169 results on '"Bernd W. Böttiger"'
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2. Outcomes of audio-instructed and video-instructed dispatcher-assisted cardiopulmonary resuscitation
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Karol Bielski, Bernd W. Böttiger, Michal Pruc, Aleksandra Gasecka, Mariusz Sieminski, Milosz J. Jaguszewski, Jacek Smereka, Natasza Gilis-Malinowska, Frank W. Peacock, and Lukasz Szarpak
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Emergency medical dispatcher ,General Medicine ,Review ,cardiac arrest ,Thorax ,cardiopulmonary resuscitation ,meta-analysis ,systematic review ,Emergency Medicine ,Humans ,Medicine ,video-call ,Out-of-Hospital Cardiac Arrest - Abstract
Background The present meta-analysis of clinical and simulation trials aimed to compare video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (V-DACPR) with conventional audio-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (C-DACPR). Methods We searched PubMed, Embase, Web of Science, Cochrane Collaboration databases and Scopus from inception until June 10, 2021. The primary outcomes were the prehospital return of spontaneous circulation (ROSC), survival to hospital discharge, and survival to hospital discharge with a good neurological outcome for clinical trials, and chest compression quality for simulation trials. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) indicated the pooled effect. The analyses were performed with the RevMan 5.4 and STATA 14 software. Results Overall, 2 clinical and 8 simulation trials were included in this meta-analysis. In clinical trials, C-DACPR and V-DACPR were characterised by, respectively, 11.8% vs. 24.3% of prehospital ROSC (OR = 0.46; 95% CI: 0.30, 0.69; I2 = 66%; p
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- 2022
3. 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces
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Myra H. Wyckoff, Robert Greif, Peter T. Morley, Kee-Chong Ng, Theresa M. Olasveengen, Eunice M. Singletary, Jasmeet Soar, Adam Cheng, Ian R. Drennan, Helen G. Liley, Barnaby R. Scholefield, Michael A. Smyth, Michelle Welsford, David A. Zideman, Jason Acworth, Richard Aickin, Lars W. Andersen, Diane Atkins, David C. Berry, Farhan Bhanji, Joost Bierens, Vere Borra, Bernd W. Böttiger, Richard N. Bradley, Janet E. Bray, Jan Breckwoldt, Clifton W. Callaway, Jestin N. Carlson, Pascal Cassan, Maaret Castrén, Wei-Tien Chang, Nathan P. Charlton, Sung Phil Chung, Julie Considine, Daniela T. Costa-Nobre, Keith Couper, Thomaz Bittencourt Couto, Katie N. Dainty, Peter G. Davis, Maria Fernanda de Almeida, Allan R. de Caen, Charles D. Deakin, Therese Djärv, Michael W. Donnino, Matthew J. Douma, Jonathan P. Duff, Cody L. Dunne, Kathryn Eastwood, Walid El-Naggar, Jorge G. Fabres, Joe Fawke, Judith Finn, Elizabeth E. Foglia, Fredrik Folke, Elaine Gilfoyle, Craig A. Goolsby, Asger Granfeldt, Anne-Marie Guerguerian, Ruth Guinsburg, Karen G. Hirsch, Mathias J. Holmberg, Shigeharu Hosono, Ming-Ju Hsieh, Cindy H. Hsu, Takanari Ikeyama, Tetsuya Isayama, Nicholas J. Johnson, Vishal S. Kapadia, Mandira Daripa Kawakami, Han-Suk Kim, Monica Kleinman, David A. Kloeck, Peter J. Kudenchuk, Anthony T. Lagina, Kasper G. Lauridsen, Eric J. Lavonas, Henry C. Lee, Yiqun (Jeffrey) Lin, Andrew S. Lockey, Ian K. Maconochie, R. John Madar, Carolina Malta Hansen, Siobhan Masterson, Tasuku Matsuyama, Christopher J.D. McKinlay, Daniel Meyran, Patrick Morgan, Laurie J. Morrison, Vinay Nadkarni, Firdose L. Nakwa, Kevin J. Nation, Ziad Nehme, Michael Nemeth, Robert W. Neumar, Tonia Nicholson, Nikolaos Nikolaou, Chika Nishiyama, Tatsuya Norii, Gabrielle A. Nuthall, Brian J. O’Neill, Yong-Kwang Gene Ong, Aaron M. Orkin, Edison F. Paiva, Michael J. Parr, Catherine Patocka, Jeffrey L. Pellegrino, Gavin D. Perkins, Jeffrey M. Perlman, Yacov Rabi, Amelia G. Reis, Joshua C. Reynolds, Giuseppe Ristagno, Antonio Rodriguez-Nunez, Charles C. Roehr, Mario Rüdiger, Tetsuya Sakamoto, Claudio Sandroni, Taylor L. Sawyer, Steve M. Schexnayder, Georg M. Schmölzer, Sebastian Schnaubelt, Federico Semeraro, Markus B. Skrifvars, Christopher M. Smith, Takahiro Sugiura, Janice A. Tijssen, Daniele Trevisanuto, Patrick Van de Voorde, Tzong-Luen Wang, Gary M. Weiner, Jonathan P. Wyllie, Chih-Wei Yang, Joyce Yeung, Jerry P. Nolan, Katherine M. Berg, Madeline C. Burdick, Susie Cartledge, Jennifer A. Dawson, Moustafa M. Elgohary, Hege L. Ersdal, Emer Finan, Hilde I. Flaatten, Gustavo E. Flores, Janene Fuerch, Rakesh Garg, Callum Gately, Mark Goh, Louis P. Halamek, Anthony J. Handley, Tetsuo Hatanaka, Amber Hoover, Mohmoud Issa, Samantha Johnson, C. Omar Kamlin, Ying-Chih Ko, Amy Kule, Tina A. Leone, Ella MacKenzie, Finlay Macneil, William Montgomery, Domhnall O’Dochartaigh, Shinichiro Ohshimo, Francesco Stefano Palazzo, Christopher Picard, Bin Huey Quek, James Raitt, Viraraghavan V. Ramaswamy, Andrea Scapigliati, Birju A. Shah, Craig Stewart, Marya L. Strand, Edgardo Szyld, Marta Thio, Alexis A. Topjian, Enrique Udaeta, Christian Vaillancourt, Wolfgang A. Wetsch, Jane Wigginton, Nicole K. Yamada, Sarah Yao, Drieda Zace, and Carolyn M. Zelop
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Emergency Medical Services ,Consensus ,pediatrics ,resuscitation ,cardiac arrest ,first aid ,Emergency Nursing ,infant ,Cardiopulmonary Resuscitation ,Out-of-Hospital Cardiac Arrest/therapy ,AHA Scientific Statements ,infant, newborn ,basic life support ,newborn ,Physiology (medical) ,Pediatrics, Perinatology and Child Health ,Settore MED/41 - ANESTESIOLOGIA ,Emergency Medicine ,advanced life support ,Humans ,Child ,Cardiology and Cardiovascular Medicine ,Emergency Treatment - Abstract
his is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; 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 and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed. This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; 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 and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.
