Resuscitation plus最新文献

Aim

To summarize existing literature and identify knowledge gaps regarding barriers and enablers of telecommunicators’ recognition of out-of-hospital cardiac arrest (OHCA).

Methods

This scoping review was undertaken by an International Liaison Committee on Resuscitation (ILCOR) Basic Life Support scoping review team and guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Studies were eligible for inclusion if they were peer-reviewed and explored barriers and enablers of telecommunicator recognition of OHCA. We searched Ovid MEDLINE® and Embase and included articles from database inception till June 18th, 2024.

Results

We screened 9,244 studies and included 62 eligible studies on telecommunicator recognition of OHCA. The studies ranged in methodology. The majority were observational studies of emergency calls. The barriers most frequently described to OHCA recognition were breathing status and agonal breathing. The most frequently tested enabler for recognition was a variety of dispatch protocols focusing on breathing assessment. Only one randomized controlled trial (RCT) was identified, which found no difference in OHCA recognition with the addition of machine learning alerting telecommunicators in suspected OHCA cases.

Conclusion

Most studies were observational, assessed barriers to recognition of OHCA and compared different dispatch protocols. Only one RCT was identified. Randomized trials should be conducted to inform how to improve telecommunicator recognition of OHCA, including recognition of pediatric OHCAs and assessment of dispatch protocols.

Aim

CPR training for schoolchildren to increase bystander CPR-rates is widely applied. HCPs are regarded as the instructor gold standard, but using non-HCP instructors (e.g., peer-tutors, schoolteachers, medical students) challenges that. This systematic review assesses whether cardiopulmonary resuscitation (CPR) training for children led by peer-tutors, schoolteachers, or medical students results in different learning outcomes to training by health-care professionals (HCPs).

Methods

We searched studies that compared CPR training for schoolchildren (population) delivered by peer-tutors, schoolteachers, or medical students (intervention), with training led by HCPs (comparison), assessing student knowledge, skills, willingness and/or confidence to perform CPR (outcome). We included randomized and non-randomized controlled trials (study design). Medline, Embase, Psychinfo, Cinahl, Cochrane, Scopus, Web of Science, and Eric were searched from inception until December 23rd, 2023 (timeframe). Two independent reviewers performed title, abstract, full text screening, bias assessment, and grading of certainty of evidence. We followed the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) guidelines, and registered the review with PROSPERO.

Results

Of 9′092 studies identified, 14 were included. Comparison of intervention groups to HCP-led training showed similar overall results (knowledge, skills, self-confidence). Superior results for HCP training were only reported for ‘ventilation volume’, while schoolteachers and medical students achieved superior knowledge transfer. A meta-analysis was possible for ‘compression depth’ between peer-tutors and HCPs showing no significant differences. Certainty of evidence was ‘low’ to ‘very low’.

Conclusion

This systematic review of CPR training for school children revealed that peer-tutors, schoolteachers and medical students achieve similar educational outcomes compared to those of HCPs. Non-HCPs training schoolchildren is an appropriate cost-efficient alternative and easy to implement in school curricula.

Objective

This study examined the impact of prior familiarity with automated external defibrillator (AED) models on the time of defibrillation and the emotional experiences of laypersons.

Methods

We conducted a randomized cross over simulation study with 123 participants to assess their reactions to both familiar and unfamiliar AED models. The time to first defibrillation was measured using three different AED training models, two of which were previously unknown to the participants. Additionally, semi-structured interviews were held with the participants to gather further insights.

Results

Participants took longer to initiate defibrillation with unfamiliar (M = 34 s) AEDs compared to familiar (M = 27 s) ones. This delay was accompanied by feelings of confusion, nervousness, and anxiety. Factors such as the design of the AED covers, electrodes, and buttons were identified as sources of confusion. Nonetheless, clear instructions and similarities between devices helped facilitate their use.

Conclusion

The findings suggest that AED design and familiarity with different AED designs may affect performance by laypersons. To improve user confidence, it would be useful to familiarize users with a variety of AED models as part of training initiatives. Understanding the impact of AED familiarity on rescuer’s response can guide CPR training strategies and improve outcomes for OHCA. As more AED models become available to the public, the user-friendliness of AEDs may also be improved. It is beneficial for AED manufacturers to consider the results of research when developing new models.

Objectives

This study examines the impact of temperature variations on out-of-hospital-cardiac-arrests in Germany over a decade (2010–2019). Out-of-hospital-cardiac-arrests affects 164 per 100,000 inhabitants annually in Germany, 11% survive to hospital discharge. The following study investigates days with the following characteristics: summer days, frost days, and high humidity days. Furthermore, the study explores incidence, causes, demographics, and outcomes of out-of-hospital-cardiac-arrests.

Methods

Data from the German Resuscitation Registry and Meteorological Service were combined for analysis. The theory posits that temperature and humidity play a significant role in the occurrence and outcomes of out-of-hospital-cardiac-arrests, potentially triggering pre-existing health issues.

Results

Findings reveal increased out-of-hospital-cardiac-arrests during frost days (6.39 up to 7.00, p < 0.001) monthly per 100,000 inhabitants), notably due to cardiac-related causes. Conversely, out-of-hospital-cardiac-arrests incidence decreases on summer days (6.61–5.79, p < 0.001 monthly per 100,000 inhabitants). High-humidity days exhibit a statistically significant increase in out-of-hospital-cardiac-arrests incidence (6.43–6.89, p < 0.001 monthly per 100,000 inhabitants).

Conclusion

In conclusion, there’s a notable rise in out-of-hospital-cardiac-arrests incidence and worse outcomes during cold days, and a significant increase in out-of-hospital-cardiac-arrests during high-humidity days. Moreover, extreme temperature events in unaccustomed regions also elevate out-of-hospital-cardiac-arrests rates. However, the dataset lacks sufficient hot days for conclusive findings, hinting that very hot days might also affect out-of-hospital-cardiac-arrests incidence. Further research, particularly on hotter days, is essential.

No third-party funding was received for this study.