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Quality of resuscitation: Flight attendants in an airplane simulator use a new mechanical resuscitation device; a simulation study
Abstracts / Resuscitation 81S (2010) S1–S114 49.4% (n = 380) described insufficient manikin practices, 50.5% (n = 388). 92.6% identified ‘112’ as EMS number. 18.8% answered CPR cycle, 7.7% CPR compression, 10.5% RB and 11.8% decision to CPR correctly. 4. Higher levels of education promote interest on BLS/AED/FA trainings. 66.1% did not trained before. 53.5% were identified their selves voluntarily participated. 100% (n = 2356) did not participate an AED training. In Turkey, public access defibrillation was not promoted during this date. 18.8% answered CPR cycle, 7.7% CPR compression, 10.5% RB and 11.8% decision to CPR correctly.
Participants who had training background have insufficient knowledge on CPR. Refreshment courses found useful tool to maintain the skills of resuscitation. Furthermore 55.2% found the previous training ‘Not Efficient ‘as a result of’ Not enough CPR manikin practices’. We have decided that low quality trainings, lack of efficient CPR manikin exercises and lack off refreshment courses are one of the major malpractice reasons for CPR.
S91
Materials and methods: Prospective, open, randomised and crossover simulation study. Study participants, competent in standard BLS were trained to use the mechanical resuscitation device to deliver both chest compressions and ventilation. 39 teams of two rescuers resuscitated a manikin for 12 min in random order, standard BLS or mechanically assisted resuscitation. Primary outcome was absolute hands-off time (sum of all periods during which no hand was placed on the chest minus ventilation time). Various parameters describing the quality of chest compression and ventilation were analysed as secondary outcome parameters. Results: Use of the device led to significantly less absolute hands-off time (164 ± 33 vs. 205 ± 42 s, p ≤ 0.001). The quality of chest compression was comparable among groups, except for a higher compression rate in the standard BLS group (123 ± 14 vs. 95 ± 11/min, p < 0.001). Tidal volume was higher in the standard BLS group (0.48 ± 0.14 vs. 0.34 ± 0.13 l, p < 0.001), but we registered fewer gastric inflations in the mechanical resuscitation device group (0 ± 0.2 vs. 12 ± 12 cases, p ≤ 0.001). Conclusion: Using the mechanical resuscitation device resulted in significantly less absolute hands-off time, but less effective ventilation. The translation of higher chest compression rate into better outcome, as shown in other studies previously, has to be investigated in another human outcome study.
doi:10.1016/j.resuscitation.2010.09.371 Reference AP227 Standard paediatric resuscitation courses meet realistic life-like environment for simulation
1. Genzwuerker HV, Hinkelbein J. Quality of chest compressions is improved with a man-powered mechanical chest compression device. Abstract. http://www.animaxcpr.de/de dokumente/.
Wermter B. 1 , Sasse M. 1 , Mitzlaff B. 1 , Luigs P. 1 , Bohlmann M. 1 , Toensfeuerborn H. 1 , Rother D. 2 , Zacharias J. 2 , Rathjens H. 2 , Groening W. 3 , Schirdewahn G. 3 , Wessel A. 1
doi:10.1016/j.resuscitation.2010.09.373
1 Paediatric Cardiology & Intensive Care, MHH Medical School Hannover, Hannover, Germany
AP229
2
Simulationcenter DRK-SiTZ, DRK German Red Cross Lower Saxony, Hannover-Misburg, Germany 3 School of Paramedics, Firebrigade City of Hannover, Hannover, Germany Purpose of the study: Paediatric Basic & Advanced Life Support Courses has been introduced as EPLS European Paediatric Life Support of ERC European Resuscitation Council in 2004 by PICU Paediatric Intensiv Care Unit of Medical School Hannover in Lower Saxony (Germany) in cooperation with Alpine Paediatric Life Support Training Center/White Cross Southtyrol. Standard paediatric resuscitation courses of ERC & AHA set the bases to start with highly advanced and/or highly realistic simulation training. Materials and methods: More than 500 participants in Paediatric Intensiv Care Network Lower-Saxony participated in the EPLS courses between 2004 and 2008. Highly advanced Simulation with very realistic setting has been realized in 2008 in cooperation with DRF, German Air rescue, Firebrigade Hannover & White Cross Southtyrol in ambulance-car-setting. In 2009 EPLS has been combined with highly realistic setting in daily indoor- and outdoor-settings of normal life. It was an EPLS-Recertification course in setting of realistic scenarios with videodebriefing. Results: EPLS-ERC (2003) Paediatric Trauma Course with real children (Argentina 1990/Spain 1996/Southtyrol 2005) well-suited since 2005 as supplementary module to EPLS and Instructor-courses in 2006 (Skill) and 2007 (scenarios). First (2008) homogenous course offered in our region: 1st level, PBLS (1 day); 2nd level, PALS (2 days); 3rd level, advanced paediatric simulation integrating real children (5 scenarios with mannequins, 2 scenarios with children, 1 day). Conclusions: Realistic Simulation with videodebriefing increase acceptance of