ABSTRACT
BACKGROUND: The emergence of an unprecedented novel severe acute respiratory syndrome coronavirus-2 (SARS-C0V-2), which causes the coronavirus disease 2019 (COVID-19) pandemic, has created new scenarios in basic life support (BLS) management. According to current evidence, SARS-CoV-2 can be transmitted airborne in aerosol particles during resuscitation. Research evidence found an alarming global increase in out-of-hospital cardiac arrests during the COVID-19 pandemic. Healthcare providers are legally obliged to respond to cardiac arrest as soon as possible. Chiropractors will likely encounter potential exercise-related and non-exercise-related cardiac emergencies at some point in their professional lives. They have a duty of care to respond to emergencies such as cardiac arrest. Chiropractors are increasingly involved in providing care, including emergency care, for athletes and spectators at sporting events. Also, exercise-related cardiac arrest in adult patients may occur during exercise testing or rehabilitation with exercise prescriptions in chiropractic and other healthcare settings. Little is known about the COVID-19 BLS guidelines for chiropractors. Knowledge of the current COVID-19-specific adult BLS guidelines is essential to developing an emergency response plan for the on-field and sideline management of exercise-related cardiac arrest and non-athletic, non-exercise-related cardiac arrest. MAIN TEXT: Seven peer-reviewed articles on the COVID-19-specific BLS guidelines, including two updates, were reviewed for this commentary. Responding to the COVID-19 pandemic, the national and international resuscitation organizations recommended interim COVID-19-specific BLS guidelines with precaution, resuscitation, and education strategies. BLS safety is paramount. A precautionary approach with the bare minimum of appropriate personal protective equipment for resuscitation is recommended. There was disagreement among the COVID-19 BLS guidelines on the level of personal protective equipment. All healthcare professionals should also undergo self-directed BLS e-learning and virtual skill e-training. The summarized COVID-19-specific adult BLS guideline strategies and protocols are tabled, respectively. CONCLUSIONS: This commentary provides a practical overview and highlights current evidence-based intervention strategies of the COVID-19-specific adult BLS guidelines that may help chiropractors and other healthcare providers reduce BLS-related exposures to SARS-CoV-2 and the risks of SARS-CoV-2 transmission and maximize the efficacy of resuscitation. This study is relevant to and impacts future COVID-19-related research in areas such as infection prevention and control.
Subject(s)
COVID-19 , Chiropractic , Heart Arrest , Adult , Humans , Emergencies , Health Personnel , Pandemics/prevention & control , SARS-CoV-2ABSTRACT
Background Members of dental fraternity have a duty of care to provide safe services to the patients. The satisfactory performance in a medical emergency in dental practice has wide-range implications. But, in the current scenario, the challenge is to ensure that patients with or without coronavirus disease 2019 (COVID-19), who undergo any medical emergency, get the best possible chance of survival without compromising the safety of rescuers, who will be needed to take care for future patients.Aim This article assesses the awareness and knowledge on interim guidelines for Basic Life Support in adults with suspected or confirmed COVID-19 among various dental health care professionals.Materials and Methods An online questionnaire-based survey was conducted;framed in Google Forms and sent to various dental health care professionals through WhatsApp, email, and other means. Results were then analyzed and are presented in the form of frequency and percentage.Results In the study, 224 responders were included comprising undergraduates, postgraduates, and dental practitioners. Dismally, none of them had complete knowledge on the interim guidance for Basic Life Support for suspected or confirmed COVID-19 patients.Conclusion The study suggests that updated interim guidelines were unknown to maximum percentage of dental professionals which implies that there is need to keep ourselves up-to-date to provide safe services.
ABSTRACT
Objective: Basic life support (BLS) training aimed at building knowledge and skills in cardiopulmonary resuscitation. During training, there is the possibility of airborne COVID-19 transmission. The aim was to evaluate students' knowledge, skills, and course satisfaction following contact-restricted BLS training under the contact restriction policy. Methods: From July 2020 to January 2021, a prospective, descriptive study was conducted among fifth-year dental students. Contact-restricted BLS training consisted of online learning, online pre-testing, non-contact training with automated real-time feedback manikins, and remote monitoring. The participants' skills, knowledge through online testing, and course satisfaction were all evaluated after training. At three months and six months after training, their knowledge was re-evaluated through online testing. Results: Fifty-five participants were included in this study. Their mean (SD) knowledge scores after training, at three and six months, were 81.5 (10.8)%, 71.1 (16.4)%, and 65.8 (14.5)%, respectively. The percentage of participants, who passed the skills test on their first, second, and third attempts had been 83.6%, 94.5%, and 100%, respectively. The mean (SD) satisfaction score with the course was 4.87 (0.34) on a five-point Likert score. After training, no participants had COVID-19 infection. Conclusion: Training in contact-restricted BLS had produced acceptable knowledge, skills, and satisfaction results. Knowledge tests, competence tests, and course satisfaction were comparable to conventional pre-pandemic trainings with similar participants. Due to the significant dangers of aerosol disease transmission, it became a viable training alternative. Trial Registration: TCTR20210503001 (Thai Clinical Trials Registry).
