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P-6 Cardiopulmonary resuscitation training for new medical graduates
s22 P-3
P-S TRAINlNG IN CARDlOPULMONARY RESUSCITATION : FIVE YEARS REMJL.TS
. m,Gcboa FJ, Lisa V, Marco P, Daroca R, Mill&t E. EmergencyRoom and Critical Care Unit. SanMilkut-San Pedro General Hospital. Logrobo. La Rioja (Spain). In 1990 our group began a Cardiopubnonary Resuscitation(RCP) training program based upon the RCP National Committee of So&dad Esparlola de Mcdicina httensiva (SEMIUC) methodology and the World Federation Societys of Anesthesiology (WFSA) recommendations. Furhamore, since 1992 WC assume the European ResuscitationCouncil (ERC) recommendations.The group is composedof nine physicians who work in the Emergency Room and Critical Cam Unit in a General Hospital. This Hospital gives its services in a 25O.OUUpersons Community. WC have enough material for a good quality training (audiovisual support,RCP book, LaerdaJmanikins, arrhytmia simultiag~, etc.). Forty four Advanced RCP Courses (512 pupils) and 11 Basic RCP Courses ( I64 pupils) have been performed. The pnpilrr’ pmfessiod chnmcteristics
E~~OFDI~ffiNTPOSl~ONSANDKECilMENSOPACI‘IVECOMPRESSION DECOMPRESSION-CPR ON MEAN BLOOD PRESSURE, HEART RATE, RFSPIRATORY RATE IN RESCUERS COMPARED TO STANDARD CPR
AND
B. FELIX. B. HENRY. S. DESMET.P. LETORET,1.. TAYMANF,P. MOLS. BelgianRedCross,RtgiondeBnrxellesCapitaleandEmergency Department, CHU SAINT-PIERRE, U.L.B., Brussels. men suggest that Active be more efficient than 4i.t~ : to compare the effects of ACD-CPR in different positions (transverse 51, transverse 15:2, side 5: I, side 152) on Mean Blood Pressure(MBP). Heart Rate (HR) and Respiratory Rate (RR) with the effects of S-CPR. M&Q& : 9 volunteer rescuers; adaEd sktllmcter mamktn (Laerdal); cardiopum (AMBU);measurcmentsof BP(sphyngomanometerKorotkott sounds),H% (cardiac monitor), RR (cardiac monttor) were performed at To and 2.4,6,8 and IO mitt during CPR. IkCW4tS: Mean Blood Pressure .a,
are shown in the enclose fnm:
These are our pupti’ main results: Basic RCP skills were correctly done by 86.37 %. Theotyc test was correctly answered (more than 70 % right answers) by 61,03 % (icluding only Advanced RCP pupils). Them were no significant differences between s&f physicians (FEA) and residents (MIR). Howewer, there were significant differences between MIR and muses (ATS HOSP) @
P-6
P-4 EXPERIENCE AND TRAINMG, CARDIOPULMONARY RESUSCITATION HOSPITAL.
Qgclusion : ACD-CPR in the sideposition showsidentical values in HR, RR. MBP compared to S-CPR. In the transverse Position, ACD-CPR shows a marked increasein theseparameterscomparedto S-CPR and to side position ACD-CPR. ACD CPR in the transverse position could be rccommendcdif further studies reveal that this position increasesCPR efficiency.
