Basic life support:knowledge and attitude of medical/paramedical professionals

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.

Short lessons in basic life support improve self-assurance in performing cardiopulmonary resuscitation

BACKGROUND:There are several reasons why resuscitation measures may lead to inferior results:difficulties in team building,delayed realization of the emergency and interruption of chest compression.This study investigated the outcome of a new form of in-hospital cardiopulmonary resuscitation(CPR) training with special focus on changes in self-assurance of potential helpers when faced with emergency situations.METHODS:Following a 12-month period of CPR training,questionnaires were distributed to participants and non-participants.Those non-participants who intended to undergo the training at a later date served as control group.RESULTS:The study showed that participants experienced a significant improvement in selfassurance,compared with their remembered self-assurance before the training.Their self-assurance also was significantly greater than that of the control group of non-participants.CONCLUSION:Short lessons in CPR have an impact on the self-assurance of medical and non-medical personnel.

Peer-assisted learning to train high-school students to perform basic life-support

BACKGROUND: The inclusion of cardiopulmonary resuscitation(CPR) in formal education has been a useful approach to providing basic life support(BLS) services. However, because not all students have been able to learn directly from certified instructors, we studied the educational efficacy of the use of peer-assisted learning(PAL) to train high-school students to perform BLS services.METHODS: This study consisted of 187 high-school students: 68 participants served as a control group and received a 1-hour BLS training from a school nurse, and 119 were included in a PAL group and received a 1-hour CPR training from a PAL leader. Participants' BLS training was preceded by the completion of questionnaires regarding their background. Three months after the training, the participants were asked to respond to questionnaires about their willingness to perform CPR on bystander CPR and their retention of knowledge of BLS.RESULTS: We found no statistically significant difference between the control and PAL groups in their willingness to perform CPR on bystanders(control: 55.2%, PAL: 64.7%, P=0.202). The PAL group was not significantly different from the control group(control: 60.78±39.77, PAL: 61.76±17.80, P=0.848) in retention of knowledge about BLS services.CONCLUSION: In educating high school students about BLS, there was no significant difference between PAL and traditional education in increasing the willingness to provide CPR to bystanders or the ability to retain knowledge about BLS.

Performance of cardiopulmonary resuscitation during prolonged basic life support in military medical university students: A manikin study

BACKGROUND: The quality of chest compressions can be significantly improved after training of rescuers according to the latest national guidelines of China. However, rescuers may be unable to maintain adequate compression or ventilation throughout a response of average emergency medical services because of increased rescuer fatigue. In the present study, we evaluated the performance of cardiopulmonary resuscitation(CPR) in training of military medical university students during a prolonged basic life support(BLS).METHODS: A 3-hour BLS training was given to 120 military medical university students. Six months after the training, 115 students performed single rescuer BLS on a manikin for 8 minutes. The qualities of chest compressions as well as ventilations were assessed.RESULTS: The average compression depth and rate were 53.7±5.3 mm and 135.1±15.7 compressions per minute respectively. The proportion of chest compressions with appropriate depth was 71.7%±28.4%. The average ventilation volume was 847.2±260.4 m L and the proportion of students with adequate ventilation was 63.5%. Compared with male students, significantly lower compression depth(46.7±4.8 vs. 54.6±4.8 mm, P<0.001) and adequate compression rate(35.5%±26.5% vs. 76.1%±25.1%, P<0.001) were observed in female students.CONCLUSIONS: CPR was found to be related to gender, body weight, and body mass index of students in this study. The quality of chest compressions was well maintained in male students during 8 minutes of conventional CPR but declined rapidly in female students after 2 minutes according to the latest national guidelines. Physical fitness and rescuer fatigue did not affect the quality of ventilation.

Knowledge,attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City,India

BACKGROUND: This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support(BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India.METHODS: The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory(STAI) Questionnaire. Chi-square test was performed on SPSS 21.0(IBM Statistics, 2012) to determine statistically signifi cant differences(P<0.05) between assessed knowledge and anxiety.RESULTS: Out of 183 interns, 39.89% had below average knowledge. A total of 123(67.21%) reported unavailability of professional training. The majority(180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above highstress level. Comparison of assessed knowledge and stress was found to be insignifi cant(P=0.983).CONCLUSION: There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.

