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[PMID]:29239577
[Au] Autor:Varpula M; Simonen P; Nurmi J; Lehtonen J; Tierala I
[Ti] Título:Mechanical compression devices for cardiac arrest: report of three cases.
[So] Source:Duodecim;133(10):945-50, 2017.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Mechanical compression devices enable transportation of patients with cardiac arrest to the catheterization laboratory. Coronary angiography and coronary interventions can be performed while the patients are being resuscitated with these devices. In this report, we describe three cases in whom resuscitation with mechanical compression devices and rapid transportation to the catheterization laboratory resulted in favorable cardiac and neurological outcome.
[Mh] Termos MeSH primário: Parada Cardíaca/terapia
Massagem Cardíaca/instrumentação
[Mh] Termos MeSH secundário: Cateterismo Cardíaco
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


  2 / 2241 MEDLINE  
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[PMID]:28550930
[Au] Autor:Sarma S; Bucuti H; Chitnis A; Klacman A; Dantu R
[Ad] Endereço:Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; Texas Health Presbyterian Hospital, Dallas, Texas. Electronic address: satyamsarma2@texashealth.org.
[Ti] Título:Real-Time Mobile Device-Assisted Chest Compression During Cardiopulmonary Resuscitation.
[So] Source:Am J Cardiol;120(2):196-200, 2017 Jul 15.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Prompt administration of high-quality cardiopulmonary resuscitation (CPR) is a key determinant of survival from cardiac arrest. Strategies to improve CPR quality at point of care could improve resuscitation outcomes. We tested whether a low cost and scalable mobile phone- or smart watch-based solution could provide accurate measures of compression depth and rate during simulated CPR. Fifty health care providers (58% intensive care unit nurses) performed simulated CPR on a calibrated training manikin (Resusci Anne, Laerdal) while wearing both devices. Subjects received real-time audiovisual feedback from each device sequentially. Primary outcome was accuracy of compression depth and rate compared with the calibrated training manikin. Secondary outcome was improvement in CPR quality as defined by meeting both guideline-recommend compression depth (5 to 6 cm) and rate (100 to 120/minute). Compared with the training manikin, typical error for compression depth was <5 mm (smart phone 4.6 mm; 95% CI 4.1 to 5.3 mm; smart watch 4.3 mm; 95% CI 3.8 to 5.0 mm). Compression rates were similarly accurate (smart phone Pearson's R = 0.93; smart watch R = 0.97). There was no difference in improved CPR quality defined as the number of sessions meeting both guideline-recommended compression depth (50 to 60 mm) and rate (100 to 120 compressions/minute) with mobile device feedback (60% vs 50%; p = 0.3). Sessions that did not meet guideline recommendations failed primarily because of inadequate compression depth (46 ± 2 mm). In conclusion, a mobile device application-guided CPR can accurately track compression depth and rate during simulation in a practice environment in accordance with resuscitation guidelines.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar/métodos
Telefone Celular
Parada Cardíaca/terapia
Massagem Cardíaca/instrumentação
[Mh] Termos MeSH secundário: Desenho de Equipamento
Parada Cardíaca/mortalidade
Seres Humanos
Manequins
Pressão
Reprodutibilidade dos Testes
Taxa de Sobrevida/tendências
Texas/epidemiologia
Tórax
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170529
[St] Status:MEDLINE


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[PMID]:28483276
[Au] Autor:Jung JY; Kwak YH; Kwon H; Choi YJ; Kim DK; Kim HC; Lee JC; Park JH; Lim H
[Ad] Endereço:Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
[Ti] Título:Effectiveness of finger-marker for maintaining the correct compression point during paediatric resuscitation: A simulation study.
