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.

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.

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.

药食同源理论及其在航天营养健康研究中的应用

载人航天飞行中面临的重力场变化、辐射、狭小空间孤闭隔离、噪声及生物节律变化等航天特因环境给维持航天员机体营养健康带来了挑战。根据载人航天实践,综述了航天特因环境下机体适应性变化,阐述了药食同源在航天营养健康保障中的应用预先研究现状,分析并提出了药食同源在支持未来载人深空探测方面的潜在应用价值。

系统思维在载人潜水器设计中的应用

系统思维以及系统方法论在复杂巨系统的设计上有着极大优势。载人潜水器作为一种大型装备,其设计过程中大量采用了系统方法论。本文对载人潜水器的组成、功能等进行介绍,对系统思维和系统方法论应用于载人潜水器设计的必要性进行分析,对常见的系统方法论进行介绍。并结合具体示例,从载人潜水器总体、载人潜水器分系统之间、载人潜水器分系统自身等层面,对载人潜水器设计过程中所采用的系统方法进行介绍。最后,以生命支持分系统为例,从该系统的运行时长及故障数量角度出发,验证系统思维和系统方法论在该系统的设计过程中发挥的作用。

空间低压环境下植物养分吸收与生长特性研究进展

针对月球/火星基地大气压控制一般低于标准大气压(101 kPa)的要求,开展低压环境下植物的养分吸收与生长特性研究有助于对低压下植物的生长差异有更深层次的理解,从而在受控生态生保系统内建立更完善的植物单元体系。综述了近年来国内外低压植物培养实验的主要研究结果,对比分析了低压植物养分吸收与动力学特性的差异,以及对植物生长状态、生物量和基因表达的影响,并对未来的低压植物实验研究方向做出展望。

基于质子膜的尿残液膜蒸馏影响因素研究

针对尿残液强酸强腐蚀性、物质含量高的特点,开发以质子膜为介质的间接加热气扫式膜蒸馏技术,完成尿残液的水分回收,以进一步提高空间站环控生保系统水资源闭合度.对比研究了7种质子膜材料的气相和液相两种接触模式下的蒸馏速率,获得质子膜材料的主动吸水、水分传输和尿残液耐受能力等特性.建立了尿残液液相接触模式下的传质传热理论模型,考察了质子膜厚度、尿残液物质浓度、进气流量、进气湿度和进气温度等5个主要变量对蒸馏速率的影响规律,其中进气湿度对蒸馏速率有着相对较大的影响.理论计算所得蒸馏速率与实测值之间的相对标准偏差为5.8%,验证了模型的有效性.研究结果为尿残液水分回收技术的开发和应用提供了理论和实验依据.

膜曝气生物膜反应器处理航天生活废水效能研究

针对未来星球基地与长期地外飞行产生废水的处理需求,构建了膜曝气生物膜反应器(MABR),以探究该工艺对含尿液与卫生废水的模拟航天废水的处理效能。通过为期376 d的连续试验,开展了反应器启动和驯化,对含不同体积分数尿液的生活废水、飞行阶段废水的处理效能进行研究。结果表明,对尿液体积分数10%的生活废水,MABR稳定运行时可实现97%的总有机碳(TOC)去除率,以及83%的总氮(TN)去除率;对尿液体积分数40%的生活废水,可实现99%的TOC去除率,以及92%的总氮去除率;对飞行阶段废水,可实现98%的TOC去除率,以及65%的总氮去除率。从反应器的活性污泥中检测到丰富的反硝化细菌以及少量厌氧氨氧化菌。经历驯化后,MABR在286 d内对航天生活废水中碳、氮保持了较高的去除率,从而初步验证了该工艺应用于载人航天生活废水处理的可行性。

供氧浓度对受控生态生保系统典型生物质固废好氧堆肥的影响

目的探讨不同供氧浓度对生物质固废好氧堆肥化处理过程的影响机制,以掌握适用于未来地外星球基地受控生态生保系统(CELSS)固废资源化处理的供氧参数,提高氧气利用率。方法利用自研的固废生物反应器试验系统,以小麦秸秆和模拟粪便为处理对象,开展10%、15%和21%三种供氧浓度的好氧堆肥化处理实验,定期采样并分析处理过程中的气体组分(O_(2)、NH_(3)、CH_(4)和N_(2)O)及物料腐熟度(含水率、溶解性有机碳、NH_(4)^(+)-N和种子发芽指数)。结果15%O_(2)处理组耗氧量最大,NH_(3)和N_(2)O排放量最小,溶解性有机碳含量降解效果最好,NH_(4)^(+)-N含量较高;3个处理组中CH_(4)排放均处于较低水平。堆肥结束时,10%O_(2)和15%O_(2)处理组的产品含水率均大于74%,保水性最好,各处理组的种子发芽指数分别达到86.64%、123.81%和97.98%。结论与10%和21%供氧浓度相比,15%供氧浓度有效减少了NH_(3)和N_(2)O的排放,且拥有良好的保氮、保水和溶解有机碳降解效果,腐熟度更高。

