A paper submitted to The University of Arizona College of Medicine - Phoenix, History of Medicine course.

Se evaluaron de manera retrospectiva a 80 casos de pacientes que presentaron paro cardio-respiratorio en la Unidad de Shock Trauma y Unidad de Cuidados Críticos del Departamento de Emergencia del Hospital Nacional Edgardo Rebagliatti EsSalud, de 01/03/2002 al 28/03/2003. Las variables establecidas en el estudio incluyeron edad, sexo, antecedentes patológicos, evolución neurológico, patrón electrocardiográfico y supervivencia hospitalaria. Se encontró que los pacientes seniles con antecedentes patológicos asociados representan un bajo nivel de supervivencia post reanimación cardiopulmonar no obstante el tratamiento con los avances tecnológicos modernos. / They were evaluated from a retrospective way to 80 cases of patients that presented cardiopulmonary arrest unemployment witnessed in the Unit of Shock Trauma and Unit of Critical Cares of Emergency of the National Hospital Edgardo Rebagliatti EsSalud, from 01/03/2002 to 28/03/2003, with favorable initial answer. Inside the variables in the study: age, sex, pathological antecedent, neurological evolution, electrocardiography pattern and hospital survival they were included. Finding that the senile patients with clinical antecedents pathology have a low-level of survival post cardiopulmonary reanimation, nevertheless the treatment with the modern technological advances.

Se evaluaron de manera retrospectiva a 80 casos de pacientes que presentaron paro cardio-respiratorio en la Unidad de Shock Trauma y Unidad de Cuidados Críticos del Departamento de Emergencia del Hospital Nacional Edgardo Rebagliatti EsSalud, de 01/03/2002 al 28/03/2003. Las variables establecidas en el estudio incluyeron edad, sexo, antecedentes patológicos, evolución neurológico, patrón electrocardiográfico y supervivencia hospitalaria. Se encontró que los pacientes seniles con antecedentes patológicos asociados representan un bajo nivel de supervivencia post reanimación cardiopulmonar no obstante el tratamiento con los avances tecnológicos modernos. / They were evaluated from a retrospective way to 80 cases of patients that presented cardiopulmonary arrest unemployment witnessed in the Unit of Shock Trauma and Unit of Critical Cares of Emergency of the National Hospital Edgardo Rebagliatti EsSalud, from 01/03/2002 to 28/03/2003, with favorable initial answer. Inside the variables in the study: age, sex, pathological antecedent, neurological evolution, electrocardiography pattern and hospital survival they were included. Finding that the senile patients with clinical antecedents pathology have a low-level of survival post cardiopulmonary reanimation, nevertheless the treatment with the modern technological advances.

Thesis (M.S.)--University of Wisconsin -- La Crosse, 1986. / Includes bibliographical references (leaves 41-42).

Cardiopulmonary resuscitation (CPR) manikins are an educational technology tool employed to train nurses to perform high-quality CPR during real-life cardiac arrest events. However, a gap exists between CPR skills learned in training and those used in real life. The purpose of this quantitative study was to examine how CPR feedback and anxiety in registered nurses affect CPR performance on a manikin. Distributed practice and attentional control theory served as the foundations for this study. The research questions addressed the influence of demographic factors, real-time CPR feedback, and simulated hospital noises on CPR performance using CPR manikins. The study included a randomized longitudinal experimental design. Data were collected from 120 nurses via a demographic questionnaire, the Cognitive and Somatic Anxiety Questionnaire, and CPR compression performance feedback via a Zoll R Series defibrillator. Data analysis involved a repeated measures ANOVA or a regression analysis. Findings indicated that participants’ age predicted CPR performance. Receiving real-time CPR feedback led to a statistically significant improvement in performance, and the introduction of hospital noises did not predict CPR performance. Findings may be used to enhance individual performance of CPR, which may benefit society through improved patient care during cardiac arrest.

No description available.

