phone APP-assisted group (n=27).Under the condition of a simulative SCA,a QCPR mannequin was used to record the hands-off time,hand placement,rate,depth and complete chest recoil after each compression of the three different groups to make analysis.The no-assisted group didn't receive any CPR instruction;the dispatcher-assisted group was instructed to do CPR through the voice from the telephone;the smartphone APP-assisted group was instructed by a preset Android smart phone CPR APP which guided the volunteers to do CPR step by step by words,voice and animations.Rank sum test analysis of each group using SPSS19.0 software.Results In aspects of hands-off time (1.0 second vs.1.5 seconds vs.5.0 seconds),mean rate of compression (121.0 per minute vs.127.5 per minute vs.58.0 per minute),percentage of correct compression rate (99.0％ vs.98.0％ vs.0.0％) and mean depth of compression (33.0 cm vs.26.5 cm vs.16.0 cm),smart phone APP-assisted group performed as well as dispatcher-assisted group (P＞0.05) and was superior to no-assisted group (P＜0.05).Conclusion In terms of increasing the quality of CPR,the smart phone APP can play the same role as dispatcher's telephone guidance,so as to enhance the effect of cardiopulmonary resuscitation.
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PURPOSE: The objective of this study was to evaluate the effects of infant-child CPR education on CPR knowledge, attitude, and self-efficacy of early childhood education students. METHODS: The subjects were 18 early childhood education students. Infant-child CPR education with theory and practice was composed of a 1:9 instructor-to-student ratio during a period of 3 hours. CPR knowledge, attitude, and self-efficacy were measured, along with CPR performance on the effect of education. The data were acquired from October 19 to November 2 in 2013. RESULTS: Significant improvement was observed for CPR knowledge (z=-3.63, p<.001), attitude (z=-3.42, p=.001), and self-efficacy (z=-3.25, p=.001). All of the subjects passed the performance test for infant-child CPR. CONCLUSION: Implemented infant-child CPR education is helpful in improving CPR knowledge, attitude, and self-efficacy.
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Humans , Cardiopulmonary Resuscitation , EducationABSTRACT
PURPOSE: The 2010 guidelines for cardiopulmonary resuscitation recommend a ventilation rate of 8 to 10/min for patients with an advanced airway; however, hyperventilation occurs in most cases. This study was conducted as an attempt to determine the effects of feedback under audio tone guidance on performance of positive-pressure ventilation using a bag-valve device and to apply this technique in clinical practice in order to reduce hyperventilation. METHODS: A total of 36 seniors at our medical school participated in the study. After receiving instruction in performance of positive-pressure ventilation using a bag-valve device, they performed ventilation using a cardiac arrest model with an advanced airway (Test 1). After they took Test 1 without any feedback, they were randomly assigned to the feedback group (Group A) and the control group (Group B) and took Test 2. In Group A, a high-pitched sound was delivered every 7 s for guidance of ventilation. RESULTS: In Group A, ventilation rate approximated feedback rate, whereas, in Group B, it showed a significant decrease, from 8.3+/-2.0 to 7.7+/-2.0/min (p<0.01). The mean ventilation volume did not differ between pre- and post-feedback. The mean inspiration time showed a decrease in both groups. However, no significant difference in mean inspiration time was observed between the two groups. CONCLUSION: Audio tone guidance can control the ventilation rate accurately without any significant change in ventilation volume and inspiration time.
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Humans , Cardiopulmonary Resuscitation , Heart Arrest , Hyperventilation , Positive-Pressure Respiration , Schools, Medical , VentilationABSTRACT
BACKGROUND: Basic life support (BLS), a key component of the chain of survival decreases the arrest – cardiopulmonary resuscitation interval and increases the rate of hospital discharge. The study aimed to explore the knowledge of and attitude towards basic life support (BLS) among medical/paramedical professionals.METHODS: An observational study was conducted by assessing response to self prepared questionnaire consisting of the demographic information of the medical/paramedical staff, their personnel experience/attitude and knowledge of BLS based on the 2005 BLS Guidelines of European Resuscitation Council.RESULTS: After excluding incomplete questionnaires, the data from 121 responders (27 clinical faculty members, 21 dental and basic sciences faculty members, 29 house officers and 44 nurses and health assistants) were analyzed. Only 9 (7.4％) of the 121 responders answered ≥11, 53 (43％) answered 7-10, and 58 (48％) answered <7 of 15 questions correctly. The clinical faculty members, house officers and nurses/HA had a mean score of 7.4±3.15, 7.37±2.02 and 6.63±2.16 respectively, while dental/basic sciences faculty members attained a least mean score of 4.52 ±2.13 (P<0.001). Those who had received cardiopulmonary resuscitation (CPR) training within 5 years obtained a highest mean score of 8.62±2.49, whereas those who had the training more than 5 years back or no training obtained a mean score of 5.54±2.38 and 6.1±2.29 respectively (P=0.001). Those who were involved in resuscitation frequently had a higher median score of 8 in comparison to those who were seldom involved or not involved at all (P<0.001).CONCLUSIONS: The average health personnel in our hospital lack adequate knowledge in CPR/BLS. Training and experience can enhance knowledge of CPR of these personnel. Thus standard of CPR/BLS training and assessment are recommended at our hospital.
