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Sample records for advanced resuscitation training

  1. [Advanced resuscitation of adults

    DEFF Research Database (Denmark)

    Lippert, F.K.; Lauritsen, T.L.; Torp-Pedersen, C.

    2008-01-01

    International and European Resuscitation Council (ERC) Guidelines for Resuscitation 2005 implicate major changes in resuscitation, including new universal treatment algorithms. This brief summary of Guidelines 2005 for advanced resuscitation of adult cardiac arrest victims is based upon the ERC...

  2. Advanced Cardiac Resuscitation Evaluation (ACRE: A randomised single-blind controlled trial of peer-led vs. expert-led advanced resuscitation training

    Directory of Open Access Journals (Sweden)

    Hughes Thomas C

    2010-01-01

    Full Text Available Abstract Background Advanced resuscitation skills training is an important and enjoyable part of medical training, but requires small group instruction to ensure active participation of all students. Increases in student numbers have made this increasingly difficult to achieve. Methods A single-blind randomised controlled trial of peer-led vs. expert-led resuscitation training was performed using a group of sixth-year medical students as peer instructors. The expert instructors were a senior and a middle grade doctor, and a nurse who is an Advanced Life Support (ALS Instructor. A power calculation showed that the trial would have a greater than 90% chance of rejecting the null hypothesis (that expert-led groups performed 20% better than peer-led groups if that were the true situation. Secondary outcome measures were the proportion of High Pass grades in each groups and safety incidents. The peer instructors designed and delivered their own course material. To ensure safety, the peer-led groups used modified defibrillators that could deliver only low-energy shocks. Blinded assessment was conducted using an Objective Structured Clinical Examination (OSCE. The checklist items were based on International Liaison Committee on Resuscitation (ILCOR guidelines using Ebel standard-setting methods that emphasised patient and staff safety and clinical effectiveness. The results were analysed using Exact methods, chi-squared and t-test. Results A total of 132 students were randomised: 58 into the expert-led group, 74 into the peer-led group. 57/58 (98% of students from the expert-led group achieved a Pass compared to 72/74 (97% from the peer-led group: Exact statistics confirmed that it was very unlikely (p = 0.0001 that the expert-led group was 20% better than the peer-led group. There were no safety incidents, and High Pass grades were achieved by 64 (49% of students: 33/58 (57% from the expert-led group, 31/74 (42% from the peer-led group. Exact

  3. Time matters – Realism in resuscitation training

    DEFF Research Database (Denmark)

    Krogh, Kristian; Høyer, Christian Bjerre; Østergaard, Doris;

    2014-01-01

    Background: The advanced life support guidelines recommend 2 min of cardiopulmonary resuscitation (CPR) and minimal hands-off time to ensure sufficient cardiac and cerebral perfusion. We have observed doctors who shorten the CPR intervals during resuscitation attempts. During simulation-based res......Background: The advanced life support guidelines recommend 2 min of cardiopulmonary resuscitation (CPR) and minimal hands-off time to ensure sufficient cardiac and cerebral perfusion. We have observed doctors who shorten the CPR intervals during resuscitation attempts. During simulation......-based resuscitation training, the recommended 2-min CPR cycles are often deliberately decreased in order to increase the number of scenarios. The aim of this study was to test if keeping 2-min CPR cycles during resuscitation training ensures better adherence to time during resuscitation in a simulated setting....... Methods: This study was designed as a randomised control trial. Fifty-four 4th-year medical students with no prior advanced resuscitation training participated in an extra-curricular one-day advanced life support course. Participants were either randomised to simulation-based training using real-time (120...

  4. Time matters--realism in resuscitation training

    DEFF Research Database (Denmark)

    Krogh, Kristian; Høyer, Christian; Ostergaard, Doris;

    2014-01-01

    BACKGROUND: The advanced life support guidelines recommend 2min of cardiopulmonary resuscitation (CPR) and minimal hands-off time to ensure sufficient cardiac and cerebral perfusion. We have observed doctors who shorten the CPR intervals during resuscitation attempts. During simulation-based resu......BACKGROUND: The advanced life support guidelines recommend 2min of cardiopulmonary resuscitation (CPR) and minimal hands-off time to ensure sufficient cardiac and cerebral perfusion. We have observed doctors who shorten the CPR intervals during resuscitation attempts. During simulation......-based resuscitation training, the recommended 2-min CPR cycles are often deliberately decreased in order to increase the number of scenarios. The aim of this study was to test if keeping 2-min CPR cycles during resuscitation training ensures better adherence to time during resuscitation in a simulated setting....... METHODS: This study was designed as a randomised control trial. Fifty-four 4th-year medical students with no prior advanced resuscitation training participated in an extra-curricular one-day advanced life support course. Participants were either randomised to simulation-based training using real-time (120...

  5. Impact of advanced cardiac life support training program on the outcome of cardiopulmonary resuscitation in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Kanwalpreet Sodhi

    2011-01-01

    Full Text Available Background: Guidelines on performing cardiopulmonary resuscitation (CPR have been published from time to time, and formal training programs are conducted based on these guidelines. Very few data are available in world literature highlighting the impact of these trainings on CPR outcome. Aim: The aim of our study was to evaluate the impact of the American Heart Association (AHA-certified basic life support (BLS and advanced cardiac life support (ACLS provider course on the outcomes of CPR in our hospital. Materials and Methods : An AHA-certified BLS and ACLS provider training programme was conducted in our hospital in the first week of October 2009, in which all doctors in the code blue team and intensive care units were given training. The retrospective study was performed over an 18-month period. All in-hospital adult cardiac arrest victims in the pre-BLS/ACLS training period (January 2009 to September 2009 and the post-BLS/ACLS training period (October 2009 to June 2010 were included in the study. We compared the outcomes of CPR between these two study periods. Results: There were a total of 627 in-hospital cardiac arrests, 284 during the pre-BLS/ACLS training period and 343 during the post-BLS/ACLS training period. In the pre-BLS/ACLS training period, 52 patients (18.3% had return of spontaneous circulation, compared with 97 patients (28.3% in the post-BLS/ACLS training period (P < 0.005. Survival to hospital discharge was also significantly higher in the post-BLS/ACLS training period (67 patients, 69.1% than in the pre-BLS/ACLS training period (12 patients, 23.1% (P < 0.0001. Conclusion : Formal certified BLS and ACLS training of healthcare professionals leads to definitive improvement in the outcome of CPR.

  6. [Resuscitation - Adult advanced life support].

    Science.gov (United States)

    Gräsner, Jan-Thorsten; Bein, Berthold

    2016-03-01

    Enhanced measures for resuscitation of adults are based on basic measures of resuscitation. The central elements are highly effective chest compressions and avoidance of disruptions that are associated with poor patient outcomes that occur within seconds. The universal algorithm distinguishes the therapy for ventricular fibrillation from the therapy in asystole or pulseless electrical activity (PEA) by the need of defibrillation, and amiodarone administration in the former. Defibrillation is biphasic. In all other aspects, there are no differences in therapy. In each episode of cardiac arrest, reversible causes should be excluded or treated. For the diagnosis during resuscitation, sonography can be helpful. What is new in the 2015 ERC recommendations is the use of capnography, which can be used for the assessment of ROSC (return of spontaneous circulation), ventilation, resuscitation and intubation quality. Mechanical resuscitation devices can be used in selected situations. Successful primary resuscitation should be directly followed by measures of the post-resuscitation care. PMID:27022698

  7. Educational aspects of cardiopulmonary resuscitation (CPR) training.

    Science.gov (United States)

    Cavanagh, S J

    1990-03-01

    The knowledge and skills surrounding the practice of cardiopulmonary resuscitation (CPR) have become essential to intensive care nurses and to nurses in general. With formalized training and refresher courses becoming more common in this country, it is evident that after relatively short periods of time the knowledge and skills acquired at such courses may be lost. While much consideration has been given to the content of both Basic and Advanced Cardiac Life Support (BCLS and ACLS) courses, relatively little attention has been paid to the educational issues surrounding CPR training. This paper explores some of these issues from the perspective of adult learning (andragogy). Research is cited from a wide range of sources to illustrate that CPR skill and knowledge deterioration is not unique to nursing, and that educational techniques exist which may improve current educational practices. PMID:2329270

  8. Strategy analysis of cardiopulmonary resuscitation training in the community

    OpenAIRE

    Wang, Jin; Ma, Li; Lu, Yuan-qiang

    2015-01-01

    Bystander cardiopulmonary resuscitation (CPR) is a crucial therapy for sudden cardiac arrest. This appreciation produced immense efforts by professional organizations to train laypeople for CPR skills. However, the rate of CPR training is low and varies widely across communities. Several strategies are used in order to improve the rate of CPR training and are performed in some advanced countries. The Chinese CPR training in communities could gain enlightenment from them.

  9. Hospital implementation of resuscitation guidelines and review of CPR training programmes

    DEFF Research Database (Denmark)

    Schmidt, Anders S; Lauridsen, Kasper G; Adelborg, Kasper; Løfgren, Bo

    2016-01-01

    This study aimed to investigate cardiopulmonary resuscitation (CPR) guideline implementation and CPR training in hospitals. This nationwide study included mandatory resuscitation protocols from each Danish hospital. Protocols were systematically reviewed for adherence to the European Resuscitation...... Council (ERC) 2010 guidelines and CPR training in each hospital. Data were included from 45 of 47 hospitals. Adherence to the ERC basic life support (BLS) algorithm was 49%, whereas 63 and 58% of hospitals adhered to the recommended chest compression depth and rate. Adherence to the ERC advanced life...... hospitals adhere to the ALS algorithm. CPR training differs among hospitals....

  10. Cardiopulmonary resuscitation: update, controversies and new advances

    Directory of Open Access Journals (Sweden)

    Zago Alexandre C.

    1999-01-01

    Full Text Available Cardiopulmonary arrest is a medical emergency in which the lapse of time between event onset and the initiation of measures of basic and advanced support, as well as the correct care based on specific protocols for each clinical situation, constitute decisive factors for a successful therapy. Cardiopulmonary arrest care cannot be restricted to the hospital setting because of its fulminant nature. This necessitates the creation of new concepts, strategies and structures, such as the concept of life chain, cardio-pulmonary resuscitation courses for professionals who work in emergency medical services, the automated external defibrillator, the implantable cardioverter-defibrillator, and mobile intensive care units, among others. New concepts, strategies and structures motivated by new advances have also modified the treatment and improved the results of cardiopulmonary resuscitation in the hospital setting. Among them, we can cite the concept of cerebral resuscitation, the application of the life chain, the creation of the universal life support algorithm, the adjustment of drug doses, new techniques - measure of the end-tidal carbon dioxide levels and of the coronary perfusion pressure - and new drugs under research.

  11. Hospital implementation of resuscitation guidelines and review of CPR training programmes: a nationwide study.

    Science.gov (United States)

    Schmidt, Anders S; Lauridsen, Kasper G; Adelborg, Kasper; Løfgren, Bo

    2016-06-01

    This study aimed to investigate cardiopulmonary resuscitation (CPR) guideline implementation and CPR training in hospitals. This nationwide study included mandatory resuscitation protocols from each Danish hospital. Protocols were systematically reviewed for adherence to the European Resuscitation Council (ERC) 2010 guidelines and CPR training in each hospital. Data were included from 45 of 47 hospitals. Adherence to the ERC basic life support (BLS) algorithm was 49%, whereas 63 and 58% of hospitals adhered to the recommended chest compression depth and rate. Adherence to the ERC advanced life support (ALS) algorithm was 81%. Hospital BLS course duration was [median (interquartile range)] 2.3 (1.5-2.5) h, whereas ALS course duration was 4.0 (2.5-8.0) h. Implementation of ERC 2010 guidelines on BLS is limited in Danish hospitals 2 years after guideline publication, whereas the majority of hospitals adhere to the ALS algorithm. CPR training differs among hospitals. PMID:26181002

  12. Design of a Functional Training Prototype for Neonatal Resuscitation

    Directory of Open Access Journals (Sweden)

    Sivaramakrishnan Rajaraman

    2014-11-01

    Full Text Available Birth Asphyxia is considered to be one of the leading causes of neonatal mortality around the world. Asphyxiated neonates require skilled resuscitation to survive the neonatal period. The project aims to train health professionals in a basic newborn care using a prototype with an ultimate objective to have one person at every delivery trained in neonatal resuscitation. This prototype will be a user-friendly device with which one can get trained in performing neonatal resuscitation in resource-limited settings. The prototype consists of a Force Sensing Resistor (FSR that measures the pressure applied and is interfaced with Arduino® which controls the Liquid Crystal Display (LCD and Light Emitting Diode (LED indication for pressure and compression counts. With the increase in population and absence of proper medical care, the need for neonatal resuscitation program is not well addressed. The proposed work aims at offering a promising solution for training health care individuals on resuscitating newborn babies under low resource settings.

  13. Voice advisory manikin versus instructor facilitated training in cardiopulmonary resuscitation

    DEFF Research Database (Denmark)

    Isbye, Dan L; Høiby, Pernilla; Rasmussen, Maria B;

    2008-01-01

    BACKGROUND: Training of healthcare staff in cardiopulmonary resuscitation (CPR) is time-consuming and costly. It has been suggested to replace instructor facilitated (IF) training with an automated voice advisory manikin (VAM), which increases skill level by continuous verbal feedback during...... individual training. AIMS: To compare a VAM (ResusciAnne CPR skills station, Laerdal Medical A/S, Norway) with IF training in CPR using a bag-valve-mask (BVM) in terms of skills retention after 3 months. METHODS: Forty-three second year medical students were included and CPR performance (ERC Guidelines for...... Resuscitation 2005) was assessed in a 2 min test before randomisation to either IF training in groups of 8 or individual VAM training. Immediately after training and after 3 months, CPR performance was assessed in identical 2 min tests. Laerdal PC Skill Reporting System 2.0 was used to collect data. To quantify...

  14. [Basic and advanced resuscitation of children

    DEFF Research Database (Denmark)

    Lauritsen, T.L.; Jensen, Tim; Greisen, G.

    2008-01-01

    The ERC Guidelines 2005 regarding the resuscitation of children and neonates recommend changes in treatment algorithms. Cardiac arrest in children is most often caused or worsened by hypoxic conditions. On confirmation of cardiac arrest in a child, treatment is initiated with 5 ventilations and c...

  15. Do Radiologists Want/Need Training in Cardiopulmonary Resuscitation?

    International Nuclear Information System (INIS)

    Purpose: Prompt and effective cardiopulmonary resuscitation (CPR) decreases morbidity and mortality following cardiopulmonary arrest. Radiologists are frequently confronted with severely ill patients, who may deteriorate at any time. Furthermore, they have to be aware of life-threatening reactions towards contrast media. This study was designed to assess experience and self-estimation of German-speaking radiologists in CPR and cardiac defibrillation (CD). Material and Methods: 650 German-speaking radiologists were audited by a specially designed questionnaire, which was sent via e-mail. The answers were expected to be re-mailed within a 2-month period. Results: The response rate was 12.6%. 72.8% of the responders had performed at least 1 CPR (range 9.5 ± 13.1) and 37% at least 1 CD. 67.9% had had opportunities to attend training courses, which had been utilized by 41.8% of them. The last training of the responders was more than 2 years ago in 69.2% and more than 5 years ago in 37%. Of all responders 75.6% expressed the need for further education. Conclusion: The small response rate indicates the small importance of CPR in the subpopulation surveyed. The vast majority of the responders, however, showed interest in basic and advanced life support and advocated regular updates. It seems reasonable that radiological Dept. themselves should organize courses in order to cope with their specific situations

  16. 高级模拟联合情景式教学在急诊心肺复苏培训中的应用%Application of Advanced Simulation Combined With Situational Teaching in the Training of Emergency Cardiopulmonary Resuscitation

    Institute of Scientific and Technical Information of China (English)

    李永宁

    2015-01-01

    心肺复苏(CPR)是针对心搏呼吸骤停患者所采取的急救措施,是每一个医学生必须掌握的急救技术之一,早期高质量的心肺复苏是患者生存的关键,临床情景结合高级模拟演练加强医学生对心肺复苏的深刻理解、扎实掌握心肺复苏技术,能够提高急诊医学教学质量和培养学生临床思维应变能力。%CPR is a breathing aid measures for cardiac arrest patients taken, is one of every medical students must master first aid techniques, early quality CPR is the key to survival, clinical scenario combined with advanced simulation exercises to strengthen the medical students a deep understanding of cardiopulmonary resuscitation, a solid grasp CPR technology can improve the quality of teaching and training of emergency medical students' clinical thinking resilience.

  17. Cardiopulmonary resuscitation: update, controversies and new advances

    OpenAIRE

    Alexandre C. Zago; Cristine E. Nunes; Viviane R. da Cunha; Euler Manenti; Luís Carlos Bodanese

    1999-01-01

    Cardiopulmonary arrest is a medical emergency in which the lapse of time between event onset and the initiation of measures of basic and advanced support, as well as the correct care based on specific protocols for each clinical situation, constitute decisive factors for a successful therapy. Cardiopulmonary arrest care cannot be restricted to the hospital setting because of its fulminant nature. This necessitates the creation of new concepts, strategies and structures, such as the concept of...

  18. Trainers' Attitudes towards Cardiopulmonary Resuscitation, Current Care Guidelines, and Training

    Science.gov (United States)

    Mäkinen, M.; Castrén, M.; Nurmi, J.; Niemi-Murola, L.

    2016-01-01

    Objectives. Studies have shown that healthcare personnel hesitate to perform defibrillation due to individual or organisational attitudes. We aimed to assess trainers' attitudes towards cardiopulmonary resuscitation and defibrillation (CPR-D), Current Care Guidelines, and associated training. Methods. A questionnaire was distributed to CPR trainers attending seminars in Finland (N = 185) focusing on the updated national Current Care Guidelines 2011. The questions were answered using Likert scale (1 = totally disagree, 7 = totally agree). Factor loading of the questionnaire was made using maximum likelihood analysis and varimax rotation. Seven scales were constructed (Hesitation, Nurse's Role, Nontechnical Skill, Usefulness, Restrictions, Personal, and Organisation). Cronbach's alphas were 0.92–0.51. Statistics were Student's t-test, ANOVA, stepwise regression analysis, and Pearson Correlation. Results. The questionnaire was returned by 124/185, 67% CPR trainers, of whom two-thirds felt that their undergraduate training in CPR-D had not been adequate. Satisfaction with undergraduate defibrillation training correlated with the Nontechnical Skills scale (p Nurse's Role (p CPR trainers and some feel uncertain of defibrillation. The train-the-trainers courses and undergraduate medical education should focus more on practical scenarios with defibrillators and nontechnical skills. PMID:27144027

  19. Trainers’ Attitudes towards Cardiopulmonary Resuscitation, Current Care Guidelines, and Training

    Directory of Open Access Journals (Sweden)

    M. Mäkinen

    2016-01-01

    Full Text Available Objectives. Studies have shown that healthcare personnel hesitate to perform defibrillation due to individual or organisational attitudes. We aimed to assess trainers’ attitudes towards cardiopulmonary resuscitation and defibrillation (CPR-D, Current Care Guidelines, and associated training. Methods. A questionnaire was distributed to CPR trainers attending seminars in Finland (N=185 focusing on the updated national Current Care Guidelines 2011. The questions were answered using Likert scale (1 = totally disagree, 7 = totally agree. Factor loading of the questionnaire was made using maximum likelihood analysis and varimax rotation. Seven scales were constructed (Hesitation, Nurse’s Role, Nontechnical Skill, Usefulness, Restrictions, Personal, and Organisation. Cronbach’s alphas were 0.92–0.51. Statistics were Student’s t-test, ANOVA, stepwise regression analysis, and Pearson Correlation. Results. The questionnaire was returned by 124/185, 67% CPR trainers, of whom two-thirds felt that their undergraduate training in CPR-D had not been adequate. Satisfaction with undergraduate defibrillation training correlated with the Nontechnical Skills scale (p<0.01. Participants scoring high on Hesitation scale (p<0.01 were less confident about their Nurse’s Role (p<0.01 and Nontechnical Skills (p<0.01. Conclusion. Quality of undergraduate education affects the work of CPR trainers and some feel uncertain of defibrillation. The train-the-trainers courses and undergraduate medical education should focus more on practical scenarios with defibrillators and nontechnical skills.

  20. The effectiveness of a 'train the trainer' model of resuscitation education for rural peripheral hospital doctors in Sri Lanka.

    Directory of Open Access Journals (Sweden)

    Bishan N Rajapakse

    Full Text Available BACKGROUND: Sri Lankan rural doctors based in isolated peripheral hospitals routinely resuscitate critically ill patients but have difficulty accessing training. We tested a train-the-trainer model that could be utilised in isolated rural hospitals. METHODS: Eight selected rural hospital non-specialist doctors attended a 2-day instructor course. These "trained trainers" educated their colleagues in advanced cardiac life support at peripheral hospital workshops and we tested their students in resuscitation knowledge and skills pre and post training, and at 6- and 12-weeks. Knowledge was assessed through 30 multiple choice questions (MCQ, and resuscitation skills were assessed by performance in a video recorded simulated scenario of a cardiac arrest using a Resuci Anne Skill Trainer mannequin. RESULTS/DISCUSSION/CONCLUSION: Fifty seven doctors were trained. Pre and post training assessment was possible in 51 participants, and 6-week and 12-week follow up was possible for 43, and 38 participants respectively. Mean MCQ scores significantly improved over time (p<0.001, and a significant improvement was noted in "average ventilation volume", "compression count", and "compressions with no error", "adequate depth", "average depth", and "compression rate" (p<0.01. The proportion of participants with compression depth ≥40mm increased post intervention (p<0.05 and at 12-week follow up (p<0.05, and proportion of ventilation volumes between 400-1000mls increased post intervention (p<0.001. A significant increase in the proportion of participants who "checked for responsiveness", "opened the airway", "performed a breathing check", who used the "correct compression ratio", and who used an "appropriate facemask technique" was also noted (p<0.001. A train-the-trainer model of resuscitation education was effective in improving resuscitation knowledge and skills in Sri Lankan rural peripheral hospital doctors. Improvement was sustained to 12 weeks for most

  1. Smartphone Apps for Cardiopulmonary Resuscitation Training and Real Incident Support: A Mixed-Methods Evaluation Study

    OpenAIRE

    Kalz, Marco; Lenssen, Niklas; Felzen, Marco; Rossaint, Rolf; Tabuenca, Bernardo; Specht, Marcus; Skorning, Max

    2014-01-01

    Background: No systematic evaluation of smartphone/mobile apps for resuscitation training and real incident support is available to date. To provide medical, usability, and additional quality criteria for the development of apps, we conducted a mixed-methods sequential evaluation combining the perspective of medical experts and end-users. Objective: The study aims to assess the quality of current mobile apps for cardiopulmonary resuscitation (CPR) training and real incident support from exper...

  2. Smartphone Apps for Cardiopulmonary Resuscitation Training and Real Incident Support: A Mixed-Methods Evaluation Study

    OpenAIRE

    2014-01-01

    Background No systematic evaluation of smartphone/mobile apps for resuscitation training and real incident support is available to date. To provide medical, usability, and additional quality criteria for the development of apps, we conducted a mixed-methods sequential evaluation combining the perspective of medical experts and end-users. Objective The study aims to assess the quality of current mobile apps for cardiopulmonary resuscitation (CPR) training and real incident support from expert ...

  3. Peer-led training in basic life support and resuscitation using an automatic external defibrillator

    DEFF Research Database (Denmark)

    Løfgren, Bo; Petersen, Christina Børlum; Mikkelsen, Ronni;

    2009-01-01

    Peer-led training has been identified as a useful tool for delivering undergraduate healthcare training. In this paper we describe the implementation of the European Resuscitation Council BLS/AED Course as a peer-led training program for medical students....

  4. Impact of a nationwide training program for neonatal resuscitation in China

    Institute of Scientific and Technical Information of China (English)

    XU Tao; MA Yi; William Keenan; Susan Niermeyer; WANG Hui-shan; YE Hong-mao; YU Ren-jie; HUANG Xing-hua; WANG Dan-hua; Wang Li-xin; FENG Qi; GONG Li-min

    2012-01-01

    Background Seventeen million births occur in China each year.Neonatal mortality is the leading cause of under 5-year-old child deaths,and intrapartum-related injury accounts for much of mental retardation in young children.The Chinese Ministry of Health sought to improve infant and child survival through a nationwide initiative to have at least one person trained in neonatal resuscitation at every birth.The aim of the current study was to evaluate the impact of China Neonatal Resuscitation Program (NRP) on policy and infrastructure changes and its effectiveness in decreasing the incidence of mortality among newborn infants.Methods The Chinese NRP incorporated policy change,professional education,and creation of a sustainable health system infrastructure for resuscitation.Multidisciplinary teams from all 31 provinces and municipal states disseminated NRP in a train-the-trainer cascade.The intervention targeted 20 provinces with high neonatal mortality and programs to reduce maternal mortality.Program evaluation data came from 322 representative hospitals in those provinces.Results Changes in policy permitted midwives to initiate resuscitation and required resuscitation training for licensure.From 2004 through 2009 more than 110659 professionals received NRP training in the 20 target provinces,with 94% of delivery facilities and 99% of counties reached.Intrapartum-related deaths in the delivery room decreased from 7.5 to 3.4per 10000 from 2003 to 2008,and the incidence of Apgar ≤7 at 1 minute decreased from 6.3% to 2.9%.Conclusions The Chinese NRP achieved policy changes promoting resuscitation,trained large numbers of professionals,and contributed to reduction in delivery room mortality.Improved adherence to the resuscitation algorithm,extension of training to the township level,and coverage of births now occurring outside health facilities can further increase the number of lives saved.

  5. Assessment of long-term impact of formal certified cardiopulmonary resuscitation training program among nurses

    Directory of Open Access Journals (Sweden)

    P P Saramma

    2016-01-01

    Full Text Available Context: Cardiopulmonary resuscitation (CPR and emergency cardiovascular care guidelines are periodically renewed and published by the American Heart Association. Formal training programs are conducted based on these guidelines. Despite widespread training CPR is often poorly performed. Hospital educators spend a significant amount of time and money in training health professionals and maintaining basic life support (BLS and advanced cardiac life support (ACLS skills among them. However, very little data are available in the literature highlighting the long-term impact of these training. Aims: To evaluate the impact of formal certified CPR training program on the knowledge and skill of CPR among nurses, to identify self-reported outcomes of attempted CPR and training needs of nurses. Setting and Design : Tertiary care hospital, Prospective, repeated-measures design. Subjects and Methods: A series of certified BLS and ACLS training programs were conducted during 2010 and 2011. Written and practical performance tests were done. Final testing was undertaken 3-4 years after training. The sample included all available, willing CPR certified nurses and experience matched CPR noncertified nurses. Statistical Analysis Used: SPSS for Windows version 21.0. Results: The majority of the 206 nurses (93 CPR certified and 113 noncertified were females. There was a statistically significant increase in mean knowledge level and overall performance before and after the formal certified CPR training program (P = 0.000. However, the mean knowledge scores were equivalent among the CPR certified and noncertified nurses, although the certified nurses scored a higher mean score (P = 0.140. Conclusions: Formal certified CPR training program increases CPR knowledge and skill. However, significant long-term effects could not be found. There is a need for regular and periodic recertification.

  6. Design of a game-based pre-hospital resuscitation training for first responders

    NARCIS (Netherlands)

    Kalz, Marco; Schmitz, Birgit; Biermann, Henning; Klemke, Roland; Ternier, Stefaan; Specht, Marcus

    2013-01-01

    Kalz, M., Schmitz, B., Biermann, H., Klemke, R., Ternier, S., & Specht, M. (2013). Design of a game-based pre-hospital resuscitation training for first responders. In A. Holzinger, M. Ziefle, & V. Glavinić (Eds.), SouthCHI 2013, LNCS 7946 (pp. 363-372). Germany: Springer, Heidelberg.

  7. Apps4CPR: A review study of mobile applications for cardiopulmonary resuscitation training and support

    NARCIS (Netherlands)

    Kalz, Marco

    2013-01-01

    Kalz, M. (2013, 23 September). Apps4CPR: A review study of mobile applications for cardiopulmonary resuscitation training and support. Presentation given during the 6th World Congress on Social Media, Mobile Apps and Internet/Web 2.0 in Medicine, Health, and Biomedical Research, London, UK.

  8. Smartphone Apps for Cardiopulmonary Resuscitation Training and Real Incident Support: A Mixed-Methods Evaluation Study

    NARCIS (Netherlands)

    Kalz, Marco; Lenssen, Niklas; Felzen, Marco; Rossaint, Rolf; Tabuenca, Bernardo; Specht, Marcus; Skorning, Max

    2014-01-01

    Background: No systematic evaluation of smartphone/mobile apps for resuscitation training and real incident support is available to date. To provide medical, usability, and additional quality criteria for the development of apps, we conducted a mixed-methods sequential evaluation combining the persp

  9. Disseminating cardiopulmonary resuscitation training by distributing 35,000 personal manikins among school children

    DEFF Research Database (Denmark)

    Isbye, Dan L; Rasmussen, Lars S; Ringsted, Charlotte;

    2007-01-01

    train 17,140 from the second tier (mean, 2.5 persons per pupil; 95% confidence interval, 2.4 to 2.5). The teachers had used a mean of 64 minutes (95% confidence interval, 60 to 68) for preparation and a mean of 13 minutes (95% confidence interval, 11 to 15) to tidy up. Incidence of bystander CPR in the......BACKGROUND: Because most cardiac arrests occur at home, widespread training is needed to increase the incidence of cardiopulmonary resuscitation (CPR) by lay persons. The aim of this study was to evaluate the effect of mass distribution of CPR instructional materials among schoolchildren. METHODS...... AND RESULTS: We distributed 35,002 resuscitation manikins to pupils (12 to 14 years of age) at 806 primary schools. Using the enclosed 24-minute instructional DVD, they trained in CPR and subsequently used the kit to train family and friends (second tier). They completed a questionnaire on who had...

  10. Diffusion of Cardiopulmonary Resuscitation Training to Chinese Immigrants with Limited English Proficiency

    OpenAIRE

    Mei Po Yip; Brandon Ong; Shin Ping Tu; Devora Chavez; Brooke Ike; Ian Painter; Ida Lam; Bradley, Steven M.; Coronado, Gloria D.; Meischke, Hendrika W.

    2011-01-01

    Cardiopulmonary resuscitation (CPR) is an effective intervention for prehospital cardiac arrest. Despite all available training opportunities for CPR, disparities exist in participation in CPR training, CPR knowledge, and receipt of bystander CPR for certain ethnic groups. We conducted five focus groups with Chinese immigrants who self-reported limited English proficiency (LEP). A bilingual facilitator conducted all the sessions. All discussions were taped, recorded, translated, and trans...

  11. Effects of training in cardiopulmonary resuscitation on competence and patient outcome.

    OpenAIRE

    Curry, L.; Gass, D

    1987-01-01

    Between 1981 and 1985 we carried out a study in two medium-sized nonteaching community hospitals to determine the rate of deterioration of knowledge and skills in cardiopulmonary resuscitation (CPR) among physicians and nurses, the accuracy of their perceptions of their knowledge and skills, the effects of practice on retention and the effect of CPR training on mortality. The participants' knowledge and skills were measured before training and immediately after, 6 months after and 12 months a...

  12. Does Resuscitation Training Reduce Neonatal Deaths in Low-Resource Communities? A Systematic Review of the Literature.

    Science.gov (United States)

    Sousa, Sarah; Mielke, John G

    2015-10-01

    Every year, nearly 1 million babies succumb to birth asphyxia (BA) within the Asia-Pacific region. The present study sought to determine whether educational interventions containing some element of resuscitation training would decrease the relative risk (RR) of neonatal mortality attributable to BA in low-resource communities. We systematically reviewed 3 electronic databases and identified 14 relevant reports. For community deliveries, providing traditional birth attendants (TBAs) with neonatal resuscitation training modestly reduced the RR in 3 of 4 studies. For institutional deliveries, training a range of clinical staff clearly reduced the RR within 2 of 8 studies. When resuscitation-specific training was directed to community and institutional health care workers, a slight benefit was observed in 1 of 2 studies. Specific training in neonatal resuscitation appears most effective when provided to TBAs (specifically, those presented with ongoing opportunities to review and update their skills), but this particular intervention alone may not appreciably reduce mortality. PMID:26378066

  13. Advances in damage control resuscitation and surgery: implications on the organization of future military field forces.

    Science.gov (United States)

    Tien, Homer; Beckett, Andrew; Garraway, Naisan; Talbot, Max; Pannell, Dylan; Alabbasi, Thamer

    2015-06-01

    Medical support to deployed field forces is increasingly becoming a shared responsibility among allied nations. National military medical planners face several key challenges, including fiscal restraints, raised expectations of standards of care in the field and a shortage of appropriately trained specialists. Even so, medical services are now in high demand, and the availability of medical support may become the limiting factor that determines how and where combat units can deploy. The influence of medical factors on operational decisions is therefore leading to an increasing requirement for multinational medical solutions. Nations must agree on the common standards that govern the care of the wounded. These standards will always need to take into account increased public expectations regarding the quality of care. The purpose of this article is to both review North Atlantic Treaty Organization (NATO) policies that govern multinational medical missions and to discuss how recent scientific advances in prehospital battlefield care, damage control resuscitation and damage control surgery may inform how countries within NATO choose to organize and deploy their field forces in the future. PMID:26100784

  14. More confident trauma resuscitation team leaders: a novel simulation-based training curriculum utilizing video feedback

    Directory of Open Access Journals (Sweden)

    John L. Falcone

    2013-02-01

    Full Text Available There are deficiencies in trauma leader performance. Simulation training and video-based feedback can lead to durable changes in behavior. A trauma resuscitation team leader training curriculum was developed. The curriculum consisted of eight simulated trauma scenarios with a mix of acuities and injury patterns using patient simulators. Other team members included a surgeon, an anesthesiologist, a chief resident, a trauma nurse, a medical student, and presenting emergency medicine staff. Each scenario was followed by video-based feedback. Attitudes regarding this curriculum were evaluated before and after the intervention with Likert-based surveys. Eight residents completed the curriculum. On a seven-point Likert scale, the median overall curriculum rating, the video discussion quality, the plan to apply leadership skills, and the plan to apply learned knowledge and behaviors was 7/7. A Wilcoxon Sign-Rank test showed improved confidence for leading Level 1 trauma resuscitations, improved beliefs in adequate training, and improved attitudes regarding team leader training (P<0.05. There was reduced nervousness of being the team leader (P=0.048. Qualitative analyses showed that the learners valued the feedback process and scenario realism. This pilot curriculum was well-received by trauma residents and offers insight into meta-cognition of trauma team leaders.

  15. What are the barriers to implementation of cardiopulmonary resuscitation training in secondary schools?

    DEFF Research Database (Denmark)

    Zinckernagel, Line; Malta Hansen, Carolina; Rod, Morten Hulvej; Folke, Fredrik; Torp-Pedersen, Christian; Tjørnhøj-Thomsen, Tine

    2016-01-01

    OBJECTIVE: Cardiopulmonary resuscitation (CPR) training in schools is recommended to increase bystander CPR and thereby survival of out-of-hospital cardiac arrest, but despite mandating legislation, low rates of implementation have been observed in several countries, including Denmark. The purpose...... of the study was to explore barriers to implementation of CPR training in Danish secondary schools. DESIGN: A qualitative study based on individual interviews and focus groups with school leadership and teachers. Thematic analysis was used to identify regular patterns of meaning both within and...... study population comprised 25 participants, 9 school leadership members and 16 teachers. RESULTS: School leadership and teachers considered it important for implementation and sustainability of CPR training that teachers conduct CPR training of students. However, they preferred external instructors to...

  16. What are the barriers to implementation of cardiopulmonary resuscitation training in secondary schools? A qualitative study

    Science.gov (United States)

    Malta Hansen, Carolina; Rod, Morten Hulvej; Folke, Fredrik; Torp-Pedersen, Christian; Tjørnhøj-Thomsen, Tine

    2016-01-01

    Objective Cardiopulmonary resuscitation (CPR) training in schools is recommended to increase bystander CPR and thereby survival of out-of-hospital cardiac arrest, but despite mandating legislation, low rates of implementation have been observed in several countries, including Denmark. The purpose of the study was to explore barriers to implementation of CPR training in Danish secondary schools. Design A qualitative study based on individual interviews and focus groups with school leadership and teachers. Thematic analysis was used to identify regular patterns of meaning both within and across the interviews. Setting 8 secondary schools in Denmark. Schools were selected using strategic sampling to reach maximum variation, including schools with/without recent experience in CPR training of students, public/private schools and schools near to and far from hospitals. Participants The study population comprised 25 participants, 9 school leadership members and 16 teachers. Results School leadership and teachers considered it important for implementation and sustainability of CPR training that teachers conduct CPR training of students. However, they preferred external instructors to train students, unless teachers acquired the CPR skills which they considered were needed. They considered CPR training to differ substantially from other teaching subjects because it is a matter of life and death, and they therefore believed extraordinary skills were required for conducting the training. This was mainly rooted in their insecurity about their own CPR skills. CPR training kits seemed to lower expectations of skill requirements to conduct CPR training, but only among those who were familiar with such kits. Conclusions To facilitate implementation of CPR training in schools, it is necessary to have clear guidelines regarding the required proficiency level to train students in CPR, to provide teachers with these skills, and to underscore that extensive skills are not required to

  17. Diffusion of Cardiopulmonary Resuscitation Training to Chinese Immigrants with Limited English Proficiency

    Directory of Open Access Journals (Sweden)

    Mei Po Yip

    2011-01-01

    Full Text Available Cardiopulmonary resuscitation (CPR is an effective intervention for prehospital cardiac arrest. Despite all available training opportunities for CPR, disparities exist in participation in CPR training, CPR knowledge, and receipt of bystander CPR for certain ethnic groups. We conducted five focus groups with Chinese immigrants who self-reported limited English proficiency (LEP. A bilingual facilitator conducted all the sessions. All discussions were taped, recorded, translated, and transcribed. Transcripts were analyzed by content analysis guided by the theory of diffusion. The majority of participants did not know of CPR and did not know where to get trained. Complexity of CPR procedure, advantages of calling 9-1-1, lack of confidence, and possible liability discourage LEP individuals to learn CPR. LEP individuals welcome simplified Hands-Only CPR and are willing to perform CPR with instruction from 9-1-1 operators. Expanding the current training to include Hands-Only CPR and dispatcher-assisted CPR may motivate Chinese LEP individuals to get trained for CPR.

  18. Brief Bedside Refresher Training to Practice Cardiopulmonary Resuscitation Skills in the Ambulatory Surgery Center Setting.

    Science.gov (United States)

    Kemery, Stephanie; Kelly, Kelley; Wilson, Connie; Wheeler, Corrine A

    2015-08-01

    Cardiac arrest can occur in any health care setting at any time, requiring nursing staff to be prepared to quickly and adequately perform basic cardiopulmonary resuscitation (CPR). Currently, the American Heart Association certifies health care providers in Basic Life Support (BLS) for a 2-year period, but evidence indicates that psychomotor skills decline well before the end of the certification time frame. Nurses in the ambulatory surgery setting expressed concern regarding their ability to implement CPR successfully, given the infrequent occurrence of cardiac and respiratory arrests. Using a study by Niles et al. as a model, the authors piloted the implementation of brief CPR refresher training at the bedside of an ambulatory surgery center to assess and increase nurse confidence in BLS skills. PMID:26247660

  19. A national survey of prevalence of cardiopulmonary resuscitation training and knowledge of the emergency number in Ireland.

    LENUS (Irish Health Repository)

    Jennings, S

    2009-07-06

    AIM: The aim of this survey was to establish prevalence of cardiopulmonary resuscitation (CPR) training within the last 5 years and reasons preventing training and initiation of CPR in Ireland as well as awareness of the emergency numbers. METHODS: An in-home omnibus survey was undertaken in 2008 with quota sampling reflecting the age, gender, social class and geography of Ireland. RESULTS: Of the 974 respondents, 23.5% had undergone CPR training in the previous 5 years with lower social class and age 65 years and older significantly less likely to be trained. The workplace was both a major source of awareness as well as training for those trained. In the untrained group lack of awareness of the need for CPR training was the most significant reason for non-training. Cost was not cited as a barrier. 88.9% of people gave a correct emergency number with geographical variation. Notably, the European emergency number 112 was not well known. CONCLUSION: Previous Irish and American population targets for CPR training have been surpassed in Ireland in 2008. New internationally agreed targets are now required. Meanwhile older people and those in lower socio-economic groups should be targeted for training. Awareness of at least one emergency number is very high in Ireland. Some geographical variation was found and this should be studied further.

  20. Basic life support skills of high school students before and after cardiopulmonary resuscitation training: a longitudinal investigation

    Directory of Open Access Journals (Sweden)

    Meissner Theresa M

    2012-04-01

    Full Text Available Abstract Background Immediate bystander cardiopulmonary resuscitation (CPR significantly improves survival after a sudden cardiopulmonary collapse. This study assessed the basic life support (BLS knowledge and performance of high school students before and after CPR training. Methods This study included 132 teenagers (mean age 14.6 ± 1.4 years. Students completed a two-hour training course that provided theoretical background on sudden cardiac death (SCD and a hands-on CPR tutorial. They were asked to perform BLS on a manikin to simulate an SCD scenario before the training. Afterwards, participants encountered the same scenario and completed a questionnaire for self-assessment of their pre- and post-training confidence. Four months later, we assessed the knowledge retention rate of the participants with a BLS performance score. Results Before the training, 29.5% of students performed chest compressions as compared to 99.2% post-training (P P Conclusions BLS training in high school seems highly effective considering the minimal amount of previous knowledge the students possess. We observed significant improvement and a good retention rate four months after training. Increasing the number of trained students may minimize the reluctance to conduct bystander CPR and increase the number of positive outcomes after sudden cardiopulmonary collapse.

  1. The role of simulation in teaching pediatric resuscitation: current perspectives

    Directory of Open Access Journals (Sweden)

    Lin Y

    2015-03-01

    Full Text Available Yiqun Lin,1 Adam Cheng2 1KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada; 2KidSIM-ASPIRE Research Program, Department of Pediatrics, Division of Emergency Medicine, University of Calgary, Alberta Children's Hospital, Calgary, AB, Canada Abstract: The use of simulation for teaching the knowledge, skills, and behaviors necessary for effective pediatric resuscitation has seen widespread growth and adoption across pediatric institutions. In this paper, we describe the application of simulation in pediatric resuscitation training and review the evidence for the use of simulation in neonatal resuscitation, pediatric advanced life support, procedural skills training, and crisis resource management training. We also highlight studies supporting several key instructional design elements that enhance learning, including the use of high-fidelity simulation, distributed practice, deliberate practice, feedback, and debriefing. Simulation-based training is an effective modality for teaching pediatric resuscitation concepts. Current literature has revealed some research gaps in simulation-based education, which could indicate the direction for the future of pediatric resuscitation research. Keywords: simulation, pediatric resuscitation, medical education, instructional design, crisis resource management, health care

  2. Advanced training of tax consultants

    Directory of Open Access Journals (Sweden)

    Adigamova Farida F.

    2016-01-01

    Full Text Available The purpose of the research is to review and analyze the data on the necessity to provide an educational environment for training and advanced training of tax consultants in Russia. The article considers the types of tax consulting, the historical background of training financiers in Russia, as well as identifies conditions determining the significance of tax consulting. The research establishes the connection between the negative attitude to tax payment and tax evasion. The advanced training of tax consultants should be a continuous process as they need to take into account both external and internal taxpayers risks associated with the development of law and law-enforcement practice. Obviously, the training of tax consultants should take into account the experience of developed foreign countries, such as Germany, Austria, Czech Republic, Slovakia and other European countries as well. In Russia, it is necessary to open educational institutions, which will not only be involved in the certification of tax consultants, but also provide training courses. These courses should contribute to constant increase of tax consultants knowledge, consider the tax treatment of economic activities, as well changes in the legislation, economics, finance, accounting, manufacturing processes, which will improve the quality of services provided by tax consultants.

  3. Conditions for learning in simulation practice: training for team-based resuscitation in nursing education

    OpenAIRE

    Husebø, Sissel Eikeland

    2012-01-01

    Background: Research demonstrates that simulation-based learning in nursing practice is a promising educational method used under appropriate conditions. Research using simulation for performing resuscitation in nursing education has been mainly concerned with the goal of justifying its use or proving that it works, while less effort has been devoted to understanding the complexity inherent in those activities. Aims: The overarching aim of the study was to develop knowledge...

  4. The impact of CPR and AED training on healthcare professionals' self-perceived attitudes to performing resuscitation

    Directory of Open Access Journals (Sweden)

    Källestedt Marie-Louise

    2012-04-01

    Full Text Available Abstract Background Healthcare professionals have shown concern about performing mouth-to-mouth ventilation due to the risks to themselves with the procedure. However, little is known about healthcare professionals' fears and attitudes to start CPR and the impact of training. Objective To examine whether there were any changes in the attitudes among healthcare professionals to performing CPR from before to after training. Methods Healthcare professionals from two Swedish hospitals were asked to answer a questionnaire before and after training. The questions were relating to physical and mental discomfort and attitudes to CPR. Statistical analysis used was generalized McNemar's test. Results Overall, there was significant improvement in 10 of 11 items, reflecting various aspects of attitudes to CPR. All groups of health care professionals (physicians, nurses, assistant nurses, and "others" = physiotherapists, occupational therapists, social welfare officers, psychologists, biomedical analysts felt more secure in CPR knowledge after education. In other aspects, such as anxiety prior to a possible cardiac arrest, only nurses and assistant nurses improved. The concern about being infected, when performing mouth to mouth ventilation, was reduced with the most marked reduction in physicians (75%; P Conclusion In this hospital-based setting, we found a positive outcome of education and training in CPR concerning healthcare professionals' attitudes to perform CPR. They felt more secure in their knowledge of cardiopulmonary resuscitation. In some aspects of attitudes to resuscitation nurses and assistant nurses appeared to be the groups that were most markedly influenced. The concern of being infected by a disease was low.

  5. Recent Advances in Forward Surgical Team Training at the U.S. Army Trauma Training Department.

    Science.gov (United States)

    Allen, Casey J; Straker, Richard J; Murray, Clark R; Hannay, William M; Hanna, Mena M; Meizoso, Jonathan P; Manning, Ronald J; Schulman, Carl I; Seery, Jason M; Proctor, Kenneth G

    2016-06-01

    U.S. Army Forward Surgical Teams (FSTs) are elite, multidisciplinary units that are highly mobile, and rapidly deployable. The mission of the FST is to provide resuscitative and damage control surgery for stabilization of life-threatening injuries in austere environments. The Army Trauma Training Center began in 2001 at the University of Miami Ryder Trauma Center under the direction of COL T. E. Knuth, MC USA (Ret.), as a multimodality combination of lectures, laboratory exercises, and clinical experiences that provided the only predeployment mass casualty and clinical trauma training center for all FSTs. Each of the subsequent five directors has restructured the training based on dynamic feedback from trainees, current military needs, and on the rapid advances in combat casualty care. We have highlighted these evolutionary changes at the Army Trauma Training Center in previous reviews. Under the current director, LTC J. M. Seery, MC USA, there are new team-building exercises, mobile learning modules and simulators, and other alternative methods in the mass casualty exercise. This report summarizes the latest updates to the state of the art training since the last review. PMID:27244065

  6. Cardiopulmonary Resuscitation (CPR)

    Science.gov (United States)

    MENU Return to Web version Cardiopulmonary Resuscitation (CPR) Cardiopulmonary Resuscitation (CPR) What is CPR? Cardiopulmonary resuscitation (CPR) is an important lifesaving technique that involves chest compressions and giving ...

  7. Knowledge and Skill Retention of In-Service versus Preservice Nursing Professionals following an Informal Training Program in Pediatric Cardiopulmonary Resuscitation: A Repeated-Measures Quasiexperimental Study

    OpenAIRE

    Nandkishore Dubey; Nandini Vijayakanthi; M. Jeeva Sankar; Jhuma Sankar

    2013-01-01

    Our objective was to compare the impact of a training program in pediatric cardiopulmonary resuscitation (CPR) on the knowledge and skills of in-service and preservice nurses at prespecified time points. This repeated-measures quasiexperimental study was conducted in the pediatric emergency and ICU of a tertiary care teaching hospital between January and March 2011. We assessed the baseline knowledge and skills of nursing staff (in-service nurses) and final year undergraduate nursing students...

  8. Advanced Training Technologies and Learning Environments

    Science.gov (United States)

    Noor, Ahmed K. (Compiler); Malone, John B. (Compiler)

    1999-01-01

    This document contains the proceedings of the Workshop on Advanced Training Technologies and Learning Environments held at NASA Langley Research Center, Hampton, Virginia, March 9-10, 1999. The workshop was jointly sponsored by the University of Virginia's Center for Advanced Computational Technology and NASA. Workshop attendees were from NASA, other government agencies, industry, and universities. The objective of the workshop was to assess the status and effectiveness of different advanced training technologies and learning environments.

  9. What are the barriers to implementation of cardiopulmonary resuscitation training in secondary schools?

    DEFF Research Database (Denmark)

    Zinckernagel, Line; Malta Hansen, Carolina; Rod, Morten Hulvej;

    2016-01-01

    of the study was to explore barriers to implementation of CPR training in Danish secondary schools. DESIGN: A qualitative study based on individual interviews and focus groups with school leadership and teachers. Thematic analysis was used to identify regular patterns of meaning both within and...

  10. Advanced Music Therapy Supervision Training

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2009-01-01

    supervision training excerpts live in the workshop will be offered. The workshop will include demonstrating a variety of supervision methods and techniques used in A) post graduate music therapy training programs b) a variety of work contexts such as psychiatry and somatic music psychotherapy. The workshop...

  11. Teaching Staff Advanced Training: European Experience

    OpenAIRE

    Kovalchuk Vasyl

    2015-01-01

    The issue of teaching staff advanced training is paid much attention in many countries. In the Republic of Moldova progressive professional credits system is used. Credits are scored not only in assigning teaching degrees or issuing a certificate of continuing professional education, but also for teachers’ evaluation at the educational institution. Advanced training of teaching staff in France is provided by various institutions of postgraduate education, university institutes and regional ce...

  12. Advances in damage control resuscitation and surgery: implications on the organization of future military field forces

    OpenAIRE

    Tien, Col Homer; Beckett, Maj Andrew; Garraway, LCol Naisan; Talbot, LCol Max; Pannell, Capt Dylan; Alabbasi, Thamer

    2015-01-01

    Medical support to deployed field forces is increasingly becoming a shared responsibility among allied nations. National military medical planners face several key challenges, including fiscal restraints, raised expectations of standards of care in the field and a shortage of appropriately trained specialists. Even so, medical services are now in high demand, and the availability of medical support may become the limiting factor that determines how and where combat units can deploy. The influ...

  13. Should prehospital resuscitative thoracotomy be incorporated in advanced life support after traumatic cardiac arrest?

    Science.gov (United States)

    Chalkias, A; Xanthos, T

    2014-06-01

    The survival of traumatic cardiac arrest patients poses a challenge for Emergency Medical Services initiating advanced life support on-scene, especially with regard to having to decide immediately whether to initiate prehospital emergency thoracotomy. Although the necessity for carrying out the procedure remains a cause for debate, it can be life-saving when performed with the correct indications and approaches. PMID:26816077

  14. Teaching Staff Advanced Training: European Experience

    Directory of Open Access Journals (Sweden)

    Kovalchuk Vasyl

    2015-08-01

    Full Text Available The issue of teaching staff advanced training is paid much attention in many countries. In the Republic of Moldova progressive professional credits system is used. Credits are scored not only in assigning teaching degrees or issuing a certificate of continuing professional education, but also for teachers’ evaluation at the educational institution. Advanced training of teaching staff in France is provided by various institutions of postgraduate education, university institutes and regional centers of education in order to help teachers to renew their professional knowledge and at the same time to refocus it on the level of consciousness according to the real problems of school and the community. The feature of teaching staff advanced training in France is that it is teachers’ personal matter and duration of all periods of training should come to one year during all professional career. In Finland, teaching staff advanced training is organized directly in schools under aegis of the National Board of Education, the National Centre for Advanced Training in Education, departments of teacher education and other faculties of higher educational institutions on credit system basis. Among the topical forms there are targeted, cascade, common (cooperative teaching and learning by own example. In the UK, advanced training takes place in two models: the course model based on higher educational establishments and school based in-service education. The main purpose of advanced training system is to familiarize teachers with theoretical and practical innovations in educational activities, progressive teaching technologies, and consolidate their skills of independent acquisition of knowledge necessary for their professional development.

  15. Resuscitation of newborn in high risk deliveries

    International Nuclear Information System (INIS)

    High risk deliveries are usually associated with increased neonatal mortality and morbidity. Neonatal resuscitation can appreciably affect the outcome in these types of deliveries. Presence of personnel trained in basic neonatal resuscitation at the time of delivery can play an important role in reducing perinatal complications in neonates at risk. The study was carried out to evaluate the effects of newborn resuscitation on neonatal outcome in high risk deliveries. Methods: This descriptive case series was carried out at the Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore. Ninety consecutive high risk deliveries were included and attended by paediatricians trained in newborn resuscitation. Babies delivered by elective Caesarean section, normal spontaneous vaginal deliveries and still births were excluded. Neonatal resuscitation was performed in babies who failed to initiate breathing in the first minute after birth. Data was analyzed using SPSS-16.0. Results: A total of 90 high risk deliveries were included in the study. Emergency caesarean section was the mode of delivery in 94.4% (n=85) cases and spontaneous vaginal delivery in 5.6% (n=5). Preterm pregnancy was the major high risk factor. Newborn resuscitation was required in 37.8% (n=34) of all high risk deliveries (p=0.013). All the new-borns who required resuscitation survived. Conclusion: New-born resuscitation is required in high risk pregnancies and personnel trained in newborn resuscitation should be available at the time of delivery. (author)

  16. Knowledge and skill retention of in-service versus preservice nursing professionals following an informal training program in pediatric cardiopulmonary resuscitation: a repeated-measures quasiexperimental study.

    Science.gov (United States)

    Sankar, Jhuma; Vijayakanthi, Nandini; Sankar, M Jeeva; Dubey, Nandkishore

    2013-01-01

    Our objective was to compare the impact of a training program in pediatric cardiopulmonary resuscitation (CPR) on the knowledge and skills of in-service and preservice nurses at prespecified time points. This repeated-measures quasiexperimental study was conducted in the pediatric emergency and ICU of a tertiary care teaching hospital between January and March 2011. We assessed the baseline knowledge and skills of nursing staff (in-service nurses) and final year undergraduate nursing students (preservice nurses) using a validated questionnaire and a skill checklist, respectively. The participants were then trained on pediatric CPR using standard guidelines. The knowledge and skills were reassessed immediately after training and at 6 weeks after training. A total of 74 participants-28 in-service and 46 preservice professionals-were enrolled. At initial assessment, in-service nurses were found to have insignificant higher mean knowledge scores (6.6 versus 5.8, P = 0.08) while the preservice nurses had significantly higher skill scores (6.5 versus 3.2, P nurses performing better in knowledge test (10.5 versus 9.1, P = 0.01) and the preservice nurses performing better in skill test (9.8 versus 7.4, P nurses in pediatric CPR improved with training. In comparison to preservice nurses, the in-service nurses seemed to retain knowledge better with time than skills. PMID:23971033

  17. Leadership and Teamwork in Trauma and Resuscitation

    Science.gov (United States)

    Ford, Kelsey; Menchine, Michael; Burner, Elizabeth; Arora, Sanjay; Inaba, Kenji; Demetriades, Demetrios; Yersin, Bertrand

    2016-01-01

    Introduction Leadership skills are described by the American College of Surgeons’ Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders. Methods We searched the PubMed database using the keywords “leadership” and then either “trauma” or “resuscitation” as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders. Results We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching

  18. Health care professionals' willingness to do mouth-to-mouth resuscitation.

    OpenAIRE

    Horowitz, B Z; Matheny, L

    1997-01-01

    To assess the willingness of physicians and nurses with training in basic cardiac life support to provide mouth-to-mouth resuscitation in both hospital and out-of-hospital settings, we surveyed all attendees at a monthly advanced life support course over a 1-year period. Of 622 attendees, 379 (61%) responded to our survey describing a variety of cardiac arrest scenarios. Less than half of the participants surveyed were willing to do mouth-to-mouth resuscitation on an unknown adult, male or fe...

  19. Cardiopulmonary resuscitation update.

    Science.gov (United States)

    Lipley, Nick

    2014-11-01

    THE ROYAL College of Nursing (RCN), Resuscitation Council (UK) and British Medical Association (BMA) have issued a new edition of their guidance on when to attempt cardiopulmonary resuscitation (CPR). PMID:25369953

  20. How we developed a comprehensive resuscitation-based simulation curriculum in emergency medicine.

    Science.gov (United States)

    Dagnone, Jeffrey Damon; McGraw, Robert; Howes, Daniel; Messenger, David; Bruder, Eric; Hall, Andrew; Chaplin, Timothy; Szulewski, Adam; Kaul, Tom; O'Brien, Terrence

    2016-01-01

    Over the past decade, simulation-based education has emerged as a new and exciting adjunct to traditional bedside teaching and learning. Simulation-based education seems particularly relevant to emergency medicine training where residents have to master a very broad skill set, and may not have sufficient real clinical opportunities to achieve competence in each and every skill. In 2006, the Emergency Medicine program at Queen's University set out to enhance our core curriculum by developing and implementing a series of simulation-based teaching sessions with a focus on resuscitative care. The sessions were developed in such as way as to satisfy the four conditions associated with optimum learning and improvement of performance; appropriate difficulty of skill, repetitive practice, motivation, and immediate feedback. The content of the sessions was determined with consideration of the national training requirements set out by the Royal College of Physicians & Surgeons of Canada. Sessions were introduced in a stepwise fashion, starting with a cardiac resuscitation series based on the AHA ACLS guidelines, and leading up to a more advanced resuscitation series as staff became more adept at teaching with simulation, and as residents became more comfortable with this style of learning. The result is a longitudinal resuscitation curriculum that begins with fundamental skills of resuscitation and crisis resource management (CRM) in the first 2 years of residency and progresses through increasingly complex resuscitation cases where senior residents are expected to play a leadership role. This paper documents how we developed, implemented, and evaluated this resuscitation-based simulation curriculum for Emergency Medicine postgraduate trainees, with discussion of some of the challenges encountered. PMID:25410350

  1. The Effect of High-Fidelity Cardiopulmonary Resuscitation (CPR) Simulation on Athletic Training Student Knowledge, Confidence, Emotions, and Experiences

    Science.gov (United States)

    Tivener, Kristin Ann; Gloe, Donna Sue

    2015-01-01

    Context: High-fidelity simulation is widely used in healthcare for the training and professional education of students though literature of its application to athletic training education remains sparse. Objective: This research attempts to address a wide-range of data. This includes athletic training student knowledge acquisition from…

  2. Sepsis Resuscitation: Fluid Choice and Dose.

    Science.gov (United States)

    Semler, Matthew W; Rice, Todd W

    2016-06-01

    Sepsis is a common and life-threatening inflammatory response to severe infection treated with antibiotics and fluid resuscitation. Despite the central role of intravenous fluid in sepsis management, fundamental questions regarding which fluid and in what amount remain unanswered. Recent advances in understanding the physiologic response to fluid administration, and large clinical studies examining resuscitation strategies, fluid balance after resuscitation, colloid versus crystalloid solutions, and high- versus low-chloride crystalloids, inform the current approach to sepsis fluid management and suggest areas for future research. PMID:27229641

  3. Assessment of training simulators with advanced models

    International Nuclear Information System (INIS)

    Training quality received by the nuclear power plants operators is related to the reliability degree reached by the models which constitute the calculation basis. TECNATOM began, in the middle of the 80's, the PWR and BWR training simulators upgrading to reproduce all type of transients with long term operation and a very high reliability degree. As a result of this, the Simulation Advanced Models Project (MAS) has been developed for both PWR and BWR simulators. The simulators software is the TRAC code running in real time on the CRAY X-MP 14 vectorial computer. The validation methodology followed in the MAS Project is based on the EPRI's one. The main goal is the detailed analysis of the variables and physical phenomena to validate ('dynamic modes') included in the validation transients matrix. The reference results are supplied by plant data or best estimate codes: TRAC-PF1/MOD1 and TRACG for PWR and BWR training simulators, respectively. This paper shows the main results of validation transients and the main conclusions: improvement of simulation scope and reliability, EOP's scenarios simulation with long term recovery and physical phenomena analysis similar to best estimate codes. (orig.) (13 refs., 17 figs., 4 tabs.)