Ideally a DNA profile will have high Peak Heights (PHs), balanced Peak Height Ratios (PHRs) and no drop out. However, low template DNA (LTDNA) is limited in quantity, quality or both and LTDNA profiles do not always consistently provide interpretable signal. Post-Polymerase Chain Reaction (PCR) purification is an efficient enhancement method that can be utilized to increase the amount of information in a LTDNA profile without elevated stutter, which can be common with other enhancement methods. Post-PCR purification decreases the remaining components left over from amplification, such as deoxyribonucleotide triphosphates, primers, salts, and enzymes so there is less competition during the electrokinetic injection and more DNA will go into the capillary. When post-PCR purification is used; PH’s will increase, PHRs should remain stable before and after purification and may result in recovery of alleles that previously had dropped out. Allele recovery may be the difference between an inconclusive result and an inclusion or exclusion. The efficacy of Post-PCR purification was assessed by amplifying single source DNA with both ABI AMPFℓSTR® Identifiler® (template mass down to 0.0625 ng) and Identifiler® PLUS (template mass down to 0.03125 ng) and performing post-PCR purification with Qiagen® MinElute® and Macherey-Nagel NucleoSpin®. The original amplified product and purified product were analyzed and compared and it was determined post-PCR purification reduced the primer front, increased the PHs, recovered additional alleles and did not affect the PHRs. On average the Fold Increase (FI) for Identifiler® product purified with Qiagen® MinElute® is 3.5 and the average FI for Identifiler® PLUS product purified with Qiagen® MinElute® and Macherey-Nagel NucleoSpin® is 3.2. Additionally, the stutter percentage observed in the original sample profile was compared to the purified samples to determine if purification affected the stutter percentage of Identifiler® PLUS product. It was determined at only a few alleles the amplified product was above or below the stutter percentage of purified product. The stutter percentage values for purified samples were further compared to the Identifiler® PLUS manual and only one allele’s stutter percentage is above the companies stutter cut off values. Post-PCR purification with Qiagen® MinElute® or Macherey-Nagel NucleoSpin® is a successful enhancement method to increase information of a LTDNA profile without introducing additional complications that other enhancement methods are known to do.

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 2002. / Includes bibliographical references.

Background According to data from Department of Health, in 2011 heart diseases was the second commonest leading cause of death in Hong Kong [13]. Shortening the time from cardiac arrest to Cardio-pulmonary Resuscitation (CPR) could increase the chance of survival. If the brain of the patient who suffers from cardiac arrest does not receive oxygen within 4 minutes, severe brain damage might occur [14]. In some countries like US and Finland, dispatcher will give CPR instruction to caller when cardiac arrest is recognized. Therefore, the patient could receive early CPR before the arrival of paramedics. If dispatcher-assisted CPR is implemented in Hong Kong, the chance of survival of out-of-hospital cardiac arrest (OHCA) patient could be increased. Objective 1. To evaluate whether it is evident that dispatcher-assisted CPR and dispatcher instruction [22] would improve survival of OHCA. 2. To evaluate whether these measures could be implemented in Hong Kong. Data Source PubMed was searched for articles in English language with no limit set for time of the study. The keywords were dispatcher-assisted CPR and out of hospital. No inclusion criteria were set on the publication type and other details. Results Initial PubMed search resulted in 24 articles. After reviewing the abstracts, 10 articles were selected for full-text assessment. Finally, four relevant articles were selected for the literature review. Of the four papers, two were retrospective cohort studies; one was before-after comparison study while the remaining one was randomized control trial. Three papers (Rea et al, Eisenberg et al, and Kuisma et al.) used the survival to hospital discharge as the effect measure for the primary outcome to evaluate the effectiveness of dispatcher-assisted CPR. The remaining paper (Hallstrom et al.) mainly studied the potential benefit and harm from dispatcher-assisted CPR. Using no bystander CPR as the reference group, the multivariate adjusted odds ratio of survival was 1.45 (95% CI, 1.21, 1.73) for dispatcher-assisted bystander CPR and 1.69 (95% CI, 1.42, 2.01) for bystander CPR without dispatcher assistance [2]. The percentage of total bystander-initiated CPR increased from 45% to 56% after the programme (difference: 11.1%, 95% CI, ±9.3%). Besides, the percentage discharged for dispatcher-assisted CPR group after the programme was 15% higher than that before the programme [6]. The most important findings are related to the number of cardiac arrest calls in that when the dispatcher handled on less than 4 Ventricular Fibrillation (VF) calls during the study period, the survival to hospital discharge was 22.1% compared to 38.2% and 39.4% when the dispatcher handled 4 to 9 calls or more than 9 calls (p = 0.0227 for the three groups) [8]. With telephone guided CPR, the survival to hospital discharge was 43.1% compared with 31.7% when CPR instructions were not provided (p = 0.0453) [8]. In patients (n = 3,320) receiving advanced cardiac life support (ACLS) a total of 993 (29.9%) was found to be benefited from dispatcher-assisted CPR [7]. Conclusion Instructions by dispatcher can improve bystander CPR rates, which in turn increases the chance of survival [26]. Dispatcher-assisted CPR is worth considering to be recommended to all callers reporting a patient in cardiac arrest in Hong Kong. / published_or_final_version / Public Health / Master / Master of Public Health

