Um dado de relevante importância nos países desenvolvidos e em desenvolvimento, como o Brasil, é a crescente incidência de mortes por doenças cardíacas, sendo a Parada Cardiorrespiratória (PCR) a situação mais temida pelos profissionais nos departamentos de emergência e em ambiente pré-hospitalar. O diagnóstico deve ser rápido e preciso, e as manobras de Ressuscitação Cardiopulmonar (RCP) devem ser iniciadas precocemente a fim de aumentar as chances de sobrevivência dos pacientes. Para um atendimento de qualidade são necessários conhecimentos técnicos e científicos, e programas de educação em RCP devem ser implantados. Considerando que a sobrecarga dos serviços de atendimento dificulta o acesso dos profissionais a capacitações, surge a necessidade da utilização de estratégias de ensino atrativas, sendo o computador uma alternativa eficaz, por facilitar a difusão de conhecimentos. Este estudo tem como objetivos desenvolver um Ambiente Virtual de Aprendizagem (AVA) para educação em Suporte Básico de Vida na PCR e avaliar a qualidade do seu conteúdo junto a especialistas na área de Urgência e Emergência. Trata-se de uma pesquisa aplicada, de produção tecnológica. Para tanto, a metodologia utilizada foi baseada no Modelo de Design Instrucional - ADDIE (em inglês: analysis, design, development, implementation and evaluation), que estrutura o planejamento de ensino- aprendizagem em estágios distintos: análise, desenho, desenvolvimento, implementação e avaliação. O AVA para Capacitação em RCP foi composto por textos elaborados a partir de pesquisa bibliográfica, links de domínio público, um vídeo construído a partir de um cenário de simulação em laboratório e questões para avaliar a fixação do conteúdo. O desenvolvimento dos conteúdos foi realizado em módulos, constituídos das seguintes estruturas: identificação do módulo, objetivos, conteúdo, links e referências. Para o desenvolvimento do AVA foi utilizada a linguagem HTML (Hyper Text Markup Language), que permite a interação com o conteúdo e pode ser acessada por meio de plataformas como celulares ou tablets. O AVA foi submetido à avaliação junto a oito juízes, com objetivo de avaliar se este corresponde à proposta educacional a que se destina, assim como se o acesso é eficaz e eficiente. Os especialistas avaliaram que os objetivos foram alcançados, sugerindo algumas modificações. As melhorias foram feitas e o AVA foi disponibilizado para acesso no endereço eletrônico: www2.eerp.usp.br/nepien/pcr. Com o desenvolvimento deste estudo, espera-se apresentar e disponibilizar para uso uma estratégia de ensino inovadora, que poderá aprimorar o aprendizado, colaborando com a qualidade da assistência prestada / Relevant information in developed and developing countries such as Brazil is the growing incidence of deaths caused by heart disease; cardiorespiratory arrest is the situation most feared by professionals in emergency rooms and in care administered prior to hospital admission. The diagnosis must be fast and precise and Cardiopulmonary Resuscitation (CPR) must promptly be initiated to increase a patient\'s chances of survival. Technical and scientific knowledge is necessary to provide quality care and CPR training programs should be implemented. Considering that the overload of services hinders the access of workers to training programs, there is a need to use attractive teaching strategies; computers are an efficacious alternative to facilitate the dissemination of knowledge. This study\'s objectives include developing a Virtual Learning Environment (VLE) to provide Basic Life Support in CPR training and assess the quality of its content with experts in the field of Emergency and Urgent Care. This is an applied study with technological matters. The methodology used was based on the instructional systems design ADDIE, which stands for analysis, design, development, implementation and evaluation, different stages to structure the teaching and learning planning. The VLE to provide CPR qualification was composed of texts based on bibliographic research, public domain websites, video with a laboratory simulation scenario and questions