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- 2022
4. Public interest in cardiac arrest and cardiopulmonary resuscitation: a Google Trends analysis of the global online search traffic
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Alexei, Birkun, Enrico, Baldi, and Bernd W, Böttiger
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Search Engine ,Emergency Medicine ,Humans ,Cardiopulmonary Resuscitation ,Out-of-Hospital Cardiac Arrest ,Heart Arrest - Published
- 2022
5. The World Restart a Heart Initiative: how to save hundreds of thousands of lives worldwide
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Nadine Rott, Bernd W. Böttiger, and Andrew Lockey
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Liaison committee ,2019-20 coronavirus outbreak ,Economic growth ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,business.industry ,Resuscitation ,MEDLINE ,COVID-19 ,Legislation ,Critical Care and Intensive Care Medicine ,Cardiopulmonary Resuscitation ,Pandemic ,Humans ,Medicine ,Social media ,business ,Developed country ,Out-of-Hospital Cardiac Arrest - Abstract
PURPOSE OF REVIEW: Sudden out-of-hospital cardiac arrest (OHCA) is still one of the top reasons for death in industrialized countries. Bystander resuscitation rates differ significantly across the world despite bystanders being easily able to save lives in this situation. In the 4 years since initiation of the International Liaison Committee on Resuscitation (ILCOR) World Restart a Heart (WRAH), the initiative helped educating millions of people and thus enabled them to save lives. RECENT FINDINGS: WRAH Day has gained more and more reach, partners and impact over the years. It has the potential of saving hundreds of thousands of lives, changing legislation and inspiring research. During the last year, new strategies had to be developed because of the COVID-pandemic. The importance of educating laypeople is underlined in recent publications and international guidelines. SUMMARY: The WRAH awareness campaign has reached 194 countries and more than 200 million people in the last years. The success of it could even be kept going in the pandemic due to social media and digital/virtual programmes. International guidelines recommend raising awareness and name ILCOR WRAH as a way to do it.
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- 2021
6. A special oropharyngeal oxygenation device to facilitate apneic oxygenation in comparison to high flow oxygenation devices
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Simon-Richard Finke, David Sander, Hannes Ecker, Wolfgang A. Wetsch, Holger Herff, Daniel C. Schroeder, and Bernd W. Böttiger
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Insufflation ,Apnea ,medicine.medical_treatment ,Neuroscience (miscellaneous) ,chemistry.chemical_element ,Manikins ,Oxygen ,intubation ,Hypoxemia ,medicine ,Intubation, Intratracheal ,Intubation ,Humans ,tracheal intubation ,Lung ,nasal oxygen ,airway management ,business.industry ,Tracheal intubation ,Oxygen Inhalation Therapy ,Oxygenation ,high flow nasal oxygen ,Respiration, Artificial ,Anesthesiology and Pain Medicine ,chemistry ,Anesthesia ,apneic oxygenation ,Airway management ,medicine.symptom ,HFNO ,business ,oxygen ,Research Article - Abstract
Oxygen application and apneic oxygenation may reduce the risk of hypoxemia due to apnea during awake fiberoptic intubation or failed endotracheal intubation. High flow devices are recommended, but their effect compared to moderate deep oropharyngeal oxygen application is unknown. Designed as an experimental manikin trial, we made a comparison between oxygen application via nasal prongs at 10 L/min (control group), applying oxygen via oropharyngeal oxygenation device (at 10 L/min), oxygen application via high flow nasal oxygen with 20 L/min and 90% oxygen (20 L/90% group), oxygen application via high flow nasal oxygen with 60 L/min and 45% oxygen (60 L/45% group), and oxygen application via sealed face mask with a special adapter to allow for fiberoptic entering of the airway. We preoxygenated the lung of a manikin and measured the decrease in oxygen level during the following 20 minutes for each way of oxygen application. Oxygen levels fell from 97 ± 1% at baseline to 75 ± 1% in control group, and to 86 ± 1% in oropharyngeal oxygenation device group. In the high flow nasal oxygen group, oxygen level dropped to 72 ± 1% in the 20 L/90% group and to 44 ± 1% in the 60 L/45% group. Oxygen level remained at 98 ± 0% in the face mask group. In conclusion, in this manikin simulation study of apneic oxygenation, oxygen insufflation using a sealed face mask kept oxygen levels in the test lung at 98% over 20 minutes, oral oxygenation device led to oxygen levels at 86%, whereas all other methods resulted in the decrease of oxygen levels below 75%.
