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.

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.

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.

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.

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.

雨课堂结合翻转课堂在护生基础生命支持教学中的应用效果研究

目的观察雨课堂与翻转课堂相结合的教学模式在护生基础生命支持教学中的应用效果。方法选取2021年8月至2021年11月在广东省中医院总院急诊科实习的护生38人作为对照组,按照传统的教学模式进行教学。选取2021年12月至2022年4月在广东省中医院总院急诊科实习的护生39人作为观察组,以雨课堂为平台进行翻转课堂教学。培训结束后进行两组的理论、操作考核,调查学生对课堂教学效果及教学满意度的评价。结果对照组培训后理论成绩为80(75,86.25)分,观察组培训后理论成绩为90(85,90)分,两组差异有统计学意义(P<0.001)。对照组培训后操作考核成绩(92.50±1.98)分,观察组培训后操作成绩为(95.13±2.80)分,两组差异有统计学意义(P<0.001),干预前后两组操作考核成绩差异有统计学意义(P<0.001)。在教学效果及教学满意度评价中对照组分别为23(22,24)分、(35.58±2.55)分,观察组分别为23(21,25)分、(37.79±3.01)分,两者之间在教学效果评价及教学满意度评价中差异均无统计学意义(P>0.05)。结论基于雨课堂的翻转课堂有利于护生对基础生命支持的理论知识的掌握、理解和提高技能操作的水平。

美国心脏协会BLS培训模式对护生心肺复苏培训的效果研究

目的:观察美国心脏协会基础生命支持(AHA BLS)培训模式对护生心肺复苏培训的教学效果。方法:选取在广西中医药大学第一附属医院实习的学生120名,采用随机数字法分为观察组和对照组各60例,对照组采用传统模式进行培训,观察组采用美国心脏协会BLS模式培训,观察2组实习护生的教学效果。结果:与传统教学模式中的心肺复苏理论和操作相比,AHA BLS模式教学得分较高,且其培训方法也获得了更高的认可,两种教学模式之间的差异具有统计学意义(P<0.05)。结论:护生成人心肺复苏培训运用AHABLS模式不仅能有效提高学生的理论成绩和胸外按压质量,而且教学方法也受到学生的广泛推崇,值得进一步推广和应用。

基于BOPPPS模型的急危重症护理学课程思政教学设计--以“基础生命支持”为例

培养德才兼备的高素质医学人才是医学院校的使命和责任,专业课教师要坚持以岗位需求为导向,将专业教育和思政教育相融合,助力大思政育人体系的形成。文章以急危重症护理学中的“基础生命支持”一节为例,根据护理学专业的实际需要,明晰课程思政教学的内涵,以“敬佑生命,救死扶伤”的思政主题为引领,结合学情和人才培养目标制定具体的教学目标,融合线上、线下各种教学资源,探索基于BOPPPS模型的课程思政教学设计,推动教学改革,提高教学质量,以促进学生岗位胜任力的提升。通过教学实施,全体学生的急救知识、态度和行为均有不同程度的提升,96.55%的学生对教学设计非常满意。通过课前课后的多手段、多频次巩固和课中的参与式学习,显著提高了学生的学习效果和所学知识的留存率。

情景模拟教学法在低年资护士基础生命支持培训中的应用

目的探讨情景模拟教学法对急诊科低年资护士基础生命支持培训的实践效果和应用体会。方法应用情景模拟教学法对我科24名N0、N1级护理人员进行理论和操作培训,培训结束后予以考核。并对培训前后急诊临床教学质量及各级医护人员的满意度进行评价。结果自实行情景模拟教学法培训以来,护理人员的心肺复苏考核成绩较前有较大提升(P<0.01);各级医护人员的满意度均有所提高,受训护士自身满意度与情景模拟教学培训前比较,差异有统计学意义(P<0.05)。结论情景模拟教学因材施教,效果显著,增进了急诊科教学效果,提高了急诊教学满意度。

基层医务人员初级急救技术的培训流程

目的对基层医务人员进行初级急救技术分级培训，考察培训效果，优化培训流程。方法依照课题组预先设计的培训流程，对苏州地区基层医务人员进行初级急救分级培训，评估培训效果，试图优化培训流程。结果①此次培训基层医务人员总计2612人，其中乡镇卫生院1442人，村卫生所1170人；其中男性1425人（54．6％），女性1187人（45．4％）；60岁以上419人（16．0％）。②乡镇卫生院、村卫生所医务人员对心肺复苏（CPR）技术掌握率分别为62．0％和59．3％；乡镇卫生院医务人员对无创与有创正压机械通气技术的不知晓率为96．1％，对心脏电除颤技术不知晓率为95．3％；村卫生所医务人员对自动体外除颤仪 （ automated external defibrillator,，AED）技术不知晓率为96．2％。③无创与有创正压机械通气、心脏电除颤／AED技术培训前后考核成绩差异无统计学意义（P〉0．05）；其他急救技术培训前后考核成绩差异有统计学意义（P〈0．05）。结论①初级急救分级培训能够使基层医务人员整体急救水平得到提高。②本研究培训流程可做如下优化：暂不将电除颤、无创与有创正压通气技术列入普及培训内容中，今后对基层医务人员应进行AED技术专项培训。

心血管病专科护士基础生命支持培训效果及分析

目的探讨全军心血管病护理示范基地专科护士基础生命支持的培训模式。方法 2013年5月,选择参加沈阳军区总医院全军培训基地心血管病专科护士班护士52名为研究对象,按随机数字表法分成观察组和对照组,每组各26名。观察组采用美国心脏协会(American Heart Association,AHA)培训模式,而对照组采用全军心血管病护理示范基地专科护士传统培训模式,在培训结束时进行理论和技能考核。结果观察组护士的基础生命支持理论和技能操作考核通过率高于对照组,差异有统计学意义(P<0.05)。结论采用AHA培训模式,有利于全军心血管病护理示范基地专科护士掌握基础生命支持理论及技能,特别有助于提高对儿童和婴儿的急救和复苏技能,实用性强,可广泛推广及应用。

利用模拟人研究操作者疲劳和心肺复苏质量相关性

目的由于操作者的疲劳,胸外按压质量会随着时间延长而下降。本研究利用模拟人研究操作者主观、客观疲劳和胸外按压之间的关系。方法130名年龄16~18岁的志愿者受邀请参与本次研究。在接受基本生命支持的培训和测试通过后,所有志愿者被要求在模拟人上实行6 min的单纯胸外按压。按压频率和深度用于评估按压质量,而志愿者的心率、血乳酸和主观疲劳程度作为评价操作者疲劳情况。结果120名志愿者参与本次研究。随着按压时间的增加,所有志愿者的按压质量明显下降而主观疲劳程度明显上升。统计学分析主观疲劳程度与按压深度呈负相关(P<0.01),而与志愿者心率和血乳酸则呈正相关(P<0.01)。结论随着按压时间的增长,操作者的按压质量下降而疲劳则增加。主观疲劳程度与按压深度呈负相关,而与操作者心率和血乳酸则呈正相关。