to assess the apprehension of context. Content was developed in modules composed of the following structures: module identification, objectives, content, links and references. Hyper Text Markup Language (HTML) was used, which enables interaction with content and can be accessed from platforms such as mobile phones or tablets. Eight judges assessed the VLE. Their objective was to verify whether the VLE corresponded to its educational proposal and whether access was efficacious and efficient. The experts assessed which objectives were achieved and suggested some improvements. Changes were implemented and the VLE was released for access on the website: www2.eerp.usp.br/nepien/pcr. The development of this study is expected to present and make available an innovative teaching strategy that can improve learning and facilitate the quality of care delivery

Background Cardiopulmonary resuscitation (CPR) increases significantly the chance of survival in cases of a cardiac arrest. The ability to respond quickly and effectively to a cardiac arrest rests on nurses being competent, prepared and up-to-date. Nursing student’s knowledge in CPR and perceptions of their own training are crucial for the pursuit of the education of professional nurses.    Aim Investigate the prerequisites for a good care of patients in need of CPR by assessing  Vietnamese nursing students' knowledge in CPR as well as their perceptions on their education in CPR.      Method A quantitative, cross sectional-study was conducted. A modified version of a questionnaire developed by the Swedish council of CPR was used. Nursing students at University of Medicine and Pharmacy in Ho Chi Minh City were asked to participate. The gathered data were analyzed with descriptive statistics, t-test and chi2 -test.   Result The participants answered right on 41 % of the questions (571/1404). The mean-score was 5.25 and the score ranged from 0 to 9 out of 13 points on the questionnaire. Participants answered correctly on most questions regarding basic CPR and were foremost wrong about questions regarding defibrillation. There was no association between a high result on the questionnaire and students rating a high grading on preparedness and/or satisfaction. No significant difference could be found based on gender.   Conclusion The knowledge in CPR, based on this survey, is generally low. One plausible explanation could be that the questionnaire did not fit the education of the participants. / Bakgrund Hjärt- och lungräddning (HLR) ökar avsevärt chanserna att överleva vid ett hjärtstopp. Att kunna reagera snabbt och effektivt på hjärtstillestånd kräver att sjuksköterskor är kompetenta och förberedda. Sjuksköterskestudenters kunskaper i HLR och deras uppfattningar om sin utbildning är avgörande för den fortsatta utbildningen av professionella sjuksköterskor.   Syfte Undersöka förutsättningarna för en patientsäker vård inom HLR, genom att kartlägga vietnamesiska sjuksköterskestudenters kunskaper i HLR samt att undersöka deras uppfattning om sin utbildning i HLR.   Metod En kvantitativ, tvärsnittsstudie genomfördes. En modifierad version av ett frågeformulär utvecklat av Svenska rådet för hjärt- och lungräddning (HLR-rådet) användes. Sjuksköterskestudenter i en klass från University of Medicine and Pharmacy, i Ho Chi Minh City blev ombedda att delta. Den insamlade informationen analyserades med beskrivande statistik, t-test och chi2-test.   Resultat Deltagarna svarade rätt på 41% av frågorna (571/1404). Det totala medelvärdet var 5.25 och poängen skilde sig från 0 till 9 av 13 poäng på frågeformuläret. Deltagarna svarade korrekt på de flesta frågor angående grundläggande HLR och svarade främst fel på frågor angående defibrillering. Det fanns inget samband mellan ett högt resultat på frågeformuläret och elever som ansåg sig vara förberedda och/eller nöjda med sin utbildning. Ingen signifikant skillnad i resultat kunde hittas baserat på kön. Slutsats Kunskaperna i HLR, baserat på den genomförda studien, är generellt låga. När det kommer till vissa frågor kan en orsak vara att frågeformuläret inte var anpassat efter deltagarnas utbildning.