  4. Academic training: Advanced lectures on multiprocessor programming

    CERN Multimedia

    PH Department

    2011-01-01

    Academic Training Lecture - Regular Programme 31 October 1, 2 November 2011 from 11:00 to 12:00 -  IT Auditorium, Bldg. 31   Three classes (60 mins) on Multiprocessor Programming Prof. Dr. Christoph von Praun Georg-Simon-Ohm University of Applied Sciences Nuremberg, Germany This is an advanced class on multiprocessor programming. The class gives an introduction to principles of concurrent objects and the notion of different progress guarantees that concurrent computations can have. The focus of this class is on non-blocking computations, i.e. concurrent programs that do not make use of locks. We discuss the implementation of practical non-blocking data structures in detail. 1st class: Introduction to concurrent objects 2nd class: Principles of non-blocking synchronization 3rd class: Concurrent queues Brief Bio of Christoph von Praun Christoph worked on a variety of analysis techniques and runtime platforms for parallel programs. Hist most recent research studies programming models an...

  5. Skill retention in adults and in children 3 months after basic life support training using a simple personal resuscitation manikin

    DEFF Research Database (Denmark)

    Isbye, Dan L; Meyhoff, Christian S; Lippert, Freddy K;

    2007-01-01

    As 70-80% of cardiac arrests occur at home, widespread training is needed to increase the likelihood of basic life support (BLS) being performed before the arrival of Emergency Medical Services personnel. Teaching BLS in public schools has been recommended to achieve this.......As 70-80% of cardiac arrests occur at home, widespread training is needed to increase the likelihood of basic life support (BLS) being performed before the arrival of Emergency Medical Services personnel. Teaching BLS in public schools has been recommended to achieve this....

  6. Complicated Burn Resuscitation.

    Science.gov (United States)

    Harrington, David T

    2016-10-01

    More than 4 decades after the creation of the Brooke and Parkland formulas, burn practitioners still argue about which formula is the best. So it is no surprise that there is no consensus about how to resuscitate a thermally injured patient with a significant comorbidity such as heart failure or cirrhosis or how to resuscitate a patient after an electrical or inhalation injury or a patient whose resuscitation is complicated by renal failure. All of these scenarios share a common theme in that the standard rule book does not apply. All will require highly individualized resuscitations. PMID:27600129

  7. Training of midwives in advanced obstetrics in Liberia

    OpenAIRE

    Dolo, Obed; Clack, Alice; Gibson, Hannah; Lewis, Naomi; Southall, David P

    2016-01-01

    Abstract Problem The shortage of doctors in Liberia limits the provision of comprehensive emergency obstetric and neonatal care. Approach In a pilot project, two midwives were trained in advanced obstetric procedures and in the team approach to the in-hospital provision of advanced maternity care. The training took two years and was led by a Liberian consultant obstetrician with support from international experts. Local setting The training took place in CB Dunbar Maternity Hospital. This rur...

  8. Influence of airway management strategy on "no-flow-time" during an "Advanced life support course" for intensive care nurses – A single rescuer resuscitation manikin study

    Directory of Open Access Journals (Sweden)

    Bahr Jan

    2008-04-01

    Full Text Available Abstract Background In 1999, the laryngeal tube (VBM Medizintechnik, Sulz, Germany was introduced as a new supraglottic airway. It was designed to allow either spontaneous breathing or controlled ventilation during anaesthesia; additionally it may serve as an alternative to endotracheal intubation, or bag-mask ventilation during resuscitation. Several variations of this supraglottic airway exist. In our study, we compared ventilation with the laryngeal tube suction for single use (LTS-D and a bag-mask device. One of the main points of the revised ERC 2005 guidelines is a low no-flow-time (NFT. The NFT is defined as the time during which no chest compression occurs. Traditionally during the first few minutes of resuscitation NFT is very high. We evaluated the hypothesis that utilization of the LTS-D could reduce the NFT compared to bag-mask ventilation (BMV during simulated cardiac arrest in a single rescuer manikin study. Methods Participants were studied during a one day advanced life support (ALS course. Two scenarios of arrhythmias requiring defibrillation were simulated in a manikin. One scenario required subjects to establish the airway with a LTS-D; alternatively, the second scenario required them to use BMV. The scenario duration was 430 seconds for the LTS-D scenario, and 420 seconds for the BMV scenario, respectively. Experienced ICU nurses were recruited as study subjects. Participants were randomly assigned to one of the two groups first (LTS-D and BMV to establish the airway. Endpoints were the total NFT during the scenario, the successful airway management using the respective device, and participants' preference of one of the two strategies for airway management. Results Utilization of the LTS-D reduced NFT significantly (p Conclusion In our manikin study, NFT was reduced significantly when using LTS-D compared to BMV. During cardiac arrest, the LTS-D might be a good alternative to BMV for providing and maintaining a patent airway

  9. Protocol compliance and time management in blunt trauma resuscitation.

    NARCIS (Netherlands)

    Spanjersberg, W.R.; Bergs, E.A.; Mushkudiani, N.; Klimek, M.; Schipper, I.B.

    2009-01-01

    OBJECTIVES: To study advanced trauma life support (ATLS) protocol adherence prospectively in trauma resuscitation and to analyse time management of daily multidisciplinary trauma resuscitation at a level 1 trauma centre, for both moderately and severely injured patients. PATIENTS AND METHODS: All vi

  10. Family Carers and the Prevention of Heroin Overdose Deaths: Unmet Training Need and Overlooked Intervention Opportunity of Resuscitation Training and Supply of Naloxone

    Science.gov (United States)

    Strang, John; Manning, Victoria; Mayet, Soraya; Titherington, Emily; Offor, Liz; Semmler, Claudia; Williams, Anna

    2008-01-01

    Aim: To assess (a) carers' experiences of witnessing overdose; (b) their training needs; and (c) their interest in receiving training in overdose management. Design: Postal questionnaire distributed through consenting participating local carer group coordinators in England. Sample: 147 carers attending local support groups for friends and families…

  11. Resuscitative thoracotomy in penetrating trauma.

    Science.gov (United States)

    Fairfax, Lindsay M; Hsee, Li; Civil, Ian D

    2015-06-01

    The resuscitative thoracotomy (RT) is an important procedure in the management of penetrating trauma. As it is performed only in patients with peri-arrest physiology or overt cardiac arrest, survival is low. Experience is also quite variable depending on volume of penetrating trauma in a particular region. Survival ranges from 0% to as high as 89% depending on patient selection, available resources, and location of RT (operating or emergency rooms). In this article, published guidelines are reviewed as well as outcomes. Technical considerations of RT and well as proper training, personnel, and location are also discussed. PMID:25342073

  12. Advanced CRM training for instructors and evaluators

    Science.gov (United States)

    Taggart, William R.

    1991-01-01

    It is seen that if the maximum operational benefit of crew resource management (CRM) is to be achieved, the evaluator group is the principal key and specialized training that is ongoing is necessary for this group. The training must be customized to fit the needs of a particular organization, and the training must address key topical issues that influence organizational dynamics. Attention is given to the use of video and full length scripted NASA research LOFTS, behavioral markers and debriefing skills, the importance of policy and written CRM standards, and line oriented simulations debriefing performance indicators.

  13. ABC of Resuscitation

    CERN Document Server

    Colquhoun, Michael

    2003-01-01

    This guide has concise and practical information on all aspects of resuscitation. New guidelines are just one of the changes to the 5th edition of this book as many of the chapters have been completely rewritten.

  14. The Advanced Embedded Training System (AETS): An Intelligent Embedded Tutoring System for Tactical Team Training

    OpenAIRE

    Zachary, Wayne; Cannon-Bowers, Janis A.; Bilazarian, Peter; Krecker, Donald K.; Lardieri, Patrick J.; Burns, John

    1998-01-01

    The Advanced Embedded Training System (AETS) applies intelligent tutoring systems technology to improving tactical training quality and reducing manpower needs in simulation-based shipboard team training. AETS provides layers of performance assessment, cognitive diagnosis, and team-training support on top of the existing embedded mission simulation capability in the Navy's Aegis-class ships. Detailed cognitive models of trainee task performance are used to drive the assessment, diagnosis and ...

  15. Current controversies in shock and resuscitation.

    Science.gov (United States)

    Orlinsky, M; Shoemaker, W; Reis, E D; Kerstein, M D

    2001-12-01

    Many controversies and uncertainties surround resuscitation of hemorrhagic shock caused by vascular trauma. Whereas the basic pathophysiology is better understood, much remains to be learned about the many immunologic cascades that lead to problems beyond those of initial fluid resuscitation or operative hemostasis. Fluid therapy is on the verge of significant advances with substitute oxygen carriers, yet surgeons are still beset with questions of how much and what type of initial fluid to provide. Finally, the parameters chosen to guide therapy and the methods used to monitor patients present other interesting issues. PMID:11766174

  16. Conversion of the dual training aircraft (DC into single control advanced training aircraft (SC. Part I

    Directory of Open Access Journals (Sweden)

    Ioan ŞTEFĂNESCU

    2011-03-01

    Full Text Available Converting the DC school jet aircraft into SC advanced training aircraft - and use them forthe combat training of military pilots from the operational units, has become a necessity due to thebudget cuts for Air Force, with direct implications on reducing the number of hours of flight assignedto operating personnel for preparing and training.The purpose of adopting such a program is to reduce the number of flight hours allocated annuallyfor preparing and training in advanced stages of instruction, for every pilot, by more intensive use ofthis type of aircraft, which has the advantage of lower flight hour costs as compared to a supersoniccombat plane.

  17. Cardiac arrest: resuscitation and reperfusion.

    Science.gov (United States)

    Patil, Kaustubha D; Halperin, Henry R; Becker, Lance B

    2015-06-01

    The modern treatment of cardiac arrest is an increasingly complex medical procedure with a rapidly changing array of therapeutic approaches designed to restore life to victims of sudden death. The 2 primary goals of providing artificial circulation and defibrillation to halt ventricular fibrillation remain of paramount importance for saving lives. They have undergone significant improvements in technology and dissemination into the community subsequent to their establishment 60 years ago. The evolution of artificial circulation includes efforts to optimize manual cardiopulmonary resuscitation, external mechanical cardiopulmonary resuscitation devices designed to augment circulation, and may soon advance further into the rapid deployment of specially designed internal emergency cardiopulmonary bypass devices. The development of defibrillation technologies has progressed from bulky internal defibrillators paddles applied directly to the heart, to manually controlled external defibrillators, to automatic external defibrillators that can now be obtained over-the-counter for widespread use in the community or home. But the modern treatment of cardiac arrest now involves more than merely providing circulation and defibrillation. As suggested by a 3-phase model of treatment, newer approaches targeting patients who have had a more prolonged cardiac arrest include treatment of the metabolic phase of cardiac arrest with therapeutic hypothermia, agents to treat or prevent reperfusion injury, new strategies specifically focused on pulseless electric activity, which is the presenting rhythm in at least one third of cardiac arrests, and aggressive post resuscitation care. There are discoveries at the cellular and molecular level about ischemia and reperfusion pathobiology that may be translated into future new therapies. On the near horizon is the combination of advanced cardiopulmonary bypass plus a cocktail of multiple agents targeted at restoration of normal metabolism and

  18. Advanced Manufacturing Training: Mobile Learning Labs

    Science.gov (United States)

    Vukich, John C.; Ackerman, Amanda A.

    2010-01-01

    Across Colorado, manufacturing employers forecast an on-going need not only for workers who are interested in career opportunities but who are prepared to enter the advanced manufacturing industry with the necessary high-tech skills. Additionally, employers report concerns about replacing retiring workers that take with them decades of…

  19. Design and implementation of the Resuscitation Outcomes Consortium Pragmatic Airway Resuscitation Trial (PART).

    Science.gov (United States)

    Wang, Henry E; Prince, David K; Stephens, Shannon W; Herren, Heather; Daya, Mohamud; Richmond, Neal; Carlson, Jestin; Warden, Craig; Colella, M Riccardo; Brienza, Ashley; Aufderheide, Tom P; Idris, Ahamed H; Schmicker, Robert; May, Susanne; Nichol, Graham

    2016-04-01

    Airway management is an important component of resuscitation from out-of-hospital cardiac arrest (OHCA). The optimal approach to advanced airway management is unknown. The Pragmatic Airway Resuscitation Trial (PART) will compare the effectiveness of endotracheal intubation (ETI) and Laryngeal Tube (LT) insertion upon 72-h survival in adult OHCA. Encompassing United States Emergency Medical Services agencies affiliated with the Resuscitation Outcomes Consortium (ROC), PART will use a cluster-crossover randomized design. Participating subjects will include adult, non-traumatic OHCA requiring bag-valve-mask ventilation. Trial interventions will include (1) initial airway management with ETI and (2) initial airway management with LT. The primary and secondary trial outcomes are 72-h survival and return of spontaneous circulation. Additional clinical outcomes will include airway management process and adverse events. The trial will enroll a total of 3000 subjects. Results of PART may guide the selection of advanced airway management strategies in OHCA. PMID:26851059

  20. Developing a Model of Advanced Training to Promote Career Advancement for Certified Genetic Counselors: An Investigation of Expanded Skills, Advanced Training Paths, and Professional Opportunities.

    Science.gov (United States)

    Baty, Bonnie J; Trepanier, Angela; Bennett, Robin L; Davis, Claire; Erby, Lori; Hippman, Catriona; Lerner, Barbara; Matthews, Anne; Myers, Melanie F; Robbins, Carol B; Singletary, Claire N

    2016-08-01

    There are currently multiple paths through which genetic counselors can acquire advanced knowledge and skills. However, outside of continuing education opportunities, there are few formal training programs designed specifically for the advanced training of genetic counselors. In the genetic counseling profession, there is currently considerable debate about the paths that should be available to attain advanced skills, as well as the skills that might be needed for practice in the future. The Association of Genetic Counseling Program Directors (AGCPD) convened a national committee, the Committee on Advanced Training for Certified Genetic Counselors (CATCGC), to investigate varied paths to post-master's training and career development. The committee began its work by developing three related grids that view career advancement from the viewpoints of the skills needed to advance (skills), ways to obtain these skills (paths), and existing genetic counselor positions that offer career change or advancement (positions). Here we describe previous work related to genetic counselor career advancement, the charge of the CATCGC, our preliminary work in developing a model through which to view genetic counselor advanced training and career advancement opportunities, and our next steps in further developing and disseminating the model. PMID:26739839

  1. A Collective Model of Advanced Teacher Training: An International Experience

    OpenAIRE

    Dmitri Rubashkin

    2014-01-01

    Dmitri Rubashkin - Canditdate of Sciences, Director at Innovation Center Modern Education Technologies. Address: Birzhevaya Liniya, 16, St. Petersburg, 199034, Russian Federation. E-mail: conventional course-based teacher training method doesnt meet the requirements of time, and neither does the reproductive teaching style. The paper offers a new alternative to that system, which is project-based and result-oriented advanced training designed to stimulate creative thinki...

  2. Advanced training of specialists in nuclear energy at ONPU

    International Nuclear Information System (INIS)

    The is considered the relevance of training of specialists in nuclear energy in the form of advanced training to maintain professional skills at the needed level.The problems of thr re-profiling of specialists working in the nuclear industry and having a non specialized education to the specialty 'Nuclear Engineering' are also considered. The results of activity of the Centre for Continuing Education of ONPU in this direction for recent years are presented.

  3. Part 10: Pediatric Basic and Advanced Life Support 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

    OpenAIRE

    Kleinman, Monica E.; de Caen, Allan R.; Chameides, Leon; Atkins, Dianne L.; Berg, Robert A.; Berg, Marc D.; Bhanji, Farhan; Biarent, Dominique; Bingham, Robert; Coovadia, Ashraf H.; Hazinski, Mary Fran; Hickey, Robert W.; Nadkarni, Vinay M.; Reis, Amelia G.; Rodriguez-Nunez, Antonio

    2010-01-01

    Note From the Writing Group: Throughout this article, the reader will notice combinations of superscripted letters and numbers (eg, “Family Presence During ResuscitationPeds-003”). These callouts are hyperlinked to evidence-based worksheets, which were used in the development of this article. An appendix of worksheets, applicable to this article, is located at the end of the text. The worksheets are available in PDF format and are open access.

  4. Hydroxyethyl starch for resuscitation

    DEFF Research Database (Denmark)

    Haase, Nicolai; Perner, Anders

    2013-01-01

    PURPOSE OF REVIEW: Resuscitation with hydroxyethyl starch (HES) is controversial. In this review, we will present the current evidence for the use of HES solutions including data from recent high-quality randomized clinical trials. RECENT FINDINGS: Meta-analyses of HES vs. control fluids show clear...

  5. Witnessed resuscitation: a concept analysis.

    Science.gov (United States)

    Walker, Wendy Marina

    2006-03-01

    The science and practice of resuscitation is recognised and endorsed on an international level, yet for more than a decade it has appeared in the literature alongside words such as witnessing or witnessed to signify the practice of family presence during a resuscitation attempt. This paper explores the meaning of witnessed resuscitation using the process for concept analysis proposed by Rodgers. The term resuscitation is explored, followed by identification of relevant uses of the concept of witnessed resuscitation. The reader is introduced to conceptual variations that challenge the way in which the concept has become associated with family or relatives presence in the resuscitation room of an accident and emergency department. Conceptual clarity is further enhanced through the identification of references, antecedents and consequences of witnessed resuscitation and by providing a model case of the concept that includes its defining attributes. PMID:16043184

  6. Hypotensive Resuscitation among Trauma Patients

    Science.gov (United States)

    Carrick, Matthew M.; Leonard, Jan; Slone, Denetta S.; Mains, Charles W.

    2016-01-01

    Hemorrhagic shock is a principal cause of death among trauma patients within the first 24 hours after injury. Optimal fluid resuscitation strategies have been examined for nearly a century, more recently with several randomized controlled trials. Hypotensive resuscitation, also called permissive hypotension, is a resuscitation strategy that uses limited fluids and blood products during the early stages of treatment for hemorrhagic shock. A lower-than-normal blood pressure is maintained until operative control of the bleeding can occur. The randomized controlled trials examining restricted fluid resuscitation have demonstrated that aggressive fluid resuscitation in the prehospital and hospital setting leads to more complications than hypotensive resuscitation, with disparate findings on the survival benefit. Since the populations studied in each randomized controlled trial are slightly different, as is the timing of intervention and targeted vitals, there is still a need for a large, multicenter trial that can examine the benefit of hypotensive resuscitation in both blunt and penetrating trauma patients. PMID:27595109

  7. Train medical physicist-urgent need for advanced radiotherapy

    International Nuclear Information System (INIS)

    A Japanese advanced charged particle therapy for cancer that places fewer physical burdens on patients is leading the world and stereotactic radiotherapy and intensity-modulated radiotherapy (IMRT) have been implemented also as a high precision radiotherapy. For the further advancement and dissemination of the therapy, training and qualification of medical physicists has become more needed. Cancer professional train course plan has been performed at many universities in Japan partly to train medical physicists. This special issue consists of seven relevant articles from experts of academia. Medical physicists have been qualified by the Japan Radiological Society, but should have national qualification such as to carry out the R and D of therapy equipment. This has been supported by many academia such as the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) but not by the Japan Association of Radiological Technologists (JART). (T. Tanaka)

  8. Evaluating Neonatal Resuscitation Skills of Nursing and Midwifery Students Using Objective Structured Clinical Examination (OSCE

    Directory of Open Access Journals (Sweden)

    Javad Malekzadeh

    2015-07-01

    Conclusion: The students’ skills in neonatal resuscitation were lower than expected. As competence in this area is of high significance for the improvement of neonatal outcomes, holding training workshops through applying novel training methods is recommended.

  9. Advances of NOAA Training Program in Climate Services

    Science.gov (United States)

    Timofeyeva, M. M.

    2012-12-01

    Since 2002, NOAA's National Weather Service (NWS) Climate Services Division (CSD) has offered numerous training opportunities to NWS staff. After eight-years of development, the training program offers three instructor-led courses and roughly 25 online (distance learning) modules covering various climate topics, such as: climate data and observations, climate variability and change, and NWS national / local climate products (tools, skill, and interpretation). Leveraging climate information and expertise available at all NOAA line offices and partners allows for the delivery of the most advanced knowledge and is a very critical aspect of the training program. The emerging NOAA Climate Service (NCS) requires a well-trained, climate-literate workforce at the local level capable of delivering NOAA's climate products and services as well as providing climate-sensitive decision support. NWS Weather Forecast Offices and River Forecast Centers presently serve as local outlets for the NCS climate services. Trained NWS climate service personnel use proactive and reactive approaches and professional education methods in communicating climate variability and change information to local users. Both scientifically-sound messages and amiable communication techniques are important in developing an engaged dialog between the climate service providers and users. Several pilot projects have been conducted by the NWS CSD this past year that apply the program's training lessons and expertise to specialized external user group training. The technical user groups included natural resources managers, engineers, hydrologists, and planners for transportation infrastructure. Training of professional user groups required tailoring instructions to the potential applications for each group of users. Training technical users identified the following critical issues: (1) knowledge of target audience expectations, initial knowledge status, and potential use of climate information; (2) leveraging

  10. Resuscitation at the limits of viability--an Irish perspective.

    LENUS (Irish Health Repository)

    Khan, R A

    2012-02-01

    BACKGROUND: Advances in neonatal care continue to lower the limit of viability. Decision making in this grey zone remains a challenging process. OBJECTIVE: To explore the opinions of healthcare providers on resuscitation and outcome in the less than 28-week preterm newborn. DESIGN\\/METHODS: An anonymous postal questionnaire was sent to health care providers working in maternity units in the Republic of Ireland. Questions related to neonatal management of the extreme preterm infant, and estimated survival and long-term outcome. RESULTS: The response rate was 55% (74% obstetricians and 70% neonatologists). Less than 1% would advocate resuscitation at 22 weeks, 10% of health care providers advocate resuscitation at 23 weeks gestation, 80% of all health care providers would resuscitate at 24 weeks gestation. 20% of all health care providers would advocate cessation of resuscitation efforts on 22-25 weeks gestation at 5 min of age. 65% of Neonatologists and 54% trainees in Paediatrics would cease resuscitation at 10 min of age. Obstetricians were more pessimistic about survival and long term outcome in newborns delivered between 23 and 27 weeks when compared with neonatologists. This difference was also observed in trainees in paediatrics and obstetrics. CONCLUSION: Neonatologists, trainees in paediatrics and neonatal nurses are generally more optimistic about outcome than their counterparts in obstetrical care and this is reflected in a greater willingness to provide resuscitation efforts at the limits of viability.

  11. Temperature Management After Cardiac Arrest: An Advisory Statement by the Advanced Life Support Task Force of the International Liaison Committee on Resuscitation and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation.

    Science.gov (United States)

    Donnino, Michael W; Andersen, Lars W; Berg, Katherine M; Reynolds, Joshua C; Nolan, Jerry P; Morley, Peter T; Lang, Eddy; Cocchi, Michael N; Xanthos, Theodoros; Callaway, Clifton W; Soar, Jasmeet

    2016-01-01

    For more than a decade, mild induced hypothermia (32 °C-34 °C) has been standard of care for patients remaining comatose after resuscitation from out-of-hospital cardiac arrest with an initial shockable rhythm, and this has been extrapolated to survivors of cardiac arrest with initially nonshockable rhythms and to patients with in-hospital cardiac arrest. Two randomized trials published in 2002 reported a survival and neurological benefit with mild induced hypothermia. One recent randomized trial reported similar outcomes in patients treated with targeted temperature management at either 33 °C or 36 °C. In response to these new data, the International Liaison Committee on Resuscitation Advanced Life Support Task Force performed a systematic review to evaluate 3 key questions: (1) Should mild induced hypothermia (or some form of targeted temperature management) be used in comatose post-cardiac arrest patients? (2) If used, what is the ideal timing of the intervention? (3) If used, what is the ideal duration of the intervention? The task force used Grading of Recommendations Assessment, Development and Evaluation methodology to assess and summarize the evidence and to provide a consensus on science statement and treatment recommendations. The task force recommends targeted temperature management for adults with out-of-hospital cardiac arrest with an initial shockable rhythm at a constant temperature between 32 °C and 36 °C for at least 24 hours. Similar suggestions are made for out-of-hospital cardiac arrest with a nonshockable rhythm and in-hospital cardiac arrest. The task force recommends against prehospital cooling with rapid infusion of large volumes of cold intravenous fluid. Additional and specific recommendations are provided in the document. PMID:26449873

  12. Retention of Cardiopulmonary Resuscitation Skills in Nigerian Secondary School Students

    Science.gov (United States)

    Onyeaso, Adedamola Olutoyin

    2016-01-01

    Background/Objective: For effective bystander cardiopulmonary resuscitation (CPR), retention of CPR skills after the training is central. The objective of this study was to find out how much of the CPR skills a group of Nigerian secondary school students would retain six weeks after their first exposure to the conventional CPR training. Materials…

  13. Viscoelastic guidance of resuscitation

    DEFF Research Database (Denmark)

    Stensballe, Jakob; Ostrowski, Sisse R; Johansson, Pär I

    2014-01-01

    populations. In trauma care, viscoelastic hemostatic assays allows for rapid and timely identification of coagulopathy and individualized, goal-directed transfusion therapy. As part of the resuscitation concept, viscoelastic hemostatic assays seem to improve outcome also in trauma; however, there is a need......PURPOSE OF REVIEW: Bleeding in trauma carries a high mortality and is increased in case of coagulopathy. Our understanding of hemostasis and coagulopathy has improved, leading to a change in the protocols for hemostatic monitoring. This review describes the current state of evidence supporting the...... use of viscoelastic hemostatic assays to guide trauma resuscitation. RECENT FINDINGS: Viscoelastic hemostatic assays such as thrombelastography and rotational thrombelastometry have shown to reduce bleeding, transfusion of fresh frozen plasma and platelets, and possibly mortality in different surgical...

  14. [Lazarus phenomenon: spontaneous resuscitation].

    Science.gov (United States)

    Casielles García, J L; González Latorre, M V; Fernández Amigo, N; Guerra Vélz, A; Cotta Galán, M; Bravo Capaz, E; de las Mulas Béjar, M

    2004-01-01

    A 94-year-old woman undergoing surgery for simple repair of a duodenal perforation experienced a sudden massive hemorrhage (1500 mL) when the duodenum was separated from adjacent structures. Hemodynamic stability was re-established when fluids were replaced. After the abdominal wall was closed, increased amplitude of the QRS wave was observed and heart rate slowed until there was no pulse. Electromechanical dissociation (EMD) was diagnosed and cardiopulmonary resuscitation was started. When EMD persisted after 40 minutes, resuscitative measures were stopped and the ventilator was disconnected, though orotracheal intubation and arterial and electrocardiographic monitoring were maintained. After 2 or 3 minutes, heart rhythm restarted spontaneously and arterial pressure waves reappeared on the monitor. The patient progressed well for 72 hours, after which she developed septic shock and multiorgan failure, dying 18 days later. The Lazarus phenomenon may be more common than the medical literature would indicate, possibly because a large gap in our understanding of the pathophysiology of the phenomenon underlies anecdotes about "miracles". As we wait for adequate international consensus on a protocol for monitoring the withdrawal of resuscitative measures, we should act prudently before definitively certifying death. The case we report occurred during a surgical intervention in which the patient had received general anesthesia. We believe that the causes that might explain the Lazarus phenomenon are quite different in that context than they would be in a nonsurgical setting, such that it would be useful to create a national database to keep a record of such intraoperative events. PMID:15495638

  15. Advanced information technology for training and emergency management

    International Nuclear Information System (INIS)

    Modern information technology provides many possibilities for improving both the safety and the availability of nuclear installations. A Nordic research programme was started in 1977, in which several organizations in Denmark, Finland, Norway and Sweden has been participating. The work has on a general level been addressing control rooms, human reliability and information technology for nuclear power plants. The research has had impact on the development of the control room solutions and the training simulators in Finland and also in the other Nordic countries. The present phase of the Nordic cooperation is investigating the use of advanced information technology in emergency management. The paper gives a brief introduction to the use of advance information technology for training and emergency management, which is based on the experience from the Nordic projects and other similar application projects in Finland. The paper includes also references to results from several of the projects. (author)

  16. Organizational training in manufacturing firms and advanced manufacturing technologies

    OpenAIRE

    Diéguez, Isabel; Cantorna, Ana; Canto, Ana

    2005-01-01

    The introduction of new microelectronic technologies in the manufacturing process forces companies to adapt human resource strategy to the changes in the workplace. While this subject has been widely researched from an operations management perspective, research from a human resource management viewpoint has been less frequent. The aim of this article is to gain insight into some of the factors that determine personnel training efforts in companies introducing advanced manufacturing technolog...

  17. Maximizing Cochlear Implant Patients’ Performance with Advanced Speech Training Procedures

    OpenAIRE

    Fu, Qian-Jie; Galvin, John J.

    2007-01-01

    Advances in implant technology and speech processing have provided great benefit to many cochlear implant patients. However, some patients receive little benefit from the latest technology, even after many years’ experience with the device. Moreover, even the best cochlear implant performers have great difficulty understanding speech in background noise, and music perception and appreciation remain major challenges. Recent studies have shown that targeted auditory training can significantly i...

  18. Advances in Husbandry Training in Marine Mammal Care Programs

    OpenAIRE

    Brando, Sabrina I. C. A.

    2010-01-01

    The aim of this paper is to illustrate how the training of marine mammals has facilitated improved marine mammal husbandry practices. The marine mammal community has seen many changes, refinements and improvements in animal care programs since the first marine mammals were brought in captivity in the early 19th century. Cross disciplinary fields such as veterinarian science, psychology, physiology and conservation biology have advanced the knowledge and care of the different species of cetace...

  19. Protocolized Resuscitation of Burn Patients.

    Science.gov (United States)

    Cancio, Leopoldo C; Salinas, Jose; Kramer, George C

    2016-10-01

    Fluid resuscitation of burn patients is commonly initiated using modified Brooke or Parkland formula. The fluid infusion rate is titrated up or down hourly to maintain adequate urine output and other endpoints. Over-resuscitation leads to morbid complications. Adherence to paper-based protocols, flow sheets, and clinical practice guidelines is associated with decreased fluid resuscitation volumes and complications. Computerized tools assist providers. Although completely autonomous closed-loop control of resuscitation has been demonstrated in animal models of burn shock, the major advantages of open-loop and decision-support systems are identifying trends, enhancing situational awareness, and encouraging burn team communication. PMID:27600131

  20. Accurately fitting advanced training. Flexible simulator training by modular training course concepts

    International Nuclear Information System (INIS)

    Every employee of a power plant contributes with his individual expertise to the success of the enterprise. Certainly personal skills of employees differ from each other as well as power plants are different. With respect to effective simulator training this means that no two simulator training courses can be identical. To exactly meet the requirements of our customers KWS has developed modules for simulation training courses. Each module represents either a technical subject or addresses a topic in the field of soft skills. An accurately fitting combination of several of these modules to the needs of our customers allows for most efficient simulator training courses. (orig.)

  1. Application of "digital code" teaching method in training community nurses of cardiopulmonary resuscitation%"数字密码"教学法在社区护士心肺复苏技术培训中的应用

    Institute of Scientific and Technical Information of China (English)

    陶秀萍

    2015-01-01

    Objective To explore effect of "digital code" teaching method in training community nurses of cardiopulmonary resuscitation (CPR).Methods 157 nurses in community hospital who had received CPR training during May 2015 and July 2015 were recruited.All trainees were divided into control group and experimental group according to training process.The control group was taught by conventional teaching method,while the experimental group was taught by "digital code" teaching method.Took International Guidelines 2010 for CPR as the standard of teaching contents,and training effects of two groups were compared.Results Before training,there were high failure rates of both groups in 12 items of operation process; after training,except total operation time of control group (P=0.246),operation failure rates of the two groups were significantly lower than those before training (P<0.05).After training,operation examination scores of experimental group were better than that of control group (t=2.854,P<0.05); operation failure rates of experimental group were lower than those of control group,among which,operation failure rate of artificial ventilation in experimental group was significantly lower than that of control group,and the difference was statistically significant (χ2=6.992,P=0.008).Conclusions The teaching method of "digital code"can effectively improve CPR skills of community nurses as well as conventional teaching method,but "digital code" teaching is suitable for CPR training of community nurses because of its advantages of easy learning and giving prominence to emphasis.%目的 探讨"数字密码"教学法在社区护士心肺复苏(cardiopulmonary resuscitation,CPR)技术培训中的教学效果.方法 将2015年05-07月接受CPR培训的157名社区护士纳入研究.按照培训进程,将学员分为对照组和试验组.对照组采用常规教学法授课,试验组采用"数字密码"教学法授课.授课内容以2010版《国际心肺复苏指南》为标准,

  2. Cardiopulmonary resuscitation and contrast media reactions in a radiology department

    International Nuclear Information System (INIS)

    AIM: To assess current knowledge and training in the management of contrast media reactions and cardiopulmonary resuscitation within a radiology department. MATERIALS AND METHODS: The standard of knowledge about the management of contrast media reactions and cardiopulmonary resuscitation among radiologists, radiographers and nurses were audited using a two-section questionnaire. Our results were compared against nationally accepted standards. Repeat audits were undertaken over a 28-month period. Three full audit cycles were completed. RESULTS: The initial audit confirmed that although a voluntary training programme was in place, knowledge of cardiopulmonary resuscitation techniques were below acceptable levels (set at 70%) for all staff members. The mean score for radiologists was 50%. Immediate changes instituted included retraining courses, the distribution of standard guidelines and the composition and distribution of two separate information handouts. Initial improvements were complemented by new wallcharts, which were distributed throughout the department, a series of lectures on management of contrast reactions and regular reviews with feedback to staff. In the third and final audit all staff groups had surpassed the required standard. CONCLUSION: Knowledge of contrast media reactions and resuscitation needs constant updating. Revision of skills requires a prescriptive programme; visual display of advice is a constant reminder. It is our contention all radiology departmental staff should consider it a personal duty to maintain their resuscitation skills at appropriate standards. O'Neill, J.M., McBride, K.D.(2001). Clinical Radiology 00, 000-000

  3. Cardiopulmonary resuscitation and contrast media reactions in a radiology department

    Energy Technology Data Exchange (ETDEWEB)

    O' Neill, John M.; McBride, Kieran D

    2001-04-01

    AIM: To assess current knowledge and training in the management of contrast media reactions and cardiopulmonary resuscitation within a radiology department. MATERIALS AND METHODS: The standard of knowledge about the management of contrast media reactions and cardiopulmonary resuscitation among radiologists, radiographers and nurses were audited using a two-section questionnaire. Our results were compared against nationally accepted standards. Repeat audits were undertaken over a 28-month period. Three full audit cycles were completed. RESULTS: The initial audit confirmed that although a voluntary training programme was in place, knowledge of cardiopulmonary resuscitation techniques were below acceptable levels (set at 70%) for all staff members. The mean score for radiologists was 50%. Immediate changes instituted included retraining courses, the distribution of standard guidelines and the composition and distribution of two separate information handouts. Initial improvements were complemented by new wallcharts, which were distributed throughout the department, a series of lectures on management of contrast reactions and regular reviews with feedback to staff. In the third and final audit all staff groups had surpassed the required standard. CONCLUSION: Knowledge of contrast media reactions and resuscitation needs constant updating. Revision of skills requires a prescriptive programme; visual display of advice is a constant reminder. It is our contention all radiology departmental staff should consider it a personal duty to maintain their resuscitation skills at appropriate standards. O'Neill, J.M., McBride, K.D.(2001). Clinical Radiology 00, 000-000.

  4. Advanced Training of Labour Force: The Usa Experience

    OpenAIRE

    Sushentsev Artem

    2014-01-01

    The importance of professional development of labor force directly in the workplace has been proved. It’s revealed that this is due not only to questions of advanced training, but also to the improvement of the situation on the labor market of unskilled groups of citizen. The current labor market recognizes the value and importance of people. Along with this a key and fundamental is stability and predictability in the workplace. It is proved that in the center of each production system are pe...

  5. Resuscitation of subdiaphragmatic exsanguination.

    Science.gov (United States)

    Ross, S E; Schwab, C W

    1988-04-01

    Subdiaphragmatic exsanguination is a major cause of death in civilian trauma. In a 1-year review of 867 consecutive admissions to a Level I Trauma Center, a 4.3 per cent incidence (37 patients) of infradiaphragmatic exsanguination was found. Eleven per cent of all abdominal injuries and 35 per cent of pelvic fractures sustained massive hemorrhage. A treatment protocol incorporating immediate airway control, MAST device, super-large bore venous access, warming rapid infusors, immediate type O blood transfusion, emergency department thoracotomy, and emergent operation as required, produced an overall mortality of 54 per cent. Mortality was higher for pelvic fracture (59%) than abdominal injury (43%). No patient survived ED thoracotomy. Continued developments in resuscitation techniques, as well as prehospital, and operative care are required to reduce mortality from exsanguinating hemorrhage. PMID:3355017

  6. Resuscitation and auto resuscitation by airway reflexes in animals

    OpenAIRE

    Tomori, Zoltan; Donic, Viliam; Benacka, Roman; Jakus, Jan; Gresova, Sona

    2013-01-01

    Various diseases often result in decompensation requiring resuscitation. In infants moderate hypoxia evokes a compensatory augmented breath – sigh and more severe hypoxia results in a solitary gasp. Progressive asphyxia provokes gasping respiration saving the healthy infant – autoresuscitation by gasping. A neonate with sudden infant death syndrome, however, usually will not survive. Our systematic research in animals indicated that airway reflexes have similar resuscitation potential as gasp...

  7. Implementing advanced technologies in the Republic of China Air Force officer training system

    OpenAIRE

    Yin, I-Hsiu

    1994-01-01

    Approved for public release, distribution unlimited Rapid advances in the level of technology in education and training have greatly increased possibilities for their use. This thesis investigates traditional and more recent applications of advanced technology. The goal of the work is to provide an introduction to concepts and considerations in implementing advanced technologies in education and training applications. Included is a mod...

  8. Human factors in resuscitation: Lessons learned from simulator studies

    Directory of Open Access Journals (Sweden)

    Hunziker S

    2010-01-01

    Full Text Available Medical algorithms, technical skills, and repeated training are the classical cornerstones for successful cardiopulmonary resuscitation (CPR. Increasing evidence suggests that human factors, including team interaction, communication, and leadership, also influence the performance of CPR. Guidelines, however, do not yet include these human factors, partly because of the difficulties of their measurement in real-life cardiac arrest. Recently, clinical studies of cardiac arrest scenarios with high-fidelity video-assisted simulations have provided opportunities to better delineate the influence of human factors on resuscitation team performance. This review focuses on evidence from simulator studies that focus on human factors and their influence on the performance of resuscitation teams. Similar to studies in real patients, simulated cardiac arrest scenarios revealed many unnecessary interruptions of CPR as well as significant delays in defibrillation. These studies also showed that human factors play a major role in these shortcomings and that the medical performance depends on the quality of leadership and team-structuring. Moreover, simulated video-taped medical emergencies revealed that a substantial part of information transfer during communication is erroneous. Understanding the impact of human factors on the performance of a complex medical intervention like resuscitation requires detailed, second-by-second, analysis of factors involving the patient, resuscitative equipment such as the defibrillator, and all team members. Thus, high-fidelity simulator studies provide an important research method in this challenging field.

  9. Teaching Staff Advanced Training in Russia, the Republic of Kazakhstan, the USA and Canada

    Directory of Open Access Journals (Sweden)

    Kovalchuk Vasyl

    2015-12-01

    Full Text Available In the article the peculiarities in organization of postgraduate teacher training in foreign countries have been highlighted; the basic problems and prospects for advanced training which stipulate for reforming the relevant national systems have been revealed; common and distinctive trends in their development have been justified. In Russia there is a cascade (cyclic system of teaching staff advanced training, based on the principles of andragogy, namely, continuity, self-control and self-analysis of professional activities by teachers and the use of their own experience during the advanced training. The abovementioned system consists of three phases such as pre-course, course and implementing. Each element of this model is a constituent part of the other, providing cycling and growth. Tasks for teachers are grounded on all the phases of the described system and influence their professional development. In the Republic of Kazakhstan there are three basic systems for teaching staff advanced training, namely, centers of educational excellence at the “Nazarbayev Intellectual Schools”, JSC “National Centre of Teaching Staff Advanced Training” (based on RIPKSO and 16 regional teaching staff advanced training institutes, teaching staff advanced training centres at universities and experimental sections. According to the defined module in the terms of the complex 3-month courses combining face-to-face and online training are provided. In the USA advanced training is provided by multilevel higher educational institutions which offer a wide range of different full-time and distance training programs and some programs are taught directly in educational establishments. The content of advanced training is determined by standards of professional pedagogical education according to the educational program and provides for fundamental, psychological, pedagogical, methodical, IT, practical, social and humanitarian training. Teaching staff advanced

  10. Effect of CRM team leader training on team performance and leadership behavior in simulated cardiac arrest scenarios: a prospective, randomized, controlled study

    OpenAIRE

    Fernandez Castelao, Ezequiel; Boos, Margarete; Ringer, Christiane; Eich, Christoph; Russo, Sebastian G.

    2015-01-01

    Background Effective team leadership in cardiopulmonary resuscitation (CPR) is well recognized as a crucial factor influencing performance. Generally, leadership training focuses on task requirements for leading as well as non-leading team members. We provided crisis resource management (CRM) training only for designated team leaders of advanced life support (ALS) trained teams. This study assessed the impact of the CRM team leader training on CPR performance and team leader verbalization. Me...

  11. 预备役官兵心肺复苏认知调查及培训效果%Survey on reserve officers cardiopulmonary resuscitation and the effect of training

    Institute of Scientific and Technical Information of China (English)

    周敏; 何小俊

    2014-01-01

    Objective Research to reserve officers and soldiers on cardiopulmonary resuscitation ( CPR) knowledge and skills before and after training .Methods A self-designed questionnaire for respondents in knowledge and skills of CPR before and after training .Results 25.3% respondents lack of knowledge on CPR Before the training, 45.2% of them gain CPR knowledge main channel obtained from television , newspapers.8.9%from professional books,20.5%from listen to others, 17.1%master skill properly, 100%cluld judgment the loss of consciousness and cardiac arrest properly , 98.6% determine respiratory arrest, 94.5%breathing and heartbeat stopped treatment measures ,73.3% basic skill of CPR,72.6% implement artificial respiration, 87.7% press accurately parts of the heart , 87.7% the depth of the sternum chest compression.146 reserve officers aware of knowledge about CPR knowledge training after all were higher than before the training, the differences were statistically significant (P<0.05) .Conclusions Through training, reserve duty's CPR knowledge and skills can be improved .Thus enhance success rate to protect people's lives and safety at a crucial moment .%目的:了解预备役官兵对徒手心肺复苏术( CPR)知识和技能的掌握情况,并分析CPR知识培训后的效果。方法采用自行设计的问卷调查表对150名预备役官兵在培训前、后CPR知识及技能掌握情况进行调查。结果本次调查发放问卷150份,4份填写不完整,回收有效问卷146份,有效回收率97.3%。培训前25.3%预备役官兵对CPR知识缺乏,45.2%获得CPR知识的途径主要来源于电视、报刊;8.9%从专业书籍中获取;20.5%听他人说。17.1%会正确CPR操作。培训后100%官兵掌握了判断意识丧失和心跳停止的方法;98.6%会判断呼吸停止;94.5%掌握了呼吸心跳停止处理措施;73.3%掌握了心肺复苏的基本步骤;72.6%会实施人工呼吸;87.7

  12. Vasopressin decreases neuronal apoptosis during cardiopulmonary resuscitation

    OpenAIRE

    Ma, Chi; Zhu, Zhe; Wang, Xu; Zhao, Gang; Liu, Xiaoliang; Li, Rui

    2014-01-01

    The American Heart Association and the European Resuscitation Council recently recommended that vasopressin can be used for cardiopulmonary resuscitation, instead of epinephrine. However, the guidelines do not discuss the effects of vasopressin during cerebral resuscitation. In this study, we intraperitoneally injected epinephrine and/or vasopressin during cardiopulmonary resuscitation in a rat model of asphyxial cardiac arrest. The results demonstrated that, compared with epinephrine alone, ...

  13. Challenges and possibilities in forward resuscitation.

    Science.gov (United States)

    Hooper, Timothy James; De Pasquale, Marc; Strandenes, Geir; Sunde, Geir; Ward, Kevin R

    2014-05-01

    The environmental and logistical constraints of the prehospital setting make it a challenging place for the treatment of trauma patients. This is perhaps more pronounced in the management of battlefield casualties before extraction to definitive care. In seeking solutions, interest has been renewed in implementing damage control resuscitation principles in the prehospital setting, a concept termed remote damage control resuscitation. These developments, while improving conflict survival rates, are not exclusive to the military environment, with similar situations existing in the civilian setting. By understanding the pathophysiology of shock, particularly the need for oxygen debt repayment, improvements in the assessment and management of trauma patients can be made. Technology gaps have previously hampered our ability to accurately monitor the prehospital trauma patient in real time. However, this is changing, with devices such as tissue hemoglobin oxygen saturation monitors and point-of-care lactate analysis currently being refined. Other monitoring modalities including newer signal analysis and artificial intelligence techniques are also in development. Advances in hemostatic resuscitation are being made as our understanding and ability to effectively monitor patients improve. The reevaluation of whole-blood use in the prehospital environment is yielding favorable results and challenging the negative dogma currently associated with its use. Management of trauma-related airway and respiratory compromise is evolving, with scope to improve on currently accepted practices. The purpose of this review is to highlight the challenges of treating patients in the prehospital setting and suggest potential solutions. In doing so, we hope to maintain the enthusiasm from people in the field and highlight areas for prehospital specific research and development, so that improved rates of casualty survival will continue. PMID:24296432

  14. Advanced Training of Labour Force: The Usa Experience

    Directory of Open Access Journals (Sweden)

    Sushentsev Artem

    2014-09-01

    Full Text Available The importance of professional development of labor force directly in the workplace has been proved. It’s revealed that this is due not only to questions of advanced training, but also to the improvement of the situation on the labor market of unskilled groups of citizen. The current labor market recognizes the value and importance of people. Along with this a key and fundamental is stability and predictability in the workplace. It is proved that in the center of each production system are people and their collective beliefs and behavior of production culture. An important point here has their adaptation to the new and conditions of work. The requirements of the labor market to the production staff in terms of different employers have been defined. It is revealed that the professional development of labor force according to labor market requirements is not isolated events, but the use of various programs (including program TWI “J”, continuous implementation of “lean tools”, vehicles, methods, ways of staff thinking.

  15. Vitamin C in Burn Resuscitation.

    Science.gov (United States)

    Rizzo, Julie A; Rowan, Matthew P; Driscoll, Ian R; Chung, Kevin K; Friedman, Bruce C

    2016-10-01

    The inflammatory state after burn injury is characterized by an increase in capillary permeability that results in protein and fluid leakage into the interstitial space, increasing resuscitative requirements. Although the mechanisms underlying increased capillary permeability are complex, damage from reactive oxygen species plays a major role and has been successfully attenuated with antioxidant therapy in several disease processes. However, the utility of antioxidants in burn treatment remains unclear. Vitamin C is a promising antioxidant candidate that has been examined in burn resuscitation studies and shows efficacy in reducing the fluid requirements in the acute phase after burn injury. PMID:27600125

  16. Echocardiography integrated ACLS protocol versus conventional cardiopulmonary resuscitation in patients with pulseless electrical activity cardiac arrest

    Institute of Scientific and Technical Information of China (English)

    Mojtaba Chardoli; Farhad Heidari; Helaleh Rabiee; Mahdi Sharif-Alhoseini; Hamid Shokoohi; Vafa Rahimi-Movaghar

    2012-01-01

    Objective: To examine the utility of bedside echocardiography in detecting the reversible causes of pulseless electrical activity (PEA) cardiac arrest and predicting the resuscitation outcomes.Methods: In this prospective interventional study,patients presenting with PEA cardiac arrest were randomized into two groups.In Group A,ultrasound trained emergency physicians performed echocardiography evaluating cardiac activity,right ventricle dilation,left ventricle function,pericardial effusion/tamponade and ⅣC size along with the advanced cardiac life support (ACLS) protocol.Patients in Group B solely underwent ACLS protocol without applying echocardiography.The presence or absence of mechanical ventricular activity (MVA) and evidences of PEA reversible causes were recorded.The return of spontaneous circulation (ROSC) and death were evaluated in both groups.Results: One hundred patients with the mean age of (58±6.1) years were enrolled in this study.Fifty patients (Group A) had echocardiography detected in parallel with cardiopulmonary resuscitation (CPR).Among them,7 patients (14%) had pericardial effusion,11 (22%) had hypovolemia,and 39 (78%) were revealed the presence of MVA.In the pseudo PEA subgroup (presence of MVA),43% had ROSC (positive predictive value) and in the true PEA subgroup with cardiac standstill (absence of MVA),there was no recorded ROSC (negative predictive value).Among patients in Group B,no reversible etiology was detected.There was no significant difference in resuscitation results between Groups A and B observed (P=0.52).Conclusion: Bedside echocardiography can identify some reversible causes of PEA.However,there are no significant changes in survival outcome between the echo group and those with traditional CPR.

  17. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi

    2014-01-01

    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  18. Resuscitation Prior to Emergency Endotracheal Intubation: Results of a National Survey

    Directory of Open Access Journals (Sweden)

    Robert S. Green

    2016-09-01

    Full Text Available Introduction: Respiratory failure is a common problem in emergency medicine (EM and critical care medicine (CCM. However, little is known about the resuscitation of critically ill patients prior to emergency endotracheal intubation (EETI. Our aim was to describe the resuscitation practices of EM and CCM physicians prior to EETI. Methods: A cross-sectional survey was developed and tested for content validity and retest reliability by members of the Canadian Critical Care Trials Group. The questionnaire was distributed to all EM and CCM physician members of three national organizations. Using three clinical scenarios (trauma, pneumonia, congestive heart failure, we assessed physician preferences for use and types of fluid and vasopressor medication in pre-EETI resuscitation of critically ill patients. Results: In total, 1,758 physicians were surveyed (response rate 50.2%, 882/1,758. Overall, physicians would perform pre-EETI resuscitation using either fluids or vasopressors in 54% (1,193/2,203 of cases. Most physicians would “always/often” administer intravenous fluid pre-EETI in the three clinical scenarios (81%, 1,484/1,830. Crystalloids were the most common fluid physicians would “always/often” administer in congestive heart failure (EM 43%; CCM 44%, pneumonia (EM 97%; CCM 95% and trauma (EM 96%; CCM 96%. Pre-EETI resuscitation using vasopressors was uncommon (4.9%. Training in CCM was associated with performing pre-EETI resuscitation (odds ratio, 2.20; 95% CI, [1.44-3.36], p<0.001. Conclusion: Pre-EETI resuscitation is common among Canadian EM and CCM physicians. Most physicians use crystalloids pre-EETI as a resuscitation fluid, while few would give vasopressors. Physicians with CCM training were more likely to perform pre-EETI resuscitation.

  19. Conflicting perspectives compromising discussions on cardiopulmonary resuscitation.

    LENUS (Irish Health Repository)

    Groarke, J

    2010-09-01

    Healthcare professionals, patients and their relatives are expected to discuss resuscitation together. This study aims to identify the differences in the knowledge base and understanding of these parties. Questionnaires examining knowledge and opinion on resuscitation matters were completed during interviews of randomly selected doctors, nurses and the general public. 70% doctors, 24% nurses and 0% of a public group correctly estimated survival to discharge following in-hospital resuscitation attempts. Deficiencies were identified in doctor and nurse knowledge of ethics governing resuscitation decisions. Public opinion often conflicts with ethical guidelines. Public understanding of the nature of cardiopulmonary arrests and resuscitation attempts; and of the implications of a \\'Do Not Attempt Resuscitation (DNAR)\\' order is poor. Television medical dramas are the primary source of resuscitation knowledge. Deficiencies in healthcare professionals\\' knowledge of resuscitation ethics and outcomes may compromise resuscitation decisions. Educational initiatives to address deficiencies are necessary. Parties involved in discussion on resuscitation do not share the same knowledge base reducing the likelihood of meaningful discussion. Public misapprehensions surrounding resuscitation must be identified and corrected during discussion.

  20. Human factors in resuscitation: Lessons learned from simulator studies

    OpenAIRE

    Hunziker S; Tschan F; Semmer N; Howell M; Marsch S

    2010-01-01

    Medical algorithms, technical skills, and repeated training are the classical cornerstones for successful cardiopulmonary resuscitation (CPR). Increasing evidence suggests that human factors, including team interaction, communication, and leadership, also influence the performance of CPR. Guidelines, however, do not yet include these human factors, partly because of the difficulties of their measurement in real-life cardiac arrest. Recently, clinical studies of cardiac arrest scenarios with h...

  1. Statins for post resuscitation syndrome.

    Science.gov (United States)

    Kämäräinen, Antti; Virkkunen, Ilkka; Silfvast, Tom; Tenhunen, Jyrki

    2009-07-01

    After sudden cardiac arrest, successful resuscitation and return of spontaneous circulation, a multi-faceted ischaemia/reperfusion related disorder develops. This condition now known as post resuscitation syndrome is characterised by marked increases in the inflammatory response and changes in coagulation profile and vascular reactivity. Additionally, the production of reactive oxygen species and activation of cytotoxic cascades of metabolism add to these injury mechanisms resulting in multiorgan perfusion deficits and dysfunction. Especially in the cerebrum these injuries may be the cause of significant morbidity and mortality. Recent evidence has shown that statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) exert numerous beneficial effects in cardiovascular diseases irrespective of the lipid status. Remarkably, these pleiotropic effects seem to extended beyond cardiovascular diseases such as immunomodulative and antioxidative properties. We hypothesised that administration of statins early in the post resuscitation phase would prove beneficial in the resuscitated patient via several pleiotropic effects. These include inhibition of excessive coagulation and inflammatory response, suppression of oxygen radical production and improved vascular reactivity. The discussed effects are mediated via multiple pathways activated in the cardiac arrest victim, to which statins have been shown to have a beneficial modulating effect in experimental settings and non-cardiac arrest patients. To test this hypothesis in clinical practice, a randomized, controlled trial with sufficient power and standardised post resuscitation treatment would be necessary. The generally good tolerance of statin therapy with minimal adverse effects would support this experiment, although a parenteral form of the drug to ensure adequate dosage might be a prerequisite. PMID:19254829

  2. Capnography during cardiopulmonary resuscitation: Current evidence and future directions

    OpenAIRE

    Bhavani Shankar Kodali; Urman, Richard D.

    2014-01-01

    Capnography continues to be an important tool in measuring expired carbon dioxide (CO 2 ). Most recent Advanced Cardiac Life Support (ACLS) guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR). Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlat...

  3. Design of Work Organization and Training during the Implementation of Advanced Information Technology

    OpenAIRE

    Leppaenen, A.

    1989-01-01

    It has been commonly recognized that training and education are success factors of advanced production automation systems. There are, however, only few answers to the questions of how to train personnel during implementation and change, how to educate trainers, or how to educate planners and managers. As a part of the collaborating network of the IIASA CIM-Project, several case studies have been carried out in Finland, where design and training methods were assessed during the real imple...

  4. Resuscitating the Baby after Shoulder Dystocia

    Directory of Open Access Journals (Sweden)

    Savas Menticoglou

    2016-01-01

    Full Text Available Background. To propose hypovolemic shock as a possible explanation for the failure to resuscitate some babies after shoulder dystocia and to suggest a change in clinical practice. Case Presentation. Two cases are presented in which severe shoulder dystocia was resolved within five minutes. Both babies were born without a heartbeat. Despite standard resuscitation by expert neonatologists, no heartbeat was obtained until volume resuscitation was started, at 25 minutes in the first case and 11 minutes in the second. After volume resuscitation circulation was restored, there was profound brain damage and the babies died. Conclusion. Unsuspected hypovolemic shock may explain some cases of failed resuscitation after shoulder dystocia. This may require a change in clinical practice. Rather than immediately clamping the cord after the baby is delivered, it is proposed that (1 the obstetrician delay cord clamping to allow autotransfusion of the baby from the placenta and (2 the neonatal resuscitators give volume much sooner.

  5. The role of experience and advanced training on performance in a motorcycle simulator.

    Science.gov (United States)

    Crundall, David; Stedmon, Alex W; Crundall, Elizabeth; Saikayasit, Rossukorn

    2014-12-01

    Motorcyclists are over-represented in collision statistics. While many collisions may be the direct fault of another road user, a considerable number of fatalities and injuries are due to the actions of the rider. While increased riding experience may improve skills, advanced training courses may be required to evoke the safest riding behaviours. The current research assessed the impact of experience and advanced training on rider behaviour using a motorcycle simulator. Novice riders, experienced riders and riders with advanced training traversed a virtual world through varying speed limits and roadways of different curvature. Speed and lane position were monitored. In a comparison of 60 mph and 40 mph zones, advanced riders rode more slowly in the 40 mph zones, and had greater variation in lane position than the other two groups. In the 60 mph zones, both advanced and experienced riders had greater lane variation than novices. Across the whole ride, novices tended to position themselves closer to the kerb. In a second analysis across four classifications of curvature (straight, slight, medium, tight) advanced and experienced riders varied their lateral position more so than novices, though advanced riders had greater variation in lane position than even experienced riders in some conditions. The results suggest that experience and advanced training lead to changes in behaviour compared to novice riders which can be interpreted as having a potentially positive impact on road safety. PMID:25180786

  6. 34 CFR 664.14 - What is an advanced overseas intensive language training project?

    Science.gov (United States)

    2010-07-01

    ... language to be studied must be indigenous to the host country and maximum use must be made of local... 34 Education 3 2010-07-01 2010-07-01 false What is an advanced overseas intensive language... overseas intensive language training project? (a)(1) An advanced overseas intensive language project...

  7. The Effect of the Advanced Placement Training and Incentive Program on Increasing Enrollment and Performance on Advanced Placement Science Exams

    Science.gov (United States)

    Ramsey, Susan Brady

    2012-01-01

    The purpose of this study is to examine the effectiveness of the National Math and Science Initiative's Advanced Placement Training and Incentive Program (APTIP) on the number of students taking AP science courses and their performance. The study evaluated 39 schools over a six-year period in six states that participate in the APTIP. The…

  8. Current status of advanced gastrointestinal endoscopy training fellowships in the United States

    Directory of Open Access Journals (Sweden)

    Stephen J Heller

    2011-01-01

    Full Text Available Stephen J Heller, Jeffrey L TokarDepartment of Medicine, Fox Chase Cancer Center, Philadelphia, PA, USAAbstract: Rapid growth in the field of advanced gastrointestinal endoscopy has led to an increase in specialized therapeutic endoscopy fellowships. The cornerstones of these programs are training in endoscopic retrograde cholangiopancreatography (ERCP and endoscopic ultrasound. These procedures are more complex and challenging to master than routine colonoscopy and upper endoscopy, and in the case of ERCP, higher risk. The concentration of the educational experience in the hands of relatively fewer trainees with specialized interest in advanced endoscopy has resulted in providing a focused cohort of graduating fellows with higher case volumes in training, which likely enhances diagnostic and therapeutic success and safer performance of these procedures. Endoscopic simulators, although not currently in widespread use, have the potential to improve advanced procedural training without jeopardizing patient safety.Keywords: gastrointestinal endoscopy, training, procedures, safety 

  9. Innovation Training within the Australian Advanced Manufacturing Industry

    Science.gov (United States)

    Donovan, Jerome Denis; Maritz, Alex; McLellan, Andrew

    2013-01-01

    Innovation has emerged as a core driver for the future profitability and success of the manufacturing sector, and increasingly both governments and the private sector are examining ways to support the development of innovation capabilities within organisations. In this research, we have evaluated a government-funded innovation training course…

  10. Comparison of the T-piece resuscitator with other neonatal manual ventilation devices: A qualitative review.

    LENUS (Irish Health Repository)

    2012-01-31

    AIM: To review the literature surrounding various aspects of T-piece resuscitator use, with particular emphasis on the evidence comparing the device to other manual ventilation devices in neonatal resuscitation. DATA SOURCES: The Medline, EMBASE, Cochrane databases were searched in April 2011. Ongoing trials were identified using www.clinicaltrials.gov and www.controlled-trials.com. Additional studies from reference lists of eligible articles were considered. All studies including T-piece resuscitator use were eligible for inclusion. RESULTS: Thirty studies were included. There were two randomised controlled trials in newborn infants comparing the devices, one of which addressed short and intermediate term morbidity and mortality outcomes and found no difference between the T-piece resuscitator and self inflating bag. From manikin studies, advantages to the T-piece resuscitator include the delivery of inflating pressures closer to predetermined target pressures with least variation, the ability to provide prolonged inflation breaths and more consistent tidal volumes. Disadvantages include a technically more difficult setup, more time required to adjust pressures during resuscitation, a larger mask leak and less ability to detect changes in compliance. CONCLUSIONS: There is a need for appropriately designed randomised controlled trials in neonates to highlight the efficacy of one device over another. Until these are performed, healthcare providers should be appropriately trained in the use of the device available in their departments, and be aware of its own limitations.

