Orientador: José Dirceu Ribeiro / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências / Made available in DSpace on 2018-08-17T20:22:28Z (GMT). No. of bitstreams: 1 Oliveira_PricilaMaraNovaisde_M.pdf: 4269847 bytes, checksum: b958bd15ceb970c0bd38d75f15de9a52 (MD5) Previous issue date: 2011 / Resumo: Introdução: O balão auto-inflável (BAI) é o equipamento utilizado para ventilar manualmente durante a manobra de hiperinsuflação manual (HM). Apesar do BAI ser amplamente utilizado, existem informações limitadas disponíveis sobre suas características físicas e parâmetros ventilatórios. O objetivo deste estudo foi avaliar o desempenho de três marcas de BAI, neonatal e pediátrico, durante a HM de acordo com o fluxo de entrada de oxigênio (O2) quando a HM é realizada por fisioterapeutas experientes e inexperientes em duas situações clínicas simuladas. Método: 22 fisioterapeutas ventilaram um pulmão-teste (Ventilator Tester 2®) simulando a mecânica respiratória normal e restritiva de um recém-nascido e de uma criança. Os modelos de BAI testados foram J.G.Moryia®, Laerdal® e Hudson®. Eles receberam fluxos de 0, 5, 10 e 15L/min O2. Medidas de volume inspiratório (Vi), pico de pressão inspiratório (PIP) e pico de fluxo inspiratório (PFI) foram registradas por um monitor de perfil respiratório (CO2SMOplus®). Resultados: Independente da marca ou fluxo, os fisioterapeutas experientes forneceram maior PFI que os inexperientes no BAI neonatal (p=0,026) e pediátrico (p=0,029). Houve diferença estatística no Vi e PIP (p?0,001) gerado pelas marcas, tanto neonatal, quanto pediátrico. O Vi fornecido pelo BAI Hudson® neonatal ao receber 0L/min O2 foi menor do que o fornecido com 15L/min. O Vi fornecido pelos modelos neonatal e pediátrico da J.G.Moryia® e Laerdal® não variaram em função dos fluxos de O2 fornecidos. O PIP apresentou aumento significante no BAI neonatal quando o fluxo variou de 0-15L/min (8,4% Hudson®, 1,7% Laerdal® e 3,7% J.G.Moryia®). O Vi, PIP e PFI foram significativamente diferentes quando comparadas as complacências normal e reduzida (p?0,001). Conclusões: O desempenho da HM com BAI em modelos neonatal e pediátrico foi influenciado pelo nível de experiência do profissional, pela mecânica pulmonar do paciente que está sendo ventilado, pela marca do BAI e fluxo de oxigênio ofertado. Estes resultados sugerem que os fisioterapeutas devem receber treinamento da HM utilizando diferentes marcas de BAI em situações clínicas distintas / Abstract: Background: Self-inflating bag (BAI) is the device used to manual ventilate during manual hyperinflation (HM) technique. Despite the BAI being widely used, there is limited information available on their physical characteristics and ventilatory outcomes. The goal of this study was to evaluate the performance of three brands of neonatal and pediatric SIB during HM, according to the oxygen flow rate delivered by experienced and inexperienced physiotherapists during HM in two simulated clinical situations. Methods: Twenty two physiotherapists ventilated a test lung (Ventilator tester 2®) simulating a normal and a restrictive respiratory mechanics of a newborn and a children. SIB models tested were J.G.Moryia®, Laerdal® and Hudson®. They received oxygen flows of 0, 5, 10, and 15L/min. Measures of inspiratory volume (Vi), peak inspiratory pressure (PIP), and peak inspiratory flow (PIF) were recorded using a respiratory profile monitor (CO2MOplus®). Results: Regardless of brand or flow, experienced physiotherapists provided largest PFI than inexperienced in neonatal (p=0.026) and pediatric BAI (p=0.029). There was statistical difference in Vi and PIP (p?0.001) delivered between models Hudson®, Laerdal® and J.G.Moryia® in both neonatal and pediatric sizes. When receiving 0L/min O2, the neonatal Hudson® bag delivered a Vi lower than that provided receiving 15L/min. The neonatal and pediatric models of J.G.Moryia® and Laerdal® did not vary the Vi generated in function of oxygen inflows. PIP showed a difference in all neonatal bags according to oxygen inflow; when compared inflows of 0 and 15 L/min, there was an increase of 8.4% in Hudson®, 1.7% in Laerdal® and 3.7% in J.G.Moryia®. Vi, PIP and PFI were significantly different when compared the normal and reduced compliance (p?0.001). Conclusions: The HM performance with BAI in neonatal and pediatric models was influenced by the experience level, the patients' lung mechanics, the BAI brand and oxygen flow supplied. These results suggest that physiotherapists should be trained in HM using different brands of BAI in distinct clinical situations / Mestrado / Saude da Criança e do Adolescente / Mestre em Saude da Criança e do Adolescente