ASSESSMENT OF (CPR) IN A GENERAL
CARDIOPULMONARY RESUSCITATION TRAINING FOR NEW MEDICAL GRADUATES
Dep of Anaesthesia. Torrccardenas Hospital Almerla. Spain
Dr D Scollnn, kCA Graham,Accident & EmergencyDepartments, Glasgow Royal Infumary and Edinburgh Royal Infumary, SCOTLAND
In casesof cardiac arrest, nursesoRen are the first ones to detect it and to start CPR skills. A survey performed in our hospital (586f54 deaths a year in the last 5 years) consisted in a questionnaire regarding experience on different aspects of CPR. 252 forms were collected from the following sources : Anaesthesia, 33 ; Surgery ward, 27 , ICU and Emergency rooms, 37 ; Diagnostic ward, 56 ; others wards, 99 86.1% (n=217) of surveyed nursety personnel bad been present during a cardiac arrest ; of these, 70% (n=l51) had detected it, at a first instance,at least once ; of these 89% (n=135) at least once had started CPR under own judgement Their assessmentof medical staff in charge performing the skills were as follows. a) correct and successf.tl, 30.3% ; b) correct and unsuccessful, 35.1% ; c) inadequate but successiirl, 17.7% ; d) inadequateand unsuccessfid,10.3% Nurses recognized their ability in management of conventional defibrillators : 23.8% ; endotracheal intubation : 29% ; face-mask ventilation 92% Nursery staff were trained for CPR as follows : Nursery School, 53%, Hospital Training Courses, 18.7%; Private Training, 30%, however all personnel confers crucial importance to daily practice 78% of courses included training on a manikin. Only 27.4% acknowledgesnot enoughtraining for CPR skills. There seems to be an overconfidence in current lraining in CPR which does not match with ideal international training standards neither with successfulresuscitation rates.
A questionnaire was distributed to all new medical graduatbsat a single UK medical school for three consecutive years. The sunFey asked about cardiopulmonary resuscitation training rcceivcd while a student and bow confident the graduate felt about his or her ability to perform resuscitation and to work in a hospital cardiac arrest team. Every graduatein the last two years has beentaught how to perform Basic Life Support, with almost everyone (99%) being taught with a mannikin and a steadily rising number working through simulated cardiac arrests. Despite a rise in the number of studentsbeing taught advanced life suppott techniques, confidence in certain areas remains low. While many graduates had been taught bow to perform endotracbeal inmbation and bow to use drugs during a cardiac arrest (93% and 74% respectively), few were confident they could do this during a resuscitation attempt (18% and 15%). Confidence in other advancedtechniqueshas beenrising. The number of graduates who had witnessed or participated in a resuscitation attempt has steadily fallen over the past three pears. However, those who had were much more confident about working in a cardiac arrest team. This study has followed the progress of resuscitation training during a period when its importance has been highlighted. The result has been more training for medical students, and graduates who are more confident in their basic and advanced life support abilities.
E.D. Fimreredo, L.G. Carrosa, J.L Blanco, R.E. Fredes
P-S TRAINlNG IN CARDlOPULMONARY RESUSCITATION : FIVE YEARS REMJL.TS
. m,Gcboa FJ, Lisa V, Marco P, Daroca R, Mill&t E. EmergencyRoom and Critical Care Unit. SanMilkut-San Pedro General Hospital. Logrobo. La Rioja (Spain). In 1990 our group began a Cardiopubnonary Resuscitation(RCP) training program based upon the RCP National Committee of So&dad Esparlola de Mcdicina httensiva (SEMIUC) methodology and the World Federation Societys of Anesthesiology (WFSA) recommendations. Furhamore, since 1992 WC assume the European ResuscitationCouncil (ERC) recommendations.The group is composedof nine physicians who work in the Emergency Room and Critical Cam Unit in a General Hospital. This Hospital gives its services in a 25O.OUUpersons Community. WC have enough material for a good quality training (audiovisual support,RCP book, LaerdaJmanikins, arrhytmia simultiag~, etc.). Forty four Advanced RCP Courses (512 pupils) and 11 Basic RCP Courses ( I64 pupils) have been performed. The pnpilrr’ pmfessiod chnmcteristics
E~~OFDI~ffiNTPOSl~ONSANDKECilMENSOPACI‘IVECOMPRESSION DECOMPRESSION-CPR ON MEAN BLOOD PRESSURE, HEART RATE, RFSPIRATORY RATE IN RESCUERS COMPARED TO STANDARD CPR
AND
B. FELIX. B. HENRY. S. DESMET.P. LETORET,1.. TAYMANF,P. MOLS. BelgianRedCross,RtgiondeBnrxellesCapitaleandEmergency Department, CHU SAINT-PIERRE, U.L.B., Brussels. men suggest that Active be more efficient than 4i.t~ : to compare the effects of ACD-CPR in different positions (transverse 51, transverse 15:2, side 5: I, side 152) on Mean Blood Pressure(MBP). Heart Rate (HR) and Respiratory Rate (RR) with the effects of S-CPR. M&Q& : 9 volunteer rescuers; adaEd sktllmcter mamktn (Laerdal); cardiopum (AMBU);measurcmentsof BP(sphyngomanometerKorotkott sounds),H% (cardiac monitor), RR (cardiac monttor) were performed at To and 2.4,6,8 and IO mitt during CPR. IkCW4tS: Mean Blood Pressure .a,
are shown in the enclose fnm:
These are our pupti’ main results: Basic RCP skills were correctly done by 86.37 %. Theotyc test was correctly answered (more than 70 % right answers) by 61,03 % (icluding only Advanced RCP pupils). Them were no significant differences between s&f physicians (FEA) and residents (MIR). Howewer, there were significant differences between MIR and muses (ATS HOSP) @
P-6
P-4 EXPERIENCE AND TRAINMG, CARDIOPULMONARY RESUSCITATION HOSPITAL.