Assessment of knowledge and attitude about basic life support among dental interns and postgraduate students in Bangalore city,India

BACKGROUND: Life-threatening emergencies can occur at anytime, at anywhere and in anyone. Effective management of an emergency situation in the dental office is ultimately the dentist's responsibility. The lack of training and inability to cope with medical emergencies can lead to tragic consequences and sometimes legal complications. Therefore, health professionals including dentists must be well prepared to deal with medical emergencies. This study was undertaken to assess the knowledge about and attitude towards basic life support(BLS) among dental interns and postgraduate students in Bangalore city, India.METHODS: A cross sectional survey was conducted among dental interns and postgraduate students from May 2014 to June 2014 since few studies have been conducted in Bangalore city. A questionnaire with 17 questions regarding the knowledge about and attitude towards BLS was distributed to 202 study participants.RESULTS: The data analyzed using the Chi-square test showed that dental interns and postgraduate students had average knowledge about BLS. In the 201 participants, 121(59.9%) had a positive attitude and 81(40.1%) had a negative attitude towards BLS.CONCLUSIONS: Cardiopulmonary resuscitation should be considered as part of the dental curriculum. Workshops on a regular basis should be focused on skills of cardiopulmonary resuscitation for dental students.

Effect of basic life support training on the knowledge and skills of first aid of first year medical students

Objective:To determine the timing of first aid training in the medical school curriculum and the training method with the 8-hour first aid training given to the first-grade students of the faculty of medicine.Method:The study was conducted prospectively with 168 first year medical students at Faculty of Medicine,Maltepe University in October 2019.An 8-hour course plan consisting of theoretical and practical applications was prepared.Theoretical courses included cardiopulmonary resuscitation,basic life supports,epileptic seizures,heatstroke,aspiration,and drowning issues,while practical applications included cardiopulmonary resuscitation techniques,basic life support scenarios,Heimlich’s Maneuver and the coma position.Students were sent a link consisting of 17 questions created with Google forms at the beginning and the end of the course.Learned knowledge was measured with the posttest,and pre-and post-training results were compared.Results:A significant increase was found in the rate of correct answers compared to the pre-training period.Even the rate of correct post-test answers increased significantly in all questions;the increase in the questions related to the subjects supported by practical applications was more remarkable.It was found that more incorrect answers were given to questions about environmental injuries.Conclusions:It is possible to improve the public recognition of first aid,even with one day of theoretical and practical training.Thus,adding first aid practical courses to the first-year medical school curriculum and raising awareness at an earlier age will play an essential role in medical education.

Is There an Improvement in Patient Survival/Code Blue Activation after Training Based on Simulation (Basic Life Support—BLS) Based Practice of Cardiopulmonary Resuscitation?

Background and Aim: The only way to survive a sudden cardiac arrest is when the CPR is performed immediately after the arrest. The focus of the present research study is to assess the effectiveness of a pre- and post-simulation-based BLS training (BLS) and the outcome was measured on the basis of patient survival after the cardiac arrest. Study Design: This pre- and post-training BLS/CPR training study enrolled all nursing staff, all hospital residents, internees, throughout the hospital in a simulation-based BLS training as per the standards of American Heart Association (AHA), to make them respond to immediate resuscitation and code blue activation during the cardiac arrest within the hospital premises including ED, wards, ICUs, MRI, CT and all miscellaneous areas. The providers completed self-efficacy questionnaires as per the AHA protocol before being certified and were evaluated during the emergency in hospital cardiopulmonary arrest. Results: 296 nursing staff, 206 non-healthcare professionals, 143 residents, 212 internees, and 98 medical staff grade doctors completed the BLS training (total 955 hospital staff—providers) were graded for the response by pre- and post-training testing. In the course of pre-BLS training period out of the 250 cardiac arrest patients, 68 patients (27.2%) had ROSC, while after instituting the BLS training period, 143 individuals (40.86%) of the 350 patients who had cardiac arrest had ROSC (p < 0.05). Conclusion: A simulation-based CPR and BLS training curriculum greatly improves patient outcome by reducing mortality and morbidity with improved subjectivity, self-efficiency along with the objective assessment of the performance scores during acute cardiac arrest in Emergency Cardiovascular Care (ECC).