[So] Source:Am J Emerg Med;35(9):1303-1308, 2017 Sep.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: High-quality cardiopulmonary resuscitation is a significant factor for increasing the survival rate of paediatric patients. This study is to investigate the effectiveness of finger-marker stickers for maintaining the correct compression point during simulated infant cardiopulmonary resuscitation (CPR). METHODS: This crossover simulation study was conducted with 40 emergency physicians and paramedics at emergency departments of 2 tertiary hospitals. We used a remodeled infant CPR manikin developed to measure CPR quality indicators. After random coupling of participants (20 pairs), the pre-group (10 pairs) performed conventional 2-rescuer infant manikin CPR, then performed sticker-applied CPR after 1month. The post-group (10 pairs) performed the process in the opposite order. The participants placed finger-marker stickers to indicate the appropriate compression point before starting CPR. We compared accurate finger placement rates and other CPR quality indicators (compression depth, rate, complete chest recoil, and hands-off time) with and without the finger-marker sticker. RESULTS: All finger-marker stickers were correctly attached within 5s (4.88±1.28s) of approaching the model. There were significant differences in the rate of correct finger compression position between conventional and sticker-applied CPR (25.4% [IQRs 7.6-69.8] vs. 88.2% [IQRs 69.6-95.5], P<0.001). Results did not differ according to sex, career, and job of the participants. There were no significant differences in mean compression rate, depth, hands-off times, and rate of fully recoiled compression between the 2 groups. CONCLUSION: Finger-marker stickers can be used to maintain correct finger positioning during 2-rescuer infant manikin CPR.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar/educação
Dedos
Massagem Cardíaca/métodos
Treinamento por Simulação
[Mh] Termos MeSH secundário: Adulto
Pessoal Técnico de Saúde
Estudos Cross-Over
Feminino
Parada Cardíaca/terapia
Seres Humanos
Lactente
Masculino
Manequins
Médicos
Pressão
Estudos Prospectivos
Indicadores de Qualidade em Assistência à Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170510
[St] Status:MEDLINE


  4 / 2241 MEDLINE  
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[PMID]:28433454
[Au] Autor:Smereka J; Szarpak L; Rodríguez-Núñez A; Ladny JR; Leung S; Ruetzler K
[Ad] Endereço:Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.
[Ti] Título:A randomized comparison of three chest compression techniques and associated hemodynamic effect during infant CPR: A randomized manikin study.
[So] Source:Am J Emerg Med;35(10):1420-1425, 2017 Oct.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Pediatric cardiac arrest is an uncommon but critical life-threatening event requiring effective cardiopulmonary resuscitation. High-quality cardio-pulmonary resuscitation (CPR) is essential, but is poorly performed, even by highly skilled healthcare providers. The recently described two-thumb chest compression technique (nTTT) consists of the two thumbs directed at the angle of 90° to the chest while having the fingers fist-clenched. This technique might facilitate adequate chest-compression depth, chest-compression rate and rate of full chest-pressure relief. METHODS: 42 paramedics from the national Emergency Medical Service of Poland performed three single-rescuer CPR sessions for 10 minutes each. Each session was randomly assigned to the conventional two-thumb (TTHT), the conventional two-finger (TFT) or the nTTT. The manikin used for this study was connected with an arterial blood pressure measurement device and blood measurements were documented on a 10-seconds cycle. RESULTS: The nTTT provided significant higher systolic (82 vs. 30 vs. 41 mmHg). A statistically significant difference was noticed between nTTT and TFT (p<.001), nTTT and TTHT (p<0.001), TFT and TTHT (p=0.003). The median diastolic preassure using nTTT was 16 mmHg compared with 9 mmHg for TFT (p<0.001), and 9.5 mmHg for TTHT (p<0.001). Mean arterial pressure using distinct methods varied and amounted to 40 vs. 22. vs. 26 mmHg (nTTT vs. TFT vs. TTHT, respectively). A statistically significant difference was noticed between nTTT and TFT (p<0.001), nTTT and TTEHT (p<0.001), and TFT and TTHT (p<0.001). The highest median pulse pressure was obtained by the nTTT 67.5 mmHg. Pulse pressure was 31.5 mmHg in the TTHT and 24 mmHg in the TFT. The difference between TFT and TTHT (p=0.025), TFT and nTTT (p<0.001), as well as between TTHT and nTTT (p<0.001) were statistically significant. CONCLUSIONS: The new nTTT technique generated higher arterial blood pressures compared to established chest compression techniques using an infant manikin model, suggesting a more effective chest compression. Our results have important clinical implications as nTTT was simple to perform and could be widely taught to both healthcare professionals and bystanders. Whether this technique translates to improved outcomes over existing techniques needs further animal studies and subsequent human trials.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar/métodos
Parada Cardíaca/terapia
Massagem Cardíaca/métodos
[Mh] Termos MeSH secundário: Adulto
Estudos Cross-Over
Serviços Médicos de Emergência
Feminino
Parada Cardíaca/fisiopatologia
Hemodinâmica
Seres Humanos
Lactente
Masculino
Manequins
Modelos Cardiovasculares
Polegar
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170424
[St] Status:MEDLINE


  5 / 2241 MEDLINE  
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[PMID]:28428021
[Au] Autor:Cotte J
[Ad] Endereço:Anaesthesia and intensive care department, Sainte-Anne military hospital, BP 20545, 83041 Toulon cedex 9, France. Electronic address: jean.cotte@gmail.com.