A parada cardiorrespiratória (PCR) é a principal causa de morte em países desenvolvidos e em desenvolvimentos, ocorrendo principalmente em ambientes extra hospitalares. Frente a esse panorama mundial considerado um problema de saúde pública atual, a capacitação de leigos no Suporte Básico de Vida (SBV) com uso da simulação clínica tem papel relevante para a melhoria das taxas de sobrevivência das vítimas de PCR. Estudo com objetivo de avaliar o conhecimento (teórico) e das habilidades (práticas) de leigos antes e após a sua participação no curso de SBV para leigos submetidos a estratégias de ensino-aprendizagem, aula expositivo-dialogada e atividade prática em laboratório de habilidades ou aula simulada no atendimento a PCR/RCP com SBV para leigos. Estudo com delineamento quase experimental, abordagem quantitativa com delineamento tempo-série. A população consistiu dos estudantes do primeiro ao quarto semestre de graduação da Faculdade de Enfermagem da Universidade Federal do Mato Grosso e a amostra de 104 estudantes que participaram do curso em SBV para leigos em duas etapas. Na etapa I todos os estudantes foram submetidos ao pré teste teórico, à aula expositivo-dialogada seguida de atividade prática em laboratório de habilidades com manequim de média fidelidade e uso do Desfibrilador Externo Automático (DEA), simulação clínica em laboratório utilizando o mesmo manequim e DEA e pós teste teórico imediato. A Etapa II ocorreu de 15 a 20 dias após a primeira e todos os estudantes foram submetidos à simulação clínica em laboratório utilizando o mesmo manequim de média fidelidade e DEA seguido de pós teste teórico mediato. Elaboraram-se os instrumentos de avaliação teórica, cenário de simulação e OSCE - avaliação clínica objetiva e estruturada no cenário de simulação com (checklist), validados em aparência e conteúdo por comitê de juízes. A estratégia de coleta de dados foi o curso de SBV para leigos. Foram avaliados as avaliações teóricas e OSCE (Exame Clínico Objetivo Estruturado) - avaliação clínica estruturada em Laboratório de Simulação, este último empregando como ferramenta o manequim de média-fidelidade e DEA. A atividade foi filmada e analisada por três avaliadores. Analisaram-se os desfechos nas etapas I e II do curso de SBV para leigos: desempenho teórico nos testes teóricos e práticos no OSCE, tempo de execução total e de cada domínio do OSCE e a qualidade das compressões torácicas externas (CTE) quanto a frequencia e profundidade em 120 segundos de reanimação cardiopulmonar (RCP). Resultados: 86 estudantes eram do sexo feminino e 18 do sexo masculino, a idade média 23,32±6,66 anos. No pré-teste a nota média foi de 3,52±2,03, e a mediana 3,0. No pós-teste imediato (pós 1) a nota média foi 8,01±1,19 (mediana 8,0) e no pós teste mediato (pós 2) foi de 7,41±2,68 (mediana 8,5). Comparando-se as médias obtidas no pré-teste, pós 1 e pós 2 há diferença estatisticamente significante (p<0,001) com retenção do conhecimento. Comparando as notas do pós 1 e pós 2 teóricos evidenciou diferença estatisticamente significante (p=0,019) com perda do conhecimento no pós 2. A média no OSCE na etapa I (pós 1) foi 3,63±0,30 e na etapa II (pós 2) de 3,63±0,31; comparou-se tais notas verificando-se que não há diferença estatisticamente significante (p=0,966). O tempo médio de execução do OSCE no pós 1 foi de 156,96±8,16s e no pós 2 foi de 138,68±43,58s, havendo diferença estatisticamente significante (p<0,001). O domínio de intervenção do OSCE \"Chegada em Cena\" apresentou média 20,78±6,20s no pós 1 e 16,46±4,56s no pós 2, o domínio \"Checar a responsividade\" média de 6,38±3,48s no pós 1 e 5,13±2,36s no pós 2, o domínio \"Usar o DEA\" média de 77,30±14,45s no pós 1 e 66,80±11,44s no pós 2, todos com diferença estatisticamente significante (p<0,001). Avaliando a qualidade das CTE a profundidade média atingida em milímetros (mm) apresentou média de 36,26±9,62 (mediana 35,00) no pós 1 e 39,36±10,96 (mediana 40,00) no pós 2. O nº de CTE média por minuto apresentou média de 116,01±21,72 (mediana 116,00) no pós 1 e 98,94±19,52 (mediana 100,00) no pós 2, o nº total de compressões (CTE) em 120 segundos apresentou média de 227,88±41,81 (mediana 226,00) no pós 1 e 197,31±30,42 (mediana 195,50) no pós 2, o nº de CTE muito superficiais média de 132,20±89,94 (mediana 146,50) no pós 1 e 74,96±75,76 (mediana 53,00) no pós 2, todos com diferenças