  11. The impact of in-house surgeons and operating room resuscitation on outcome of traumatic injuries.

    Science.gov (United States)

    Hoyt, D B; Shackford, S R; McGill, T; Mackersie, R; Davis, J; Hansbrough, J

    1989-08-01

    As trauma systems develop, more patients can potentially benefit from immediate surgery. With in-house surgeons available, enthusiasm for direct transfer from the scene to the operating room (OR) has developed in many institutions. The purpose of this study was to define precisely which patients should be taken to the OR for resuscitation. Three hundred twenty-three patients were taken to the OR directly from the field during a 4-year period (6.9% of trauma activations). Indications included the following: (1) cardiac arrest--one vital sign present, (2) persistent hypotension despite field intravenous fluid, and (3) uncontrolled external hemorrhage. A board-certified surgeon and resuscitation team met the field transport team in the OR in all cases. Cardiopulmonary resuscitation for patients with blunt trauma was not accompanied by survival even with immediate surgery by a trained surgeon and it wastes valuable OR resources. Patients with prehospital hypotension unresponsive to fluid resuscitation indicate the need for rapid surgery. Patients with blunt injuries even with hypotension infrequently undergo operations in less than 20 minutes and can be resuscitated in traditional areas where better roentgenograms are obtained. Penetrating injuries to the chest and abdomen with hypotension are the primary indications for OR resuscitation. It can be anticipated with field communication and accompanied by enhanced survival. PMID:2757502

  12. A study of advanced training technology: Emerging answers to tough questions

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-01

    This study reports the result of an extensive nationwide review of military, private sector, and other federal agencies and organizations that are implementing a wide variety of advanced training technologies. This report classifies the general categories of advanced training technologies found and provides an overview of each, including specific types and examples. In addition, the research findings present an organizational model for training development linking overall organizational maturity to readiness to implement specific kinds of advanced training technologies. It also presents proposed methods for selecting media, describes the organizations and the data gathered, and provides a summary of implementation success at each organization. This study is organized as a set of five topics. Each topic raises a number of important questions and provides complete or emerging answers. For organizations who have made advanced training selections, this study is a resource to benchmark their success with other organizations who have made similar selections. For new or developing training organizations, this study will help plan their future technology selections by comparing their level of organizational maturity to the documented experiences of similar organizations.

  13. S.C. Advanced Training Aircraft IAR 99 (A SOIM

    Directory of Open Access Journals (Sweden)

    Ioan STEFANESCU

    2012-06-01

    Full Text Available The use of subsonic single control aircraft and especially of double–control ones, instead of supersonic combat aircraft in the military pilot training programs in the operational units, has be-come a necessity due to the economic and financial world-wide crisis which began during the 70’s-80’s, with the advent of the oil crisis, affecting many countries, which have their own Military Air Forces.

  14. Training Advanced Writing Skills: The Case for Deliberate Practice

    Science.gov (United States)

    Kellogg, Ronald T.; Whiteford, Alison P.

    2009-01-01

    The development of advanced writing skills has been neglected in schools of the United States, with even some college graduates lacking the level of ability required in the workplace (National Commission on Writing, 2003, 2004). The core problem, we argue, is an insufficient degree of appropriate task practice distributed throughout the secondary…

  15. Advanced Technology Training Program for the Apparel Industry. Final Report.

    Science.gov (United States)

    El Paso Community Coll., TX.

    A project developed rapid response, advanced technology courses that met the apparel market labor needs of the El Paso (Texas) community. Courses were designed for four options: computerized marker making and pattern grading, computerized front office systems, high technology machinery operation, and high technology machinery mechanics. The…

  16. Role of oxygen in resuscitation

    Energy Technology Data Exchange (ETDEWEB)

    Bokeriya, L.A.; Sokolova, N.A.; Konikova, A.S.

    At the present time, improvement of the system of medical care of cosmonauts is an important problem. For this reason, there are plans for development of a set of resuscitation measures that would be necessary in the case of onset of acute hypoxic and anoxic states, which may occur in sudden emergency situations. The purpose of the experiment was to examine the mechanism of transition from life to death on the molecular level. Renewal of proteins and nucleic acids, and change in their conformation (spatial arrangement) were used as the main indicators of changes in metabolic processes in case of death due to anoxic anoxia (exsanguination). With this procedure it was possible to reflect some patterns of biopolymer conversions related to processes of dying and resuscitation. Processes examined were the intensity of synthesis and dissociation of proteins and nucleic acids in the basic organs and tissues of experimental animals: different parts of the brain, myocardium and skeletal muscles, liver, kidneys, lung, spleen, adrenals, thyroid and pancreas, blood, bile and urine.

  17. Resuscitation, prolonged cardiac arrest, and an automated chest compression device

    DEFF Research Database (Denmark)

    Risom, Martin; Jørgensen, Henrik; Rasmussen, Lars S;

    2010-01-01

    The European Resuscitation Council's 2005 guidelines for cardiopulmonary resuscitation (CPR) emphasize the delivery of uninterrupted chest compressions of adequate depth during cardiac arrest.......The European Resuscitation Council's 2005 guidelines for cardiopulmonary resuscitation (CPR) emphasize the delivery of uninterrupted chest compressions of adequate depth during cardiac arrest....

  18. Metabolic resuscitation in sepsis: a necessary step beyond the hemodynamic?

    Science.gov (United States)

    Leite, Heitor Pons; de Lima, Lúcio Flávio Peixoto

    2016-07-01

    Despite the advances made in monitoring and treatment of sepsis and septic shock, many septic patients ultimately develop multiple organ dysfunction (MODS) and die, suggesting that other players are involved in the pathophysiology of this syndrome. Mitochondrial dysfunction occurs early in sepsis and has a central role in MODS development. MODS severity and recovery of mitochondrial function have been associated with survival. In recent clinical and experimental investigations, mitochondrion-target therapy for sepsis and septic shock has been suggested to reduce MODS severity and mortality. This intervention, which might be named "metabolic resuscitation", would lead to improved mitochondrial activity afforded by pharmacological and nutritional agents. Of particular interest in this therapeutic strategy is thiamine, a water-soluble vitamin that plays an essential role in cellular energy metabolism. Critical illness associated with hypermetabolic states may predispose susceptible individuals to the development of thiamine deficiency, which is not usually identified by clinicians as a source of lactic acidosis. The protective effects of thiamine on mitochondrial function may justify supplementation in septic patients at risk of deficiency. Perspectives of supplementation with other micronutrients (ascorbic acid, tocopherol, selenium and zinc) and potential metabolic resuscitators [coenzyme Q10 (CoQ10), cytochrome oxidase (CytOx), L-carnitine, melatonin] to target sepsis-induced mitochondrial dysfunction are also emerging. Metabolic resuscitation may probably be a safe and effective strategy in the treatment of septic shock in the future. However, until then, preliminary investigations should be replicated in further researches for confirmation. Better identification of groups of patients presumed to benefit clinically by a certain intervention directed to "mitochondrial resuscitation" are expected to increase driven by genomics and metabolomics. PMID:27501325

  19. Successful application of acute cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Derya ztrk; Erturul Altinbilek; Murat Koyuncu; Bedriye Mge Snmez; ilem altili; Ibrahim Ikzcel; Cemil Kavalci; Glsm Kavalci

    2015-01-01

    Objective: To compare the quality and correct the deficiencies of cardiopulmonary resuscitation (CPR) procedures performed in patients who developed cardiopulmonary cardiopulmonary arrest before or after Emergency Department admission. Methods: This study was conducted on patients who were applied CPR atŞŞişli Etfal Training and Research and Research Hospital, Emergency Department between 01 January 2012 and 31 December 2012. Chi-square and Mann-Whitney U test were used to compare the patients' data. The study data were analyzed in SPSS 18.0 software package. A P value less than 0.05 was considered statistically significant. Results: A total of 155 patients who were applied CPR were included in the analysis. Among the study patients, seventy eight (50.3%) were brought to Emergency Department after developing cardiopulmonary arrest while 77 (49.7%) developed cardiopulmonary arrest at Emergency Department. The mean age of the study population was (66 ± 16) years and 64%of the patients were male. The initial rhythms of the CPR-applied patients were different (P 0.05). The CPR response time was longer in ED (P Conclusions: The scientific data obtained in this study suggest that an early response and therapy improves outcomes in CPR procedure.

  20. [Advanced Trauma Life Support. A training concept also for Europe].

    Science.gov (United States)

    Helm, M; Kulla, M; Lampl, L

    2007-11-01

    Advanced Trauma Life Support (ATLS) is a concept for rapid initial assessment and primary management of an injured patient, starting at the time of injury and continuing through initial assessment, lifesaving interventions, re-evaluation, stabilization and, when needed, transfer to a trauma centre. Despite some shortcomings, it is the only standardized concept for emergency room management, which is internationally accepted. Because of its simple and clear structure, it is flexible and can be universally integrated into existing emergency room algorithms under consideration of local, regional as well as national and international peculiarities in the sense of a "common language of trauma". Under these aspects ATLS also seems to be a valid concept for Europe. PMID:17726585

  1. Effects of Age, Gender, School Class on Cardiopulmonary Resuscitation Skills of Nigerian Secondary School Students

    Science.gov (United States)

    Onyeaso, Adedamola Olutoyin; Onyeaso, Chukwudi Ochi

    2016-01-01

    Background: The need for training of schoolchildren on cardiopulmonary resuscitation (CPR) as potential bystander CPR providers is growing globally but Nigeria is still behind and lacks basic necessary data. Purpose: The purpose of this study was to investigate the effects of age, gender and school class on CPR skills of Nigerian secondary school…

  2. Persisting effect of community approaches to resuscitation

    DEFF Research Database (Denmark)

    Nielsen, Anne Møller; Isbye, Dan Lou; Lippert, Freddy Knudsen;

    2014-01-01

    BACKGROUND: On the Danish island of Bornholm an intervention was carried out during 2008-2010 aiming at increasing out-of-hospital cardiac arrest (OHCA) survival. The intervention included mass media focus on resuscitation and widespread educational activities. The aim of this study was to compare...... resuscitation through mass education in BLS combined with a media focus on resuscitation, we observed a persistent significant increase in the bystander BLS rate for all OHCAs with presumed cardiac aetiology. There was no significant difference in 30-day survival....

  3. The Effect of the Implementation of Advanced Manufacturing Technologies on Training in the Manufacturing Sector

    Science.gov (United States)

    Castrillon, Isabel Dieguez; Cantorna, Ana I. Sinde

    2005-01-01

    Purpose: The aim of this article is to gain insight into some of the factors that determine personnel-training efforts in companies introducing advanced manufacturing technologies (AMTs). The study provides empirical evidence from a sector with high rates of technological modernisation. Design/methodology/approach: "Ad hoc" survey of 90 firms in…

  4. Long-term intended and unintended experiences after Advanced Life Support training

    DEFF Research Database (Denmark)

    Rasmussen, M.B.; Dieckmann, Peter; Issenberg, Berry; Ostergaard, Doris; Søreide, Eldar; Ringsted, Charlotte Vibeke

    2012-01-01

    Highly structured simulation-based training (SBT) on managing emergency situations can have a significant effect on immediate satisfaction and learning. However, there are some indications of problems when applying learned skills to practice. The aim of this study was to identify long-term intended...... and unintended learner reactions, experiences and reflections after attending a simulation based Advanced Life Support (ALS) course....

  5. Implementation of team training in medical education in Denmark.

    Science.gov (United States)

    Østergaard, H T; Østergaard, D; Lippert, A

    2008-10-01

    In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies. The use of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies to document the effect of the different types of training on patient safety are discussed. PMID:19017834

  6. Bispectral index monitoring during cardiopulmonary resuscitation repeated twice within 8 days in the same patient: a case report

    OpenAIRE

    Pawlik, Michael T.; Seyfried, Timo F.; Riegger, Christian; Klingler, Werner; Selig, Christoph

    2008-01-01

    Research on cardiac resuscitation has led to various changes in the techniques and drug administration involved in modern advanced life support. Besides improving primary cardiac survival, interest is increasingly focused on a favourable neurological outcome. However, until now there has been no on-site equipment to support the clinical observations of the cardiopulmonary resuscitation (CPR) team. Bispectral index (BIS) monitoring has been used for avoiding awareness during anaesthesia for ma...

  7. Modification of the Neonatal Resuscitation Program Algorithm for Resuscitation of Conjoined Twins.

    Science.gov (United States)

    Yamada, Nicole K; Fuerch, Janene H; Halamek, Louis P

    2016-03-01

    There are no national or international guidelines for the resuscitation of conjoined twins. We have described how the U.S. Neonatal Resuscitation Program algorithm can be modified for delivery room resuscitation of omphaloischiopagus conjoined twins. In planning for the delivery and resuscitation of these patients, we considered the challenges of providing cardiopulmonary support to preterm conjoined twins in face-to-face orientation and with shared circulation via a fused liver and single umbilical cord. We also demonstrate how in situ simulation can be used to prepare a large, multidisciplinary team of health care professionals to deliver safe, efficient, and effective care to such patients. PMID:26461924

  8. 非医学类本科生心肺复苏知识认知与需求分析及培训模式探讨%Discussion on Cognition, Need and Training Model of Cardiopulmonary Resuscitation for Non-medical Undergraduates

    Institute of Scientific and Technical Information of China (English)

    张敏; 聂雷霞; 蒋萍; 喻娟

    2011-01-01

    Objective To understand tie status of cognition and need of cardioplmonary resuscitation (CPR) for non-medical undergraduates and to explore a suitable training model. Methods A questionnaire on CPR was applied among 211 non-medical undergraduates. Results 97.2% had strong desire to know CPR and receive related training and 98.6% would perform CPR if necessary but only 9.0% received relevant training. Most undergraduates knew little about how to perform CPR. ConcluSion The popularization of CPR should cover non-medical undergraduates who have strong desire to acquire the knowledge of CPR. It is necessary to conduct systematic and diversified training.%目的 了解非医学类本科生心肺复苏(cardiopulmonary resuscitation,CPR)急救知识需求和认知现状,探索并建立相应培训模式.方法 对湖北省某大学非医学类211名本科学生CPR急救知识认知和需求情况进行问卷调查.结果 (1)被调查者中,97.2%有强烈的CPR学习意愿和培训需求,98.6%表示愿意在掌握CPR急救知识和技能后成为"第一目击者"实施现场急救,而曾参与CPR急救知识和技能培训者仅占9.0%.(2)本组学生对各项CPR知识和操作技能掌握率2.4%~48.3%,其中打开气道方法 、现场环境评估、人工呼吸、复苏指标、救护新概念的掌握率均不足5%.结论 大学生对CPR知识需求强烈但相关知识缺乏,大学生是普及CPR技术不能忽视的群体;为确保CPR培训效果,施训人员应专业化,训练要突出操作性和培训多样化、系统化.

  9. Fuzzy expert system in the prediction of neonatal resuscitation

    Directory of Open Access Journals (Sweden)

    Reis M.A.M.

    2004-01-01

    Full Text Available In view of the importance of anticipating the occurrence of critical situations in medicine, we propose the use of a fuzzy expert system to predict the need for advanced neonatal resuscitation efforts in the delivery room. This system relates the maternal medical, obstetric and neonatal characteristics to the clinical conditions of the newborn, providing a risk measurement of need of advanced neonatal resuscitation measures. It is structured as a fuzzy composition developed on the basis of the subjective perception of danger of nine neonatologists facing 61 antenatal and intrapartum clinical situations which provide a degree of association with the risk of occurrence of perinatal asphyxia. The resulting relational matrix describes the association between clinical factors and risk of perinatal asphyxia. Analyzing the inputs of the presence or absence of all 61 clinical factors, the system returns the rate of risk of perinatal asphyxia as output. A prospectively collected series of 304 cases of perinatal care was analyzed to ascertain system performance. The fuzzy expert system presented a sensitivity of 76.5% and specificity of 94.8% in the identification of the need for advanced neonatal resuscitation measures, considering a cut-off value of 5 on a scale ranging from 0 to 10. The area under the receiver operating characteristic curve was 0.93. The identification of risk situations plays an important role in the planning of health care. These preliminary results encourage us to develop further studies and to refine this model, which is intended to implement an auxiliary system able to help health care staff to make decisions in perinatal care.

  10. ARN Training Course on Advance Methods for Internal Dose Assessment: Application of Ideas Guidelines

    International Nuclear Information System (INIS)

    Dose assessment in case of internal exposure involves the estimation of committed effective dose based on the interpretation of bioassay measurement, and the assumptions of hypotheses on the characteristics of the radioactive material and the time pattern and the pathway of intake. The IDEAS Guidelines provide a method to harmonize dose evaluations using criteria and flow chart procedures to be followed step by step. The EURADOS Working Group 7 'Internal Dosimetry', in collaboration with IAEA and Czech Technical University (CTU) in Prague, promoted the 'EURADOS/IAEA Regional Training Course on Advanced Methods for Internal Dose Assessment: Application of IDEAS Guidelines' to broaden and encourage the use of IDEAS Guidelines, which took place in Prague (Czech Republic) from 2-6 February 2009. The ARN identified the relevance of this training and asked for a place for participating on this activity. After that, the first training course in Argentina took place from 24-28 August for training local internal dosimetry experts. (authors)

  11. Return on Investment and Technology-Based Training--An Introduction and a Case Study at Advanced Micro Devices.

    Science.gov (United States)

    Masumian, Bijan

    1999-01-01

    Summarizes findings from studies comparing classroom and technology-based approaches to training and the respective Return on Investment (ROI) data. Highlights several advantages of technology-based training. Offers information and initial ROI numbers on the use of technology-based training at Advanced Micro Devices, a global manufacturer of…

  12. The Need for Interoperability for Urban Training in the Live Environment- - The Work of the Urban Combat Advanced Training Technology (UCATT) Group in NATO

    NARCIS (Netherlands)

    Galvin, K.E.; Gouweleeuw, R.G.W.

    2006-01-01

    The Urban Combat Advanced Training Technology (UCATT) was established within the NATO Modelling and Simulation Group (NMSG) in 2003 as MSG 032. UCATT was tasked to exchange and assess information on Military Operations in Urban Terrain (MOUT) facilities and training/simulation systems with a view to

  13. Prolonged Intraoperative Cardiac Resuscitation Complicated by Intracardiac Thrombus in a Patient Undergoing Orthotopic Liver Transplantation.

    Science.gov (United States)

    Kim, Sang; DeMaria, Samuel; Cohen, Edmond; Silvay, George; Zerillo, Jeron

    2016-09-01

    We report the case of successful resuscitation after prolonged cardiac arrest during orthotopic liver transplantation. After reperfusion, the patient developed ventricular tachycardia, complicated by intracardiac clot formation and massive hemorrhage. Transesophageal echocardiography demonstrated stunned and nonfunctioning right and left ventricles, with developing intracardiac clots. Treatment with heparin, massive transfusion and prolonged cardiopulmonary resuscitation ensued for 51 minutes. Serial arterial blood gases demonstrated adequate oxygenation and ventilation during cardiopulmonary resuscitation. Cardiothoracic surgery was consulted for potential use of extracorporeal membrane oxygenation, however, the myocardial function improved and the surgery was completed without further intervention. On postoperative day 6, the patient was extubated without neurologic or cardiac impairment. The patient continues to do well 2 years posttransplant, able to perform independent daily activities of living and his previous job. This case underscores the potential for positive outcomes with profoundly prolonged, effective advanced cardiovascular life support in patients who experience postreperfusion syndrome. PMID:27233818

  14. Implementation of team training in medical education in Denmark

    DEFF Research Database (Denmark)

    Østergaard, H T; Østergaard, Ditte; Lippert, A

    2008-01-01

    of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies......In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type....... The use of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of...

  15. Advanced technologies in plastic surgery: how new innovations can improve our training and practice.

    Science.gov (United States)

    Grunwald, Tiffany; Krummel, Thomas; Sherman, Randy

    2004-11-01

    Over the last two decades, virtual reality, haptics, simulators, robotics, and other "advanced technologies" have emerged as important innovations in medical learning and practice. Reports on simulator applications in medicine now appear regularly in the medical, computer science, engineering, and popular literature. The goal of this article is to review the emerging intersection between advanced technologies and surgery and how new technology is being utilized in several surgical fields, particularly plastic surgery. The authors also discuss how plastic and reconstructive surgeons can benefit by working to further the development of multimedia and simulated environment technologies in surgical practice and training. PMID:15509950

  16. Initial resuscitation of hemorrhagic shock

    Directory of Open Access Journals (Sweden)

    Krausz Michael M

    2006-04-01

    Full Text Available Abstract The primary treatment of hemorrhagic shock is control of the source of bleeding as soon as possible and fluid replacement. In controlled hemorrhagic shock (CHS where the source of bleeding has been occluded fluid replacement is aimed toward normalization of hemodynamic parameters. In uncontrolled hemorrhagic shock (UCHS in which bleeding has temporarily stopped because of hypotension, vasoconstriction, and clot formation, fluid treatment is aimed at restoration of radial pulse, or restoration of sensorium or obtaining a blood pressure of 80 mmHg by aliquots of 250 ml of lactated Ringer's solution (hypotensive resuscitation. When evacuation time is shorter than one hour (usually urban trauma immediate evacuation to a surgical facility is indicated after airway and breathing (A, B have been secured ("scoop and run". Precious time is not wasted by introducing an intravenous line. When expected evacuation time exceeds one hour an intravenous line is introduced and fluid treatment started before evacuation. Crystalloid solutions and blood transfusion are the mainstays of pre-hospital and in-hospital treatment of hemorrhagic shock. In the pre-hospital setting four types of fluid are presently recommended: crystalloid solutions, colloid solutions, hypertonic saline and oxygen-carrying blood substitutes. In unstable or unresponsive hemorrhagic shock surgical treatment is mandatory as soon as possible to control the source of bleeding.

  17. Trauma systems, shock, and resuscitation.

    Science.gov (United States)

    Fallon, W F

    1993-01-01

    This review of early care covers issues pertaining to the analysis of system function, prehospital intravascular volume replacement, diagnosis of proximity vascular injury, the role of emergency thoracotomy, and the value of transesophageal echocardiography. The first six articles deal with various aspects of system function, from triage to analysis of outcome. The next series of articles reviews work in progress evaluating optimal fluid for resuscitation. Hypertonic saline and dextran combinations have been shown to restore vital signs better than isotonic solutions; they are safe, require smaller volumes, and may improve head injury outcome. Danger lies in the restoration of perfusion without hemorrhage control. Two articles on emergency thoracotomy review the indications and outcome in blunt and penetrating trauma. Survival in blunt trauma is virtually zero. An article and two editorials summarize state of the art for diagnosis and treatment of proximity vascular injury. Two articles describe the potential use of the new technique of transesophageal echocardiography. This new modality has not formed a solid indication at present and can be considered investigational in trauma care. PMID:7584006

  18. Optimization of time distribution for studying the course modules on advanced training of health care administrators

    Directory of Open Access Journals (Sweden)

    Dorovskaya A.l.

    2015-06-01

    Full Text Available The research objective is rational (optimal time management in studying the course modules on Advanced Training of Health Care Administrators. Materials and methods. We conducted expert survey of 73 healthcare administrators from medical organizations of Saratov region. Branch-and-bound method was used for rescheduling the educational program. Results. Both direct and inverse problems have been solved. The direct one refers to time distribution for each module of the advanced Training of Healthcare Administrators course so that the total score is maximum and each module is marked not lower than "satisfactory". The inverse one resulted in achieving minimal time characteristics for varieties of average score. Conclusion. The offered approach allows to solve problems of managing time given for education.

  19. CIP Training Manual: Collaborative Information Portal Advance Training Information for Field Test Participants

    Science.gov (United States)

    Schreiner, John; Clancy, Daniel (Technical Monitor)

    2002-01-01

    The Collaborative Information Portal (CIP) is a web-based information management and retrieval system. Its purpose is to provide users at MER (Mars Exploration Rover) mission operations with easy access to a broad range of mission data and products and contextual information such as the current operations schedule. The CIP web-server provides this content in a user customizable web-portal environment. Since CIP is still under development, only a subset of the full feature set will be available for the EDO field test. The CIP web-portal will be accessed through a standard web browser. CIP is intended to be intuitive and simple to use, however, at the training session, users will receive a one to two page reference guide, which should aid them in using CIP. Users must provide their own computers for accessing CIP during the field test. These computers should be configured with Java 1.3 and a Java 2 enabled browser. Macintosh computers should be running OS 10.1.3 or later. Classic Mac OS (OS 9) is not supported. For more information please read section 7.3 in the FIASCO Rover Science Operations Test Mission Plan. Several screen shots of the Beta Release of CIP are shown on the following pages.

  20. Virginia Tech hosts 5th Annual Short Course on Advanced Sales Training in Forest Products Industry

    OpenAIRE

    Davis, Lynn

    2005-01-01

    Virginia Tech's Center for Forest Products Marketing and Management will offer its fifth annual short course on Advanced Sales Training in the Forest Products Industry. The event will be held from 8:30 a.m. to 4 p.m. Thursday, April 21, and continues from 8:30 a.m. to noon Friday, April 22, at the Donaldson Brown Hotel and Conference Center in Blacksburg.

  1. Technical Basis for Physical Fidelity of NRC Control Room Training Simulators for Advanced Reactors

    Energy Technology Data Exchange (ETDEWEB)

    Minsk, Brian S.; Branch, Kristi M.; Bates, Edward K.; Mitchell, Mark R.; Gore, Bryan F.; Faris, Drury K.

    2009-10-09

    The objective of this study is to determine how simulator physical fidelity influences the effectiveness of training the regulatory personnel responsible for examination and oversight of operating personnel and inspection of technical systems at nuclear power reactors. It seeks to contribute to the U.S. Nuclear Regulatory Commission’s (NRC’s) understanding of the physical fidelity requirements of training simulators. The goal of the study is to provide an analytic framework, data, and analyses that inform NRC decisions about the physical fidelity requirements of the simulators it will need to train its staff for assignment at advanced reactors. These staff are expected to come from increasingly diverse educational and experiential backgrounds.

  2. Characteristics of in-hospital cardiac arrest and cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Josip Ivić

    2009-02-01

    Full Text Available Aim We have studied epidemiology of in-hospital cardiac arrest, characteristics of organizing a reanimationand its,procedures as well as its documenting.Methods We analyzed all resuscitation procedure data where anesthesiology reanimation teams (RT providedcardiopulmonary resuscitation (CPR during one-year period. We included resuscitation attemptsthat were initiated outside the Department of Anesthesiology, excluding incidents in operation rooms andIntensive Care Unit (ICU. Data on every cardiac arrest and CPR were entered in a special form.Results During one-year period 87 CPR were performed. Victims of cardiac arrest were principallyelderly patients (age 60 – 80, mostly male (60%. Most frequent victims were neurological patients(42%, surgical patients (21% and neurosurgical patients (10%. The leading cause of cardiac arrestwas primary heart disease, following neurological diseases and respiration disorders of severe etiology.In over 90% cases CPR was initiated by medical personnel in their respective departments, RT arrivedwithin 5 minutes in 73,56% cases. Initially survival was 32%, but full recovery was accomplished in 4patients out of 87 (4,6%.Conclusion Victims of cardiac arrest are patients whose primary disease contributes to occurrence ofcardiorespiratory complications. High mortality and low percentage of full recovery can be explainedby characteristics of patients (old age, nature and seriousness of primary disease which significantly affectthe outcome of CPR. In some cases a question is raised whether to initiate the CPR at all. We wouldlike to point out that continous monitoring of potentially critical patients may prevent cardiorespiratoryincidents whereas the quality and success of CPR may be improved by training of staff and better technicalequipment on the relevant locations in the in the hospital where such incidents usually occur.

  3. Decision to resuscitate or not in patients with chronic diseases

    DEFF Research Database (Denmark)

    Saltbæk, Lena; Tvedegaard, Erling

    2012-01-01

    Do-not-resuscitate (DNR) decisions are frequently made without informing the patients. We attempt to determine whether patients and physicians wish to discuss the DNR decision, who they think, should be the final decision maker and whether they agree on the indication for cardiopulmonary resuscit...... resuscitation (CPR) in case of cardiac arrest....

  4. Release of endogenous vasopressors during and after cardiopulmonary resuscitation.

    OpenAIRE

    Lindner, K. H.; Haak, T; Keller, A; Bothner, U.; Lurie, K. G.

    1996-01-01

    OBJECTIVE: To assess whether plasma endothelin, adrenaline, noradrenaline, arginine vasopressin, adrenocorticotropin, and cortisol concentrations were higher during cardiopulmonary resuscitation in patients in whom resuscitation was successful than in those in whom it failed, and to measure the concentrations of these hormones in the immediate post-resuscitation phase. DESIGN: Prospective, descriptive study. SETTING: Emergency medical service at a university hospital. PATIENTS: 60 patients wi...

  5. Nonlinear Exercise Training in Advanced Chronic Obstructive Pulmonary Disease Is Superior to Traditional Exercise Training A Randomized Trial

    NARCIS (Netherlands)

    Klijn, Peter; van Keimpema, Anton; Legemaat, Monique; Gosselink, Rik; van Stel, Henk

    2013-01-01

    Rationale: The optimal exercise training intensity and strategy for individualized exercise training in chronic obstructive pulmonary disease (COPD) is not clear. Objectives: This study compares the effects of nonlinear periodized exercise (NLPE) training used in athletes to traditional endurance an

  6. Current Status of Core and Advanced Adult Gastrointestinal Endoscopy Training in Canada: Survey of Existing Accredited Programs

    OpenAIRE

    Xiong, Xin; Barkun, Alan N; Waschke, Kevin; Martel, Myriam

    2013-01-01

    OBJECTIVE: To determine the current status of core and advanced adult gastroenterology training in Canada.METHODS: A survey consisting of 20 questions pertaining to core and advanced endoscopy training was circulated to 14 accredited adult gastroenterology residency program directors. For continuous variables, median and range were analyzed; for categorical variables, percentage and associated 95% CIs were analyzed.RESULTS: All 14 programs responded to the survey. The median number of core tr...

  7. Descriptive Analysis of Medication Administration During Inpatient Cardiopulmonary Arrest Resuscitation (from the Mayo Registry for Telemetry Efficacy in Arrest Study).

    Science.gov (United States)

    Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Dumitrascu, Adrian; Harris, Dana; Bosworth, Veronica; Clark, Brooke; Thomas, Colleen S; Heckman, Michael G; Vadeboncoeur, Tyler; Kusumoto, Fred; Burton, M Caroline

    2016-05-15

    Advanced cardiovascular life support guidelines exist, yet there are variations in clinical practice. Our study aims to describe the utilization of medications during resuscitation from in-hospital cardiopulmonary arrest. A retrospective review of patients who suffered a cardiopulmonary arrest from May 2008 to June 2014 was performed. Clinical and resuscitation data, including timing and dose of medications used, were extracted from the electronic medical record and comparisons made. A total of 94 patients were included in the study. Patients were divided into different groups based on the medication combination used during resuscitation: (1) epinephrine; (2) epinephrine and bicarbonate; (3) epinephrine, bicarbonate, and calcium; (4) epinephrine, bicarbonate, and epinephrine drip; and (5) epinephrine, bicarbonate, calcium, and epinephrine drip. No difference in baseline demographics or clinical data was present, apart from history of dementia and the use of calcium channel blockers. The number of medications given was correlated with resuscitation duration (Spearman's rank correlation = 0.50, p <0.001). The proportion of patients who died during the arrest was 12.5% in those who received epinephrine alone, 30.0% in those who received only epinephrine and bicarbonate, and 46.7% to 57.9% in the remaining groups. Patients receiving only epinephrine had shorter resuscitation durations compared to that of the other groups (p <0.001) and improved survival (p = 0.003). In conclusion, providers frequently use nonguideline medications in resuscitation efforts for in-hospital cardiopulmonary arrests. Increased duration and mortality rates were found in those resuscitations compared with epinephrine alone, likely due to the longer resuscitation duration in the former groups. PMID:27015887

  8. A randomized controlled evaluation study of the effects of a one-day advanced rider training course.

    OpenAIRE

    Boele-Vos, M.J. & Craen, S. de

    2016-01-01

    Motorcyclists have a relative high risk of crash involvement. As a consequence there is an on-going search for safety measures to improve road safety for motorcyclists. One popular measure is motorcycle training. Although intuitively sound, there are only few thorough studies on rider training courses and they do not always show a positive safety effect. The aim of this study was to assess the effects of the advanced rider training course ‘Risk’. Through random assignment motorcyclists (N = 2...

  9. Resuscitation and Obstetrical Care to Reduce Intrapartum-Related Neonatal Deaths: A MANDATE Study.

    Science.gov (United States)

    Kamath-Rayne, Beena D; Griffin, Jennifer B; Moran, Katelin; Jones, Bonnie; Downs, Allan; McClure, Elizabeth M; Goldenberg, Robert L; Rouse, Doris; Jobe, Alan H

    2015-08-01

    To evaluate the impact of neonatal resuscitation and basic obstetric care on intrapartum-related neonatal mortality in low and middle-income countries, using the mathematical model, Maternal and Neonatal Directed Assessment of Technology (MANDATE). Using MANDATE, we evaluated the impact of interventions for intrapartum-related events causing birth asphyxia (basic neonatal resuscitation, advanced neonatal care, increasing facility birth, and emergency obstetric care) when implemented in home, clinic, and hospital settings of sub-Saharan African and India for 2008. Total intrapartum-related neonatal mortality (IRNM) was acute neonatal deaths from intrapartum-related events plus late neonatal deaths from ongoing intrapartum-related injury. Introducing basic neonatal resuscitation in all settings had a large impact on decreasing IRNM. Increasing facility births and scaling up emergency obstetric care in clinics and hospitals also had a large impact on decreasing IRNM. Increasing prevalence and utilization of advanced neonatal care in hospital settings had limited impact on IRNM. The greatest improvement in IRNM was seen with widespread advanced neonatal care and basic neonatal resuscitation, scaled-up emergency obstetric care in clinics and hospitals, and increased facility deliveries, resulting in an estimated decrease in IRNM to 2.0 per 1,000 live births in India and 2.5 per 1,000 live births in sub-Saharan Africa. With more deliveries occurring in clinics and hospitals, the scale-up of obstetric care can have a greater effect than if modeled individually. Use of MANDATE enables health leaders to direct resources towards interventions that could prevent intrapartum-related deaths. A lack of widespread implementation of basic neonatal resuscitation, increased facility births, and emergency obstetric care are missed opportunities to save newborn lives. PMID:25656720

  10. ARN Training on Advance Methods for Internal Dose Assessment: Application of Ideas Guidelines

    International Nuclear Information System (INIS)

    Dose assessment in case of internal exposure involves the estimation of committed effective dose based on the interpretation of bioassay measurement, and the assumptions of hypotheses on the characteristics of the radioactive material and the time pattern and the pathway of intake. The IDEAS Guidelines provide a method to harmonize dose evaluations using criteria and flow chart procedures to be followed step by step. The EURADOS Working Group 7 'Internal Dosimetry', in collaboration with IAEA and Czech Technical University (CTU) in Prague, promoted the 'EURADOS/IAEA Regional Training Course on Advanced Methods for Internal Dose Assessment: Application of IDEAS Guidelines' to broaden and encourage the use of IDEAS Guidelines, which took place in Prague (Czech Republic) from 2-6 February 2009. The ARN identified the relevance of this training and asked for a place for participating on this activity. After that, the first training course in Argentina took place from 24-28 August for training local internal dosimetry experts. This paper resumes the main characteristics of this activity. (authors)

  11. Advanced Educational Methodology on Nuclear Control for Establishment of International Training Center

    International Nuclear Information System (INIS)

    In accordance with the Notice of Ministry of Education, Science and Technology(MEST), KINAC has carried out compulsory education for domestic inspectors, nuclear operators and R and D project managers on nuclear fuel cycle. In addition, as a part of Korea President's declaration at 1st International Nuclear Security Summit Conference, KINAC has to establish an International Training Center(ITC) to increase mutual cooperation among Member States as well as to strengthen their capabilities for effectively coping with current nuclear threats. Along with this, this paper suggests an advanced educational methodology to develop international training course on nuclear control as well as to contribute to effectively ensure human resource in developing countries

  12. Delaying urinary catheter insertion in the reception and resuscitation of blunt multitrauma and using a full bladder to tamponade pelvic bleeding.

    Science.gov (United States)

    Huang, Sean; Vohora, Ashray; Russ, Matthias K; Mathew, Joseph K; Johnny, Cecil S; Stevens, Jeremy; Fitzgerald, Mark C

    2015-01-01

    This article proposes a counter-argument to standard Advanced Trauma Life Support (ATLS) training--which advocates bladder catheterisation to be performed as an adjunct to the primary survey and resuscitation for early decompression of the bladder and urine output monitoring. We argue the case for delaying bladder catheterisation until after definitive truncal Computed Tomography (CT) imaging. To reduce pelvic volume and associated bleeding, our trauma team delay catheter insertion until after the initial CT scan. The benefits of a full bladder also include improved views on initial Focussed Assessment with Sonography in Trauma (FAST) scan and improved interpretation of injuries on CT. Our urinary catheter related infection rates anecdotally decreased when insertion was delayed and consequently performed in a more controlled, non-resuscitation setting following CT. Adult blunt multitrauma patients with pelvic ring fractures are at risk of significant haemorrhage. Venous, arterial and medullary injuries with associated bleeding may be potentiated by an increased pelvic volume with ring disruption, as well as a reduced pressure effect from retroperitoneal and intra-pelvic organs on bleeding sites. Various techniques are used to reduce intra-pelvic bleeding. For shocked patients who have sustained major pelvic injuries with no other signs of urinary tract trauma and minimal urine in the bladder on initial FAST scan, we advocate careful, aseptic Foley catheter insertion followed by bladder insufflation with 500-600 mL of Normal Saline (NS) and subsequent catheter clamping to tamponade pelvic bleeding. PMID:25805552

  13. O custo direto do programa de treinamento em ressuscitação cardiopulmonar em um hospital universitário El costo directo del programa de entrenamiento em resucitación cardiopulmonar en un hospital universitário The direct cost of the cardiopulmonary resuscitation training program in a university hospital

    Directory of Open Access Journals (Sweden)

    Nadia Nasser Follador

    2007-03-01

    resuscitation for technicians and assistant nurses of the Intensive Care and Semi-Intensive Care units at the University of São Paulo's Hospital Universitário (HU-USP, and at checking the direct costs of the main activities in the process. This is an exploratory research, a retrospective, documental survey, using the case study model. The results showed that the total direct cost of the cardiopulmonary resuscitation training program was 9,081.44 reals. The direct cost with personnel represented 96.74%, and with material 3.26%. In the training planning sub-process, most of the direct cost was represented by the instructor-assisting nurse, with 5,451.60 reals (62.04%. The direct costs related to the material that was used were also higher in the training program sub-process, 188.80 reals (63.73%. The total cost per trainee was 206.40 reals.

  14. Quality and outcome of cardiopulmonary resuscitation

    NARCIS (Netherlands)

    S.G. Beesems

    2015-01-01

    Important factors in a successful resuscitation are optimal chest compression rate of 100/min, a compression depth of 5 cm and minimization of pauses in chest compressions. This constitutes ‘high quality’ CPR. The first part of this thesis focuses on assessing this quality and how feedback devices m

  15. Computed tomography scanning during a traumatic resuscitation

    NARCIS (Netherlands)

    L.F.M. Beenen; R. Adams; R.W. Koster; T. Otto

    2011-01-01

    In cardiopulmonary resuscitation, computed tomography (CT) imaging could be of decisive importance to therapeutic strategy making but is yet unavailable because of incompatibility of CT scanning and manual chest compressions. In this report, we describe a case in which CT scanning was performed on a

  16. Virginia Tech hosts short course on Advanced Sales Training in the Forest Products Industry

    OpenAIRE

    Davis, Lynn

    2004-01-01

    Virginia Tech's Center for Forest Products Marketing and Management will offer its third annual short course on Advanced Sales Training in the Forest Products Industry. The course will be held on Thursday, September 23, from 8:30 a.m. to 4 p.m. and continues to Friday, September 24, from 8:30 a.m. to noon. The one and a half day event will be held at the Donaldson Brown Hotel and Conference Center on the Virginia Tech campus.

  17. Knowledge and psychomotor skills of nursing students in North Cyprus in the area of cardiopulmonary resuscitation

    OpenAIRE

    Dal, Umran; Sarpkaya, Dilek

    2013-01-01

    Objective : The aim of the study was to determine the cardiopulmonary resuscitation (CPR) knowledge and skill levels of nursing students in North Cyprus. Methods : The study design was quasi-experimental and longitudinal. A questionnaire was applied to the students before the CPR lecture. Then the students were informed about adult CPR by the researchers and all of the students practiced CPR on a Resusci-Anne manikin. One and six months after this training the same questionnaire and skills ch...

  18. Cardio-pulmonary resuscitation challenges in selected Botswana hospitals: Nurse managers’ views

    OpenAIRE

    Lakshmi Rajeswaran; Valerie J. Ehlers

    2013-01-01

    Road traffic accident victims, as well as persons experiencing cardiac and other medical emergencies, might lose their lives due to the non-availability of trained personnel to provide effective cardio-pulmonary resuscitation (CPR) with functional equipment and adequate resources.The objectives of the study were to identify unit managers’ perceptions about challenges encountered when performing CPR interventions in the two referral public hospitals in Botswana. These results could be used to ...

  19. Use of instructional video to prepare parents for learning infant cardiopulmonary resuscitation

    OpenAIRE

    Brannon, Timothy S.; White, Lisa A.; Kilcrease, Julie N.; Richard, LaShawn D.; Spillers, Jana G.; Cynthia L. Phelps

    2009-01-01

    Parents of premature infants often receive infant cardiopulmonary resuscitation (CPR) training prior to discharge from the hospital, but one study showed that 27.5% of parents could not demonstrate adequate CPR skills after completing an instructor-led class. We hypothesized that parents who viewed an instructional video on infant CPR before attending the class would perform better on a standardized skills test than parents who attended the class with no preparation. Parents randomized to the...

  20. Evaluation of Training for Public about Cardiopulmonary Resuscitation Skills in Pingliang of Gansu Province%甘肃省平凉市崆峒区公众心肺复苏技能培训效果评价

    Institute of Scientific and Technical Information of China (English)

    李进伟

    2011-01-01

    目的:探讨对公众进行心肺复苏知识和技能培训的方法及效果.方法:随机抽取平凉市崆峒区不同公众共160人,进行CPR问卷调查与CPR技能的培训.结果:培训前公众普遍缺乏心肺复苏知识和技能;培训后,公众对CPR知识知晓情况、CPR技能操作测试及施救意愿程度与培训前相比,差异均有统计学意义(P<0.01).结论:公众心肺复苏知识及技能普遍缺乏,培训能有效地提高公众心肺复苏知识与技能并有助于提高公众实施CPR的信心及意愿程度.%Objective: To explore the methods and effects of training for public about the knowledge and skills of CPR. Methods: Randomly selected total 160 people from the different public that were carried out the survey questionnaires of CPR knowledge and the skills of CPR training. Results: Before the Training, the public are general lack of the knowledge and skills of CPR , Through training, the knowledge of CPR and the skills operation test of CPR were better than before (P<0.01). Conclusions: The publics are general lack of the knowledge and skills of CPR. Through training can improve the knowledge and skills of CPR among public. it will help increase the public to implement the confidence and willingness of CPR.

  1. 如何改善心肺复苏培训质量的研究进展%Research progress on how to improve the quality of cardiopulmonary resuscitation training

    Institute of Scientific and Technical Information of China (English)

    杨正飞

    2012-01-01

    院外心脏性猝死(out of hospital cardiac arrest,OHCA)发生率高,但是OHCA患者的生存率却很低.对旁观者开展心肺复苏(CPR)培训是改善实际CPR质量、提高OHCA生存率的重要手段.CPR培训质量的评估包括即时的理论与技能掌握效果以及中长期的知识巩固程度.通过理论考核以及模拟人技能操作评估培训效果,评估指标包括反映CPR质量的大部分参数.不同的教学方法、方式及学员本身的因素(如年龄、性别、身体因素、动机与态度等)也会影响CPR的培训质量.希望通过端正学员学习动机,根据其自身特点综合运用各种教学辅助器材开展个性化的CPR教学,同时建立标准化的考评指标体系,定期进行重复更新训练,以此优化即时的教学效果,巩固中长期的技能掌握程度.%Lots of people experience out of hospilal cardiac arrest (OHCA) , but the survival rale from OHCA was very low. Byslander - initialed cardiopulmonary resuscilalion ( CPR) plays a major role in the " chain of survival" to save the OHCA, therefore, the quality of CPR training is very important. We assess the quality of CPR training that comprised the short - term effect and skill retention by theoretical examination and skill performance on the manikin. The quality of CPR training is affected by different education means or method and the students' factors themselves such as age, gender, motivation, attitude and so on. Improving students'motivation and attitude, personalized training and tutoring program, application all kinds of training auxiliary instrument, establishment of the standard assessment system and recurrent training can optimize the short - term teaching effectiveness and consolidatethe retention.

  2. Using virtual reality environment to facilitate training with advanced upper-limb prosthesis

    Directory of Open Access Journals (Sweden)

    Linda Resnik, PT, PhD, OCS

    2011-07-01

    Full Text Available Technological advances in upper-limb prosthetic design offer dramatically increased possibilities for powered movement. The DEKA Arm system allows users 10 powered degrees of movement. Learning to control these movements by utilizing a set of motions that, in most instances, differ from those used to obtain the desired action prior to amputation is a challenge for users. In the Department of Veterans Affairs "Study to Optimize the DEKA Arm," we attempted to facilitate motor learning by using a virtual reality environment (VRE program. This VRE program allows users to practice controlling an avatar using the controls designed to operate the DEKA Arm in the real world. In this article, we provide highlights from our experiences implementing VRE in training amputees to use the full DEKA Arm. This article discusses the use of VRE in amputee rehabilitation, describes the VRE system used with the DEKA Arm, describes VRE training, provides qualitative data from a case study of a subject, and provides recommendations for future research and implementation of VRE in amputee rehabilitation. Our experience has led us to believe that training with VRE is particularly valuable for upper-limb amputees who must master a large number of controls and for those amputees who need a structured learning environment because of cognitive deficits.

  3. History of the evolution of cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    George Karlis

    2013-04-01

    Full Text Available Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references on CPR go back to the era of Ancient Egypt (3100 B.C.. Although the technique for mouth to mouth ventilation was known in ancient times, its efficacy was demonstrated just in 1958. The ease and efficacy of chest compressions were demonstrated in 1960. Electrical defibrillation may have begun in 1775, but it was applied to a victim of cardiac arrest in the 1950s. Conclusion: CPR is currently a rapidly evolving field of medical science. According to latest data, there is evidence that high quality chest compressions, prompt defibrillation if applicable and treatment of reversible causes improve Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references

  4. Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths: a systematic review, meta-analysis and Delphi estimation of mortality effect

    Directory of Open Access Journals (Sweden)

    Carlo Waldemar A

    2011-04-01

    Full Text Available Abstract Background Of 136 million babies born annually, around 10 million require assistance to breathe. Each year 814,000 neonatal deaths result from intrapartum-related events in term babies (previously “birth asphyxia” and 1.03 million from complications of prematurity. No systematic assessment of mortality reduction from tactile stimulation or resuscitation has been published. Objective To estimate the mortality effect of immediate newborn assessment and stimulation, and basic resuscitation on neonatal deaths due to term intrapartum-related events or preterm birth, for facility and home births. Methods We conducted systematic reviews for studies reporting relevant mortality or morbidity outcomes. Evidence was assessed using GRADE criteria adapted to provide a systematic approach to mortality effect estimates for the Lives Saved Tool (LiST. Meta-analysis was performed if appropriate. For interventions with low quality evidence but strong recommendation for implementation, a Delphi panel was convened to estimate effect size. Results We identified 24 studies of neonatal resuscitation reporting mortality outcomes (20 observational, 2 quasi-experimental, 2 cluster randomized controlled trials, but none of immediate newborn assessment and stimulation alone. A meta-analysis of three facility-based studies examined the effect of resuscitation training on intrapartum-related neonatal deaths (RR= 0.70, 95%CI 0.59-0.84; this estimate was used for the effect of facility-based basic neonatal resuscitation (additional to stimulation. The evidence for preterm mortality effect was low quality and thus expert opinion was sought. In community-based studies, resuscitation training was part of packages with multiple concurrent interventions, and/or studies did not distinguish term intrapartum-related from preterm deaths, hence no meta-analysis was conducted. Our Delphi panel of 18 experts estimated that immediate newborn assessment and stimulation would

  5. Editorial: Advances in healthcare provider and patient training to improve the quality and safety of patient care

    Directory of Open Access Journals (Sweden)

    Elizabeth M. Borycki

    2015-09-01

    Full Text Available This special issue of the Knowledge Management & E-Learning: An International Journal is dedicated to describing “Advances in Healthcare Provider and Patient Training to Improve the Quality and Safety of Patient Care.” Patient safety is an important and fundamental requirement of ensuring the quality of patient care. Training and education has been identified as a key to improving healthcare provider patient safety competencies especially when working with new technologies such as electronic health records and mobile health applications. Such technologies can be harnessed to improve patient safety; however, if not used properly they can negatively impact on patient safety. In this issue we focus on advances in training that can improve patient safety and the optimal use of new technologies in healthcare. For example, use of clinical simulations and online computer based training can be employed both to facilitate learning about new clinical discoveries as well as to integrate technology into day to day healthcare practices. In this issue we are publishing papers that describe advances in healthcare provider and patient training to improve patient safety as it relates to the use of educational technologies, health information technology and on-line health resources. In addition, in the special issue we describe new approaches to training and patient safety including, online communities, clinical simulations, on-the-job training, computer based training and health information systems that educate about and support safer patient care in real-time (i.e. when health professionals are providing care to patients. These educational and technological initiatives can be aimed at health professionals (i.e. students and those who are currently working in the field. The outcomes of this work are significant as they lead to safer care for patients and their family members. The issue has both theoretical and applied papers that describe advances in patient

  6. Teaching Emergency Surgical Skills for Trauma Resuscitation-Mechanical Simulator versus Animal Model

    OpenAIRE

    Jameel Ali; Anne Sorvari; Anand Pandya

    2012-01-01

    Background. Traditionally, surgical skills in trauma resuscitation have been taught using animal models in the advanced trauma life support (ATLS) course. We compare one mechanical model (TraumaMan simulator) as an alternative teaching tool for these skills. Method. Eighteen providers and 14 instructors performed four surgical procedures on TraumaMan and compared educational effectiveness with the porcine model. Evaluation was conducted (Likert system 1: very poor to 5: excellent). The partic...

  7. Automated cardiopulmonary resuscitation: a case study.

    Science.gov (United States)

    Spiro, Jon; Theodosiou, Maria; Doshi, Sagar

    2014-02-01

    Rates of survival after cardiac arrest are low and correlate with the quality of cardiopulmonary resuscitation (CPR). Devices that deliver automated CPR (A-CPR) can provide sustained and effective chest compressions, which are especially useful during patient transfer and while simultaneous invasive procedures are being performed. The use of such devices can also release members of resuscitation teams for other work. This article presents a case study involving a man with acute myocardial infarction complicated by cardiogenic shock and pulmonary oedema. It describes how ED nursing and medical teams worked together to deliver A-CPR, discusses the use of A-CPR devices in a tertiary cardiac centre, and highlights the advantages of using such devices. PMID:24494769

  8. Indication for resuscitative thoracotomy in thoracic injuries-Adherence to the ATLS guidelines. A forensic autopsy based evaluation

    DEFF Research Database (Denmark)

    Ohrt-Nissen, S; Colville-Ebeling, B; Kandler, K; Hornbech, K; Steinmetz, J; Ravn, J; Lehnert, P

    2016-01-01

    BACKGROUND: The appropriate indications for Resuscitative Thoracotomy (RT) are still debated in the literature and various guidelines have been proposed. This study aimed to evaluate whether Advanced Trauma Life Support (ATLS) guidelines for RT were applied correctly and to evaluate the proportion...

  9. Early experience with simulated trauma resuscitation

    OpenAIRE

    McLellan, Barry A.

    1999-01-01

    Although trauma resuscitation is best taught through direct exposure with hands-on experience, the opportunities for this type of teaching in Canada are limited by the relatively low incidence of serious injury and the consolidation of trauma care to a small number of centres. Simulators have been used extensively outside the health care environment and more recently have been used by anesthetists to simulate intraoperative crises. In this paper early experience using a realistic mannequin, c...

  10. Survival after in-hospital Cardiopulmonary Resuscitation

    OpenAIRE

    M Adib Hajbaghery; H. Akbari; GA. Mousavi

    2005-01-01

    Background: During recent years, cardiopulmonary resuscitation (CPR) in hospital has received much attention. However, the survival rate of CPR in Iran’s hospitals is unknown. This study was designed to evaluate outcome of in-hospital CPR in Kashan. Methods: A longitudinal case registry study was conducted on all cases of in-hospital CPR during 6 months at 2002. Necessary data including; age, sex, underlying disease, working shift, time from cardiac arrest until initiating of CPR and unt...

  11. A user-designed resuscitation unit.

    OpenAIRE

    MacVicar, S M; Watts, M P; Watt, C S

    1986-01-01

    Prior to the commissioning of the Phase I redevelopment of Glasgow Royal Infirmary, the need for the development of a new type of resuscitation trolley had been identified by a liaison group consisting of medical, nursing and scientific staff which had been set up to collaborate on the selection and specification of clinical equipment. A design study involving the liaison group and the Product Design Section of the Glasgow School of Art was, therefore, undertaken. This resulted in a basic des...

  12. Editorial: Advances in healthcare provider and patient training to improve the quality and safety of patient care

    OpenAIRE

    Borycki, Elizabeth M

    2015-01-01

    This special issue of the Knowledge Management & E-Learning: An International Journal is dedicated to describing “Advances in Healthcare Provider and Patient Training to Improve the Quality and Safety of Patient Care.” Patient safety is an important and fundamental requirement of ensuring the quality of patient care. Training and education has been identified as a key to improving healthcare provider patient safety competencies especially when working with new technologies such as electronic ...

  13. Advanced virtual energy simulation training and research: IGCC with CO2 capture power plant

    Energy Technology Data Exchange (ETDEWEB)

    Zitney, S.; Liese, E.; Mahapatra, P.; Bhattacharyya, D.; Provost, G.

    2011-01-01

    In this presentation, we highlight the deployment of a real-time dynamic simulator of an integrated gasification combined cycle (IGCC) power plant with CO{sub 2} capture at the Department of Energy's (DOE) National Energy Technology Laboratory's (NETL) Advanced Virtual Energy Simulation Training and Research (AVESTARTM) Center. The Center was established as part of the DOE's accelerating initiative to advance new clean coal technology for power generation. IGCC systems are an attractive technology option, generating low-cost electricity by converting coal and/or other fuels into a clean synthesis gas mixture in a process that is efficient and environmentally superior to conventional power plants. The IGCC dynamic simulator builds on, and reaches beyond, conventional power plant simulators to merge, for the first time, a 'gasification with CO{sub 2} capture' process simulator with a 'combined-cycle' power simulator. Fueled with coal, petroleum coke, and/or biomass, the gasification island of the simulated IGCC plant consists of two oxygen-blown, downward-fired, entrained-flow, slagging gasifiers with radiant syngas coolers and two-stage sour shift reactors, followed by a dual-stage acid gas removal process for CO{sub 2} capture. The combined cycle island consists of two F-class gas turbines, steam turbine, and a heat recovery steam generator with three-pressure levels. The dynamic simulator can be used for normal base-load operation, as well as plant start-up and shut down. The real-time dynamic simulator also responds satisfactorily to process disturbances, feedstock blending and switchovers, fluctuations in ambient conditions, and power demand load shedding. In addition, the full-scope simulator handles a wide range of abnormal situations, including equipment malfunctions and failures, together with changes initiated through actions from plant field operators. By providing a comprehensive IGCC operator training system, the

  14. Analysis of Medication Errors in Simulated Pediatric Resuscitation by Residents

    OpenAIRE

    Porter, Evelyn; Barcega, Besh; Kim, Tommy Y.

    2014-01-01

    Introduction: The objective of our study was to estimate the incidence of prescribing medication errors specifically made by a trainee and identify factors associated with these errors during the simulated resuscitation of a critically ill child. Methods: The results of the simulated resuscitation are described. We analyzed data from the simulated resuscitation for the occurrence of a prescribing medication error. We compared univariate analysis of each variable to medication error r...

  15. The development of CANDU technology and training at the institute for advanced engineering in Korea

    Energy Technology Data Exchange (ETDEWEB)

    MacBeth, M.J.; Cho, U.Y. [Electrical Power Systems, Institute for Advanced Engineering (Korea, Republic of); Muzumdar, A.P. [Atomic Energy of Canada Limited (Canada)

    1998-07-01

    This paper presents an overview of the cooperative agreement between the Institute for Advanced Engineering (IAE) and Atomic Energy of Canada Limited (AECL) to facilitate the transfer of CANDU technology in South Korea. This paper will present those AECL technology program activities worked on by IAE staff with AECL support along with the associated issues which these activities addressed and the expertise nature of this work. The training methods utilized and an assessment of their success will be discussed to show the potential applicability of these methods to the nuclear power industry staff of other countries. The spin-off cooperative work initiated with other Korean organizations as part of this initiative will also be considered. (author)

  16. Cooperation with Emerging Countries in Advanced Mining Training Programmes Involving an Industrial Partner

    International Nuclear Information System (INIS)

    After about 20 years at a low level of activity the global uranium mining industry has been enjoying a significant expansion since about 2003. However, it is apparent that the “quiet” period has led to a shortage of new staff coming into the industry, many middle ranking and skilled professionals have moved to other industries and many of the remaining staff is fast approaching retirement. Many organizations are looking at ways to address this situation as quickly and effectively as possible, including governments, industry and the IAEA. This paper describes one training programme that has been developed, and is currently being implemented, as a joint venture between the uranium mining company AREVA NC and the Centre for Advanced Studies of Mineral Resources, which is located at the School of Mines in Ales, France. (author)

  17. Laypersons may learn basic life support in 24min using a personal resuscitation manikin

    DEFF Research Database (Denmark)

    Isbye, Dan Lou; Rasmussen, Lars Simon; Lippert, Freddy Knudsen;

    2006-01-01

    challenge is to find the most efficient one. AIMS: To compare the efficiency of a 24 min instruction using a DVD-based self-training BLS course combined with a simple, take-home resuscitation manikin to a conventional 6h course for teaching BLS to laypersons. METHODS: In total, 238 laypersons (age 21......: When assessed after 3 months, a 24 min DVD-based instruction plus subsequent self-training in BLS appears equally effective compared to a 6h BLS course and hence is more efficient. Udgivelsesdato: 2006-Jun...