Orientador: Sergio Tadeu Martins Marba / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-14T00:59:17Z (GMT). No. of bitstreams: 1 Bassani_MarianaAlmada_M.pdf: 763837 bytes, checksum: c0d2ff89684b98347f303d71e7f06dbe (MD5) Previous issue date: 2009 / Resumo: O objetivo deste estudo foi analisar variáveis ventilatórias - frequência ventilatória (FV), pressão de pico inspiratória (PIP), volume corrente (Vt), tempo inspiratório (Ti) e fluxo inspiratório (Vinsp) - durante o manejo do ventilador pulmonar manual autoinflável neonatal. Foi realizado um estudo experimental em que diferentes profissionais de saúde que trabalham na Unidade de Terapia Intensiva Neonatal do CAISM/UNICAMP ventilaram manualmente um pulmão artificial (Biotek, VT-2) ajustado com complacência (0,003 l/ cmH2O) e resistência (200 cmH2O/l/min) de um recém-nascido a termo intubado. Foi utilizado um reanimador autoinflável modelo neonatal (JG Moriya), sem fonte de gás comprimido e sem reservatório. As variáveis ventilatórias estudadas foram analisadas em relação a cinco diferentes manuseios (10, 5, 4, 3 e 2 dedos), tamanho de mão (pequena, média, grande) e profissão do operador (médicos assistentes ou docentes, médicos residentes, fisioterapeutas, enfermeiros, técnicos de enfermagem). As variáveis ventilatórias também foram analisadas levando-se em consideração categorias de referência estabelecidas. Para análise estatística foram utilizadas tabelas de freqüência, medidas de tendência central e de dispersão para a descrição da amostra. Para avaliar as variáveis ventilatórias segundo o manuseio, tamanho de mão e profissão aplicou-se análise de variância para medidas repetidas, seguida dos testes perfil por contraste ou Tukey. Os testes de Friedman, Fisher e Quiquadrado foram aplicados para avaliar as variáveis ventilatórias categorizadas segundo o manuseio, tamanho de mão e profissão do operador. Foram incluídos 172 diferentes profissionais: 15 médicos assistentes/docentes, 28 médicos residentes, 43 fisioterapeutas, 30 enfermeiros e 56 técnicos de enfermagem. O modo de manuseio influenciou de maneira estatisticamente significativa Vinsp, PIP e Vt, cujos valores foram tanto maiores quanto maior o número de dedos utilizados para ventilar. Observou-se, também, para estas 3 variáveis, uma alta variabilidade dos valores obtidos. O tamanho de mão não afetou nenhuma das variáveis ventilatórias estudadas. Os valores de Vt, Ti e FV foram influenciados significativamente pela profissão. Em geral, observou-se que os fisioterapeutas geraram maiores valores de Vt e Ti e menores valores de FV do que os demais profissionais. Na comparação dos valores das variáveis ventilatórias obtidos em relação aos valores de referência, observamos pouca adequação dos valores das variáveis obtidas pelos profissionais, exceto para Vinsp, para o qual 84,9% dos voluntários forneceram valores adequados. Para PIP, Vt e Ti, a grande maioria dos voluntários gerou valores acima dos considerados adequados para reanimação neonatal. Em contrapartida, 49,4% dos voluntários geraram valores baixos de FV. O manuseio e o tamanho de mão não influenciaram a ampla inadequação dos valores fornecidos. No entanto, observamos influências significativas da profissão sobre Ti e FV em suas diferentes categorias. Concluímos que apenas Vinsp, PIP e Vt foram influenciados pelo manuseio de modo significativo. O tamanho de mão não influenciou nenhuma das variáveis estudadas. O Vt, Ti e FV foram afetados pela profissão. Houve pouca adequação dos valores gerados pelos profissionais para PIP, Vt, Ti e FV. O manuseio e tamanho de mão não afetaram a ampla inadequação da técnica, no entanto, a profissão influenciou o Ti e FV quando categorizados / Abstract: The main goal of this study was to evaluate how ventilator variables - inspiratory flow rate (IFR), peak inspiratory pressure (PIP), tidal volume (Vt), inspiratory time (Ti), and and ventilatory rate (VR) - may be affected by different ways of handling a neonatal selfinflating bag. This is an experimental study in which different health professionals who work at the Neonatal Intensive Care Unit of CAISM/UNICAMP ventilated an artificial lung (Biotek, VT-2) adjusted with airway resistance (200 cmH2O/l/min) and compliance (0,003 l/ cmH2O) compatible with physiologic values of an intubated term