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Objective To explore the relation between the level of oxygen pressure and lactate in arterial blood and prognosis of cardiopulmonary resuscitation (CPR).Methods 36 patients with sudden cardiac arrest received CPR were selected.Patients were divided into 3 groups.The 21 patients who 30 minutes of CPR didn't regain heart beats were group A,those 10 who kept blood circulation for over 2 hours but finally died were group B,and the remaining 5 who survived were group C.Control group was made up of 20 people with no disease.In CPR immediately (0h),1h,3h,6h,12h were measured in blood specimens from arterial partial pressure of oxygen and lactate levels were compared among groups of patients dynamic changes of the index.Results The 3 groups A,B,C significantly reduced blood oxygen pressure,blood lactate increased significantly the CPR in the early,and compared with the control group there was significant difference( P ＜ 0.01 ).The group B CPR 3h,6h,and continue until no significant changes in 12h;The group C CPR 3h,6h began to increase blood oxygen pressure and blood lactate levels begin to decline,blood oxygen pressure increased significantly,lower blood lactate to a lower level after 12h.Taken with marked changes in B group,the difference was significant ( P ＜ 0.05 ).Conclusion Arterial partial pressure of oxygen and blood lactate levels could be used as indicators of prognosis of patients with CPR.Sustained increase in arterial oxygen partial pressure showed a good prognosis,lactate levels continued to rise that a poor prognosis.
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OBJECTIVES: The purpose of this study is to compare educational effects between traditional classroom instruction and video self-instruction (VSI) for cardiopulmonary resuscitation (CPR) in boy's high school students. METHODS: This study was carried out targeting totally 96 boy students(47 people for experimental group, 49 people for control group) in the second grade of high school where is located in G city of G province from July 9-10, 2009. The experimental group and control group were arbitrarily selected two classes in the second grade. One class was assigned to the experimental group. another class was assigned to the control group. The experimental group was educated with VSI for CPR. The control group was educated with traditional classroom instructions for CPR. The analysis was performed with SPSS WIN (version 12.0) program using frequency chi-square(chi2) test, independent samples t-test, and paired t-test. RESULTS: After instructions, the knowledge, attitude, self-confidence, and skill performance accuracy scores on CPR increased statistically in both group. The increases of self-confidence (2.40 +/- 0.73) and skill performance accuracy score (2.67 +/- 0.29) in the experiment group were significantly higher than those (2.01 +/- 0.96 and 2.54 +/- 0.31) in the control group, respectively. CONCLUSION: This study suggested that VSI was more effective than traditional classroom education for self-confidence and skill-performance accuracy in CPR. To confirm it, more studies are warranted.
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Humans , Cardiopulmonary ResuscitationABSTRACT
Objective To explore the effects of intraventricular administration of insulin on the expressions of Bcl-2,Bax mRNA and neuronal hippocampus apoptosis in rats after cardiopulmonary resuscitation (CPR).Methods This experiment was implemented in the animal Laboratory center of Xuanwu Hospital of Capital Medical University.Thirty male SD rats were randomly (random number)divided into three groups:control group (n=6),CPR group (n=12),insulin treated group ( n =12).CPR was performed at 6 minutes after ventricular fibrillation induced by transesophageal overdrive pacing.Resuscitation procedures lasted until restoration of spontaneous circulation (ROSC).ROSC was defined as the recovery of the supraventricular heart rates and the increase of mean arterial pressure (MAP) ＞ 60mmHg for more than 10 minutes.Ten minutes after ROSC in rats,12.5 μL ( 1 U) regular insulin was injected into the left ventricle in the insulin group,and 12.5 μL isotonic saline was injected the control and CPR groups at least 10 minutes.Real-time PCR was used to observe the expressions of Bcl-2,Bax mRNA in hippocampus CAI after reperfusion 24 h and 72 h.TUNEL staining was used to observe the neuronal apoptosis in all groups after reperfusion 7 days.Blood glucose was monitored in rats before and after CPR.Results ① The Bcl-2mRNA in insulin groups were significantly higher than those in the CPR group after 24 h and 72 h (P ＜0.01 ).The expression of Bcl-2 mRNA in 24 h insulin group were significantly higher than those in 72 h insulin group ( P ＜ 0.01 ) ; There were no significantly different in the Bax mRNA between insulin groups and the CPR and the control group after 24 h and 72 h ( P ＞ 0.05 ) ; ②After CPR 7 d,the apoptotic neurons of hippocampal CA1 area in the CPR group ( 124.75 ± 17.35 ) were significantly higher than those in the control group (5.12 ± 3.26) ( P ＜ 0.01 ) and the insulin group (92.79 ± 7.35 )(P ＜0.01 ); the apoptotic neurons in the insulin group were higher than those in the control group (P ＜0.0l ),and the differences were statistically significant.③There were no significant difference in venous blood glucose in the CPR and insulin groups (P ＞ 0.05).Conclusions Insulin may regulate Bcl-2mRNA expression in hippocampus,inhibit neuronal apoptosis and protect neurons after CPR in rats.