recertification courses, because the provider courses are different from recertification. Standard courses helps to prepare highly advanced Simulation providing good Algorithm knowledge. To bring participants from PBLS/EPLS/PALS and EPLS recertification courses to highly advanced simulation with good basic knowledges and skills; ERC/AHA-courses are very helpful. Intermediate simulation settings as at www.drk-sitz.de could be usefull. Realistic environment makes recertification more attractive and prepare for highly advanced simulation. Different levels of Simulation should be used following needs of participants. doi:10.1016/j.resuscitation.2010.09.372 AP228 Quality of resuscitation: Flight attendants in an airplane simulator use a new mechanical resuscitation device; a simulation study Fischer H. 1 , Neuhold S. 2 , Hochbrugger E. 3 , Steinlechner B. 1 , Maurer C. 4 , Zapletal B. 4 , Stumpf D. 4 , Karner P. 4 , Greif R. 5 1 Department of Anaesthesia, General Intensive Care and Pain Control, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care, Medical University Vienna, Vienna, Austria 2 Department of Internal Medicine II, Division of Cardiology, Medical University Vienna, Vienna, Austria 3 Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University Vienna, Vienna, Austria 4 Medical University Vienna, Vienna, Austria 5 Department of Anaesthesiology and Pain Therapy, University Hospital Bern and University of Bern, Bern, Switzerland
Purpose of the study: Cardio-pulmonary resuscitation during flight is challenging and has to be sustained for long periods. In this setting a mechanical resuscitation device might improve performance. In this study we compared the quality of resuscitation of trained flight attendants practicing either standard basic-life-support (BLS) or using a mechanical resuscitation device (Animax) in a cabin simulator.1
Effects and limitations of an AED with audiovisual feedback for cardiopulmonary resuscitation: A manikin study Fischer H. 1 , Gruber J. 2 , Neuhold S. 3 , Hochbrugger E. 4 , Stumpf D. 2 , Zablethal B. 2 , Koinig H. 1 , Steinlechner B. 1 , Greif R. 5 1 Department of Anaesthesia, General Intensive Care and Pain Medicine, Division of CardioThoracic-Vascular Surgical Anaesthesia and Intensive Care Medicine, Medical University Vienna, Vienna, Austria 2 Medical University Vienna, Vienna, Austria 3 Department of Internal Medicine II, Division of Cardiology, Medical University Vienna, Vienna, Austria 4 Department of Internal Medicine III, Clinical Division of Endocrinology and Metabolism, Medical University Vienna, Vienna, Austria 5 Department of Anaesthesiology and Pain Therapy, University Hospital Bern and University of Bern, Bern, Switzerland
Purpose of the study: Correctly performed BLS and early defibrillation are the most effective measures to treat sudden cardiac arrest. Audiovisual feedback improves BLS. AEDs with feedback technology may play an important role in improving CPR quality if their feedback is adequate and corrects CPR performance. The aim of this simulation study was to investigate if an AED with audiovisual feedback improves CPR parameters during standard basic life support performed by trained laypersons. Materials and methods: With ethics committee approval and informed consent, 68 teams (2 flight attendants each) performed 12 min of standard CPR with the AED’s audiovisual feedback mechanism enabled or disabled. We recorded CPR quality parameters during mock resuscitations on a manikin in this open, prospective, randomized controlled trial. Between the feedback and non-feedback group we measured differences in compression depth and rate as main outcome parameters and effective compressions, correct hand position, and incomplete decompression as secondary outcome parameters. An effective compression was defined as a compression with correct depth, hand position, and decompression. Results: The group with feedback delivered compression rates closest to the recommended guidelines (101 ± 9 vs. 109 ± 15/min, p = 0.009), more effective compressions (20 ± 18% vs. 5 ± 6%, p < 0.001), more compressions with correct hand position (96 ± 13% vs. 88 ± 16%, p < 0.001), and less leaning (21 ± 31% vs. 77 ± 33%, p < 0.001). However, only the group without feedback adhered to the recommended compression depth (44 ± 7 vs. 39 ± 6 mm, p = 0.003). Conclusion: Use of an AED’s audiovisual feedback system resulted in some improved CPR quality parameters, thus confirming findings of earlier studies with the notable exception of decreased compression depth, which is a key parameter that might be linked to reduced cardiac output. doi:10.1016/j.resuscitation.2010.09.374
Participants who had training background have insufficient knowledge on CPR. Refreshment courses found useful tool to maintain the skills of resuscitation. Furthermore 55.2% found the previous training ‘Not Efficient ‘as a result of’ Not enough CPR manikin practices’. We have decided that low quality trainings, lack of efficient CPR manikin exercises and lack off refreshment courses are one of the major malpractice reasons for CPR.