estatisticamente significante (p<0,001). Já o nº de CTE incompletas apresentou média de 25,09±56,95 (mediana 0,00) no pós 1 e 14,51±35,45 (mediana 0,00) no pós 2 com diferença estatisticamente significante (p=0,012). No presente estudo, apesar de diferentes estratégias de ensino abordarem o SBV para leigos, os resultados demonstram que as mesmas foram eficazes e os objetivos de aprendizagem foram alcançados, pois houve incremento nas notas obtidas nos pós-testes e no OSCE tanto na etapa I quanto na etapa II em relação ao conhecimento prévio e habilidades, porém houve perda da retenção de conhecimento e habilidade de 15 a 20 dias após o curso de SBV para leigos o que reforça a necessidade da capacitação permanente / Cardiac arrest is the leading cause of death in developed and developing countries, and mainly occurs in non-hospital environments. With this global scenario, which is considered a present public health problem, training laypeople in Basic Life Support (BLS) with clinical simulation has an important role in improving survival rate of the cardiac arrest victims. This present study aims to evaluate the knowledge (theoretical) and skills (practical) of laypeople before and after the BLS training underwent to teaching and learning strategies, expository and dialogue class and practical activities in skills lab or simulation class in CPR/CPA. This study has an almost experimental, quantitative and time-series approach. The population study is composed of students from the first to fourth semester of Nursing at Federal University of Mato Grosso (UFMT) and the sample of 104 participants in BLS for laypeople in two steps. In Step 1, all the students had to undergo to the theoretical pretest, expository and dialogue class followed by practical activity in the skills lab with a mid-fidelity manikin and using automated external defibrillator (AED), clinical simulation in the lab using the same manikin and AED and immediate theoretical posttest. Step 2 occurred from the 15th to 20th days after the first one and all the students had to undergo to clinical simulation in the lab using the same mid-fidelity manikin and AED followed by immediate theoretical posttest. It was elaborated theoretical evaluation tools, simulation scenario and OSCE - objective structured clinical examination in the clinical scenario with checklist, validated in aspect and content by a judges committee. The data collection strategy was the BLS for laypeople. It was evaluated the theoretical tests and OSCE (objective structured clinical examination) - clinical examination structured in Simulation Lab, using as tool the mid-fidelity manikin and AED. The activity was filmed and analysed by three evaluators. The outcomes of Step 1 and 2 of BLS for laypeople were analysed: theoretical performance on theoretical and practical tests in OSCE, total execution time, each OSCE realm and the quality of external chest compression (ECC) such as frequency and deepness in 120 seconds of cardiopulmonary resuscitation (CPR). Outcomes: 86 female and 18 male students, median age 23.32±6.66. Median score in pretest was 3.52±2.03 and the average 3.0. At immediate posttest (post 1) the median was 8.01±1.19 (average = 8.0) and at immediate posttest (post 2) 7.41±2.68 (average = 8.5). Comparing the pretest averages and posttests 1 and 2, there is a statistically significant difference (p<0.001) of knowledge retention. Comparing theoretical posttests 1 and 2 revealed the statistically significant difference (p=0.019) with knowledge loss at posttest 2. Step 1 OSCE average (posttest 1) was 3.63±0.30 and Step 2 (posttest 2) 3.63±0.31; when compared, these scores demonstrated that there is not a statistically significant difference (p=0.966). The OSCE execution time average at posttest 1 was 156,96±8,16 seconds and at posttest 2 138.68±43.58 seconds, which demonstrated statistically significant difference (p<0.001). OSCE intervention realm \"Arrival on the scene\" showed posttest 1 20,78±6,20s and posttest 2 16,46±4,56s averages, the realm \"Check Responsiveness\" had averages of 6,38±3,48s in posttest 1 and 5,13±2,36s in posttest 2, the realm \"Using DEA\" averages of 77,30±14,45s in posttest 1 and posttest 2 of 66,80±11,44s, all of them with statistically significant difference (p<0,001). Evaluating the quality of ECT the reached deepness average in millimeters (mm) resulted 