newborn (approximately 3 kg). It was used a neonatal self-inflating resuscitator (JG Moriya), with no reservoir bag or source of compressed gas. The ventilatory variables were assessed considering five different ways of handling (with 10, 5, 4, 3 and 2 fingers), operator's hand size (small, medium and large) and profession (faculty/assistant physicians, resident physicians, physiotherapists, nurses and nursing technicians). These variables were also assessed considering established reference categories. For the statistical analysis, frequency tables and measures of central tendency and dispersion were used to describe the studied sample. Analysis of variance for repeated measures, followed by contrast profile or Tukey's tests, was used to evaluate how different ways of handling, hand size and profession affect the ventilatory variables. Friedman's, Fisher's and Chi-square tests were used to analyze the categorized variables considering the different ways of handling and operator's hand size and profession. This study was conducted with 172 professionals: 15 faculty/assistant physicians, 28 physician residents, 43 physiotherapists, 30 nurses and 56 nursing technicians. Bag handling influenced significantly IRF, PIP and Vt values, which were the higher the greater the number of fingers used, and presented high variability. Hand size did not affect significantly any of the studied variables, whereas, profession influenced Vt, Ti and VR. In the general, physiotherapists delivered higher values of Vt and Ti, and lower values of VR than the other professional groups. When comparing variable values considering the reference values, it was observed poor adequacy of these values, except for VR, which was adequate in 84.9% of the cases. For PIP, Vt and Ti, the majority of volunteers delivered values considered excessive for neonatal resuscitation. On the other hand, 49.4% of the volunteers delivered low values for VR. Handling and hand size did not influence the overall poor adequacy of the delivered values, whereas profession significantly influenced Ti and VR values in their categories. We conclude that only IFR, PIP and Vt were significantly influenced by bag handling. Hand size did not affect any of the studied variables. Vt, Ti e FV were influenced by the operator's profession. There was poor adequacy for all values of PIP, Vt, Ti and VR. Bag handling and operator's hand size did not affect the overall poor adequacy, although profession influenced categorized Ti and FV / Mestrado / Saude da Criança e do Adolescente / Mestre em Saude da Criança e do Adolescente

Introdução: Apesar dos avanços e uniformização preconizada pelas diretrizes mundiais de ressuscitação cardiopulmonar (RCP), ainda é insuficiente o conhecimento da efetividade da RCP intra-hospitalar no Brasil. Neste estudo avaliamos variáveis clínicas e demográficas de pacientes submetidos à RCP e preditores independentes associados à sobrevivência imediata (recuperação da circulação espontânea acima de 24h), sobrevivência até a alta hospitalar, em seis e doze meses. Métodos: este estudo transversal incluiu, de forma prospectiva, 763 pacientes em parada cardiorrespiratória (PCR) entre 1º de novembro de 2007 a 1º de novembro de 2010, ocorrida no ambiente intra-hospitalar de 17 hospitais gerais e institutos de especialidades. As manobras de RCP foram executadas em 575 pacientes. Resultados: A modalidade de PCR mais frequente foi a assistolia (40,7%), seguida de atividade elétrica sem pulso (39,3%). A sobrevivência imediata foi de 48,8%, sobrevivência até a alta hospitalar foi de 13%, de 4,3% em seis e de 3,8% em doze meses. Os preditores independentes associados à sobrevivência imediata foram o ritmo inicial em fibrilação ventricular ou taquicardia ventricular sem pulso (Razão de Taxas RT 1,31; IC 95% 1,10 a 1,55; p=0,002); presença de sinais de consciência da vítima, ao chegar a equipe atendimento (RT 1,37; IC95% 1,16 a 1,61; p<0,001); uso de epinefrina durante a RCP (RT 1,61; IC 95% 1,32 a 1,98; p < 0,001); hipoglicemia como causa da PCR (RT 1,68; IC 95% 1,11 a 2,55; p=0,014). Foram preditores independentes associados à menor sobrevivência imediata: hipotensão como causa da PCR (RT 0,74; IC 95% 0,61 a 0,90; p=0,003); sedentarismo como antecedente à PCR (RT 0,76; IC 95% 0,66 a 0,88; p< 0,001) e tempos da duração da RCP: maiores tempos com menor sobrevivência. Como preditores independentes associados à sobrevivência até a alta hospitalar, foram identificados: presença de médicos