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Justificativa e objetivos: O Serviço de Atendimento Médico de Urgência de Belo Horizonte (SAMUBH), implantado em 2003, possui equipe preparada e ambulâncias equipadas para atendimento pré-hospitalar. Dentre os atendimentos, a parada cardiorrespiratória (PCR) é a ocorrência mais grave. O objetivo deste estudo foi analisar os casos de PCR pré-hospitalar em BH. Método: Estudo epidemiológico, descritivo e retrospectivo. Foram avaliadas as fichas de atendimento de pessoas que tiveram PCR atendidas pelo SAMU/BH em 2005. Utilizou-se instrumento com variáveis baseadas no estilo Utstein para a coleta de dados. Tratamento estatístico descritivo e de associação dos dados foi realizado. Resultados: No período foram atendidas 5.058 ocorrências, sendo 1.548 (30,2%) casos de PCR (68,8% masculinos), idade 0 a 106 anos, com predomínio de causas clínicas (62,2%). No município de BH, o tempo médio para atendimento (tempo-resposta) foi de 10,3 minutos e, em cidades da região metropolitana, de 18 minutos. Em 1.197 (77,3%) atendimentos a equipe apenas constatou o óbito. Manobras de RCP foram realizadas em 351 (22,7%) pessoas, e, 117 (33,3%) destas apresentavam fibrilação ventricular ou taquicardia ventricular sem pulso na avaliação inicial da equipe de atendimento. Sobrevida imediata ocorreu em 83 (23,6%) pessoas, sendo encaminhadas para diversos hospitais. Entre os fatores que influenciaram a sobrevida imediata pós-RCP destacam-se: tempo-resposta da ambulância, "PCR presenciada pela equipe" e ritmo cardíaco. Porém, na regressão logística, somente as duas últimas variáveis foram significativas. Conclusão: Os resultados mostram que o SAMU tem um papel significativo e de impacto positivo no atendimento a vítimas de PCR na comunidade.
Background and objectives: The Mobile Emergency Service of Belo Horizonte (SAMU/BH), initiated in 2003, has trained staff members and ambulances equipped for out-of-hospital (OH) healthcare, and cardiac arrest (CA) is the most stressful event faced. The aim of the study was to analyze out-of-hospital CA cases attended by the SAMU-BH. Method: Retrospective, descriptive and epidemiological study. All OH-CA patients' charts attended by the SAMU-BH in 2005 were reviewed, and data were collected by using an instrument elaborated in Utstein style. Descriptive and associations statistical analysis were performed to treat data. Results: During the period 5,058 patients were attended with 1,548 (30.2%) cases of OH-CA (68.8% males), age 0-106 years, and clinical causes were prevalent (62.2%). The ambulance time-response in BH city was of 10.3 minutes, and of 18 minutes in the great metropolitan area. The majority of patients (1,197; 77.3%) were already dead when the ALS team arrived. CPR-maneuvers were performed in 351 (22.7%) patients and 117 (33.3%) of them have shown ventricular fibrillation or pulseless ventricular tachycardia at the initial evaluation by the ALS team. Immediate recovery was obtained in 83 (23.6%) patients, and they were taken to a hospital. Ambulance time-response, witnessed CA-CPR by ALS team and initial cardiac rhythm were the main factors influencing the immediate CPR survival. Logistic regression, however, indicated only the last two variables as significant factors in short-term survival. Conclusion: Our results highlighted the importance of SAMU for increasing CPR survival in out-of-hospital cardiac arrest.
