Resuscitation
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Randomized Controlled Trial Comparative Study Clinical Trial
Efficacy of the laryngeal tube by inexperienced personnel.
We compared the laryngeal tube and the laryngeal mask in the ease of insertion, ventilation volume and the incidence of gastric insufflation by inexperienced personnel. In a randomized, cross-over design, each of 28 students of a Fire Defense Academy attempted to insert the laryngeal tube and laryngeal mask in turn using an airway management trainer manikin. A self-inflating bag (2000 ml) was attached and ventilation volume was measured. ⋯ The incidence of gastric insufflation was significantly lower for the laryngeal tube (2 times) than for the laryngeal mask (10 times) (P < 0.05). Twenty six of 28 students stated that insertion of the laryngeal tube was easier than insertion of the laryngeal mask, whereas the remaining two stated that there was no difference in the ease of insertion between two devices. Therefore, the laryngeal tube has a potential role in providing a clear airway during cardiopulmonary resuscitation.
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Randomized Controlled Trial Clinical Trial
The effect of seeing the rhythm display on performance of cardiopulmonary resuscitation.
Semiautomated external defibrillators are widely used by prehospital emergency personnel. Some of the devices have a rhythm display and some show only text commands on the screen. To evaluate the effects on cardiopulmonary resuscitation (CPR) performance of seeing the rhythm during resuscitation, 60 fire-fighter students were randomly divided in two groups and trained to use either a defibrillator with a rhythm display or one without a display. ⋯ The teams using a defibrillator with a rhythm display more often interrupted CPR for pulse checks than those who did not see the rhythm (P=0.003). The duration of CPR between rhythm analyses was shorter in the group who saw the rhythm on the screen (P=0.002). Our data suggest that seeing an organised rhythm on a monitor during CPR interferes with adherence to CPR algorithms which may have a negative influence on the performance of CPR.
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Randomized Controlled Trial Clinical Trial
Effectiveness of ventilation-compression ratios 1:5 and 2:15 in simulated single rescuer paediatric resuscitation.
Current guidelines for paediatric basic life support (BLS) recommend a ventilation-compression ratio of 1:5 during child resuscitation compared with 2:15 for adults, based on the consensus that ventilation is more important in paediatric than in adult BLS. We hypothesized that the ratio 2:15 would provide the same minute ventilation as 1:5 during single-rescuer paediatric BLS due to the reduced time required to change between ventilations and compressions. Fourteen lay rescuers were trained with both ratios and thereafter performed single rescuer BLS for approximately 4 min with each of the two ratios in random order on a child-sized manikin with a built-in respiratory monitor. ⋯ Nearly all chest compressions were within acceptable limits for depth and place with both methods, but the mean number of chest compressions per minute was 48+/-15% greater with ratio 2:15. In conclusion, there was no difference in ventilation, but nearly one and a half times as many compressions with a ratio of 2:15 than 1:5 for lay rescuers during single rescuer paediatric CPR. In order to simplify CPR training for laypersons, we recommend a 2:15 ratio for both single- and two-person, adult and paediatric layperson BLS.
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Randomized Controlled Trial Comparative Study Clinical Trial
Trials of teaching methods in basic life support (3): comparison of simulated CPR performance after first training and at 6 months, with a note on the value of re-training.
A randomised controlled trial comparing staged teaching of cardiopulmonary resuscitation (CPR) with conventional training provided the additional opportunity to investigate skill acquisition and retention in those attending conventional CPR classes. All subjects were tested immediately after their first instruction period and again at 6-9 months at an unheralded home visit. We were able to assess how far performance was related to poor acquisition of skills and how far it was related to skill decay. ⋯ This improvement was significant for only two of them, but all were relatively small with limited practical value. Many who attend conventional CPR classes fail to acquire the necessary skills, and the skills that are acquired decline appreciably over the subsequent 6-9 months. The value of conventional re-training was modest in this study of community volunteers.
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Randomized Controlled Trial Comparative Study Clinical Trial
Retention of basic life support skills 6 months after training with an automated voice advisory manikin system without instructor involvement.
To evaluate the retention of skills 6 months after training in ventilation and chest compressions (CPR) on a manikin with computer based on-line voice advisory feedback and the possible effects of initial overtraining. ⋯ The computer-based voice advisory manikin (VAM) feedback system can improve immediate performance of basic life support (BLS) skills, with better long-term retention with overtraining.