智慧重症监护室建设背景下生命支持设备的临床辅助决策效能分析

目的:基于医院智慧重症监护室(ICU)建设,分析智慧ICU病房生命支持设备在临床辅助决策中的效能。方法:设计智慧ICU病房交互系统、设备管理系统、风险应对系统和智能查房系统功能模块,实时采集生命支持设备在诊疗、护理、运行和技术保障中的信息数据,为危重症患者诊疗和护理措施改善提供医疗辅助决策依据。选取2018年7月1日至2022年12月31日上海市青浦区朱家角人民医院等3家医院临床在用的115台生命支持设备,分别采用传统辅助决策管理模式(简称传统管理模式,83台)和智慧辅助决策管理模式(简称智慧管理模式,89台,含传统管理模式中57台和新增加的32台)管理,对比两种管理模式生命支持设备的管理水平和管理效果。结果:智慧管理模式下的设备数据采集时间为(5.67±2.80)min,少于传统管理模式,数据采集准确率和完整度,以及设备调配使用、监测报警、设备故障和紧急应答的有效解决率分别为(99.02±1.14)%、(94.35±3.46)%、(98.78±0.90)%、(98.99±0.91)%、(88.26±5.31)%和(90.23±5.54)%,均高于传统管理模式,其差异有统计学意义(t=6.504、6.474、3.574、7.620、6.784、4.522、3.719,P<0.05);智慧管理模式下的设备治疗、护理和康复的诊断决策有效利用率分别为(93.83±3.12)%、(94.99±2.47)%和(91.44±4.62)%,呼吸功能支持设备、循环功能支持设备、血液净化支持设备和急救监测支持设备的综合评分分别为(92.97±4.35)分、(94.34±2.95)分、(93.01±2.44)分和(94.11±1.89)分,均高于传统管理模式,其差异有统计学意义(t=4.169、4.875、5.159、4.069、3.033、2.757、6.893,P<0.05)。结论:基于智慧ICU建设能够提高生命支持设备运行数据采集质量,及时解决设备运行问题,为危重症患者诊疗、护理和康复的诊断决策提供有效依据,提升设备临床服务水平。

水乐园室内观演区建筑声学设计研究

目前高品质的水乐园都设计有开敞空间游乐区和室内空间观演区,但国内暂无针对水乐园室内观演区混响时间和背景噪声限值的标准规范。分析了相关工程测试结果和目前可参照的国家规范标准,结合观演区的使用功能和扩声条件,对水乐园室内海洋剧场、表演厅的设计指标和设计要点进行了研究。结果表明,海洋剧场、表演厅混响时间宜根据每座容积设计,海洋剧场、表演厅背景噪声限值宜设计为NR45,应重点对维生机房内水泵进行隔振设计。

成人终身学习社会支持评估指标体系构建

成人终身学习社会支持体系是构建服务全民终身学习的教育体系的重要组成部分,也是制约我国教育发展的突出问题、薄弱环节和短板。构建科学有效的成人终身学习社会支持评估指标体系,有助于科学诊断成人终身学习社会支持的现状、问题和成效,从而为构建服务全民终身学习的教育体系提供科学的决策依据。本研究基于终身学习和社会支持等相关理论,以理论分析与实证检验相结合,采用文献研究、专家咨询、问卷调查等方法,构建了成人终身学习社会支持评估指标体系,包括支持系统和支持评价这两个一级维度,具体又涵盖政府组织保障、社会氛围营造、正规学校教育支持、社区教育支持、职场学习支持、社会公共资源支持、家庭成员支持、社会支持满意度、终身学习满意度等9个二级指标,以及60个三级指标。经检验,该指标体系的信度和效度良好,具有较高的科学性与可靠性,能够在一定程度上丰富终身学习、社会支持等领域相关问题的研究,并为相关工作开展提供实践指导。

人工肝支持系统联合全程护理在肝硬化患者中的应用效果

目的探讨人工肝支持系统联合全程护理在肝硬化患者中的应用效果。方法选取2020年6月至2023年1月山西医科大学第一医院收治的126例肝硬化患者作为本次研究对象,按照随机数字表法分为对照组(人工肝支持系统+常规护理,63例)和观察组(人工肝支持系统+全程护理,63例)。干预2个月后,对比2组的肝功能指标和肝储备功能,以及生活质量和护理满意度。结果干预2个月后,观察组的丙氨酸氨基转移酶、总胆红素和天门冬氨酸氨基转移酶水平均低于对照组,白蛋白水平高于对照组;观察组的肝脏有效循环量、吲哚菁绿15 min潴留率和终末期肝病模型评分均低于对照组,生活质量评分和护理满意率均高于对照组(P均<0.05);2组的上述指标和评分与干预前相比均更优(P均<0.05)。结论将人工肝支持系统联合全程护理应用于肝硬化患者,可改善其肝功能指标和肝储备功能,提高其生活质量和护理满意度。