36.26±9.62 (average 35.00) in posttest 1 and 39.36±10.96 (average 40.00) in posttest 2. The number of ECC per minute showed 116.01±21.72 (average 116.00) in posttest 1 and 98.94±19.52 (average 100.00) in posttest 2, the total of compressions (ECC) in 120 seconds showed 227.88±41.81 (average 226.00) and 197.31±30.42 (average 195,50) in posttest 2, the number of surface ECC 132.20±89.94 (average 146.50) and 74.96±75.76 (average 53,00) in posttest 2, all of them with statistically significant difference (p<0,001). In the incomplete ECC showed 25.09±56.95 (average 0,00) in posttest 1 and 14.51±35.45 (average 0,00) in posttest 2 with statistically significant difference (p=0,012). In this present study, besides the different teaching strategies approaches for laypeople, the outcomes demonstrate that they were effective and the learning goals reached, since the posttests had higher scores in previous knowledge and skills of steps 1 and 2 of OSCE. However it showed a loss of knowledge and skills retention in 15 to 20 days after the BLS training for laypeople, what demonstrates the need of permanent training

The issue of pressure ulcers is related to limited mobility of P/Cs in bed, and is well known at present. With regard to the permanent increase of surviving P/Cs in critical conditions the prevention of pressure ulcers is a current nationwide topic. Nevertheless, statistical information admits the occurrence of pressure ulcers. The occurrence of pressure ulcers is a rapidly developing nursing problem. This problem has to be taken into account and its prevention has to start from the very beginning of the limited mobility of a P/C in bed.The theoretical part of the thesis is divided into three areas. The first one describes the quality of nursing care in general. The second area is directly focused on pressure ulcers. A chapter dealing particularly with the prevention of pressure ulcers at an ARD extends the last area of the theoretical part. Two goals were set for this thesis: 1. To map the roles of nurses (medical rescue workers) in the prevention of pressure ulcers at an ARD. 2. To map the factors affecting the occurrence of pressure ulcers at an ARD. Four research questions were formulated to achieve the goals: 1. What role does a nurse (a medical rescue worker) play in the prevention of pressure ulcers at an ARD? 2. What factors influence the occurrence of pressure ulcers at an ARD? 3. What information do nurses (medical rescue workers) working at an ARD miss? 4. What problems do nurses (medical rescue workers) working at an ARD have? The empiric part of the thesis was processed by a qualitative method in the forms of the semi-structured interview and involved observation. On the basis of the obtained data the research was extended by a chapter "The Occurrence of Pressure Ulcers", where the data obtained from the head nurses of the involved workplaces was processed and described to summarize the research. The elaboration and the processing of the research brought answers to all four research questions. The results of the research have revealed a number of roles that nurses play. The roles are: the provision of the prevention as such, detection of the first stage of a pressure ulcer, the care of a pressure ulcer already occurred and the prevention of complications. The internal and external factors influencing the occurrence of pressure ulcers are also describer here. The information on the issues of pressure ulcers prevention among nurses and medical rescue workers, the interest in the issues, where the results are surprising in the negative sense, where two thirds of the respondents showed disinterest. We have found that the respondents miss basic information like the classification of pressure ulcers, the information on modern prevention materials and on the healing and treatment of pressure ulcers. Problems in the prevention of pressure ulcers based on two sides were also found out, namely on the side of the management and on the side of the nursing care. On the basis of the circumstances ascertained within the research head nurses from the involved workplaces of the "X" region have been invited to participate in the organization of a seminar for nurses and medical rescue workers working at ARDs, focused on the topic: The issues of the prevention of pressure ulcers at an anaesthesiology and resuscitation department.