  18. Training reactor deployment. Advanced experimental course on designing new reactor cores

    International Nuclear Information System (INIS)

    Czech Technical University in Prague (CTU) operating its training nuclear reactor VR1, in cooperation with the North West University of South Africa (NWU), is applying for accreditation of the experimental training course ''Advanced experimental course on designing the new reactor core'' that will guide the students, young nuclear engineering professionals, through designing, calculating, approval, and assembling a new nuclear reactor core. Students, young professionals from the South African nuclear industry, face the situation when a new nuclear reactor core is to be build from scratch. Several reactor core design options are pre-calculated. The selected design is re-calculated by the students, the result is then scrutinized by the regulator and, once all the analysis is approved, physical dismantling of the current core and assembling of the new core is done by the students, under a close supervision of the CTU staff. Finally the reactor is made critical with the new core. The presentation focuses on practical issues of such a course, desired reactor features and namely pedagogical and safety aspects. (orig.)

  19. Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training

    Directory of Open Access Journals (Sweden)

    James Coyle

    2012-06-01

    Full Text Available Many patients survive severe stroke because of aggressive management in intensive care units.  However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP, a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians.  Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas.  Tele-dysphagia management has the potential to increase patients’ survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year.  Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

  20. Advanced international training course on state systems of accounting for and control of nuclear materials

    Energy Technology Data Exchange (ETDEWEB)

    1981-10-01

    This report incorporates all lectures and presentations at the Advanced International Training Course on State Systems of Accounting for and Control of Nuclear Material held April 27 through May 12, 1981 at Santa Fe and Los Alamos, New Mexico, and Richland, Washington, USA. Authorized by the US Nuclear Non-Proliferation Act and sponsored by the US Department of Energy in cooperation with the International Atomic Energy Agency, the course was developed to provide practical training in the design, implementation, and operation of a state system of nuclear materials accountability and control that satisfies both national and international safeguards. Major emphasis for the 1981 course was placed on safeguards methods used at bulk-handling facilities, particularly low-enriched uranium conversion and fuel fabrication plants. The course was conducted by the University of California's Los Alamos National Laboratory, the Battelle Pacific Northwest Laboratory, and Exxon Nuclear Company, Inc. Tours and demonstrations were arranged at both the Los Alamos National Laboratory, Los Alamos, New Mexico, and the Exxon Nuclear fuel fabrication plant, Richland, Washington.

  1. Advanced international training course on state systems of accounting for and control of nuclear materials

    International Nuclear Information System (INIS)

    This report incorporates all lectures and presentations at the Advanced International Training Course on State Systems of Accounting for and Control of Nuclear Material held April 27 through May 12, 1981 at Santa Fe and Los Alamos, New Mexico, and Richland, Washington, USA. Authorized by the US Nuclear Non-Proliferation Act and sponsored by the US Department of Energy in cooperation with the International Atomic Energy Agency, the course was developed to provide practical training in the design, implementation, and operation of a state system of nuclear materials accountability and control that satisfies both national and international safeguards. Major emphasis for the 1981 course was placed on safeguards methods used at bulk-handling facilities, particularly low-enriched uranium conversion and fuel fabrication plants. The course was conducted by the University of California's Los Alamos National Laboratory, the Battelle Pacific Northwest Laboratory, and Exxon Nuclear Company, Inc. Tours and demonstrations were arranged at both the Los Alamos National Laboratory, Los Alamos, New Mexico, and the Exxon Nuclear fuel fabrication plant, Richland, Washington

  2. Resuscitation and post resuscitation care of the very old after out-of-hospital cardiac arrest is worthwhile

    DEFF Research Database (Denmark)

    Winther-Jensen, Matilde; Kjaergaard, Jesper; Hassager, Christian;

    2015-01-01

    in octogenarians (≥80) to assess whether resuscitation and post resuscitation care should be avoided. METHODS: During 2007-2011 consecutive OHCA-patients were attended by the physician-based Emergency Medical Services-system in Copenhagen. Pre-hospital data based on Utstein-criteria, and data on post resuscitation......BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is associated with a poor prognosis. As comorbidity and frailty increase with age; ethical dilemmas may arise when OHCA occur in the very old. OBJECTIVES: We aimed to investigate mortality, neurological outcome and post resuscitation care...... care were collected. Primary outcome was successful resuscitation; secondary endpoints were 30-day mortality and neurological outcome (Cerebral Performance Category (CPC)). RESULTS: 2509 OHCA-patients with attempted resuscitation were recorded, 22% (n=558) were octogenarians/nonagenarians. 166 (30...

  3. Review article: Updated resuscitation guidelines for 2016: A summary of the Australian and New Zealand Committee on Resuscitation recommendations.

    Science.gov (United States)

    Leman, Peter; Morley, Peter

    2016-08-01

    This review paper summarises the key changes made to the resuscitation guidelines used in Australia and New Zealand. They were released by the Australian and New Zealand Committee on Resuscitation in January 2016. These are local adaptations of the evidence previously published in October 2015 by the International Liaison Committee on Resuscitation (ILCOR). They are presented across the main working groups in ILCOR: ALS, BLS, paediatrics, neonates, acute coronary syndromes, first aid and 'Education, Implementation and Teams'. PMID:27357213

  4. Renewable Energy SCADA/Training Using NASA's Advanced Technology Communication Satellite

    Science.gov (United States)

    Kalu, A.; Emrich, C.; Ventre, G.; Wilson, W.; Acosta, Roberto (Technical Monitor)

    2000-01-01

    The lack of electrical energy in the rural communities of developing countries is well known, as is the economic unfeasibility of providing much needed energy to these regions via electric grids. Renewable energy (RE) can provide an economic advantage over conventional forms in meeting some of these energy needs. The use of a Supervisory Control and Data Acquisition (SCADA) arrangement via satellite could enable experts at remote locations to provide technical assistance to local trainees while they acquire a measure of proficiency with a newly installed RE system through hands-on training programs using the same communications link. Upon full mastery of the technologies, indigenous personnel could also employ similar SCADA arrangements to remotely monitor and control their constellation of RE systems. Two separate ACTS technology verification experiments (TVEs) have demonstrated that the portability of the Ultra Small Aperture Terminal (USAT) and the versatility of NASA's Advanced Communications Technology Satellite (ACTS), as well as the advantages of Ka band satellites, can be invaluable in providing energy training via distance education (DE), and for implementing renewable energy system SCADA. What has not been tested is the capabilities of these technologies for a simultaneous implementation of renewable energy DE and SCADA. Such concurrent implementations will be useful for preparing trainees in developing countries for their eventual SCADA operations. The project described in this correspondence is the first effort, to our knowledge, in this specific TVE. The setup for this experiment consists of a one-Watt USAT located at Florida Solar Energy Center (FSEC) connected to two satellite modems tuned to different frequencies to establish two duplex ACTS Ka-band communication channels. A short training program on operation and maintenance of the system will be delivered while simultaneously monitoring and controlling the hybrid using the same satellite

  5. Cooperation with emerging countries in advanced mining training programmes involving an industrial partner

    International Nuclear Information System (INIS)

    Full text: The Centre for Advanced Studies of Mineral Resources (CESMAT) is a Higher Education Institution in France to train and perform the upper management personnel working in mining, throughout the world. The program of study is comprised of seven separate year long study programs, a network of some 2 300 former students from a hundred countries with whom regular contact is maintained, and a permanent think tank unit that concentrates on the training of mining sector managers. The guiding principle for CESMAT is that cooperation and training hold a special position in French policy concerning relations with mineral producing countries. Seven programmes have been progressively developed on minerals prospecting and processing, resources evaluation, open cast mining techniques, mining economics, impact of mining on environment, management of closure of mining activities and the role of the State. These programmes bring together ten to twelve engineers or geologists who have already had professional experience. For non-French speakers, a language-training phase of three months may precede the programs. The following specializations are currently being offered: - Ore Prospecting and Mineral Processing - Nancy School of Geology - CESEV, - Treatment of Industrial Evolutions and Changes - CESTEMIN, - Geostatistical Analysis of Ore Deposits - Paris School of Mines - C.F.S.G., - Open Cut Mining Operations - Paris School of Mines - CESECO, - Economic Analysis of Mining Projects - Paris School of Mines - CESPROMIN, - Mine Safety and Environments - Ales School of Mines - CESSEM, - Mines Public Administration - Paris School of Mines - CESAM. Teaching is done both by Institute professors and by public and private sector industry experts. These instructors rely heavily on technical visits and on practical case studies. One specific example is the student research project mentored by specialists in the field, which is oriented directly to circumstances in the student's country

  6. Cardiopulmonary resuscitation knowledge and skills of registered nurses in Botswana

    Directory of Open Access Journals (Sweden)

    Lakshmi Rajeswaran

    2014-02-01

    Full Text Available Background: In Botswana nurses provide most health care in the primary, secondary and tertiary level clinics and hospitals. Trauma and medical emergencies are on the increase, and nurses should have cardiopulmonary resuscitation (CPR knowledge and skills in order to be able to implement effective interventions in cardiac arrest situations.Objective: The objective of this descriptive study was to assess registered nurses’ CPR knowledge and skills.Method: A pre-test, intervention and re-test time-series research design was adopted, and data were collected from 102 nurses from the 2 referral hospitals in Botswana. A multiple choice questionnaire and checklist were used to collect data.Results: All nurses failed the pre-test. Their knowledge and skills improved after training, but deteriorated over the three months until the post-test was conducted.Conclusion: The significantly low levels of registered nurses’ CPR skills in Botswana should be addressed by instituting country-wide CPR training and regular refresher courses.

  7. How many training modalities are needed to obtain procedural confidence in intraosseous access?

    DEFF Research Database (Denmark)

    Hallas, Peter; Folkestad, Lars; Brabrand, Mikkel

    2011-01-01

    Participants in advanced resuscitation courses are often expected to learn to perform intraosseous access (IO). But how many learning modalities are needed to achieve procedural confidence in IO? We distributed an online questionnaire to members of emergency medicine, paediatric and anaesthesiolo...... single training modality seemed as effective as the combination of two modalities....... societies in Scandinavia. The responders without real-life experience with IO (n=322) were classified as 'not confident' or 'confident' in IO. Of total responders 22.8% without training felt confident. Confidence increased to 74.8% after one training modality, 87.9% after two modalities, 98.7% after three...... modalities and 100% after four modalities (P<0.0001). Of total responders 89.5% who had 'workshop or similar training with hands-on experience' as sole teaching method was confident. Confidence in IO increases with the number of learning modalities. 'Workshop or similar training with hands-on experience' as...

  8. Intact Survival After Obstetric Hemorrhage and 55 Minutes of Cardiopulmonary Resuscitation.

    Science.gov (United States)

    Anast, Nicholas; Kwok, Joseph; Carvalho, Brendan; Lipman, Steven; Flood, Pamela

    2015-07-01

    Cardiac arrest occurs in approximately 1:12,000 parturients. Among nonpregnant patients who have in-hospital cardiac arrest, those whose spontaneous circulation does not return within 15 to 20 minutes have a high risk of death and disability, so life support efforts are generally stopped after this period. However, among parturients, witnessed in-hospital arrest is often reversible and has a better prognosis. We describe a successful clinical outcome after maternal cardiac arrest and 55 minutes of advanced cardiac life support. This case underscores the importance of high-quality cardiopulmonary resuscitation and raises questions about the appropriate duration of resuscitation efforts in otherwise healthy young mothers with a potentially reversible cause of arrest. PMID:26125692

  9. Effects of crew resource management training on the team performance of operators in an advanced nuclear power plant

    International Nuclear Information System (INIS)

    The objectives of the study are twofold: the development of a CRM training program appropriate to Korean NPPs and the evaluation of CRM training effectiveness. Firstly, the CRM program was developed with a focus on nontechnical skills - such as leadership, situational awareness, teamwork, and communication - which have been widely known to be critical for improving operational performance. Secondly, the effectiveness tests were conducted for two different crews of operators, performing six different emergency operation scenarios during a four-week period. All the crews (crews A and B) participated in the training program for the technical knowledge and skills, which were required to operate the simulator of the MCR during the first week. However, for the verification of the effectiveness of the CRM training program, only crew A was randomly selected to attend the CRM training after the technical knowledge and skills training. The results of the experiments showed that the CRM training program improved the individual attitudes of crew A with a statistical significance. The team skills of crew A were found to be significantly more advanced than those of crew B. However, the CRM training did not have a positive effect on enhancing the individual performance of crew A, as compared with that of crew B. (author)

  10. Transition of Monju simulator training owing to Monju accident and upgrade of Monju advanced reactor simulator (MARS)

    International Nuclear Information System (INIS)

    The Monju advanced reactor simulator (MARS) has been operated for training of Monju operators and for verification of Monju operating manual's appropriateness since 1991 for over 11 years. This report covers transition of Monju training system and modified of MARS owing to Monju accident as operating experience of MARS on from 1994 to 2001. The principal points mentioned are as follows: (1) Improved Monju training system owing to Monju accident 1) Reinforcement of sodium handling and sodium fire-fighting exercise. 2) Improved of training system and revised of training frequency. 3) Introduced of evaluation and analysis system regarding training results. 4) Providing of training guide line. 5) Step up of fundamental education by introducing of CAI (Computer Assisted Instruction System). (2) Upgrade of MARS for Monju restarting. 1) Reflected of the real plant data obtained from Monju performance test. 2) Addition of malfunction items. 3) Development of simulation software and addition of simulation panel concerning reinforced sodium leakage corresponding training. 4) Improvement of simulation ability and remodeling of calculating model by renewal of computer system. 5) Up graded program in the future. (author)

  11. Cardiopulmonary resuscitation: how far have we come?

    Science.gov (United States)

    Whitcomb, John J; Blackman, Virginia Schmied

    2007-01-01

    In the 43 years since it was first described, cardiopulmonary resuscitation (CPR) has grown from an obscure medical theory to a basic first aid skill taught to adults and is now the near-universal technique used in CPR instruction. This article provides insight into the history of CPR. We explore the phenomenon of sudden cardiac arrest, the historical roots of CPR, current practice data and recommendations, and the society's role in the development of this life-saving technique. We conclude with a review of CPR's economic impact on the healthcare system and the ethical and policy issues surrounding CPR. PMID:17179837

  12. N-Nitrosamines and halogenated disinfection byproducts in U.S. Full Advanced Treatment trains for potable reuse.

    Science.gov (United States)

    Zeng, Teng; Plewa, Michael J; Mitch, William A

    2016-09-15

    Water utilities are increasingly considering indirect and direct potable reuse of municipal wastewater effluents. Disinfection byproducts (DBPs), particularly N-nitrosamines, are key contaminants of potential health concern for potable reuse. This study quantified the concentrations of N-nitrosamines and a suite of regulated and unregulated halogenated DBPs across five U.S. potable reuse Full Advanced Treatment trains incorporating microfiltration, reverse osmosis, and UV-based advanced oxidation. Low μg/L concentrations of trihalomethanes, haloacetic acids, dichloroacetonitrile, and dichloroacetamide were detected in the secondary or tertiary wastewater effluents serving as influents to potable reuse treatment trains, while the concentrations of N-nitrosamines were more variable (e.g., significance of haloacetonitriles, which were not effectively removed by reverse osmosis and advanced oxidation, to the DBP-associated toxicity in potable reuse waters. PMID:27262122

  13. Effect of listening to Nellie the Elephant during CPR training on performance of chest compressions by lay people: randomised crossover trial

    OpenAIRE

    Rawlins, L; Woollard, M; Williams, J.; Hallam, P

    2009-01-01

    Objectives To determine whether listening to music during cardiopulmonary resuscitation (CPR) training increases the proportion of lay people delivering chest compressions of 100 per minute. Design Prospective randomised crossover trial. Setting Large UK university. Participants 130 volunteers (81 men) recruited on an opportunistic basis. Exclusion criteria included age under 18, trained health professionals, and cardiopulmonary resuscitation (CPR) training within the past three months. Inter...

  14. Training toward Advanced 3D Seismic Methods for CO2 Monitoring, Verification, and Accounting

    Energy Technology Data Exchange (ETDEWEB)

    Christopher Liner

    2012-05-31

    The objective of our work is graduate and undergraduate student training related to improved 3D seismic technology that addresses key challenges related to monitoring movement and containment of CO{sub 2}, specifically better quantification and sensitivity for mapping of caprock integrity, fractures, and other potential leakage pathways. We utilize data and results developed through previous DOE-funded CO{sub 2} characterization project (DE-FG26-06NT42734) at the Dickman Field of Ness County, KS. Dickman is a type locality for the geology that will be encountered for CO{sub 2} sequestration projects from northern Oklahoma across the U.S. midcontinent to Indiana and Illinois. Since its discovery in 1962, the Dickman Field has produced about 1.7 million barrels of oil from porous Mississippian carbonates with a small structural closure at about 4400 ft drilling depth. Project data includes 3.3 square miles of 3D seismic data, 142 wells, with log, some core, and oil/water production data available. Only two wells penetrate the deep saline aquifer. In a previous DOE-funded project, geological and seismic data were integrated to create a geological property model and a flow simulation grid. We believe that sequestration of CO{sub 2} will largely occur in areas of relatively flat geology and simple near surface, similar to Dickman. The challenge is not complex geology, but development of improved, lower-cost methods for detecting natural fractures and subtle faults. Our project used numerical simulation to test methods of gathering multicomponent, full azimuth data ideal for this purpose. Our specific objectives were to apply advanced seismic methods to aide in quantifying reservoir properties and lateral continuity of CO{sub 2} sequestration targets. The purpose of the current project is graduate and undergraduate student training related to improved 3D seismic technology that addresses key challenges related to monitoring movement and containment of CO{sub 2

  15. Hypertonic saline solution resuscitation in hemorrhagic shock dogs

    Institute of Scientific and Technical Information of China (English)

    蔡秀军; 黄迪宇; 牟一平; 彭淑牖

    2002-01-01

    To find out the optimal concentration, infusion rate and dosage of saline for resuscitation. Methods: Forty-five dogs were used to establish hypovolemic shock models. The dogs were resuscitated with saline of different concentrations and different dosages under different infusion rates, and the resuscitation results were compared. Results: The best concentration was 7.5%, the best rate of infusion 20 ml/min (a volume equivalent to 15% of the shed blood) and the best dosage 5.71 ml/kg. The method was effective for resuscitation, the mean arterial pressure (MAP) could be elevated to 89% of the baseline, and this MAP could be kept for more than one hour. Conclusions: Using 7.5% sodium chloride solution equivalent to 15% of the shed blood at an infusion rate of 20 ml/min can achieve a best resuscitation result.

  16. Advanced graphic interface man machine for a simulator of nuclear processes for training in classroom

    International Nuclear Information System (INIS)

    This work describes a working prototype that will serve as experimental platform for the specification and development of a commercial classroom analysis simulator. The classroom analysis simulator will be used as analytical tool for an optimal and more efficient training of operation personnel of Laguna Verde Power Plant. The focus of this work is on the advanced graphical interface of the classroom analysis simulator and those issues involved with its design. This interface offers two distinctive features: 1) virtual representation of instrumentation and controls of different control panels; and 2) direct manipulation as main interaction method. These features provide an easy and intuitive way to manipulate and monitor virtual instrumentation as well as an effortless manner to control the interface. By using object menus with special control features, it is possible to perform visualization functions such as navigation among control panels, location of instrumentation, panning, zooming and reset. The system and its interface provide immediate feedback and reversible operation capabilities allowing an easy, fast and natural human-machine interaction within a graphical environment that the operator is familiar with. The system gives also access and displays a functional copy of the Laguna Verde Safety Parameters Display System. In addition, a special set of graphic displays representing the full animation of transients and severe accidents via output data files from specialized nuclear codes are being designed. The features of the system mentioned above, supported by advanced mathematical models, currently under development, will provide an exceptional simulation environment. It is expected that the simulator will be used not only as an alternative to reduce expensive load of the current hard wire simulator, but also as a powerful extension analytical tool. (Author)

  17. An integrative review: instructional strategies to improve nurses' retention of cardiopulmonary resuscitation priorities.

    Science.gov (United States)

    Sullivan, Nancy

    2015-01-01

    Recognizing and responding to a cardiac arrest in the hospital setting is a high stress, high anxiety event for all healthcare providers. It requires the performance of several basic, but extremely important cardiopulmonary resuscitation (CPR) skills and response priorities. If not executed correctly and in a timely manner, a bad outcome may result. Poor retention of cardiopulmonary resuscitation skills and priorities is well documented in the literature. An integrative review of the evidence was conducted to answer the question, "Is there a more effective training method to improve nurses' retention of CPR priorities during an in hospital cardiac arrest as compared to traditional American Heart Association training? "This review evaluated high fidelity and low fidelity simulation training, online or computer-based training and video instruction as potential teaching strategies focusing on CPR priorities. The role of deliberate practice is discussed. The strongest evidence suggests that a teaching plan employing brief, frequent, repetitive or deliberate practice used in collaboration with low fidelity or high fidelity simulation may be a potential strategy to improve nurses' retention of CPR priorities over time. PMID:25830906

  18. Rabbit model of uncontrolled hemorrhagic shock and hypotensive resuscitation

    Directory of Open Access Journals (Sweden)

    J.B. Rezende-Neto

    2010-12-01

    Full Text Available Clinically relevant animal models capable of simulating traumatic hemorrhagic shock are needed. We developed a hemorrhagic shock model with male New Zealand rabbits (2200-2800 g, 60-70 days old that simulates the pre-hospital and acute care of a penetrating trauma victim in an urban scenario using current resuscitation strategies. A laparotomy was performed to reproduce tissue trauma and an aortic injury was created using a standardized single puncture to the left side of the infrarenal aorta to induce hemorrhagic shock similar to a penetrating mechanism. A 15-min interval was used to simulate the arrival of pre-hospital care. Fluid resuscitation was then applied using two regimens: normotensive resuscitation to achieve baseline mean arterial blood pressure (MAP, 10 animals and hypotensive resuscitation at 60% of baseline MAP (10 animals. Another 10 animals were sham operated. The total time of the experiment was 85 min, reproducing scene, transport and emergency room times. Intra-abdominal blood loss was significantly greater in animals that underwent normotensive resuscitation compared to hypotensive resuscitation (17.1 ± 2.0 vs 8.0 ± 1.5 mL/kg. Antithrombin levels decreased significantly in normotensive resuscitated animals compared to baseline (102 ± 2.0 vs 59 ± 4.1%, sham (95 ± 2.8 vs 59 ± 4.1%, and hypotensive resuscitated animals (98 ± 7.8 vs 59 ± 4.1%. Evidence of re-bleeding was also noted in the normotensive resuscitation group. A hypotensive resuscitation regimen resulted in decreased blood loss in a clinically relevant small animal model capable of reproducing hemorrhagic shock caused by a penetrating mechanism.

  19. Comparison of end-tidal carbon dioxide levels with cardiopulmonary resuscitation success presented to emergency department with cardiopulmonary arrest.

    Science.gov (United States)

    Akinci, Emine; Ramadan, Hayri; Yuzbasioglu, Yucel; Coskun, Figen

    2014-01-01

    Objective: To measure end-tidal carbon dioxide pressure (PetCO2) in preset interval in order to evaluate the efficiency of cardiopulmonary resuscitation (CPR) performed on patients in cardiopulmonary arrest, evaluate the validity of PetCO2 in predicting the mortality and finally assess the PetCO2 levels of the patients in cardiopulmonary arrest based on the initial presenting rhythm. Methods: This prospective study was conducted at the Ankara Training and Research Hospital on patients who presented with cardiopulmonary arrest. Standard ACLS (Advanced Cardiac Life Support) protocols were performed. Patients were categorized in two groups based on their rhythms as Ventricular Fibrillation and Asystole. Patients’ PetCO2 values were recorded. Results: PetCO2 levels of the Return of Spontaneous Circulation (ROSC) group in the 5th, 10th, 15th and 20th minutes were significantly higher compared to the exitus group (p<0.001). In distinguishing ROSC and exitus, PetCO2 measurements within 5-20 minute intervals showed highest performance on the 20th and lowest on the 5th minutes. Conclusion: PetCO2 values are higher in the ROSC group. During the CPR, the most reliable time for ROSC estimation according to PetCO2 values is 20th minute. None of the patients who had PetCO2 levels less than 14 mmHg survived. PMID:24639823

  20. Emergency center thoracotomy: impact of prehospital resuscitation.

    Science.gov (United States)

    Durham, L A; Richardson, R J; Wall, M J; Pepe, P E; Mattox, K L

    1992-06-01

    Emergency center thoracotomy was performed at our facility on 389 patients from 1984 through 1989. There were no patients excluded from the study, and survival for all patients was 8.3% with survival rates of 15.2% and 7.3% for stab and gunshot wounds, respectively. Emergency center thoracotomy was performed on 42 patients suffering from isolated extrathoracic injuries with 7% survival. There were no survivors of blunt trauma in this study. Fifty-three percent of the patients arrived with cardiopulmonary resuscitation (CPR) in progress. The average time of prehospital CPR for survivors was 5.1 minutes compared with 9.1 minutes for nonsurvivors. Of the survivors, prehospital endotracheal intubation prolonged successful toleration of CPR to 9.4 minutes compared with 4.2 minutes for nonintubated surviving patients (p less than 0.001). Emergency center thoracotomy is useful in the resuscitation of victims dying of penetrating truncal trauma. Prehospital endotracheal intubation significantly lengthened the time of successful CPR. PMID:1613838

  1. Indiana Advanced Electric Vehicle Training and Education Consortium (I-AEVtec)

    Energy Technology Data Exchange (ETDEWEB)

    Caruthers, James; Dietz, J.; Pelter, Libby; Chen, Jie; Roberson, Glen; McGinn, Paul; Kizhanipuram, Vinodegopal

    2013-01-31

    The Indiana Advanced Electric Vehicle Training and Education Consortium (I-AEVtec) is an educational partnership between six universities and colleges in Indiana focused on developing the education materials needed to support electric vehicle technology. The I-AEVtec has developed and delivered a number of degree and certificate programs that address various aspects of electric vehicle technology, including over 30 new or significantly modified courses to support these programs. These courses were shared on the SmartEnergyHub. The I-AEVtec program also had a significant outreach to the community with particular focus on K12 students. Finally, the evGrandPrix was established which is a university/college student electric go-kart race, where the students get hands-on experience in designing, building and racing electric vehicles. The evGrandPrix now includes student teams from across the US as well as from Europe and it is currently being held on Opening Day weekend for the Indy500 at the Indianapolis Motor Speedway.

  2. Use of information and communication technologies in training, experiences, advances and tends

    International Nuclear Information System (INIS)

    Tecnatom has carried out for the last seven years development and investments to use Information and Communication Technologies (ICT) in training areas. This paper presents, from a chronological perspective, Tecnatom's representative experiences when implementing solutions and methods. Firstly, a brief explanation of a Training Management and Training Area Intranet application is provided, to focus next on the e-learning approach which has been followed to develop Tecnatom's Virtual Campus. Finally, the paper describes summaries of some interesting and innovative R and D projects for application of virtual and augmented reality to training, and the development of new e-learning courses in the area of maintenance. These projects are the following: VIRMAN, Spanish project to use virtual mock-iups in training; STARMATE, European augmented reality application for training and guided maintenance; PRVIR, virtual reality application for training in radiological protection; SIMU2, virtual reality application for training O and M personnel in radioactive environments. (Author)

  3. CHALLENGES FOR IMPROVED EDUCATIONAL PROCESSES IN THE ADVANCED TECHNOLOGIES OF TEACHING CADETS OF MILITARY HIGH SCHOOLS IN FIRE TRAINING

    Directory of Open Access Journals (Sweden)

    Vyacheslav Vladimirovich KUZYAKIN

    2015-02-01

    Full Text Available The article investigates ways of improving the process of preparation of military specialists for fire training using advanced learning technologies. According to the results it is concluded that the goal of teaching students on the fire training in SIO - skill system that is adequate to the structure of the learning content, i.e. the target (desired outcomes achieved during the intensive, didactic pro-cess is required. Therefore, the SIO is a system of guar-anteed quality of education.

  4. Advanced aerospace management of integrated education and training towards comprehensive security

    Directory of Open Access Journals (Sweden)

    Peter TEREM

    2010-09-01

    Full Text Available The aviatic integrated education and training based on the progressive technologies towards comprehensive security will be necessary for the future specialized preparation and training of the personnel in civil and military aerospace management and aviation, especially for expeditionary missions. The integrated pilot flight preparation and training based on the modern methodology of situational control would be used for improving our general system of present preparation and training, within the framework of the Armed Forces of the Slovak Republic.

  5. Advanced aerospace management of integrated education and training towards comprehensive security

    OpenAIRE

    Peter TEREM; Pavel NEČAS; Miroslav KELEMEN

    2010-01-01

    The aviatic integrated education and training based on the progressive technologies towards comprehensive security will be necessary for the future specialized preparation and training of the personnel in civil and military aerospace management and aviation, especially for expeditionary missions. The integrated pilot flight preparation and training based on the modern methodology of situational control would be used for improving our general system of present preparation and training, within ...

  6. Advances in Training Evaluation - Psychological, Educational, Economic, and Econometric Perspectives on the Kirkpatrick Model

    OpenAIRE

    Christiane Hinerasky

    2014-01-01

    Research on the process of training evaluation has progressed in many independent fields. In our study, we combine the unique views on training, and training evaluation from the fields of psychology, education, economics, and econometrics. Psychology and education provide knowledge on how to conduct training, and they emphasize important individual and environmental factors that may facilitate the transfer of skills and prevent skill decay. However, empirical methods offer a sound way of not ...

  7. Nurses’ attitude in out-of-hospital cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Theodore Kapadohos

    2015-10-01

    Full Text Available Sudden cardiac arrest is one of the leading causes of death in Europe. Bystanders’ early Cardio-Pulmonary Resuscitation (CPR may double or triple survival rates of out-of-hospital cardiac arrest victims. Aim: To investigate nurses’ attitude, in starting or not CPR and also the most frequent reasons that deter them from engaging in. Materials and Methods: The study had a sample of 177 nurses and assistant nurses that were working in nine hospitals of Athens. Nurses filled out the same, predetermined questionnaire, voluntarily and anonymously. The collected answers were analyzed with the help of the statistical program SPSS v.16, using x2 and Kendall’s Tau-B methods. Results: From 177 participants, 78% (137 were women and 22% (40 men with mean age 31 years (±7. According to their education, 16% (28 were Assistant Nurses, 79% (140 Registered Nurses (ATEI, AEI and 5% (9 Nurses had an MSc diploma. Nurses that had been recently trained in certified BLS courses felt more confident and were more willing to start CPR in a known victim (p=0.004 and in an unknown victim (p=0.02 comparing to nurses that had been trained a long time ago or never. Most frequent reasons nurses reported that deter them from starting CPR are the fear of a possible lawsuit (43%, the fear of harming instead of helping (30% and the fear of infectious transmission from victim to rescuer (15%. The fear of harming correlates considerably with lower ages (the younger the nurse the more is afraid, p=0.04 and also correlates substantially with the training in a certified CPR course (the more a nurse is trained, the less is afraid, p<0.001. Accordingly, the fear of infection diminishes as long as the CPR training is repeated (p=0.03. Conclusions: According to the results, there is a necessity of continuous education and re-education of nurses, in certified Basic Life Support programs. With frequent and specialized training, nurses will show more willingness to engage in an out

  8. The Iranian physicians attitude toward the do not resuscitate order

    Science.gov (United States)

    Fallahi, Masood; Banaderakhshan, Homayion; Abdi, Alireza; Borhani, Fariba; Kaviannezhad, Rasool; Karimpour, Hassan Ali

    2016-01-01

    Background Physicians are responsible for making decisions about the do not resuscitate (DNR) order of patients; however, most of them are faced with some uncertainty in decision making and ethical aspects. Moreover, there are differences on decision making related to the DNR order among physicians, which may be related to the different attitudes toward this issue. Considering the lack of information, this study was performed to investigate doctors’ attitude about DNR order for patients in their final phases of life. Methods In a descriptive–analytical study, 152 physicians were enrolled as quota sampling subjects from educational hospitals affiliated to the Kermanshah University of Medical Sciences. The tool used was a researcher-developed questionnaire. Data were analyzed using SPSS 16 software by descriptive and inferential statistics. Results The mean of attitude toward DNR was 3.22, for which the univariate t-test showed a significant positive attitude toward DNR (P=0.002); the mean of attitude number toward DNR was higher in physicians with higher education level (P=0.002). But this difference was not found in terms of age group, sex, and experiences in participating in DNR decisions. Conclusion Due to the positive attitude of doctors toward DNR orders and lack of identified guidance, clear guidelines that comply with the Iranian Islamic culture are necessary to be established. Implementing this directive requires comprehensive training to various groups, including patients, doctors, nurses, administrators, and policy makers of the health system. PMID:27418832

  9. Development of a formative assessment tool for measurement of performance in multi-professional resuscitation teams

    DEFF Research Database (Denmark)

    Andersen, Peter Oluf; Jensen, Michael Kammer; Lippert, Anne;

    2010-01-01

    part of crew resource management training, created to improve safety in aviation. This study aimed, first, to establish crew resource management and non-technical skill-based learning objectives and behavioural markers for the performance of multi-professional resuscitation teams; second, to develop a......Treating cardiac arrest is linked to the mutual performance of several health-care individuals' task coordination. Non-technical skills, including communication, leadership and team interaction, could improve sequencing the tasks in the cardiac arrest algorithm. Non-technical skills have been a...

  10. Can the ETView VivaSight SL Rival Conventional Intubation Using the Macintosh Laryngoscope During Adult Resuscitation by Novice Physicians?

    OpenAIRE

    Szarpak, Lukasz; Truszewski, Zenon; Czyzewski, Lukasz; Kurowski, Andrzej

    2015-01-01

    Abstract The aim of this study was to assess the performance of the ETView VivaSight SL (ETView) single-lumen airway tube with an integrated high-resolution imaging camera in a manikin-simulated cardiopulmonary resuscitation scenario with and without chest compression. This was a randomized crossover manikin trial. Following a brief training session, 107 volunteer novice physicians who were inexperienced with airway management attempted to intubate a manikin using a Macintosh laryngoscope (MA...

  11. Availability and Utilization of Cardiac Resuscitation Centers

    Directory of Open Access Journals (Sweden)

    Bryn E. Mumma

    2014-11-01

    Full Text Available Introduction: The American Heart Association (AHA recommends regionalized care following out-of-hospital cardiac arrest (OHCA at cardiac resuscitation centers (CRCs. Key level 1 CRC criteria include 24/7 percutaneous coronary intervention (PCI capability, therapeutic hypothermia capability, and annual volume of ≥40 patients resuscitated from OHCA. Our objective was to characterize the availability and utilization of resources relevant to post-cardiac arrest care, including level 1 CRCs in California. Methods: We combined data from the AHA, the California Office of Statewide Health Planning and Development (OSHPD, and surveys to identify CRCs. We surveyed emergency department directors and nurse managers at all 24/7 PCI centers identified by the AHA to determine their post-OHCA care capabilities. The survey included questions regarding therapeutic hypothermia use and specialist availability and was pilot-tested prior to distribution. Cases of OHCA were identified in the 2011 OSHPD Patient Discharge Database using a “present on admission” diagnosis of cardiac arrest (ICD-9-CM code 427.5. We defined key level 1 CRC criteria as 24/7 PCI capability, therapeutic hypothermia, and annual volume ≥40 patients admitted with a “present on admission” diagnosis of cardiac arrest. Our primary outcome was the proportion of hospitals meeting these criteria. Descriptive statistics and 95% CI are presented. Results: Of the 333 acute care hospitals in California, 31 (9.3%, 95% CI 6.4-13% met level 1 CRC criteria. These hospitals treated 25% (1937/7780; 95% CI 24-26% of all admitted OHCA patients in California in 2011. Of the 125 hospitals identified as 24/7 PCI centers by the AHA, 54 (43%, 95% CI 34-52% admitted ≥40 patients following OHCA in 2011. Seventy (56%, 95% CI 47-65% responded to the survey; 69/70 (99%, 95% CI 92-100% reported having a therapeutic hypothermia protocol in effect by 2011. Five percent of admitted OHCA patients (402/7780; 95% CI

  12. Resuscitation of the trauma patient:tell me a trigger for early haemostatic resuscitation please!

    OpenAIRE

    Reed, Matthew J; Lone, Nazir; Walsh, Timothy S

    2011-01-01

    The management of trauma-related coagulopathy and haemorrhage is changing from a reactive strategy to a proactive early intervention with blood products and haemostatic agents. Although major haemorrhage and massive transfusion are associated with higher mortality, the pattern of this association with modern trauma care is poorly described. In addition, early predictors of massive transfusion, which might trigger a proactive haemostatic resuscitation strategy, are not currently available. We ...

  13. Cerebral blood flow in humans following resuscitation from cardiac arrest

    International Nuclear Information System (INIS)

    Cerebral blood flow was measured by xenon-133 washout in 13 patients 6-46 hours after being resuscitated from cardiac arrest. Patients regaining consciousness had relatively normal cerebral blood flow before regaining consciousness, but all patients who died without regaining consciousness had increased cerebral blood flow that appeared within 24 hours after resuscitation (except in one patient in whom the first measurement was delayed until 28 hours after resuscitation, by which time cerebral blood flow was increased). The cause of the delayed-onset increase in cerebral blood flow is not known, but the increase may have adverse effects on brain function and may indicate the onset of irreversible brain damage

  14. A prospective study to determine the circumstances, incidence and outcome of cardiopulmonary resuscitation in a referral hospital in India, in relation to various factors

    Directory of Open Access Journals (Sweden)

    Muralidhar Joshi

    2015-01-01

    Full Text Available Background and Aims: Cardiac arrest has multifactorial aetiology and the outcome depends on timely and correct interventions. We decided to investigate the circumstances, incidence and outcome of cardiopulmonary resuscitation (CPR at a tertiary hospital in India, in relation to various factors, including extensive basic life support and advanced cardiac life support training programme for all nurses and doctors. Methods: It has been over a decade and a half with periodical updates and implementation of newer guidelines prepared by various societies across the world about CPR for both in-hospital and out-of hospital cardiac arrests (IHCA and OHCA. We conducted a prospective study wherein all cardiac arrests reported in the hospital consecutively for 12 months were registered for the study and followed their survival up to 1-year. Statistical analysis was performed by using Chi-square test for significant differences in proportions applied to various parameters of the study. Results: The main outcome measures were; (following CPR return of spontaneous circulation, survival for 24 h, survival from 24 h to 6 weeks or discharge, alive at 1-year. For survivors, an assessment was made about their cerebral performance and overall performance and accordingly graded. All these data were tabulated. Totally 419 arrests were reported in the hospital, out of which 413 were in-hospital arrests. Out of this 260 patients were considered for resuscitation, we had about 27 survivors at the end of 1-year follow-up (10.38%. Conclusion: We conclude by saying there are many factors involved in good clinical outcomes following IHCAs and these variable factors need to be researched further.

  15. Evaluation of coma patients after cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    SU Ying-ying; YANG Qing-lin; PANG Ying; LV Xiang-ping

    2005-01-01

    Background Coma after cardiopulmonary resuscitation (CPR) is commonly seen in daily clinical practice. How to objectively evaluate brain function after CPR is essential to the following treatment. Coma patients after CPR had been studied prospectively at the Neuro-Intensive Care Unit of Xuanwu Hospital since 2002. In this study, we focused on the topic of how to evaluate the severity of coma after CPR .Methods From April 2002 to November 2004, patients in coma 24 hours after CPR were monitored, the evaluation methods included Glasgow coma score (GCS),brain stem reflection, and spinal reflection. Laboratory evaluation included electroencephalography (EEG),brainstem auditory evoked potential (BAEP), short latency somatosensory evoked potential (SLSEP), and transcranial Doppler (TCD) .Results Twenty-four of 35 patients(68.57%)were in deep coma. The GCS was 3 except for 2 patients;EEG was evaluated not less than grade Ⅳ except for 4 patients, BAEP was evaluated as grade Ⅲ except for 3 patients, and SLSEP was evaluated as grade Ⅲ except for 1 patient.Twenty-four patients died within 1 month and 11 of them(45.83%)were determined as brain death. Glasgow outcome score (GOS) was evaluated as grade Ⅰ. Eleven of the 35 patients survived and their consciousness changed from deep coma to coma vigil. EEG was evaluated as gradeⅠin 5 patients, BAEP and SLSEP were evaluated as grade Ⅰ in 3 patients, and GOS was all evaluated as grade Ⅱ among the 11 patients.Two patients(18.18%)regained consciousness in 35 and 90 days after cardiopulmonary resuscitation and GOS was evaluated as grade Ⅳ and Ⅲ, respectively.Conclusion Combined or continuous evaluation of clinical examinations and laboratory tests can accurately and objectively determine brain function after CPR.

  16. 16 Weeks of Training with the International Space Station Advanced Resistive Exercise Device (aRED) Is not Different than Training with Free Weights

    Science.gov (United States)

    Loehr, J. A.; Lee, S. M. C.; English, K. E.; Leach, M.; Bentley, J.; Nash, R.; Hagan, R. D.

    2008-01-01

    The advanced Resistive Exercise Device (aRED) is a resistive exercise system designed to maintain muscle mass and strength in microgravity by simulating free weight (FW) exercise. aRED utilizes vacuum cylinders and inertial flywheels to replicate the constant mass and inertial components, respectively, of FW exercise in normal gravity. PURPOSE: To compare the effectiveness of aRED and FW resistive exercise training in ambulatory subjects. METHODS: Untrained subjects were assigned to two groups, FW (6 males, 3 females) and aRED (8 males, 3 females), and performed squat (SQ), heel raise (HR), and deadlift (DL) exercises 3 d wk-1 for 16 wks. SQ, HR and DL strength (1RM) were measured using FW hardware pre-, mid- and post-training. Subjects participated in a periodized training protocol with the exercise prescription based on a percentage of 1RM. Thigh and lower leg muscle volume were assessed using Magnetic Resonance Imaging (MRI), and leg (LLM) and total body lean mass (BLM) were measured using Dual Energy X-ray Absorptiometry (DXA) pre- and post-training. RESULTS: SQ 1RM increased in both FW (48.9+/-6.1%) and aRED (31.2+/-3.8%) groups, and there was a greater training response in FW compared with aRED (p=0.01). HR and DL 1RM increased in FW (HR: 12.3+/-2.4%, DL: 23.3+/-4.4%) and aRED (HR: 18.0+/-1.6%, DL: 23.2+'-2.8%), but there were no differences between groups. Thigh muscle volume was greater following training in both groups (FW: 9.8+/-0.9%, aRED: 7.1+/-1.2%) but lower leg muscle volume increased only in the FW group (3.0+/-1.1%). Lean tissue mass increased in both FW (LLM: 3.9+/-1.1%, BLM: 2.5+/-0.7%) and aRED (LLM: 4.8+/-0.7%, BLM: 2.6 0.7%). There were no between group differences in muscle volume or lean mass in response to training. CONCLUSIONS: In general, the increase in muscle strength, muscle volume, and lean tissue mass when training with aRED was not different than when using the same training protocol with FW. The smaller increase in SQ 1RM in the a

  17. Capnography during cardiopulmonary resuscitation: Current evidence and future directions

    Directory of Open Access Journals (Sweden)

    Bhavani Shankar Kodali

    2014-01-01

    Full Text Available Capnography continues to be an important tool in measuring expired carbon dioxide (CO 2 . Most recent Advanced Cardiac Life Support (ACLS guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR. Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO 2 (PETCO 2 and cardiac output that can indicate the return of spontaneous circulation (ROSC. Additional evidence favoring the use of capnography during CPR includes definitive proof of correct placement of the endotracheal tube and possible prediction of patient survival following cardiac arrest, although the latter will require further investigations. There is emerging evidence that PETCO 2 values can guide the initiation of extracorporeal life support (ECLS in refractory cardiac arrest (RCA. There is also increasing recognition of the value of capnography in intensive care settings in intubated patients. Future directions include determining the outcomes based on capnography waveforms PETCO 2 values and determining a reasonable duration of CPR. In the future, given increasing use of capnography during CPR large databases can be analyzed to predict outcomes.

  18. Advanced simulation and management software for nuclear emergency training and response

    International Nuclear Information System (INIS)

    The importance of training safety personnel to deal with real world scenarios is prevalent amongst nuclear emergency preparedness and response organizations. International Safety Research (ISR) has committed to ensure that field procedures, data collection software and decision making tools be identical during training sessions as they would be during a real emergency. By identifying the importance of a fully integrated tool, ISR has developed a safety support system capable of both functioning in training mode and real mode, enabling emergency response organizations to train more efficiently and effectively. This new fully integrated emergency management tool is called S3-FAST also known as Safety Support Systems - Field Assessment Survey Tool. (orig.)

  19. Myocardial stunning after resuscitation from cardiac arrest following spinal anaesthesia

    Directory of Open Access Journals (Sweden)

    Pranjali Madhav Kurhekar

    2014-01-01

    Full Text Available Cardiac arrest associated with spinal anaesthesia has been well researched. Myocardial stunning after successful resuscitation from cardiac arrest is seen in up to 2/3 rd of in-hospital cardiac arrests. Myocardial stunning after resuscitation from cardiac arrest associated with spinal anaesthesia has probably not been reported earlier. Our case, an ASA physical status I lady, posted for tubal reanastomosis surgery developed bradycardia followed by asystole, approximately 5 minutes after giving subarachnoid block. Return of spontaneous circulation (ROSC was achieved within 2 minutes with cardiopulmonary resuscitation (CPR and defibrillation for pulseless ventricular tachycardia. Patient developed delayed pulmonary oedema, which was probably due to myocardial stunning. In the present case, inadequate preloading could have precipitated bradycardia progressing to cardiac arrest which, after resuscitation led to reversible myocardial dysfunction. We conclude that early vasopressor infusion, titrated fluids and echocardiography should be considered in immediate post cardiac arrest phase following spinal anaesthesia.

  20. Termination of resuscitative efforts: medical futility for the trauma patient.

    Science.gov (United States)

    Eckstein, M

    2001-12-01

    Despite years of research on the resuscitation of the patient with critical traumatic injuries, controversy remains surrounding the criteria to waive initiation of resuscitation in the pre-hospital setting or to terminate such efforts in the emergency department. The decision to initiate or continue resuscitation on moribund trauma patients is associated with considerable costs. Ambulance transport using lights and sirens carries potential risk. Emergency department thoracotomy, with exposure to high risk bodily fluids, involvement of numerous staff, and usage precious blood products, is a procedure that has fewer and fewer indications. This review presents guidelines to help determine when to initiate resuscitation for the critically injured trauma patient and when to cease these efforts in the emergency department. Since there are economic, societal, and ethical implications, each system should establish their own criteria, using these guidelines as a basis. PMID:11805549

  1. Current Care Guidelines for Cardiopulmonary Resuscitation : Implementation, skills and attitudes

    OpenAIRE

    MÀkinen, Marja

    2010-01-01

    Background: The national resuscitation guidelines were published in Finland in 2002 and are based on international guidelines published in 2000. The main goal of the national guidelines, available on the Internet free of charge, is early defibrillation by nurses in an institutional setting. Aim: To study possible changes in cardiopulmonary resuscitation (CPR) practices, especially concerning early defibrillation, nurses and students attitudes of guideline implementation and nurses and ...

  2. Myocardial stunning after resuscitation from cardiac arrest following spinal anaesthesia

    OpenAIRE

    Pranjali Madhav Kurhekar; VSG Yachendra; Simi P Babu; Raghavelu Govindasamy

    2014-01-01

    Cardiac arrest associated with spinal anaesthesia has been well researched. Myocardial stunning after successful resuscitation from cardiac arrest is seen in up to 2/3 rd of in-hospital cardiac arrests. Myocardial stunning after resuscitation from cardiac arrest associated with spinal anaesthesia has probably not been reported earlier. Our case, an ASA physical status I lady, posted for tubal reanastomosis surgery developed bradycardia followed by asystole, approximately 5 minutes after givin...

  3. Resuscitation of preterm infants: delivery room interventions and their effect on outcomes.

    LENUS (Irish Health Repository)

    O'Donnell, Colm P F

    2012-12-01

    Despite advances in neonatal care, the rate of oxygen dependence at 36 weeks\\' postmenstrual age or bronchopulmonary dysplasia has not fallen. Neonatologists are increasingly careful to apply ventilation strategies that are gentle to the lung in the neonatal intensive care unit. However, there has not been the same emphasis applying gentle ventilation strategies immediately after birth. A lung-protective strategy should start immediately after birth to establish a functional residual capacity, reduce volutrauma and atelectotrauma, facilitate gas exchange, and improve oxygenation during neonatal transition. This article discusses techniques and equipment recommended by international resuscitation guidelines during breathing assistance in the delivery room.

  4. Rank Advancement in Academia: What Are the Roles of Postdoctoral Training?

    Science.gov (United States)

    Su, Xuhong

    2014-01-01

    This article reports on a study that investigated whether postdoctoral training contributes to scientists' and engineers' attainment of tenure and full professorship in research-extensive universities. It was found that training does not assist scientists in climbing the career ladder faster nor does it help them to secure more…

  5. Advancement of education and training with secondary system visual display system

    International Nuclear Information System (INIS)

    NTC makes effort to improve and complete knowledge and understanding of various nuclear plants condition and dynamics for operator. It is important to understand the behavior of secondary system of nuclear plant. Therefore, we have developed a secondary system visual display system. We would introduce this training system and a part of training materials. (author)

  6. The Influence of Advanced General Dentistry Training on Practice Patterns of Iowa Dental Graduates.

    Science.gov (United States)

    Bolden, Aljernon J.; And Others

    1992-01-01

    A study compared the practice patterns of 41 dentists with graduate training in general dentistry with those of 41 dentists without such training, in terms of number and types of procedures performed, patient characteristics, professional and community activities, and practice characteristics. Some differences were found, particularly in patient…

  7. Self-Paced Advanced Individual Training (AIT) and Duty Assignment Procedures.

    Science.gov (United States)

    Hunter, Harold; Wagner, Harold

    A study was made to (a) describe how self-paced Military Occupational Specialty (MOS) training affects the Army assignment system; (b) identify ways the existing assignment system can accommodate individualized instruction; and (c) suggest modifications to the assignment system to provide better integration of self-paced training with assignment…

  8. Advanced simulation and management software for nuclear emergency training and response

    International Nuclear Information System (INIS)

    The importance of training of safety personnel to deal with real world scenarios is prevalent amongst nuclear emergency preparedness and response organizations. For the development of training tools we have committed to ensure that field procedures, data collection software and decision making tools be identical during training sessions as they would be during a real emergency. By identifying the importance of a fully integrated tool, we have developed a safety support system capable of both functioning in training mode and real mode, enabling emergency response organizations to train more efficiently and effectively. This new fully integrated emergency management tool is called S3-FAST also known as Safety Support Systems - Field Assessment Survey Tool. (orig.)

  9. Advanced simulation and management software for nuclear emergency training and response

    Energy Technology Data Exchange (ETDEWEB)

    Rose, K.W. [RCE Rose Consulting and Engineering, Alzenau (Germany)

    2011-12-15

    The importance of training of safety personnel to deal with real world scenarios is prevalent amongst nuclear emergency preparedness and response organizations. For the development of training tools we have committed to ensure that field procedures, data collection software and decision making tools be identical during training sessions as they would be during a real emergency. By identifying the importance of a fully integrated tool, we have developed a safety support system capable of both functioning in training mode and real mode, enabling emergency response organizations to train more efficiently and effectively. This new fully integrated emergency management tool is called S3-FAST also known as Safety Support Systems - Field Assessment Survey Tool. (orig.)

  10. Muscle Volume Increases Following 16 Weeks of Resistive Exercise Training with the Advanced Resistive Exercise Device (ARED) and Free Weights

    Science.gov (United States)

    Nash, R. E.; Loehr, J. A.; Lee, S. M. C.; English, K. L.; Evans, H.; Smith, S. A.; Hagan, R. D.

    2009-01-01

    Space flight-induced muscle atrophy, particularly in the postural and locomotorymuscles, may impair task performance during long-duration space missions and planetary exploration. High intensity free weight (FW) resistive exercise training has been shown to prevent atrophy during bed rest, a space flight analog. NASA developed the Advanced Resistive Exercise Device (ARED) to simulate the characteristics of FW exercise (i.e. constant mass, inertial force) and to be used as a countermeasure during International Space Station (ISS) missions. PURPOSE: To compare the efficacy of ARED and FW training to induce hypertrophy in specific muscle groups in ambulatory subjects prior to deploying ARED on the ISS. METHODS: Twenty untrained subjects were assigned to either the ARED (8 males, 3 females) or FW (6 males, 3 females) group and participated in a periodizedtraining protocol consisting of squat (SQ), heel raise (HR), and deadlift(DL) exercises 3 d wk-1 for 16 wks. SQ, HR, and DL muscle strength (1RM) was measured before, after 8 wks, and after 16 wks of training to prescribe exercise and measure strength changes. Muscle volume of the vastigroup (V), hamstring group (H), hip adductor group (ADD), medial gastrocnemius(MG), lateral gastrocnemius(LG), and deep posterior muscles including soleus(DP) was measured using MRI pre-and post-training. Consecutive cross-sectional images (8 mm slices with a 2 mm gap) were analyzed and summed. Anatomical references insured that the same muscle sections were analyzed pre-and post-training. Two-way repeated measures ANOVAs (pmuscle strength and volume between training devices. RESULTS: SQ, HR, and DL 1RM increased in both FW (SQ: 49+/-6%, HR: 12+/-2%, DL: 23+/-4%) and ARED (SQ: 31+/-4%, HR: 18+/-2%, DL: 23+/-3%) groups. Both groups increased muscle volume in the V (FW: 13+/-2%, ARED: 10+/-2%), H (FW: 3+/-1%, ARED: 3+/-1 %), ADD (FW: 15=/-2%, ARED: 10+/-1%), LG (FW: 7+/-2%, ARED: 4+/-1%), MG (FW: 7+/-2%, ARED: 5+/-2%), and DP (FW: 2

  11. Vasopressin decreases neuronal apoptosis during cardiopulmonar y resuscitation

    Institute of Scientific and Technical Information of China (English)

    Chi Ma; Zhe Zhu; Xu Wang; Gang Zhao; Xiaoliang Liu; Rui Li

    2014-01-01

    The American Heart Association and the European Resuscitation Council recently recommend-ed that vasopressin can be used for cardiopulmonary resuscitation, instead of epinephrine. However, the guidelines do not discuss the effects of vasopressin during cerebral resuscitation. In this study, we intraperitoneally injected epinephrine and/or vasopressin during cardiopul-monary resuscitation in a rat model of asphyxial cardiac arrest. The results demonstrated that, compared with epinephrine alone, the pathological damage to nerve cells was lessened, and the levels of c-Jun N-terminal kinase and p38 expression were signiifcantly decreased in the hippo-campus after treatment with vasopressin alone or the vasopressin and epinephrine combination. No signiifcant difference in resuscitation effects was detected between vasopressin alone and the vasopressin and epinephrine combination. These results suggest that vasopressin alone or the vasopressin and epinephrine combination suppress the activation of mitogen-activated protein kinase and c-Jun N-terminal kinase signaling pathways and reduce neuronal apoptosis during cardiopulmonary resuscitation.

  12. Enhancing pediatric safety: assessing and improving resident competency in life-threatening events with a computer-based interactive resuscitation tool

    International Nuclear Information System (INIS)

    Though rare, allergic reactions occur as a result of administration of low osmolality nonionic iodinated contrast material to pediatric patients. Currently available resuscitation aids are inadequate in guiding radiologists' initial management of such reactions. To compare radiology resident competency with and without a computer-based interactive resuscitation tool in the management of life-threatening events in pediatric patients. The study was approved by the IRB. Radiology residents (n=19; 14 male, 5 female; 19 certified in basic life support/advanced cardiac life support; 1 certified in pediatric advanced life support) were videotaped during two simulated 5-min anaphylaxis scenarios involving 18-month-old and 8-year-old mannequins (order randomized). No advance warning was given. In half of the scenarios, a computer-based interactive resuscitation tool with a response-driven decision tree was available to residents (order randomized). Competency measures included: calling a code, administering oxygen and epinephrine, and correctly dosing epinephrine. Residents performed significantly more essential interventions with the computer-based resuscitation tool than without (72/76 vs. 49/76, P<0.001). Significantly more residents appropriately dosed epinephrine with the tool than without (17/19 vs. 1/19; P<0.001). More residents called a code with the tool than without (17/19 vs. 14/19; P = 0.08). A learning effect was present: average times to call a code, request oxygen, and administer epinephrine were shorter in the second scenario (129 vs. 93 s, P=0.24; 52 vs. 30 s, P<0.001; 152 vs. 82 s, P=0.025, respectively). All the trainees found the resuscitation tool helpful and potentially useful in a true pediatric emergency. A computer-based interactive resuscitation tool significantly improved resident performance in managing pediatric emergencies in the radiology department. (orig.)

  13. The effect of a structured neonatal resuscitation program on delivery room practices.

    LENUS (Irish Health Repository)

    Ryan, C A

    2012-02-03

    PURPOSE: This study evaluated the introduction of the Neonatal Resuscitation Program (NRP) of the American Academy of Pediatrics and the American Heart Association into the delivery room of an Irish maternity hospital. DESIGN: Prospective, controlled observational study of 51 deliveries before and 51 deliveries following the training of delivery room personnel in the NRP. SAMPLE: Participants were 33 nurse-midwives and 11 pediatric resident physicians. MAIN OUTCOME VARIABLE: Evaluation of postdelivery, newborn resuscitation practices. RESULTS: The introduction of the NRP was associated with significant improvements in delivery room preparation, in the evaluation and management of the newborn infant, and in thermal protection at birth. Although there was a trend to use more free-flow oxygen following the introduction of the NRP, this was not statistically significant. Bag and mask ventilation was also used more frequently following NRP training. However, there were no significant differences in the use of endotracheal intubation, chest compressions, and medications. Fifteen of the 51 infants became hypothermic prior to the introduction of the NRP; none of the infants developed hypothermia in the post-NRP part of the study.

  14. Occupational affiliation does not influence practical skills in cardiopulmonary resuscitation for in-hospital healthcare professionals

    Directory of Open Access Journals (Sweden)

    Thoren Ann-Britt

    2011-01-01

    Full Text Available Abstract Background D-CPR (Defibrillator Cardiopulmonary Resuscitation is a technique for optimal basic life support during cardiopulmonary resuscitation (CPR. Guidelines recommend that healthcare professionals can perform CPR with competence. How CPR training and provision is organized varies between hospitals, and it is our impression that in Sweden this has generally improved during the last 15-20 years. However, some hospitals still do not have any AED (Automated External Defibrillators. The aim was to investigate potential differences in practical skills between different healthcare professions before and after training in D-CPR. Methods Seventy-four healthcare professionals were video recorded and evaluated for adherence to a modified Cardiff Score. A Laerdal Resusci Anne manikin in connection to PC Skill reporting System was used to evaluate CPR quality. A simulated CPR situation was accomplished during a 5-10 min scenario of ventricular fibrillation. Paired and unpaired statistical methods were used to examine differences within and between occupations with respect to the intervention. Results There were no differences in skills among the different healthcare professions, except for compressions per minute. In total, the number of compression per minute and depth improved for all groups (P P Conclusion Nearly all healthcare professionals learned to use the AED. There were no differences in CPR skill performances among the different healthcare professionals.

  15. A model for emergency department end-of-life communications after acute devastating events--part II: moving from resuscitative to end-of-life or palliative treatment.

    Science.gov (United States)

    Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

    2012-11-01

    The model for emergency department (ED) end-of-life communications after acute devastating events addresses decision-making capacity, surrogates, and advance directives, including legal definitions and application of these steps. Part II concerns communications moving from resuscitative to palliative and end-of-life treatments. After completing the steps involved in determining decision-making, emergency physicians (EPs) should consider starting palliative measures versus continuing resuscitative treatment. As communications related to these end-of-life decisions increasingly fall within the scope of emergency medicine (EM) practice, we need to become educated about and comfortable with them. PMID:23167864

  16. Dextrose containing intravenous fluid impairs outcome and increases death after eight minutes of cardiac arrest and resuscitation in dogs.