Aims The aim of this thesis was to describe out-of-hospital cardiac arrest (OHCA) due to drowning from the following angles. In Paper I: To describe the characteristics of OHCA due to drowning and evaluate factors of importance for survival. In Paper II: To describe lifesaving skills and CPR competence among surf lifeguards. In Paper III: To describe the characteristics of interventions performed by the Swedish fire and rescue services (SFARS) and evaluate survival with or without rescue diving units. In Paper IV: To describe the prevalence of possible confounders for death due to drowning. In Paper V: To describe changes in characteristics and survival over time and again to evaluate factors of importance for survival Methods Papers I and III-V are based on retrospective register data from the Swedish OHCA Register reported by Emergency Medical Service (EMS) clinicians between 1990-2011. In addition, in Paper III, the data have been analysed and compared with the SFARS database for rescue characteristics. In Paper IV, the data have been compared with those of the National Board of Forensic Medicine (NBFM). Paper II is a descriptive study of 40 surf lifeguards evaluating delay and CPR quality as peformed on a manikin. Results Survival in OHCA due to drowning is about 10% and does not differ significantly from OHCA with a cardiac aetiology. The proportion of witnessed cases was low. Survival appears to increase with a short EMS response time, i.e. early advanced life support. Surf lifeguards perform CPR with sustained high quality, independent of prior physical strain. In half of about 7,000 drowning calls, there was need for a water rescue by the fire and rescue services. Among the OHCA in which CPR was initiated, a majority were found floating on the surface. Rescue diving took place in a small percentage of all cases. Survival when using rescue divers did not differ significantly from drownings where rescue diving units were not used. No survivors were found after &gt;15 minutes of submersion in warm water. After submersion in cold water, survival with a good neurological outcome was extended. Among 2,166 autopsied cases of drowning, more than half were judged as accidents and about one third as intentional suicide cases. Among accidents, 14% were found to have a cardiac aetiology, while the corresponding figure among suicides was 0%. In a 20-year follow-up of OHCA due to drowning in Sweden, both bystander CPR and early survival to hospital admission are increasing. The proportion of cases alive after one month has not changed significantly during the period. Conclusions Survival from OHCA due to drowning is low. A reduction in the EMS response time appears to have high priority, i.e. early ALS is important. The quality of CPR among surf lifeguards appear to be high and not affected by prior physical strain. In all treated OHCA cases, the majority were found at the surface and survival when rescue diving took place did not appear to be poorer than in non-rescue diving cases. In a minor proportion of cases, cardiac disease could be a confounder for death due to drowning. Bystander CPR in OHCA due to drowning has increased over a 20-year period and the proportion of early survivors to hospital admission is increasing. We speculate that our studies were underpowered with regard to the opportunity adequately to assess the effects of bystander CPR on survival to hospital discharge. A uniform Swedish definition of drowning based on the recommended international terms should be implemented throughout Swedish authorities and health care, in order to enhance the quality of data and improve the potential for future research. / <p>Disputationen sker Fredagen den 20 September 2013, kl. 13.00 Sahlgrens aula, Blå stråket 5, Sahlgrenska universitetssjukhuset, Göteborg.</p>