<p>Death from heart diseases is the most common type of mortality in western countries and the survival rate of cardiac arrest is dismally low. In the treatment of cardiac arrest, two therapeutic methods are most important: cardiopulmonary resuscitation (CPR; chest compressions and ventilations) and defibrillation (electrical shocks to restart a fibrillating heart).</p><p>An automated external defibrillator is commonly used for such shocks, and records and performs signal analysis on the electrocardiogram(ECG) in order to advice when to shock the patient. However, the mechanical activity during CPR introduces artifact components in the ECG. To perform reliable ECG signal analysis, CPR is therefore discontinued for a substantial time before the potential delivery of a shock. This wastes valuable therapy time, and if this hands-off time could be reduced or eliminated by removing these artifacts, it should improve the chance of return of spontaneous circulation.</p><p>We propose a method for removing CPR artifacts using a novel multichannel adaptive filter, the computationally efficient and numerically robust MultiChannel Recursive Adaptive Matching Pursuit(MC-RAMP) filter. Using the most realistic data set to date, human out-of-hospital cardiac arrest data of both shockable and non-shockable rhythms, we test MC-RAMP and evaluate the feasibility of ECG analysis during CPR. In our experiments we use a shock advice algorithm and individual ECG signal features to reach the conclusion that after CPR artifact filtering, ECG rhythm analysis during ongoing CPR is feasible. </p><p>Finally, we analyze and quantify the time intervals without blood flow (no flow time(NFT)) during external automatic defibrillation in cardiac arrest patients and show that these patients were not perfused around half of the time. We propose methods using CPR artifact filtering to reduce the NFT, and show their significant and promising potential. By introducing the proposed methods into defibrillators, the NFT would be significantly reduced, hopefully increasing the survival.</p>

<p>Aim: The aim was to investigate the ambulance nurses experiences during a specific ambulance missions that led to usage of LUCAS ™.Method: Participating ambulance nurses were randomly assigned from a total sample group of 12 women and 39 men. Five women and five men participated. Qualitative interviews were conducted, where the Critical Incident Technique approach was used. Collected interviews were valued using qualitative content analysis.Result: Interview texts were divided into three domains, 10 subcategories could be identified which were sorted into three categories. A theme was finally formulated.The initial alarm data from SOS Alarm is important for the ambulance nurses preparation. There where cardiac arrest situations when the work went well, as well as situations where problems arose. The informants expressed that they should practice on LUCAS ™ to a greater extent than they now are doing. Staff in the emergency room, some time was perceived as stressful and they did not listen. The informants expressed frustration with the major administrative tasks after a LUCAS™ case, on the other hand, the "team spirit" where highlighted, they solve the task together.Conclusion: Developments during ambulance missions where LUCAS ™ will be used depends on, alarm data, resources, situation at the scene, planning, roles, supervision, handling of LUCAS ™ and Case Report Form, relatives and viewer reactions, the receipt at the emergency department and finally that ambulance staff cooperates after the LUCAS ™ mission.</p> / <p>Syfte:<strong> </strong>Syftet var att undersöka ambulanssjuksköterskors upplevelser under ett bestämt ambulansuppdrag som ledde fram till begagnande av LUCAS™.</p><p>Metod: Deltagande ambulanssjuksköterskor lottades ur en total urvalsgrupp bestående av 12 kvinnor och 39 män. Fem kvinnor och<strong> </strong>fem män deltog. Kvalitativa intervjuer genomfördes, där Critical Incident Technique metoden användes. Insamlade intervjudata värderades med hjälp av kvalitativ innehållsanalys.</p><p>Resultat:<strong> </strong>Intervjutexten kunde delas in i tre domäner, 10 underkategorier kunde identifieras som sorterades i tre kategorier. Slutligen formulerades ett tema. De initiala larmuppgifter från SOS Alarm är viktiga för ambulanssjuksköterskornas förberedelser. Det förekom hjärtstoppssituationer där arbetet gick bra, likväl situationer där problem uppstod. Informanterna uttryckte att de borde öva på LUCAS™ i större utsträckning än de gör i nu läget. Vid en del situationer upplevdes mottagande personal på akutmottagningen som stressade och att de inte lyssnade. Betecknande för informanternas upplevelser vad gäller de administrativa uppgifterna efter LUCAS™ uppdraget var inte positivt, dock betonades "team work".</p><p>Slutsats: Utvecklingen under ambulansuppdrag där LUCAS™ kommer till användning är beroende av; larmfakta, resurser, situationen på plats, planering, roller, arbetsledning, hanterandet av LUCAS™ och Case Report Form, anhöriga och åskådares reaktioner, mottagandet på akutmottagningen och slutligen att ambulanspersonalen samarbetar efter LUCAS™ uppdraget.</p>