Quality of Chest Compressions Differs over Time between Advanced and Basic Life Support

Purpose: According to guideline recommendations, chest compressions (CC) during cardiopulmonary resuscitation (CPR) should be performed at a rate of 100 - 120 per minute, with a CC fraction (CCF) of ≥80%. The aim of this work is to explore whether CC quality differs between advanced life support (ALS) and basic life support (BLS) performed by two rescuers. Method: Cardiopulmonary resuscitation was performed by two ambulance personnel in ten ALS and ten BLS manikin scenarios. Data from these scenarios were then compared with data on ten ALS cases from the clinical setting, all with non-shockable rhythms. Data from the first two 5-minute periods of CC were evaluated from impedance data (LIFEPAK 12 defibrillator monitors) using a modified Laerdal Skillmaster manikin. Quality parameters compared were: number of CC pauses (CCPs), total time of CC (%), number of CC given and CC rate/min. Results: During the first 5 minutes, the BLS manikin scenarios had the highest number of CCPs, 15 (14 - 16), compared with the ALS manikin scenario, 14 (13 - 15), and the clinical ALS cases, 12 (10 - 15). The BLS scenario also had the highest CCFs, 81% (77% - 85%), and number of CC, 450 (435 - 495), compared with the ALS manikin scenario, 75% (64% - 81%) and 400 (365 - 444) respectively, and the clinical ALS cases, 63% (50% - 74%) and 408 (306 - 489). The median rate of CC/min in the BLS scenario was 115 (110 - 120) compared with the ALS manikin scenario, 110 (106 - 115), and the clinical ALS cases, 130 (118 - 146). During the second 5-minute period, the BLS scenario had the highest number of CCPs, 16 (15 - 17), compared with 15 (14 - 16) for the ALS manikin scenario and 11 (11 - 12) for the clinical ALS cases. The CCF in the BLS setting was 79% (75% - 83%), and the number of CC 455 (430 - 480), compared with the ALS manikin scenario, 79% (74% - 84%) and 435 (395 - 480) respectively, and the clinical ALS cases, 71% (57% - 77%) and 388 (321 - 469) respectively. The median CC rate was 118 (113 - 124) for BLS, 111 (105 - 120) for ALS manikins and 123 (103 - 128) CC/min for clinical ALS cases. Conclusion: None of the groups being studied could deliver CC at a rate of 100 - 120 CC/min or a CCF of ≥80% over the whole 10-minute period in any of the resuscitation scenarios analyzed. However, BLS had the best compliance with CC quality recommendations according to the 2010 guidelines.

Training of Laic Blind Subjects to Basic Life Support Manoeuvres

Heart attack is an extremely urgent medical condition which may occur at any time and can affect anybody and means the failure of the pump function of the heart and it represents the condition which brings to death. The aim of this study is the training, which is the acquisition of knowledge, abilities and skills as a result of education and practice in a certain discipline and this project has been created to make as accessible to all as possible the information about the identification and treatment of heart attack. However, the key objective has been involving only laic blind subjects in the trial and theoretical-practical course to support vital functions （BLS （basic life support））, to demonstrate that in a state of emergency, like a heart attack, even a subject affected by visual impairment, if properly trained, can be very helpful and can contribute to save a life. Fifteen partially sighted and sightless executors have participated in this study. In order to evaluate learning objectives of the course, participants have completed a pre-course test to examine these areas： cognitive and emotional, motivational, theoretical-practical; while, at the end of the course, participants have completed a comment card about the course. At the end of this study it can be seen that blind subjects do not present any type of limitation in the learning and in the execution of BLS manoeuvres after an appropriate training.

Do medical students studying in the United Kingdom have an adequate factual knowledge of basic life support?

BACKGROUND: Healthcare professionals have a duty to maintain basic life support(BLS) skills. This study aims to evaluate medical students' factual knowledge of BLS and the training they receive.METHODS: A cross-sectional, closed-response questionnaire was distributed to the fi rst-and fourth-year students studying at institutions in the United Kingdom. The paper questionnaire sought to quantify respondent's previous BLS training, factual knowledge of the BLS algorithm using five multiple choice questions(MCQs), and valuate their desire for further BLS training. Students received 1 point for each correctly identifi ed answer to the 5 MCQ's.RESULTS: A total of 3,732 complete responses were received from 21 medical schools. Eighty percent(n=2,999) of students completed a BLS course as part of their undergraduate medical studies. There was a signifi cant difference(P<0.001) in the percentage of the fourth-year students selecting the correct answer in all the MCQ's compared to the fi rst-year students except in identifyingthe correct depth of compressions required during CPR(P=0.095). Overall 10.3%(95% CI 9.9% to 10.7%) of respondents correctly identified the answer to 5 MCQ's on BLS: 9% of the first-year students(n=194) and 12% of the fourth-year students(n=190). On an institutional level the proportion of students answering all MCQ's correctly ranged from 2% to 54% at different universities. Eighty-one percent of students(n=3,031) wished for more BLS training in their curriculum.CONCLUSION: Factual knowledge of BLS is poor among medical students in the UK. There is a disparity in standards of knowledge across institutions and respondents indicating that they would like more training.