[Ti] Título:A pilot study of mechanical chest compression with the LifeLine ARM device during simulated cardiopulmonary resuscitation: Reply.
[So] Source:Anaesth Crit Care Pain Med;36(4):251, 2017 08.
[Is] ISSN:2352-5568
[Cp] País de publicação:France
[La] Idioma:eng
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar
Massagem Cardíaca
[Mh] Termos MeSH secundário: Parada Cardíaca
Seres Humanos
Parada Cardíaca Extra-Hospitalar
Projetos Piloto
Estudos Prospectivos
Ressuscitação
Tórax
Resultado do Tratamento
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE


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[PMID]:28377054
[Au] Autor:Contri E; Cornara S; Somaschini A; Dossena C; Tonani M; Epis F; Zambaiti E; Fichtner F; Baldi E
[Ad] Endereço:Pavia nel Cuore, IRC-Comunità Training Center, 27100 Pavia, Italy; Robbio nel Cuore, IRC-Comunità Training Center, 27038 Robbio, Italy; University of Pavia, School of Anesthesia and Intensive Care, 27100 Pavia, Italy.
[Ti] Título:Complete chest recoil during laypersons' CPR: Is it a matter of weight?
[So] Source:Am J Emerg Med;35(9):1266-1268, 2017 Sep.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Chest compressions depth and complete chest recoil are both important for high-quality Cardio-Pulmonary Resuscitation (CPR). It has been demonstrated that anthropometric variables affect chest compression depth, but there are no data about they could influence chest recoil. The aim of this study was to verify whether physical attributes influences chest recoil in lay rescuers. METHODS: We evaluated 1 minute of compression-only CPR performed by 333 laypersons immediately after a Basic Life Support and Automated External Defibrillation (BLS/AED) course. The primary endpoint was to verify whether anthropometric variables influence the achievement a complete chest recoil. Secondary endpoint was to verify the influence of anthropometric variables on chest compression depth. RESULTS: We found a statistically significant association between weight and percentage of compressions with correct release (p≤0.001) and this association was found also for height, BMI and sex. People who are heavier, who are taller, who have a greater BMI and who are male are less likely to achieve a complete chest recoil. Regarding chest compressions depth, we confirm that the more a person weighs, the more likely the correct depth of chest compressions will be reached. CONCLUSIONS: Anthropometric variables affect not only chest compression depth, but also complete chest recoil. CPR instructors should tailor their attention during training on different aspect of chest compression depending on the physical characteristics of the attendee.
[Mh] Termos MeSH primário: Peso Corporal
Reanimação Cardiopulmonar/educação
Massagem Cardíaca/métodos
Pressão
[Mh] Termos MeSH secundário: Adulto
Feminino
Parada Cardíaca/terapia
Seres Humanos
Itália
Masculino
Manequins
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170406
[St] Status:MEDLINE


  7 / 2241 MEDLINE  
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[PMID]:28350933
[Au] Autor:Taran S
[Ad] Endereço:University of Toronto, Toronto, Canada.
[Ti] Título:The Lisboa Café.