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- 2021
7. European Resuscitation Council Guidelines 2021: Executive summary
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J. Schlieber, P. Druwe, Fernando Rosell-Ortiz, D. Meyran, N. De Lucas, A.B. te Pas, Robert Greif, J. Madar, A. Boccuzzi, Kirstie L. Haywood, Jana Djakow, E. Goemans, Jonathan Wyllie, W. Renier, Patrick Van de Voorde, Carsten Lott, Tobias Cronberg, Koenraad G. Monsieurs, A. Cariou, Pierre Carli, Therese Djärv, V. Borra, Siobhán Masterson, L. Sanchez Santos, I. Lulic, E. Oliver, Theresa M. Olasveengen, David Zideman, G. Eldin, Giuseppe Ristagno, S. Akin, C. D. Cimpoesu, E. M. Singletary, Spyridon Mentzelopoulos, Joyce Yeung, A. Barelli, D. Hendrickx, G. D. Perkins, Berndt Urlesberger, Lucas Pflanzl-Knizacek, J. K. Heltne, Leo Bossaert, Andrea Scapigliati, L. Bossaert, H. van Grootven, Gavin D. Perkins, Sean Ainsworth, Ferenc Sari, Tomasz Szczapa, K. Pitches, Gamal Eldin Abbas Khalifa, B. Dirks, Dominic Wilkinson, P. Cassan, Jan Wnent, Charles Christoph Roehr, Johan Herlitz, A. de Roovere, Abel Martinez-Mejias, J. Delchef, Florian Hoffmann, M. Blom, J. Koppl, J. Soar, Keith Couper, Artem Kuzovlev, Marios Georgiou, A. Truhlar, Federico Semeraro, G. Trummer, R. Burkart, Mario Rüdiger, V. R. M. Moulaert, John Madar, Jan-Thorsen Gräsner, W. Behringer, R. Greif, C. Clarens, Spyros D. Mentzelopoulos, Torsten Lauritsen, A. Alfonzo, Freddy Lippert, Hildigunnur Svavarsdóttir, Markus B. Skrifvars, Koen Monsieurs, B. Bein, Tommaso Pellis, Maaret Castren, H. Friberg, Jan Breckwoldt, U. Kreimeier, Charles D. Deakin, Christiane Skåre, Nikolaos I. Nikolaou, S. Hunyadi Anticevic, J. P. Nolan, Anthony J. Handley, F. Taccone, S. Schilder, Jerry P. Nolan, Janusz Andres, A. Safri, O. Brissaud, Hege Langli Ersdal, Peter Paal, B. Klaassen, Karl-Christian Thies, Dominique Biarent, D. A. Zideman, Gisela Lilja, J.T. Graesner, Sebastian Schnaubelt, P. Van de Voorde, Ian Maconochie, Violetta Raffay, Michael Smyth, P. Gradisek, C. Lott, C. Genbrugge, Salma Shammet, Daniele Trevisanuto, Violeta González-Salvado, H. Svavarsdottir, N. M. Turner, M. Tageldin Mustafa, Ingvild Tjelmeland, Patricia Conaghan, T. Christophides, Colin J Morley, J. Vaahersalo, M. Baubin, Kurtis Poole, Claudio Sandroni, N. Mpotos, Jasmeet Soar, Bernd W. Böttiger, S. Attard Montalto, Jochen Hinkelbein, M. Maas, Robert Bingham, C. Hassager, T. M. Olasveengen, Francesc Carmona, Groa Bjork Johannesdottir, Andy Lockey, E. De Buck, and European Resuscitation Council Gui
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Adult ,Resuscitation ,medicine.medical_treatment ,education ,030204 cardiovascular system & hematology ,Emergency Nursing ,03 medical and health sciences ,0302 clinical medicine ,resuscitation ,guidelines ,summary ,Nursing ,First Aid ,Humans ,Medicine ,Cardiopulmonary resuscitation ,610 Medicine & health ,Child ,Executive summary ,business.industry ,Infant, Newborn ,Basic life support ,030208 emergency & critical care medicine ,Cardiopulmonary Resuscitation ,Heart Arrest ,Advanced life support ,Europe ,Systematic review ,Life support ,Emergency Medicine ,Human medicine ,Cardiology and Cardiovascular Medicine ,business ,Systematic Reviews as Topic ,First aid - Abstract
Informed by a series of systematic reviews, scoping reviews and evidence updates from the International Liaison Committee on Resuscitation, the 2021 European Resuscitation Council Guidelines present the most up to date evidence-based guidelines for the practice of resuscitation across Europe. The guidelines cover the epidemiology of cardiac arrest; the role that systems play in saving lives, adult basic life support, adult advanced life support, resuscitation in special circumstances, post resuscitation care, first aid, neonatal life support, paediatric life support, ethics and education.
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- 2021
8. World Restart a Heart 2020: How to keep a life-saving awareness campaign alive in a pandemic
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Siddha S.C. Chakra Rao, Hitendra Chandrakant Mahajan, Rakesh Garg, Naomi Kondo Nakagawa, Nilmini Wijesuriya, Federico Semeraro, Nadine Rott, Kevin Nation, Andrew Lockey, Abdulmajeed Khan, Marios Georgiou, Koenraad G. Monsieurs, Monica Sales, Vinay M. Nadkarni, Robert W. Neumar, Tzong-Luen Wang, Raffo Escalante-Kanashiro, Krista O'Shaughnessy, Amber V. Hoover, Heleen van Grootven, Swee Han Lim, Bernd W. Böttiger, Teghan Mear, Salome Boucif, Cianna Levi, Pascal Cassan, Maria José Carvalho Carmona, and WRAH Collaborators
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Health Knowledge, Attitudes, Practice ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Health Promotion ,Awareness ,Emergency Nursing ,medicine.disease ,Pandemic ,Emergency Medicine ,medicine ,Humans ,Human medicine ,Medical emergency ,Life saving ,Cardiology and Cardiovascular Medicine ,business ,Pandemics - Published
- 2021
9. Evaluation des Projekts zur Einführung von Laienreanimation an Schulen in Nordrhein-Westfalen
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Rico Dumcke, Ruth Koch-Schultze, Claas Wegner, Bernd W. Böttiger, Nadine Rott, Marc Felzen, Stefan K. Beckers, Sabine Wingen, Rolf Rossaint, Andreas Meißner, Hugo Van Aken, Olaf Picker, Hanna Schröder, Niels Rahe-Meyer, Oliver Weber, Antje Gottschalk, and Iris Santowski
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medicine.medical_specialty ,030204 cardiovascular system & hematology ,Originalien ,03 medical and health sciences ,0302 clinical medicine ,Herzstillstand ,Germany ,Surveys and Questionnaires ,Ein Leben retten ,Resuscitation in schools ,Humans ,Medicine ,Students ,Wiederbelebung in Schulen ,Gynecology ,Schools ,business.industry ,030208 emergency & critical care medicine ,General Medicine ,Safe a live ,Cardiac arrest ,Cardiopulmonary Resuscitation ,Ministerium für Schule und Bildung ,Anesthesiology and Pain Medicine ,Erste Hilfe ,First aid ,Ministry for schols and education ,business - Abstract