e enfermeiros treinados em ACLS e/ou BLS na equipe de atendimento (HR 3,07; IC 95% 1,39 a 6,78; p=0,006) e ritmo sinusal após a recuperação da circulação espontânea (HR 1,44; IC 95% 1,26 a 1,75; p=0,002). Como preditores independentes para maior sobrevivência em seis meses identificou-se: uso de epinefrina (HR 4,09; IC 95% 1,14 a 14,69; p=0,030), ritmo sinusal após a recuperação da circulação espontânea (HR 4,09; IC 95% 1,14 a 14,69; p=0,030) e antecedente de infarto do miocárdio (HR 4,08; IC 95% 1,51 a 11,06; p=0,006). Não foram identificados preditores independentes para sobrevivência em doze meses. Conclusões: Foram identificados como preditores independentes para sobrevivência imediata o ritmo inicial em fibrilação ventricular ou taquicardia ventricular sem pulso, presença de sinais de consciência da vítima, uso de epinefrina durante a RCP, hipoglicemia como causa da PCR. Como preditores independentes associados à sobrevivência até a alta hospitalar a presença de médicos e enfermeiros treinados em ACLS e/ou BLS e o ritmo sinusal após a recuperação da circulação espontânea. Os achados sugerem perfil multicêntrico nacional da ressuscitação, fornecendo dados potencialmente representativos da ressuscitação cardiopulmonar intra-hospitalar no Brasil. / Introduction: in spite of the advances and worldwide standardization for cardiopulmonary resuscitation recommended by international guidelines, knowledge on the effectiveness of in-hospital cardiopulmonary resuscitation (CPR) is not yet sufficient in Brazil. In this study, we evaluated both demographic and clinical variables in patients underwent cardiopulmonary resuscitation and independent predictors associated to immediate (recovery of spontaneous circulation up to 24 h), until hospital discharge, six and twelve months survival rates. Methods: This cross-sectional study included, prospectively, 763 patients who presented in-hospital cardiac arrest between November 1st 2007 and 01 November 1st 2010, from 17 general hospitals and specialty institutes. CPR procedures were performed in 575 patients. RESULTS: The cardiac arrest modality most frequently found was asystole (40.7%), followed by pulseless electrical activity (39,3%). Immediate survival was 48,8%, survival until hospital discharge was 13%, 4.3% in six months and 3.8% in twelve months. Independent predictors associated with higher immediate survival were: ventricular fibrillation or ventricular tachycardia without pulse as the initial rhythm of cardiac arrest (Rate Ratio- RR 1.31; IC 95% 1.10 to 1.55; p = 0.002); presence of victim consciousness signs when arrival of the emergency staff (RR 1.37; IC95% 1.16 to 1.61; p < 0.001); use of epinephrine during CPR (RR 1.61; IC 95% 1.32 to 1.98; p < 0.001); hypoglycemia as cause of cardiac arrest (RR 1.68; IC 95% 1.11 to 2.55; p = 0.014). Independent predictors associated with lower immediate survival were: hypotension as cause of cardiac arrest (RR 0.74; IC 95% 0.61 to 0.90; p = 0.003); sedentary lifestyle prior to cardiac arrest (RR 0.76; IC 95% 0.66 to 0.88; p < 0.001) and duration of the cardiopulmonary resuscitation: the longer the duration, the lower the survival. Independent predictors associated with hospital discharge survival were: presence of doctors and nurses with ACLS and/or BLS previous training, in the emergency team (HR 3.07; IC 95% 1.39 to 6.78; p = 0.006) and sinus rhythm after recovery of spontaneous circulation (HR 1.44; IC 95% 1.26 to 1.75; p = 0.002). Independent predictors of higher six-month survival rate were use of epinephrine (HR 4.09; IC 95% 1.14 to 14.69; p = 0.030), sinus rhythm after return of spontaneous circulation (HR 4.09; IC 95% 1.14 to 14.69; p = 0.030) and previous myocardial infarction (HR 4.08; IC 95% 1.51 to 11.06; p = 0.006). Independent predictors of 12-month survival were not identified. Conclusion: As independent predictors for immediate survival we identified: ventricular fibrillation or ventricular tachycardia without pulse as the initial rhythm, presence of signs of awareness of the victim, use of epinephrine during RCP, hypoglycemia as cause of PCR. As independent predictors associated survival until discharged the presence of doctors and nurses trained in ACLS and BLS and the sinus rhythm after recovery of spontaneous circulation (ROSC). These findings suggest a multicentre and national resuscitation profile, providing relevant information, potentially representative of the in-hospital cardiopulmonary resuscitation in Brazil.