    Science.gov (United States)

    D'Alecy, L G; Lundy, E F; Barton, K J; Zelenock, G B

    1986-09-01

    Use of dextrose in intravenous resuscitation fluids is common practice; however, this study indicates that 5% dextrose solutions, even if administered in physiologic quantities, greatly worsens the outcome of survivable cardiac arrest. Twelve adult male mongrel dogs were premedicated with morphine, anesthetized with halothane, instrumented, intubated, and ventilated. Each dog was first given 500 ml of either lactated Ringer's (LR) (n = 6) or 5% dextrose in LR (D5LR) (n = 6). Halothane was stopped and fibrillation was induced (60 Hz). Blood glucose just before cardiac arrest was 129 mg/dl in the LR dogs and was increased to 335 mg/dl in the D5LR dogs. After eight minutes of arrest, resuscitation, including internal cardiac massage and standard advanced cardiac life support drug protocols (modified for dogs), was begun. When stable cardiac rhythm was obtained, the chest was closed, and LR or D5LR continued until a total of 1L was given. A neurologic score (0 = normal to 100 = dead) was assigned at 1, 2, 6, and 24 hours. The LR group did not differ statistically from the D5LR group in operative time, number of defibrillatory shocks, time to spontaneous ventilation, time to extubation, or drugs required. Resuscitation was successful in all six LR and five of six D5LR group; however, by 2 hours after resuscitation and thereafter, D5LR group had a significantly greater neurologic deficit (p less than 0.05) than did the LR group. By 9 hours, four of six D5LR dogs displayed convulsive activity and died. At 24 hours the D5LR group had a greater (p less than 0.008) neurologic deficit (82 +/- 11) than did the LR group (21 +/- 7), which walked and ate. We conclude that the addition of 5% dextrose to standard intravenous fluids greatly increases the morbidity and mortality associated with cardiac resuscitation. PMID:3738770

  17. Educating the Educator: Use of Advanced Bleeding Control Mechanisms in Athletic Training: A Shift in the Thought Process of Prehospital Care. Part 2: Hemostatic Agents

    Science.gov (United States)

    Payne, Ellen K.; Berry, David C.; Seitz, S. Robert

    2014-01-01

    In Part 1 of this series [see: EJ1044392], the concepts of hemorrhaging, shock, and controlling bleeding as they relate to athletic training and prehospital emergency care along with the use of tourniquets were presented for athletic training educators (ATEs) to teach the skill in the classroom. This article, Part 2 of advanced bleeding control,…

  18. Resuscitation of the trauma patient: tell me a trigger for early haemostatic resuscitation please!

    Science.gov (United States)

    Reed, Matthew J; Lone, Nazir; Walsh, Timothy S

    2011-01-01

    The management of trauma-related coagulopathy and haemorrhage is changing from a reactive strategy to a proactive early intervention with blood products and haemostatic agents. Although major haemorrhage and massive transfusion are associated with higher mortality, the pattern of this association with modern trauma care is poorly described. In addition, early predictors of massive transfusion, which might trigger a proactive haemostatic resuscitation strategy, are not currently available. We review recent literature relating to predictors of massive transfusions and the relationship between transfusion and mortality. PMID:21371347

  19. THE FEATURES OF TRAINING WITH ADVANCED STUDY OF FOREIGN LANGUAGES FOR INDUSTRIAL JOINT COMPANIES

    Directory of Open Access Journals (Sweden)

    Berezhnoy S. B.

    2015-04-01

    Full Text Available This article deals with the problems of system development of professional education and enhanced training in foreign languages for the Russian-German (Swiss, French joint venture companies. We have shown new perspectives and possibilities improving work efficiency in staff training in relation with the new Russian Federation Federal Law of Education, creation basic universities departments in enterprises, ligitation new network forms for the implementation of network programs. We have also presented some measures to improve the quality of education, to attract highly qualified specialists of enterprises, the use of their scientific and technical base, ties companies with leading foreign organizations, the use of new educational technologies, assessment of professional competence of students in educational programs. At present the main role is played by foreign language, possession of which at this stage is an essential attribute of a successful specialist. The article has an analysis of existing methods and training courses in foreign languages and proposes a system of training of foreign language on the basis of educational industrial cluster which allows using not only the faculty of universities and training facilities, but the full potential of joint ventures, including foreign training. The proposed system involves learning a foreign language training in the following courses: general business, specialized business, intensive English, business training and other. The substantive content of special courses focused on professional activities with the use of interactive teaching methods, such as role-playing, methods for solving situational problems, methods of design activity that contributes to the development of skills to analyze, compare facts and events, to learn independently, to work in teams, to express and defend their point of view

  20. Improving Quality of Ecotourism through Advancing Education and Training for Eco-tourism Guides

    OpenAIRE

    Skanavis, Constantina; Giannoulis, Christos

    2009-01-01

    Environmental interpretation in Greece is in its infancy as an academic field. There are no nature guides or specific conservation objectives, and there is no professional training for non formal environmental educators and/or interpreters. The a of this paper is to reveal the necessity of integrating environmental interpretation in training of Greek Ecotour guides.The focus is on developing abilities which could enable Greek Ecotour guides to communicate and interpret the significance of the...

  1. FROM WORK EXPERIENCE IN ADVANCED TRAINING OF NORWEGIAN TEACHERS IN ATTENTION DEFICIT HYPERACTIVITY DISORDER

    OpenAIRE

    Bakken, Anne

    2014-01-01

    The article presents the experience of building competence of educators in attention deficit hyperactivity disorder in Norway. The course “Attention deficit hyperactivity disorder, Tourette syndrome, Asperger syndrome” is included in the curriculum of “Special education”. The course is divided into training modules of 10 credits (points). The courses are funded by regional administrations and local authorities, who pay for staff training, thus supporting the state system of special education....

  2. Advanced Social Skills. Facilitator's Skill Packets 16-22. Social Skills Training.

    Science.gov (United States)

    Model Classrooms, Bellevue, WA.

    These facilitator's skill packets contain seven individual packets related to advanced social skills: (1) asking for help; (2) joining in; (3) giving instructions; (4) following instructions; (5) apologizing; (6) convincing others; and (7) making a decision. Each packet contains the following sections: definition of advanced social skills;…

  3. Association of cardiopulmonary resuscitation psychomotor skills with knowledge and self-efficacy in nursing students.

    Science.gov (United States)

    Roh, Young Sook; Issenberg, S Barry

    2014-12-01

    Effective cardiopulmonary resuscitation (CPR) skills are essential for better patient survival, but whether these skills are associated with knowledge of and self-efficacy in CPR is not well known. The purpose of this study was to assess the quality of CPR skills and identify the association of the psychomotor skills with knowledge and self-efficacy at the time of CPR skills training. A convenience sample of 124 nursing students participated in a one-group posttest-only study. The quality of CPR psychomotor skills, as assessed by structured observation using a manikin, was suboptimal. Nursing students who performed correct chest compression skills reported higher self-efficacy, but there was no association between CPR psychomotor skills and total knowledge. Rigorous skills training sessions with more objective feedback on performance and individual coaching are warranted to enable mastery learning and self-efficacy. PMID:24219782

  4. Advanced life support provider course in Italy: A 5-year nationwide study to identify the determinants of course success

    NARCIS (Netherlands)

    F. Semeraro; A. Scapigliati; G. Tammaro; U. Olcese; E.L. Cerchiari; G. Ristagno

    2015-01-01

    INTRODUCTION: The advanced life support (ALS) provider course is the gold standard for teaching and assessing competence in advanced resuscitation. Outcomes over a 5-year period of European Resuscitation (ERC)/IRC ALS provider courses in Italy were investigated, and the factors associated with cours

  5. Lessons Learned for the Resuscitation of Traumatic Hemorrhagic Shock.

    Science.gov (United States)

    Spinella, Philip C; Perkins, Jeremy G; Cap, Andrew P

    2016-01-01

    The lessons learned regarding the resuscitation of traumatic hemorrhagic shock are numerous and come from a better understanding of the epidemiology, pathophysiology, and experience in this population over 10-plus years of combat operations. We have now come to better understand that the greatest benefit in survival can come from improved treatment of hemorrhage in the prehospital phase of care. We have learned that there is an endogenous coagulopathy that occurs with severe traumatic injury secondary to oxygen debt and that classic resuscitation strategies for severe bleeding based on crystalloid or colloid solutions exacerbate coagulopathy and shock for those with life-threatening hemorrhage. We have relearned that a whole blood-based resuscitation strategy, or one that at least recapitulates the functionality of whole blood, may reduce death from hemorrhage and reduce the risks of excessive crystalloid administration which include acute lung injury, abdominal compartment syndrome, cerebral edema, and anasarca. Appreciation of the importance of shock and coagulopathy management underlies the emphasis on early hemostatic resuscitation. Most importantly, we have learned that there is still much more to understand regarding the epidemiology, pathophysiology, and the resuscitation strategies required to improve outcomes for casualties with hemorrhagic shock. PMID:27215864

  6. Analysis of Medication Errors in Simulated Pediatric Resuscitation by Residents

    Directory of Open Access Journals (Sweden)

    Evelyn Porter

    2014-07-01

    Full Text Available Introduction: The objective of our study was to estimate the incidence of prescribing medication errors specifically made by a trainee and identify factors associated with these errors during the simulated resuscitation of a critically ill child. Methods: The results of the simulated resuscitation are described. We analyzed data from the simulated resuscitation for the occurrence of a prescribing medication error. We compared univariate analysis of each variable to medication error rate and performed a separate multiple logistic regression analysis on the significant univariate variables to assess the association between the selected variables. Results: We reviewed 49 simulated resuscitations . The final medication error rate for the simulation was 26.5% (95% CI 13.7% - 39.3%. On univariate analysis, statistically significant findings for decreased prescribing medication error rates included senior residents in charge, presence of a pharmacist, sleeping greater than 8 hours prior to the simulation, and a visual analog scale score showing more confidence in caring for critically ill children. Multiple logistic regression analysis using the above significant variables showed only the presence of a pharmacist to remain significantly associated with decreased medication error, odds ratio of 0.09 (95% CI 0.01 - 0.64. Conclusion: Our results indicate that the presence of a clinical pharmacist during the resuscitation of a critically ill child reduces the medication errors made by resident physician trainees.

  7. Advanced Psychotherapy Training: Psychotherapy Scholars' Track, and the Apprenticeship Model

    Science.gov (United States)

    Feinstein, Robert E.; Yager, Joel

    2013-01-01

    Background/Objective: Guided by ACGME's requirements, psychiatric residency training in psychotherapy currently focuses on teaching school-specific forms of psychotherapy (i.e., cognitive-behavioral, supportive, and psychodynamic psychotherapy). On the basis of a literature review of common factors affecting psychotherapy outcomes and…

  8. Computer-assisted generation of individual training concepts for advanced education in manufacturing metrology

    Science.gov (United States)

    Werner, Teresa; Weckenmann, Albert

    2010-05-01

    Due to increasing requirements on the accuracy and reproducibility of measurement results together with a rapid development of novel technologies for the execution of measurements, there is a high demand for adequately qualified metrologists. Accordingly, a variety of training offers are provided by machine manufacturers, universities and other institutions. Yet, for an interested learner it is very difficult to define an optimal training schedule for his/her individual demands. Therefore, a computer-based assistance tool is developed to support a demand-responsive scheduling of training. Based on the difference between the actual and intended competence profile and under consideration of amending requirements, an optimally customized qualification concept is derived. For this, available training offers are categorized according to different dimensions: regarding contents of the course, but also intended target groups, focus of the imparted competences, implemented methods of learning and teaching, expected constraints for learning and necessary preknowledge. After completing a course, the achieved competences and the transferability of gathered knowledge are evaluated. Based on the results, recommendations for amending measures of learning are provided. Thus, a customized qualification for manufacturing metrology is facilitated, adapted to the specific needs and constraints of each individual learner.

  9. Cultural Background Variables in Dance Talent Development: Findings from the UK Centres for Advanced Training

    Science.gov (United States)

    Sanchez, Erin N.; Aujla, Imogen J.; Nordin-Bates, Sanna

    2013-01-01

    This study is a qualitative enquiry into cultural background variables--social support, values, race/ethnicity and economic means--in the process of dance talent development. Seven urban dance students in pre-vocational training, aged 15-19, participated in semi-structured interviews. Interviews were inductively analysed using QSR International…

  10. Computer-assisted generation of individual training concepts for advanced education in manufacturing metrology

    International Nuclear Information System (INIS)

    Due to increasing requirements on the accuracy and reproducibility of measurement results together with a rapid development of novel technologies for the execution of measurements, there is a high demand for adequately qualified metrologists. Accordingly, a variety of training offers are provided by machine manufacturers, universities and other institutions. Yet, for an interested learner it is very difficult to define an optimal training schedule for his/her individual demands. Therefore, a computer-based assistance tool is developed to support a demand-responsive scheduling of training. Based on the difference between the actual and intended competence profile and under consideration of amending requirements, an optimally customized qualification concept is derived. For this, available training offers are categorized according to different dimensions: regarding contents of the course, but also intended target groups, focus of the imparted competences, implemented methods of learning and teaching, expected constraints for learning and necessary preknowledge. After completing a course, the achieved competences and the transferability of gathered knowledge are evaluated. Based on the results, recommendations for amending measures of learning are provided. Thus, a customized qualification for manufacturing metrology is facilitated, adapted to the specific needs and constraints of each individual learner

  11. Extracorporeal Cardiopulmonary Resuscitation: Predictors of Survival

    Science.gov (United States)

    Kim, Dong Hee; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won

    2016-01-01

    Background The use of extracorporeal life support (ECLS) in the setting of cardiopulmonary resuscitation (CPR) has shown improved outcomes compared with conventional CPR. The aim of this study was to determine factors predictive of survival in extracorporeal CPR (E-CPR). Methods Consecutive 85 adult patients (median age, 59 years; range, 18 to 85 years; 56 males) who underwent E-CPR from May 2005 to December 2012 were evaluated. Results Causes of arrest were cardiogenic in 62 patients (72.9%), septic in 18 patients (21.2%), and hypovolemic in 3 patients (3.5%), while the etiology was not specified in 2 patients (2.4%). The survival rate in patients with septic etiology was significantly poorer compared with those with another etiology (0% vs. 24.6%, p=0.008). Septic etiology (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.49 to 5.44; p=0.002) and the interval between arrest and ECLS initiation (HR, 1.05 by 10 minutes increment; 95% CI, 1.02 to 1.09; p=0.005) were independent risk factors for mortality. When the predictive value of the E-CPR timing for in-hospital mortality was assessed using the receiver operating characteristic curve method, the greatest accuracy was obtained at a cutoff of 60.5 minutes (area under the curve, 0.67; 95% CI, 0.54 to 0.80; p=0.032) with 47.8% sensitivity and 88.9% specificity. The survival rate was significantly different according to the cutoff of 60.5 minutes (p=0.001). Conclusion These results indicate that efforts should be made to minimize the time between arrest and ECLS application, optimally within 60 minutes. In addition, E-CPR in patients with septic etiology showed grave outcomes, suggesting it to be of questionable benefit in these patients. PMID:27525236

  12. Acute posthypoxic myoclonus after cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Bouwes Aline

    2012-08-01

    Full Text Available Abstract Background Acute posthypoxic myoclonus (PHM can occur in patients admitted after cardiopulmonary resuscitation (CPR and is considered to have a poor prognosis. The origin can be cortical and/or subcortical and this might be an important determinant for treatment options and prognosis. The aim of the study was to investigate whether acute PHM originates from cortical or subcortical structures, using somatosensory evoked potential (SEP and electroencephalogram (EEG. Methods Patients with acute PHM (focal myoclonus or status myoclonus within 72 hours after CPR were retrospectively selected from a multicenter cohort study. All patients were treated with hypothermia. Criteria for cortical origin of the myoclonus were: giant SEP potentials; or epileptic activity, status epilepticus, or generalized periodic discharges on the EEG (no back-averaging was used. Good outcome was defined as good recovery or moderate disability after 6 months. Results Acute PHM was reported in 79/391 patients (20%. SEPs were available in 51/79 patients and in 27 of them (53% N20 potentials were present. Giant potentials were seen in 3 patients. EEGs were available in 36/79 patients with 23/36 (64% patients fulfilling criteria for a cortical origin. Nine patients (12% had a good outcome. A broad variety of drugs was used for treatment. Conclusions The results of this study show that acute PHM originates from subcortical, as well as cortical structures. Outcome of patients admitted after CPR who develop acute PHM in this cohort was better than previously reported in literature. The broad variety of drugs used for treatment shows the existing uncertainty about optimal treatment.

  13. A study on optimization of hybrid drive train using Advanced Vehicle Simulator (ADVISOR)

    Science.gov (United States)

    Same, Adam; Stipe, Alex; Grossman, David; Park, Jae Wan

    This study investigates the advantages and disadvantages of three hybrid drive train configurations: series, parallel, and "through-the-ground" parallel. Power flow simulations are conducted with the MATLAB/Simulink-based software ADVISOR. These simulations are then applied in an application for the UC Davis SAE Formula Hybrid vehicle. ADVISOR performs simulation calculations for vehicle position using a combined backward/forward method. These simulations are used to study how efficiency and agility are affected by the motor, fuel converter, and hybrid configuration. Three different vehicle models are developed to optimize the drive train of a vehicle for three stages of the SAE Formula Hybrid competition: autocross, endurance, and acceleration. Input cycles are created based on rough estimates of track geometry. The output from these ADVISOR simulations is a series of plots of velocity profile and energy storage State of Charge that provide a good estimate of how the Formula Hybrid vehicle will perform on the given course. The most noticeable discrepancy between the input cycle and the actual velocity profile of the vehicle occurs during deceleration. A weighted ranking system is developed to organize the simulation results and to determine the best drive train configuration for the Formula Hybrid vehicle. Results show that the through-the-ground parallel configuration with front-mounted motors achieves an optimal balance of efficiency, simplicity, and cost. ADVISOR is proven to be a useful tool for vehicle power train design for the SAE Formula Hybrid competition. This vehicle model based on ADVISOR simulation is applicable to various studies concerning performance and efficiency of hybrid drive trains.

  14. Emergency Neurological Life Support: Resuscitation Following Cardiac Arrest.

    Science.gov (United States)

    Rittenberger, Jon C; Friess, Stuart; Polderman, Kees H

    2015-12-01

    Cardiac arrest is the most common cause of death in North America. Neurocritical care interventions, including targeted temperature management (TTM), have significantly improved neurological outcomes in patients successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an emergency neurological life support protocol. Patients remaining comatose following resuscitation from cardiac arrest should be considered for TTM. This protocol will review induction, maintenance, and re-warming phases of TTM, along with management of TTM side effects. Aggressive shivering suppression is necessary with this treatment to ensure the maintenance of a target temperature. Ancillary testing, including electrocardiography, computed tomography and/or magnetic resonance imaging of the brain, continuous electroencephalography monitoring, and correction of electrolyte, blood gas, and hematocrit changes, are also necessary to optimize outcomes. PMID:26438463

  15. [Cardiopulmonary resuscitation and post-cardiac arrest brain injury].

    Science.gov (United States)

    Sakurai, Atsushi

    2016-02-01

    One of the most important topics in the field of resuscitation at present is the drafting of the 2015 version of the Consensus on Science and Treatment Recommendation (CoSTR) by the International Liaison Committee on Resuscitation. The Japan Resuscitation Council is preparing its 2015 Guideline based on this CoSTR and plans to release it in October 2015. A critical change in the upcoming CoSTR is the adoption of the GRADE system. The new Guideline incorporating the GRADE system will surely be more scientific than the previous Guideline issued in 2010. Meanwhile, an important finding appeared in a report from Nielsen et al.: hypothermia at a targeted temperature of 33 degrees C did not confer a benefit versus 36 degrees in unconscious survivors of out-of-hospital cardiac arrest of presumed cardiac cause. PMID:26915250

  16. Management of acute burns and burn shock resuscitation.

    Science.gov (United States)

    Faldmo, L; Kravitz, M

    1993-05-01

    Initial management of minor and moderate, uncomplicated burn injury focuses on wound management and patient comfort. Initial management of patients with major burn injury requires airway support, fluid resuscitation for burn shock, treatment for associated trauma and preexisting medical conditions, management of adynamic ileus, and initial wound treatment. Fluid resuscitation, based on assessment of the extent and depth of burn injury, requires administration of intravenous fluids using resuscitation formula guidelines for the initial 24 hours after injury. Inhalation injury complicates flame burns and increases morbidity and mortality. Electrical injury places patients at risk for cardiac arrest, metabolic acidosis, and myoglobinuria. Circumferential full-thickness burns to extremities compromise circulation and require escharotomy or fasciotomy. Circumferential torso burns compromise air exchange and cardiac return. Loss of skin function places patients at risk for hypothermia, fluid and electrolyte imbalances, and systemic sepsis. The first 24 hours after burn injury require aggressive medical management to assure survival and minimize complications. PMID:8489882

  17. Willingness to Perform Chest Compression Only in Witnessed Cardiac Arrest Victims versus Cardiopulmonary Resuscitation in Iran

    Directory of Open Access Journals (Sweden)

    Nesreen Yaghmour

    2015-03-01

    Full Text Available Background: Performing immediate bystander Cardio Pulmonary Resuscitation (CPR is the most important factor that determines survival from cardiac arrest. Recommended mouth to mouth ventilation maneuver during CPR has led to lower rate of CPR performance in the population. Objectives: The present survey aimed to evaluate the willingness of nurses at Shiraz University of Medical Sciences for performing CPR versus chest-compression-only CPR. Patients and Methods: During a CPR course, we performed a survey on 25 nurses from Shiraz University of Medical Sciences, Iran. This survey included age and gender of the participants. In the first question, they were asked about their willingness to perform CPR with mouth to mouth breathing for witnessed cardiac arrest victims. In the second question, they were asked about their willingness to perform chest compression only for cardiac arrest victims. Results: Among the participating nurses, 96% were female with a mean age of 31 years. Only 40% were willing to perform CPR that requires mouth to mouth ventilation. On the other hand, 92% were willing to perform chest compression only without mouth to mouth ventilation. The mean age of the nurses who would do CPR was lower compared to those who would not. Conclusions: In this survey, we demonstrated that eliminating mouth to mouth ventilation maneuver could lead to markedly higher willingness to perform CPR for witnessed cardiac arrest victims in CPR trained nursing personnel. Our study is in agreement with other studies advocating that chest-compression-only CPR could lead to higher bystander resuscitation efforts.

  18. Simulation Manikin Modifications for High-Fidelity Training of Advanced Airway Procedures.

    Science.gov (United States)

    Hirsch, Jan; Generoso, Jose R; Latoures, Renee; Acar, Yahya; Fidler, Richard L

    2016-05-01

    Thoracic anesthesia procedures are challenging to master during anesthesia training. A Laerdal ALS Simulator® manikin was modified by adding a bronchial tree module to create fidelity to the fourth generation. After modification, placement of endotracheal tubes up to 8.0 mm is possible by direct laryngoscopy, video laryngoscopy, and fiberoptically; in addition, it allows fiberoptically guided insertion of endobronchial blockers. Insertion of left and right 35-Fr double-lumen tubes permits double- and single-lung ventilation with continuous positive airway pressure and positive end-expiratory pressure. This anatomical modification created a high-fidelity training tool for thoracic anesthesia that has been incorporated into educational curricula for anesthesia. PMID:26752178

  19. Harnessing Innovative Technologies to Advance Children’s Mental Health: Behavioral Parent Training As an Example

    OpenAIRE

    Jones, Deborah J.; Forehand, Rex; Cuellar, Jessica; Kincaid, Carlye; Parent, Justin; Fenton, Nicole; Goodrum, Nada

    2012-01-01

    Disruptive behaviors of childhood are among the most common reasons for referral of children to mental health professionals. Behavioral parent training (BPT) is the most efficacious intervention for these problem behaviors, yet BPT is substantially underutilized beyond university research and clinic settings. With the aim of addressing this research-to-practice gap, this article highlights the considerable, but largely unrealized, potential for technology to overcome the two most pressing cha...

  20. The management of high risk labours by midwives with advanced training

    Directory of Open Access Journals (Sweden)

    J.V. Larsen

    1980-09-01

    Full Text Available A survey undertaken in 1977' demonstrated that 53,3 percent of women delivering in a rural obstetric unit had high risk factors demanding hospital delivery. The present shortage of medical staff available in such areas demands that even patients with high risk factors must often be delivered by midwives. Midwives are however, usually trained on the understanding that all patients with significant risk factors should be delivered by medical staff, and thus

  1. Aligning Further Education And Training With The Advanced Manufacturing Technology Strategy: South Africa Case Study

    OpenAIRE

    Dube Partson; Muyengwa Goodwell; Battle Kimberly

    2014-01-01

    Academic institutions need to exhibit the appropriate flexibility to meet the demands of industry. This descriptive study seeks to identify the problems both in the private sector and in the education sector with regards to engineer training and to utilise the strengths of both to provide a solution. The study highlights the current growth of the manufacturing sector and the continuing skills gap. It identifies the problems faced by the manufacturing industry and also changes that can be made...

  2. Utilization of simple and double control subsonic aircraft for advanced combat training of the military pilots

    Directory of Open Access Journals (Sweden)

    Ioan STEFANESCU

    2012-03-01

    Full Text Available The use of subsonic single control aircraft and especially of double–control ones, instead of supersonic combat aircraft in the military pilot training programs in the operational units, has be-come a necessity due to the economic and financial world-wide crisis which began during the 70’s-80’s, with the advent of the oil crisis, affecting many countries, which have their own Military Air Forces.

  3. Obesity Bias in Training: Attitudes, Beliefs, and Observations among Advanced Trainees in Professional Health Disciplines

    OpenAIRE

    Puhl, Rebecca M; Luedicke, Joerg; Grilo, Carlos M.

    2013-01-01

    Objective This study examined weight bias among students training in health disciplines and its associations with their perceptions about treating patients with obesity, causes of obesity, and observations of weight bias by instructors and peers. Design and Methods Students (N = 107) enrolled in a post-graduate health discipline (Physician Associate, Clinical Psychology, Psychiatric Residency) completed anonymous questionnaires to assess the above variables. Results Students reported that pat...

  4. Advanced manned space flight simulation and training: An investigation of simulation host computer system concepts

    Science.gov (United States)

    Montag, Bruce C.; Bishop, Alfred M.; Redfield, Joe B.

    1989-01-01

    The findings of a preliminary investigation by Southwest Research Institute (SwRI) in simulation host computer concepts is presented. It is designed to aid NASA in evaluating simulation technologies for use in spaceflight training. The focus of the investigation is on the next generation of space simulation systems that will be utilized in training personnel for Space Station Freedom operations. SwRI concludes that NASA should pursue a distributed simulation host computer system architecture for the Space Station Training Facility (SSTF) rather than a centralized mainframe based arrangement. A distributed system offers many advantages and is seen by SwRI as the only architecture that will allow NASA to achieve established functional goals and operational objectives over the life of the Space Station Freedom program. Several distributed, parallel computing systems are available today that offer real-time capabilities for time critical, man-in-the-loop simulation. These systems are flexible in terms of connectivity and configurability, and are easily scaled to meet increasing demands for more computing power.

  5. Communicating with Patients Who Have Advanced Dementia: Training Nurse Aide Students

    Science.gov (United States)

    Beer, Laura E.; Hutchinson, Susan R.; Skala-Cordes, Kristine K.

    2012-01-01

    The increase of dementia in older adults is changing how medical care is delivered. Recognizing symptoms of pain, managing behaviors, and providing quality of life for people who have advanced dementia requires a new skill set for caregivers. Researchers in this study targeted nurse aide students to test an educational module's effect on students'…

  6. Clinical Curriculum Reform and Advanced Care Training at the New England College of Optometry.

    Science.gov (United States)

    Wilson, Roger

    1998-01-01

    Discusses how the New England College of Optometry has expanded clinical education so graduates are equipped to handle new and advanced clinical and patient-care responsibilities and meet the changing standards of professional entry-level competency. The reform process, third- and fourth-year curriculum components, rotations, and plans for…

  7. Outcome of cardiopulmonary resuscitation - predictors of survival

    International Nuclear Information System (INIS)

    To assess the outcomes of patients undergoing cardiopulmonary resuscitation (CPR). Data were collected retrospectively of all adult patients who underwent CPR. Clinical outcomes of interest were survival at the end of CPR and survival at discharge from hospital. Factors associated with survival were evaluated using logistic regression analysis. Of the 159 patients included, 55 (35%) were alive at the end of CPR and 17 (11%) were discharged alive from the hospital. At the end of CPR, univariate logistic regression analysis found the following factors associated with survival: cardiac arrest within hospital as compared to outside the hospital (odds ratio = 2.8, 95% CI = 1.27-6.20, p-value = 0.01), both cardiac and pulmonary arrest as compared to either cardiac or pulmonary arrest (odds ratio = 0.37, 95% CI = 0.19- 0.73, p-value = 0.004), asystole as cardiac rhythm at presentation (odds ratio = 0.47, 95% CI = 0.24-0.93, p-value = 0.03), and total atropine dose given during CPR (odds ratio = 0.78, 95% CI = 0.62-0.97, p-value = 0.02). In multivariate logistic regression, cardiac arrest within hospital (odds ratio = 2.52, 95% CI = 1.06-5.99, p-value = 0.04) and both cardiac and pulmonary arrest as compared to cardiac or pulmonary arrest (odds ratio = 0.44, 95% CI = 0.21-0.91, p-value = 0.03) were associated with survival at the end of CPR. At the time of discharge from hospital, univariate logistic regression analysis found following factors that were associated with survival: cardiac arrest within hospital (odds ratio = 8.4, 95% CI = 1.09-65.64, p-value = 0.04), duration of CPR (odds ratio = 0.91, 95% CI = 0.85-0.96, p-value = 0.001), and total atropine dose given during CPR (odds ratio = 0.68, 95% CI = 0.47-0.99, p-value = 0.05). In multivariate logistic regression analysis cardiac arrest within hospital (odds ratio 8.69, 95% CI = 1.01-74.6, p-value = 0.05) and duration of CPR (odds ratio 0.92, 95% CI = 0.87-0.98, p-value = 0.01) were associated with survival at

  8. Restructuring of advanced instruction and training programs in order to increase the number of flight hours for military pilots. Part II

    Directory of Open Access Journals (Sweden)

    Ioan STEFANESCU

    2011-12-01

    Full Text Available Converting the DC school jet aircraft into SC advanced training aircraft - and use them for the combat training of military pilots from the operational units, has become a necessity due to the budget cuts for Air Force, with direct implications on reducing the number of hours of flight assigned to operating personnel for preparing and training.The purpose of adopting such a program is to reduce the number of flight hours allocated annually for preparing and training in advanced stages of instruction, for every pilot, by more intensive use of this type of aircraft, which has the advantage of lower flight hour costs as compared to a supersonic combat plane.

  9. Simball Box for Laparoscopic Training With Advanced 4D Motion Analysis of Skills.

    Science.gov (United States)

    Hagelsteen, Kristine; Sevonius, Dan; Bergenfelz, Anders; Ekelund, Mikael

    2016-06-01

    Background Laparoscopic skills training and evaluation outside the operating room is important for all surgeons learning new skills. To study feasibility, a video box trainer tracking 4-dimensional (4D) metrics was evaluated as a laparoscopic training tool. Method Simball Box is a video box trainer with authentic surgical instruments and camera with video recording, equipped with 4D motion analysis registered through trocars using machine vision technology. Residents attending a 3-day laparoscopy course were evaluated performing a laparoscopic surgical knot at start, middle, and end. Metrics were obtained. Feedback data were presented in reference to expert/tutorial performance. Results Ten right-handed residents were included. Median time (range) to finish the task was 359 (253-418), 129 (95-166), and 95 (52-156) seconds; 655%, 236%, and 174% of tutorial performance, with significance pre-/midcourse (P distance in radians (range) was 150 (87-251), 65 (42-116), and 50 (33-136) with significance pre-/midcourse (P = .022) and pre-/postcourse (P = .0002). Right-handed average speed (cm/s) increased: 1.94 (1.11-2.27) pre-, 2.39 (1.56-2.83) mid-, 2.60 (1.67-3.19) postcourse with significance pre-/midcourse (P = .022) and pre-/postcourse (P = .002). Average acceleration (mm/s(2)) and motion smoothness (µm/s(3)) failed to show any difference. Conclusion For laparoscopic training and as a promising evaluation device, Simball Box obtained metrics mirroring progression well. PMID:26857834

  10. DNR policies in North America: A procedural morass - resuscitation practices revisited

    Directory of Open Access Journals (Sweden)

    Puri V

    2006-01-01

    Full Text Available More than twenty-five years have elapsed since the first Do Not Resuscitate (DNR policies were proposed. A historical review of the application of DNR policies is provided with its rationale and perceived effects. A viewpoint is presented, that acceptance of implied consent for cardiopulmonary resuscitation (CPR in hospitalized patients was responsible for drawing up of DNR policies. Unfortunately, the principle of informed consent as related to CPR and DNR policies, has had unintended consequences. Practical results do not indicate that medical practices have become more humane. Abuses of the process go beyond matters of style and experience, in communicating with surrogate decision-makers. Instead of generating compassion and respect for the patient, policies may contribute to cynicism and lack of caring amongst physicians. Overly optimistic dependence on advance directives to reform medical practices, appears unjustified. The concept of futility to limit demands for non-beneficial care is examined. It is unlikely that physicians can routinely invoke futility, as an argument to limit treatments. A re-examination of DNR policies as a defense against technologic imperative is warranted.

  11. QUALITY-OF-LIFE AFTER CARDIOPULMONARY-RESUSCITATION

    NARCIS (Netherlands)

    MIRANDA, DR

    1994-01-01

    Objectives: This study evaluates the influence of Cardiopulmonary Resuscitation (CPR) on the components of quality of life (QOL) of patients after discharge from the hospital. Design: Extracted from a prospective national survey on Dutch intensive care units (ICUs). Setting: Thirty-six ICUs of both

  12. Extensive subcutaneous bleeding after cardiopulmonary resuscitation and thrombolytic therapy.

    Science.gov (United States)

    Wong, S S; Lazarus, J H; Weston, C F

    1991-06-01

    A patient with acute myocardial infarction, complicated by pre-hospital cardiac arrest, was treated with anistreplase, heparin and aspirin following resuscitation. She developed a large lower lip haematoma and extensive bruising over the chest wall ten hours after thrombolytic therapy. A blood transfusion was required. PMID:1888410

  13. Extensive subcutaneous bleeding after cardiopulmonary resuscitation and thrombolytic therapy.

    OpenAIRE

    Wong, S. S.; Lazarus, J H; Weston, C. F.

    1991-01-01

    A patient with acute myocardial infarction, complicated by pre-hospital cardiac arrest, was treated with anistreplase, heparin and aspirin following resuscitation. She developed a large lower lip haematoma and extensive bruising over the chest wall ten hours after thrombolytic therapy. A blood transfusion was required.

  14. Induction and Resuscitation of Viable Nonculturable Arcobacter butzleri Cells▿

    OpenAIRE

    Fera, M. T.; Maugeri, T. L.; Gugliandolo, C.; La Camera, E.; Lentini, V.; Favaloro, A; Bonanno, D; Carbone, M

    2008-01-01

    Two strains of Arcobacter butzleri, ATCC 49616 and an environmental isolate, became nonculturable in seawater microcosms at 4°C by 20 days and at room temperature by 14 days. Nonculturable cells were viable for up to 270 days of incubation in microcosms. Resuscitation of A. butzleri cells from microcosms at both temperatures was achieved 9 days after nutrient addition.

  15. A feasibility study for the establishment of HSIF for the research of advanced control room and nuclear human resource education/training

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Inseok; Lee, C. K.; Kim, J. T.; and others

    2013-08-15

    According to the objective; A feasibility study for the establishment of HSIF(human system interface facility) for the research of advanced using APR 1400 simulator for R and D(research and development) of advanced I and C system/HMI and nuclear human resource education/training, the following are researched. - Concept for establishment of APR 1400 simulation model - Concept for development of Interface and Program for nuclear human resource education/training - Concept of the Interface development for the validation of NPP I and C system - Concept of Graphic Builder to easily establish the interface of control board.

  16. Assessment Of Nurses Performance During Cardiopulmonary Resuscitation In Intensive Care Unit And Cardiac Care Unit At The Alexandria Main University Hospital.

    Directory of Open Access Journals (Sweden)

    Dr. Nagla Hamdi Kamal Khalil El- Meanawi

    2015-08-01

    Full Text Available Abstract Background Cardiopulmonary resuscitation one of the most emergency management the nurse has a pivotal role and should be highly qualified in performing these procedures. The aim of the study is to assess performance of nurses during Cardio pulmonary resuscitation for patient with cardiac arrest In Intensive Care Unit and Cardiac Care Unit at the Alexandria main university hospital. To answer the question what are the most common area of satisfactory and area of neglection in nurses performance during Cardio Pulmonary Resuscitation. The sample consists of 53 staff nurses working in Intensive care unit amp cardiac care unit at Alexandria main university hospital. The tools of data collection were structured of questionnaire sheet and observational cheek list. The results showed that unsatisfactory performance between nurses in both units. The study concluded that all nurses need to improve their performance during cardiopulmonary resuscitation for patient with cardiac arrest it is crucial for nursing staff to participate in CPR courses in order to refresh and update their theoretical knowledge and performance skills and consequently to improve the safety and effectiveness of care. The study recommended that continuous evaluation of nurses knowledge and performance is essential the optimal frequency with which CPR training should be implemented at least every 6 months in order to avoid deterioration in nurses CPR knowledge and skills.

  17. Neuroprotective role of Batroxobin in cardiopulmonary resuscitation rabbits

    Institute of Scientific and Technical Information of China (English)

    Zhoujun Kang; Hui Cao; Bing Mei

    2007-01-01

    BACKGROUND: Batroxobin has been found to have protective effect on cerebral ischemia-reperfusion,and cardiopulmonary resuscitation (CPR) is the common cause of global brain ischemia-reperfusion.OBJECTIVE: To observe the effect of Batroxobin on the morphological results of cerebral cortex and hippocampus in rabbit models of CPR, and the changes of serum concentration of tumor necrosis factor alpha (TNF- α) after CPR.DESIGN: A randomized controlled observation.SETTING: Laboratory of the Department of Burns, Changhai Hospital affiliated to the Second Military Medical University of Chinese PLA.MATERIALS: Thirty healthy New Zealand rabbits of 2.5 - 3.0 kg, either male or female, were used. Kits for TNF- α determination were provided by LIFEKEY BioMeditech Company (USA).METHODS: The experiments were carried out in the laboratory of Department of Burns, Changhai Hospital from February 2001 to January 2002. The 32 rabbits were randomly divided into sham-operated group (n=8),conventional resuscitation group (n=12) and Batroxobin-treated group (n=12). The animals in the conventional resuscitation group and Batroxobin-treated group were anesthetized, then induced into modified Pittsburg's model of mechanical ventricular fibrillation. Sham-operated group was discharged on the chest wall, which did not cause ventricular fibrillation. Conventional resuscitation group and Batroxobin-treated group were exposed to 6 minutes of cardiac arrest induced by ventricular fibrillation, then the resuscitation began. A dosage of 0.3 Bu/kg of Batroxobin was administered to the rabbits in the Batroxobin-treated group at the beginning of resuscitation. Blood sample was collected at 4 and 12 hours after CPR to determine the concentration of TNF- α in serum. After the second blood collection, brain tissue was taken out immediately,and the forms of nerve cells in cerebral cortex and hippocampal CA1 region were observed under light microscope.MAIN OUTCOME MEASURES: ① TNF-α concentration in

  18. Artificial Neural Network trained by Genetic Algorithm for Smart MIMO Channel Estimation for Downlink LTE-Advance System

    Directory of Open Access Journals (Sweden)

    Nirmalkumar S. Reshamwala

    2014-02-01

    Full Text Available Long-Term Evolution (LTE is the next generation of current mobile telecommunication networks. LTE has a ?at radio-network architecture and signi?cant increase in spectrum efficiency, throughput and user capacity. In this paper, performance analysis of robust channel estimators for Downlink Long Term Evolution-Advanced (DL LTE-A system using three Artificial Neural Networks: Feed-forward neural network (FFNN, Cascade-forward neural network (CFNN and Layered Recurrent Neural Network (LRN are trained separately using Back-Propagation Algorithm and also ANN is trained by Genetic Algorithm (GA. The methods use the information got by the received reference symbols to estimate the total frequency response of the channel in two important phases. In the first phase, the proposed ANN based method learns to adapt to the channel variations, and in the second phase it estimates the channel matrix to improve performance of LTE. The performance of the estimation methods is evaluated by simulations in Vienna LTE-A DL Link Level Simulator in MATLAB software. Performance of the proposed channel estimator, ANN trained by Genetic Algorithm (ANN-GA is compared with traditional Least Square (LS algorithm and ANN based other estimator like Feed-forward neural network, Layered Recurrent Neural Network and Cascade-forward neural network for Closed Loop Spatial Multiplexing (CLSM-Single User Multi-input Multi-output (MIMO-2×2 and 4×4 in terms of throughput. Simulation result shows proposed ANN-GA gives better performance than other ANN based estimations methods and LS.

  19. Development of a formative assessment tool for measurement of performance in multi-professional resuscitation teams

    DEFF Research Database (Denmark)

    Andersen, Peter Oluf; Jensen, Michael Kammer; Lippert, Anne; Østergaard, Doris; Klausen, Tobias Wirenfelt

    2010-01-01

    part of crew resource management training, created to improve safety in aviation. This study aimed, first, to establish crew resource management and non-technical skill-based learning objectives and behavioural markers for the performance of multi-professional resuscitation teams; second, to develop a...... checklist and to evaluate the validity and reliability of the checklist; and, finally, to develop a simulation-based course including the checklist on behavioural markers, as a tool for learning and assessment.......Treating cardiac arrest is linked to the mutual performance of several health-care individuals' task coordination. Non-technical skills, including communication, leadership and team interaction, could improve sequencing the tasks in the cardiac arrest algorithm. Non-technical skills have been a...

  20. A survey of attitudes and factors associated with successful cardiopulmonary resuscitation (CPR knowledge transfer in an older population most likely to witness cardiac arrest: design and methodology

    Directory of Open Access Journals (Sweden)

    Brehaut Jamie C

    2008-11-01

    Full Text Available Abstract Background Overall survival rates for out-of-hospital cardiac arrest rarely exceed 5%. While bystander cardiopulmonary resuscitation (CPR can increase survival for cardiac arrest victims by up to four times, bystander CPR rates remain low in Canada (15%. Most cardiac arrest victims are men in their sixties, they usually collapse in their own home (85% and the event is witnessed 50% of the time. These statistics would appear to support a strategy of targeted CPR training for an older population that is most likely to witness a cardiac arrest event. However, interest in CPR training appears to decrease with advancing age. Behaviour surrounding CPR training and performance has never been studied using well validated behavioural theories. Methods/Design The overall goal of this study is to conduct a survey to better understand the behavioural factors influencing CPR training and performance in men and women 55 years of age and older. The study will proceed in three phases. In phase one, semi-structured qualitative interviews will be conducted and recorded to identify common categories and themes regarding seeking CPR training and providing CPR to a cardiac arrest victim. The themes identified in the first phase will be used in phase two to develop, pilot-test, and refine a survey instrument based upon the Theory of Planned Behaviour. In the third phase of the project, the final survey will be administered to a sample of the study population over the telephone. Analyses will include measures of sampling bias, reliability of the measures, construct validity, as well as multiple regression analyses to identify constructs and beliefs most salient to seniors' decisions about whether to attend CPR classes or perform CPR on a cardiac arrest victim. Discussion The results of this survey will provide valuable insight into factors influencing the interest in CPR training and performance among a targeted group of individuals most susceptible to

  1. Aircrew Training Devices: Utility and Utilization of Advanced Instructional Features (Phase II-Air Training Command, Military Airlift Command, and Strategic Air Command [and] Phase III-Electronic Warfare Trainers).

    Science.gov (United States)

    Polzella, Donald J.; Hubbard, David C.

    This document consists of an interim report and a final report which describe the second and third phases of a project designed to determine the utility and utilization of sophisticated hardware and software capabilities known as advanced instructional features (AIFs). Used with an aircrew training device (ATD), AIFs permit a simulator instructor…

  2. Clinician performed resuscitative ultrasonography for the initial evaluation and resuscitation of trauma

    Directory of Open Access Journals (Sweden)

    Gillman Lawrence M

    2009-08-01

    Full Text Available Abstract Background Traumatic injury is a leading cause of morbidity and mortality in developed countries worldwide. Recent studies suggest that many deaths are preventable if injuries are recognized and treated in an expeditious manner – the so called 'golden hour' of trauma. Ultrasound revolutionized the care of the trauma patient with the introduction of the FAST (Focused Assessment with Sonography for Trauma examination; a rapid assessment of the hemodynamically unstable patient to identify the presence of peritoneal and/or pericardial fluid. Since that time the use of ultrasound has expanded to include a rapid assessment of almost every facet of the trauma patient. As a result, ultrasound is not only viewed as a diagnostic test, but actually as an extension of the physical exam. Methods A review of the medical literature was performed and articles pertaining to ultrasound-assisted assessment of the trauma patient were obtained. The literature selected was based on the preference and clinical expertise of authors. Discussion In this review we explore the benefits and pitfalls of applying resuscitative ultrasound to every aspect of the initial assessment of the critically injured trauma patient.

  3. The effect of an advanced glycation end-product crosslink breaker and exercise training on vascular function in older individuals: a randomized factorial design trial.

    NARCIS (Netherlands)

    Oudegeest-Sander, M.H.; Olde Rikkert, M.G.M.; Smits, P.; Thijssen, D.H.J.; Dijk, A.P.J. van; Levine, B.D.; Hopman, M.T.E.

    2013-01-01

    Aging leads to accumulation of irreversible advanced glycation end-products (AGEs), contributing to vascular stiffening and endothelial dysfunction. When combined with the AGE-crosslink breaker Alagebrium, exercise training reverses cardiovascular aging in experimental animals. This study is the fir

  4. Assessment of the role of aptitude in the acquisition of advanced laparoscopic surgical skill sets: results from a virtual reality-based laparoscopic colectomy training programme.

    LENUS (Irish Health Repository)

    Nugent, Emmeline

    2012-09-01

    The surgeons of the future will need to have advanced laparoscopic skills. The current challenge in surgical education is to teach these skills and to identify factors that may have a positive influence on training curriculums. The primary aim of this study was to determine if fundamental aptitude impacts on ability to perform a laparoscopic colectomy.

  5. Morphological adaptation of muscle collagen and receptor of advanced glycation end product (RAGE) in osteoarthritis patients with 12 weeks of resistance training

    DEFF Research Database (Denmark)

    Mattiello-Sverzut, Ana Claudia; Petersen, Susanne G; Kjaer, Michael;

    2013-01-01

    The aim of this study was to investigate the effect of 12-week resistance training on morphological presence of collagen and RAGE (receptor for advanced glycation end products) in skeletal muscle of patients with knee osteoarthritis (OA). Little is known about the influence of exercise on the...

  6. Sharing perspectives and experiences of doctoral fellows in the first cohort of Consortium for Advanced Research Training in Africa: 2011–2014

    Directory of Open Access Journals (Sweden)

    Babatunde Adedokun

    2014-09-01

    Full Text Available Background: Resolution of public health problems in Africa remains a challenge because of insufficient skilled human resource capacity. The Consortium for Advanced Research Training in Africa (CARTA was established to enhance capacity in multi-disciplinary health research that will make a positive impact on population health in Africa. Objective: The first cohort of the CARTA program describes their perspectives and experiences during the 4 years of fellowship and puts forward suggestions for future progress and direction of research in Africa. Conclusions: The model of training as shown by the CARTA program is an effective model of research capacity building in African academic institutions. An expansion of the program is therefore warranted to reach out to more African academics in search of advanced research training.

  7. Critical care considerations in the management of the trauma patient following initial resuscitation

    Directory of Open Access Journals (Sweden)

    Shere-Wolfe Roger F

    2012-09-01

    Full Text Available Abstract Background Care of the polytrauma patient does not end in the operating room or resuscitation bay. The patient presenting to the intensive care unit following initial resuscitation and damage control surgery may be far from stable with ongoing hemorrhage, resuscitation needs, and injuries still requiring definitive repair. The intensive care physician must understand the respiratory, cardiovascular, metabolic, and immunologic consequences of trauma resuscitation and massive transfusion in order to evaluate and adjust the ongoing resuscitative needs of the patient and address potential complications. In this review, we address ongoing resuscitation in the intensive care unit along with potential complications in the trauma patient after initial resuscitation. Complications such as abdominal compartment syndrome, transfusion related patterns of acute lung injury and metabolic consequences subsequent to post-trauma resuscitation are presented. Methods A non-systematic literature search was conducted using PubMed and the Cochrane Database of Systematic Reviews up to May 2012. Results and conclusion Polytrauma patients with severe shock from hemorrhage and massive tissue injury present major challenges for management and resuscitation in the intensive care setting. Many of the current recommendations for “damage control resuscitation” including the use of fixed ratios in the treatment of trauma induced coagulopathy remain controversial. A lack of large, randomized, controlled trials leaves most recommendations at the level of consensus, expert opinion. Ongoing trials and improvements in monitoring and resuscitation technologies will further influence how we manage these complex and challenging patients.

  8. Improving medical graduates' training in palliative care: advancing education and practice

    Directory of Open Access Journals (Sweden)

    Head BA

    2016-02-01

    Full Text Available Barbara A Head,1 Tara J Schapmire,1 Lori Earnshaw,1 John Chenault,2 Mark Pfeifer,1 Susan Sawning,3 Monica A Shaw,3 1Division of General Internal Medicine, Palliative Care and Medical Education, University of Louisville School of Medicine, 2Kornhouser Health Sciences Library, University of Louisville, 3Undergraduate Medical Education Office, University of Louisville School of Medicine, Louisville, KY, USA Abstract: The needs of an aging population and advancements in the treatment of both chronic and life-threatening diseases have resulted in increased demand for quality palliative care. The doctors of the future will need to be well prepared to provide expert symptom management and address the holistic needs (physical, psychosocial, and spiritual of patients dealing with serious illness and the end of life. Such preparation begins with general medical education. It has been recommended that teaching and clinical experiences in palliative care be integrated throughout the medical school curriculum, yet such education has not become the norm in medical schools across the world. This article explores the current status of undergraduate medical education in palliative care as published in the English literature and makes recommendations for educational improvements which will prepare doctors to address the needs of seriously ill and dying patients. Keywords: medical education, palliative care, end-of-life care

  9. 46 CFR 28.210 - First aid equipment and training.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false First aid equipment and training. 28.210 Section 28.210....210 First aid equipment and training. (a) Each vessel must have on board a complete first aid manual... location. (b) First aid and cardiopulmonary resuscitation (CPR) course certification. Certification...

  10. Programa de capacitação em ressuscitação cardiorrespiratória com uso do desfibrilador externo automático em uma universidade Programa de formación en reanimación cardiopulmonar con el uso del desfibrilador externo automático en una universidad Training program on cardiopulmonary resuscitation with the use of automated external defibrillator in a university

    Directory of Open Access Journals (Sweden)

    Ana Paula Boaventura

    2012-03-01

    .Early defibrillation in cardiopulmonary resuscitation (CPR receives increasing emphasis on its priority and rapidity. This is an experience report about the implementation of a training program in CPR using a defibrillator in a private university. The training program in basic CPR maneuvers was based on global guidelines, including a theorical course with practical demonstration of CPR maneuvers with the defibrillator, individual practical training and theoretical and practical assessments. About the performance of students in the practical assessment, the mean scores obtained by students in the first stage of the course was 26.4 points, while in the second stage the mean was 252.8 points; in the theoretical assessment the mean in the first stage was 3.06 points and in the second 9.0 points. The implementation of programs like this contribute to the effective acquisition of knowledge (theory and skill (pratice for the care of CPR victims.

  11. Cardiopulmonary resuscitation: biomedical and biophysical analysis (Chapter XXX)

    DEFF Research Database (Denmark)

    Noordergraaf, G.J; Ottesen, Johnny T.; Scheffer, G.J.;

    2004-01-01

    The evolution of the human in caring for others is reflected in the development of cardiopulmonary resuscitation (CPR). Superstition, divine intervention and finally science have contributed to the development of a technique which may allow any person to save another’s life. Fully 50% of the first...... presentation of coronary artery disease is sudden death, typically in (western) men. [Anonymous, 2000, ID-469] However, achieving a clear understanding of why CPR saves some lives remains shrouded in mist; mist made even thicker by contradictory reports, different school of thought and persistently low...... survival rates. Despite the suggestion that much remains unclear, CPR is not new. An early report, in an 18 year old woman, of CPR as performed today, initially known as closed-chest cardiac resuscitation (CCCR), dates from 1858 [Husveti, ID-649]. Following airway obstruction and hypoxia, cardiac arrest...

  12. Functional systemic approach to the resuscitation and intensive care

    Directory of Open Access Journals (Sweden)

    Sadchikov D.V.

    2014-09-01

    Full Text Available Functional systemic approach to the resuscitation and intensive care may be considered as a direct correlation between analysis and synthesis, induction and deduction, and, in general, between the formal and dialectical categories. The realization of this system should be started with the interaction and formation of the final beneficial result. Therefore the experience assessment on the basis of functional systematic approach will enable us to formulate more precisely the subject and methods of resuscitation from the philosophical point of view taking into consideration the interaction of the human life integrity with death phenomenon as fixed in ontogenesis and will allow to methodically justify the distinguishing of functional systems and standard processes both in sanogenesis and thanatogenesis.

  13. Cardiorespiratory Monitoring during Neonatal Resuscitation for Direct Feedback and Audit.

    Science.gov (United States)

    van Vonderen, Jeroen J; van Zanten, Henriëtte A; Schilleman, Kim; Hooper, Stuart B; Kitchen, Marcus J; Witlox, Ruben S G M; Te Pas, Arjan B

    2016-01-01

    Neonatal resuscitation is one of the most frequently performed procedures, and it is often successful if the ventilation applied is adequate. Over the last decade, interest in seeking objectivity in evaluating the infant's condition at birth or the adequacy and effect of the interventions applied has markedly increased. Clinical parameters such as heart rate, color, and chest excursions are difficult to interpret and can be very subjective and subtle. The use of ECG, pulse oximetry, capnography, and respiratory function monitoring can add objectivity to the clinical assessment. These physiological parameters, with or without the combination of video recordings, can not only be used directly to guide care but also be used later for audit and teaching purposes. Further studies are needed to investigate whether this will improve the quality of delivery room management. In this narrative review, we will give an update of the current developments in monitoring neonatal resuscitation. PMID:27148507

  14. Cardiorespiratory monitoring during neonatal resuscitation for direct feedback and audit

    Directory of Open Access Journals (Sweden)

    Jeroen Johannes van Vonderen

    2016-04-01

    Full Text Available Neonatal resuscitation is one of the most frequently performed procedures and it is often successful if the ventilation applied is adequate. Over the last decade, interest in seeking objectivity in evaluating the infant’s condition at birth or the adequacy and effect of the interventions applied has markedly increased. Clinical parameters such as heart rate, colour and chest excursions are difficult to interpret and can be very subjective and subtle. The use of ECG, pulse oximetry, capnography and respiratory function monitoring can add objectivity to the clinical assessment. These physiological parameters, with or without the combination of video recordings, can be used directly to guide care, but can also be used later for audit and teaching purposes. Further studies are needed to investigate whether this will improve the quality of delivery room management. In this review we will give an update of the current developments in monitoring neonatal resuscitation.

  15. Manual versus mechanical cardiopulmonary resuscitation. An experimental study in pigs

    OpenAIRE

    Wohlfart Björn; Paskevicius Audrius; Sjöberg Trygve; Liao Qiuming; Steen Stig

    2010-01-01

    Abstract Background Optimal manual closed chest compressions are difficult to give. A mechanical compression/decompression device, named LUCAS, is programmed to give compression according to the latest international guidelines (2005) for cardiopulmonary resuscitation (CPR). The aim of the present study was to compare manual CPR with LUCAS-CPR. Methods 30 kg pigs were anesthetized and intubated. After a base-line period and five minutes of ventricular fibrillation, manual CPR (n = 8) or LUCAS-...

  16. Visual TASK: A Collaborative Cognitive Aid for Acute Care Resuscitation

    OpenAIRE

    Gonzales, Michael J.; Henry, Joshua M.; Calhoun, Aaron W.; Riek, Laurel D.

    2016-01-01

    Preventable medical errors are a severe problem in healthcare, causing over 400,000 deaths per year in the US in hospitals alone. In acute care, the branch of medicine encompassing the emergency department (ED) and intensive care units (ICU), error rates may be higher to due low situational awareness among clinicians performing resuscitation on patients. To support cognition, novice team leaders may rely on reference guides to direct and anticipate future steps. However, guides often act as a...

  17. Cardiopulmonary resuscitation knowledge and skills of registered nurses in Botswana

    OpenAIRE

    Lakshmi Rajeswaran; Valerie J Ehlers

    2014-01-01

    Background: In Botswana nurses provide most health care in the primary, secondary and tertiary level clinics and hospitals. Trauma and medical emergencies are on the increase, and nurses should have cardiopulmonary resuscitation (CPR) knowledge and skills in order to be able to implement effective interventions in cardiac arrest situations.Objective: The objective of this descriptive study was to assess registered nurses’ CPR knowledge and skills.Method: A pre-test, intervention and re-test ...

  18. Potential wrist ligament injury in rescuers performing cardiopulmonary resuscitation

    OpenAIRE

    Robert Curran; Sasha Sorr; Eva Aquino

    2013-01-01

    Wrist pain in rescuers performing chest compressions as part of cardiopulmonary resuscitation has been reported anecdotally and recently in the literature. Studies have indicated that rescuers apply as much as 644 N of force to the victim′s chest with each compression, while standards require one hundred compressions per minute. Recent research suggests that forces transmitted through the rescuers′ wrists of less than 10% of those seen during the performance of chest compressions significantl...

  19. Implementation of cardiopulmonary resuscitation workshop in first MBBS

    OpenAIRE

    Saiyad, Shaista M; Saiyad, Mubassir; Pandya, Charu J

    2015-01-01

    Context: Students should be exposed to early clinical scenario so that they start developing competency-based learning right from their MBBS 1st year. Medical Council of India has recognized this need and has suggested early clinical exposure of MBBS 1st year students in their document Vision 2015. Medical education in India needs change for achieving desired competencies. It has been concluded that Indian medical undergraduates have inadequate knowledge in cardiopulmonary resuscitation (CPR)...

  20. Cardiorespiratory Monitoring during Neonatal Resuscitation for Direct Feedback and Audit

    OpenAIRE

    van Vonderen, Jeroen J.; van Zanten, Henriëtte A.; Schilleman, Kim; Hooper, Stuart B.; Kitchen, Marcus J.; Witlox, Ruben S. G. M.; te Pas, Arjan B.

    2016-01-01

    Neonatal resuscitation is one of the most frequently performed procedures, and it is often successful if the ventilation applied is adequate. Over the last decade, interest in seeking objectivity in evaluating the infant’s condition at birth or the adequacy and effect of the interventions applied has markedly increased. Clinical parameters such as heart rate, color, and chest excursions are difficult to interpret and can be very subjective and subtle. The use of ECG, pulse oximetry, capnograp...

  1. Cardiorespiratory monitoring during neonatal resuscitation for direct feedback and audit

    OpenAIRE

    Jeroen Johannes van Vonderen; van Zanten, Henriëtte A.; Kim eSchilleman; Hooper, Stuart B.; Kitchen, Marcus J.; Ruben SGM Witlox; Arjan Benedictus Te Pas

    2016-01-01

    Neonatal resuscitation is one of the most frequently performed procedures and it is often successful if the ventilation applied is adequate. Over the last decade, interest in seeking objectivity in evaluating the infant’s condition at birth or the adequacy and effect of the interventions applied has markedly increased. Clinical parameters such as heart rate, colour and chest excursions are difficult to interpret and can be very subjective and subtle. The use of ECG, pulse oximetry, capnograph...

  2. Plasma catecholamines after endotracheal administration of adrenaline during postnatal resuscitation.

    OpenAIRE

    K. O. Schwab; von Stockhausen, H B

    1994-01-01

    To analyse the degradation of adrenaline after cardiopulmonary resuscitation of preterm neonates, free and sulphoconjugated adrenaline, noradrenaline, and dopamine were determined in 31 preterm neonates by a radioenzymatic method. Nine of the neonates received a high dose (250 micrograms/kg) of endotracheally administered adrenaline (1:1000); three of them had more than one dose of adrenaline. With the exception of sulphoconjugated dopamine, the free and sulphoconjugated catecholamine concent...

