Resuscitation
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Law enforcement (LE) professionals are often dispatched to out-of-hospital cardiac arrests (OHCA) to provide early cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) application with mixed evidence of a survival benefit. Our objective was to comprehensively evaluate LE care in OHCA. ⋯ LE arrival before EMS and ensuring both CPR and AED application is associated with significantly improved functional survival in OHCA patients not already receiving bystander CPR.
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Bag-Valve-Device (BVD) is the most frequently used device for pre-oxygenation and ventilation during cardiopulmonary resuscitation (CPR). A minimal expired fraction of oxygen (FeO2) above 0.85 is recommended during pre-oxygenation while insufflated volume (VTi) should be reduced during manual ventilation. The objective was to compare the performances of different BVD in simulated conditions. ⋯ Several BVD did not reach the FeO2 required during pre-oxygenation. Manual ventilation was significantly less protective in three BVD. These observations are related to the different BVD working principles.
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Clinical Trial
Live stream of prehospital point-of-care ultrasound during cardiopulmonary resuscitation - a feasibility trial.
Current resuscitation guidelines recommend that skilled persons could use ultrasound to detect reversible causes during cardiopulmonary resuscitation (CPR) where the examination can be safely integrated into the Advanced Life Support (ALS) algorithm. However, in a prehospital setting performing and rapidly interpreting ultrasound can be challenging for physicians. Implementing remote, expert-guided, and real-time transmissions of ultrasound examinations offers the opportunity for tele-support, even during an out-of-hospital cardiac arrest (OHCA). The aim of this feasibility study was to evaluate the impact of tele-supported ultrasound in ALS on hands-off time during an OHCA. ⋯ This feasibility study demonstrated that POCUS with tele-support can be safely performed during OHCA in an urban environment. Trial Registration (before patient enrolment): ClinicalTrials.gov, NCT04817475.
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Observational Study
Empowering the Next Generation: An innovative "Kids Save Lives" blended learning programme for schoolchildren training.
Guidelines recommend teaching resuscitation from school age; however, little is known about the best methods to provide it. We devised a blended learning program for primary and secondary students (Kids Save Lives - KSL) consisting of brief lectures, practical training with mannequins, and virtual reality. We aimed to evaluate its impact on students' attitudes towards intervening during cardiac arrest and their knowledge about basic life support. ⋯ The blended learning method improved students' understanding of basic life support techniques and their attitude to act during cardiac arrest situations. The positive reception of the virtual reality component underscores technology's potential to bolster engagement and should be further explored for basic life support teaching in schoolchildren.
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We sought to describe the impact of the COVID-19 pandemic on the care provided by Canadian emergency medical system (EMS) clinicians to patients suffering out of hospital cardiac arrest (OHCA), and whether any observed changes persisted beyond the initial phase of the pandemic. ⋯ The COVID-19 pandemic was associated with substantial changes in EMS management of OHCA. EMS leaders should consider these findings to optimise current OHCA management and prepare for future pandemics.