Orientador: Maria José D'Elboux / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T02:20:00Z (GMT). No. of bitstreams: 1 Pergola-Marconato_AlineMaino_D.pdf: 6010690 bytes, checksum: 45ae36cd11e1369ccd7bd4efb047650e (MD5) Previous issue date: 2013 / Resumo: Introdução. A eficácia na aplicação dos primeiros socorros com a participação do leigo nas situações de emergência determina a sobrevivência das vítimas e aponta para a relevância de sua capacitação. Em âmbito nacional não existe programa modelo desta capacitação. Objetivos. Comparar o conhecimento dos alunos que participaram da capacitação em primeiros socorros do Curso de Formação de Condutores (CFC) com aqueles que participaram do curso elaborado e ministrado por profissional da saúde; adaptar, validar o conteúdo e testar a confiabilidade de questionário para avaliar conhecimentos de primeiros socorros de leigos; propor e aplicar programa para esta capacitação; identificar retenção do conteúdo dos participantes em ambos os cursos; e, comparar assimilação e retenção do conteúdo de ambos os grupos conforme a idade. Sujeitos e método. Estudo experimental em que se elaborou programa de capacitação teórica em primeiros socorros para leigos e o aplicou aos alunos do CFC divididos aleatoriamente em: Grupo Intervenção (GI) - participou do programa elaborado e Grupo Controle (GC) - do CFC. Mesmo questionário, composto por 29 questões fechadas, foi aplicado: Etapa I - antes, Etapa II - após e, Etapa III - três meses após participação na capacitação; adaptado e submetido à validação e teste de confiabilidade (estabilidade). Após a coleta, houve rearranjo conforme idade (GIA/GCA - idade inferior a 50 anos; GIB/GCB - superior ou igual a 50 anos). Atribuiu-se nota às respostas e o desempenho de cada indivíduo foi classificado: qualificado (7,1 a 10,0), pouco qualificado (5,0 a 7,0) e não qualificado (0 e 4,9). Resultados. Nove juízes (três leigos e seis especialistas) validaram o conteúdo e apenas 1/9 (11,2%) não considerou a parte do suporte básico de vida (SBV) abrangente devido à ausência de questão sobre reconhecimento da parada cardiorrespiratória. Dezesseis questões obtiveram concordância de 100,0% para clareza. No domínio Abordagem da vítima, 10/27 (37,0%) das questões apresentaram concordância perfeita (Kappa=1,0) e no SBV, 5/9 (55,6%) boa. Obteve se Coeficiente de Correlação Intraclasses indicativo de boa concordância para todo o instrumento (0,63). Amostra de 367 sujeitos (GI=182 e GC=185), homogênea quanto variáveis sociodemográficas entre grupos. Observou-se ascensão das notas médias da Etapa I (7,7) para a II (8,1) e, decréscimo na III (7,9) no GI. No GC também ocorreu esta oscilação, mas com notas menores (I - 5,3; II - 7,0; III - 6,3). No GI não houve nenhum classificado como não qualificado nas Etapas II e III. No GC, houve redução dos sujeitos não qualificados de 73/185 (39,5%) na I para 16/185 (8,6%) na II, mas na III ainda havia 25/185 (13,5%). Predominaram sujeitos qualificados no GIA. A comparação da classificação de desempenho entre grupos mostrou diferença significativa nas Etapas II e III (p<0,0001). Conclusão. Apesar de a capacitação ser apenas teórica, possibilitou aumento significativo de qualificados nas Etapas II e III do GI. A capacitação proposta propiciou assimilação e retenção adequada. Considerações finais. Sugere-se a aplicação deste programa, pois os resultados evidenciaram boa assimilação e retenção. Não houve amostra considerável de idosos, mas é essencial que recebam atenção especial na capacitação. Estudo inserido na Linha de Pesquisa Processo de Cuidar em Saúde e Enfermagem / Abstract: Background. The effective use of first aid with the lay people involvement in emergencies determines the survival of victims and points to the relevance of their training. Nationally there is no standard for this training program. Aims: Compare the knowledge of the students who participated in the Driver's License Course (DLC) first aid training with those who attended the course prepared and delivered by a health professional; adapt, validate the content and test the questionnaire reliability to assess knowledge of first aid laity; propose and apply this training program, identify retention of the content from the participants in both courses, and compare assessment and content retention from both groups according to age. Subjects and method. Experimental study where theoretical training program in first aid was developed and applied randomly for DLC lay students DLC, divided into Intervention Group (IG) - participated in the prepared program, and Group Control (GC) - CFC. A questionnaire consisting in 29 closed questions was applied: Stage I - before Stage II - after, and Stage III - three months after participation in the training, tailored and subject to validation and reliability testing (stability). Afterward, there was rearrangement with age (IGA / CGA - age under 50 years; IGB / CGB - greater than or equal to 50 years). A grade was assigned to responses, and performance of each individual was classified: Qualified (7.1 to 10.0), unskilled (5.0 to 7.0) and unskilled (0 and 4.9). Results. Nine judges (three nonprofessionals and six experts) validated the content, and only 1/9 (11.2%) did not consider part of the basic life support (BLS) due to the absence of comprehensive question in recognizing cardiopulmonary arrest. Sixteen questions had agreement of 100.0% for clarity. In the victim approach method, 10/27 (37.0%) of the questions were perfect agreement (Kappa = 1.0) and BLS, 5/9 (55.6%) good. It obtained intraclass correlation coefficient indicative of good agreement for the entire instrument (0.63). A sample of 367 subjects (IG = 182 and CG = 185), as homogeneous