  3. The Attitude of Iranian Nurses About Do Not Resuscitate Orders

    OpenAIRE

    Sima Mogadasian; Farahnaz Abdollahzadeh; Azad Rahmani; Caleb Ferguson; Fermisk Pakanzad; Vahid Pakpour; Hamid Heidarzadeh

    2014-01-01

    Background: Do not resuscitate (DNR) orders are one of many challenging issues in end of life care. Previous research has not investigated Muslim nurses′ attitudes towards DNR orders. Aims: This study aims to investigate the attitude of Iranian nurses towards DNR orders and determine the role of religious sects in forming attitudes. Materials and Methods: In this descriptive-comparative study, 306 nurses from five hospitals affiliated to Tabriz University of Medical Sciences (TUOMS) i...

  4. Midwives' Experiences, Education, and Support Needs Regarding Basic Newborn Resuscitation in Jordan.

    Science.gov (United States)

    Kassab, Manal; Alnuaimi, Karimeh; Mohammad, Khitam; Creedy, Debra; Hamadneh, Shereen

    2016-06-01

    Newborns who are compromised at birth require rapid attention to stabilize their respiration attempts. Lack of knowledge regarding basic newborn resuscitation is a contributing factor to poor newborn health outcomes and increased mortality. The purpose of this study was to explore Jordanian midwives' experiences, education, and support needs to competently perform basic newborn resuscitation. Qualitative descriptive methodology was used to analyze a convenience sample of 20 midwives. A thematic approach was used to analyze the data. Participants discussed their experiences of basic newborn resuscitation including knowledge, skills, and barriers and suggested solutions to improve practice. Four themes were revealed: lack of knowledge and skills in newborn resuscitation, organizational constraints, inadequate teamwork, and educational needs. The midwives perceived that their ability to perform newborn resuscitation was hindered by lack of knowledge and skills in newborn resuscitation, organizational constraints (such as lack of equipment), and poor co-ordination and communication among team members. PMID:26635311

  5. Successful roadside resuscitative thoracotomy: case report and literature review.

    Science.gov (United States)

    Wall, M J; Pepe, P E; Mattox, K L

    1994-01-01

    Patients with injuries severe enough to require cardiopulmonary resuscitation (CPR) have a dismal prognosis. Time to surgical intervention is a major determinant of outcome in moribund trauma patients who have a potential for survival. With the exception of endotracheal intubation during evacuation to surgical intervention, no other usual prehospital procedures have been validated to affect outcome in such cases of extremis. This is a report of a case in which resuscitative surgical techniques were extended successfully to the prehospital environment. The patient was a 30-year-old man in extremis after a stab wound to the left chest. Estimating a transport time of 15 minutes, a physician riding with the emergency medical service (EMS) crews elected to perform a resuscitative thoracotomy. Following digital aortic compression, the patient regained both blood pressure and consciousness by the time of arrival at the trauma center. A left lower lobectomy was then performed in the operating room. The patient recovered fully and was discharged home in 21 days, neurologically intact. Four years later, the patient was alive, healthy, and working. This report demonstrates the feasibility of prehospital thoracotomy and raises provocative issues regarding future intense surgical involvement in prehospital care. PMID:8295241

  6. eLearning in education and advanced training in neuroradiology: introduction of a web-based teaching and learning application

    International Nuclear Information System (INIS)

    New information technologies offer the possibility of major improvements in the professional education and advanced training of physicians. The web-based, multimedia teaching and learning application Schoolbook has been created and utilized for neuroradiology. Schoolbook is technically based as a content management system and is realized in a LAMP environment. The content is generated with the help of the developed system and stored in a database. The layout is defined by a PHP application, and the webpages are generated from the system. Schoolbook is realized as an authoring tool so that it can be integrated into daily practice. This enables the teacher to autonomously process the content into the web-based application which is used for lectures, seminars and self-study. A multimedia case library is the central building block of Schoolbook for neuroradiology, whereby the learner is provided with original diagnostic and therapeutic data from numerous individual cases. The user can put individual emphasis on key learning points as there are various ways to work with the case histories. Besides the case-based way of teaching and learning, a systematically structured way of dealing with the content is available. eLearning offers various opportunities for teaching and learning in academic and scientific as well as in economic contexts. Web-based applications such as Schoolbook may be beneficial not only for basic university education but also for the realization of international educational programmes such as the European Master of Medical Science with a major in neuroradiology. (orig.)

  7. Family-Witnessed Resuscitation: Perceptions of Nurses and Doctors Working in an Australian Emergency Department

    OpenAIRE

    Angela Bushby; Shane Combs; Rochelle Watkins; Rose Chapman

    2012-01-01

    Inconsistencies abound in the literature regarding staff attitudes and perceptions toward family-witnessed resuscitation. Our study builds on previous research by using a validated tool to investigate emergency department staff perceptions of family-witnessed resuscitation. A cross-sectional survey was distributed to 221 emergency department doctors' and nurses'. We found few differences between doctors and nurses perceptions toward family-witnessed resuscitation. Both nurses and doctors who ...

  8. Marked variation in newborn resuscitation practice: a national survey in the UK

    OpenAIRE

    Mann, Chantelle; Ward, Carole; Grubb, Mark; Hayes-Gill, Barrie; Crowe, John; Marlow, Neil; Sharkey, Don

    2012-01-01

    Abstract Background Although international newborn resuscitation guidance has been in force for some time, there are no UK data on current newborn resuscitation practices. Objective Establish delivery room (DR) resuscitation practices in the UK, and identify any differences between neonatal intensive care units (NICU), and other local neonatal services. Methods We conducted a structured two-stage survey of DR management, among UK neonatal units during 2009–2010 (n = 192). ...

  9. Awareness of cardiopulmonary resuscitation in medical-students and doctors in Rawalpindi-Islamabad, Pakistan

    International Nuclear Information System (INIS)

    Objective: To assess the level of awareness regarding basic and practical knowledge of cardiopulmonary resuscitation and its importance in the eyes of medical/dental students and doctors. Methods: The cross-sectional study was conducted in medical and dental colleges as well as hospitals of Rawalpindi and Islamabad, Pakistan, from June to September 2011. Non-probability convenience sampling was used and structured questionnaires on basic and practical knowledge of the procedure were distributed. The questionnaire had 26 items related to basic and advanced knowledge of the required skills. Doctors were divided into two groups based on their years of service and practice. Those with less than 5 years' experience were grouped as junior doctors, while rest as senior doctors. Descriptive statistics were employed to analyse the data using SPPS version 17 and Microsoft Excel. Percentages were worked out and the results were interpreted. Result: Of the 1000 questionnaires distributed, 646 (64.6%) were received duly filled and represented the study sample. Of the 646 participants, 34 (5.26%) were dentists, 424 (65.63%) were medical students, 92 (14.24%) were doctors and 96 (14.86%) were dental students. Basic knowledge of doctors was found to be better than that of dentists (n=96; 50% vs. n=8; 23%). Similarly, the advance knowledge of doctors was better than the dentists (n=53; 58% vs. n=11; 31%). The basic knowledge of junior doctors was found to be almost equal to the senior doctors (n=26; 44.75% vs. n=15; 45.5%). The advance knowledge of junior doctors was found to be better than the senior doctors (n=27; 45.37% vs. n=10; 29.48%). Among the students, 157 (37%) of the medical students had basic knowledge of CPR, while 36 (38%) dental students had basic knowledge of the topic. Medical students had more advanced knowledge (n=157; 37%) than dental students (n=34; 35%). Conclusion: The awareness of basic and advance knowledge of cardiopulmonary resuscitation skills in medical

  10. Can PC-9 Zhong chong replace K-1 Yong quan for the acupunctural resuscitation of a bilateral double-amputee? Stating the “random criterion problem” in its statistical analysis

    Science.gov (United States)

    Inchauspe, Adrián Angel

    2016-01-01

    AIM: To present an inclusion criterion for patients who have suffered bilateral amputation in order to be treated with the supplementary resuscitation treatment which is hereby proposed by the author. METHODS: This work is based on a Retrospective Cohort model so that a certainly lethal risk to the control group is avoided. RESULTS: This paper presents a hypothesis on acupunctural PC-9 Zhong chong point, further supported by previous statistical work recorded for the K-1 Yong quan resuscitation point. CONCLUSION: Thanks to the application of the resuscitation maneuver herein proposed on the previously mentioned point, patients with bilateral amputation would have another alternative treatment available in case basic and advanced CPR should fail. PMID:27152257

  11. Robotic-locomotor training as a tool to reduce neuromuscular abnormality in spinal cord injury: the application of system identification and advanced longitudinal modeling.

    Science.gov (United States)

    Mirbagheri, Mehdi M; Kindig, Matthew; Niu, Xun; Varoqui, Deborah; Conaway, Petra

    2013-06-01

    In this study, the effect of the LOKOMAT, a robotic-assisted locomotor training system, on the reduction of neuromuscular abnormalities associated with spasticity was examined, for the first time in the spinal cord injury (SCI) population. Twenty-three individuals with chronic incomplete SCI received 1-hour training sessions in the LOKOMAT three times per week, with up to 45 minutes of training per session; matched control group received no intervention. The neuromuscular properties of the spastic ankle were then evaluated prior to training and after 1, 2, and 4 weeks of training. A parallel-cascade system identification technique was used to determine the reflex and intrinsic stiffness of the ankle joint as a function of ankle position at each time point. The slope of the stiffness vs. joint angle curve, i.e. the modulation of stiffness with joint position, was then calculated and tracked over the four-week period. Growth Mixture Modeling (GMM), an advanced statistical method, was then used to classify subjects into subgroups based on similar trends in recovery pattern of slope over time, and Random Coefficient Regression (RCR) was used to model the recovery patterns within each subgroup. All groups showed significant reductions in both reflex and intrinsic slope over time, but subjects in classes with higher baseline values of the slope showed larger improvements over the four weeks of training. These findings suggest that LOKOMAT training may also be useful for reducing the abnormal modulation of neuromuscular properties that arises as secondary effects after SCI. This can advise clinicians as to which patients can benefit the most from LOKOMAT training prior to beginning the training. Further, this study shows that system identification and GMM/RCR can serve as powerful tools to quantify and track spasticity over time in the SCI population. PMID:24187312

  12. Smaller self-inflating bags produce greater guideline consistent ventilation in simulated cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Boyle Malcolm J

    2009-02-01

    Full Text Available Abstract Background Suboptimal bag ventilation in cardiopulmonary resuscitation (CPR has demonstrated detrimental physiological outcomes for cardiac arrest patients. In light of recent guideline changes for resuscitation, there is a need to identify the efficacy of bag ventilation by prehospital care providers. The objective of this study was to evaluate bag ventilation in relation to operator ability to achieve guideline consistent ventilation rate, tidal volume and minute volume when using two different capacity self-inflating bags in an undergraduate paramedic cohort. Methods An experimental study using a mechanical lung model and a simulated adult cardiac arrest to assess the ventilation ability of third year Monash University undergraduate paramedic students. Participants were instructed to ventilate using 1600 ml and 1000 ml bags for a length of two minutes at the correct rate and tidal volume for a patient undergoing CPR with an advanced airway. Ventilation rate and tidal volume were recorded using an analogue scale with mean values calculated. Ethics approval was granted. Results Suboptimal ventilation with the use of conventional 1600 ml bag was common, with 77% and 97% of participants unable to achieve guideline consistent ventilation rates and tidal volumes respectively. Reduced levels of suboptimal ventilation arouse from the use of the smaller bag with a 27% reduction in suboptimal tidal volumes (p = 0.015 and 23% reduction in suboptimal minute volumes (p = 0.045. Conclusion Smaller self-inflating bags reduce the incidence of suboptimal tidal volumes and minute volumes and produce greater guideline consistent results for cardiac arrest patients.

  13. Vasopressin during cardiopulmonary resuscitation and different shock states: a review of the literature.

    Science.gov (United States)

    Krismer, Anette C; Dünser, Martin W; Lindner, Karl H; Stadlbauer, Karl H; Mayr, Viktoria D; Lienhart, Hannes G; Arntz, Richard H; Wenzel, Volker

    2006-01-01

    Vasopressin administration may be a promising therapy in the management of various shock states. In laboratory models of cardiac arrest, vasopressin improved vital organ blood flow, cerebral oxygen delivery, the rate of return of spontaneous circulation, and neurological recovery compared with epinephrine (adrenaline). In a study of 1219 adult patients with cardiac arrest, the effects of vasopressin were similar to those of epinephrine in the management of ventricular fibrillation and pulseless electrical activity; however, vasopressin was superior to epinephrine in patients with asystole. Furthermore, vasopressin followed by epinephrine resulted in significantly higher rates of survival to hospital admission and hospital discharge. The current cardiopulmonary resuscitation guidelines recommend intravenous vasopressin 40 IU or epinephrine 1mg in adult patients refractory to electrical countershock. Several investigations have demonstrated that vasopressin can successfully stabilize hemodynamic variables in advanced vasodilatory shock. Use of vasopressin in vasodilatory shock should be guided by strict hemodynamic indications, such as hypotension despite norepinephrine (noradrenaline) dosages >0.5 mug/kg/min. Vasopressin must never be used as the sole vasopressor agent. In our institutional routine, a fixed vasopressin dosage of 0.067 IU/min (i.e. 100 IU/50 mL at 2 mL/h) is administered and mean arterial pressure is regulated by adjusting norepinephrine infusion. When norepinephrine dosages decrease to 0.2 microg/kg/min, vasopressin is withdrawn in small steps according to the response in mean arterial pressure. Vasopressin also improved short- and long-term survival in various porcine models of uncontrolled hemorrhagic shock. In the clinical setting, we observed positive effects of vasopressin in some patients with life-threatening hemorrhagic shock, which had no longer responded to adrenergic catecholamines and fluid resuscitation. Clinical employment of

  14. Assessment of the teaching-learning process in students of the health area: cardiopulmonary resuscitation maneuvers

    Directory of Open Access Journals (Sweden)

    Patrícia Moita Garcia Kawakame

    2015-08-01

    Full Text Available OBJECTIVETo evaluate the skills and knowledge of undergraduate students in the health area on cardiopulmonary resuscitation maneuvers with the use of an automatic external defibrillator.METHODThe evaluation was performed in three different stages of the teaching-learning process. A theoretical and practical course was taught and the theoretical classes included demonstration. The evaluation was performed in three different stages of the teaching-learning process. Two instruments were applied to evaluate the skills (30-items checklist and knowledge (40-questions written test. The sample comprised 84 students.RESULTSAfter the theoretical and practical course, an increase was observed in the number of correct answers in the 30-items checklist and 40-questions written test.CONCLUSIONAfter the theoretical class (including demonstration, only one of the 30-items checklist for skills achieved an index ≥ 90% of correct answers. On the other hand, an index of correct answers greater than 90% was achieved in 26 (86.7% of the 30 items after a practical training simulation, evidencing the importance of this training in the defibrillation procedure.

  15. An Introduction to the Inverted/Flipped Classroom Model in Education and Advanced Training in Medicine and in the Healthcare Professions

    OpenAIRE

    Tolks, Daniel; Schäfer, Christine; Raupach, Tobias; Kruse, Leona; Sarikas, Antonio; Gerhardt-Szép, Susanne; Kllauer, Gertrud; Lemos, Martin; Fischer, Martin R.; Eichner, Barbara; Sostmann, Kai; Hege, Inga

    2016-01-01

    In describing the inverted classroom model (ICM), the following paper is meant to provide an introduction to the subject matter and to serve as a practical guide for those wishing to employ its methods in basic and advanced medical training and education. The ICM is a blended-learning method in which a self-directed learning phase (individual phase) precedes the classroom-instruction phase. During the online phase, factual knowledge is imparted that serves as a basis for the classroom phase. ...

  16. Further Democratizing Latin America: Broadening Access to Higher Education and Promoting Science Policies Focused on the Advanced Training of Human Resources

    OpenAIRE

    2014-01-01

    We focus this paper on the conditions to build reliable science, technology and higher education systems in Latin America, based on international comparative studies, fieldwork and interviews conducted over the last three years. The analysis shows that science can have a major role in furthering the democratization of society through public policies that foster opportunities to access knowledge and the advanced training of human resources. Broadening the social basis for higher education prom...

  17. Whole blood for hemostatic resuscitation of major bleeding.

    Science.gov (United States)

    Spinella, Philip C; Pidcoke, Heather F; Strandenes, Geir; Hervig, Tor; Fisher, Andrew; Jenkins, Donald; Yazer, Mark; Stubbs, James; Murdock, Alan; Sailliol, Anne; Ness, Paul M; Cap, Andrew P

    2016-04-01

    Recent combat experience reignited interest in transfusing whole blood (WB) for patients with life-threatening bleeding. US Army data indicate that WB transfusion is associated with improved or comparable survival compared to resuscitation with blood components. These data complement randomized controlled trials that indicate that platelet (PLT)-containing blood products stored at 4°C have superior hemostatic function, based on reduced bleeding and improved functional measures of hemostasis, compared to PLT-containing blood products at 22°C. WB is rarely available in civilian hospitals and as a result is rarely transfused for patients with hemorrhagic shock. Recent developments suggest that impediments to WB availability can be overcome, specifically the misconceptions that WB must be ABO specific, that WB cannot be leukoreduced and maintain PLTs, and finally that cold storage causes loss of PLT function. Data indicate that the use of low anti-A and anti-B titer group O WB is safe as a universal donor, WB can be leukoreduced with PLT-sparing filters, and WB stored at 4°C retains PLT function during 15 days of storage. The understanding that these perceived barriers are not insurmountable will improve the availability of WB and facilitate its use. In addition, there are logistic and economic advantages of WB-based resuscitation compared to component therapy for hemorrhagic shock. The use of low-titer group O WB stored for up to 15 days at 4°C merits further study to compare its efficacy and safety with current resuscitation approaches for all patients with life-threatening bleeding. PMID:27100756

  18. CT findings of the brain post cardiopulmonary resuscitation

    International Nuclear Information System (INIS)

    The subjects were 88 cases of non-traumatic CPA excluding those with primary brain disease. The subjects were divided into 4 groups according to the duration of cardiac arrest: Group A (less than 15 minutes, 2 cases), Group B (15-30 minutes, 11 cases), Group C (more than 30 minutes, 40 cases), Group D (no resuscitation after cardiac arrest, 35 cases). All cases in Group A were observed to be clear consciousness after resuscitation. Not only the functional outcome but also the survivals rates were poorer as the duration of cardiac arrest increased in Groups B and C compared to Group A. The mortality rate was 85% or higher for cardiac arrest of 15 minutes or longer. Brain edema after resuscitation was examined by head CT in the basal-ganglia and thalamus regions, and in the corticomedullary junction of the cerebrum. In the cases of short duration of cardiac arrest, the basal-ganglia and thalamus regions, and the corticomedullary junction were clearly visible on CT. On the other hand, these areas were poorly or not visible (marked brain edema) in the cases of longer duration of cardiac arrest. The borders of the basal-ganglia and thalamus regions, and the corticomedullary junction were not obscured in any of the cases in Group A. However, the borders of these regions were poorly visible or not visible more frequently as the duration of cardiac arrest increased. In particular, the corticomedullary junction was not visible more frequently after cardiac arrest of long duration. Brain edema is caused and intensified by prolongation of hypoxia, but it is also reported to be caused by external cardiac massage, which increases the intracranial pressure. This was also suggested by the more notable brain edema in the corticomedullary junction than in the basal-ganglia and thalamus regions. These findings of brain edema appeared on head CT within 4 hours after CPR. Findings suggestive of vascular occlusion were also obtained. (K.H.)

  19. Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 11: Computer-Aided Manufacturing & Advanced CNC, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

    Science.gov (United States)

    Texas State Technical Coll., Waco.

    This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

  20. Initial fluid resuscitation of patients with septic shock in the intensive care unit

    DEFF Research Database (Denmark)

    Carlsen, Sarah; Perner, A

    2011-01-01

    Fluid is the mainstay of resuscitation of patients with septic shock, but the optimal composition and volume are unknown. Our aim was to evaluate the current initial fluid resuscitation practice in patients with septic shock in the intensive care unit (ICU) and patient characteristics and outcome...

  1. Unexpected Fatal Hypernatremia after Successful Cardiopulmonary Resuscitation with Therapeutic Hypothermia: A Case Report

    OpenAIRE

    Choi, Sang-Sik; Kim, Won Young; Kim, Won; Lim, Kyung-Su

    2012-01-01

    Central diabetes insipidus (DI), characterized by unexpected fatal hypernatremia, is a rare complication after successful cardiopulmonary resuscitation with therapeutic hypothermia, but may be potentially fatal if recognition is delayed. We describe here a patient who experienced cardiac arrest due to a pulmonary embolism, followed by successful resuscitation after induction of therapeutic hypothermia. The patient, however, suddenly developed unexpected hypernatremia with increased urine outp...

  2. Acceptability and implementation of debriefings after trauma resuscitation.

    Science.gov (United States)

    Berg, Gina M; Hervey, Ashley M; Basham-Saif, Angela; Parsons, Deanna; Acuna, David L; Lippoldt, Diana

    2014-01-01

    Postresuscitation debriefings allow team members to reflect on performance and discuss areas for improvement. Pre-/postsurveys of trauma team members (physicians, mid-level practitioners, technicians, pharmacists, and nurses) were administered to evaluate the acceptability of debriefings and self-perceptions after multidisciplinary trauma resuscitations. After a 3-month trial period, improvements were observed in perceptions of psychological and patient safety, role on team, team communication, and acceptability of the debriefing initiative. Regrouping for a debriefing requires organizational change, which may be more easily assimilated if team members recognize the potential for process improvement and feel confident about success. PMID:25198073

  3. [Do not resuscitate orders in the intensive care setting].

    Science.gov (United States)

    Kleiren, P; Sohawon, S; Noordally, S O

    2010-01-01

    Even if Belgium (2002), The Netherlands (2002) and Luxemburg (2009) are the first three countries in the world to have legalized active euthanasia, there still is not a law on the do not resuscitate concept (NTBR or DNR). Nevertheless, numerous royal decrees and some consensus as well as advice given by the Belgian Medical Council, hold as jurisprudence. These rules remain amenable to change so as to suite the daily practice in intensive care units. This article describes the actual Belgian legal environment surrounding the intensive care specialist when he has to take such decisions. PMID:20687449

  4. A method of automatic control procedures cardiopulmonary resuscitation

    Science.gov (United States)

    Bureev, A. Sh.; Zhdanov, D. S.; Kiseleva, E. Yu.; Kutsov, M. S.; Trifonov, A. Yu.

    2015-11-01

    The study is to present the results of works on creation of methods of automatic control procedures of cardiopulmonary resuscitation (CPR). A method of automatic control procedure of CPR by evaluating the acoustic data of the dynamics of blood flow in the bifurcation of carotid arteries and the dynamics of air flow in a trachea according to the current guidelines for CPR is presented. Evaluation of the patient is carried out by analyzing the respiratory noise and blood flow in the interspaces between the chest compressions and artificial pulmonary ventilation. The device operation algorithm of automatic control procedures of CPR and its block diagram has been developed.

  5. Potential wrist ligament injury in rescuers performing cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Robert Curran

    2013-01-01

    Full Text Available Wrist pain in rescuers performing chest compressions as part of cardiopulmonary resuscitation has been reported anecdotally and recently in the literature. Studies have indicated that rescuers apply as much as 644 N of force to the victim′s chest with each compression, while standards require one hundred compressions per minute. Recent research suggests that forces transmitted through the rescuers′ wrists of less than 10% of those seen during the performance of chest compressions significantly strain the scapholunate ligament. Biomechanical research should be performed to further evaluate this possible correlation. Compensation for worker injury maybe involved.

  6. Associations of Hospital and Patient Characteristics with Fluid Resuscitation Volumes in Patients with Severe Sepsis

    DEFF Research Database (Denmark)

    Hjortrup, Peter Buhl; Haase, Nicolai; Wetterslev, Jørn;

    2016-01-01

    PURPOSE: Fluid resuscitation is a key intervention in patients with sepsis and circulatory impairment. The recommendations for continued fluid therapy in sepsis are vague, which may result in differences in clinical practice. We aimed to evaluate associations between hospital and patient...... characteristics and fluid resuscitation volumes in ICU patients with severe sepsis. METHODS: We explored the 6S trial database of ICU patients with severe sepsis needing fluid resuscitation randomised to hydroxyethyl starch 130/0.42 vs. Ringer's acetate. Our primary outcome measure was fluid resuscitation volume...... sepsis. The data indicate variations in clinical practice not explained by patient characteristics emphasizing the need for RCTs assessing fluid resuscitation volumes fluid in patients with sepsis....

  7. IMPROVING QUALITY OF ECOTOURISM THROUGH ADVANCING EDUCATION & TRAINING OF GREEK ECO-TOUR GUIDES: THE ROLE OF TRAINING IN ENVIRONMENTAL INTERPRETATION

    Directory of Open Access Journals (Sweden)

    Christos Giannoulis

    2010-10-01

    Full Text Available Environmental interpretation in Greece is in its infancy as an academic field. There are no nature guides or specific conservation objectives, and there is no professional training for non formal environmental educators and/or interpreters. The a of this paper is to reveal the necessity of integrating environmental interpretation in training of Greek Ecotour guides.The focus is on developing abilities which could enable Greek Ecotour guides to communicate and interpret the significance of the environment, promote minimal impact practices, ensure the sustainability of the natural and cultural environment, and motivate visiting tourists to evaluate the quality of life in relation to larger ecological or cultural concerns. The rationale underpinning this objective is that by providing accurate and effective interpretation of ecotourism sites as well as monitoring and modelling environmental responsible behaviour, the outcome will be to promote positive impacts of tourism and alleviate negative ones Local community will be encouraged to participate in environmental management of ecotourism settings. Furthermore, connecting ecotourism commitment to returning benefits, particularly economic and employment ones to local communities, it stresses that training local people to be interpretive guides, helps achieving not only ecological sustainability but also economic sustainability. Once trained, guides may encourage conservation action amongst both tourists and the local community.

  8. Training Preschoolers on First-Order False Belief Understanding: Transfer on Advanced ToM Skills and Metamemory

    Science.gov (United States)

    Lecce, Serena; Bianco, Federica; Demicheli, Patrizia; Cavallini, Elena

    2014-01-01

    This study investigated the relation between theory of mind (ToM) and metamemory knowledge using a training methodology. Sixty-two 4- to 5-year-old children were recruited and randomly assigned to one of two training conditions: A first-order false belief (ToM) and a control condition. Intervention and control groups were equivalent at pretest for…

  9. Strategies for Small Volume Resuscitation: Hyperosmotic-Hyperoncotic Solutions, Hemoglobin Based Oxygen Carriers and Closed-Loop Resuscitation

    Science.gov (United States)

    Kramer, George C.; Wade, Charles E.; Dubick, Michael A.; Atkins, James L.

    2004-01-01

    Introduction: Logistic constraints on combat casualty care preclude traditional resuscitation strategies which can require volumes and weights 3 fold or greater than hemorrhaged volume. We present a review of quantitative analyses of clinical and animal data on small volume strategies using 1) hypertonic-hyperosmotic solutions (HHS); 2) hemoglobin based oxygen carriers (HBOCs) and 3) closed-loop infusion regimens.Methods and Results: Literature searches and recent queries to industry and academic researchers have allowed us to evaluate the record of 81 human HHS studies (12 trauma trials), 19 human HBOCs studies (3trauma trials) and two clinical studies of closed-loop resuscitation.There are several hundreds animal studies and at least 82 clinical trials and reports evaluating small volume7.2%-7.5% hypertonic saline (HS) most often combined with colloids, e.g., dextran (HSD) or hetastarch(HSS). HSD and HSS data has been published for 1,108 and 392 patients, respectively. Human studies have documented volume sparing and hemodynamic improvements. Meta-analyses suggest improved survival for hypotensive trauma patients treated with HSD with significant reductions in mortality found for patients with blood pressure cardiac output. There is some evidence that HBOCs more efficiently unload oxygen from plasma hemoglobin as well as facilitate RBC unloading. We analyzed one volunteer study, 15 intraoperative trials, and 3 trauma studies using HBOCs. Perioperative studies generally suggest ability to deliver oxygen, but one trauma trial using HBOCs (HemAssist) for treatment of trauma resulted in a dramatic increase in mortality, while an intraoperative trauma study using Polyheme demonstrated reductions in blood use and lower mortality compared to historic controls of patients refusing blood. Transfusion reductions with HBOC use have been modest. Two HBOCs (Hemopure and Polyheme) are now in new or planned large-scale multicenter prehospital trials of trauma treatment. A new

  10. Fatores que afetam a ventilação com o reanimador manual autoinflável: uma revisão sistemática Factors affecting manual resuscitator use: a systematic review

    Directory of Open Access Journals (Sweden)

    Pricila Mara N. de Oliveira

    2011-12-01

    a device that provides positive pressure ventilation. Surveys conducted to assess the adequacy of manual resuscitators to American Society for Testing and Materials standards show that several factors affect manual ventilation. However, results are conflicting. The aim of this study was to verify evidence of factors that influence pediatric/adult pulmonary ventilation with manual resuscitator by a systematic review. DATA SOURCE: Original articles indexed in Medline, Lilacs and SciELO published from January 1986 to March 2011. The key-words used were: "manual resuscitator", "manual ventilation", "positive pressure ventilation" in Portuguese and English, as well as "bag-valve". DATA SYNTHESIS: 45 articles were selected, most of them experimental. The studies compared manual resuscitator brands and models, and analyzed the physical characteristics of professionals. The effectiveness of ventilation with manual resuscitator depends on the brand, model and functional characteristics of the equipment. Ventilation also varies with the education, training and experience of the professional who handles the equipment. Other factors that can influence effectiveness are the manual resuscitator compression form, the use of a pressure relief valve and the flow of oxygen provided to the manual resuscitator. CONCLUSIONS: The variability of ventilatory parameters during manual resuscitation does not allow a standardization of the technique, being harmful to cardiopulmonary resuscitation. Although most manual resuscitator seem to follow international standards, the equipment must be evaluated in the clinical settings. There are few studies about pediatric and neonatal manual resuscitator models.

  11. Family presence during cardiopulmonary resuscitation: who should decide?

    Science.gov (United States)

    Lederman, Zohar; Garasic, Mirko; Piperberg, Michelle

    2014-05-01

    Whether to allow the presence of family members during cardiopulmonary resuscitation (CPR) has been a highly contentious topic in recent years. Even though a great deal of evidence and professional guidelines support the option of family presence during resuscitation (FPDR), many healthcare professionals still oppose it. One of the main arguments espoused by the latter is that family members should not be allowed for the sake of the patient's best interests, whether it is to increase his chances of survival, respect his privacy or leave his family with a last positive impression of him. In this paper, we examine the issue of FPDR from the patient's point of view. Since the patient requires CPR, he is invariably unconscious and therefore incompetent. We discuss the Autonomy Principle and the Three-Tiered process for surrogate decision making, as well as the Beneficence Principle and show that these are limited in providing us with an adequate tool for decision making in this particular case. Rather, we rely on a novel principle (or, rather, a novel specification of an existing principle) and a novel integrated model for surrogate decision making. We show that this model is more satisfactory in taking the patient's true wishes under consideration and encourages a joint decision making process by all parties involved. PMID:23557910

  12. New tools for optimizing fluid resuscitation in acute pancreatitis

    Science.gov (United States)

    Bortolotti, Perrine; Saulnier, Fabienne; Colling, Delphine; Redheuil, Alban; Preau, Sebastien

    2014-01-01

    Acute pancreatitis (AP) is a frequent disease with degrees of increasing severity responsible for high morbidity. Despite continuous improvement in care, mortality remains significant. Because hypovolemia, together with microcirculatory dysfunction lead to poor outcome, fluid therapy remains a cornerstone of the supportive treatment. However, poor clinical evidence actually support the aggressive fluid therapy recommended in recent guidelines since available data are controversial. Fluid management remains unclear and leads to current heterogeneous practice. Different strategies may help to improve fluid resuscitation in AP. On one hand, integration of fluid therapy in a global hemodynamic resuscitation has been demonstrated to improve outcome in surgical or septic patients. Tailored fluid administration after early identification of patients with high-risk of poor outcome presenting inadequate tissue oxygenation is a major part of this strategy. On the other hand, new decision parameters have been developed recently to improve safety and efficiency of fluid therapy in critically ill patients. In this review, we propose a personalized strategy integrating these new concepts in the early fluid management of AP. This new approach paves the way to a wide range of clinical studies in the field of AP. PMID:25473163

  13. Age-related changes in chest geometry during cardiopulmonary resuscitation.

    Science.gov (United States)

    Dean, J M; Koehler, R C; Schleien, C L; Michael, J R; Chantarojanasiri, T; Rogers, M C; Traystman, R J

    1987-06-01

    We studied alterations of chest geometry during conventional cardiopulmonary resuscitation in anesthetized immature swine. Pulsatile force was applied to the sternum in increments to determine the effects of increasing compression on chest geometry and intrathoracic vascular pressures. In 2-wk- and 1-mo-old piglets, permanent changes in chest shape developed due to incomplete recoil of the chest along the anteroposterior axis, and large intrathoracic vascular pressures were generated. In 3-mo-old animals, permanent chest deformity did not develop, and large intrathoracic vascular pressures were not produced. We propose a theoretical model of the chest as an elliptic cylinder. Pulsatile displacement along the minor axis of an ellipse produces a greater decrease in cross-sectional area than displacement of a circular cross section. As thoracic cross section became less circular due to deformity, greater changes in thoracic volume, and hence pressure, were produced. With extreme deformity at high force, pulsatile displacement became limited, diminishing pressure generation. We conclude that changes in chest geometry are important in producing intrathoracic intravascular pressure during conventional cardiopulmonary resuscitation in piglets. PMID:3610916

  14. Interactive Graphic Simulation: An Advanced Methodology to Improve the Teaching-Learning Process in Nuclear Engineering Education and Training

    OpenAIRE

    Ahnert Iglesias, Carolina; Cuervo Gómez, Diana; García Herranz, Nuria; Cabellos de Francisco, Oscar Luis; Gallego Díaz, Eduardo F.; Mínguez Torres, Emilio; Lorente, A; Piedra, David; Rebollo, Luis; J Blanco

    2011-01-01

    Nowadays, computer simulators are becoming basic tools for education and training in many engineering fields. In the nuclear industry, the role of simulation for training of operators of nuclear power plants is also recognized of the utmost relevance. As an example, the International Atomic Energy Agency sponsors the development of nuclear reactor simulators for education, and arranges the supply of such simulation programs. Aware of this, in 2008 Gas Natural Fenosa, a Spanish gas...

  15. Neonatal resuscitation 3: manometer use in a model of face mask ventilation

    Science.gov (United States)

    O'Donnell, C; Davis, P; Lau, R; Dargaville, P; Doyle, L; Morley, C

    2005-01-01

    Background: Adequate ventilation is the key to successful neonatal resuscitation. Positive pressure ventilation (PPV) is initiated with manual ventilation devices via face masks. These devices may be used with a manometer to measure airway pressures delivered. The expiratory tidal volume measured at the mask (VTE(mask)) is a good estimate of the tidal volume delivered during simulated neonatal resuscitation. Aim: To assess the effect of viewing a manometer on the peak inspiratory pressures used, the volume delivered, and leakage from the face mask during PPV with two manual ventilation devices in a model of neonatal resuscitation. Methods: Participants gave PPV to a modified resuscitation mannequin using a Laerdal infant resuscitator and a Neopuff infant resuscitator at specified pressures ensuring adequate chest wall excursion. Each participant gave PPV to the mannequin with each device twice, viewing the manometer on one occasion and unable to see the manometer on the other. Data from participants were averaged for each device used with the manometer and without the manometer separately. Results: A total of 7767 inflations delivered by the 18 participants were recorded and analysed. Peak inspiratory pressures delivered were lower with the Laerdal device. There were no differences in leakage from the face mask or volumes delivered. Whether or not the manometer was visible made no difference to any measured variable. Conclusions: Viewing a manometer during PPV in this model of neonatal resuscitation does not affect the airway pressure or tidal volumes delivered or the degree of leakage from the face mask. PMID:15871988

  16. Closed-loop and decision-assist resuscitation of burn patients.

    Science.gov (United States)

    Salinas, Jose; Drew, Guy; Gallagher, James; Cancio, Leopoldo C; Wolf, Steven E; Wade, Charles E; Holcomb, John B; Herndon, David N; Kramer, George C

    2008-04-01

    Effective resuscitation is critical in reducing mortality and morbidity rates of patients with acute burns. To this end, guidelines and formulas have been developed to define infusion rates and volume requirements during the first 48 hours postburn. Even with these standardized resuscitation guidelines, however, over- and under-resuscitation are not uncommon. Two approaches to adjust infusion rate are decision-assist and closed-loop algorithms based on levels of urinary output. Specific decision assist guidelines or a closed-loop system using computer-controlled feedback technology that supplies automatic control of infusion rates can potentially achieve better control of urinary output. In a properly designed system, closed-loop control has the potential to provide more accurate titration rates, while lowering the incidence of over- and under-resuscitation. Because the system can self-adjust based on monitoring inputs, the technology can be pushed to environments such as combat zones where burn resuscitation expertise is limited. A closed-loop system can also assist in the management of mass casualties, another scenario in which medical expertise is often in short supply. This article reviews the record of fluid balance of contemporary burn resuscitation and approaches, as well as the engineering efforts, animal studies, and algorithm development of our most recent autonomous systems for burn resuscitation. PMID:18385584

  17. New guidelines for cardiopulmonary resuscitation Nuevas directrices para la resucitación cardiopulmonar Novas diretrizes da ressuscitação cardiopulmonar

    Directory of Open Access Journals (Sweden)

    Maria Celia Barcellos Dalri

    2008-12-01

    Full Text Available Cardiopulmonary arrest (CPA poses a severe threat to life; cardiopulmonary resuscitation (CPR represents a challenge for research and assessment by nurses and their team. This study presents the most recent international recommendations for care in case of cardiopulmonary heart arrest, based on the 2005 Guidelines by the American Heart Association (AHA. These CPR guidelines are based on a large-scale review process, organized by the International Liaison Committee on Resuscitation (ILCOR. High-quality basic and advanced CPR maneuvers can save lives.La parada cardiorrespiratoria (PCR es una ocurrencia que presenta una grave amenaza a la vida; la resucitación cardiopulmonar (RCP representa un desafío para la investigación y la evaluación por parte del enfermero y su equipo. Este estudio presenta las más recientes recomendaciones internacionales sobre la atención a la parada cardiorrespiratoria, basada en las Directrices de 2005 de la American Heart Asociation (AHA. Esas directrices sobre RCP se fundamentan en un proceso de revisión extenso, organizado por el International Liasion Committee on Resuscitation (ILCOR. Las maniobras básicas y avanzadas de RCP ofrecidas con calidad pueden salvar vidas.A parada cardiorrespiratória (PCR é intercorrência de grave ameaça à vida; a ressuscitação cardiopulmonar (RCP representa desafio para a investigação e a avaliação por parte do enfermeiro e sua equipe. Esse estudo apresenta as mais recentes recomendações internacionais sobre atendimento da parada cardiorrespiratória, baseado nas Diretrizes de 2005 da American Heart Association (AHA. Essas diretrizes sobre RCP fundamentam-se num processo de revisão extenso, organizado pelo International Liasion Committee on Resuscitation (ILCOR. As manobras básicas e avançadas de RCP com qualidade podem salvar vidas.

  18. Cardio-pulmonary resuscitation challenges in selected Botswana hospitals: Nurse managers’ views

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    Lakshmi Rajeswaran

    2013-05-01

    Full Text Available Road traffic accident victims, as well as persons experiencing cardiac and other medical emergencies, might lose their lives due to the non-availability of trained personnel to provide effective cardio-pulmonary resuscitation (CPR with functional equipment and adequate resources.The objectives of the study were to identify unit managers’ perceptions about challenges encountered when performing CPR interventions in the two referral public hospitals in Botswana. These results could be used to recommend more effective CPR strategies for Botswana’s hospitals. Interviews, comprising two quantitative sections with closed ended questions and one qualitative section with semi-structured questions, were conducted with 22 unit managers. The quantitative data indicated that all unit managers had at least eight years’ nursing experience, and could identify CPR shortcomings in their hospitals. Only one interviewee had never performed CPR. The qualitative data analysis revealed that the hospital units sometimes had too few staff members and did not have fully equipped emergency trolleys and/or equipment. No CPR teams and no CPR policies and guidelines existed. Nurses and doctors reportedly lacked CPR knowledge and skills. No debriefing services were provided after CPR encounters. The participating hospitals should address the following challenges that might affect CPR outcomes: shortages of staff, overpopulation of hospital units, shortcomings of the emergency trolleys and CPR equipment, absence of CPR policies and guidelines, absence of CPR teams, limited CPR competencies of doctors and nurses and the lack of debriefing sessions after CPR attempts.

  19. Factors affecting the quality of cardiopulmonary resuscitation in inpatient units: perception of nurses

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    Clairton Marcos Citolino Filho

    2015-12-01

    Full Text Available Abstract OBJECTIVE To identify, in the perception of nurses, the factors that affect the quality of cardiopulmonary resuscitation (CPR in adult inpatient units, and investigate the influence of both work shifts and professional experience length of time in the perception of these factors. METHOD A descriptive, exploratory study conducted at a hospital specialized in cardiology and pneumology with the application of a questionnaire to 49 nurses working in inpatient units. RESULTS The majority of nurses reported that the high number of professionals in the scenario (75.5%, the lack of harmony (77.6% or stress of any member of staff (67.3%, lack of material and/or equipment failure (57.1%, lack of familiarity with the emergency trolleys (98.0% and presence of family members at the beginning of the cardiopulmonary arrest assistance (57.1% are factors that adversely affect the quality of care provided during CPR. Professional experience length of time and the shift of nurses did not influence the perception of these factors. CONCLUSION The identification of factors that affect the quality of CPR in the perception of nurses serves as parameter to implement improvements and training of the staff working in inpatient units.

  20. A simple accurate chest-compression depth gauge using magnetic coils during cardiopulmonary resuscitation

    Science.gov (United States)

    Kandori, Akihiko; Sano, Yuko; Zhang, Yuhua; Tsuji, Toshio

    2015-12-01

    This paper describes a new method for calculating chest compression depth and a simple chest-compression gauge for validating the accuracy of the method. The chest-compression gauge has two plates incorporating two magnetic coils, a spring, and an accelerometer. The coils are located at both ends of the spring, and the accelerometer is set on the bottom plate. Waveforms obtained using the magnetic coils (hereafter, "magnetic waveforms"), which are proportional to compression-force waveforms and the acceleration waveforms were measured at the same time. The weight factor expressing the relationship between the second derivatives of the magnetic waveforms and the measured acceleration waveforms was calculated. An estimated-compression-displacement (depth) waveform was obtained by multiplying the weight factor and the magnetic waveforms. Displacements of two large springs (with similar spring constants) within a thorax and displacements of a cardiopulmonary resuscitation training manikin were measured using the gauge to validate the accuracy of the calculated waveform. A laser-displacement detection system was used to compare the real displacement waveform and the estimated waveform. Intraclass correlation coefficients (ICCs) between the real displacement using the laser system and the estimated displacement waveforms were calculated. The estimated displacement error of the compression depth was within 2 mm (ICCs (two springs and a manikin) were above 0.85 (0.99 in the case of one of the springs). The developed simple chest-compression gauge, based on a new calculation method, provides an accurate compression depth (estimation error < 2 mm).

  1. Knowledge and attitudes towards cardiopulmonary resuscitation among university students in Riyadh, Saudi Arabia

    International Nuclear Information System (INIS)

    Objective was to assess the knowledge and attitudes towards cardiopulmonary resuscitation (CPR) among the students of King Saud University. This study was a cross sectional survey among King Saud University students, Riyadh, Kingdom of Saudi Arabia, which took place on December 17-20, 2006. The data was collected from self-administered questionnaires prepared in Arabic. The questionnaires were distributed to all 15 colleges of the university. Out of a study sample of 2250 students, 31% did not have prior CPR information. Of those with previous knowledge, 85% feel that it is inadequate. The most common sources of information were television and movies. The 12.7% of individuals encountered a situation that required the use of CPR. However, 14% of them performed it. This was mostly due to lack of knowledge (42.8%). Eighty-eight percent of students would like to learn how to perform CPR. Out of all King Saud University students, 45% believe that CPR training should be a graduation requirement. It was found that overall attitude towards CPR was positive. However, the knowledge on the topic was insufficient. Thus, more focus should be placed on the improvement of CPR skills. In addition, more studies are needed to assess knowledge and attitudes towards CPR in the community. (author)

  2. Impact of hemoglobin nitrite to nitric oxide reductase on blood transfusion for resuscitation from hemorrhagic shock

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    Chad Brouse

    2015-01-01

    Full Text Available Background: Transfusion of blood remains the gold standard for fluid resuscitation from hemorrhagic shock. Hemoglobin (Hb within the red blood cell transports oxygen and modulates nitric oxide (NO through NO scavenging and nitrite reductase. Aims: This study was designed to examine the effects of incorporating a novel NO modulator, RRx-001, on systemic and microvascular hemodynamic response after blood transfusion for resuscitation from hemorrhagic shock in a hamster window chamber model. In addition, to RRx-001 the role of low dose of nitrite (1 × 10−9 moles per animal supplementation after resuscitation was studied. Materials and Methods: Severe hemorrhage was induced by arterial controlled bleeding of 50% of the blood volume (BV and the hypovolemic state was maintained for 1 h. The animals received volume resuscitation by an infusion of 25% of BV using fresh blood alone or with added nitrite, or fresh blood treated with RRx-001 (140 mg/kg or RRx-001 (140 mg/kg with added nitrite. Systemic and microvascular hemodynamics were followed at baseline and at different time points during the entire study. Tissue apoptosis and necrosis were measured 8 h after resuscitation to correlate hemodynamic changes with tissue viability. Results: Compared to resuscitation with blood alone, blood treated with RRx-001 decreased vascular resistance, increased blood flow and functional capillary density immediately after resuscitation and preserved tissue viability. Furthermore, in RRx-001 treated animals, both mean arterial pressure (MAP and met Hb were maintained within normal levels after resuscitation (MAP >90 mmHg and metHb <2%. The addition of nitrite to RRx-001 did not significantly improve the effects of RRx-001, as it increased methemoglobinemia and lower MAP. Conclusion: RRx-001 alone enhanced perfusion and reduced tissue damage as compared to blood; it may serve as an adjunct therapy to the current gold standard treatment for resuscitation from

  3. Fluid resuscitation protocols for burn patients at intensive care units of the United Kingdom and Ireland

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    Al-Benna, Sammy

    2011-01-01

    Full Text Available Introduction: The objective of this study was to determine the thermal injury fluid resuscitation protocols at intensive care units (ICUs in the United Kingdom and Ireland. Materials and methods: A telephone questionnaire was designed to survey the fluid resuscitation protocols of ICUs at all hospitals with plastic/burn surgery departments in the British Isles in 2010. The feedback from the questionnaire was from the senior nurse in charge of the ICUs. Results: 32/64 (50% of these ICUs had provided care to burns patients. A 100% response from these 32 units was obtained. 71.4% commence fluid resuscitation at 15% total body surface area burn (TBSA, 21.4% at 20% TBSA and 7.1% at 10% TBSA in adults. The estimated resuscitation volume was most often calculated using the Parkland/Modified Parkland formula (87.5% or the Muir and Barclay formula (12.5%. Interestingly, of the ICUs using formulae, two had recently moved from using the Muir and Barclay formula to Parkland formula and one had recently moved from using the Parkland formula to Muir and Barclay formula. Despite this, 37.5% of ICUs using a formula did not rigidly follow it exactly. The most commonly used resuscitation fluid was Ringer’s lactate solution (46.9% and Human Albumin Solution was used in 12.5%. No ICU used red cell concentrate as a first line fluid. 18.8% used a central line. 40.6% ICUs considered changing the IV solution during resuscitation. 78.1% ICUs consider urine output to be the most important factor in modifying resuscitation volumes. 59.4% ICUs calculate a maintenance fluid rate after completion of resuscitation. The endpoint for resuscitation was at 24 h in 46.9% ICUs and at 36 h in 9.4%. 5/32 (16% felt their protocol gave too little and 6/32 (19% felt their protocol gave too much. 59.3% ICUs gave oral/enteral fluids by naso-gastric or naso-jejenal tubes. 21.9% felt that oral/enteral resuscitation worked. Exactly half of the units believed that the formula that they used

  4. Role of emergency thoracotomy in the resuscitation of moribund trauma victims: 100 consecutive cases.

    Science.gov (United States)

    Harnar, T J; Oreskovich, M R; Copass, M K; Heimbach, D M; Herman, C M; Carrico, C J

    1981-07-01

    (1) Emergency thoracotomy can be a lifesaving procedure in critically injured patients who present with no detectable pulse or blood pressure. (2) Emergency thoracotomy is nonproductive if cardiac electrical activity is absent. (3) Best results are achieved in patients with chest injuries and the worst results in those with isolated blunt abdominal injury. (4) Survival was better if patient was taken directly to the operating room with ongoing cardiopulmonary resuscitation. (5) Prehospital airway control, volume resuscitation and cardiopulmonary resuscitation play a significant role in improving the outcome in traumatized patients who undergo emergency thoracotomy. PMID:7258520

  5. Novel Approaches to Neonatal Resuscitation and the Impact on Birth Asphyxia.

    Science.gov (United States)

    Te Pas, Arjan B; Sobotka, Kristina; Hooper, Stuart B

    2016-09-01

    Historically, recommendations for neonatal resuscitation were largely based on dogma, but there is renewed interest in performing resuscitation studies at birth. The emphasis for resuscitation following birth asphyxia is administering effective ventilation, as adequate lung aeration leads not only to an increase in oxygenation but also increased pulmonary blood flow and heart rate. To aerate the lung, an initial sustained inflation can increase heart rate, oxygenation, and blood pressure recovery much faster when compared with standard ventilation. Hyperoxia should be avoided, and extra oxygen given to restore cardiac function and spontaneous breathing should be titrated based on oxygen saturations. PMID:27524447

  6. Advancing Tobacco Dependence Treatment Services in the Eastern Mediterranean Region: International collaboration for training and capacity-building

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    Feras I. Hawari

    2014-10-01

    Full Text Available Tobacco use negatively affects health and is a major risk factor for non-communicable diseases (NCDs. Today, tobacco use ranks third among risk factors in North Africa and the Middle East in terms of disease burden. Despite the established need for these services, tobacco dependence treatment (TDT services are still inadequate in the Eastern Mediterranean region (EMR. Among the main challenges hindering their expansion is the current lack of training opportunities. The provision of training and capacity-building—a key enabler of TDT—offers an excellent catalyst to launch TDT services in the region. This review discusses the need for TDT training in the EMR and describes a model for providing regional evidence-based training in line with international standards. The King Hussein Cancer Center in Amman, Jordan, is the regional host for Global Bridges, a worldwide TDT initiative. Using this model, they have trained 1,500 professionals and advocates from the EMR over the past three years.

  7. Evaluation of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses: a non-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kaitani T

    2015-02-01

    Full Text Available Toshiko Kaitani,1 Gojiro Nakagami,2 Junko Sugama,3 Masahiro Tachi,4 Yutaka Matsuyama,5 Yoshiki Miyachi,6 Takashi Nagase,2 Yukie Takemura,7 Hiromi Sanada2 1School of Nursing, Sapporo City University, Hokkaido, Japan; 2Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 3Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan; 4Department of Plastic Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan; 5Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 6Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan; 7Department of Nursing, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan Aims and objectives: We investigated the effectiveness and safety of an advanced pressure ulcer (PU management protocol comprising 1 ultrasonography to assess the deep tissue, 2 use of a non-contact thermometer to detect critical colonization, 3 conservative sharp debridement, 4 dressing selection, 5 negative pressure wound therapy, and 6 vibration therapy in comparison with those of a conventional approach. Each protocol was followed by trained wound, ostomy, and continence nurses (WOCNs. Background: At present, there is no systematic PU management protocol for nurses that includes appropriate assessment and intervention techniques for deep tissue injury and critical colonization. In Japan, there is no such protocol that the nurses can follow without a physician’s orders. Design and methods: This was a prospective non-randomized controlled trial. Over a 3-week period, we evaluated the effectiveness of an advanced protocol by comparing the PU severity and healing on the basis of the DESIGN-R scale and presence of patients' discomfort. We recruited ten WOCNs to follow

  8. Manual versus mechanical cardiopulmonary resuscitation. An experimental study in pigs

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    Wohlfart Björn

    2010-10-01

    Full Text Available Abstract Background Optimal manual closed chest compressions are difficult to give. A mechanical compression/decompression device, named LUCAS, is programmed to give compression according to the latest international guidelines (2005 for cardiopulmonary resuscitation (CPR. The aim of the present study was to compare manual CPR with LUCAS-CPR. Methods 30 kg pigs were anesthetized and intubated. After a base-line period and five minutes of ventricular fibrillation, manual CPR (n = 8 or LUCAS-CPR (n = 8 was started and run for 20 minutes. Professional paramedics gave manual chest compression's alternating in 2-minute periods. Ventilation, one breath for each 10 compressions, was given to all animals. Defibrillation and, if needed, adrenaline were given to obtain a return of spontaneous circulation (ROSC. Results The mean coronary perfusion pressure was significantly (p Conclusions LUCAS-CPR gave significantly higher coronary perfusion pressure and significantly fewer rib fractures than manual CPR in this porcine model.

  9. Cardiopulmonary resuscitation in the elderly: a clinical and ethical perspective

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The daily practice of cardiopulmonary resuscitation (CPR) in elderly patients has brought up the attention of outcome research and resource allocation. Determinants to predict survival have been well identified. There has been empirical evidence that CPR is of doubtful utility in the geriatric population, more studies have showed controversial data. Sometimes situations in which CPR needs to be given in the elderly, causes stress to healthcare providers, due to lack of communication of the patient's wishes and the belief that it will not be successful. It is of importance to state that we have the duty to identify on time the patients that will most likely benefit from CPR, and find out the preferences of the same. Whenever it is possible to institute these guidelines, we will avoid patient suffering.

  10. Coronary blood flow during cardiopulmonary resuscitation in swine

    International Nuclear Information System (INIS)

    Recent papers have raised doubt as to the magnitude of coronary blood flow during closed-chest cardiopulmonary resuscitation. We will describe experiments that concern the methods of coronary flow measurement during cardiopulmonary resuscitation. Nine anesthetized swine were instrumented to allow simultaneous measurements of coronary blood flow by both electromagnetic cuff flow probes and by the radiomicrosphere technique. Cardiac arrest was caused by electrical fibrillation and closed-chest massage was performed by a Thumper (Dixie Medical Inc., Houston). The chest was compressed transversely at a rate of 66 strokes/min. Compression occupied one-half of the massage cycle. Three different Thumper piston strokes were studied: 1.5, 2, and 2.5 inches. Mean aortic pressure and total systemic blood flow measured by the radiomicrosphere technique increased as Thumper piston stroke was lengthened (mean +/- SD): 1.5 inch stroke, 23 +/- 4 mm Hg, 525 +/- 195 ml/min; 2 inch stroke, 33 +/- 5 mm Hg, 692 +/- 202 ml/min; 2.5 inch stroke, 40 +/- 6 mm Hg, 817 +/- 321 ml/min. Both methods of coronary flow measurement (electromagnetic [EMF] and radiomicrosphere [RMS]) gave similar results in technically successful preparations (data expressed as percent prearrest flow mean +/- 1 SD): 1.5 inch stroke, EMF 12 +/- 5%, RMS 16 +/- 5%; 2 inch stroke, EMF 30 +/- 6%, RMS 26 +/- 11%; 2.5 inch stroke, EMF 50 +/- 12%, RMS 40 +/- 20%. The phasic coronary flow signal during closed-chest compression indicated that all perfusion occurred during the relaxation phase of the massage cycle. We concluded that coronary blood flow is demonstrable during closed-chest massage, but that the magnitude is unlikely to be more than a fraction of normal

  11. A cross-sectional study on awareness and perception about basic life support/cardio-pulmonary resuscitation among undergraduate medical students from coastal South India

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    HN Harsha Kumar

    2013-07-01

    Full Text Available Background: Basic Life Support (BLS/Cardiopulmonary Resuscitation (CPR is an important part of emergency medical care. This study is done among medical undergraduate students, to know their knowledge and perceptions about BLS, as they are going to face such situations in future, as doctors. Materials and Methods: A questionnaire-based study was conducted among 377 medical undergraduate students. The questionnaire included the following parts: (1 Basic characteristics of the study participants, (2 Knowledge about BLS/CPR, (3 Perceptions about BLS/CPR. The components of knowledge and perception based questions were scored. The data was analyzed using SPSS version 12. Results were expressed as proportions in appropriate tables and graphs. Student's Independent 't' test was used to compare means between students who had undergone previous training if any and those who had no such training. Results: Out of 377 students, majority (84.6% had heard of BLS/CPR. Some of them (30.6% could give the correct order of performing CPR as per the AHA guidelines (Year 2010. Few (18.9% had undergone prior training in BLS, whereas, only 17.7% had been in a situation that needed BLS/CPR. Nearly half (50.2% were not confident of performing BLS/CPR. Comparison of the students revealed that students who had training had higher mean scores for 'response to a situation needing BLS/CPR' and 'signs of successful resuscitation', though there was little difference in their knowledge of 'indications for BLS/CPR. Overall perception was not favourable and the students were not confident of performing BLS/CPR. Conclusions: The students need to be taught and trained in the CPR/BLS early in the curriculum to improve their knowledge. Repeated training would increase their confidence.

  12. 34 CFR 350.12 - What are the general requirements for an Advanced Rehabilitation Research Training Project?

    Science.gov (United States)

    2010-07-01

    ... setting, and a practicum that involve each individual in clinical research and in practical activities... Rehabilitation Research Training Project? 350.12 Section 350.12 Education Regulations of the Offices of the... EDUCATION DISABILITY AND REHABILITATION RESEARCH PROJECTS AND CENTERS PROGRAM What Projects Does...

  13. Changing attitudes to cardiopulmonary resuscitation in older people: a 15-year follow-up study.

    LENUS (Irish Health Repository)

    Cotter, P E

    2009-03-01

    while it is well established that individual patient preferences regarding cardiopulmonary resuscitation (CPR) may change with time, the stability of population preferences, especially during periods of social and economic change, has received little attention.

  14. "In the beginning...": tools for talking about resuscitation and goals of care early in the admission.

    Science.gov (United States)

    White, Jocelyn; Fromme, Erik K

    2013-11-01

    Quality standards no longer allow physicians to delay discussing goals of care and resuscitation. We propose 2 novel strategies for discussing goals and resuscitation on admission. The first, SPAM (determine Surrogate decision maker, determine resuscitation Preferences, Assume full care, and advise them to expect More discussion especially with clinical changes), helps clinicians discover patient preferences and decision maker during routine admissions. The second, UFO-UFO (Understand what they know, Fill in knowledge gaps, ask about desired Outcomes, Understand their reasoning, discuss the spectrum Feasible Outcomes), helps patients with poor or uncertain prognosis or family-team conflict. Using a challenging case example, this article illustrates how SPAM and UFO-UFO can help clinicians have patient-centered resuscitation and goals of care discussions at the beginning of care. PMID:23236089

  15. Failed resuscitation in acute severe asthma: a medical indication for emergency thoracotomy?

    OpenAIRE

    Diament, R H; Sloan, J P

    1987-01-01

    A case is reported in which a 32-year-old man who had a cardiac arrest secondary to acute severe asthma was successfully resuscitated following an emergency thoracotomy when conventional external measures failed.

  16. Management of cardiac arrest in the community: a survey of resuscitation services.

    OpenAIRE

    Jones, R. H.

    1983-01-01

    A survey of the English health regions identified nine ambulance based resuscitation schemes. Their structure and function are heterogeneous and their impact on patient survival is often speculative. There is considerable medical, paramedical, and lay enthusiasm for resuscitation schemes but this cannot be harnessed until medicolegal uncertainties are removed and guidelines for development are set out. Better documentation of the benefits of existing schemes should be undertaken so that advan...