Teaching of resuscitation measures is not mandatory in all schools in Germany. It is currently limited to individual, partly mandatory projects despite a low bystander resuscitation rate. For this reason, the Ministry for Schools and Education of North Rhine-Westphalia initiated the project "Bystander resuscitation at schools in NRW" in March 2017.The aim of this work was to evaluate this project.All secondary schools in North Rhine-Westphalia were invited to participate in the project. Medical partners from each administrative district took part, who carried out resuscitation training with existing concepts for teacher or student training. After a 3-year period, the evaluation was carried out using standardized questionnaires for school headmasters, teachers and students.In total, more than 40,000 pupils from 249 schools in NRW could be trained in resuscitation within the project with 6 different concepts. Of the students 85% answered the questions regarding resuscitation correctly and overall felt safe in resuscitation measures. The one-off investment requirement for all schools is roughly 4-6.5 million € and around 340,000 € in each budget year.A legal constitution and funding are necessary for a nationwide introduction of resuscitation in schools. All established concepts are effective, therefore each school can use them exactly according to their needs, optimally in a stepped form. Training for teachers should focus on resuscitation.HINTERGRUND: Wiederbelebungsunterricht ist nicht in allen Schulen Deutschlands verpflichtend, dieser beschränkt sich trotz niedriger Laienreanimationsrate aktuell auf einzelne, z. T verpflichtende Projekte in unterschiedlichen Bundesländern. Aus diesem Grunde hat das Ministerium für Schule und Bildung Nordrhein-Westfalen per Runderlass im März 2017 das Projekt „Laienreanimation an Schulen in NRW“ initiiert.Ziel dieser Arbeit ist die Evaluation dieses Projekts.Alle weiterführenden Schulen in Nordrhein-Westfalen wurden zur Teilnahme am Projekt eingeladen. Aus jedem Regierungsbezirk nahmen ärztliche Partner teil, welche Wiederbelebungstrainings mit bereits bestehenden Konzepten zum Lehrer- oder Schülertraining durchführten. Nach einer 3‑jährigen Laufzeit erfolgte die Evaluation anhand von standardisierten Fragebögen für Schuldezernenten, Lehrer und Schüler.Insgesamt konnten durch das Projekt mehr als 40.000 Schüler aus 249 Schulen in NRW mit 6 unterschiedlichen Konzepten in Wiederbelebung trainiert werden. Fragen bezüglich Wiederbelebungsmaßnahmen konnten durch 85 % der Schüler richtig beantwortet werden. Die Schüler fühlen sich insgesamt sicher in Wiederbelebungsmaßnahmen. Der Investitionsbedarf für alle Schulen liegt bei einmalig zwischen 4 und 6,5 Mio. € sowie rund 340.000 € in jedem Haushaltsjahr.Eine gesetzliche Verpflichtung und Finanzierung von Wiederbelebungstrainings sind unerlässlich für eine flächendeckende Durchführung. Alle durchgeführten Konzepte sind effektiv, dementsprechend kann jede Schule ein auf ihre Bedürfnisse abgestimmtes Konzept auswählen und dieses bestenfalls gestuft anwenden. Die Schulung von Lehrern sollte gezielt auf Wiederbelebung ausgerichtet sein.
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- 2020
10. Adult Advanced Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations
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Jasmeet Soar, Katherine M. Berg, Lars W. Andersen, Bernd W. Böttiger, Sofia Cacciola, Clifton W. Callaway, Keith Couper, Tobias Cronberg, Sonia D’Arrigo, Charles D. Deakin, Michael W. Donnino, Ian R. Drennan, Asger Granfeldt, Cornelia W.E. Hoedemaekers, Mathias J. Holmberg, Cindy H. Hsu, Marlijn Kamps, Szymon Musiol, Kevin J. Nation, Robert W. Neumar, Tonia Nicholson, Brian J. O’Neil, Quentin Otto, Edison Ferreira de Paiva, Michael J.A. Parr, Joshua C. Reynolds, Claudio Sandroni, Barnaby R. Scholefield, Markus B. Skrifvars, Tzong-Luen Wang, Wolfgang A. Wetsch, Joyce Yeung, Peter T. Morley, Laurie J. Morrison, Michelle Welsford, Mary Fran Hazinski, Jerry P. Nolan, Issa Mahmoud, Monica E. Kleinman, Giuseppe Ristagno, Julie Arafeh, Justin L. Benoit, Maureen Chase, Bryan L. Fischberg, Gustavo E. Flores, Mark S. Link, Joseph P. Ornato, Sarah M. Perman, Comilla Sasson, Carolyn M. Zelop, HUS Emergency Medicine and Services, Department of Diagnostics and Therapeutics, University of Helsinki, and Helsinki University Hospital Area
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Emergency Medical Services ,Resuscitation ,NEURON-SPECIFIC ENOLASE ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Emergency Nursing ,FIBRILLATION WAVE-FORM ,TARGETED TEMPERATURE MANAGEMENT ,0302 clinical medicine ,Emergency medical services ,Vasoconstrictor Agents ,echocardiography ,FOCUSED ECHOCARDIOGRAPHIC EVALUATION ,3. Good health ,AHA Scientific Statements ,Systematic review ,Cardiovascular Diseases ,Emergency Medicine ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,arrhythmias ,Adult ,medicine.medical_specialty ,Consensus ,cardiopulmonary arrest ,postresuscitation care ,cardiopulmonary resuscitation and emergency cardiac care ,Article ,post–cardiac arrest care ,03 medical and health sciences ,Physiology (medical) ,sudden cardiac arrest ,Settore MED/41 - ANESTESIOLOGIA ,medicine ,Humans ,SEQUENTIAL EXTERNAL DEFIBRILLATION ,Cardiopulmonary resuscitation ,Intensive care medicine ,TIDAL CARBON-DIOXIDE ,REFRACTORY VENTRICULAR-FIBRILLATION ,business.industry ,HOSPITAL CARDIAC-ARREST ,Basic life support ,030208 emergency & critical care medicine ,Sudden cardiac arrest ,3126 Surgery, anesthesiology, intensive care, radiology ,ventricular fibrillation ,Cardiopulmonary Resuscitation ,Heart Arrest ,Advanced life support ,Life Support Care ,post-cardiac arrest care ,3121 General medicine, internal medicine and other clinical medicine ,BRAIN COMPUTED-TOMOGRAPHY ,MULTIMODAL OUTCOME PREDICTION ,prognostication ,business ,Out-of-Hospital Cardiac Arrest ,Neonatal resuscitation ,Systematic Reviews as Topic ,Defibrillators - Abstract
This2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendationsfor advanced life support includes updates on multiple advanced life support topics addressed with 3 different types of reviews. Topics were prioritized on the basis of both recent interest within the resuscitation community and the amount of new evidence available since any previous review. Systematic reviews addressed higher-priority topics, and included double-sequential defibrillation, intravenous versus intraosseous route for drug administration during cardiac arrest, point-of-care echocardiography for intra-arrest prognostication, cardiac arrest caused by pulmonary embolism, postresuscitation oxygenation and ventilation, prophylactic antibiotics after resuscitation, postresuscitation seizure prophylaxis and treatment, and neuroprognostication. New or updated treatment recommendations on these topics are presented. Scoping reviews were conducted for anticipatory charging and monitoring of physiological parameters during cardiopulmonary resuscitation. Topics for which systematic reviews and new Consensuses on Science With Treatment Recommendations were completed since 2015 are also summarized here. All remaining topics reviewed were addressed with evidence updates to identify any new evidence and to help determine which topics should be the highest priority for systematic reviews in the next 1 to 2 years.