sociodemographic variables between groups. It was observed a rising of average marks of Stage I (7.7) for II (8.1) and decrease in III (7.9) in IG. CG also occurred in this oscillation, but with lower grades (I - 5.3 II - 7.0 III - 6.3). In IG there was no classified as unskilled in Stages II and III, and between skilled. In CG, a reduction of subjects unqualified 73/185 (39.5%) in the I to 16/185 (8.6%) in II, III but there was still 25/185 (13.5%). A comparison of the performance rating showed a significant difference between groups in Stages II and III (p <0.0001). Conclusion. Despite being just theoretical training, quality significantly increased in Stages II and III of the IG. The proposed training provided proper assimilation and retention. Final considerations. The implementation of this program is suggested, as the results pointed good uptake and retention. There was not a considerable sample of elderly, but it is essential that they receive special attention in training. This study was inserted on Line Research Process in Nursing and Health Care / Doutorado / Enfermagem e Trabalho / Doutora em Enfermagem

The thesis deals with an overview of the history of First Aid, focusing on the development of cardiopulmonary resuscitation. It is a historical-comparative work of theoretical nature. The intention is to map the knowledge and experience that can be used effectively to develop and study the issue. When writing a thesis, an analysis of the available literature, both historical and contemporary, foreign and Czech, was used. Articles from professional periodicals and monographs were searched. The work was, for the sake of completeness, supplemented with period pictures and diagrams. The introduction justifies the choice of the topic and depicts the current state of knowledge in the field of First Aid. The next chapter explains the basic concepts which are important for orientation in the issue. Following a historical study First Aid aimed at developments providing cardiopulmonary resuscitation. The chapter is divided into subchapters describing the chronology of events to present recommendations for resuscitation and First Aid, so called CPR Guidelines 2015. The last chapter deals with the basic legal minimum. The outcome of this work is an extremely comprehensive overview of mapping the formation and development of First Aid from its history to current recommendations for resuscitation. This thesis...

Introduktion: Hjärtstopp är ett livshotande tillstånd med hög dödlighet där hjärtats pumpförmåga har upphört att fungera. Under 2019 utfördes hjärt- och lungräddning (HLR) på 8404 personer till följd av ett hjärtstopp i Sverige. Patienterna som överlever hjärtstopp kan drabbas av komplikationer som kan påverka deras återhämtning och livskvalitet. Syfte: Att beskriva patienters upplevelser efter att ha överlevt ett hjärtstopp med utförd HLR. Metod: En litteraturstudie baserat på tio kvalitativa originalartiklar från databaserna APA PsycInfo och PubMed. Resultat: Fyra kategorier och tolv subkategorier identifierades. Mötet med vården beskriver upplevelser av bemötandet från vårdpersonal, patienternas informationsbehov och att utskrivningen från sjukhuset var en kritisk period. Påverkan efter hjärtstopp innefattar de fysiska och kognitiva besvär patienten upplever. Känslor efter hjärtstopp beskriver att patienterna upplevde oro och rädsla efter hjärtstoppet samt att synen på livet och döden förändrades. Vägen tillbaka innefattar hur patienten bearbetar händelsen och strävar efter en återgång till normalitet. Slutsats: Att överleva ett hjärtstopp är en livsomvälvande händelse som medför en ny syn på livet. Patienterna upplevde oro och rädsla inför risken för ännu ett hjärtstopp. Brist på information skapar osäkerhetskänslor hos patienterna som påverkar dem i sin vardag. Genom tillräcklig information kring händelsen och känslorna som uppstår kan sjuksköterskan minska patientens oro. Genom kunskap om förändrade familjerelationer kan sjuksköterskan bättre möta patienter och anhöriga och hjälpa dem med de nya rollerna de numera behöver inta. / Introduction: Cardiac arrest is a life-threatening condition with a high mortality where the heart’s ability to contract has ceased to function. In 2019 cardiopulmonary resuscitation (CPR) was performed on 8404 cardiac arrest patients in Sweden. Survivors face potential complications that can affect their recovery and quality of life. Aim: To describe the experiences after surviving a cardiac arrest with performed CPR.  Method: A literature review based on ten qualitative original articles from the databases APA PsycInfo and PubMed. Result: Four categories and twelve subcategories were identified. The meeting with healthcare describes experiences of the treatment from healthcare workers, patients' need for information and that the discharge was a critical time. Effects after cardiac arrest includes patients’ experiences regarding physical and cognitive difficulties. Feelings after cardiac arrest describes that the patients experienced anxiety and fear after the cardiac arrest and a changed view on life and death. The way back includes the processing of the event and the strive for normality. Conclusion: Surviving a cardiac arrest is a life-changing event that entails a new view on life. The patients experienced anxiety and fear due to the risk of another cardiac arrest. Lack of information created feelings of uncertainty in the patients that affected them in their everyday life. Through sufficient information regarding the event and the emotions that follows the nurse can ease the patients concerns. Through knowledge about changed family relations the nurse can better aid patients and relatives in their new roles.