ABSTRACT
BACKGROUND: Conventional cardiopulmonary resuscitation (CPR) training for the general public involves the use of a manikin and a training video, which has limitations related to a lack of realism and immersion. To overcome these limitations, virtual reality and extended reality technologies are being used in the field of medical education. The aim of this study is to explore the efficacy and safety of extended reality (XR)-based basic life support (BLS) training. METHODS: This study is a prospective, multinational, multicentre, randomised controlled study. Four institutions in 4 countries will participate in the study. A total of 154 participants will be randomly assigned to either the XR group or the conventional group stratified by institution and sex (1:1 ratio). Each participant who is allocated to either group will be sent to a separate room to receive training with an XR BLS module or conventional CPR training video. All participants will perform a test on a CPR manikin after the training. The primary outcome will be mean compression depth. The secondary outcome will be overall BLS performance, including compression rate, correct hand position, compression, and full release and hands-off time. DISCUSSION: Using virtual reality (VR) to establish a virtual educational environment can give trainees a sense of realism. In the XR environment, which combines the virtual world with the real world, trainees can more effectively learn various skills. This trial will provide evidence of the usefulness of XR in CPR education. TRIAL REGISTRATION: ClinicalTrials.gov NCT04736888. Registered on 29 January 2021.
Subject(s)
Research Design , Humans , Multicenter Studies as Topic , Prospective Studies , Randomized Controlled Trials as TopicABSTRACT
AIM OF THE STUDY: Community cardiopulmonary resuscitation (CPR) education is important for laypersons. However, during the COVID-19 pandemic, with social distancing, conventional face-to-face CPR training was unavailable. We developed a distance learning CPR training course (HEROS-Remote) using a smartphone application that monitors real-time chest compression quality and a home delivery collection system for mannikins. This study aimed to evaluate the efficacy of the HEROS-Remote course by comparing chest compression quality with that of conventional CPR training. METHODS: We applied layperson CPR education with HEROS-Remote and conventional education in Seoul during the COVID-19 pandemic. Both groups underwent a 2-min post-training chest compression test, and we tested non-inferiority. Chest compression depth, rate, complete recoil, and composite chest compression score was measured. Trainees completed a satisfaction survey on CPR education and delivery. The primary outcome was the mean chest compression depth. RESULTS: A total of 180 trainees were enrolled, with 90 assigned to each training group. Chest compression depth of HEROS-Remote training showed non-inferiority to that of conventional training (67.4 vs. 67.8, p = 0.78), as well as composite chest compression score (92.7 vs. 95.5, p = 0.16). The proportions of adequate chest compression depth, chest compression rate, and chest compressions with complete chest recoil were similar in both training sessions. In the HEROS-Remote training, 90% of the trainees were satisfied with CPR training, and 96% were satisfied with the delivery and found it convenient. CONCLUSION: HEROS-Remote training was non-inferior to conventional CPR training in terms of chest compression quality. Distance learning CPR training using a smartphone application and mannikin delivery had high user satisfaction and was logistically feasible.
