Résumé
Objective: To develop decision-support tools to identify patients experiencing sudden cardiac arrest [SCA]
Methods: Eighty calls related to SCA were content analyzed, and the contextual patterns that emerged were organized into a checklist. Two researchers independently analyzed the recorded calls and compared their findings. Eighteen dispatchers scored 20 cases [which included SCA and non-SCA cases] both with and without the checklist. Correct responses for each case and agreement among dispatchers have been reported
Results: Eighty audio files [total time, 96 min] were analyzed, and a total of 602 codes were extracted from the text and recordings. The caller's tone of voice and presence or absence of background voices, calling for an ambulance and giving the dispatcher the address promptly, and description of the primary complaint and respirations accounted for 38%, 39%, and 23% of all codes, respectively. A 15-item complementary checklist has been developed. The mean percentages of correct responses were 66.9% +/- 27.96% prior to the use of checklist and 80.05%+10.84% afterwards. Results of the independent t test for checklist scores showed that statistically significant differences were present between the SCA and non-SCA cases [t=5.88, df=18, p=0.000]
Conclusion: Decision support tools can potentially increase the recognition rate of SCA cases, and therefore produce a higher rate of dispatcher-directed CPR
Résumé
Neonatal resuscitation training is mandatory for the staff providing maternity and neonatal services in order to ensure competence during the academic period. This study was conducted to assess the neonatal resuscitation skills of nursing and midwifery students. In this study, the skills of 48 nursing and midwifery students were assessed, using Objective Structured Clinical Examination [OSCE], which consists of seven "stations", lasting 28 minutes. In station 1, students' knowledge was assessed. In stations 2-7, students' skills in the initial steps of resuscitation, positive pressure ventilation, intubation, chest compression, medication prescription and management of cardiopulmonary resuscitation were assessed. Time management and students' re-evaluation of the infant were also assessed. The total score of OSCE was calculated to be 236. Also, students' self-evaluation regarding their competence in neonatal resuscitation and their satisfaction with OSCE were evaluated, using two self-structured questionnaires. The mean score of students' skills in neonatal resuscitation was 97.85 +/- 23.15 out of 236. On average, students obtained 38%, 49%, 20% and 72% of the total score in the initial steps of resuscitation, positive pressure ventilation, intubation and chest compression, respectively. Also, the students obtained 45%, 29% and 56% of the total score in prescribing medications [drug dosage and route of administration], management skills in advanced resuscitation and knowledge on neonatal resuscitation, respectively. Students' self-confidence was lower than half of the optimal score, and their satisfaction with OSCE was high. The students' skills in neonatal resuscitation were lower than expected. As competence in this area is of high significance for the improvement of neonatal outcomes, holding training workshops through applying novel training methods is recommended
Résumé
Introduction and Aims: the main cause of death in the adult population in the industrialized world is sudden cardiac arrest. The first purpose of cardiopulmonary resuscitation is return of spontaneous circulation. Post cardiopulmonary resuscitation cares are fifth stage of American Heart Association cardiopulmonary resuscitation that less take into consideration. Therefore, the present study was conducted with the aim of "24 Hour Survival Rate and it's determinants in patients with Successful Cardiopulmonary Resuscitation in Ghaem Hospital of Mashhad"
Materials and Methods: in this descriptive and analytical study, 80 cases of CPR were selected by convenience sampling in Ghaem hospital of Mashhad. After confirming of cardiac arrest by a resident physician in the wards and declaration of code 99, was performed cardiopulmonary resuscitation by CPR team. Rate of 24 hour survival was determined in patients that had return of spontaneous circulation by form the researcher's observations. Data were collected and analyzed using of descriptive statistics [frequency, mean, standard deviation] and inferential statistics [Fishers, Chi-square, logistic regression] and SPSS software version of 16
Results: mean and standard deviation of age patients was 67.3+/-1.5 year. In 45 patients [56.2%], was achieved return of spontaneous circulation. The rate of 24 hour survival was in 30 patients that cardiopulmonary resuscitation on them was successful. The chi-square test, showed that is significant differences between 24 hour survival with sex and diabetes in patients [P<0.05]. The Fisher's test, showed that there is significant differences between 24 hour survival and history of cardiopulmonary resuscitation [P<0.04]
Conclusion: the rate of 24 hour survival was 66.7% in patients with a successful cardiopulmonary resuscitation. This reflects that must be considered after cardiopulmonary resuscitation cares
Résumé
Background and Purpose: Arterial blood gases measurement are the most frequently performed blood test in ICU. Sodium Heparin, which is vastly used as an anticoagulant in analyzing blood gases, Causes different densities of heparin in blood samples which in turn changes the test results when samples are of various volumes. Therefore, this study was conducted to determine the effect of heparin density on the arterial blood gases
Mathods and Materials: This experimental study was doue on 30 arterial blood samples with three groups of 7.5%, 15% and 30% volume of heparin to blood sample [heparinized with 1cc=5000 u] and a control group [120 samples] heparinized with 1cc=1000 u
Results: No significant change was found in the changes by ABG parameters to the density of 75 ou per 1cc of blood but it was significant in the density of 1500 unit per 1cc of blood in most measured parameters
Conclusion: According to the findings, it is suggested that, in order to reduce the error, in sampling the arterial blood gases the amount of the blood drawn into syringes after heparinizing must be more than 10 times the amount of residual heparin in syringes. In other words, if heparin amounts to 75-375u in 1cc of blood, the density of heparin will not affect the results of arterial blood gases