UTBILDNING I BARN-HLR TILL FÖRÄLDRAR MED SVÅRT SJUKA BARN -Intervjustudie om sjuksköterskors erfarenheterHELENE JÖNSSONJönsson, H. Utbildning i barn-HLR till föräldrar med svårt sjuka barn – Intervjustudie om sjuksköterskors erfarenheter. Examensarbete i Omvårdnad 15 högskolepoäng avancerad nivå. Malmö Universitet: Fakulteten för hälsa och samhälle, institutionen för Vårdvetenskap, 2018.Bakgrund: Föräldrar till svårt sjuka barn som erbjuds förebyggande föräldrautbildning i barn-HLR före hemgång från sjukhus upplever ökad trygghet samt medför en ökad säkerhet för de sjuka barnen i hemmet. Det saknas kunskap huruvida sjuksköterskor på barnkliniker i Sverige har erfarenhet av att erbjuda denna föräldragrupp utbildning i barn-HLR och hur den i så fall bedrivs. Syfte: Syftet med studien var att undersöka sjuksköterskors erfarenheter av att utbilda föräldrar med svårt sjuka barn i barn- HLR, i samband med sjukhusvistelse.Metod: En kvalitativ semistrukturerad intervjustudie utfördes, med totalt elva sjuksköterskor från de större barnklinikerna i Sverige. Med induktiv innehållsanalys analyserades materialet enligt Burnard.Resultat: Temat som framkom var: Sjuksköterskor har en nyckelroll i föräldrautbildning, samt följande kategorier: Sjuksköterskans undervisande funktioner, Föräldrar och närståendes utbildningsbehov, Utbildningsstrategier, Resultat och konsekvenser av utbildningen. Sjuksköterskornas erfarenhet var att föräldrar till svårt sjuka barn inte alltid får tillräcklig undervisning inför hemgång, de påvisade stress över att inte kunna hantera akuta situationer. Föräldrarna upplevdes tryggare när de fick information och kunskap. Det utbildningsprogram i barn-HLR som finns upplevdes som otillräckligt då det inte täcker behovet som föräldrautbildning till svårt sjuka barn. Slutsats: En standardiserad preventiv föräldrautbildning för barn-HLR till svårt sjuka barn saknas - med de individuella behov som de barnen kan ha. Ansvarsfördelningen är otydlig om vem som tar beslutet om föräldrautbildning ska erbjudas, samt sjuksköterskorna har en nyckelroll i föräldrautbildningen men har ett svagt mandat att bedriva undervisning då stöd från riktlinjer saknas.Nyckelord: Barn-HLR, föräldrautbildning, sjuksköterskors erfarenheter, svårt-sjuka barn. / EDUCATION IN CPR TO CHILDREN FOR PARENTS WITH HIGH-RISK CHILDREN -INTERVIEW STUDY OF NURSES´ EXPERIENCEHELENE JÖNSSONJonsson, H. Education in CPR to children for parents with high-risk children – Interview study of nurses´ experience. Degree project in nursing 15 credits - advanced level. Malmö University: Faculty of Health and Society, Department of Care Science, 2018.Background: Parents with high-risk children who are offered preventive parental education in Cardiopulmonary resuscitation (CPR) for children before departure from hospitals experience increased security and result in increased safety for the sick children in the home. There was no knowledge whether nurses at children's clinics in Sweden had experience in offering this parent group training in CPR for children or, if so, how it was conducted. Aim: The aim of the study was to investigate nurses´ experiences of educating parents with high-risk children in CPR for children, during hospitalization.Methods: A qualitative study incorporating semi-structured interviews was performed, with a total of eleven nurses from the major children’s clinics in Sweden. The interview material was analyzed through inductive content analysis according to Burnard.Results: The theme that emerged was: Nurses have a key role in parental education, and following categories were: Nurse's educational functions, Parents and relatives´ educational needs, Educational strategies, Results and consequences of education. Parents to high-risk children are not always adequately taught pre-departure, they demonstrate of stress over not being able to cope with emergency situations. Parents was felt safer when they received information and knowledge. The educational program of CPR for children that exist were perceived as insufficient as it does not cover the need for parental education to high-risk children. Conclusion: A standardized preventive parental training in CPR for children is lacking, with the individual needs that high-risk children may have. Responsibilities are unclear on who takes the decision on parental education and who will be offered, the nurses have a key role in parental education but have a weak mandate to carry out teaching when support from recommendation was lacking.Keywords: Cardiopulmonary-resuscitation, high-risk child, nurse-experience, parents-education.