  17. Cardiac arrest teams and time of day: effects on surviving in-hospital resuscitation

    OpenAIRE

    Christ M; Dierschke W; von Auenmueller KI; van Bracht M; Grett M; Trappe HJ

    2014-01-01

    Martin Christ, Wolfgang Dierschke, Katharina Isabel von Auenmueller, Marc van Bracht, Martin Grett, Hans-Joachim Trappe Department of Cardiology and Angiology, Marienhospital Herne, Ruhr – University Bochum, Herne, Germany Objectives: Little is known about the factors that influence survival following in-hospital resuscitation, but previous investigations have suggested that in-hospital resuscitations outside of regular working hours are associated with worse survival rates. Materi...

  18. Albumin in Burn Shock Resuscitation: A Meta-Analysis of Controlled Clinical Studies

    OpenAIRE

    Navickis, Roberta J.; Greenhalgh, David G; Wilkes, Mahlon M.

    2016-01-01

    Critical appraisal of outcomes after burn shock resuscitation with albumin has previously been restricted to small relatively old randomized trials, some with high risk of bias. Extensive recent data from nonrandomized studies assessing the use of albumin can potentially reduce bias and add precision. The objective of this meta-analysis was to determine the effect of burn shock resuscitation with albumin on mortality and morbidity in adult patients. Randomized and nonrandomized controlled cli...

  19. Cardiopulmonary resuscitation quality and beyond: the need to improve real-time feedback and physiologic monitoring

    OpenAIRE

    Lin, Steve; Scales, Damon C.

    2016-01-01

    High-quality cardiopulmonary resuscitation (CPR) has been shown to improve survival outcomes after cardiac arrest. The current standard in studies evaluating CPR quality is to measure CPR process measures—for example, chest compression rate, depth, and fraction. Published studies evaluating CPR feedback devices have yielded mixed results. Newer approaches that seek to optimize CPR by measuring physiological endpoints during the resuscitation may lead to individualized patient care and improve...

  20. 1. Predictors of cardio pulmonary resuscitation outcome in post-operative cardiac children

    OpenAIRE

    Nasser, B.

    2016-01-01

    Outcome of cardiopulmonary resuscitation (CPR) in children with congenital heart disease has improved and many children survived after in hospital cardiac arrestthe purpose of this study is to determine predictor of poor outcome after CPR in critical children undergoing cardiac surgerywe conducted a retrospective chart review and data analysis of all CPR records and charts of all postoperative cardiac children who had cardiac arrest and required resuscitation from 2012 till 2015. Demographic,...

  1. Resuscitation prior to emergency endotracheal intubation: results of a national survey

    OpenAIRE

    Green, Robert S.; Fergusson, Dean A; Turgeon, Alexis F; McIntyre, Lauralyn A; Kovacs, George J.; Griesdale, Donald E.; Zarychanski, Ryan; Butler, Michael B.; Kureshi, Nelofar; Erdogan, Mete

    2016-01-01

    Introduction: Respiratory failure is a common problem in emergency medicine (EM) and critical care medicine (CCM). However, little is known about the resuscitation of critically ill patients prior to emergency endotracheal intubation (EETI). Our aim was to describe the resuscitation practices of EM and CCM physicians prior to EETI. Methods: A cross-sectional survey was developed and tested for content validity and retest reliability by members of the Canadian...

  2. Avoiding hyperoxemia during neonatal resuscitation: time to response of different SpO2 monitors

    OpenAIRE

    Baquero, Hernando; Alviz, Ramiro; Castillo, Armando; Neira, Fredy; Sola, Augusto

    2011-01-01

    Aim To assess the time to obtain reliable oxygen saturation readings by different pulse oximeters during neonatal resuscitation in the delivery room or NICU. Methods Prospective study comparing three different pulse oximeters: Masimo Radical-7 compared simultaneously with Ohmeda Biox 3700 or with Nellcor N395, in newborn infants who required resuscitation. Members of the research team placed the sensors for each of the pulse oximeters being compared simultaneously, one sensor on each foot of ...

  3. Causes of death after fluid bolus resuscitation: new insights from FEAST

    OpenAIRE

    Myburgh, John; Finfer, Simon

    2013-01-01

    The Fluid Expansion as Supportive Therapy (FEAST study) was an extremely well conducted study that gave unexpected results. The investigators had reported that febrile children with impaired perfusion treated in low-income countries without access to intensive care are more likely to die if they receive bolus resuscitation with albumin or saline compared with no bolus resuscitation at all. In a secondary analysis of the trial, published in BMC Medicine, the authors found that increased mortal...

  4. Resuscitering av skredoffer: : eit litteraturstudie om patofysiologi og dokumentasjon av dagens anbefalingar

    OpenAIRE

    2011-01-01

    Background and objective Every year, between 100 and 250 people die in snow avalanches in Europe and North America. Rescue missions are dangerous and difficult, and resuscitation of avalanche victims often proves to be non-successful. European Resuscitation Council (ERC) guidelines for 2010 included specific advice concerning avalanche victims. In this student assignment I attempt to describe the pathophysiology and documentation for these guidelines, with special emphasis on time factors, ...

  5. Proposing "the burns suite" as a novel simulation tool for advancing the delivery of burns education.

    Science.gov (United States)

    Sadideen, Hazim; Wilson, David; Moiemen, Naiem; Kneebone, Roger

    2014-01-01

    Educational theory highlights the importance of contextualized simulation for effective learning. We explored this concept in a burns scenario in a novel, low-cost, high-fidelity, portable, immersive simulation environment (referred to as distributed simulation). This contextualized simulation/distributed simulation combination was named "The Burns Suite" (TBS). A pediatric burn resuscitation scenario was selected after high trainee demand. It was designed on Advanced Trauma and Life Support and Emergency Management of Severe Burns principles and refined using expert opinion through cognitive task analysis. TBS contained "realism" props, briefed nurses, and a simulated patient. Novices and experts were recruited. Five-point Likert-type questionnaires were developed for face and content validity. Cronbach's α was calculated for scale reliability. Semistructured interviews captured responses for qualitative thematic analysis allowing for data triangulation. Twelve participants completed TBS scenario. Mean face and content validity ratings were high (4.6 and 4.5, respectively; range, 4-5). The internal consistency of questions was high. Qualitative data analysis revealed that participants felt 1) the experience was "real" and they were "able to behave as if in a real resuscitation environment," and 2) TBS "addressed what Advanced Trauma and Life Support and Emergency Management of Severe Burns didn't" (including the efficacy of incorporating nontechnical skills). TBS provides a novel, effective simulation tool to significantly advance the delivery of burns education. Recreating clinical challenge is crucial to optimize simulation training. This low-cost approach also has major implications for surgical education, particularly during increasing financial austerity. Alternative scenarios and/or procedures can be recreated within TBS, providing a diverse educational immersive simulation experience. PMID:23877145

  6. Comparisons of the Pentax-AWS, Glidescope, and Macintosh Laryngoscopes for Intubation Performance during Mechanical Chest Compressions in Left Lateral Tilt: A Randomized Simulation Study of Maternal Cardiopulmonary Resuscitation

    OpenAIRE

    Sanghyun Lee; Wonhee Kim; Hyunggoo Kang; Jaehoon Oh; Tae Ho Lim; Yoonjae Lee; Changsun Kim; Jun Hwi Cho

    2015-01-01

    Purpose. Rapid advanced airway management is important in maternal cardiopulmonary resuscitation (CPR). This study aimed to compare intubation performances among Pentax-AWS (AWS), Glidescope (GVL), and Macintosh laryngoscope (MCL) during mechanical chest compression in 15° and 30° left lateral tilt. Methods. In 19 emergency physicians, a prospective randomized crossover study was conducted to examine the three laryngoscopes. Primary outcomes were the intubation time and the success rate for i...

  7. Design of a cost-effective, hemodynamically adjustable model for resuscitative endovascular balloon occlusion of the aorta (REBOA) simulation.

    Science.gov (United States)

    Keller, Benjamin A; Salcedo, Edgardo S; Williams, Timothy K; Neff, Lucas P; Carden, Anthony J; Li, Yiran; Gotlib, Oren; Tran, Nam K; Galante, Joseph M

    2016-09-01

    Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct technique for salvaging patients with noncompressible torso hemorrhage. Current REBOA training paradigms require large animals, virtual reality simulators, or human cadavers for acquisition of skills. These training strategies are expensive and resource intensive, which may prevent widespread dissemination of REBOA. We have developed a low-cost, near-physiologic, pulsatile REBOA simulator by connecting an anatomic vascular circuit constructed out of latex and polyvinyl chloride tubing to a commercially available pump. This pulsatile simulator is capable of generating cardiac outputs ranging from 1.7 to 6.8 L/min with corresponding arterial blood pressures of 54 to 226/14 to 121 mmHg. The simulator accommodates a 12 French introducer sheath and a CODA balloon catheter. Upon balloon inflation, the arterial waveform distal to the occlusion flattens, distal pulsation within the simulator is lost, and systolic blood pressures proximal to the balloon catheter increase by up to 62 mmHg. Further development and validation of this simulator will allow for refinement, reduction, and replacement of large animal models, costly virtual reality simulators, and perfused cadavers for training purposes. This will ultimately facilitate the low-cost, high-fidelity REBOA simulation needed for the widespread dissemination of this life-saving technique. PMID:27270855

  8. Education and Training of Future Nuclear Engineers at DIN: From Advanced Computer Codes to an Interactive Plant Simulator.

    OpenAIRE

    Cabellos de Francisco, Oscar Luis; Ahnert Iglesias, Carolina; Cuervo Gómez, Diana; García Herranz, Nuria; Gallego Díaz, Eduardo F.; Mínguez Torres, Emilio; Aragonés Beltrán, José María; Lorente Fillol, Alfredo; Piedra, David

    2010-01-01

    This paper summarizes the work being performed at the Department of Nuclear Engineering (www.din.upm.es) of the Universidad Politécnica de Madrid to improve the education and training of future Spanish nuclear engineers according to the Bologna rules. We present two main efforts introduced in our programme: i) the understanding of the current computational methodologies/codes starting from the nuclear data processing, then the lattice and core calculations codes, and finally the power plant ...

  9. Cardiac arrest teams and time of day: effects on surviving in-hospital resuscitation

    Directory of Open Access Journals (Sweden)

    Christ M

    2014-06-01

    Full Text Available Martin Christ, Wolfgang Dierschke, Katharina Isabel von Auenmueller, Marc van Bracht, Martin Grett, Hans-Joachim Trappe Department of Cardiology and Angiology, Marienhospital Herne, Ruhr – University Bochum, Herne, Germany Objectives: Little is known about the factors that influence survival following in-hospital resuscitation, but previous investigations have suggested that in-hospital resuscitations outside of regular working hours are associated with worse survival rates. Material and methods: In-hospital cardiac arrest teams at our hospital were instructed to complete a questionnaire following every emergency call between July 2011 and June 2013. Data on all resuscitation attempts were collected and analyzed. Results: A total of 65 in-hospital resuscitations were recorded in 42 males (64.6% and 23 females (35.4% (mean age 72.0±14.3 years. A total of 54 (83.1% cardiac arrests were witnessed; seven (10.8% showed a shockable rhythm at the time of the first ECG. Resuscitation attempts lasted 29.3±41.3 minutes, and 4.1±3.1 mg epinephrine was given. Return of spontaneous circulation could be achieved in 38 patients (58.5%; 29 (44.6% survived the first day, 23 (35.4% the seventh day, and 15 patients (23.1% were discharged alive. Significantly more in-hospital resuscitations were obtained for those performed during non-regular working hours (P<0.001, with higher neuron-specific enolase levels at 72 hours after resuscitation during nonregular working hours (P=0.04. Patients who were discharged alive were significantly younger (P=0.01, presented more often with an initial shockable rhythm (P=0.04, and had a shorter duration of resuscitation (P<0.001 with the need of a lower dose of epinephrine (P<0.001. Discussion: Survival rates following in-hospital resuscitation were poor at any time, but appear to depend less on time-dependent effects of the quality of resuscitation and more on time-dependent effects of recognition of cardiac arrests

  10. Impact of manikin based training in intern

    Directory of Open Access Journals (Sweden)

    Dr Pramila Menon,

    2011-03-01

    Full Text Available Introduction: Newborn care is a crucial challenge that is faced by every health professional dealing with maternal and child health. Navjaat Shishu Suraksha Karyakram (NSSK" a simple training module on Basic Newborn Care and Resuscitation using manikins. Training of Doctors, Nurses and ANMs with appropriate knowledge and skill base of neonatal resuscitation is very important to improve the quality of newborn survival. Material and Methods: We conducted NSSK training for interns at Maharashtra University of Health Sciences, Pune Regional Centre. (n= 69 .They were given pre Test which included written evaluation and Performance evaluation Part .The workshop methodology included lecture PowerPoint presentation , demonstration, videos of the same and individual practice . There was introduction and demonstration of performance evaluation (mega code followed by practice performance evaluation (mega code at respective stations .The workshop concluded with post test written test and Performance evaluation test.Results: There were good suggestions and students liked the programme very much. Majority of them expressed their confidence in handling newborns improved after this training and commented about the methodology of training as excellent. They liked the videos, demonstration, systematic and individual approach. The best part of the training was Kangaroo mother care .The participants opined that this type of training given in initial period of internship will be really useful. Conclusion: manikin based workshops along with videos and demonstrations helped the participants to increase the confidence level in handling newborns and also helped in active thinking.

  11. The Effect of Instructional Method on Cardiopulmonary Resuscitation Skill Performance: A Comparison Between Instructor-Led Basic Life Support and Computer-Based Basic Life Support With Voice-Activated Manikin.

    Science.gov (United States)

    Wilson-Sands, Cathy; Brahn, Pamela; Graves, Kristal

    2015-01-01

    Validating participants' ability to correctly perform cardiopulmonary resuscitation (CPR) skills during basic life support courses can be a challenge for nursing professional development specialists. This study compares two methods of basic life support training, instructor-led and computer-based learning with voice-activated manikins, to identify if one method is more effective for performance of CPR skills. The findings suggest that a computer-based learning course with voice-activated manikins is a more effective method of training for improved CPR performance. PMID:26381346

  12. Training program for energy conservation in new-building construction. Volume IV. Energy conservation technology: advanced course for plan examiners

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-12-01

    A Model Code for Energy Conservation in New Building Construction has been developed by those national organizations primarily concerned with the development and promulgation of model codes. The technical provisions are based on ASHRAE Standard 90-75 and are intended for use by state and local officials. This manual contains a more in-depth training in the review techniques and concepts required by the plan examiners and code officials in administering the code for conventional (buildings of 3 stories or less) construction.

  13. Using "The Burns Suite" as a Novel High Fidelity Simulation Tool for Interprofessional and Teamwork Training.

    Science.gov (United States)

    Sadideen, Hazim; Wilson, David; Moiemen, Naiem; Kneebone, Roger

    2016-01-01

    Educational theory highlights the importance of contextualized simulation for effective learning. The authors recently published the concept of "The Burns Suite" (TBS) as a novel tool to advance the delivery of burns education for residents/clinicians. Effectively, TBS represents a low-cost, high-fidelity, portable, immersive simulation environment. Recently, simulation-based team training (SBTT) has been advocated as a means to improve interprofessional practice. The authors aimed to explore the role of TBS in SBTT. A realistic pediatric burn resuscitation scenario was designed based on "advanced trauma and life support" and "emergency management of severe burns" principles, refined utilizing expert opinion through cognitive task analysis. The focus of this analysis was on nontechnical and interpersonal skills of clinicians and nurses within the scenario, mirroring what happens in real life. Five-point Likert-type questionnaires were developed for face and content validity. Cronbach's alpha was calculated for scale reliability. Semistructured interviews captured responses for qualitative thematic analysis allowing for data triangulation. Twenty-two participants completed TBS resuscitation scenario. Mean face and content validity ratings were high (4.4 and 4.7 respectively; range 4-5). The internal consistency of questions was high. Qualitative data analysis revealed two new themes. Participants reported that the experience felt particularly authentic because the simulation had high psychological and social fidelity, and there was a demand for such a facility to be made available to improve nontechnical skills and interprofessional relations. TBS provides a realistic, novel tool for SBTT, addressing both nontechnical and interprofessional team skills. Recreating clinical challenge is crucial to optimize SBTT. With a better understanding of the theories underpinning simulation and interprofessional education, future simulation scenarios can be designed to provide

  14. Emergency room resuscitative thoracotomy: when is it indicated?

    Science.gov (United States)

    Boyd, M; Vanek, V W; Bourguet, C C

    1992-11-01

    This study was designed to examine the results of emergency room resuscitative thoracotomy (ERRT) and to formulate cost-effective indications for this procedure. A retrospective study was performed of 28 patients who had ERRT at St. Elizabeth Hospital Medical Center, Youngstown, Ohio, during the 4 years from July 1985 through June 1989. The prognostic factors analyzed included mechanism and site of injury, signs of life (SOL), vital signs (VS), age, gender, and prehospital care. The overall survival rate of ERRT was 7% (2 of 28 patients). The survival rate was 18% (2 of 11 patients) with penetrating trauma, and 0% (none of 17 patients) with blunt trauma. The best survival rate was 66% in the subgroup of patients with penetrating trauma and SOL present at the scene and in the emergency room (ER), (two of three patients). Our observations were combined with those of 23 studies from the literature involving 2294 trauma patients who had ERRT. Using meta-analysis, the survival rate was 11% overall. Improved survival was noted for patients with penetrating trauma compared with patients with blunt trauma (14% vs. 2%, p ERRTs performed by 41% without decreasing the number of neurologically intact survivors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1464921

  15. Innovative Training Experience for Advancing Entry Level, Mid-Skilled and Professional Level URM Participation in the Geosciences Workforce

    Science.gov (United States)

    Okoro, M. H.; Johnson, A.

    2015-12-01

    The representation of URMs in the U.S. Geosciences workforce remains proportionally low compared to their representation in the general population (Bureau of Labor Sta.s.cs, 2014). Employment in this and related industries is projected to grow 32% by 2030 for minority workers (Gillula and Fullenbaum, 2014), corresponding to an additional 48,000 jobs expected to be filled by minorities (National Research Council, 2014). However, there is a shortage of employees with proper training in the hard sciences (Holeywell, 2014; Ganzglass, 2011), as well as craft skills (Hoover and Duncan, 2013), both important for middle skill employment. Industry recognizes the need for developing and retaining a diverse workforce, therefore we hightlight a program to serve as a potential vanguard initative for developing an innovative training experience for URM and underserved middle skilled workers with essential knowledge, experience and skills necessary to meet the demands of the Geosciences industry's growing need for a safe, productive and diverse workforce. Objectives are for participants to achieve the following: understanding of geosciences workforce trends and associated available opportunities; mastery of key environmental, health and safety topics; improvements in decision making skills and preparedness for responding to potential environmental, health and safety related situations; and engagement in one-on-one coaching sessions focused on resume writing, job interviewing and key "soft skills" (including conflict resolution, problem solving and critical observation, representing 3 major skills that entry- level workers typically lack.

  16. Effect of different resuscitation strategies on post-resuscitation brain damage in a porcine model of prolonged cardiac arrest

    Institute of Scientific and Technical Information of China (English)

    Gu Wei; Hou Xiaomin; Li Chunsheng

    2014-01-01

    Background The choice of a defibrillation or a cardiopulmonary resuscitation (CPR)-first strategy in the treatment of prolonged cardiac arrest (CA) is still controversial.The purpose of this study was to compare the effects of defibrillation or CPR administered first on neurological prognostic markers in a porcine model of prolonged CA.Methods After 8 minutes of untreated ventricular fibrillation (VF),24 inbred Chinese Wuzhishan minipigs were randomized to receive either defibrillation first (ID group,n=12) or chest compression first (IC group,n=12).In the ID group,a shock was delivered immediately.If defibrillation failed to attain restoration of spontaneous circulation (ROSC),manual chest compressions were rapidly initiated at a rate of 100 compressions/min and a compression-to-ventilation ratio of 30:2.If VF persisted after five cycles of CPR,a second defibrillation attempt was made.In the IC group,chest compressions were delivered first,followed by a shock.After successful ROSC,hemodynamic status and blood samples were obtained at 0.5,1,2,4,6,and 24 hours after ROSC.Porcine-specific neuron-specific enolase (NSE) and S100B were measured from sera using enzyme-linked immunosorbent assays.Porcine cerebral performance category scores were used to evaluate preliminary neurological function following 24 hours recovery.Surviving pigs were sacrificed at 24 hours after ROSC and brains were removed for electron microscopy analysis.Results The number of shocks,total defibrillation energy,and time to ROSC were significantly lower in the ID group compared with the IC group.Compared with the IC group,S100B expression was decreased at 2 and 4 hours after ROSC,and NSE expression decreased at 6 and 24 hours after ROSC in the ID group.Brain tissue analysis showed that injury was attenuated in the ID group compared with the IC group.There were no significant differences between 6 and 24 hours survival rates.Conclusion Defibrillation first may result in a shorter time to ROSC and

  17. Minocycline and Doxycycline, but not Tetracycline, Mitigate Liver and Kidney Injury after Hemorrhagic Shock/Resuscitation*

    Science.gov (United States)

    Kholmukhamedov, Andaleb; Czerny, Christoph; Hu, Jiangting; Schwartz, Justin; Zhong, Zhi; Lemasters, John J.

    2014-01-01

    Background Despite recovery of hemodynamics by fluid resuscitation after hemorrhage, development of the systemic inflammatory response and multiple organ dysfunction syndromes can nonetheless lead to death. Minocycline and doxycycline are tetracycline derivatives that are protective in models of hypoxic, ischemic and oxidative stress. Our Aim was to determine whether minocycline and doxycycline protect liver and kidney and improve survival in a mouse model of hemorrhagic shock and resuscitation. Methods Mice were hemorrhaged to 30 mm Hg for 3 h and then resuscitated with shed blood followed by half the shed volume of lactated Ringer's solution containing tetracycline (10 mg/kg), minocycline (10 mg/kg), doxycycline (5 mg/kg) or vehicle. For pre-plus post-treatment, drugs were administered intraperitoneally prior to hemorrhage followed by second equal dose in Ringer's solution after blood resuscitation. Blood and tissue were harvested after 6 h. Results Serum alanine aminotransferase (ALT) increased to 1988 and 1878 U/L after post-treatment with vehicle and tetracycline, respectively, whereas minocycline and doxycycline post-treatment decreased ALT to 857 and 863 U/L. Pre-plus post-treatment with minocycline and doxycycline also decreased ALT to 849 and 834 U/L. After vehicle, blood creatinine increased to 279 μM, which minocycline and doxycycline post-treatment decreased to 118 and 112 μM. Minocycline and doxycycline pre- plus post-treatment decreased creatinine similarly. Minocycline and doxycycline also decreased necrosis and apoptosis in liver and apoptosis in both liver and kidney, the latter assessed by TUNEL and caspase-3 activation. Lastly after 4.5 h of hemorrhage followed by resuscitation, minocycline and doxycycline (but not tetracycline) post-treatment improved 1-week survival from 38%(vehicle) to 69% and 67%, respectively. Conclusion Minocycline and doxycycline were similarly protective when given before as after blood resuscitation and might therefore

  18. Level of Knowledge of specialist cardiologists and anesthesiologists in Basic and Advanced Life Support

    Directory of Open Access Journals (Sweden)

    Maria Vachla

    2013-01-01

    Full Text Available Health professionals often witness in-hospital episodes of cardiac arrest. The quality of the Cardiopulmonary Resuscitation (CPR depends on the level of theoretical background and practical skills. Purpose: The aim of the present study was to investigate the level of theoretical knowledge of skilled cardiologists and anesthesiologists in the Basic and Advanced Life Support (BLS/ ALS. Material - method: In this study, sample included 240 cardiologists and anesthesiologists, chosen randomly from employers of 17 General Public Hospitals of Athens. For data collection, a questionnaire with 16 theoretical questions was designed, based on the guidelines of the European Resuscitation Council (ERC 2005. Significance level was set at p=≤0,05. The analysis was performed with the Statistical Package IBM SPSS Statistics 19. Results: No statistically significant difference was observed between specialists cardiologists and anesthesiologists in overall performance in theoretical knowledge on the BLS and ALS. Additionally, no statistical significance was observed between the two separate groups of theoretical background. Statistically significant difference was observed among those who had participated in a training seminar in BLS and ALS and those who had not participated (p<0,001. Also, there was statistical significance between the follow-up seminar in BLS/ ALS and specialty for the right answer to the question "which is the right ratio of chest compressions and ventilation", (p<0,001. Conclusions: The level of background knowledge of specialist cardiologists and anesthesiologists in the algorithms of BLS and ALS seem to correlate to the attendance of a training course.

  19. Foreign Approaches to Determining the Categories of Teachers' Professionalization and Professionalism in the System of Continuing Advanced Training

    Directory of Open Access Journals (Sweden)

    Postryhach Nadia

    2014-12-01

    Full Text Available In this article we have tried to switch our attention towards the contemporary debates about the teaching profession that are more focused on a recognized reality that the profession is changing due to the development of modern society, with more complex tasks in the system of pedagogic education. Accordingly, we felt it necessary to respond to several issues raised by researchers in this problem field: what skills should teachers possess in a society that is constantly evolving and changing? What are teachers to “know” and “know how to do?” How should they be prepared to practice this profession? What types of theoretical, methodological, professional skills do teachers need to achieve? What are the most appropriate and effective primary training programs for teaching staff?

  20. Learning to Connect: a Training Model for Public Sector on Advanced E-Government Services and Inter-Organizational Cooperation

    Directory of Open Access Journals (Sweden)

    Nunzio Casalino

    2014-04-01

    Full Text Available Accomplishing interoperability among public information systems is a complex task not only by the variety of technological specifications and by the nature of the organisations in which the systems are implemented, but also because a detailed evaluation and analysis of the multiple aspects involved is lacking. The aim of this paper is to identify and summarize the main aspects regarding the field of interoperability (strategic frameworks, laws, regulations, specific requirements, organizational and technical issues by means of the location and assessment of works that focus on the identification and analysis of the barriers, issues and risk factors involved in IS corporate learning in public sector. The training model proposed and the project described are based on the analysis of several themes such as bond interconnection, information sharing, and processes integration between public European administrations.

  1. SAGA advances in ShApes, Geometry, and Algebra : results from the Marie Curie initial training network

    CERN Document Server

    Muntingh, Georg

    2014-01-01

    This book summarizes research carried out in workshops of the SAGA project, an Initial Training Network exploring the interplay of Shapes, Algebra, Geometry and Algorithms. Written by a combination of young and experienced researchers, the book introduces new ideas in an established context. Among the central topics are approximate and sparse implicitization and surface parametrization; algebraic tools for geometric computing; algebraic geometry for computer aided design applications and problems with industrial applications. Readers will encounter new methods for the (approximate) transition between the implicit and parametric representation; new algebraic tools for geometric computing; new applications of isogeometric analysis, and will gain insight into the emerging research field situated between algebraic geometry and computer aided geometric design.

  2. Characterization and physiological effect of tapioca maltodextrin colloid plasma expander in hemorrhagic shock and resuscitation model.

    Science.gov (United States)

    Chatpun, Surapong; Sawanyawisuth, Kittisak; Wansuksri, Rungtiva; Piyachomkwan, Kuakoon

    2016-05-01

    Plasma expanders (PEs) are administered fluids to replace blood volume when massive blood loss has occured. Maltodextrin from tapioca starch was selected as a study candidate to prepare a colloid PE due to an uncomplicated production process. The formulations of mixture between tapioca maltodextrin and 0.9 % sodium chloride solution were prepared and then characterized. This was to investigate the effects of a dextrose equivalent (DE) and the concentration on the physical properties. Storage stability of each formulation was also determined and compared with clinically used PE [6 % hydroxyethyl starch (HES), 130/0.4]. The effects on the circulatory system in hamsters with hemorrhagic shock and resuscitation using prepared PE were also investigated. The results showed that low DE value led to high retrogradation, turbidity and viscosity but low colloid osmotic pressure and poor solubility. Among the prepared solutions, tapioca maltodextrin with DE6 at 10 % w/v concentration had comparable properties with 6 % HES 130/0.4. Animals resuscitated with 10 % DE6 PE had improved mean arterial blood pressure similar to those resuscitated with 6 % HES 130/0.4. However, several parameters in animals resuscitated with 10 % DE6 PE were lower than those resuscitated with 6 % HES 130/0.4, i.e., heart rate, functional capillary density. Therefore, if using tapioca maltodextrin for PE, some properties have to be considered and efficiently optimized. PMID:27015687

  3. Fluid therapy for septic shock resuscitation: which fluid should be used?

    Science.gov (United States)

    Corrêa, Thiago Domingos; Rocha, Leonardo Lima; Pessoa, Camila Menezes Souza; Silva, Eliézer; de Assuncao, Murillo Santucci Cesar

    2015-01-01

    Early resuscitation of septic shock patients reduces the sepsis-related morbidity and mortality. The main goals of septic shock resuscitation include volemic expansion, maintenance of adequate tissue perfusion and oxygen delivery, guided by central venous pressure, mean arterial pressure, mixed or central venous oxygen saturation and arterial lactate levels. An aggressive fluid resuscitation, possibly in association with vasopressors, inotropes and red blood cell concentrate transfusion may be necessary to achieve those hemodynamic goals. Nonetheless, even though fluid administration is one of the most common interventions offered to critically ill patients, the most appropriate type of fluid to be used remains controversial. According to recently published clinical trials, crystalloid solutions seem to be the most appropriate type of fluids for initial resuscitation of septic shock patients. Balanced crystalloids have theoretical advantages over the classic solutions, but there is not enough evidence to indicate it as first-line treatment. Additionally, when large amounts of fluids are necessary to restore the hemodynamic stability, albumin solutions may be a safe and effective alternative. Hydroxyethyl starches solutions must be avoided in septic patients due to the increased risk of acute renal failure, increased need for renal replacement therapy and increased mortality. Our objective was to present a narrative review of the literature regarding the major types of fluids and their main drawbacks in the initial resuscitation of the septic shock patients. PMID:26313437

  4. Fat embolism with the use of intraosseous infusion during cardiopulmonary resuscitation.

    Science.gov (United States)

    Fiallos, M; Kissoon, N; Abdelmoneim, T; Johnson, L; Murphy, S; Lu, L; Masood, S; Idris, A

    1997-08-01

    The objective of this prospective study was to assess the incidence and magnitude of fat emboli after cardiopulmonary resuscitation and intraosseous infusions. An animal laboratory at a university center was used to study 33 mixed-breed piglets. The piglets underwent hypoxic cardiac arrest followed by chest compressions and mechanical ventilation for a minimum of 30 minutes. The animals were divided in groups: group 1 (n = 5), which had no intraosseous cannulas, group 2 (n = 6), which had intraosseous cannulas with infusion, groups 3 (n = 6), 4 (n = 6), and 5 (n = 8), which had intraosseous cannulas with infusion of epinephrine, normal saline, and sodium bicarbonate respectively, and group 6 (n = 2), which was a sham group with no intraosseous cannulas and no cardiopulmonary resuscitation. At cessation of cardiopulmonary resuscitation, representative lung samples were collected from upper and lower lobes of each lung and observed for fat globules and bone marrow elements. Fat globules were seen in the peribronchial blood vessels and intravascular areas throughout all lung fields of groups 1 through 5. There was no difference in appearance or distribution of fat globules among the 5 treatment groups. Analysis of variance showed no statistical significance (P fat embolization over cardiopulmonary resuscitation alone in this animal model. The benefits of using this procedure in critically ill children as a means of rapid vascular access for resuscitation is well established. However, the risk of fat embolism in this population needs further study. PMID:9258208

  5. Therapeutic effect of cisapride on gastric injury following hemorrhagic shock resuscitation in rats

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lian-yang; WANG Zheng-guo; ZHU Pei-fang; XU Yan

    2005-01-01

    Objective: To investigate the therapeutic effect of cisapride on gastric injury following hemorrhagic shock resuscitation.Methods: 108 Wistar rats weighing (200 g±30 g) were randomly divided into a sham shock (SS) group (n=36), a hemorrhagic shock resuscitation (HS) group (n=36) and a hemorrhagic shock cisapride treated (HSC) group (n=36). Sampling at 1, 2 and 4 hours after resuscitation was done and 6 samples for each observation item were taken. The gastric blood flow volume was measured by isotope label biological microglobulin. Gastric pHi, gastric emptying, MDA and Na+-K+-ATPase of gastric mucosa were measured.Results: In the HSC group, the relative residual rate of gastric pigment decreased significantly, the gastric blood flow volume elevated; gastric pHi increased significantly at 2 hours; the level of mucosal MDA decreased at 4 hours, the activity of Na+-K+-ATPase increased and the lactic acid level in the portal vein decreased significantly compared to the HS group.Conclusions: After hemorrhagic shock resuscitation, cisapride contained the following functions,1) promoting gastric emptying, 2) increasing the blood flow of gastric blood flow volume and gastric pHi, 3) depressing the lactic acid concentration of the portal vein and improving MDA volume and Na+-K+ -ATPase activity of gastric mucosa. It suggests that after comple menting effective circulating blood volume for hemorrhagic shock resuscitation, early use of cisapride for gastric motility is helpful for an improvement of lasting ischemia and hypoxia in stomach.

  6. Old age and poor prognosis increase the likelihood of disagreement between cancer patients and their oncologists on the indication for resuscitation attempt

    DEFF Research Database (Denmark)

    Saltbaek, Lena; Michelsen, Hanne M; Nelausen, Knud M;

    2013-01-01

    The do-not-resuscitate decision is a common ethical problem. However, the concordance between patients' preferences and physicians' assessments of the indication for cardiopulmonary resuscitation attempt (CPR) has only been modestly investigated.......The do-not-resuscitate decision is a common ethical problem. However, the concordance between patients' preferences and physicians' assessments of the indication for cardiopulmonary resuscitation attempt (CPR) has only been modestly investigated....

  7. [Tension pneumomediastinum and tension pneumothorax following tracheal perforation during cardiopulmonary resuscitation].

    Science.gov (United States)

    Buschmann, C T; Tsokos, M; Kurz, S D; Kleber, C

    2015-07-01

    Tension pneumothorax can occur at any time during cardiopulmonary resuscitation (CPR) with external cardiac massage and invasive ventilation either from primary or iatrogenic rib fractures with concomitant pleural or parenchymal injury. Airway injury can also cause tension pneumothorax during CPR. This article presents the case of a 41-year-old woman who suffered cardiopulmonary arrest after undergoing elective mandibular surgery. During CPR the upper airway could not be secured by orotracheal intubation due to massive craniofacial soft tissue swelling. A surgical airway was established with obviously unrecognized iatrogenic tracheal perforation and subsequent development of tension pneumomediastinum and tension pneumothorax during ventilation. Neither the tension pneumomediastinum nor the tension pneumothorax were decompressed and accordingly resuscitation efforts remained unsuccessful. This case illustrates the need for a structured approach to resuscitate patients with ventilation problems regarding decompression of tension pneumomediastinum and/or tension pneumothorax during CPR. PMID:26036317

  8. The role of pre-hospital blood gas analysis in trauma resuscitation

    Directory of Open Access Journals (Sweden)

    Katila Ari

    2010-04-01

    Full Text Available Abstract Background To assess, whether arterial blood gas measurements during trauma patient's pre-hospital shock resuscitation yield useful information on haemodynamic response to fluid resuscitation by comparing haemodynamic and blood gas variables in patients undergoing two different fluid resuscitation regimens. Methods In a prospective randomised study of 37 trauma patients at risk for severe hypovolaemia, arterial blood gas values were analyzed at the accident site and on admission to hospital. Patients were randomised to receive either conventional fluid therapy or 300 ml of hypertonic saline. The groups were compared for demographic, injury severity, physiological and outcome variables. Results 37 patients were included. Mean (SD Revised Trauma Score (RTS was 7.3427 (0.98 and Injury Severity Score (ISS 15.1 (11.7. Seventeen (46% patients received hypertonic fluid resuscitation and 20 (54% received conventional fluid therapy, with no significant differences between the groups concerning demographic data or outcome. Base excess (BE values decreased significantly more within the hypertonic saline (HS group compared to the conventional fluid therapy group (mean BE difference -2.1 mmol/l vs. -0.5 mmol/l, p = 0.003. The pH values on admission were significantly lower within the HS group (mean 7.31 vs. 7.40, p = 0.000. Haemoglobin levels were in both groups lower on admission compared with accident site. Lactate levels on admission did not differ significantly between the groups. Conclusion Pre-hospital use of small-volume resuscitation led to significantly greater decrease of BE and pH values. A portable blood gas analyzer was found to be a useful tool in pre-hospital monitoring for trauma resuscitation.

  9. Effect of four resuscitation methods on lung ventilation of pigs with respiratory arrest

    Directory of Open Access Journals (Sweden)

    Ya-hua LIU

    2012-03-01

    Full Text Available Objective To observe the effects of four cardiopulmonary resuscitation (CPR methods on lung ventilation of pigs with respiratory arrest. The four CPR methods included chest compression CPR (C-CPR, compression under the diaphragm CPR (D-CPR, abdominal compression CPR (A-CPR, and abdominal wall lifting and compression CPR (L-CPR. Methods  A total of 28 healthy domestic pigs were randomly divided into four groups. The pig respiratory arrest model was reproduced by intravenous injection of suxamethonium. Instantly after respiratory arrest, one of the 4 CPR methods was performed immediately on the groups of pigs respectively. After 2min of CPR, compression was stopped. The experimental pigs were given assisted respiration using a ventilator until autonomous respiration recovered. The tidal volume (VT in basic status and that during resuscitation by the four respective resuscitation methods was determined, and minute ventilation (MV was calculated. Furthermore, heart rate (HR, mean arterial blood pressure, and recovery time of autonomous respiration were compared between all the groups. Results In basic status, there was no statistical difference (P > 0.05 in VT and MV between the four groups. Approximately 2min after resuscitation, the VT and MV of D-CPR were higher than that of C-CPR; that of A-CPR was higher than that of D-CPR; and that of L-CPR was higher than that of A-CPR. The differences were statistically significant (P 0.05. HR in C-CPR and D-CPR were notably lower than the basic value (P < 0.01. Two minutes after resuscitation, mechanical ventilation was given, and HR in all the groups was close to the basic value 5 min after resuscitation. In the respiratory arrest pig model, L-CPR could provide more effective VT and MV than the other methods. Conclusion For the porcine respiratory arrest model, L-CPR can provide more effective lung ventilation than the other methods.

  10. THE EFFECT OF ANISODAMINE ON CEREBRAL RESUSCITATION OF RATS IN ACUTE CEREBRAL ISCHEMIA FROM CARDIAC ARREST

    Institute of Scientific and Technical Information of China (English)

    彭新琦; 曹苏谊; 可君

    1995-01-01

    In order to investigate the mechanisms of acute cerebral ischemia,and to look for effective drugs on cerebral resuscitation,we made a model of acute complete global brain ischemia,reperfusion and resuscita-tion on rats according to Garavilla's method.Our results showed that the event of cerebral ischemia and reperfusion injury could result in the in-crease of total brain calcium content,and anisodamine has the same reducing brain calcium contents as dil-tiazem's,while improving neurological outcome and alleviating injury to neurons.

  11. Newly graduated doctors' competence in managing cardiopulmonary arrests assessed using a standardized Advanced Life Support (ALS) assessment

    DEFF Research Database (Denmark)

    Jensen, Marianne Lidang; Hesselfeldt, R.; Rasmussen, M.B.;

    2008-01-01

    Aim of the study: Several studies using a variety of assessment approaches have demonstrated that young doctors possess insufficient resuscitation competence. The aims of this study were to assess newly graduated doctors’ resuscitation competence against an internationally recognised standard and...... to study whether teaching site affects their resuscitation competence. Materials and methods: The entire cohort of medical students from Copenhagen University expected to graduate in June 2006 was invited to participate in the study. Participants’ ALS- competence was assessed using the Advanced Life...... resuscitation teaching issued by the university. Results: Participation was accepted by 154/240 (64%) graduates. Only 23% of the participants met the ALS pass criteria. They primarily lacked skills in managing cardiopulmonary arrest. There were significant differences in ALS-competence between teaching sites....

  12. The significance of clinical experience on learning outcome from resuscitation training-a randomised controlled study

    DEFF Research Database (Denmark)

    Jensen, Morten Lind; Lippert, Freddy; Hesselfeldt, Rasmus;

    2009-01-01

    retention of learning. Materials and methods: This was a prospective single blinded randomised controlled study of the learning outcome from a standard ALS course on a volunteer sample of the entire cohort of newly graduated doctors from Copenhagen University. The outcome measurement was ALS...... immediately following graduation. Results: Invitation to participate was accepted by 154/240 (64%) graduates and 117/154 (76%) completed the study. There was no difference between the intervention and control groups with regard to the imme- diate learning outcome. The intervention group had significantly...... small but statistically significant impact on the retention of learning, but not on the immediate learning outcome....

  13. An Introduction to the Inverted/Flipped Classroom Model in Education and Advanced Training in Medicine and in the Healthcare Professions.

    Science.gov (United States)

    Tolks, Daniel; Schäfer, Christine; Raupach, Tobias; Kruse, Leona; Sarikas, Antonio; Gerhardt-Szép, Susanne; Kllauer, Gertrud; Lemos, Martin; Fischer, Martin R; Eichner, Barbara; Sostmann, Kai; Hege, Inga

    2016-01-01

    In describing the inverted classroom model (ICM), the following paper is meant to provide an introduction to the subject matter and to serve as a practical guide for those wishing to employ its methods in basic and advanced medical training and education. The ICM is a blended-learning method in which a self-directed learning phase (individual phase) precedes the classroom-instruction phase. During the online phase, factual knowledge is imparted that serves as a basis for the classroom phase. The classroom phase should subsequently be used to assimilate and implement the previously gained knowledge. In contrast, traditional course concepts impart factual knowledge in lectures, for example, or in other face-to-face teaching formats and are followed by the students' self-instruction in order to assimilate this knowledge. The goal of the ICM is the shift from passive learning to accelerated learning in order to foster learning at cognitively demanding levels such as analysis, synthesis and evaluation. The concurrent increase in production and use of screencasts and educational videos, the Open Educational Resources "movement" and the widespread use of Massive Open Online Courses (MOOCS) have contributed to the increased dissemination of the inverted-classroom method. The intention of the present paper is to provide an introduction to the subject matter and simultaneously to offer a short overview of important projects and research results in the field of medical education and other health professions. Furthermore, an outline is given of the advantages and disadvantages of the model as well as its potential benefit to the future of medical education and training. PMID:27275511

  14. An Introduction to the Inverted/Flipped Classroom Model in Education and Advanced Training in Medicine and in the Healthcare Professions

    Science.gov (United States)

    Tolks, Daniel; Schäfer, Christine; Raupach, Tobias; Kruse, Leona; Sarikas, Antonio; Gerhardt-Szép, Susanne; Kllauer, Gertrud; Lemos, Martin; Fischer, Martin R.; Eichner, Barbara; Sostmann, Kai; Hege, Inga

    2016-01-01

    In describing the inverted classroom model (ICM), the following paper is meant to provide an introduction to the subject matter and to serve as a practical guide for those wishing to employ its methods in basic and advanced medical training and education. The ICM is a blended-learning method in which a self-directed learning phase (individual phase) precedes the classroom-instruction phase. During the online phase, factual knowledge is imparted that serves as a basis for the classroom phase. The classroom phase should subsequently be used to assimilate and implement the previously gained knowledge. In contrast, traditional course concepts impart factual knowledge in lectures, for example, or in other face-to-face teaching formats and are followed by the students’ self-instruction in order to assimilate this knowledge. The goal of the ICM is the shift from passive learning to accelerated learning in order to foster learning at cognitively demanding levels such as analysis, synthesis and evaluation. The concurrent increase in production and use of screencasts and educational videos, the Open Educational Resources “movement” and the widespread use of Massive Open Online Courses (MOOCS) have contributed to the increased dissemination of the inverted-classroom method. The intention of the present paper is to provide an introduction to the subject matter and simultaneously to offer a short overview of important projects and research results in the field of medical education and other health professions. Furthermore, an outline is given of the advantages and disadvantages of the model as well as its potential benefit to the future of medical education and training.

  15. An Introduction to the Inverted/Flipped Classroom Model in Education and Advanced Training in Medicine and in the Healthcare Professions

    Directory of Open Access Journals (Sweden)

    Tolks, Daniel

    2016-05-01

    Full Text Available In describing the inverted classroom model (ICM, the following paper is meant to provide an introduction to the subject matter and to serve as a practical guide for those wishing to employ its methods in basic and advanced medical training and education. The ICM is a blended-learning method in which a self-directed learning phase (individual phase precedes the classroom-instruction phase. During the online phase, factual knowledge is imparted that serves as a basis for the classroom phase. The classroom phase should subsequently be used to assimilate and implement the previously gained knowledge. In contrast, traditional course concepts impart factual knowledge in lectures, for example, or in other face-to-face teaching formats and are followed by the students’ self-instruction in order to assimilate this knowledge. The goal of the ICM is the shift from passive learning to accelerated learning in order to foster learning at cognitively demanding levels such as analysis, synthesis and evaluation. The concurrent increase in production and use of screencasts and educational videos, the Open Educational Resources “movement” and the widespread use of Massive Open Online Courses (MOOCS have contributed to the increased dissemination of the inverted-classroom method. The intention of the present paper is to provide an introduction to the subject matter and simultaneously to offer a short overview of important projects and research results in the field of medical education and other health professions. Furthermore, an outline is given of the advantages and disadvantages of the model as well as its potential benefit to the future of medical education and training.

  16. Evaluation of a Brief Intervention Designed to Increase CPR Training among Pregnant Pool Owners

    Science.gov (United States)

    Girasek, Deborah C.

    2011-01-01

    This study evaluated whether a brief videotape could motivate pregnant pool owners to be trained in infant/child cardiopulmonary resuscitation (CPR). Women were recruited from prenatal classes in South Florida. Eligible volunteers were randomized to view a video or receive standard treatment, after completing a questionnaire. The video explained…

  17. CPR in the Schools: Training Students to Save Heart Attack Victims.

    Science.gov (United States)

    Britton, Royce J.

    1978-01-01

    A community cardiac emergency medical plan should include training of family and co-workers of high risk patients, including teenage students. The American Heart Association lists ways to introduce cardiopulmonary resuscitation (CPR) into school curricula and describes the plan implemented in Pennsylvania. (MF)

  18. Training and Confidence Level of Junior Anaesthetists in CPR- Experience in A Developing Country

    Directory of Open Access Journals (Sweden)

    Desalu Ibironke

    2008-01-01

    There is low confidence among junior anaesthetists in Nigeria in performance of CPR, poor knowledge of ECG interpretation of cardiac arrest rhythm and little practice in defibrillation. The establishment of a Resuscitation council would ensure adequate and frequent training which would improve knowledge, boost confidence and result in better patient care.

  19. Interaction and educational design of mobile equipment for crisis management training

    DEFF Research Database (Denmark)

    Ørngreen, Rikke

    2011-01-01

    discussion, where the empirical data have to do with first aid in general and training cardiocerebral resuscitation in office settings specifically. Consequently, the paper contains design ideas, analysis and evaluation of current work with mobile equipment and augmented reality features, utilizing...

  20. Samarbeid i hjertestansteam : en kvalitativ studie om intensivsyke- pleieres erfaringer fra samarbeid i hjertestansteam under resuscitering

    OpenAIRE

    Skeivoll, Anne; Bjørlykke, Carina

    2014-01-01

    Project backround: Several areas in health care have recently seen an increased focus on the importance of cooperation. In its guidelines from 2010, The American Heart Association (AHA) places increased importance on non-technical skills in the training of personnel who perform advanced cardiac life support (ACLS). The Better And Systematic Team Foundation (BEST), have in recent years contributed to a growing focus on cooperation in trauma teams. However, in Norway, there is little research d...

  1. Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 2: Career Development, General Education and Remediation, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

    Science.gov (United States)

    Texas State Technical Coll., Waco.

    This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

  2. Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 3: Machining, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

    Science.gov (United States)

    Texas State Technical Coll., Waco.

    This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

  3. Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 5: Mold Making, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

    Science.gov (United States)

    Texas State Technical Coll., Waco.

    This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational speciality areas within the U.S. machine tool and metals-related…

  4. Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 13: Laser Machining, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

    Science.gov (United States)

    Texas State Technical Coll., Waco.

    This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

  5. Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 10: Computer-Aided Drafting & Design, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

    Science.gov (United States)

    Texas State Technical Coll., Waco.

    This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

  6. Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 4: Manufacturing Engineering Technology, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

    Science.gov (United States)

    Texas State Technical Coll., Waco.

    This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

  7. Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 7: Industrial Maintenance Technology, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

    Science.gov (United States)

    Texas State Technical Coll., Waco.

    This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

  8. Do Not Attempt Resuscitation (DNAR)--The Role of the School Nurse. Position Statement

    Science.gov (United States)

    Tuck, Christine M.; Jordan, Alicia; Lambert, Patrice; Porter, Jessica

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that each student with a Do Not Attempt Resuscitation (DNAR) order have an Individualized Healthcare Plan (IHP) and an Emergency Care Plan (ECP) developed by the registered professional school nurse (hereinafter referred to as school nurse) with input from parents or guardians,…

  9. Imaging the human microcirculation during cardiopulmonary resuscitation in a hypothermic victim of submersion trauma

    NARCIS (Netherlands)

    P.W.G. Elbers; A.J. Craenen; A. Driessen; M.C. Stehouwer; L. Munsterman; M. Prins; M. van Iterson; P. Bruins; C. Ince

    2010-01-01

    The microcirculation is essential for delivery of oxygen and nutrients to tissue. However, the human microvascular response to cardiopulmonary resuscitation (CPR) is unknown. We report on the first use of sidestream dark field imaging to assess the human microcirculation during CPR with a mechanical

  10. The presence of resuscitation equipment and influencing factors at General Practitioners' offices in Denmark

    DEFF Research Database (Denmark)

    Niegsch, Mark L; Krarup, Nikolaj T; Clausen, Niels Erikstrup

    2013-01-01

    Automated external defibrillators (AEDs) have proven effective when used by GPs. Despite this and the latest guidelines from the European Resuscitation Council, there are no recommendations for Danish GPs regarding proper equipment to treat cardiac arrest. Currently, there are no published data on...

  11. Increased susceptibility to cardiovascular effects of dihydrocapcaicin in resuscitated rats. Cardiovascular effects of dihydrocapsaicin

    DEFF Research Database (Denmark)

    Fosgerau, Keld; Ristagno, Giuseppe; Jayatissa, Magdalena Niepsuj; Axelsen, Mads; Gotfredsen, Jacob W; Weber, Uno J; Køber, Lars; Torp-Pedersen, Christian; Videbaek, Charlotte

    2010-01-01

    Survivors of a cardiac arrest often have persistent cardiovascular derangements following cardiopulmonary resuscitation including decreased cardiac output, arrhythmias and morphological myocardial damage. These cardiovascular derangements may lead to an increased susceptibility towards the external...... and internal environment of the cardiovascular system as compared to the healthy situation....

  12. Resuscitation of patients suffering from sudden cardiac arrests in nursing homes is not futile

    DEFF Research Database (Denmark)

    Søholm, Helle; Bro-Jeppesen, John; Lippert, Freddy K;

    2014-01-01

    and prognosis after OHCA in NH. METHODS: Consecutive Emergency Medical Service (EMS) attended OHCA-patients in Copenhagen during 2007-2011 were included. Utstein-criteria for pre-hospital data and review of individual patient charts for in-hospital post-resuscitation care were collected. RESULTS: A total...

  13. Implementation of a High-Performance Cardiopulmonary Resuscitation Protocol at a Collegiate Emergency Medical Services Program

    Science.gov (United States)

    Stefos, Kathryn A.; Nable, Jose V.

    2016-01-01

    Out-of-hospital cardiac arrest (OHCA) is a significant public health issue. Although OHCA occurs relatively infrequently in the collegiate environment, educational institutions with on-campus emergency medical services (EMS) agencies are uniquely positioned to provide high-quality resuscitation care in an expedient fashion. Georgetown University's…

  14. Effect of Haemostatic Control Resuscitation on mortality in massively bleeding patients: a before and after study

    DEFF Research Database (Denmark)

    Johansson, P I; Stensballe, J

    2009-01-01

    BACKGROUND AND OBJECTIVES: Evidence supporting the use of platelets and plasma in resuscitation of massive bleedings is questionable. Current consensus guidelines recommend restrictive use. Our aim was to determine the effect of changing the transfusion practice on 30-day survival in massively bl...

  15. 骨科总住院医师在进修医生教学和管理工作中的作用%The role of chief resident in teaching and management of advanced training doctors in orthopaedics

    Institute of Scientific and Technical Information of China (English)

    严望军; 袁文; 吴海山; 倪斌; 叶晓健; 陈爱民

    2010-01-01

    目的 探讨总住院医师在进修医生的带教和管理工作中的作用.方法 分析第二军医大学附属长征医院骨科总住院医师作为科事主任的助手,参与科室日常的医疗、教学及管理工作,特别是在进修医生带教和管理工作中的组织实施和管理方法 .结果 总住院医师切实做好科室和进修生的协调工作,可以促进进修医生素质的提高,对教学医院科室管理工作和长远发展有着积极的影响.结论 总住院医师在进修医生教学及其管理工作中起着重要作用.%Objective To explore the role of chief resident for teaching and management of advanced training doctors in the department of orthopaedics.Methods The experiences of chief resident as the assistant of director, who took part in clinical work, teaching and management in department were summarized.Especially the organization and methods of teaching and management of advanced training doctors were analyzed.Results It would contribute to teaching and management of advanced training doctors if the rules and regulations of chief resident were implemented well.Conclusions The role of chief resident is very important to train and manage advanced training doctors.

  16. Phase II trial of isotonic fluid resuscitation in Kenyan children with severe malnutrition and hypovolaemia

    Directory of Open Access Journals (Sweden)

    Boga Mwanamvua

    2010-10-01

    Full Text Available Abstract Background Children with severe malnutrition who develop shock have a high mortality. Contrary to contemporaneous paediatric practice, current guidelines recommend use of low dose hypotonic fluid resuscitation (half-strength Darrows/5% dextrose (HSD/5D. We evaluated the safety and efficacy of this guideline compared to resuscitation with a standard isotonic solution. Methods A Phase II randomised controlled, safety and efficacy trial in Kenyan children aged over 6 months with severe malnutrition and shock including children with severe dehydration/shock and presumptive septic shock (non-diarrhoeal shock. Eligible children were randomised to HSD/5D or Ringer's Lactate (RL. A maximum of two boluses of 15 ml/kg of HSD/5D were given over two hours (as recommended by guidelines while those randomised to RL received 10 ml/kg aliquots half hourly (maximum 40 ml/kg. Primary endpoint was resolution of shock at 8 and 24 hours. Secondary outcomes included resolution of acidosis, adverse events and mortality. Results 61 children were enrolled: 41 had shock and severe dehydrating diarrhoea, 20 had presumptive septic shock; 69% had decompensated shock. By 8 hours response to volume resuscitation was poor with shock persisting in most children:-HSD/5D 15/22 (68% and RL14/25 (52%, p = 0.39. Oliguria was more prevalent at 8 hours in the HSD/5D group, 9/22 (41%, compared to RL-3/25 (12%, p = 0.02. Mortality was high, HSD/5D-15/26(58% and RL 13/29(45%; p = 0.42. Most deaths occurred within 48 hours of admission. Neither pulmonary oedema nor cardiogenic failure was detected. Conclusions Outcome was universally poor characterised by persistence of shock, oliguria and high case fatality. Isotonic fluid was associated with modest improvement in shock and survival when compared to HSD/5D but inconclusive due to the limitations of design and effectiveness of either resuscitation strategy. Although isotonic fluid resuscitation did not result in cardiogenic heart

  17. I diretriz de ressuscitação cardiopulmonar e cuidados cardiovasculares de emergência da Sociedade Brasileira de Cardiologia: resumo executivo I guideline for cardiopulmonary resuscitation and emergency cardiovascular care - Brazilian Society of Cardiology: executive summary

    Directory of Open Access Journals (Sweden)

    Maria Margarita Gonzalez

    2013-02-01

    the early recognition and delivery of cardiopulmonary resuscitation maneuvers focused on high-quality thoracic compressions and rapid defibrillation by means of the implementation of public access-to-defibrillation programs. These aspects are of the utmost importance and may make the difference on the patient's outcomes, such as on hospital survival with no permanent neurological damage. Early initiation of the Advanced Cardiology Life Support also plays an essential role by keeping the quality of thoracic compressions; adequate airway management; specific treatment for the different arrest rhythms; defibrillation; and assessment and treatment of the possible causes during all the assistance. More recently, emphasis has been given to post-resuscitation care, with the purpose of reducing mortality by means of early recognition and treatment of the post-cardiac arrest syndrome. Therapeutic hypothermia has provided significant improvement of neurological damage and should be performed in comatose individuals post-cardiac arrest. For physicians working in the emergency department or intensive care unit, it is extremely important to improve the treatment given to these patients by means of specific training, thus giving them the chance of higher success and of better survival rates.

  18. Evaluating an undergraduate interprofessional simulation-based educational module: communication, teamwork, and confidence performing cardiac resuscitation skills

    Directory of Open Access Journals (Sweden)

    Marian Luctkar-Flude

    2010-11-01

    Full Text Available Marian Luctkar-Flude1, Cynthia Baker1, Cheryl Pulling1, Robert McGraw2, Damon Dagnone2, Jennifer Medves1, Carly Turner-Kelly11School of Nursing, Queen’s University, Kingston, Ontario, Canada; 2School of Medicine, Queen’s University, Kingston, Ontario, CanadaPurpose: Interprofessional (IP collaboration during cardiac resuscitation is essential and contributes to patient wellbeing. The purpose of this study is to evaluate an innovative simulation-based IP educational module for undergraduate nursing and medical students on cardiac resuscitation skills.Methods: Nursing and medical trainees participated in a new cardiac resuscitation curriculum involving a 2-hour IP foundational cardiac resuscitation skills lab, followed by three 2-hour IP simulation sessions. Control group participants attended the existing two 2-hour IP simulation sessions. Study respondents (N = 71 completed a survey regarding their confidence performing cardiac resuscitation skills and their perceptions of IP collaboration.Results: Despite a consistent positive trend, only one out of 17 quantitative survey items were significantly improved for learners in the new curriculum. They were more likely to report feeling confident managing the airway during cardiac resuscitation (P = 0.001. Overall, quantitative results suggest that senior nursing and medical students were comfortable with IP communication and teamwork and confident with cardiac resuscitation skills. There were no significant differences between nursing students’ and medical students’ results. Through qualitative feedback, participants reported feeling comfortable learning with students from other professions and found value in the IP simulation sessions.Conclusion: Results from this study will inform ongoing restructuring of the IP cardiac resuscitation skills simulation module as defined by the action research process. Specific improvements that are suggested by these findings include strengthening the team

  19. [Endotracheal aspiration: respirator vs. manual resuscitation as method for hyperoxygenation and hyperinflation].

