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 t...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.展开更多
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 ...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.展开更多
Dear editor, Out-of-hospital cardiac arrest survival rates vary between 7% and 46% and are lower than those for inhospital cardiac arrests (IHCA).[1,2] Therefore, efforts are being made to increase survival rates for ...Dear editor, Out-of-hospital cardiac arrest survival rates vary between 7% and 46% and are lower than those for inhospital cardiac arrests (IHCA).[1,2] Therefore, efforts are being made to increase survival rates for out-ofhospital cardiac arrests (OHCA). According to advanced cardiac life support (ACLS) guidelines, out-of-hospital cardiac arrest survival rates may be increased by performing cardiopulmonary resuscitation (CPR) with minimal interruptions.[3] According to the latest ACLS, does the patient need an advanced airway.展开更多
目的探讨院前指导自救联合现场高级生命支持(ALS)在心源性猝死(SCD)患者急救中的应用效果。方法选取2020年2月至2022年2月北京怀柔医院120急救分中心收治的经院前指导自救联合现场ALS抢救成功的SCD患者71例作为观察组,另按照年龄进行1∶...目的探讨院前指导自救联合现场高级生命支持(ALS)在心源性猝死(SCD)患者急救中的应用效果。方法选取2020年2月至2022年2月北京怀柔医院120急救分中心收治的经院前指导自救联合现场ALS抢救成功的SCD患者71例作为观察组,另按照年龄进行1∶1匹配,选取同期本院120急救分中心收治的经传统急救方案抢救成功的SCD患者71例作为对照组。比较两组基线资料、心肺复苏成功后血气指标〔动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))〕、心肺复苏成功后心功能指标〔左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、E/A比值、QT离散度(QTd)〕、心肺复苏成功后脑氧代谢指标〔颈内静脉血氧含量(CajvO_(2))、颈内静脉血氧饱和度(SjvO_(2))、脑氧摄取率(CEO_(2))〕、心肺复苏成功后24 h格拉斯哥昏迷量表(GCS)评分、心肺复苏成功后2周日常生活活动能力(ADL)分级、院内死亡率及康复出院率。结果观察组心肺复苏成功后PaO_(2)、SaO_(2)高于对照组,PaCO_(2)低于对照组(P<0.05)。观察组心肺复苏成功后LVEF、E/A值高于对照组,LVEDD小于对照组,QTd短于对照组(P<0.05)。观察组心肺复苏成功后CajvO_(2)、SjvO_(2)、CEO_(2)及心肺复苏成功后24 h GCS评分高于对照组(P<0.05)。观察组心肺复苏成功后2周ADL分级优于对照组,院内死亡率低于对照组,康复出院率高于对照组(P<0.05)。结论院前指导自救联合现场ALS可有效改善SCD患者心肺复苏成功后血气指标、心功能,提高心肺复苏成功后脑氧代谢水平、日常生活活动能力,降低院内死亡率,有助于改善患者预后。展开更多
文摘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.
文摘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.
文摘Dear editor, Out-of-hospital cardiac arrest survival rates vary between 7% and 46% and are lower than those for inhospital cardiac arrests (IHCA).[1,2] Therefore, efforts are being made to increase survival rates for out-ofhospital cardiac arrests (OHCA). According to advanced cardiac life support (ACLS) guidelines, out-of-hospital cardiac arrest survival rates may be increased by performing cardiopulmonary resuscitation (CPR) with minimal interruptions.[3] According to the latest ACLS, does the patient need an advanced airway.
文摘目的探讨院前指导自救联合现场高级生命支持(ALS)在心源性猝死(SCD)患者急救中的应用效果。方法选取2020年2月至2022年2月北京怀柔医院120急救分中心收治的经院前指导自救联合现场ALS抢救成功的SCD患者71例作为观察组,另按照年龄进行1∶1匹配,选取同期本院120急救分中心收治的经传统急救方案抢救成功的SCD患者71例作为对照组。比较两组基线资料、心肺复苏成功后血气指标〔动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))〕、心肺复苏成功后心功能指标〔左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、E/A比值、QT离散度(QTd)〕、心肺复苏成功后脑氧代谢指标〔颈内静脉血氧含量(CajvO_(2))、颈内静脉血氧饱和度(SjvO_(2))、脑氧摄取率(CEO_(2))〕、心肺复苏成功后24 h格拉斯哥昏迷量表(GCS)评分、心肺复苏成功后2周日常生活活动能力(ADL)分级、院内死亡率及康复出院率。结果观察组心肺复苏成功后PaO_(2)、SaO_(2)高于对照组,PaCO_(2)低于对照组(P<0.05)。观察组心肺复苏成功后LVEF、E/A值高于对照组,LVEDD小于对照组,QTd短于对照组(P<0.05)。观察组心肺复苏成功后CajvO_(2)、SjvO_(2)、CEO_(2)及心肺复苏成功后24 h GCS评分高于对照组(P<0.05)。观察组心肺复苏成功后2周ADL分级优于对照组,院内死亡率低于对照组,康复出院率高于对照组(P<0.05)。结论院前指导自救联合现场ALS可有效改善SCD患者心肺复苏成功后血气指标、心功能,提高心肺复苏成功后脑氧代谢水平、日常生活活动能力,降低院内死亡率,有助于改善患者预后。