Bakgrund: Möjligheten för anhöriga att närvara vid återupplivningsförsök är ett omdiskuterat ämne och rutinerna kring detta skiljer sig åt beroende länders olika riktlinjer kring ämnet. Det finns ett större antal kvantitativa studier som behandlar upplevelser av anhörigas närvaro vid återupplivningsförsök. Däremot finns det inte lika många kvalitativa studier som berör ämnet. Därför kan det vara relevant att studera dessa kvalitativa studier närmare och belysa de anhörigas upplevelser i relation till sjukvårdspersonalens.Syfte: Syftet med denna litteraturstudie var att belysa både anhörigas och sjukvårdspersonalens upplevelser av att anhörigas närvaro vid ett återupplivningsförsök på en närstående.Metod: En litteraturstudie baserad på tio kvalitativa artiklar som belyser både sjukvårdspersonalens och de anhörigas perspektiv. Artikelsökningen genomfördes i databaserna PubMed och CINAHL.Resultat: Fyra huvudkategorier med två underkategorier vardera identifierades. Delaktighet; Aktivt deltagande och Insyn och stöd, Information och kommunikation; God kommunikation och Bristande kommunikation, Trauma; Oro för familjen och Risker, Förutsättningar; personal- och platsbrist och Personalens upplevelse av utsatthet.Slutsats: I resultatet framkom både positiva och negativa effekter av att anhöriga närvarar vid ett återupplivningsförsök på en närstående. Möjligheten att ha fått vara närvarande kunde underlätta sorgearbetet för familjen och hjälpa dessa att acceptera situationens utfall. Närvaron kunde även ge familjen en chans att agera stöd åt patienten. De största orosmomenten för sjukvårdspersonalen handlade om hur familjens beteende eventuellt kunde påverka arbetet med patienten samt eventuella negativa effekter för familjens psykiska hälsa i framtiden. / Background: The opportunity for families to be present during resuscitation is a well discussed subject. The routines regarding family witnessed resuscitation (FWR) depends on the national guidelines. Research has been conducted regarding experiences of FWR. The majority of this previous research used quantitative methods. Therefore, it ́s relevant to further explore the existing qualitative research regarding FWR.Aim: The aim of this study was to illuminate families ́ and health care professionals ́ experiences of FWR.Method: A literature review based on ten qualitative articles obtained from PubMed and CINAHL.Results: Four main categories with two subcategories each were identified. Participation; Active participation and Transparent & support, Information and communication; Good communication and Lack of communication, Trauma; Concerns for the family and Risks, Conditions; Lack of staff and space and The staff ́s sense of exposure.Conclusion: The result that emerged showed both positive and negative effects of FWR. The opportunity to be present could help the family accept the outcome of the procedure and help to ease the grieving process. Family ́s presence could also function as a source of support for the patient. The health care professionals ́ biggest concerns were about the family's behavior and how it possibly could affect the situation in a negative way and also the risk of negative effects on the family ́s psychic health in the future.

Thesis (MPH) -- University of Limpopo, 2007. / Aim of the study: To determine knowledge of CPR and heart attack or cardiac arrest signs and symptoms among university students. Study Design: A questionnaire based descriptive, cross – sectional study. Setting: University of Limpopo – Turfloop Campus in Limpopo Province of South Africa. Subjects: A total sample of 400 students participated in the study. The sample was selected randomly using simple random sampling techniques. Outcome measures: The faculty, age, gender and level of study were determined as well as the knowledge each student has on signs and symptoms of impending heart attack and CPR. Results: Of the 400 students only 26% (n=104) knew the signs and symptoms of an impending heart attack as well as out of hospital management of heart attack by performing CPR. There were differences between and within faculties, age groups, gender and level of study. Based on the Bonferroni test the student from faculty of Sciences, Health and Agriculture are more likely (p-value 0017) to know when to perform CPR compared to students from other faculties. Level of study is not associated (p-value 0128) with how much the students know about the timing and indications of CPR. Overall female students performed worse with 79% (n=123) responding incorrectly to the questions compared to 69% (n=169) males. Conclusion: Based on the results of this study it safely can be concluded that the students’ knowledge of signs and symptoms of an impending heart attack and CPR procedure is poor. It is therefore important for the university as a center of teaching and learning to consider including as part of university curriculum, basic life support v and first aid courses which include CPR. The inclusion of basic life support and first aid in university curriculum will prepare students to be able to effectively manage out of hospital heart attack and reduce mortality resulting from the latter. The findings of this study might to a certain extent be reflecting what the public’s knowledge on the subject is, hence the need for the policy makers to take serious note of the findings when public health promotion programmes are developed.

Sudden out-of-hospital cardiac arrest is the third leading cause of death in industrialized nations. Many of these lives could be saved if bystander cardiopulmonary resuscitation rates were better. "All citizens of the world can save a life-CHECK-CALL-COMPRESS." With these words, the International Liaison Committee on Resuscitation launched the 2019 global "World Restart a Heart" initiative to increase public awareness and improve the rates of bystander cardiopulmonary resuscitation and overall survival for millions of victims of cardiac arrest globally. All participating organizations were asked to train and to report the numbers of people trained and reached. Overall, social media impact and awareness reached up to 206 million people, and >5.4 million people were trained in cardiopulmonary resuscitation worldwide in 2019. Tool kits and information packs were circulated to 194 countries worldwide. Our simple and unified global message, "CHECK-CALL-COMPRESS," will save hundreds of thousands of lives worldwide and will further enable many policy makers around the world to take immediate and sustainable action in this most important healthcare issue and initiative. / Revisión por pares