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- 2020
11. Transjugular intrahepatic portosystemic shunt, local thrombaspiration, and lysis for management of fulminant portomesenteric thrombosis and atraumatic splenic rupture due to vector-vaccine-induced thrombotic thrombocytopenia: a case report
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Sandra Emily Stoll, Patrick Werner, Wolfgang A. Wetsch, Fabian Dusse, Alexander C. Bunck, Matthias Kochanek, Felix Popp, Thomas Schmidt, Christiane Bruns, and Bernd W. Böttiger
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Adult ,Male ,Purpura, Thrombocytopenic, Idiopathic ,Vaccines ,Heparin ,ChAdOx1 nCoV-19 ,COVID-19 ,Humans ,Thrombosis ,General Medicine ,Splenic Rupture ,Portasystemic Shunt, Transjugular Intrahepatic ,Thrombocytopenia - Abstract
Introduction Recombinant adenoviral vector vaccines against severe acute respiratory syndrome coronavirus 2 have been observed to be associated with vaccine-induced immune thrombotic thrombocytopenia. Though vaccine-induced immune thrombotic thrombocytopenia is a rare complication after vaccination with recombinant adenoviral vector vaccines, it can lead to severe complications. In vaccine-induced immune thrombotic thrombocytopenia, the vector vaccine induces heparin-independent production of platelet factor 4 autoantibodies, resulting in platelet activation and aggregation. Therefore, patients suffering from vaccine-induced immune thrombotic thrombocytopenia particularly present with signs of arterial or venous thrombosis, often at atypical sites, but also signs of bleeding due to disseminated intravascular coagulation and severe thrombocytopenia. We describe herein a rare case of fulminant portomesenteric thrombosis and atraumatic splenic rupture due to vaccine-induced immune thrombotic thrombocytopenia. Case summary (main symptoms and therapeutic interventions) This case report presents the diagnosis and treatment of a healthy 29-year-old male Caucasian patient suffering from an extended portomesenteric thrombosis associated with atraumatic splenic rupture due to vaccine-induced immune thrombotic thrombocytopenia after the first dose of an adenoviral vector vaccine against severe acute respiratory syndrome coronavirus 2 [ChAdOx1 nCoV-19 (AZD1222)]. Therapeutic management of vaccine-induced immune thrombotic thrombocytopenia initially focused on systemic anticoagulation avoiding heparin and the application of steroids and intravenous immune globulins as per the recommendations of international societies of hematology and hemostaseology. Owing to the atraumatic splenic rupture and extended portomesenteric thrombosis, successful management of this case required splenectomy with additional placement of a transjugular intrahepatic portosystemic shunt to perform local thrombaspiration, plus repeated local lysis to reconstitute hepatopetal blood flow. Conclusion The complexity and wide spectrum of the clinical picture in patients suffering from vaccine-induced immune thrombotic thrombocytopenia demand an early interdisciplinary diagnostic and therapeutic approach. Severe cases of portomesenteric thrombosis in vaccine-induced immune thrombotic thrombocytopenia, refractory to conservative management, may require additional placement of a transjugular intrahepatic portosystemic shunt, thrombaspiration, thrombolysis, and surgical intervention for effective management.
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- 2022
12. The effectiveness of targeted temperature management following cardiac arrest may depend on bystander cardiopulmonary resuscitation rates
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Bernd W. Böttiger, Martin Hellmich, and Wolfgang A. Wetsch
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Emergency Medical Services ,Anesthesiology and Pain Medicine ,Hypothermia, Induced ,Humans ,Registries ,Cardiopulmonary Resuscitation ,Out-of-Hospital Cardiac Arrest ,Heart Arrest - Published
- 2022
13. [The new 2021 resuscitation guidelines and the importance of lay resuscitation]
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Lina, Horriar, Nadine, Rott, and Bernd W, Böttiger
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Survival Rate ,Emergency Medical Services ,Germany ,Humans ,Cardiopulmonary Resuscitation ,Out-of-Hospital Cardiac Arrest - Abstract
Lay resuscitation is one of the most important measures to increase the survival rate of patients after out-of-hospital cardiac arrest. While European countries, and especially Scandinavian countries, achieve lay resuscitation rates of over 80%, the rate in Germany is only around 40%. The 2021 Resuscitation Guidelines updated by the European Resuscitation Council give special weight to Systems Saving Lives and focus on resuscitation by laypersons. The Systems Saving Lives emphasize the interplay between all actors involved in the chain of survival and thereby specify the link between the emergency service and the general population.Based on the BIG FIVE survival strategies after cardiac arrest, five key strategies are outlined that can achieve the greatest improvement in survival. These are (1) increasing lay resuscitation rates through campaigns and KIDS SAVE LIVES school-based resuscitation training, (2) implementing telephone resuscitation in dispatch centers, (3) first responder systems, (4) advanced life support, and (5) specialized cardiac arrest centers.Die Wiederbelebung durch Laien ist eine der wichtigsten Maßnahmen, um die Überlebensrate von Patientinnen und Patienten nach außerklinischem Herz-Kreislauf-Stillstand zu erhöhen. Während in anderen europäischen Ländern, vor allem in Skandinavien, Laienreanimationsquoten von über 80 % erreicht werden, liegt die Quote in Deutschland nur bei rund 40 %. Die vom European Resuscitation Council aktualisierten Reanimationsleitlinien 2021 messen den lebensrettenden Systemen eine zentrale Bedeutung bei und legen dabei einen Fokus auf die Wiederbelebung durch Laien. Die lebensrettenden Systeme betonen das Zusammenspiel zwischen allen an der Überlebenskette beteiligten Akteurinnen und Akteuren. So wird auch die Verbindung von Rettungsdienst und der Allgemeinbevölkerung konkretisiert.Angelehnt an die BIG-FIVE-Überlebensstrategien nach Herz-Kreislauf-Stillstand werden 5 zentrale Strategien erläutert, mit denen die größte Verbesserung des Überlebens erreicht werden kann. Darunter fallen 1) die Erhöhung der Laienreanimationsquote durch Kampagnen und die schulische Ausbildung in Wiederbelebung KIDS SAVE LIVES, 2) die Implementierung der Telefonreanimation in Leitstellen, 3) Ersthelfersysteme, 4) die flächendeckende Advanced-Life-Support-Versorgung und 5) spezialisierte Kliniken, sogenannte Cardiac Arrest Centers, nach Herz-Kreislauf-Stillstand.