Theoretical knowledge and psychomotor skill acquisition of basic life support training programme among secondary school students

BACKGROUND: The aim of the study is to evaluate the theoretical knowledge and psychomotor skill acquisition of basic life support(BLS) by a group of secondary school students in Nigeria pre and post BLS training. METHODS: This was quasi-experimental study design with 210 participants. They were taught on adult BLS and all the participants practiced BLS on a Resusci-Anne manikin immediately after the training. Data were collected using American Heart Association(AHA) structured questionnaire and psychomotor skills checklist for BLS at baseline, and post BLS training.RESULTS: The pre-training knowledge score was 1.9±1.4. This increased after the BLS training to 11.4±2.4, and the mean difference between the pre and post BLS training scores was 9.48571. Pre-training psychomotor skill score was 0.00±0.00, this increased to 8.9±1.9 after the training, and the mean difference was 8.90000. The knowledge and psychomotor skill difference between pre and post BLS training was signifi cant(P<0.000).CONCLUSION: Most Nigerian secondary school students were not knowledgeable about BLS. Therefore, there is need for the creation of more awareness among the students.

Standards Ensure Basic Life Quality and Safety

October 14th will be an important day for all of our colleagues engaged in standardization.The theme of the 2008 World Standards Day is'Intelli-gent and sustainable buildings'.The requirements for urban residential developments are rising daily,accompanied by increasing public awareness

Is current training in basic and advanced cardiac life support(BLS & ACLS) effective? A study of BLS & ACLS knowledge amongst healthcare professionals of North-Kerala

BACKGROUND:Healthcare professionals are expected to have knowledge of current basic and advanced cardiac life support(BLS/ACLS) guidelines to revive unresponsive patients.METHODS:Across-sectional study was conducted to evaluate the current practices and knowledge of BLS/ACLS principles among healthcare professionals of North-Kerala using pretested self-administered structured questionnaire.Answers were validated in accordance with American Heart Association's BLS/ACLS teaching manual and the results were analysed.RESULTS:Among 461 healthcare professionals,141(30.6%) were practicing physicians,268(58.1%) were nurses and 52(11.3%) supporting staff.The maximum achievable score was 20(BLS15/ACLS 5).The mean score amongst all healthcare professionals was 8.9±4.7.The mean score among physicians,nurses and support staff were 8.6±3.4,9±3.6 and 9±3.3 respectively.The majority of healthcare professionals scored <50%(237,51.4%);204(44.3%) scored 51%-80%and 20(4.34%)scored >80%.Mean scores decreased with age,male sex and across occupation.Nurses who underwent BLS/ACLS training previously had significantly higher mean scores(10.2±3.4) than untrained(8.2±3.6,P=0.001).Physicians with <5 years experience(P=0.002) and nurses in the private sector(P=0.003)had significantly higher scores.One hundred and sixty three(35.3%) healthcare professionals knew the correct airway opening manoeuvres like head tilt,chin lift and jaw thrust.Only 54(11.7%) respondents were aware that atropine is not used in ACLS for cardiac arrest resuscitation and 79(17.1%) correctly opted ventricular fibrillation and pulseless ventricular tachycardia as shockable rhythms.The majority of healthcare professionals(356,77.2%) suggested that BLS/ACLS be included in academic curriculum.CONCLUSION:Inadequate knowledge of BLS/ACLS principles amongst healthcare professionals,especially physicians,illuminate lacunae in existing training systems and merit urgent redressal.

视练同步联合反馈装置在心肺复苏培训中的效果评价

目的评估视练同步(PWW)培训联合反馈装置在基础生命支持心肺复苏教学中的作用。方法选取2023年1月至6月苏州大学附属儿童医院参加心肺复苏培训的60名学员作为研究对象,按照性别配对分组法将学员分为传统教学组(n=30)和联合组(n=30)。传统教学组采用由传统的导师主导的教学模式进行心肺复苏培训,联合组采用视频教学联合反馈装置进行心肺复苏培训。使用Simpad Plus分别收集各项参数,评估两组学员心肺复苏操作考核的结果和学员的满意度及有效性评价。结果培训后,两组学员的平均按压深度、有效按压分数、按压百分比及平均潮气量均优于培训前,差异有统计学意义(P<0.05);联合组的整体得分高于传统教学组,差异有统计学意义(P<0.05);联合组中考核为优秀的学员多于传统教学组,差异有统计学意义(P<0.05);联合组对培训的满意度及有效性评价高于传统教学组,差异有统计学意义(P<0.05);两组学员的平均按压次数、2 min通气次数、手部放置位置等比较,差异无统计学意义(P>0.05)。结论PWW培训联合反馈装置能帮助学员快速掌握心肺复苏核心要素,有效提高心肺复苏质量,提高学员的满意度,值得在临床和教学工作中进一步推广。