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Emergency Medical Services , Heart Arrest/epidemiologyABSTRACT
[Objective] To explore the variety of matrix metalloproteinase 9 (MMP9) and blood brain barrier (BBB) in cardiopulmonary resuscitation rats.[Methods] Eighty rats were randomly divided into 2 groups:the sham-operated group (n ＝ 40) and the resuscitation group (n ＝ 40).The two groups were anaesthetized and endotracheally intubated,the resuscitation group was also induced to cardiac arrest by aphysia.Then the rats were put to death and samples were taken at immediate,3 h,9 h,24 h,and 48 h.After that,the expression of MMP9,MMP9 mRNA,water content and Evans blue content in brain tissue were detected.Ultramicrostructure of brain tissue was observed with electron microscope.[Results] Compared to the sham-operated group,at 3 h,9 h,24 h and 48 h,the expression of MMP9 of resuscitation group was significantly changed.MMP9mRNA significantly increased.Water content statistically increased and so was Evans blue content.The change of ultramicrostructure in the resuscitation group at 3 h,9 h,24 h,and 48 h was obvious.[Conclusion] The expression of MMP9 and MMP9mRNA obviously increased in the cerebral ischemia model with CPR rats,and got to peak at 24 h.Water content and Evans blue content in brain tissue obviously increased in the cerebral ischemia model with CPR rats,BBB was destroyed,and the peak was 24 h.The injury of ultramicrostructure of brain tissue with electron microscope was obvious,and the peak was 24 h.
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PURPOSE: This study was designed to provide a systematic understanding of nursing students' knowledge, attitude and ability to perform cardiopulmonary resuscitation (CPR). Fundamental data regarding CPR education was processed in order to analyze factors influencing knowledge, attitude and ability. METHODS: A total of 663 nursing students from G city and South Jeolla Province participated in this study during March and April 2009. Questionnaires were used to gather the data. Descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients with SPSS WIN 12.0 were used for data analysis. RESULTS: The mean score for knowledge regarding CPR was 7.84 of a total possible score of 15, for attitude, 39.90 of a total possible score of 55 and for performance ability, 40.17 of a total possible score of 75. There was a positive correlation between CPR knowledge, attitude and performance ability. As knowledge increased so did attitude and performance ability. CONCLUSION: In order to develop positive attitudes in nursing students toward the performance of CPR, we need to strengthen education related to CPR and create effective education programs which are focused particularly on practical training for the students.
Subject(s)
Humans , Cardiopulmonary Resuscitation , Surveys and Questionnaires , Statistics as Topic , Students, NursingABSTRACT
Objective To evaluate the role of standard CPR training in Beijing Olympics medical volunteers by compared with the no-traimng medical personnel.Method Performance qualities of CPR was evaluated in the 44 medical vohmteers,who worked in a Beijing Olympic Venue.They received the training On standard CPR for 6 monthes,and served as training group.The performance of another 72 emergency medical workers from first-class hospitals without the training on stand CPR within 1 year(control group) Was compared with training group.Phillips QCPR3535 monitor was used to measure the compression frequency,depth and chest re-expand between the compression and the operation time via the sternal chest compression pad fitted with an accelerometer.Personal practical results of 5 circles of CPR operation were recorded in a table and the numbers ofpractical. Compression in one minute were counted.Data Were analyzed with chi-quare test and t-test.The parameters ofthe influence fac.tor(gender,age,hand placement,hand skill,compression posture and standard training)were brought into logistic regression analysis.Results Compared with the control group,the qualification rate of general CPR performance in the training group was much higher(86.4%vs.31.9%),and the compression cpmlification rates of the chestcompression,depth and chest re-palld betweenthe compression wcfe higher(88.6%,93.2%,95.5% vs.40.3%,43.0%,86.1%,P<0.01),the duration of ventilation in each operationstion was shorter[(6.38±1.3)vs.(7.57±1.6),P<O.01],but the total performance durations Wel'e not significant different[(118.4±18.5)s vs.(116.0 4-5.4)s,P>0.05],pratieal compressionn flberin oneminutewas not different[(77.2±3.5)vs.(77.8±12.2),P>0.05)],the ratios of the duration of compression to that of ventilation was higher(2.6:1 vs.2.1:1).Logistic analysis showed that hand skill,compression posture and standard CPR trainings were high correlated with the CPR performance qualities(P<0.05).Conclusions The performance quahty of training group is much higher thanthat ofcontrol group.The standard and continuous CPR training is elfecfive in improving the quality of CPR operation.