Summary Introduction Previous studies have documented poor quality CPR during real life resuscitation attempts. This study investigated whether poor quality CPR during advanced life support training ...could be contributing to poor performance in clinical practice. Methods Observational study of quality of CPR during advanced life support training courses before and after the implementation of the European Resuscitation Council Guidelines 2005 into the ALS course. The quality of chest compressions were downloaded from a manikin and direct observations of no-flow time; pre-shock pauses were recorded. Results 94 cardiac arrest simulations were studied (46 before implementation of Guidelines 2005 and 48 after). Delays in starting CPR, inadequate compression depth, prolonged interruptions of chest compressions and excessive pre-shock pauses were identified. The introduction of Guidelines 2005 resulted in improvements in the number of compressions given per minute and a reduction in no-flow time and duration of pre-shock pauses, but overall the quality of CPR performed during the ALS course remained poor. There was little evidence of performance improving over successive simulations as the course progressed. Conclusion The implementation of Guidelines 2005 into the ALS course appear to have improved the process of CPR by reducing no-flow time during simulated CPR. However, the quality of CPR during ALS training remains sub-optimal. Delays in starting CPR, inadequate compression depth, excessive interruptions in chest compressions and prolonged pre-shock pauses mirror observations from clinical practice. Strategies to improve CPR performance during ALS training should be explored and potentially may result in improvements in clinical practice.
Aim: Cardiac arrest teams may be activated only to find that the patient does not require cardiac or respiratory resuscitation. Members of the cardiac arrest team are drawn from medical personnel ...with other responsibilities who may disperse quickly, leaving ongoing care of the patient to existing ward staff. The outcome for such false cardiac arrests, however, is rarely reported. The objective of this study was to determine the causes of false cardiac arrest team alerts (FCAs) and to assess the outcome of these patients relative to the general hospital population. Setting: Tertiary care hospital. Participants: Patients subject to a cardiac arrest call who were found not to require basic or advanced cardiac life support on arrival. Results: In 512 events over a 1-year period, patients suffering FCAs were more likely to survive compared to patients suffering cardiac arrest (15% vs 73%, odds ratio (OR) 14.95; χ2 p⩽0.0001), but significantly less likely to survive than the general hospitalised population (73% vs 97%, OR 14.15; χ2 p⩽0.0001). The cause of the FCA was often minimised as collapse or vasovagal syncope; in 58% (87/150) of cases no further action was taken by the attending medical team. Patients suffering FCAs tended to be long-stay patients with a worse outcome at weekends. Conclusion: In areas lacking a medical alert, outreach or patient at risk system, particular attention should be paid to optimising care of those suffering FCAs.
Describes statewide information automation and connectivity efforts in North Carolina. Highlights include Triangle Research Libraries Network Document Delivery System; cooperative networking ...projects; public library connectivity to the state library; rural access projects; community college automation; K-12 technology plans; electronic government information; and Internet training for public librarians. (LRW)
A second example of anti-Hil Ellisor, S S; Zelski, D; Sugasawara, E ...
Transfusion (Philadelphia, Pa.),
09/1982, Letnik:
22, Številka:
5
Journal Article
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