[So] Source:JAMA;317(12):1213-1214, 2017 Mar 28.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Processos Grupais
Internato e Residência
Restaurantes
Redação
[Mh] Termos MeSH secundário: Massagem Cardíaca
Seres Humanos
Música
Ontário
Estresse Psicológico
[Pt] Tipo de publicação:JOURNAL ARTICLE; PERSONAL NARRATIVES
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170421
[Lr] Data última revisão:
170421
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2016.16801


  8 / 2241 MEDLINE  
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[PMID]:28349529
[Au] Autor:Zhan L; Yang LJ; Huang Y; He Q; Liu GJ
[Ad] Endereço:Department of Neurosurgery, The First People's Hospital of Shuangliu County, Chengdu, China, 610041.
[Ti] Título:Continuous chest compression versus interrupted chest compression for cardiopulmonary resuscitation of non-asphyxial out-of-hospital cardiac arrest.
[So] Source:Cochrane Database Syst Rev;3:CD010134, 2017 Mar 27.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a major cause of death worldwide. Cardiac arrest can be subdivided into asphyxial and non asphyxial etiologies. An asphyxia arrest is caused by lack of oxygen in the blood and occurs in drowning and choking victims and in other circumstances. A non asphyxial arrest is usually a loss of functioning cardiac electrical activity. Cardiopulmonary resuscitation (CPR) is a well-established treatment for cardiac arrest. Conventional CPR includes both chest compressions and 'rescue breathing' such as mouth-to-mouth breathing. Rescue breathing is delivered between chest compressions using a fixed ratio, such as two breaths to 30 compressions or can be delivered asynchronously without interrupting chest compression. Studies show that applying continuous chest compressions is critical for survival and interrupting them for rescue breathing might increase risk of death. Continuous chest compression CPR may be performed with or without rescue breathing. OBJECTIVES: To assess the effects of continuous chest compression CPR (with or without rescue breathing) versus conventional CPR plus rescue breathing (interrupted chest compression with pauses for breaths) of non-asphyxial OHCA. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1 2017); MEDLINE (Ovid) (from 1985 to February 2017); Embase (1985 to February 2017); Web of Science (1985 to February 2017). We searched ongoing trials databases including controlledtrials.com and clinicaltrials.gov. We did not impose any language or publication restrictions. SELECTION CRITERIA: We included randomized and quasi-randomized studies in adults and children suffering non-asphyxial OHCA due to any cause. Studies compared the effects of continuous chest compression CPR (with or without rescue breathing) with interrupted CPR plus rescue breathing provided by rescuers (bystanders or professional CPR providers). DATA COLLECTION AND ANALYSIS: Two authors extracted the data and summarized the effects as risk ratios (RRs), adjusted risk differences (ARDs) or mean differences (MDs). We assessed the quality of evidence using GRADE. MAIN RESULTS: We included three randomized controlled trials (RCTs) and one cluster-RCT (with a total of 26,742 participants analysed). We identified one ongoing study. While predominantly adult patients, one study included children. Untrained bystander-administered CPRThree studies assessed CPR provided by untrained bystanders in urban areas of the USA, Sweden and the UK. Bystanders administered CPR under telephone instruction from emergency services. There was an unclear risk of selection bias in two trials and low risk of detection, attrition, and reporting bias in all three trials. Survival outcomes were unlikely to be affected by the unblinded design of the studies.We found high-quality evidence that continuous chest compression CPR without rescue breathing improved participants' survival to hospital discharge compared with interrupted chest compression with pauses for rescue breathing (ratio 15:2) by 2.4% (14% versus 11.6%; RR 1.21, 95% confidence interval (CI) 1.01 to 1.46; 3 studies, 3031 participants).One trial reported survival to hospital admission, but the number of participants was too low to be certain about the effects of the different treatment strategies on survival to admission(RR 1.18, 95% CI 0.94 to 1.48; 1 study, 520 participants; moderate-quality evidence).There were no data available for survival at one year, quality of life, return of spontaneous circulation or adverse effects.There