Subject(s)
COVID-19 , Cardiopulmonary Resuscitation , Mobile Applications , Humans , Cardiopulmonary Resuscitation/education , Smartphone , Pandemics , ManikinsABSTRACT
This study aimed to investigate the usefulness of cerebral regional oxygen saturation (rSO2) during the initial 5 and 10 minutes of cardiopulmonary resuscitation (CPR) compared with an initial rSO2 and mean rSO2 during entire CPR to predict the futility of resuscitation for patients without of-hospital-cardiac arrest (OHCA). This was a prospective study involving 52 adult patients presenting in OHCA and whose cerebral rSO2 values were measured until either CPR was terminated or sustained return of spontaneous circulation (ROSC) was achieved. Receiver operating characteristics analyses were used to evaluate which time and type of measurement is better to predict non-ROSC. The area under the curve (AUC) of each rSO2 value according to measurement time (overall, initial 5 minutes and 10 minutes) were the highest value of 0.743, 0.724, and 0.739, mean values of 0.724, 0.677 and 0.701 and rSO2 (Changes in values of regional cerebral oxygen) value of 0.722, 0.734 and 0.724, respectively, while all of the initial values had a poor AUC (<0.7) and also were not statistically significant. The optimal cut-off value of each rSO2 values during overall, initial 5 minutes and 10 minutes were the highest value of 26% (sensitivity, 53.9% specificity, 92.3%), 24% (sensitivity, 56.4% specificity, 92.3%), and 30% (sensitivity, 61.5% specificity, 84.6%), mean value of 15.2%, 15.3% and 16%, respectively. None of the patients with a persistent rSO2 <=18% during the overall period achieved ROSC. Initial 5 minutes and 10 minutes cerebral rSO2 values an out-of-hospital-cardiac arrest (OHCA) are a better predictor in deciding the futility of CPR, compared to initial and overall measurements.Copyright © 2023 The Author(s). Published by MRE Press.
ABSTRACT
Introduction: To address the risks of transmission by COVID-19, various recommendations been released by medical societies, which include strongly advocating for the use of personal protective equipment. In addition, hands-only cardiopulmonary resuscitation (CPR) has also been promoted among cardiac arrest victims. Some studies which evaluated healthcare practitioners' attitudes towards CPR during the pandemic showed negative attitudes in responding to those who have unknown COVID-19 status citing safety as the primary reason. At present, there is no study which evaluates the attitudes of medical students towards Basic Life Support (BLS) during the pandemic. Purpose(s): The study aimed to determine the factors associated with willingness of medical students to perform basic life support in out-of-hospital cardiac arrest during the COVID-19 pandemic. Method(s): This is a cross-sectional study using online surveys. We performed face validation and pilot study on 39 medical students. The main survey was disseminated in Metro Manila schools wherein 349 medical students participated. Questions included demographic data, prior BLS training, and vaccination status, evaluated knowledge of CPR, and determined their attitudes on CPR during the pandemic. Result(s): Results showed that 338 (97%) were willing to do CPR during the pandemic. Majority are fully vaccinated (99%) and are BLS-trained (75%). The median total knowledge score was 7 out of 10. Of all participants, 37 (11%) had a perfect score. Most (79%) had a passing mark. Majority (61%) claimed that a victim's vaccination status does not play a role in deciding to perform CPR. Among the unwilling, 55% factored in a victim's vaccination status. Most who agreed to perform CPR will do so if they are provided with adequate protection (55%). Simple and multiple logistic regression analyses showed that students who will do CPR on a patient who is not fully vaccinated or has unknown vaccination status have about 5 times higher odds of having the will to perform BLS during the pandemic. It also found that there is no correlation between knowledge, vaccination status, and prior training with choosing to perform BLS during the pandemic. This means that if a student is willing to do CPR on a victim wherein chances of contracting COVID-19 infection are higher, then their likelihood of performing BLS regardless of victim status, during the pandemic is five times more likely. Conclusion(s): Most Filipino medical students are willing to perform BLS during the pandemic and in spite of risks of COVID-19 transmission. Their adequate knowledge, full vaccination status, or prior training did not influence their decision. In a pandemic situation, the students' willingness to perform CPR among those with unknown COVID-19 status influences their decision to perform BLS in general.