Death from heart diseases is the most common type of mortality in western countries and the survival rate of cardiac arrest is dismally low. In the treatment of cardiac arrest, two therapeutic methods are most important: cardiopulmonary resuscitation (CPR; chest compressions and ventilations) and defibrillation (electrical shocks to restart a fibrillating heart). An automated external defibrillator is commonly used for such shocks, and records and performs signal analysis on the electrocardiogram(ECG) in order to advice when to shock the patient. However, the mechanical activity during CPR introduces artifact components in the ECG. To perform reliable ECG signal analysis, CPR is therefore discontinued for a substantial time before the potential delivery of a shock. This wastes valuable therapy time, and if this hands-off time could be reduced or eliminated by removing these artifacts, it should improve the chance of return of spontaneous circulation. We propose a method for removing CPR artifacts using a novel multichannel adaptive filter, the computationally efficient and numerically robust MultiChannel Recursive Adaptive Matching Pursuit(MC-RAMP) filter. Using the most realistic data set to date, human out-of-hospital cardiac arrest data of both shockable and non-shockable rhythms, we test MC-RAMP and evaluate the feasibility of ECG analysis during CPR. In our experiments we use a shock advice algorithm and individual ECG signal features to reach the conclusion that after CPR artifact filtering, ECG rhythm analysis during ongoing CPR is feasible. Finally, we analyze and quantify the time intervals without blood flow (no flow time(NFT)) during external automatic defibrillation in cardiac arrest patients and show that these patients were not perfused around half of the time. We propose methods using CPR artifact filtering to reduce the NFT, and show their significant and promising potential. By introducing the proposed methods into defibrillators, the NFT would be significantly reduced, hopefully increasing the survival.

This is a quasi experimental study, evaluating the teaching methods of a CPR training program conducted in a rural high school on 161 students. Students were divided into three experimental groups, varying the days and instructor/student ratios in order to determine the most effective teaching methods.Two hypotheses were generated to be tested through use of instruments developed by the American Red Cross. The first hypothesis was supported--lengthening instruction time does improve performance levels in basic life support. The second hypothesis was rejected--increasing instructor ratio per student groups does not improve performance levels in basic life support. In addition, the number of days over which the course was taught was a more influential variable than instructor/student ratios.Ball State UniversityMuncie, IN 47306

Bakgrund: Plötsligt hjärtstopp är en av de vanligaste orsakerna till för tidig död i vårt samhälle och den största dödsorsaken runt om i världen. Syfte: Syftet med studien var att studera vilken kunskap, utbildning och beredskap i hjärt-lungräddning (HLR), som medarbetarna i primärvården anser sig ha och om det fanns skillnader i detta mellan yrkesprofessioner och mellan vårdcentraler i stad respektive landsort. Metod: Designen är en deskriptiv och jämförande tvärsnittsstudie. En enkät användes för att få med så många respondenter som möjligt. Resultat: Resultatet baseras på svar från 144 respondenter. Av samtliga medarbetare hade 87 ­% gen­omgått en HLR utbildning det senaste året. Detta till trots ansåg sig endast 66 % ha tillräckliga kunskaper i HLR. Någon signifikant skillnad mellan yrkesprofessioner gällande kunskap i HLR gick inte att signifikant säkerställa (p = 0,107). Endast 80 % av medarbetarna visste hur ambulans larmas. I en jämförelse mellan stad och landsort