Dataset Information

Basic life support and automated external defibrillator skills among ambulance personnel: a manikin study performed in a rural low-volume ambulance setting.

ABSTRACT:

Background

Ambulance personnel play an essential role in the 'Chain of Survival'. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island.

Methods

The Basic Life Support (BLS) and Automated External Defibrillator (AED) skills of the ambulance personnel were tested in a simulated cardiac arrest. Points were given according to a scoring sheet. One sample t test was used to analyze the deviation from optimal care according to the 2005 guidelines. After each assessment, individual feedback was given.

Results

On 3 consecutive days, we assessed the individual EMS teams responding to OHCA on the island. Overall, 70% of the maximal points were achieved. The hands-off ratio was 40%. Correct compression/ventilation ratio (30:2) was used by 80%. A mean compression depth of 40-50 mm was achieved by 55% and the mean compression depth was 42 mm (SD 7 mm). The mean compression rate was 123 per min (SD 15/min). The mean tidal volume was 746 ml (SD 221 ml). Only the mean tidal volume deviated significantly from the recommended (p = 0.01). During the rhythm analysis, 65% did not perform any visual or verbal safety check.

Conclusion

The EMS providers achieved 70% of the maximal points. Tidal volumes were larger than recommended when mask ventilation was applied. Chest compression depth was optimally performed by 55% of the staff. Defibrillation safety checks were not performed in 65% of EMS providers.

SUBMITTER: Nielsen AM

PROVIDER: S-EPMC3430550 | biostudies-literature | 2012 May

REPOSITORIES: biostudies-literature

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Publications

Basic life support and automated external defibrillator skills among ambulance personnel: a manikin study performed in a rural low-volume ambulance setting.

Nielsen Anne Møller AM Isbye Dan Lou DL Lippert Freddy Knudsen FK Rasmussen Lars Simon LS

Scandinavian journal of trauma, resuscitation and emergency medicine 20120508

<h4>Background</h4>Ambulance personnel play an essential role in the 'Chain of Survival'. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island.<h4>Methods</h4>The Basic Life Support (BLS) and Automated External Defibrillator (AED) skills of the ambulance personnel were tested in a simulated cardiac arrest. Points were given according to a scoring she ...[more]

PMID: 22569089

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Project description:BACKGROUND:Educating lay public can significantly strengthen the Chain of Survival after out of hospital cardiac arrest. Schoolchildren are an accessible population for learning basic life support (BLS) and use of an automated external defibrillator (AED) and can be regarded as multipliers of knowledge that can reach the whole population. This study aimed to develop and validate a test for examining levels of knowledge about BLS and AED among schoolchildren that can be used to uniformly present reliable data. METHODS:A knowledge test about BLS and AED consisting of 10 multiple-choice questions was developed and implemented before and after a 2-h BLS and AED course consisting of an interactive lecture and a practical workshop for 783 students in seventh and ninth grades of elementary schools in Maribor, Slovenia. Each question was analyzed and presented with descriptive statistics and educometric parameters (difficulty and discriminating indices). All variables were checked for normality with the Kolmogorov-Smirnov test and analyzed using non-parametric tests. Statistical significance of the differences in knowledge before and after intervention were calculated with chi-square statistics and effect sizes r are reported. Differences between genders, grades and previous attendance to BLS courses were compared using Mann - Whitney U test. The effect size was calculated from the Z score and reported as r value. RESULTS:After educometric analysis, questions were adjusted to meet the requirements of satisfactory functioning difficulty and discriminating indices (values between 0,40 and 0,60, and above 0,20, respectively). Only one question had to be eliminated due to inadequate difficulty and discriminating index (0,99 and 0,02, respectively). Measurement invariance across gender (p?<?0,001), school grade (p <?0,001), and attendance to previous courses (p?=?0,303) was assured. CONCLUSIONS:A test for accurate and reliable measurement of knowledge of BLS and AED among schoolchildren was developed and validated. According to the findings it can now reliably be used to assess baseline knowledge and potential improvement in knowledge after a course on BLS and AED. Standardized data gathered with a validated tool can now be presented at legislative levels to promote BLS and AED courses implementation in school curricula.

Project description:BackgroundNot all children with an out-of-hospital emergency medical contact are transported by ambulance to the emergency department (ED). Non-transport means that after on-scene evaluation and possible treatment, ambulance personnel may advise the patient to monitor the situation at home or may refer the patient to seek medical attention by other means of transport. As selecting the right patients for ambulance transport is critical for optimising patient safety and resource use, we studied outcomes in non-transported children to identify possible risk groups that could benefit from ambulance transport.MethodsIn a population-based retrospective cohort study of all children aged 0-15?years encountered but not transported by ambulance in Helsinki, Finland, between 1 January 2014 and 31 December 2016, we evaluated (1) 12-month mortality, (2) intensive care admissions, (3) unscheduled ED contacts within the following 96?hours after the non-transport decision and (4) the clinical status of the child on presentation to ED in the case of a secondary ED visit.ResultsOf all children encountered by out-of-hospital emergency medical services, 3579/7765 (46%) were not transported to ED by ambulance. There was no mortality or intensive care admissions related to the non-transport. The risk factors for an unscheduled secondary ED visit after a non-transport decision were young age (p=0.001), non-transport decision during the early morning hours (p<0.001) and certain dispatch codes, including 'dyspnoea' (p<0.001), 'vomiting/diarrhoea' (p=0.030) and 'mental illness' (p=0.019). We did not detect deterioration in patients' clinical presentation at ED traceable to non-transport decisions.ConclusionsNot transporting all children by ambulance after an out-of-hospital emergency medical contact was not associated with deaths, intensive care admissions or significant deterioration in general condition in our study population and healthcare system. Special attention and a formal non-transport protocol are warranted in certain subgroups, including infants.

Dataset Information

Basic life support and automated external defibrillator skills among ambulance personnel: a manikin study performed in a rural low-volume ambulance setting.

Background

Methods

Results

Conclusion

Publications

Basic life support and automated external defibrillator skills among ambulance personnel: a manikin study performed in a rural low-volume ambulance setting.

Similar Datasets

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