ABSTRACT
BACKGROUND: Basic life support (BLS) education is essential for improving bystander cardiopulmonary resuscitation (CPR) rates, but the imparting of such education faces obstacles during the outbreak of emerging infectious diseases, such as COVID-19. When face-to-face teaching is limited, distance learning-blended learning (BL) or an online-only model-is encouraged. However, evidence regarding the effect of online-only CPR training is scarce, and comparative studies on classroom-based BL (CBL) are lacking. While other strategies have recommended self-directed learning and deliberate practice to enhance CPR education, no previous studies have incorporated all of these instructional methods into a BLS course. OBJECTIVE: This study aimed to demonstrate a novel BLS training model-remote practice BL (RBL)-and compare its educational outcomes with those of the conventional CBL model. METHODS: A static-group comparison study was conducted. It included RBL and CBL courses that shared the same paradigm, comprising online lectures, a deliberate practice session with Little Anne quality CPR (QCPR) manikin feedback, and a final assessment session. In the main intervention, the RBL group was required to perform distant self-directed deliberate practice and complete the final assessment via an online video conference. Manikin-rated CPR scores were measured as the primary outcome; the number of retakes of the final examination was the secondary outcome. RESULTS: A total of 52 and 104 participants from the RBL and CBL groups, respectively, were eligible for data analysis. A comparison of the 2 groups revealed that there were more women in the RBL group than the CBL group (36/52, 69.2% vs 51/104, 49%, respectively; P=.02). After adjustment, there were no significant differences in scores for QCPR release (96.9 vs 96.4, respectively; P=.61), QCPR depth (99.2 vs 99.5, respectively; P=.27), or QCPR rate (94.9 vs 95.5, respectively; P=.83). The RBL group spent more days practicing before the final assessment (12.4 vs 8.9 days, respectively; P<.001) and also had a higher number of retakes (1.4 vs 1.1 times, respectively; P<.001). CONCLUSIONS: We developed a remote practice BL-based method for online-only distant BLS CPR training. In terms of CPR performance, using remote self-directed deliberate practice was not inferior to the conventional classroom-based instructor-led method, although it tended to take more time to achieve the same effect. TRIAL REGISTRATION: Not applicable.
Subject(s)
COVID-19 , Cardiopulmonary Resuscitation , Humans , Female , Cardiopulmonary Resuscitation/education , Educational Measurement/methods , Learning , Feedback , ManikinsABSTRACT
Introduction:The use of personal protective equipment (PPE) in prehospital emergency care has significantly increased since the onset of the coronavirus disease 2019 (COVID-19) pandemic. Several studies investigating the potential effects of PPE use by Emergency Medical Service providers on the quality of chest compressions during resuscitation have been inconclusive.Study Objectives:This study aimed to determine whether the use of PPE affects the quality of chest compressions or influences select physiological biomarkers that are associated with stress.Methods:This was a prospective randomized, quasi-experimental crossover study with 35 Emergency Medical Service providers who performed 20 minutes of chest compressions on a manikin. Two iterations were completed in a randomized order: (1) without PPE and (2) with PPE consisting of Tyvek, goggles, KN95 mask, and nitrile gloves. The rate and depth of chest compressions were measured. Salivary cortisol, lactate, end-tidal carbon dioxide (EtCO2), and body temperature were measured before and after each set of chest compressions.Results:There were no differences in the quality of chest compressions (rate and depth) between the two groups (P >.05). After performing chest compressions, the group with PPE did not have elevated levels of cortisol, lactate, or EtCO2 when compared to the group without PPE, but did have a higher body temperature (P <.001).Conclusion:The use of PPE during resuscitation did not lower the quality of chest compressions, nor did it lead to higher stress-associated biomarker levels, with the exception of body temperature.
ABSTRACT
Introduction:The use of personal protective equipment (PPE) in prehospital emergency care has significantly increased since the onset of the coronavirus disease 2019 (COVID-19) pandemic. Several studies investigating the potential effects of PPE use by Emergency Medical Service providers on the quality of chest compressions during resuscitation have been inconclusive.Study Objectives:This study aimed to determine whether the use of PPE affects the quality of chest compressions or influences select physiological biomarkers that are associated with stress.Methods:This was a prospective randomized, quasi-experimental crossover study with 35 Emergency Medical Service providers who performed 20 minutes of chest compressions on a manikin. Two iterations were completed in a randomized order: (1) without PPE and (2) with PPE consisting of Tyvek, goggles, KN95 mask, and nitrile gloves. The rate and depth of chest compressions were measured. Salivary cortisol, lactate, end-tidal carbon dioxide (EtCO2), and body temperature were measured before and after each set of chest compressions.Results:There were no differences in the quality of chest compressions (rate and depth) between the two groups (P >.05). After performing chest compressions, the group with PPE did not have elevated levels of cortisol, lactate, or EtCO2 when compared to the group without PPE, but did have a higher body temperature (P <.001).Conclusion:The use of PPE during resuscitation did not lower the quality of chest compressions, nor did it lead to higher stress-associated biomarker levels, with the exception of body temperature.