S91
Materials and methods: Prospective, open, randomised and crossover simulation study. Study participants, competent in standard BLS were trained to use the mechanical resuscitation device to deliver both chest compressions and ventilation. 39 teams of two rescuers resuscitated a manikin for 12 min in random order, standard BLS or mechanically assisted resuscitation. Primary outcome was absolute hands-off time (sum of all periods during which no hand was placed on the chest minus ventilation time). Various parameters describing the quality of chest compression and ventilation were analysed as secondary outcome parameters. Results: Use of the device led to significantly less absolute hands-off time (164 ± 33 vs. 205 ± 42 s, p ≤ 0.001). The quality of chest compression was comparable among groups, except for a higher compression rate in the standard BLS group (123 ± 14 vs. 95 ± 11/min, p < 0.001). Tidal volume was higher in the standard BLS group (0.48 ± 0.14 vs. 0.34 ± 0.13 l, p < 0.001), but we registered fewer gastric inflations in the mechanical resuscitation device group (0 ± 0.2 vs. 12 ± 12 cases, p ≤ 0.001). Conclusion: Using the mechanical resuscitation device resulted in significantly less absolute hands-off time, but less effective ventilation. The translation of higher chest compression rate into better outcome, as shown in other studies previously, has to be investigated in another human outcome study.
doi:10.1016/j.resuscitation.2010.09.371 Reference AP227 Standard paediatric resuscitation courses meet realistic life-like environment for simulation
1. Genzwuerker HV, Hinkelbein J. Quality of chest compressions is improved with a man-powered mechanical chest compression device. Abstract. http://www.animaxcpr.de/de dokumente/.
Wermter B. 1 , Sasse M. 1 , Mitzlaff B. 1 , Luigs P. 1 , Bohlmann M. 1 , Toensfeuerborn H. 1 , Rother D. 2 , Zacharias J. 2 , Rathjens H. 2 , Groening W. 3 , Schirdewahn G. 3 , Wessel A. 1
doi:10.1016/j.resuscitation.2010.09.373
1 Paediatric Cardiology & Intensive Care, MHH Medical School Hannover, Hannover, Germany
AP229
2
Simulationcenter DRK-SiTZ, DRK German Red Cross Lower Saxony, Hannover-Misburg, Germany 3 School of Paramedics, Firebrigade City of Hannover, Hannover, Germany Purpose of the study: Paediatric Basic & Advanced Life Support Courses has been introduced as EPLS European Paediatric Life Support of ERC European Resuscitation Council in 2004 by PICU Paediatric Intensiv Care Unit of Medical School Hannover in Lower Saxony (Germany) in cooperation with Alpine Paediatric Life Support Training Center/White Cross Southtyrol. Standard paediatric resuscitation courses of ERC & AHA set the bases to start with highly advanced and/or highly realistic simulation training. Materials and methods: More than 500 participants in Paediatric Intensiv Care Network Lower-Saxony participated in the EPLS courses between 2004 and 2008. Highly advanced Simulation with very realistic setting has been realized in 2008 in cooperation with DRF, German Air rescue, Firebrigade Hannover & White Cross Southtyrol in ambulance-car-setting. In 2009 EPLS has been combined with highly realistic setting in daily indoor- and outdoor-settings of normal life. It was an EPLS-Recertification course in setting of realistic scenarios with videodebriefing. Results: EPLS-ERC (2003) Paediatric Trauma Course with real children (Argentina 1990/Spain 1996/Southtyrol 2005) well-suited since 2005 as supplementary module to EPLS and Instructor-courses in 2006 (Skill) and 2007 (scenarios). First (2008) homogenous course offered in our region: 1st level, PBLS (1 day); 2nd level, PALS (2 days); 3rd level, advanced paediatric simulation integrating real children (5 scenarios with mannequins, 2 scenarios with children, 1 day). Conclusions: Realistic Simulation with videodebriefing increase acceptance of recertification courses, because the provider courses are different from recertification. Standard courses helps to prepare highly advanced Simulation providing good Algorithm knowledge. To bring participants from PBLS/EPLS/PALS and EPLS recertification courses to highly advanced simulation with good basic knowledges and skills; ERC/AHA-courses are very helpful. Intermediate simulation settings as at