ObjectiveTo evaluate the effect of basic life support (BLS) intensive training for medical students who have received BLS training within one year. MethodsWe enrolled 865 medical students between January to December 2015 who had received BLS training within one year. These students were divided into three groups [undergraduate upcoming doctor (group A, n=436), postgraduate upcoming doctor (group B, n=197), and undergraduate upcoming medical technician (group C, n=232)] based on their major and educational background. In the study, they received on-the-spot BLS intensive training, and took BLS basic knowledge examination, skill examination and comprehensive capacity test before and after training. During the study, comprehensive capacity was evaluated by training scale including such items as emergency awareness, psychological diathesis, disposal ability, cooperation ability, and operation accuracy. ResultsBLS basic knowledge scores for the above three groups before and after training were respectively 58.9±9.5 vs 93.5±7.6, 52.5±4.5 vs 90.3±3.5, 54.8±5.3 vs 88.5±4.5, and the skill scores were 58.8±3.2 vs 95.3±1.7, 57.6±4.2 vs 90.5±2.3, 50.9±3.8 vs 93.5±1.8, respectively. The scores after training were significantly better than those before training (P＜0.05). Comprehensive capacity was also improved significantly after intensive training (P＜0.05). ConclusionsEstablishing a BLS intensive training program has important clinical significances for updating and consolidating the emergency knowledge, improving teaching quality and emergency training effect. So it is worth popularizing.
ObjectiveTo explore the application of PDCA (plan, do, check, action) circulation method in basic life support (BLS) technique training among non-medical personnel in hospitals. MethodsIn a third-level grade-A hospital, BLS technique training was carried out for 66 non-medical personnel of various working categories between July and September 2011. During the training process, PDCA circulation method was applied to each step. The existing problems were searched and causes of the problems were found. Improving strategies were made and carried out, and finally, the effect of training was statistically analyzed. ResultsAfter the application of PDCA circulation method, the test scores in the three training stages were significantly different (P ＜ 0.05) . ConclusionPDCA circulation method can help non-medical personnel to master the operation process and the technique points of BLS quickly, and it also can improve the quality of BLS technique training for non-medical personnel in hospitals.
The American Heart Association (AHA) released the 2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality (2017 AHA guidelines update) in November 2017. The 2017 AHA guidelines update was updated according to the rules named " the update of the guideline is no longer released every five years, but whenever new evidence is available” in the 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The updated content in this guideline included five parts: dispatch-assisted cardiopulmonary resuscitation (CPR), bystander CPR, emergency medical services - delivered CRP, CRP for cardiac arrest, and chest compression - to - ventilation ratio. This review will interpret the 2017 AHA guidelines update in detail.
In November 2017, the American Heart Association updated the pediatric basic life support and cardiopulmonary resuscitation (CPR) quality. The new guidelines focused on the clinical value of chest compression-only CPR versus CPR using chest compressions with rescue breaths in children, rather than a comprehensive revision of the 2015 edition guidelines. The Pediatric Task Force of the International Liaison Committee on Resuscitation updated part content of the guidelines according to the continuous evidence review process. Guidelines recommend CPR using chest compressions with rescue breaths should be provided for infants and children with cardiac arrest. Bystanders provide chest compressions if they are unwilling or unable to deliver rescue breaths. This article mainly interprets the updated content.
In November 2018, the American Heart Association (AHA) updated Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Rather than a comprehensive revision of the 2015 edition guidelines, the 2018 AHA guidelines update was updated again according to the rule " the update of the guideline is whenever new evidence is available”, providing the evidence review and treatment recommendation for antiarrhythmic drug therapy in pediatric shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. The Pediatric Task Force of the International Liaison Committee on Resuscitation updated the guideline, reaffirming the 2015 pediatric advanced life support guideline recommendation that either lidocaine or amiodarone may be used to treat pediatric patients with shock-refractory ventricular fibrillation or pulseless ventricular tachycardia.
American Heart Association (AHA) updated the advanced cardiovascular life support use of antiarrhythmic drugs during and immediately after cardiac arrest in the AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care in November 2018. Based on the latest progress of relative evidence-based clinical evidence and 2015 AHA guidelines for cardiopulmonary resuscitation and cardiovascular emergency cardiovascular care. This update gave recommends on the use of antiarrhythmic drugs during resuscitation from adult shock-refractory ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) cardiac arrest and immediately after restoration of spontaneous circulation following shock-refractory VF/pVT cardiac arrest, respectively. This review aims to interpret this update by reviewing the literature and comparing the recommends in this update with other guidelines.