ABSTRACT
Simulation is a technique where the situation or a process is imitated. This process makes one to pretend the scenario. Aviation industry is one of the oldest industry which uses simulation technique to simulate the aviation technique. The main aim of having simulation lab is to make students acquire psychomotor skills before they actually treat the patients. Presently the National Medical Council of India has made it mandatory to have a skill lab but desirable to have a simulated mannequin for the training of medical students before actually treating the patients. Various advantages and disadvantages are appreciated in simulation technique. It is not very far that Dental council of India may make compulsory training of certain simulated modules in dentistry before treating the patient. Simulation lab in the pandemic like COVID has really helped people to undergo extensive training before treating patients, especially one who were catering the COVID ward or intensive care units. The simulation in dentistry is not a very old technique, certain technique are already in practice, but this article tries to highlight the necessity and gray areas where simulation can be improved for the benefit of students to learn and for the benefit of patients in view of safety. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
ABSTRACT
Introduction: In the first wave of COVID-19 pandemic, Emergency Medical Dispatch Centers (EMDC) faced an influx of calls. During this time, with the scope of handling emergency calls more quickly, it was decided to use an Interactive Voice Server (IVS). The objective of this study was to identify whether the implementation of an IVS is efficient and safe. Method(s): From 20/03/19 until 20/04/26, an IVS was activated between 8 AM and midnight. IVS offered the caller to choose either 1-press the 'zero' key for Coronavirus Syndrome with no respiratory difficulties;or 2-stay on line for any other reason. If the caller typed 'zero', the call was directed to a 'crisis dispatcher' specially trained to handle COVID cases. If he stayed on line, his call was placed in the same queueing list as all emergency calls and handled by a "conventional dispatcher". All medical dispatch files picked up during IVS activation period were included and classified in 2 groups: "IVS Yes" if caller pressed 'zero' and "IVS No" if not. Patient's age, gender and profile of the caller (patient or third party) were collected. The level of severity of the patients was assessed upon the dispatcher' decision ranging from sending an Advanced Life Support ambulance (ALS), a Basic Life Support ambulance (BLS) or no transport. Data were compared between the 2 groups with Chi-square tests. Result(s): 2846 callers were in the group "IVS Yes" and 12111 in "IVS No". Main results are in table 1. Conclusion(s): IVS allowed almost 15% of calls to be directed to a specialized provider where they waited to be processed by staff trained within a few days to deal exclusively with COVID cases. This has led to decrease the number of calls handled by the conventional dispatch and allowed more time to respond to severe emergency calls. Moreover, because only 0.07% "IVS Yes" needed an ALS ambulance, we can assume that the use of IVS is safe. IVS is therefore an effective tool, which allows safe triage of less serious patients and frees up time to answer to severe calls.
ABSTRACT
BACKGROUND: Early recognition and call for help, fast initiation of chest compressions, and early defibrillation are key elements to improve survival after cardiac arrest but are often not achieved. We aimed to investigate what occurs during the initial treatment of unannounced in situ simulated inhospital cardiac arrests and reasons for successful or inadequate initial resuscitation efforts. METHODS: We conducted unannounced full-scale in situ simulated inhospital cardiac arrest followed by a debriefing. Simulations and debriefings were video recorded for subsequent analysis. We analyzed quantitative data on actions performed and time measurements to key actions from simulations and qualitative data from transcribed debriefings. RESULTS: We conducted 36 simulations. Time to diagnosis of cardiac arrest was 37 (27; 55) s. Time to first chest compression from diagnosis of cardiac arrest was 37 (18; 74) s, time to calling the cardiac arrest team was 144 (71; 180) s, and time to first shock was 221 (181; 301) s. We observed participants perform several actions after diagnosing the cardiac arrest and before initiating chest compressions. Domains emerging from the debriefings were teaming and resources. Teaming included the themes communication, role allocation, leadership, and shared knowledge, which all included facilitators and barriers. Resources included the themes knowledge, technical issues, and organizational resources, of which all included barriers, and knowledge also included facilitators. CONCLUSION: Using unannounced in situ simulated cardiac arrests, we found that key elements such as chest compressions, calling the cardiac arrest team, and defibrillation were delayed. Perceived barriers to resuscitation performance were leadership and teaming, whereas experience, clear leadership, and recent training were perceived as important facilitators for treatment progress.