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- 2022
14. [Guidelines of the European Resuscitation Council (ERC) on cardiopulmonary resuscitation 2021: update and comments]
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Guido, Michels, Johann, Bauersachs, Bernd W, Böttiger, Hans-Jörg, Busch, Burkhard, Dirks, Norbert, Frey, Carsten, Lott, Nadine, Rott, Wolfgang, Schöls, P Christian, Schulze, and Holger, Thiele
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Adult ,Humans ,Cardiopulmonary Resuscitation ,Heart Arrest - Abstract
The European guidelines on cardiopulmonary resuscitation, which are divided into 12 chapters, have recently been published. In addition to the already known chapters, the topics "epidemiology" and "life-saving systems" have been integrated for the first time. For each chapter five practical key statements were formulated. In the present article the revised recommendations on basic measures and advanced resuscitation measures in adults as well as on postresuscitation treatment are summarized and commented on.Jüngst wurden die europäischen Leitlinien zur kardiopulmonalen Reanimation verabschiedet, die in 12 Kapitel unterteilt sind. Erstmals wurden die Themen „Epidemiologie“ und „lebensrettende Systeme“ integriert. Für jedes Kapitel wurden 5 praxisnahe Kernaussagen formuliert. In dem vorliegenden Artikel werden die aktuellen Empfehlungen zu Basismaßnahmen und erweiterten Maßnahmen der Erwachsenenreanimation sowie zur Postreanimationsbehandlung zusammengefasst und kommentiert.
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- 2022
15. BIG FIVE strategies for survival following out-of-hospital cardiac arrest
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Karl B. Kern, Freddy Lippert, Bernd W. Böttiger, Sabine Wingen, Giuseppe Ristagno, Federico Semeraro, Lance B Becker, and Andrew Lockey
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Emergency Medical Services ,medicine.medical_specialty ,Editorial ,Anesthesiology and Pain Medicine ,business.industry ,Emergency medicine ,medicine ,Humans ,business ,Cardiopulmonary Resuscitation ,Out-of-Hospital Cardiac Arrest ,Out of hospital cardiac arrest - Published
- 2020
16. COVID‐19 associated pulmonary aspergillosis
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Philipp Koehler, Dennis A. Eichenauer, Oliver A. Cornely, Bernd W. Böttiger, Norma Jung, Florian Klein, Fabian Dusse, Alexander Shimabukuro-Vornhagen, Frieder Fuchs, Michael Hallek, Matthias Kochanek, Thorsten Persigehl, Boris Böll, and Jan Rybniker
- Subjects
Lung Diseases ,Male ,0301 basic medicine ,Thorax ,ARDS ,Antifungal Agents ,Pyridines ,Disease ,Aspergillosis ,SARS‐CoV‐2 ,Mannans ,030207 dermatology & venereal diseases ,0302 clinical medicine ,Germany ,Medicine ,Respiratory Distress Syndrome ,Paramyxoviridae Infections ,General Medicine ,Middle Aged ,Intensive Care Units ,Aspergillus ,Infectious Diseases ,Original Article ,Female ,ECMO ,Coronavirus Infections ,Bronchoalveolar Lavage Fluid ,medicine.drug ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Pneumonia, Viral ,030106 microbiology ,Hemorrhage ,Dermatology ,03 medical and health sciences ,Nitriles ,voriconazole ,Humans ,Hospitals, Teaching ,Pandemics ,Aged ,Retrospective Studies ,Voriconazole ,business.industry ,isavuconazole ,COVID-19 ,Galactose ,Retrospective cohort study ,Original Articles ,Triazoles ,medicine.disease ,Pulmonary aspergillosis ,ICU ,Emergency medicine ,Metapneumovirus ,Pulmonary Aspergillosis ,Tomography, X-Ray Computed ,business - Abstract
Summary Objectives Patients with acute respiratory distress syndrome (ARDS) due to viral infection are at risk for secondary complications like invasive aspergillosis. Our study evaluates coronavirus disease 19 (COVID‐19) associated invasive aspergillosis at a single centre in Cologne, Germany. Methods A retrospective chart review of all patients with COVID‐19 associated ARDS admitted to the medical or surgical intensive care unit at the University Hospital of Cologne, Cologne, Germany. Results COVID‐19 associated invasive pulmonary aspergillosis was found in five of 19 consecutive critically ill patients with moderate to severe ARDS. Conclusion Clinicians caring for patients with ARDS due to COVID‐19 should consider invasive pulmonary aspergillosis and subject respiratory samples to comprehensive analysis to detect co‐infection.
- Published
- 2020
17. Verbal Motivation vs. Digital Real-Time Feedback during Cardiopulmonary Resuscitation: Comparing Bystander CPR Quality in a Randomized and Controlled Manikin Study of Simulated Cardiac Arrest
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Bernd W. Böttiger, Jochen Hinkelbein, Johannes Loeser, Oliver Spelten, Susanne Steinhauser, Hendrik Drinhaus, Michael Nowack, Christopher Plata, and Wolfgang A. Wetsch
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Emergency Medical Services ,medicine.medical_specialty ,medicine.medical_treatment ,media_common.quotation_subject ,education ,030204 cardiovascular system & hematology ,Emergency Nursing ,Smartphone application ,Manikins ,Feedback ,03 medical and health sciences ,0302 clinical medicine ,health services administration ,medicine ,Humans ,Quality (business) ,Prospective Studies ,cardiovascular diseases ,Cardiopulmonary resuscitation ,health care economics and organizations ,media_common ,Motivation ,business.industry ,030208 emergency & critical care medicine ,Cardiopulmonary Resuscitation ,Heart Arrest ,Emergency medicine ,Emergency Medicine ,Bystander cpr ,business ,therapeutics - Abstract
The use of smartphone applications increases bystander CPR quality as well as the use of telephone CPR protocols. The present prospective, randomized, controlled manikin trial analyses the effects of a smartphone application (PocketCPR©) on CPR quality in a bystander CPR scenario compared to a dispatcher-assisted telephone CPR with the additional use of a metronome and verbal motivation.