Learning from the Film “Mitorishi (Transition Doula)”—Application to Understanding the End-of-Life in a Gerontological Nursing Practice Course in Japan

Purpose: This study aims to detail what nursing students learned from watching the film “Mitorishi”, which was used among the teaching materials in a gerontological nursing practice course in nursing education in Japan, and demonstrate the applicability of using the film as an element relevant to the teaching of end-of-life care in Japan. Methods: The participants were fourth-year nursing students at University A who had watched the film “Mitorishi” during the course, had submitted a report on what they learned, and provided informed consent to the study participation. The reports submitted by the participants were used as data and analyzed qualitatively using the content analysis approach. Results: The analysis identified the following five categories (number of codes): Characteristics of life during the final days (9), Importance of views on life and death (3), Importance of end-of-life care (3), Assistance in preparation for the final days of life (13), and Understanding the profession of transition doula (9). Discussion: The five categories show that the students have learned about the “role of nurses at the time of end-of-life care” while “visualizing end-of-life care” and learning “preparedness for end-of-life care”. These findings suggest that using the film “Mitorishi” in the teaching curriculum is effective for learning about end-of-life care for older people.

“马克思主义基本原理”课程渗透生命教育的三个着力点

生命教育是一种全人教育,既关乎大学生的生存与生活,也关乎大学生的成长与发展,更关乎大学生的本性与价值。将生命教育融入“马克思主义基本原理”课程教学,为其课程优化提供了新契机。从辩证唯物主义、唯物辩证法、劳动价值理论与科学社会主义四个方面引导学生理解生命本质特征、掌握生命发展规律、认识生命存在状态、树立生命理想,继而在教学目标上注重引领学生生命幸福、教学内容上解决学生生命困惑、教学方法上丰富学生生命体验,以助推“马克思主义基本原理”课程教学与生命教育深度融合,提升育人实效。

关于医学伦理学的基本原则

医学伦理学与生命伦理学既有相同之处也有诸多差异,它的基本原则和生命伦理学应有所不同。将病人利益置于首位、自主、不伤害、公正、友善五原则可视为医学伦理学的基本原则。病人利益主要是指病人生命和健康利益,是由医生根据医学科学允许度、医生的经验和病人实情决定的;将病人利益置于首位原则的落实,首先需要医生和医院对此有真切的认识,同时也需要有制度的保障和国家的财政支持;将目前实际上已经被倒置的医患利益关系纠正过来,是既艰难又十分迫切的,需要做多方面的工作。假以时日,这一目标是应当而且能够实现的。

老年人独处能力与生命意义感:基本心理需求的中介和家庭亲密度的调节作用

为考察独处能力对老年人生命意义感的影响及其内在机制,本研究对1082名55岁及以上老年人进行问卷调查,采用潜调节的结构方程模型进行检验,结果显示:(1)老年人独处能力显著正向预测生命意义感。(2)自主、胜任、关联三种基本心理需求的满足在独处能力和生命意义感之间起完全中介作用,其中自主需求满足的中介效应最强。(3)家庭亲密度负向调节独处能力与基本心理需求满足之间的关系。对于缺乏关爱和支持的家庭,独处能力对老年人基本心理需求满足的促进作用更显著,从而部分缓解了亲密关系缺失的负面影响。

新时代人民精神生活共同富裕实现路径探析

精神文明作为人类文明新形态的重要组成部分,其发展程度高是社会主义现代化的根本要求。然而,当前人民群众精神状态面临国内外社会思潮的双重挑战,精神文明建设存在不平衡、不充分、不协调的问题,人民精神生活的内生动力与外在推力耦合度较低。为有效解决上述问题,必须以政府治理创新为核心,以社会资本参与为基础,以人民首创精神为根本,激发广大人民群众的创新创造活力,让社会主义精神文明建设落地生根,稳步促进人民精神生活共同富裕,为实现中华民族伟大复兴提供坚实的精神支撑。