ABSTRACT
Performing cardiopulmonary resuscitation is a key competency for healthcare professionals. Training in immediate and advanced life support is a requirement for UK doctors; this is depicted in the Foundation training programme competencies and in the Internal Medicine Training curriculum. It requires being able to identify unwell patients, perform a structured assessment and treatment approach, master relevant procedural aspects and demonstrate non-technical skills including leading the resuscitation team. The Resuscitation Council UK has recently provided updated guidance on basic and advanced life support. These guidelines align with similar international guidelines, taking into account evidence from clinical trials of cardiac arrest management and national data on cardiac arrest outcomes in the community and in the hospital. The guidance includes considerations regarding individuals with suspected or confirmed coronavirus disease (COVID-19). The complex ethical aspects around escalation of care, advance care planning, 'Do Not Attempt Cardiopulmonary Resuscitation' decisions and communication with patients and their loved ones are also discussed. This chapter summarizes the current guidance on cardiopulmonary resuscitation.
ABSTRACT
Despite a recent decrease in drowning deaths, the number of drownings in Australia remains too high. Being reminded of key considerations for a drowning emergency is helpful preparation for health professionals who may take control at the scene © 2021 Medicine Today Pty Ltd. All rights reserved.
ABSTRACT
AIM: To perform a systematic review of cardiopulmonary resuscitation (CPR) and/or defibrillation in the prone position compared to turning the patient supine prior to starting CPR and/or defibrillation. METHODS: The search included PubMed, Embase, Web of Science, Cochrane, CINAHL Plus, and medRxiv on December 9, 2020. The population included adults and children in any setting with cardiac arrest while in the prone position. The outcomes included arterial blood pressure and end-tidal capnography during CPR, time to start CPR and defibrillation, return of spontaneous circulation, survival and survival with favorable neurologic outcome to discharge, 30 days or longer. ROBINS-I was performed to assess risk of bias for observational studies. RESULTS: The systematic review identified 29 case reports (32 individual cases), two prospective observational studies, and two simulation studies. The observational studies enrolled 17 patients who were declared dead in the supine position and reported higher mean systolic blood pressure from CPR in prone position (72 mmHg vs 48 mmHg, p < 0.005; 79 ± 20 mmHg vs 55 ± 20 mmHg, p = 0.028). One simulation study reported a faster time to defibrillation in the prone position. Return of spontaneous circulation, survival to discharge or 30 days were reported in adult and paediatric case reports. Critical risk of bias limited our ability to perform pooled analyses. CONCLUSIONS: We identified a limited number of observational studies and case reports comparing prone versus supine CPR and/or defibrillation. Prone CPR may be a reasonable option if immediate supination is difficult or poses unacceptable risks to the patient.
ABSTRACT
BACKGROUND: In 2015, approximately 350,000 adults in the United States experienced nontraumatic out-of-hospital cardiac arrest and were treated by the emergency medical services (EMS) personnel. Despite recent increases, <40% of adults receive layman-initiated cardiopulmonary resuscitation (CPR), and <12% apply an automated external defibrillator before EMS personnel. AIM: To know the ability of the Medan city community in handling cardiac arrest for the first time and implementing the 2020 AHA basic life support (BLS). METHODS: This study used a descriptive method with a cross-sectional approach and was conducted in the city of Medan in the period July–October 2021. Sampling used cluster sampling and purposive sampling with inclusion and exclusion criteria. RESULTS: In this study, it was found that the majority of the people of Medan City had less knowledge about CPR in BLS. In this study, only respondents from Medan Marelan District were dominated by good knowledge by 80%. It was found that the people of Medan City have a good level of knowledge about these cardiac events, and the people of Medan City have a low level of knowledge about BLS and CPR. CONCLUSION: The ability of the people of Medan City in implementing BLS and CPR in BLS for cardiac events outside the hospital is still lacking.
