Articles: advanced-cardiac-life-support-standards.
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Survival after out-of-hospital cardiac arrest (OHCA) depends on a well functioning Chain of Survival. We wanted to assess if targeted attempts to strengthen the weak links of our local chain; quality of advanced life support (ALS) and post-resuscitation care, would improve outcome. ⋯ Survival after OHCA was increased after improving weak links of our local Chain of Survival, quality of ALS and post-resuscitation care.
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Randomized Controlled Trial Comparative Study
Out-of hospital advanced life support with or without a physician: effects on quality of CPR and outcome.
The presence of physicians is believed to facilitate optimal management of out-of-hospital cardiac arrest, but has not been sufficiently documented. ⋯ Survival after out-of-hospital cardiac arrest was not different for patients treated by the PMA and non-PMA in our EMS system.
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Advanced life support (ALS) assessments are performed to assess nurses' abilities to recognize cardiac arrest events, and appropriately manage patients according to resuscitation guidelines. Although there is evidence for conducting assessments after initial ALS education, there is little evidence to guide educators about ongoing assessments in terms of methods, format and frequency. The aim of this study was to determine methods used by educators to assess ALS skills and knowledge for nurses in Victorian intensive care units. ⋯ Consideration should be given to the purposes and methods of conducting annual ALS assessments to ensure resources and strategies are directed appropriately. To encourage nurses to retain ALS skills and knowledge, regular practices are recommended as an alternative to assessments. However, further research is required to support this notion.
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Multicenter Study Comparative Study
Validation for a scoring system of the ALS cardiac arrest simulation test (CASTest).
The cardiac arrest simulation test (CASTest) assesses resuscitation knowledge and skills during a simulated cardiac arrest. The aim of this study is to validate an alternative scoring system for measuring individual candidate performance during research involving the CASTest. ⋯ This new simple scoring system can be used to better characterise performance on the ALS course CASTest than the current binary pass-fail outcome.
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Comparative Study
Validation of a universal prehospital termination of resuscitation clinical prediction rule for advanced and basic life support providers.
Prehospital termination of resuscitation rules have been derived for Emergency Medical Technician-Paramedics providing advanced life support care and defibrillation-only Emergency Medical Technicians providing basic life support care. We sought to externally validate each rule on a prospective cohort of prehospital cardiac arrest patients to determine if either rule could be proposed as a universal prehospital termination of resuscitation rule. ⋯ Implementing the basic life support rule as a universal termination of resuscitation clinical prediction rule would result in a lower overall transport rate without missing any potential survivors. The universal rule would recommend termination of resuscitation when there was no return of spontaneous circulation prior to transport, no shock was given and the arrest was not witnessed by Emergency Medical Services personnel. This rule may be useful for emergency medical services systems with mixed levels of providers responding to cardiac arrest patients.