In November 2019, the American Heart Association updated guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care. This update is not a comprehensive revision of the 2015 version. The updates for children and newborns mainly include three aspects: ① Pediatric basic life support: A. It is recommended that emergency medical dispatch centers offer dispatcher-assisted CPR instructions for presumed pediatric cardiac arrest. B. It is recommended that emergency dispatchers provide CPR instructions for pediatric cardiac arrest when no bystander CPR is in progress. ② Pediatric advanced life support: A. The bag-mask ventilation is reasonable compared with advanced airway interventions (endotracheal intubation or supraglottic airway) in the management of children during out-of-hospital cardiac arrest (OHCA). B. The extracorporeal CPR may be considered for pediatric patients with cardiac diagnoses who have in-hospital cardiac arrest (IHCA) in settings with existing extracorporeal membrane oxygenation protocols, expertise, and equipment. C. Continuous measurement of core temperature during targeted temperature management is recommended; for infants or children between 24 hours and 18 years of age who remain comatose after OHCA or IHCA, targeted temperature management is recommened. ③ Neonatal resuscitation: A. In term and late-preterm newborns (≥35 weeks of gestation) receiving respiratory support at birth, the initial use of 21% oxygen is reasonable. B. One hundred percent oxygen should not be used to initiate resuscitation because it is associated with excess mortality. C. In preterm newborns (<35 weeks of gestation) receiving respiratory support at birth, it may be reasonable to begin with 21% to 30% oxygen.
In October 2020, the American Heart Association issued the 2020 edition of guidelines for cardiopulmonary resuscitation and cardiovascular first aid, which comprehensively revised cardiopulmonary resuscitation and emergency cardiovascular care guidelines related to adults, children, newborns, resuscitation education science and treatment system. According to the latest edition of International Liaison Committee on Resuscitation’s classes of recommendation and levels of evidence, relevant suggestions are put forward. This article interprets the main updated and revised content, including children’s basic and advanced life support and neonatal resuscitation, in order to better guide emergency personnel and improve the quality of cardiopulmonary resuscitation and cardiovascular first aid.
The International Liaison Committee on Resuscitation published the 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations in Circulation, Resuscitation, and Pediatrics in November 2022. This consensus updates and recommends important aspects of cardiopulmonary resuscitation based on recently published resuscitation evidence. Herein, we interpret the consensus focusing on adult cardiopulmonary resuscitation including basic life support (ventilation techniques, compressions pause, transport strategies during resuscitation, and resuscitation procedures in drowning), advanced life support (target temperature management, point-of-care ultrasound as a diagnostic tool during cardiac arrest, vasopressin and corticosteroids for cardiac arrest, and post-cardiac arrest coronary angiography), cardiopulmonary resuscitation education/implementation/team (survival prediction after resuscitation of patients with in-hospital cardiac arrest, basic life support training, advanced life support training, blended learning for life support education, and faculty development approaches for life support courses) and recovery positions on rescue scene. This consensus provides important guidance for clinical practice and clear hints for the development of clinical research.
In November 2022, the International Liaison Committee on Resuscitation updated the International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations for the sixth time. The 2022 review includes 21 topics addressed with systematic reviews by the Recovery Task Force of International Liaison Committee on Resuscitation. Among them, there are nine topics related to life support for newborns and children, including public-access defibrillation devices for children, pediatric early warning systems, maintaining normal temperature immediately after birth, suctioning of amniotic fluid at birth, tactile stimulation for resuscitation immediately after birth, use of continuous positive airway pressure for respiratory distress at term birth, respiratory monitoring in the delivery room, heart rate monitoring in the delivery room, and supraglottic airway use in neonates. The Task Force made treatment recommendations for each of the above topics after weighing evidence and discussion. In some cases, good practice statements have been provided for topics thought to be of particular interest to the resuscitation community when the evidence is insufficient to support a recommendation. Good practice statements are not recommendations but represent expert opinion. In order to facilitate the readers to understand the treatment recommendation well, in the recommendation basis part, the basic principle is briefly described. In addition, the existing problems and future research directions of each topic after the systematic reviews are also clearly stated.