ABSTRACT
Introduction: The annual incidence of out of hospital cardiac arrest in Europe is between 67 to 170 per 100,000 inhabitants1. Basic Life Support (BLS) with Automated External Defibrillation (AED) are techniques with undoubted benefit2. Still, the use of AEDs remains low in Europe (average 28%)1. Training in BLS with AED is mandatory for health care professionals. Within the scope of the curriculum reform of the Integrated Master of Medicine (IMM), an Introduction to Medicine unit was created, which includes a BLS with AED course.We assessed medical students rating of this course. Material and methods: Assessment of satisfaction of the certified Portuguese Resuscitation Council/European Resuscitation Council BLS and AED course3 to first year students of the IMM at Instituto de Ciências Biomédicas Abel Salazar. School of Medicine and Biomedical Sciences, Porto, Portugal, since 2018 to 2021. Twelve questions regarding four areas, BLS, AED, Recovery position (RP) and Foreign body airway obstruction (FBAO), were graded from 0 = none to 5 = maximum. Results: In total, 38 courses were held, attended by 719 students. The global assessment was maximum on most questions. This trend was most pronounced in issues relating to the BLS (mean of 96,6% for grade 5) and AED (mean of 96,5% for grade 5). The relevance of the content in the four different areas was also very high (range 96,2 to 99,3%). In contrast, the RP (mean of 92,9% for grade 5) and FBAO (mean of 90,4% for grade 5) training ratings were the lowest, yet still quite high. The training conditions, either by limitations imposed by COVID, or by the training models, may have contributed to the less favourable results. Conclusions: Training in BLS and AED is confirmed as a very relevant practice for 1st year medical students. Improvement in its practical implementation may promote greater satisfaction and learning.
ABSTRACT
Purpose of the study: Online resuscitation learning constitiutes an important alternative to classroom training when in-person education is restricted, in particular, during the ongoing COVID-19 pandemic. However, there is no available evidence on accessibility of the resuscitation e-learning for people with disabilities who comprise 15% of the world population. This study aimed to analyse web accessibility of content of online basic life support (BLS) courses. Materials and methods: In December 2021, free English-language online courses in adult BLSwere searched and analysed for compliance with theWeb Content Accessibility Guidelines (WCAG 2.1) utilising an automated web accessibility evaluation tool (WAVE, WebAIM, USA). Results: Only 30 free-of-charge online courses were revealed. All courses had accessibility violations, which were recognised as errors (clearly identified problems) and alerts (indicating content items that may cause accessibility issues) for 9 of 13 (69%) WCAG 2.1 guidelines, namely basic goals to make content accessible for users with disabilities. The most frequently reported violations refer to the following guidelines (Fig.): 1.1-Text Alternatives (lack of text alternatives for non-text content);1.2-Time-based Media (lack of alternatives to media content such as video or audio);1.3-Adaptable (limitations of flexibility of content presentation);1.4-Distinguishable (content recognition problems, including low contrast);2.4-Navigable (difficulties in navigating content and finding information);3.3-Input Assistance (no or limited help for user input);4.1-Compatible (limitations of use of assistive technologies). The violations may limit use of the online courses by people with visual, hearing, physical and cognitive impairments, including older users. (Figure Presented) Conclusions: Based on the automated assessment, the online BLS courses fail to meet relevant web accessibility criteria, which makes the lifesaving knowledge unobtainable for people with disabilities. Further research and organisational efforts are necessary for promoting awareness of theweb accessibility problem and developing uniform procedures for surveillance and assurance of equal access to resuscitation education.
ABSTRACT
Background and objective: The prognosis of cardiac arrest victims strongly depends on the prompt provision of Basic Life Support (BLS) maneuvers. Medical students should therefore be proficient in this area, but many lack essential BLS knowledge. The goal of this prospective, closed web-based study was to determine whether a short intervention designed to motivate first-year medical students to follow a blended BLS course could lead to a significant improvement in BLS knowledge in the following year. Materials and Methods: A fully automated web-based questionnaire was administered to second-year medical students one year after they had been given the opportunity of following a blended BLS course (e-learning and practice session). The primary outcome was the difference, on a 6-question score assessing essential BLS knowledge, between these students and those from the 2020 promotion since the latter had not been offered the optional BLS course. Results: The score was similar between the two study periods (3.3 ± 0.8 in 2022 vs. 3.0 ± 1.0 in 2020, p = 0.114), but no firm conclusion could be drawn since participation was much lower than expected (17.9% in 2022 vs. 43.7% in 2020, p < 0.001). Therefore, a second questionnaire was created and administered to understand the reasons underlying this low participation. Conclusions: There was a lack of improvement in BLS knowledge in second-year medical students after the introduction of an optional introductory BLS course in the first-year curriculum, but the limited participation rate precludes drawing definitive conclusions. Ineffective communication appears to be the cause of this low participation rate, but a lack of motivation in the aftermath of the COVID-19 pandemic cannot be ruled out. Corrective actions should be considered to enhance communication, restore motivation, and ultimately improve BLS knowledge among medical and dental students.