was insufficient evidence to determine the effect of the different strategies on neurological outcomes at hospital discharge (RR 1.25, 95% CI 0.94 to 1.66; 1 study, 1286 participants; moderate-quality evidence). The proportion of participants categorized as having good or moderate cerebral performance was 11% following treatment with interrupted chest compression plus rescue breathing compared with 10% to 18% for those treated with continuous chest compression CPR without rescue breathing. CPR administered by a trained professional In one trial that assessed OHCA CPR administered by emergency medical service professionals (EMS) 23,711 participants received either continuous chest compression CPR (100/minute) with asynchronous rescue breathing (10/minute) or interrupted chest compression with pauses for rescue breathing (ratio 30:2). The study was at low risk of bias overall.After OHCA, risk of survival to hospital discharge is probably slightly lower for continuous chest compression CPR with asynchronous rescue breathing compared with interrupted chest compression plus rescue breathing (9.0% versus 9.7%) with an adjusted risk difference (ARD) of -0.7%; 95% CI (-1.5% to 0.1%); moderate-quality evidence.There is high-quality evidence that survival to hospital admission is 1.3% lower with continuous chest compression CPR with asynchronous rescue breathing compared with interrupted chest compression plus rescue breathing (24.6% versus 25.9%; ARD -1.3% 95% CI (-2.4% to -0.2%)).Survival at one year and quality of life were not reported.Return of spontaneous circulation is likely to be slightly lower in people treated with continuous chest compression CPR plus asynchronous rescue breathing (24.2% versus 25.3%; -1.1% (95% CI -2.4 to 0.1)), high-quality evidence.There is high-quality evidence of little or no difference in neurological outcome at discharge between these two interventions (7.0% versus 7.7%; ARD -0.6% (95% CI -1.4 to 0.1).Rates of adverse events were 54.4% in those treated with continuous chest compressions plus asynchronous rescue breathing versus 55.4% in people treated with interrupted chest compression plus rescue breathing compared with the ARD being -1% (-2.3 to 0.4), moderate-quality evidence). AUTHORS' CONCLUSIONS: Following OHCA, we have found that bystander-administered chest compression-only CPR, supported by telephone instruction, increases the proportion of people who survive to hospital discharge compared with conventional interrupted chest compression CPR plus rescue breathing. Some uncertainty remains about how well neurological function is preserved in this population and there is no information available regarding adverse effects.When CPR was performed by EMS providers, continuous chest compressions plus asynchronous rescue breathing did not result in higher rates for survival to hospital discharge compared to interrupted chest compression plus rescue breathing. The results indicate slightly lower rates of survival to admission or discharge, favourable neurological outcome and return of spontaneous circulation observed following continuous chest compression. Adverse effects are probably slightly lower with continuous chest compression.Increased availability of automated external defibrillators (AEDs), and AED use in CPR need to be examined, and also whether continuous chest compression CPR is appropriate for paediatric cardiac arrest.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar/métodos
Massagem Cardíaca/métodos
Parada Cardíaca Extra-Hospitalar/terapia
[Mh] Termos MeSH secundário: Adulto
Circulação Sanguínea/fisiologia
Reanimação Cardiopulmonar/mortalidade
Criança
Auxiliares de Emergência
Hospitalização
Seres Humanos
Parada Cardíaca Extra-Hospitalar/classificação
Parada Cardíaca Extra-Hospitalar/etiologia
Parada Cardíaca Extra-Hospitalar/mortalidade
Ensaios Clínicos Controlados Aleatórios como Assunto
Telefone
Tórax
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170705
[Lr] Data última revisão:
170705
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD010134.pub2


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[PMID]:28343813
[Au] Autor:Ding J; Zhang M; Jiang L
[Ad] Endereço:Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine&Institute of emergency Medicine, Zhejiang University, jiefang road 88, Hangzhou, China. Electronic address: dingjb1982@163.com.
[Ti] Título:Radiological assessment of the compression depth: A hospital based trauma database quantitative analysis from China.
