ABSTRACT
BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) is a crucial therapy for sudden cardiac arrest (SCA), yet rates of bystander CPR are low. This is especially the case for SCA occurring in the home setting, as family members of at-risk patients are often not CPR trained. OBJECTIVE: To evaluate the feasibility of a novel hospital-based CPR education program targeted to family members of patients at increased risk for SCA. DESIGN: Prospective, multicenter, cohort study. SETTING: Inpatient wards at 3 hospitals. SUBJECTS: Family members of inpatients admitted with cardiac-related diagnoses. MEASUREMENTS AND RESULTS: Family members were offered CPR training via a proctored video-self instruction (VSI) program. After training, CPR skills and participant perspectives regarding their training experience were assessed. Surveys were conducted one month postdischarge to measure the rate of "secondary training" of other individuals by enrolled family members. At the 3 study sites, 756 subjects were offered CPR instruction; 280 agreed to training and 136 underwent instruction using the VSI program. Of these, 78 of 136 (57%) had no previous CPR training. After training, chest compression performance was generally adequate (mean compression rate 90 ± 26/minute, mean depth 37 ± 12 mm). At 1 month, 57 of 122 (47%) of subjects performed secondary training for friends or family members, with a calculated mean of 2.1 persons trained per kit distributed. CONCLUSIONS: The hospital setting offers a unique "point of capture" to provide CPR instruction to an important, undertrained population in contact with at-risk individuals.
Subject(s)
Cardiopulmonary Resuscitation/education , Family , Heart Arrest/prevention & control , Patient Discharge , Videotape Recording/methods , Adult , Aged , Cardiopulmonary Resuscitation/methods , Cohort Studies , Feasibility Studies , Female , Humans , Longitudinal Studies , Male , Middle Aged , Prospective Studies , Young AdultABSTRACT
Opioid-induced bowel dysfunction (OBD) is characterized by a constellation of symptoms, including constipation; dry, hard stools; straining; and incomplete evacuation. The use of a prophylactic bowel regimen that includes a stimulant laxative and stool softener generally is accepted and should be initiated at the start of opioid therapy. Effective prevention and treatment of OBD reduce the risk of associated physiologic complications and can improve pain management and quality of life for patients and their families.