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- 2020
18. Survival after out-of-hospital cardiac arrest in Europe - Results of the EuReCa TWO study
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Peter Wright, Johan Herlitz, Leo Bossaert, Jan Wnent, Violetta Raffay, Vitor H Correia, Hajriz Alihodžić, Joséphine Escutnaire, Nikolaos I. Nikolaou, Scott J. Booth, Roman Burkart, Ari Salo, Jan-Thorsten Gräsner, Pierre Mols, Anatolij Truhlář, Grzegorz Cebula, Anneli Strömsöe, Siobhán Masterson, Mads Wissenberg, Diana Cimpoesu, Ingvild Tjelmeland, Irzal Hadžibegović, Bergthor Steinn Jonsson, Bernd W. Böttiger, Stefan Trenkler, Carlo Clarens, Gavin D. Perkins, Federico Semeraro, Rudolph W. Koster, Andrej Markota, Holger Maurer, Endre Nagy, Rolf Lefering, Marios Ioannides, Fernando Rossell-Ortiz, Maximilian Moertl, Steffie Beesems, Cardiology, ACS - Amsterdam Cardiovascular Sciences, and ACS - Heart failure & arrhythmias
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Emergency Medical Services ,medicine.medical_specialty ,Resuscitation ,030204 cardiovascular system & hematology ,Emergency Nursing ,Return of spontaneous circulation ,Out of hospital cardiac arrest ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,medicine ,Humans ,Prospective Studies ,Registries ,Out-of-hospital cardiac arrest ,Portugal ,business.industry ,Incidence (epidemiology) ,Public health ,Bystander CPR ,Outcome after OHCA ,030208 emergency & critical care medicine ,medicine.disease ,European registry of cardiac arrest ,Cardiopulmonary Resuscitation ,3. Good health ,Europe ,Ventricular fibrillation ,Emergency medicine ,Emergency Medicine ,Bystander cpr ,Human medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background The epidemiology and outcome after out-of-hospital cardiac arrest (OHCA) varies across Europe. Following on from EuReCa ONE, the aim of this study was to further explore the incidence of and outcomes from OHCA in Europe and to improve understanding of the role of the bystander. Methods This prospective, multicentre study involved the collection of registry-based data over a three-month period (1st October 2017 to 31st December 2017). The core study dataset complied with the Utstein-style. Primary outcomes were return of spontaneous circulation (ROSC) and survival to hospital admission. Secondary outcome was survival to hospital discharge. Results All 28 countries provided data, covering a total population of 178,879,118. A total of 37,054 OHCA were confirmed, with CPR being started in 25,171 cases. The bystander cardiopulmonary resuscitation (CPR) rate ranged from 13% to 82% between countries (average: 58%). In one third of cases (33%) ROSC was achieved and 8% of patients were discharged from hospital alive. Survival to hospital discharge was higher in patients when a bystander performed CPR with ventilations, compared to compression-only CPR (14% vs. 8% respectively). Conclusion In addition to increasing our understanding of the role of bystander CPR within Europe, EuReCa TWO has confirmed large variation in OHCA incidence, characteristics and outcome, and highlighted the extent to which OHCA is a public health burden across Europe. Unexplained variation remains and the EuReCa network has a continuing role to play in improving the quality management of resuscitation. info:eu-repo/semantics/publishedVersion
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- 2020
19. Accuracy of automatic geolocalization of smartphone location during emergency calls — A pilot study
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Hannes Ecker, Wolfgang A. Wetsch, S. Wingen, Bernd W. Böttiger, Jan Dressen, Falko Lindacher, and Stefanie Hamacher
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Pilot Projects ,030204 cardiovascular system & hematology ,Emergency Nursing ,Time-to-Treatment ,03 medical and health sciences ,0302 clinical medicine ,Software ,Humans ,Medicine ,Location data ,business.industry ,Emergency Medical Service Communication Systems ,Ethics committee ,Emergency Medical Dispatch ,Signal Processing, Computer-Assisted ,030208 emergency & critical care medicine ,EMS dispatch ,medicine.disease ,Quality Improvement ,Cardiopulmonary Resuscitation ,Geolocation ,Geographic Information Systems ,Emergency Medicine ,Smartphone ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest - Abstract
Widespread use of smartphones allows automatic geolocalization (i.e., transmission of location data) in countless apps. Until now, this technology has not been routinely used in connection with an emergency call in which location data play a decisive role This study evaluated a new software automatically providing emergency medical service (EMS) dispatchers with a caller's geolocation. We hypothesized that this technology will provide higher accuracy, faster dispatching of EMS and a faster beginning of thoracic compressions in a cardiac arrest scenario.Approval from the local Ethics Committee was obtained. 108 simulated emergency calls reporting a patient in cardiac arrest were conducted at 54 metropolitan locations, which were chosen according to a realistic pattern. At each location, a conventional emergency call, with an oral description of the location, was given first; subsequently, another call using an app with automatic geolocation was placed. Accuracy of localization, time to location, time to EMS dispatch and time to first thoracic compression were compared between both groups.The conventional emergency call was always successful (n = 54). Emergency call via app worked successfully in n = 46 cases (85.2%). Automatic geolocation was provided to EMS in all these n = 46 cases (100%). Deviation from estimated position to actual position was 1173.5 ± 4343.1 m for conventional and 65.6 ± 320.5 m for automatic geolocalization (p 0.001). In addition, time to localization was significantly shorter using automatic geolocalization (34.7 vs. 71.7 s, p 0.001). Time to first thoracic compression was significantly faster in the geolocalization group (83.0 vs. 122.6 s; p 0.001).This pilot study showed that automatic geolocalization leads to a significantly shorter duration of the emergency call, significantly shorter times until the beginning of thoracic compressions, and a higher precision in determining the location of an emergency.