fanns dock ingen signifikant skillnad i den kunskapen (p = 0,12). Slutsats: Det är viktigt att skapa förutsättningar för fortlöpande utbildningar till medarbetarna för att öka kunskap, utbildning och beredskap i HLR, vilket även kan ses som ett kvalitetssäkringsarbete i vården. / Background: Sudden cardiac arrest is one of the most common causes of premature death in our society and the largest cause of death worldwide. Purpose: The purpose of this study was to investigate primary health care employee’s knowledge, training and preparedness they consider themselves to have in cardiopulmonary resuscitation (CPR) and to study whether there are differences between professional roles as well as differences in urban and rural health centers. Method: The design of this study is a descriptive and comparative cross-sectional study.  To capture as many respondents as possible a questionnaire was used. Result: The result in this study is based on responses from 144 respondents. Eighty-seven percent of employees have been training CPR the last year. Despite that only 66 % felt they have sufficient know­­ledge. There was no significant differences indicated in knowledge in CPR between professions roles (p = 0,107). Only 80 % knew how to alert the ambulance. In a comparison between urban and rural no significant difference in knowledge can be seen (p = 0, 12). Conclusion: The conclusion of the study is that it´s important to create competence for the employees, education for members of the CPR in order to improve the skills which can also be seen as a quality work in health care centers.

The Analysis of Ilan¡¦s Out-of-Hospital Cardiac Arrest (OHCA) Patients Abstract The study uses Ilan¡¦s out-of-hospital cardiac arrest (OHCA) patients as the research object to understand the variable backgrounds of OHCA patients how they are affected by first aid factors between the period of pre-hospital and post-hospital admission. The study also discusses whether there is a correlation between first aid factors and first aid prognosis among those OHCA patients during pre-hospital and post-hospital admission periods. The study is retrospective and based on the Utstein style format. It collects 284 out-of-hospital cardiac arrest (OHCA) patient cases with trauma and non-trauma (282 effective samples) in an example of a regional teaching hospital in Ilan from 2007 to 2009. It uses descriptive statistics, independent sample t test, and Chi-Square test as the statistical analysis to obtain the following conclusions: 1. There are 282 effective sample patients in the study. There are 57 patients ( 20.2 %) who were return of spontaneous circulation (ROSC) after cardiac arrest approximately 14.77 minutes on average. There are 33 patients (11.7 % ) who survived to be hospitalized for 15.36 days on average, and there are 6 patients ( 2.1 % ) who were discharged from the hospital. 2. Internal medicine disease is the major causative factor of out-of-hospital cardiac arrest. Among those internal medicine disease cases, the history showed hypertension, diabetes mellitus, and heart diseases are the main causes of out-of-hospital cardiac arrest. Patients who are older than 65 years old are the main age groups, accounting for 67.7% of these cases. 3. The pre-hospital admission factors which affect the prognosis after the Emergency Department (ED) are the place of the accident, whether there are witnesses, scene process time , total reaction time , whether automatic external defibrillation was used, and whether people at the scene used CPR. 4. The post-hospital admission factors which affect the prognosis after the ED are initial cardiac rhythm, body temperature, pupil size , dose of epinephrine, whether defibrillation was used, the time of applying emergency first-aid, and medical expense. 5. The percentages of return of spontaneous circulation and survival rates in the study are lower than those of past studies of Taipei City and National Taiwan University Hospital. The possible factors are probably related to differences between rural and urban areas in the quality of emergency medical service systems (EMSS), and healthcare training. 6. From now on, in addition to improving the first-aid continuous monitoring system, we should also enhance EMT related training, and actively educate people to understand and learn CPR, so that comprehensive first-aid systems are available everywhere to effectively increase the success rate of first-aid. Keywords¡GOut-of-hospital cardiac arrest (OHCA), Cardiopulmonary resuscitation