Qgclusion : ACD-CPR in the sideposition showsidentical values in HR, RR. MBP compared to S-CPR. In the transverse Position, ACD-CPR shows a marked increasein theseparameterscomparedto S-CPR and to side position ACD-CPR. ACD CPR in the transverse position could be rccommendcdif further studies reveal that this position increasesCPR efficiency.
ASSESSMENT OF (CPR) IN A GENERAL
CARDIOPULMONARY RESUSCITATION TRAINING FOR NEW MEDICAL GRADUATES
Dep of Anaesthesia. Torrccardenas Hospital Almerla. Spain
Dr D Scollnn, kCA Graham,Accident & EmergencyDepartments, Glasgow Royal Infumary and Edinburgh Royal Infumary, SCOTLAND
In casesof cardiac arrest, nursesoRen are the first ones to detect it and to start CPR skills. A survey performed in our hospital (586f54 deaths a year in the last 5 years) consisted in a questionnaire regarding experience on different aspects of CPR. 252 forms were collected from the following sources : Anaesthesia, 33 ; Surgery ward, 27 , ICU and Emergency rooms, 37 ; Diagnostic ward, 56 ; others wards, 99 86.1% (n=217) of surveyed nursety personnel bad been present during a cardiac arrest ; of these, 70% (n=l51) had detected it, at a first instance,at least once ; of these 89% (n=135) at least once had started CPR under own judgement Their assessmentof medical staff in charge performing the skills were as follows. a) correct and successf.tl, 30.3% ; b) correct and unsuccessful, 35.1% ; c) inadequate but successiirl, 17.7% ; d) inadequateand unsuccessfid,10.3% Nurses recognized their ability in management of conventional defibrillators : 23.8% ; endotracheal intubation : 29% ; face-mask ventilation 92% Nursery staff were trained for CPR as follows : Nursery School, 53%, Hospital Training Courses, 18.7%; Private Training, 30%, however all personnel confers crucial importance to daily practice 78% of courses included training on a manikin. Only 27.4% acknowledgesnot enoughtraining for CPR skills. There seems to be an overconfidence in current lraining in CPR which does not match with ideal international training standards neither with successfulresuscitation rates.
A questionnaire was distributed to all new medical graduatbsat a single UK medical school for three consecutive years. The sunFey asked about cardiopulmonary resuscitation training rcceivcd while a student and bow confident the graduate felt about his or her ability to perform resuscitation and to work in a hospital cardiac arrest team. Every graduatein the last two years has beentaught how to perform Basic Life Support, with almost everyone (99%) being taught with a mannikin and a steadily rising number working through simulated cardiac arrests. Despite a rise in the number of studentsbeing taught advanced life suppott techniques, confidence in certain areas remains low. While many graduates had been taught bow to perform endotracbeal inmbation and bow to use drugs during a cardiac arrest (93% and 74% respectively), few were confident they could do this during a resuscitation attempt (18% and 15%). Confidence in other advancedtechniqueshas beenrising. The number of graduates who had witnessed or participated in a resuscitation attempt has steadily fallen over the past three pears. However, those who had were much more confident about working in a cardiac arrest team. This study has followed the progress of resuscitation training during a period when its importance has been highlighted. The result has been more training for medical students, and graduates who are more confident in their basic and advanced life support abilities.
E.D. Fimreredo, L.G. Carrosa, J.L Blanco, R.E. Fredes