www.drk-sitz.de could be usefull. Realistic environment makes recertification more attractive and prepare for highly advanced simulation. Different levels of Simulation should be used following needs of participants. doi:10.1016/j.resuscitation.2010.09.372 AP228 Quality of resuscitation: Flight attendants in an airplane simulator use a new mechanical resuscitation device; a simulation study Fischer H. 1 , Neuhold S. 2 , Hochbrugger E. 3 , Steinlechner B. 1 , Maurer C. 4 , Zapletal B. 4 , Stumpf D. 4 , Karner P. 4 , Greif R. 5 1 Department of Anaesthesia, General Intensive Care and Pain Control, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care, Medical University Vienna, Vienna, Austria 2 Department of Internal Medicine II, Division of Cardiology, Medical University Vienna, Vienna, Austria 3 Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University Vienna, Vienna, Austria 4 Medical University Vienna, Vienna, Austria 5 Department of Anaesthesiology and Pain Therapy, University Hospital Bern and University of Bern, Bern, Switzerland
Purpose of the study: Cardio-pulmonary resuscitation during flight is challenging and has to be sustained for long periods. In this setting a mechanical resuscitation device might improve performance. In this study we compared the quality of resuscitation of trained flight attendants practicing either standard basic-life-support (BLS) or using a mechanical resuscitation device (Animax) in a cabin simulator.1
Effects and limitations of an AED with audiovisual feedback for cardiopulmonary resuscitation: A manikin study Fischer H. 1 , Gruber J. 2 , Neuhold S. 3 , Hochbrugger E. 4 , Stumpf D. 2 , Zablethal B. 2 , Koinig H. 1 , Steinlechner B. 1 , Greif R. 5 1 Department of Anaesthesia, General Intensive Care and Pain Medicine, Division of CardioThoracic-Vascular Surgical Anaesthesia and Intensive Care Medicine, Medical University Vienna, Vienna, Austria 2 Medical University Vienna, Vienna, Austria 3 Department of Internal Medicine II, Division of Cardiology, Medical University Vienna, Vienna, Austria 4 Department of Internal Medicine III, Clinical Division of Endocrinology and Metabolism, Medical University Vienna, Vienna, Austria 5 Department of Anaesthesiology and Pain Therapy, University Hospital Bern and University of Bern, Bern, Switzerland
Purpose of the study: Correctly performed BLS and early defibrillation are the most effective measures to treat sudden cardiac arrest. Audiovisual feedback improves BLS. AEDs with feedback technology may play an important role in improving CPR quality if their feedback is adequate and corrects CPR performance. The aim of this simulation study was to investigate if an AED with audiovisual feedback improves CPR parameters during standard basic life support performed by trained laypersons. Materials and methods: With ethics committee approval and informed consent, 68 teams (2 flight attendants each) performed 12 min of standard CPR with the AED’s audiovisual feedback mechanism enabled or disabled. We recorded CPR quality parameters during mock resuscitations on a manikin in this open, prospective, randomized controlled trial. Between the feedback and non-feedback group we measured differences in compression depth and rate as main outcome parameters and effective compressions, correct hand position, and incomplete decompression as secondary outcome parameters. An effective compression was defined as a compression with correct depth, hand position, and decompression. Results: The group with feedback delivered compression rates closest to the recommended guidelines (101 ± 9 vs. 109 ± 15/min, p = 0.009), more effective compressions (20 ± 18% vs. 5 ± 6%, p < 0.001), more compressions with correct hand position (96 ± 13% vs. 88 ± 16%, p < 0.001), and less leaning (21 ± 31% vs. 77 ± 33%, p < 0.001). However, only the group without feedback adhered to the recommended compression depth (44 ± 7 vs. 39 ± 6 mm, p = 0.003). Conclusion: Use of an AED’s audiovisual feedback system resulted in some improved CPR quality parameters, thus confirming findings of earlier studies with the notable exception of decreased compression depth, which is a key parameter that might be linked to reduced cardiac output. doi:10.1016/j.resuscitation.2010.09.374