    Science.gov (United States)

    Herce, A; Lerga, C; Martínez, A; Zapata, M A; Asiain, M C

    1999-01-01

    Endotracheal aspiration protocols (EAT) include hyperoxygenation and hyperinflation to minimize the negative effects of the technique. No conclusive studies have determined the most effective hyperoxygenation and hyperinflation method. This study had two aims: to compare the effects on patient oxygenation and hemodynamics during endotracheal aspiration of secretions using, respectively, a respirator or manual resuscitator as the hyperoxygenation and hyperinflation method. Tidal volume (TV) and FIO2 with the manual resuscitator were quantified. The study was based on 172 aspiration sessions carried out under artificial ventilation in the immediate postoperative period of 26 patients who had undergone cardiac surgery without lung damage. Hyperinflation and hyperoxygenation before, during and after aspiration were carried out with and artificial ventilator in group I and with a manual resuscitator in group II. In all aspiration interventions, an analysis was made of hemodynamic parameters (MAP, MPAP, HR, CO and arrhythmias), ventilation and oxygenation parameters (HR, FIO2, SpO2, and SvO2), and the influence of the method on the appearance of atelectasis. Both methods produced small increases in all hemodynamic parameters, and significant differences in HR (p < 0.001) and MPAP (p < 0.002), although no clinical repercussions were observed. No severe arrhythmias were observed. No statistically significant differences between the two methods were found in the evolution of SpO2 and SvO2, which remained above baseline levels throughout both procedures. Analysis of the effectiveness of the manual resuscitator (the second aim) under the conditions established yielded a mean FIO2 of 0.86 and a mean tidal volume of 153% in relation to baseline tidal volume. Both methods of hyperoxygenation and hyperinflation prevent hypoxia and maintain hemodynamic stability in patients without producing lung damage. The effectiveness of the manual resuscitator for administering high oxygen

  20. CPR Training for Nurses: How often Is It Necessary?

    OpenAIRE

    Mokhtari Nori, J; Saghafinia, M; Kalantar Motamedi, M H; Khademol Hosseini, S M

    2012-01-01

    Background The ability to respond quickly and effectively to a cardiac arrest situation rests on nurses being competent, prepared and up-to-date in the emergency life-saving procedure of cardiopulmonary resuscitation (CPR). This study aimed to determine the extent to which nurses acquire and retain CPR cognitive knowledge and psychomotor skills following CPR training courses. Methods A quasi-experiment was used. CPR knowledge of 112 nurses was assessed via a questionnaire using valid multiple...

  1. Clinical skills assessment of procedural and advanced communication skills: performance expectations of residency program directors

    Directory of Open Access Journals (Sweden)

    Erik E. Langenau

    2012-07-01

    Full Text Available Background: High stakes medical licensing programs are planning to augment and adapt current examinations to be relevant for a two-decision point model for licensure: entry into supervised practice and entry into unsupervised practice. Therefore, identifying which skills should be assessed at each decision point is critical for informing examination development, and gathering input from residency program directors is important. Methods: Using data from previously developed surveys and expert panels, a web-delivered survey was distributed to 3,443 residency program directors. For each of the 28 procedural and 18 advanced communication skills, program directors were asked which clinical skills should be assessed, by whom, when, and how. Descriptive statistics were collected, and Intraclass Correlations (ICC were conducted to determine consistency across different specialties. Results: Among 347 respondents, program directors reported that all advanced communication and some procedural tasks are important to assess. The following procedures were considered ‘important’ or ‘extremely important’ to assess: sterile technique (93.8%, advanced cardiovascular life support (ACLS (91.1%, basic life support (BLS (90.0%, interpretation of electrocardiogram (89.4% and blood gas (88.7%. Program directors reported that most clinical skills should be assessed at the end of the first year of residency (or later and not before graduation from medical school. A minority were considered important to assess prior to the start of residency training: demonstration of respectfulness (64%, sterile technique (67.2%, BLS (68.9%, ACLS (65.9% and phlebotomy (63.5%. Discussion: Results from this study support that assessing procedural skills such as cardiac resuscitation, sterile technique, and phlebotomy would be amenable to assessment at the end of medical school, but most procedural and advanced communications skills would be amenable to assessment at the end of the

  2. Cardio-pulmonary resuscitation of brain-dead organ donors: a literature review and suggestions for practice.

    Science.gov (United States)

    Dalle Ave, Anne L; Gardiner, Dale; Shaw, David M

    2016-01-01

    "Organ preserving cardiopulmonary resuscitation (OP-CPR)" is defined as the use of CPR in cases of cardiac arrest to preserve organs for transplantation, rather than to revive the patient. Is it ethical to provide OP-CPR in a brain-dead organ donor to save organs that would otherwise be lost? To answer this question, we review the literature on brain-dead organ donors, conduct an ethical analysis, and make recommendations. We conclude that OP-CPR can benefit patients and families by fulfilling the wish to donate. However, it is an aggressive procedure that can cause physical damage to patients, and risks psychological harm to families and healthcare professionals. In a brain-dead organ donor, OP-CPR is acceptable without specific informed consent to OP-CPR, although advance discussion with next of kin regarding this possibility is strongly advised. In a patient where brain death is yet to be determined, but there is known wish for organ donation, OP-CPR would only be acceptable with a specific informed consent from the next of kin. When futility of treatment has not been established or it is as yet unknown if the patient wished to be an organ donor then OP-CPR should be prohibited, in order to avoid any conflict of interest. PMID:26073934

  3. Advancing adolescent health and health services in Saudi Arabia: exploring health-care providers' training, interest, and perceptions of the health-care needs of young people

    Directory of Open Access Journals (Sweden)

    AlBuhairan FS

    2014-09-01

    Full Text Available Fadia S AlBuhairan,1–3 Tina M Olsson3,4 1Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 4School of Social Work, Lund University, Lund, Sweden Background: Adolescent health is regarded as central to global health goals. Investments made in adolescent health and health services protect the improvements witnessed in child health. Though Saudi Arabia has a large adolescent population, adolescent health-care only began to emerge in recent years, yet widespread uptake has been very limited. Health-care providers are key in addressing and providing the necessary health-care services for adolescents, and so this study was conducted with the aim of identifying opportunities for the advancement of knowledge transfer for adolescent health services in Saudi Arabia. Methods: This Web-based, cross-sectional study was carried out at four hospitals in Saudi Arabia. Physicians and nurses were invited to participate in an online survey addressing their contact with adolescent patients, and training, knowledge, and attitudes towards adolescent health-care. Results: A total of 232 professionals participated. The majority (82.3% reported sometimes or always coming into contact with adolescent patients. Less than half (44%, however, had received any sort of training on adolescent health during their undergraduate or postgraduate education, and only 53.9% reported having adequate knowledge about the health-care needs of adolescents. Nurses perceived themselves as having more knowledge in the health-care needs of adolescents and reported feeling more comfortable in communicating with adolescents as compared with physicians. The majority of participants were interested in gaining further skills and knowledge in adolescent health-care and agreed or strongly agreed that adolescents have

  4. Correlation of the National Board of Medical Examiners Emergency Medicine Advanced Clinical Examination Given in July to Intern American Board of Emergency Medicine in-training Examination Scores: A Predictor of Performance?

    OpenAIRE

    Katherine Hiller; Doug Franzen; Corey Heitz; Matthew Emery; Stacy Poznanski

    2015-01-01

    Introduction: There is great variation in the knowledge base of Emergency Medicine (EM) interns in July. The first objective knowledge assessment during residency does not occur until eight months later, in February, when the American Board of EM (ABEM) administers the in-training examination (ITE). In 2013, the National Board of Medical Examiners (NBME) released the EM Advanced Clinical Examination (EM-ACE), an assessment intended for fourth-year medical students. Administration of the EM-AC...

  5. The effects of neoadjuvant chemoradiotherapy and an in-hospital exercise training programme on physical fitness and quality of life in locally advanced rectal cancer patients (The EMPOWER Trial): study protocol for a randomised controlled trial

    OpenAIRE

    Loughney, Lisa; West, Malcolm A.; Kemp, Graham J.; Rossiter, Harry B.; Burke, Shaunna M.; Cox, Trevor; Barben, Christopher P.; Mythen, Michael G; Calverley, Peter; Palmer, Daniel H.; Grocott, Michael P. W.; Jack, Sandy

    2016-01-01

    Background The standard treatment pathway for locally advanced rectal cancer is neoadjuvant chemoradiotherapy (CRT) followed by surgery. Neoadjuvant CRT has been shown to decrease physical fitness, and this decrease is associated with increased post-operative morbidity. Exercise training can stimulate skeletal muscle adaptations such as increased mitochondrial content and improved oxygen uptake capacity, both of which are contributors to physical fitness. The aims of the EMPOWER trial are to ...

  6. Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia : Dutch nationwide retrospective cohort study

    NARCIS (Netherlands)

    Kieboom, J. K.; Verkade, H. J.; Burgerhof, J. G.; Bierens, J. J.; van Rheenen, P. F.; Kneyber, M. C.; Albers, M. J.

    2015-01-01

    OBJECTIVES To evaluate the outcome of drowned children with cardiac arrest and hypothermia, and to determine distinct criteria for termination of cardiopulmonary resuscitation in drowned children with hypothermia and absence of spontaneous circulation. DESIGN Nationwide retrospective cohort study. S

  7. An atypical case of successful resuscitation of an accidental profound hypothermia patient, occurring in a temperate climate.

    LENUS (Irish Health Repository)

    Coleman, E

    2010-03-01

    Cases of accidental profound hypothermia occur most frequently in cold, northern climates. We describe an atypical case, occurring in a temperate climate, where a hypothermic cardiac-arrested patient was successfully resuscitated using extracorporeal circulation (ECC).

  8. Effective mechanic training

    International Nuclear Information System (INIS)

    The need for the training of mechanics is discussed, and the increased interest within the utility industry of placing a similar importance on this training as it has traditionally placed on operator training, is expressed. Effective approaches and techniques are described. Fundamental mechanical maintenance concepts and their practical application are discussed, including the use of supporting video programs. The importance of follow-up practical shop exercise which reinforces classroom instruction is stressed, drawing from practical utility experience. Utilizing success in training as a measure of eligibility for advancement is discussed as well as the interface between training and the company bargaining unit

  9. The use of a cardiac output monitor to guide the initial fluid resuscitation in a patient with burns

    OpenAIRE

    Reid, Robert Darren; Jayamaha, John

    2007-01-01

    A case of initial resuscitation of a patient with severe burns is described. Such patients can have hypotension and reduced organ perfusion for a number of reasons, and can remain in the emergency department for many hours while awaiting transfer to specialist centres. The case provides a comparison between resuscitation using traditional burns formulae and a relatively new and simple‐to‐use cardiac output (CO) monitor—the Vigileo monitor (Edwards Lifesciences, Irvine, California, USA). The c...

  10. Vasopressin Infusion with Small-Volume Fluid Resuscitation during Hemorrhagic Shock Promotes Hemodynamic Stability and Survival in Swine

    OpenAIRE

    Gazmuri, Raúl J.; Kasen Whitehouse; Karla Whittinghill; Alvin Baetiong; Jeejabai Radhakrishnan

    2015-01-01

    Introduction Current management of hemorrhagic shock (HS) in the battlefield and civilian settings favors small-volume fluid resuscitation before controlling the source of bleeding. We investigated in a swine model of HS the effects of vasopressin infusion along with small-volume fluid resuscitation; with erythropoietin (EPO) and HS severity as additional factors. Methods HS was induced in 24 male domestic pigs (36 to 41 kg) by blood withdrawal (BW) through a right atrial cannula modeling spo...

  11. Combination of Epinephrine with Esmolol Attenuates Post-Resuscitation Myocardial Dysfunction in a Porcine Model of Cardiac Arrest

    OpenAIRE

    Qian Zhang; Chunsheng Li

    2013-01-01

    BACKGROUND: Recent experimental and clinical studies have indicated that the β-adrenergic effect of epinephrine significantly increases the severity of post resuscitation myocardial dysfunction. The aim of the study was to investigate whether the short-acting β₁-selective adrenergic blocking agent, esmolol, would attenuate post resuscitation myocardial dysfunction in a porcine model of cardiac arrest. METHODS AND RESULTS: After 8 min of untreated ventricular fibrillation and 2 min of basic li...

  12. Safety support systems field assessment survey tool S3 FAST. Advanced simulation and management software for nuclear emergency training and response

    International Nuclear Information System (INIS)

    The importance of training safety personnel to deal with real world scenarios is prevalent amongst nuclear emergency preparedness and response organizations. International Safety Research (ISR) has committed to ensure that field procedures, data collection software and decision making tools be identical during training sessions as they would be during a real emergency. By identifying the importance of a fully integrated tool, ISR has developed a safety support system capable of both functioning in training mode and real mode, enabling emergency response organizations to train more efficiently and effectively.This new fully integrated emergency management tool is called S3-FAST also known as Safety Support Systems - Field Assessment Survey Tool. (orig.)

  13. Multimedia and solar energy - chances for basic and advanced training of tradesmen. Conference; Multimedia und Sonnenenergie - Chancen fuer die Aus-, Fort- und Weiterbildung im Handwerk. Tagung

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    Subjects: Didactics of vocational training and multimedia learning; Internet services of the Koordinierungsstelle Energie des Westdeutschen Handwerkskammertages; Training in solar engineering at HBZ Muenster; Training software for the space HVAC sector; Interactive learning software for vocational training in solar engineering; E-learning; Multimedia applications in photovoltaics. [German] Die Tagungsunterlagen bestehen aus einzelnen ungebundenen Artikeln. Sie behandeln die folgenden Themen: Didaktik der beruflichen Bildung und multimediales Lernen; Internet Angebot der Koordinierungsstelle Energie des Westdeutschen Handwerkskammertages; Solartechnik-Schulungen am HBZ Muenster; Trainingssoftware fuer das SHK-Handwerk; Einsatz interaktiver Lernsoftware fuer Solarthermie in der beruflichen Bildung; E-Learning; Multimedia-Anwendungen im Bereich Photovoltaik. (AKF)

  14. Neonatal resuscitation 1: a model to measure inspired and expired tidal volumes and assess leakage at the face mask

    Science.gov (United States)

    O'Donnell, C; Kamlin, C; Davis, P; Morley, C

    2005-01-01

    Background: Neonatal resuscitation is a common and important intervention, and adequate ventilation is the key to success. In the delivery room, positive pressure ventilation is given with manual ventilation devices using face masks. Mannequins are widely used to teach and practise this technique. During both simulated and real neonatal resuscitation, chest excursion is used to assess tidal volume delivery, and leakage from the mask is not measured. Objective: To describe a system that allows measurement of mask leakage and estimation of tidal volume delivery. Methods: Respiratory function monitors, a modified resuscitation mannequin, and a computer were used to measure leakage from the mask and to assess tidal volume delivery in a model of neonatal resuscitation. Results: The volume of gas passing through a flow sensor was measured at the face mask. This was a good estimate of the tidal volume entering and leaving the lung in this model. Gas leakage between the mask and mannequin was also measured. This occurred principally during inflation, although gas leakage during deflation was seen when the total leakage was large. A volume of gas that distended the mask but did not enter the lung was also measured. Conclusion: This system can be used to assess the effectiveness of positive pressure ventilation given using a face mask during simulated neonatal resuscitation. It could be useful for teaching neonatal resuscitation and assessing ventilation through a face mask. PMID:15871990

  15. Training of radwaste management specialists

    International Nuclear Information System (INIS)

    Highly professional and knowledgeable employees for chemical, and especially radiochemical, technology companies are very much sought after these days. Taking into account the advancement of nuclear power and the associated expansion of radioactive waste management facilities, the demand for staff that possesses all the necessary knowledge is set to increase multi-tenfold. In such circumstances, training of personnel is becoming a key element of the human resource management process. The author says that training of personnel at SUE SIA Radon Moscow is conducted in accordance with the Program of Training, Advanced Training and Personnel Qualification, which prescribes areas of training, categories of trainees, approximate number of trainees for each area, schedule and budget of training sessions. The cooperation of SUE SIA Radon Moscow with higher-education institutions in the field of young specialists training and advanced training of managerial, technical and administrative staff is reported

  16. Clinical audit on documentation of anticipatory "Not for Resuscitation" orders in a tertiary australian teaching hospital

    Directory of Open Access Journals (Sweden)

    Naveen Sulakshan Salins

    2011-01-01

    Full Text Available Aim: The purpose of this clinical audit was to determine how accurately documentation of anticipatory Not for Resuscitation (NFR orders takes place in a major metropolitan teaching hospital of Australia. Materials and Methods: Retrospective hospital-based study. Independent case reviewers using a questionnaire designed to study NFR documentation reviewed documentation of NFR in 88 case records. Results: Prognosis was documented in only 40% of cases and palliative care was offered to two-third of patients with documented NFR. There was no documentation of the cardiopulmonary resuscitation (CPR process or outcomes of CPR in most of the cases. Only in less than 50% of cases studied there was documented evidence to suggest that the reason for NFR documentation was consistent with patient′s choices. Conclusion: Good discussion, unambiguous documentation and clinical supervision of NFR order ensure dignified and quality care to the dying.

  17. [Role of an anesthesiologist-resuscitation specialist in organ donation for transplantation].

    Science.gov (United States)

    Iaroshetskiĭ, A I; Protsenko, D N; Gel'fand, B R

    2010-01-01

    There is an annual reduction in the number of donors worldwide. An anesthesiologist-resuscitation specialist is a key figure in the whole system of organ donation. The so-called transplantation, i.e., the organization of the whole process of interaction between a healthy care facility, a local organ donation center, and ancillary laboratory and diagnostic services is one of his/her primary roles in organ donation. The organizational, legal, and ethic issues of organ donation for transplantation are discussed from the viewpoint of an anesthesiologist-resuscitation specialist. There is a parallel between the treatment of a patient with multiple organ dysfunction and the management of a donor with brain death. PMID:20737699

  18. Are the current guideline recommendations for neonatal cardiopulmonary resuscitation safe and effective?

    Science.gov (United States)

    Rottenberg, Eric M

    2016-08-01

    A recently published review of approaches to optimize chest compressions in the resuscitation of asphyxiated newborns discussed the current recommendations and explored potential determinants of effective neonatal cardiopulmonary resuscitation (CPR). However, not all potential determinants of effective neonatal CPR were explored. Chest compression shallower than the current guideline recommendation of approximately 33% of the anterior-posterior (AP) chest diameter may be safer and more effective. From a physiological standpoint, high-velocity brief duration shallower compression may be more effective than current recommendations. The application of a 1- or 2-finger method of high-impulse CPR, which would depend on the size of the subject, may be more effective than using a 2-thumb (TT) encircling hands method of CPR. Adrenaline should not be used in the treatment of asphyxiated neonates and when necessary titrated vasopressin should be used. PMID:27220864

  19. Retrospective Study of the Survival of Patients who Underwent Cardiopulmonary Resuscitation in an Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Moreira Daniel Martins

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate clinical and evolutive characteristics of patients admitted in an intensive care unit after cardiopulmonary resuscitation, identifying prognostic survival factors.METHODS: A retrospective study of 136 patients admitted between 1995 and 1999 to an intensive care unit, evaluating clinical conditions, mechanisms and causes of cardiopulmonary arrest, and their relation to hospital mortality.RESULTS: A 76% mortality rate independent of age and sex was observed. Asystole was the most frequent mechanism of death, and seen in isolation pulmonary arrest was the least frequent. Cardiac failure, need for mechanical ventilation, cirrhosis and previous stroke were clinically significant (p<0.01 death factors.CONCLUSION: Prognostic factors supplement the doctor's decision as to whether or not a patient will benefit from cardiopulmonary resuscitation.

  20. Reanimación neonatal: actualización Neonatal resuscitation: up-date

    Directory of Open Access Journals (Sweden)

    E. Burón Martínez

    2009-01-01

    Full Text Available Las últimas recomendaciones en reanimación neonatal fueron publicadas en el año 2005 por el ERC (European Resuscitation Council, el grupo ILCOR (International Liaison Committee on Resuscitation y la AHA (American Heart Association. En nuestro país estas normas fueron difundidas por el grupo de RCP Neonatal de la Sociedad Española de Neonatología, introduciendo algunas adaptaciones y ampliando algunos capítulos como la reanimación del recién nacido de muy bajo peso (RNMBP. En la figura 1 se recoge el algoritmo de reanimación neonatal en sala de partos y en la figura 2 el algoritmo de reestabilización inicial y manejo respiratorio en sala de partos del prematuro de < 32 semanas realizados por el grupo RCP neonatal-SEN y consensuados por el Consejo Español de RCP y el ERC...

  1. Feedback in Videogame-Based Adaptive Training

    Science.gov (United States)

    Rivera, Iris Daliz

    2010-01-01

    The field of training has been changing rapidly due to advances in technology such as videogame-based adaptive training. Videogame-based adaptive training has provided flexibility and adaptability for training in cost-effective ways. Although this method of training may have many benefits for the trainee, current research has not kept up to pace…

  2. Training safely, Training safety

    OpenAIRE

    Jianjun Wu; An, M.; Jin, Y.; H. Geng

    2014-01-01

    It is the basic requirement of maritime safety education to guarantee the safety of teaching operation while training the crew's occupation safety capability. Marine Training Center of Shanghai Maritime University has undertaken the practical teaching of "marine survival" for many years and come up with the whole safety procedures of training. Based on the requirements of SOLAS convention and regulations of STCW over crew training, this paper introduces the safety allocation, utilization and ...

  3. Investigating Resuscitation Code Assignment in the Intensive Care Unit using Structured and Unstructured Data

    OpenAIRE

    Lojun, Sharon L.; Sauper, Christina J.; Medow, Mitchell; Long, William J.; Mark, Roger G.; Barzilay, Regina

    2010-01-01

    This study investigates the feasibility of using structured data (age, gender, and medical condition), and unstructured medical notes on classification accuracy for resuscitation code status. Data was extracted from the MIMICII database. Natural language processing (NLP) was used to evaluate the social section of the nurses’ progress notes. BoosTexter was used to predict the code-status using notes, age, gender, and Simplified Acute Physiology Score (SAPS). The relative impact of features was...

  4. Fluid compartments in hemorrhaged rats after hyperosmotic crystalloid and hyperoncotic colloid resuscitation.

    Science.gov (United States)

    Moon, P F; Hollyfield-Gilbert, M A; Myers, T L; Uchida, T; Kramer, G C

    1996-01-01

    Postresuscitation organ failure may be associated with detrimental changes in body fluid compartments. We measured how shock and resuscitation acutely alters the interstitial, cellular, and plasma compartments in different organs. Nephrectomized, anesthetized rats were bled to 50 mmHg mean arterial pressure for 1 h, followed by 60 min of resuscitation to restore blood pressure using 0.9% normal saline (NS,n = 10), 7.5% hypertonic saline (HS,n = 8), 10% hyperoncotic albumin (HA, n = 8), or 7.5% hypertonic saline and 10% hyperoncotic albumin (HSA, n = 7). A 2-h 51Cr-EDTA distribution space estimated extracellular fluid volume (ECFV), and a 5-min 125I-labeled albumin distribution space measured plasma volume (PV). Total tissue water (TW) was measured from wet and dry weights; interstitial fluid volume (ISFV) and cell water were calculated. NS resuscitation required 7 times more fluid (50.9 +/- 7.7 vs. 8.6 +/- 0.7 for HA, 5.9 +/- 0.4 for HS, and 3.9 +/- 0.5 ml/kg for HSA), but there were no differences between solutions in whole animal PV, ECFV, or ISFV. Fluid shifts within tissues depended on resuscitation solution and type of tissue. TW was significantly reduced by hypertonic saline groups in heart, muscle, and liver (P skin. In all tissues, mean cell water in groups receiving HS was smaller; this was significant for heart, lung, muscle, and skin. In conclusion, 1) HS solutions mobilize fluid from cells while expanding both PV and ISFV, and 2) TW and cellular water increase with both isotonic crystalloids and hyperoncotic colloids in many tissues. PMID:8769817

  5. Chest Compression Synchronized Ventilation versus Intermitted Positive Pressure Ventilation during Cardiopulmonary Resuscitation in a Pig Model

    OpenAIRE

    Kill, Clemens; Galbas, Monika; Neuhaus, Christian; Hahn, Oliver; Wallot, Pascal; Kesper, Karl; Wulf, Hinnerk; Dersch, Wolfgang

    2015-01-01

    Background Guidelines recommend mechanical ventilation with Intermitted Positive Pressure Ventilation (IPPV) during resuscitation. The influence of the novel ventilator mode Chest Compression Synchronized Ventilation (CCSV) on gas exchange and arterial blood pressure compared with IPPV was investigated in a pig model. Methods In 12 pigs (general anaesthesia/intubation) ventricular fibrillation was induced and continuous chest compressions were started after 3min. Pigs were mechanically ventil...

  6. Minocycline Decreases Liver Injury after Hemorrhagic Shock and Resuscitation in Mice

    Directory of Open Access Journals (Sweden)

    Christoph Czerny

    2012-01-01

    Full Text Available Patients that survive hemorrhage and resuscitation (H/R may develop a systemic inflammatory response syndrome (SIRS that leads to dysfunction of vital organs (multiple organ dysfunction syndrome, MODS. SIRS and MODS may involve mitochondrial dysfunction. Under pentobarbital anesthesia, C57BL6 mice were hemorrhaged to 30 mm Hg for 3 h and then resuscitated with shed blood plus half the volume of lactated Ringer’s solution containing minocycline, tetracycline (both 10 mg/kg body weight or vehicle. Serum alanine aminotransferase (ALT, necrosis, apoptosis and oxidative stress were assessed 6 h after resuscitation. Mitochondrial polarization was assessed by intravital microscopy. After H/R with vehicle or tetracycline, ALT increased to 4538 U/L and 3999 U/L, respectively, which minocycline decreased to 1763 U/L (P<0.01. Necrosis and TUNEL also decreased from 24.5% and 17.7 cells/field, respectively, after vehicle to 8.3% and 8.7 cells/field after minocycline. Tetracycline failed to decrease necrosis (23.3% but decreased apoptosis to 9 cells/field (P<0.05. Minocycline and tetracycline also decreased caspase-3 activity in liver homogenates. Minocycline but not tetracycline decreased lipid peroxidation after resuscitation by 70% (P<0.05. Intravital microscopy showed that minocycline preserved mitochondrial polarization after H/R (P<0.05. In conclusion, minocycline decreases liver injury and oxidative stress after H/R by preventing mitochondrial dysfunction.

  7. Effect of four resuscitation methods on lung ventilation of pigs with respiratory arrest

    OpenAIRE

    Ya-hua LIU; Xiu-man LI; Li-xiang WANG

    2012-01-01

    Objective To observe the effects of four cardiopulmonary resuscitation (CPR) methods on lung ventilation of pigs with respiratory arrest. The four CPR methods included chest compression CPR (C-CPR), compression under the diaphragm CPR (D-CPR), abdominal compression CPR (A-CPR), and abdominal wall lifting and compression CPR (L-CPR). Methods  A total of 28 healthy domestic pigs were randomly divided into four groups. The pig respiratory arrest model was reproduced by intravenous injection of s...

  8. Willingness to Perform Chest Compression Only in Witnessed Cardiac Arrest Victims versus Cardiopulmonary Resuscitation in Iran

    OpenAIRE

    Nesreen Yaghmour; Mohammad Reza Movahed

    2015-01-01

    Background: Performing immediate bystander Cardio Pulmonary Resuscitation (CPR) is the most important factor that determines survival from cardiac arrest. Recommended mouth to mouth ventilation maneuver during CPR has led to lower rate of CPR performance in the population. Objectives: The present survey aimed to evaluate the willingness of nurses at Shiraz University of Medical Sciences for performing CPR versus chest-compression-only CPR. Patients and Methods: During a CPR course, we...

  9. Usefulness of the bispectral index during cardiopulmonary resuscitation -A case report-

    OpenAIRE

    Jung, Jin Yong; Kim, Yeonbaek; Kim, Jung-Eun

    2013-01-01

    The usefulness of using the bispectral index (BIS) for monitoring during cardiopulmonary resuscitation (CPR) is not clearly understood. However, BIS has been a popular anesthetic monitoring device used during operations. The case presented is of a pregnant woman going into cardiac arrest due to an amniotic fluid embolism during a Cesarean section. CPR was performed, but neither the return of spontaneous circulation (ROSC) nor the return of consciousness was achieved, despite 50 min of effecti...

  10. A Prospective Study of Survival After In-Hospital Cardiopulmonary Resuscitation and its Related Factors

    OpenAIRE

    Miranzadeh, Sedigheh; Adib-Hajbaghery, Mohsen; Hosseinpour, Nadimeh

    2016-01-01

    Background Despite several studies, there is no agreement on factors that affect survival after in-hospital cardiopulmonary resuscitation (CPR). Objectives This study aimed to evaluate the survival rate of in-hospital CPR and its related factors at Shahid Beheshti hospital in Kashan, Iran, in 2014. Patients and Methods A descriptive study was conducted on all cases of CPR performed in Kashan Shahid Beheshti hospital during a 6-month period in 2014. Through a consecutive sampling method, 250 c...

  11. Marginally effective medical care: ethical analysis of issues in cardiopulmonary resuscitation (CPR)

    OpenAIRE

    Hilberman, M.; Kutner, J; Parsons, D; Murphy, D. J.

    1997-01-01

    Outcomes from cardiopulmonary resuscitation (CPR) remain distressingly poor. Overuse of CPR is attributable to unrealistic expectations, unintended consequences of existing policies and failure to honour patient refusal of CPR. We analyzed the CPR outcomes literature using the bioethical principles of beneficence, non-maleficence, autonomy and justice and developed a proposal for selective use of CPR. Beneficence supports use of CPR when most effective. Non-maleficence argues against performi...

  12. Effects of flashlight guidance on chest compression performance in cardiopulmonary resuscitation in a noisy environment

    OpenAIRE

    You, Je Sung; Chung, Sung Phil; Chang, Chul Ho; Park, Incheol; Lee, Hye Sun; Kim, SeungHo; Lee, Hahn Shick

    2012-01-01

    Background In real cardiopulmonary resuscitation (CPR), noise can arise from instructional voices and environmental sounds in places such as a battlefield and industrial and high-traffic areas. A feedback device using a flashing light was designed to overcome noise-induced stimulus saturation during CPR. This study was conducted to determine whether ‘flashlight’ guidance influences CPR performance in a simulated noisy setting. Materials and methods We recruited 30 senior medical students with...

  13. Vasopressin combined with epinephrine during cardiac resuscitation: a solution for the future?

    OpenAIRE

    Wenzel, Volker; Lindner, Karl H

    2006-01-01

    Epinephrine given during cardiopulmonary resuscitation (CPR) may cause beta-mimetic complications in the postresuscitation phase. Vasopressin may be an alternative vasopressor drug during CPR. A subgroup analysis of a large prospective CPR investigation and of retrospective CPR studies suggests that vasopressin may be especially beneficial when combined with epinephrine. Beneficial effects of adding vasopressin were observed in other catecholamine-refractory shock states as well, such as vaso...

  14. Assessment of the teaching-learning process in students of the health area: cardiopulmonary resuscitation maneuvers

    OpenAIRE

    Patrícia Moita Garcia Kawakame; Ana Maria Kazue Miyadahira

    2015-01-01

    OBJECTIVETo evaluate the skills and knowledge of undergraduate students in the health area on cardiopulmonary resuscitation maneuvers with the use of an automatic external defibrillator.METHODThe evaluation was performed in three different stages of the teaching-learning process. A theoretical and practical course was taught and the theoretical classes included demonstration. The evaluation was performed in three different stages of the teaching-learning process. Two instruments were applied ...

  15. Resuscitation speed affects brain injury in a large animal model of traumatic brain injury and shock

    DEFF Research Database (Denmark)

    Sillesen, Martin; Jin, Guang; Johansson, Pär I;

    2014-01-01

    infusion speed increment NS (n¿=¿7). Hemodynamic variables over a 6-hour observation phase were recorded. Following euthanasia, brains were harvested and lesion size as well as brain swelling was measured.ResultsBolus FFP resuscitation resulted in greater brain swelling (22.36¿±¿1.03% vs. 15.58¿±¿2.52%, p...

  16. Resuscitation-induced intestinal edema and related dysfunction: State of the science

    OpenAIRE

    Shah, Shinil K.; Uray, Karen S.; Stewart, Randolph H.; Laine, Glen A.; Cox, Charles S.

    2009-01-01

    High volume resuscitation and damage control surgical methods, while responsible for significantly decreasing morbidity and mortality from traumatic injuries, are associated with pathophysiological derangements that lead to subsequent end organ edema and dysfunction. Alterations in hydrostatic and oncotic pressures frequently result in intestinal edema and subsequent dysfunction. The purpose of this review is to examine the principles involved in the development of intestinal edema, current a...

  17. Effect of Haemostatic Control Resuscitation on mortality in massively bleeding patients: a before and after study

    OpenAIRE

    Johansson, P I; Stensballe, J

    2008-01-01

    Background and Objectives Evidence supporting the use of platelets and plasma in resuscitation of massive bleedings is questionable. Current consensus guidelines recommend restrictive use. Our aim was to determine the effect of changing the transfusion practice on 30-day survival in massively bleeding patients. Materials and Methods Consecutive adult patients receiving more than 10 units of red blood cells (RBC) within 24 h 2 years prior to (2002–2003) and 2 years after (2005–2006) a change i...

  18. The ethics of cardiopulmonary resuscitation. II. Medical logistics and the potential for good response.

    OpenAIRE

    Davies, J M; Reynolds, B M

    1992-01-01

    Mismatches between provision of paediatric cardiopulmonary resuscitation (CPR) and potential to benefit are examined. Deficiencies are most likely to occur in peripheral maternity units but futile CPR is more common in emergency departments where the child is unknown. Decision making in individual cases is best retained by the medical profession for the sake of the child and family. American style intervention by the legislature is likely to dissipate scarce resources and perhaps harm infants...

  19. Sonoclot coagulation analysis of in-vitro haemodilution with resuscitation solutions.

    OpenAIRE

    Brazil, E V; Coats, T J

    2000-01-01

    The colloid and crystalloid solutions used for resuscitation should preferably be free from effects on coagulation. In 10 volunteers, the effects of haemodilution with various concentrations of 0.9% sodium chloride and 4% succinylated gelatin were assessed by Sonoclot analysis, which describes the whole coagulation process. Small and moderate haemodilution (up to 40%) with 0.9% sodium chloride promoted coagulation. Similar haemodilution with 4% succinylated gelatin impaired coagulation, and a...

  20. Left Internal Mammary Artery Injury Requiring Resuscitative Thoracotomy: A Case Presentation and Review of the Literature

    OpenAIRE

    Ammar Al Hassani; Yassir Abdul Rahman; Ahad Kanbar; Ayman El-Menyar; Abubaker Al-Aieb; Mohammad Asim; Rifat Latifi

    2012-01-01

    Background. Penetrating injuries to the chest and in particular to the heart that results in pericardial tamponade and cardiac arrest requires immediate resuscitative thoracotomy as the only lifesaving technique and should be performed without delay. Objective. To describe an external cardiac tamponade caused by massive tension hemothorax from penetrating injury of the left internal mammary artery (LIMA). Method. A case presentation treated at the Level I trauma center at Hamad General Hospit...

  1. Is there any role for resuscitative emergency department thoracotomy in blunt trauma?

    OpenAIRE

    Khorsandi, Maziar; Skouras, Christos; Shah, Rajesh

    2012-01-01

    A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether there is any role for resuscitative emergency department thoracotomy in severe blunt trauma. Emergency thoracotomy is an accepted intervention for patients with penetrating cardiothoracic trauma. However, its role in blunt trauma has been challenged and has been a subject of considerable debate. Altogether, 186 relevant papers were identified, of which 14 represen...

  2. Differential resuscitative effect of pyruvate and its analogues on VBNC (viable but non-culturable) Salmonella.

    Science.gov (United States)

    Morishige, Yuta; Fujimori, Ko; Amano, Fumio

    2013-01-01

    An environmental isolate of Salmonella Enteritidis (SE), grown to the logarithmic phase, rapidly lost culturability by the addition of 3 mM H2O2 to cultures grown in Luria-Bertani (LB) medium; however, some H2O2-treated bacteria regained their culturability in M9 minimal medium, if sodium pyruvate was present at at least 0.3 mM. In addition, most pyruvate analogues, such as bromopyruvate or phenylpyruvate, did not show restoration activity similar to that of pyruvate, except in the case of α-ketobutyrate. Further analysis of the mechanism underlying the resuscitation by pyruvate revealed that although many of the bacteria showed respiratory activity on CTC (5-cyano-2,3-di-(p-tolyl) tetrazolium chloride) reduction with or without pyruvate, the biosynthesis of DNA and protein synthesis were quite different in the presence or absence of pyruvate, i.e., pyruvate endowed the cells with the ability to incorporate much more radio-label into precursors during the resuscitation process. These results suggest that pyruvate is one of the key molecules working in the resuscitation process by taking bacteria from the non-culturable state to the growing and colony-forming state by triggering the synthesis of macromolecules such as DNA and protein. PMID:23595023

  3. Cardiopulmonary resuscitation decisions in the emergency department: An ethnography of tacit knowledge in practice.

    Science.gov (United States)

    Brummell, Stephen P; Seymour, Jane; Higginbottom, Gina

    2016-05-01

    Despite media images to the contrary, cardiopulmonary resuscitation in emergency departments is often unsuccessful. The purpose of this ethnographic study was to explore how health care professionals working in two emergency departments in the UK, make decisions to commence, continue or stop resuscitation. Data collection involved participant observation of resuscitation attempts and in-depth interviews with nurses, medical staff and paramedics who had taken part in the attempts. Detailed case examples were constructed for comparative analysis. Findings show that emergency department staff use experience and acquired tacit knowledge to construct a typology of cardiac arrest categories that help them navigate decision making. Categorisation is based on 'less is more' heuristics which combine explicit and tacit knowledge to facilitate rapid decisions. Staff then work as a team to rapidly assimilate and interpret information drawn from observations of the patient's body and from technical, biomedical monitoring data. The meaning of technical data is negotiated during staff interaction. This analysis was informed by a theory of 'bodily' and 'technical' trajectory alignment that was first developed from an ethnography of death and dying in intensive care units. The categorisation of cardiac arrest situations and trajectory alignment are the means by which staff achieve consensus decisions and determine the point at which an attempt should be withdrawn. This enables them to construct an acceptable death in highly challenging circumstances. PMID:27017090

  4. Abramovo Counterterrorism Training Center

    International Nuclear Information System (INIS)

    The U.S. government has been assisting the Russian Federation (RF) Ministry of Defense (MOD) for many years with nuclear weapons transportation security (NWTS) through the provision of specialized guard escort railcars and cargo railcars with integrated physical security and communication systems, armored transport vehicles, and armored escort vehicles. As a natural continuation of the NWTS program, a partnership has been formed to construct a training center that will provide counterterrorism training to personnel in all branches of the RF MOD. The Abramovo Counterterrorism Training Center (ACTC) is a multinational, multiagency project with funding from Canada, RF and the U.S. Departments of Defense and Energy. ACTC will be a facility where MOD personnel can conduct basic through advanced training in various security measures to protect Category IA material against the threat of terrorist attack. The training will enhance defense-in-depth principles by integrating MOD guard force personnel into the overall physical protection systems and improving their overall response time and neutralization capabilities. The ACTC project includes infrastructure improvements, renovation of existing buildings, construction of new buildings, construction of new training facilities, and provision of training and other equipment. Classroom training will be conducted in a renovated training building. Basic and intermediate training will be conducted on three different security training areas where various obstacles and static training devices will be constructed. The central element of ACTC, where advanced training will be held, is the 'autodrome,' a 3 km road along which various terrorist events can be staged to challenge MOD personnel in realistic and dynamic nuclear weapons transportation scenarios. This paper will address the ACTC project elements and the vision for training development and integrating this training into actual nuclear weapons transportation operations.

  5. MODALITIES OF TRAINING PARAMETER ALTERNATION IN NOWADAYS STRENGTH TRAINING PRACTICE

    Directory of Open Access Journals (Sweden)

    RANISAVLJEV IGOR

    2010-12-01

    Full Text Available Large number of variables could be alternated during the process of planning and programming in sports training. Superior training results in majority of sports are achieved by optimally manipulating training parameters in appropriate sequences and combinations. Additionally, in some sports they might be the result of appropriate periodization pattern. Today's tendency in strength training practice is training movements instead of training muscles. Exercise classification according to the dominant movement types, allows creating new modalities in training alternation. Additional variations in volume, intensity, rest brakes, repetition velocity andinter-repetition rest can be the important part of functional strength training program. Alternation and combination of different training parameters makes appropriate training stimulus for strength increase in the most of nowadays sports. Optimal alternation of basic training parameters should be the first part in the processof planning and programming. As a result, majority of athletes might not need advanced periodization patterns for optimal improvement in muscle strength and power

  6. Development of Knowledge and Skills in Cardiopulmonary Resuscitation for Medical Students and Research Assistants

    Directory of Open Access Journals (Sweden)

    Hayati Kandiş1

    2014-09-01

    Full Text Available Aim: Aimed to asses the level of knowledge and skills of medical students attending medical school from different classes and resident physicians about CPR training before and after training course. Methods: Theorical and practical training and education on basic life support, advanced cardiac life support, airway management, airway obstruction due to foreign body, cervical collar and spine board application were given. Education program during course was didactic and interactive. Pre-test was applied before theoric education program and post-test was applied after theoric education. Practical training was applied after theoric education was applied. Results: Before CPR course program, average scores of pre-test of participants from class 1, 2, 3, 4, 5 and 6 were 40.5±9.6; 46.1±9.7; 53.8±16.4; 39.9±18.5; 56.6±14.1; 52.5±11.7, respectively. For resident physicians, average score of pre-test was 72.3±11.6. Average scores of post-test for participants from medical students and resident physicians were 58.2±11.4; 62.2±9.2; 79.3±7.5; 73.3±15.6; 94.3±6.2, 80.6±9.1 and 94.2±7.1, respectively. Conclusion: Training program about CPR improved level knowledge and skill with theoric and practical education, and CPR should be implemented to faculty curriculum of medical schools for graduate and post-graduate trainers. Standardization and assessment measures of curriculum were adapted to international standard can be suggested.

  7. Comparative Effectiveness of Emergency Resuscitative Thoracotomy versus Closed Chest Compressions among Patients with Critical Blunt Trauma: A Nationwide Cohort Study in Japan

    OpenAIRE

    Suzuki, Kodai; Inoue, Shigeaki; Morita, Seiji; Watanabe, Nobuo; Shintani, Ayumi; Inokuchi, Sadaki; Ogura, Shinji

    2016-01-01

    Background Although emergency resuscitative thoracotomy is performed as a salvage maneuver for critical blunt trauma patients, evidence supporting superior effectiveness of emergency resuscitative thoracotomy compared to conventional closed-chest compressions remains insufficient. The objective of this study was to investigate whether emergency resuscitative thoracotomy at the emergency department or in the operating room was associated with favourable outcomes after blunt trauma and to compa...

  8. First responder resuscitation teams in a rural Norwegian community: sustainability and self-reports of meaningfulness, stress and mastering

    Directory of Open Access Journals (Sweden)

    Meland Eivind

    2010-05-01

    Full Text Available Abstract Background Training of lay first responder personnel situated closer to the potential victims than medical professionals is a strategy potentially capable of shortening the interval between collapse and start of cardiopulmonary resuscitation (CPR in cases of out-of-hospital cardiac arrest. In this study we trained lay first responders personnel in basic life support (BLS and defibrillation for cases of cardiac arrest and suspected acute myocardial infarction (AMI. Methods Forty-two lay first responders living in remote areas or working in industries in the island community of Austevoll, Western Norway, were trained in CPR and defibrillation. We placed particular emphasis on the first responders being able to defibrillate a primary ventricular fibrillation (PVF in patients with AMI. The trainees were organised in four teams to attend victims of AMI and cardiac arrest while awaiting the arrival of the community emergency medical services. The purpose of the study was to find out whether the teams were able to function during the five-year study project, and to examine whether lives could be saved. The first responders completed questionnaires each year on their experiences of participation. Data on the medical actions of the teams were also collected. Results By the end of the project all groups were functioning. The questionnaires evidenced a reasonable degree of motivation and self-evaluated competence in both types of group organisation, but in spite of this attrition effects in the first responders were considerable. The first responders were called out on 24 occasions, for a total of 17 patients. During the study period no case of PVF occurred after the arrival of the first responders, and the number of AMIs was very low, strongly deviating from what was anticipated. No lives were saved by the project. Conclusions The teams were sustained for almost five years without any significant deterioration of self-reported stress or mastering

  9. The impact of quality of cardiopulmonary resuscitation on post-resuscitation inflammatory reaction in a porcine cardiac arrest model%心肺复苏的质量对复苏后炎症反应的影响

    Institute of Scientific and Technical Information of China (English)

    武军元; 李春盛

    2008-01-01

    目的 评价临床上常见的不标准心肺复苏(N-CPR)和2005年国际CPR指南推荐的标准心肺复苏(S-CPR)对心脏停搏(CA)猪复苏后炎症反应的影响.方法 18头猪被随机均分成两组,经麻醉、插管、机械通气后,应用程控刺激方法制备心室纤颤(VF)模型.S-CPR组应用2005年指南推荐的CPR方式;N-CPR组模拟临床上经常出现的低质量CPR方式.VF 4 min后开始进行CPR,CPR 9 min后进行电除颤及高级生命支持,自主循环恢复(ROSC)后进行各项指标观察.24 h仍存活的猪经处死后取脑、心、肝、肾组织,应用免疫组化法检测核转录因子-kB(NF-kB)的表达.实验期间连续监测CPR后3、6和9 min的血流动力学变化,并抽取基础状态、CPR 9 rain、ROSC 4 h的静脉血,测定血清肿瘤坏死因子-a(TNF-α)、白细胞介素-1β(IL-1β)的浓度.结果 与N-CPR组比较,S-CPR组ROSC率(22.2%比88.9%)及24 h存活率(22.2%比88.9%)明显提高(P均<0.05);CPR后3、6和9 min心排血量(CO)和平均动脉压(MAP)也均显著升高(P均<0.01);并且CPR后9 min和ROSC 4 h血清促炎症因子TNF-α、IL-1β]水平和各组织NF-kB表达程度均降低.结论 高质量的CPR后不仅能提高CA猪的生存率,也明显改善CPR后的炎症反应.%Objective To evaluate the effects of quality of non-standard cardiopulmonary resuscitation (N-CPR)and new guidelines recommended standard CPR(S-CPR)on post-resuscitation inflammatory reaction in a cardiac arrest(CA)porcine model.Methods Eighteen pigs were randomly divided into two groups,and ventricular fibrillation(VF)was induced by programmed electrical stimulation after giving anesthesia,intubation tube and mechanical ventilation.S-CPR(n=9):CPR was consistent with recommendation of the 2005 guidelines.N-CPR(n=9):given CPR with low quality CPR usually instituded in clinic.After 4 minutes of untreated VF,CPR was started for 9 minutes.Defibrillation and advanced lire support were attempted at 13 minutes of CA

  10. Language Training: English Training

    CERN Multimedia

    2004-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. Language Training Françoise Benz tel. 73127 language.training@cern.ch General and Professional English Courses The next session will take place: from 1st March to 25 June 2004 (2 weeks break at Easter). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957.

  11. Language Training: English Training

    CERN Multimedia

    2004-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. LANGUAGE TRAINING Françoise Benz tel. 73127 language.training@cern.ch General and Professional English Courses The next session will take place: from 1st March to 25 June 2004 (2 weeks break at Easter). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957.

  12. Role of the community matron in advance care planning and 'do not attempt CPR' decision-making: a qualitative study.

    Science.gov (United States)

    Kazmierski, Mandy; King, Nigel

    2015-01-01

    The community matron (CM) is often the key worker caring for patients with chronic, life-limiting, long-term conditions, but these patients are not always recognised as palliative cases. This study explored the experiences of CMs with regard to advance care planning (ACP) and 'do not attempt cardiopulmonary resuscitation' (DNACPR) decision-making to understand whether or not they felt adequately prepared for this aspect of their role, and why. Qualitative data were generated from six CMs using a broad interpretive phenomenological approach. Face-to-face recorded interviews were analysed using template analysis. The study found that although participants faced complex ethical situations around ACP and DNACPR almost on a daily basis, none had received any formal training despite the emphasis on training in national and local guidelines. Participants often struggled to get their patients accepted on to the Gold Standards Framework. The research found variability and complexity of cases to be the main barriers to clear identification of the palliative phase. PMID:25559025

  13. 护士CPR操作现状调查%A survey on the status of performing cardiopulmonary resuscitation by nurses

    Institute of Scientific and Technical Information of China (English)

    方春艳; 赵爱兰; 李国明; 刘惠萍

    2012-01-01

    目的 了解我院中青年护士心肺复苏(CPR)知识、操作技能掌握情况,应用反馈装置培训能否改善心肺复苏培训质量.方法 从我院中青年护士群体(中级职称以下)中随机抽取120名,对其进行CPR知识调查并记录应用反馈装置培训前后两轮心肺复苏参数,统计并比较CPR知识和应用反馈装置前后两轮CPR质量的变化情况.结果 培训前心肺复苏操作总体合格率低,培训前、后呼吸正确率分别为32.18%、82.74%,培训前后按压正确率为55.36%、95.47%.主要原因为按压过浅(28.12%)、通气过度和通气不足(30.79%/26.41%).应用反馈装置培训后CPR有效按压率、人工通气和操作时间均明显改善.结论 中青年护士CPR知识和技能掌握情况欠理想,CPR培训时应用反馈装置能提高护士CPR质量.%Objective To comprehend knowledge about cardiopulmonary resuscitation (CPR)and skills of performing CPR in nurses,and if the quality of CPR training can be improved by using a feedback device.Methods 120 young and middle-aged nurses were randomly selected from those in our hospital to receive a survey on knowledge about CPR.The parameters for CPR were documented before and after training with a feedback device.Knowledge about CPR and changes in quality of CPR were compared.Results Before training,the overall pass rate of performing CPR was lower.The rate of correct artificial respiration was 32.18% before training and up to 82.74% after training and the rate of correct compression was 55.36% and 95.47%,respectively.The main errors were shallow compression (28.12%),hyperventilation (30.79%),and hypoventilation (26.41%).The effective compression rate,artificial ventilation,and time to performing CPR were significantly improved after application of a feedback device.Conclusions Knowledge about CPR and skills of performing CPR in nurses are unsatisfactory.A feedback device can improve quality of CPR training.

  14. Resuscitative Long-Bone Sonography for the Clinician: Usefulness and Pitfalls of Focused Clinical Ultrasound to Detect Long-Bone Fractures During Trauma Resuscitation.

    Science.gov (United States)

    Al-Kadi, Azzam S; Gillman, Lawrence M; Ball, Chad G; Panebianco, Nova L; Kirkpatrick, Andrew W

    2009-08-01

    Bone has one of the highest acoustic densities (AD) in the human body. Traditionally, bone has been considered to be a hindrance to the use of ultrasound (US), as US waves are reflected by the dense matrix and obscure underlying structures. The intense wave reflection, however, can clearly illustrate the cortical bony anatomy of long bones, making cortical disruption obvious. Ultrasound can be used at the bedside concurrently with the overall trauma resuscitation, and may potentially limit the patient's and treating team's exposure to ionizing radiation, corroborate clinical findings, and augment procedural success. The extended focused assessment with sonography for trauma (EFAST) is an essential tool in the resuscitation of severe torso trauma, frequently demonstrating intra- pericardial and intra-peritoneal fluid, inferring hemo/pneumothoraces, and demonstrating cardiac function. Although it is typically considered as a diagnosis of exclusion, multiple long-bone fractures may be a source of shock and can be quickly confirmed at the bedside with EFAST. Further, the early detection of long-bone fractures can also aid in the early stabilization of severely injured patients. Sonographic evaluation for long-bone fractures may be particularly useful in austere environments where other imaging modalities are limited, such as in the battlefield, developing world, and space. While prospective study has been limited, selected series have demonstrated high accuracy among both physician and para-medical clinicians in detecting long-bone fractures. Pitfalls in this technique include reduced accuracy with the small bones of the hands and feet, as well as great reliance on user experience. PMID:26815050

  15. 以强军目标为统领推进实战化训练创新发展%Advance the Innovative DeveIopment of Warfighting-oriented Training Under the Objective of BuiIding a Strong Army

    Institute of Scientific and Technical Information of China (English)

    王树林; 韩兵; 赵士夯

    2014-01-01

    实战化训练是在近似实战环境条件下进行的训练,就是按实战要求进行训练,按训练去实战,使训练与实战达到一体化。加强实战化训练是我军一以贯之的思想,是解决现实问题的必要举措。推进实战化训练深入发展,应转变训练作风,加强战法研究,创新组训方法,构设训练条件,严格训练考评,强化训练指导。%Warfighting-oriented training is the training under approximate actual combat environ-mental conditions,with the requirements of actual combat to train,according to the training to actual combat,to achieve consistent in training and actual combat.To strengthen warfighting-oriented train-ing is persistent thoughts for our army,and it is necessary to solve practical problems.Advancing the innovative development of warfighting-oriented training should change the training style,strengthen the methods research,innovate the organization method,structure the training conditions,strict the training evaluation,and strengthen the training guide.

  16. Resuscitation of the rare biosphere contributes to pulses of ecosystem activity

    Directory of Open Access Journals (Sweden)

    Zach eAanderud

    2015-01-01

    Full Text Available Dormancy is a life history trait that may have important implications for linking microbial communities to the functioning of natural and managed ecosystems. Rapid changes in environmental cues may resuscitate dormant bacteria and create pulses of ecosystem activity. In this study, we used heavy-water (H218O stable isotope probing (SIP to identify fast-growing bacteria that were associated with pulses of trace gases (CO2, CH4, and N2O from different ecosystems (agricultural site, grassland, deciduous forest, and coniferous forest following a soil-rewetting event. Irrespective of ecosystem type, a large fraction (69 - 74% of the bacteria that responded to rewetting were below detection limits in the dry soils. Based on the recovery of sequences, in just a few days, hundreds of rare taxa increased in abundance and in some cases became dominant members of the rewetted communities, especially bacteria belonging to the Sphingomonadaceae, Comamonadaceae, and Oxalobacteraceae. Resuscitation led to dynamic shifts in the rank abundance of taxa that caused previously rare bacteria to comprise nearly 60% of the sequences that were recovered in rewetted communities. This rapid turnover of the bacterial community corresponded with a 5 20 fold increase in the net production of CO2 and up to a 150% reduction in the net production of CH4 from rewetted soils. Results from our study demonstrate that the rare biosphere may account for a large and dynamic fraction of a community that is important for the maintenance of bacterial biodiversity. Moreover, our findings suggest that the resuscitation of rare taxa from seed banks contribute to ecosystem functioning.

  17. Coagulation factor concentrate-based therapy for remote damage control resuscitation (RDCR): a reasonable alternative?

    Science.gov (United States)

    Maegele, Marc

    2016-04-01

    The concept of remote damage control resuscitation (RDCR) is still in its infancy and there is significant work to be done to improve outcomes for patients with life-threatening bleeding secondary to injury. The prehospital phase of resuscitation is critical and if shock and coagulopathy can be rapidly minimized before hospital admission this will very likely reduce morbidity and mortality. The optimum transfusion strategy for these patients is still highly debated and the potential implications of the recently published pragmatic, randomize, optimal platelet, and plasma ratios trial (PROPPR) for RDCR have been reviewed. Identifying the appropriate transfusion strategy is mandatory before adopting prehospital hemostatic resuscitation strategies. An alternative approach is based on the early administration of coagulation factor concentrates combined with the antifibrinolytic tranexamic acid (TXA). The three major components to this approach in the context of RDCR target the following steps to achieve hemostasis: 1) stop (hyper)fibrinolysis; 2) support clot formation; and 3) increase thrombin generation. Strong evidence exists for the use of TXA. The data from the prospective fibrinogen in trauma induced coagulopathy (FIinTIC) study will inform on the prehospital use of fibrinogen in bleeding trauma patients. Deficits in thrombin generation may be addressed by the administration of prothrombin complex concentrates. Handheld point-of-care devices may be able to support and guide the prehospital and remote use of intravenous hemostatic agents including coagulation factor concentrates along with clinical presentation, assessment, and the extent of bleeding. Combinations may even be more effective for bleeding control. More studies are urgently needed. PMID:27100752

  18. Pulmonary embolism as a cause of cardiac arrest: Hypothermia in post-resuscitation period (cooling therapy

    Directory of Open Access Journals (Sweden)

    Niković Vuk

    2013-01-01

    Full Text Available Introduction. Pulmonary embolism as a possible cause of acute heart failure is a potentially fatal condition that can cause death in all age groups. Patients successfully resuscitated after cardiac arrest have a high risk of increased mortality and their poor long­term outcome is often associated with severe neurological complications. Case Outline. This is a case report of a 67­year­old man after a successful cardiopulmonary resuscitation (CPR which was followed by therapeutic hypothermia (TH. The patient visited the dermatological outpatients’ department with clinical presentation of pain and swelling of the right leg, shortness of breath and chest pain. During examination the patient lost consciousness, stopped breathing and had cardiac arrest. ECG was done which registered asystole. We began CPR. After 59 minutes of resuscitation return of heartbeat was achieved. The patient was transported to the Emergency Department. On admission, after computerized tomography (CT of the chest confirmed massive pulmonary embolism (PE, the patient was administered thrombolytic therapy with Metalyse (tenecteplase and anti­coagulation therapy (heparin. After stabilization, therapeutic hypothermia was applied. Combination of EMCOOLSpad on the chest and abdomen and cold Ringer lactate 500 ml at 4°C was flushed. Temperature was decreased to 33°C and kept stabile for 24 hours. After eight days the patient was conscious with a minimal neurological deficit. Conclusion. As shown in this case report, and according to the rich experience elsewhere, cooling therapy after out­of­hospital cardiac arrest and successful CRP may be useful in preventing neurological complications.

  19. Survival after In-Hospital Cardiopulmonary Resuscitation in a Major Referral Center during 2001-2008

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    Hasan Rafati

    2011-03-01

    Full Text Available Despite efforts to save more people suffering from in-hospital cardiac arrest, rates of survival after in-hospital cardiopulmonary resuscitation (CPR are no better today than they were more than a decade ago. This study was undertaken to assess the demographics, clinical parameters and outcomes of patients undergoing CPR by the code blue team at our center during 2001 to 2008. Data were collected retrospectively from adult patients (n=2262 who underwent CPR. Clinical outcomes of interest were survival at the end of CPR and survival at discharge from the hospital. Factors associated with survival were evaluated using binomial and Chi Square tests. Of the patients included (n=2262, 741 patients (32.8% had successful CPR. The number of male patients requiring CPR was more than females in need of the procedure. The majority of patients requiring CPR were older than 60 years (56.4±17.9. The number of successful CPR cases in long-day shift (7:00 to 19:00 was more than that in the night shift (19:00 to 7:00. Furthermore, 413 (18.4% cases were resuscitated on holidays and 1849 (81.7% on the working days. The duration of CPR was 10 min or less in 710 (31.4% cases. Cardiopulmonary resuscitations which lasted less than 10 minutes were associated with better outcomes. The findings of the present study indicate that some manageable factors including the duration of CPR, working shift, working day (holiday or non-holiday could affect the CPR outcomes. The findings might also be taken as evidence to suggest that the allocation of more personnel in each shift especially in night shifts and holidays, planning to increase the personnel's CPR skills, and decreasing the waste time would result in the improvement of CPR outcome.

  20. A Prospective Study of Survival After In-Hospital Cardiopulmonary Resuscitation and its Related Factors

    Science.gov (United States)

    Miranzadeh, Sedigheh; Adib-Hajbaghery, Mohsen; Hosseinpour, Nadimeh

    2016-01-01

    Background Despite several studies, there is no agreement on factors that affect survival after in-hospital cardiopulmonary resuscitation (CPR). Objectives This study aimed to evaluate the survival rate of in-hospital CPR and its related factors at Shahid Beheshti hospital in Kashan, Iran, in 2014. Patients and Methods A descriptive study was conducted on all cases of CPR performed in Kashan Shahid Beheshti hospital during a 6-month period in 2014. Through a consecutive sampling method, 250 cases of CPR were studied. A three-part researcher-made instrument was used. The outcome of CPR was documented as either survival to hospital discharge or unsuccessful (death of the patient). Chi-square test, t test, and logistic regression analysis were used to analyze the data. Results Of all CPR cases, 238 (95.2%) were unsuccessful and 12 (4.8%) survived to hospital discharge. Only 2.6% of patients who were resuscitated in medical units survived to hospital discharge, whereas this rate was 11.4% in the emergency department. Only 45 (18%) patients were defibrillated during resuscitation; in 11 patients, defibrillation was performed between 15 to 45 minutes after the initiation of CPR. The mean time from initiation of CPR to the first DC shock was 13.93 ± 8.88 minutes. Moreover, the mean duration of CPR was 35.11 ± 11.42 minutes. The survival rate was higher in the morning shift and lower during the time of shift change (9.4% vs. 0). The duration of CPR and speed of arrival of the CPR team were identified as factors that predicted the outcome of CPR. Conclusions The survival rate after in-hospital CPR was very low. The duration of CPR and the time of initiating CPR effects patients’ outcomes. These findings highlight the crucial role of an organized, skilled, well-established and timely CPR team. PMID:27218061