[So] Source:Am J Emerg Med;35(7):1017-1019, 2017 07.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar/normas
Massagem Cardíaca/métodos
Parada Cardíaca Extra-Hospitalar/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
China
Bases de Dados Factuais
Estudos de Avaliação como Assunto
Feminino
Massagem Cardíaca/normas
Seres Humanos
Masculino
Meia-Idade
Parada Cardíaca Extra-Hospitalar/mortalidade
Guias de Prática Clínica como Assunto
Estudos Retrospectivos
Tórax/diagnóstico por imagem
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:LETTER; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170328
[St] Status:MEDLINE


  10 / 2241 MEDLINE  
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[PMID]:28323084
[Au] Autor:Hunt EA; Duval-Arnould JM; Chime NO; Jones K; Rosen M; Hollingsworth M; Aksamit D; Twilley M; Camacho C; Nogee DP; Jung J; Nelson-McMillan K; Shilkofski N; Perretta JS
[Ad] Endereço:Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Anesthesiology and Critical Care Medicine, Baltimore, Maryland, USA; Department of Pediatrics, Baltimore, Maryland, USA; Division of Health Sciences Informatics, Baltimore, Maryland, USA; Johns Hopkins Medicine Simu
[Ti] Título:Integration of in-hospital cardiac arrest contextual curriculum into a basic life support course: a randomized, controlled simulation study.
[So] Source:Resuscitation;114:127-132, 2017 May.
[Is] ISSN:1873-1570
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The objective was to compare resuscitation performance on simulated in-hospital cardiac arrests after traditional American Heart Association (AHA) Healthcare Provider Basic Life Support course (TradBLS) versus revised course including in-hospital skills (HospBLS). DESIGN: This study is a prospective, randomized, controlled curriculum evaluation. SETTING: Johns Hopkins Medicine Simulation Center. SUBJECTS: One hundred twenty-two first year medical students were divided into fifty-nine teams. INTERVENTION: HospBLS course of identical length, containing additional content contextual to hospital environments, taught utilizing Rapid Cycle Deliberate Practice (RCDP). MEASUREMENTS: The primary outcome measure during simulated cardiac arrest scenarios was chest compression fraction (CCF) and secondary outcome measures included metrics of high quality resuscitation. MAIN RESULTS: Out-of-hospital cardiac arrest HospBLS teams had larger CCF: [69% (65-74) vs. 58% (53-62), p<0.001] and were faster than TradBLS at initiating compressions: [median (IQR): 9s (7-12) vs. 22s (17.5-30.5), p<0.001]. In-hospital cardiac arrest HospBLS teams had larger CCF: [73% (68-75) vs. 50% (43-54), p<0.001] and were faster to initiate compressions: [10s (6-11) vs. 36s (27-63), p<0.001]. All teams utilized the hospital AED to defibrillate within 180s per AHA guidelines [HospBLS: 122s (103-149) vs. TradBLS: 139s (117-172), p=0.09]. HospBLS teams performed more hospital-specific maneuvers to optimize compressions, i.e. utilized: CPR button to flatten bed: [7/30 (23%) vs. 0/29 (0%), p=0.006], backboard: [21/30 (70%) vs. 5/29 (17%), p<0.001], stepstool: [28/30 (93%) vs. 8/29 (28%), p<0.001], lowered bedrails: [28/30 (93%) vs. 10/29 (34%), p<0.001], connected oxygen appropriately: [26/30 (87%) vs. 1/29 (3%), p<0.001] and used oral airway and/or two-person bagging when traditional bag-mask-ventilation unsuccessful: [30/30 (100%) vs. 0/29 (0%), p<0.001]. CONCLUSION: A hospital focused BLS course utilizing RCDP was associated with improved performance on hospital-specific quality measures compared with the traditional AHA course.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar/educação
Cardioversão Elétrica/métodos
Parada Cardíaca/terapia
Massagem Cardíaca/normas
Parada Cardíaca Extra-Hospitalar/terapia
Treinamento por Simulação/métodos
[Mh] Termos MeSH secundário: Reanimação Cardiopulmonar/normas
Currículo
Feminino
Seres Humanos
Masculino
Estudos Prospectivos
Estudantes de Medicina
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170322
[St] Status:MEDLINE



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