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- 2020
20. Final-year medical students’ knowledge of cardiac arrest and CPR: We must do more!
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Johannes Franke, Valeria Turcan, Niklas Hertenberger, Kristina Rendic, Enrico Contri, Bernd W. Böttiger, Enrico Baldi, Anastasiia Petrenko, Gabrielle Labbe, Nikola Donchev, Alessandra Bailoni, Ana Maria Petrica, Redon Jashari, Alba Pérez Dalí, Jordy Borg, Ilia Nadareishvili, and Irene Yerolemidou
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Adult ,Male ,Health Knowledge, Attitudes, Practice ,Students, Medical ,education ,030204 cardiovascular system & hematology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Young doctor ,business.industry ,Incidence (epidemiology) ,medicine.disease ,Cardiopulmonary Resuscitation ,Europe ,Community response ,Female ,Clinical Competence ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest ,Education, Medical, Undergraduate - Abstract
Background Students are an important part of the community response to an out-of-hospital cardiac arrest (OHCA). If even schoolchildren now know cardio-pulmonary resuscitation (CPR), even more the reason a young doctor should know how to treat an OHCA. The aim of our study was to assess medical students’ knowledge of CPR and OHCA throughout Europe. Methods An online survey was given to final-year students by the Medical Student Associations of different countries. Results 1012 medical students from 99 different universities and 14 different countries completed the questionnaire. A total of 82.2% attended a BLS or BLS/AED course, provided by the University in only 69.7% of cases. In 84.3% it was a mandatory part of their degree. A total of 78.6% felt able to rescue a person in OHCA. Only 49.3% knew that ‘unresponsiveness’ and ‘absence of normal breathing’ are sufficient for lay people to identify an OHCA, and less than half of those interviewed knew the incidence of OHCA in Europe and the decrease in chance of survival if CPR is not performed. The correct compression:ventilation ratio was known by 90.2%, the correct compression depth by 69.7%, whilst only 57.8% knew the right compression rate. In total, 69.7% knew that an AED must be used immediately when available, and only 57.2% recognized the AED symbol. Conclusions Medical students’ knowledge of cardiac arrest and CPR needs to be improved throughout Europe and we believe that BLS/AED training should be mandatory in all European Universities.
- Published
- 2019
21. Cytokine adsorption in patients with post-cardiac arrest syndrome after extracorporeal cardiopulmonary resuscitation (CYTER) - A single-centre, open-label, randomised, controlled trial
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Alexander Supady, Timm Zahn, Moritz Kuhl, Sven Maier, Christoph Benk, Klaus Kaier, Bernd W. Böttiger, Christoph Bode, Achim Lother, Dawid L. Staudacher, Tobias Wengenmayer, and Daniel Duerschmied
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Extracorporeal Membrane Oxygenation ,Treatment Outcome ,Emergency Medicine ,Cytokines ,Humans ,Post-Cardiac Arrest Syndrome ,Adsorption ,Emergency Nursing ,Cardiology and Cardiovascular Medicine ,Cardiopulmonary Resuscitation ,Retrospective Studies - Abstract
To investigate the effect of cytokine adsorption in patients receiving extracorporeal cardiopulmonary resuscitation (ECPR) after cardiac arrest.CYTER was a single-centre, open-label, randomised, controlled trial. Patients selected for ECPR at the University Medical Center Freiburg (Freiburg, Germany) were assigned to extracorporeal membrane oxygenation (ECMO) support with or without cytokine adsorption (1:1) using the CytoSorb adsorber, incorporated into the ECMO, replaced every 24 hours, and removed after 72 hours. The primary endpoint was serum interleukin (IL)-6 concentration at 72 hours (intention-to-treat analysis). Secondary endpoints included 30-day survival, vasopressor support and biomarkers of end-organ injury.Of 50 patients enrolled in the trial, 26 (52%) were treated with cytokine adsorption and 24 (48%) without. Nine patients were excluded (informed consent could not be obtained); 41 patients were therefore included in the primary analysis. Median IL-6 levels (IQR) decreased from 408.0(93.4-906.5) to 324.0 (134.3-4617.3) pg/mL and increased from 133.0 (56.2-528.5) to 241.0 (132.8-718.0) pg/mL in the cytokine adsorption and control group, respectively (linear regression for treatment [cytokine adsorption vs control]: p = 0.48). Three (14%) of 22 patients treated with cytokine adsorption and 8 (42%) of 19 patients treated without cytokine adsorption survived to day 30 (HR = 1.85, 95% CI 0.86-4.01; p = 0.10). Vasopressor support and NSE, S100b, troponin T, CRP and PCT levels were similar between groups.Cytokine adsorption in patients receiving ECPR did not reduce serum IL-6 and had no significant effect on survival, vasopressor support, or biomarkers of injury.ClinicalTrials.gov: NCT03685383.
- Published
- 2021
22. ERC-ESICM guidelines on temperature control after cardiac arrest in adults
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Claudio Sandroni, Jerry P. Nolan, Lars W. Andersen, Bernd W. Böttiger, Alain Cariou, Tobias Cronberg, Hans Friberg, Cornelia Genbrugge, Gisela Lilja, Peter T. Morley, Nikolaos Nikolaou, Theresa M. Olasveengen, Markus B. Skrifvars, Fabio S. Taccone, Jasmeet Soar, UCL - (SLuc) Service des urgences, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, HUS Emergency Medicine and Services, Department of Diagnostics and Therapeutics, and University of Helsinki
- Subjects
Adult ,ADVISORY STATEMENT ,Critical Care ,Resuscitation ,SOCIETY ,Hypothermia ,Emergency Nursing ,Critical Care and Intensive Care Medicine ,Practice guidelines ,MILD THERAPEUTIC HYPOTHERMIA ,Hypothermia, Induced ,EUROPEAN RESUSCITATION COUNCIL ,Settore MED/41 - ANESTESIOLOGIA ,MANAGEMENT ,Humans ,Coma ,MORTALITY ,Temperature ,3126 Surgery, anesthesiology, intensive care, radiology ,Cardiac arrest ,Prognosis ,Cardiopulmonary Resuscitation ,CARDIOPULMONARY-RESUSCITATION ,3121 General medicine, internal medicine and other clinical medicine ,Emergency Medicine ,COMATOSE SURVIVORS ,Cardiology and Cardiovascular Medicine ,RB ,CONSENSUS ,Out-of-Hospital Cardiac Arrest ,RC - Abstract
The aim of these guidelines is to provide evidence based guidance for temperature control in adults who are comatose after resuscitation from either in-hospital or out-of-hospital cardiac arrest, regardless of the underlying cardiac rhythm. These guidelines replace the recommendations on temperature management after cardiac arrest included in the 2021 post-resuscitation care guidelines co-issued by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). The guideline panel included thirteen international clinical experts who authored the 2021 ERC-ESICM guidelines and two methodologists who participated in the evidence review completed on behalf of the International Liaison Committee on Resuscitation (ILCOR) of whom ERC is a member society. We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence and grade recommendations. The panel provided suggestions on guideline implementation and identified priorities for future research. The certainty of evidence ranged from moderate to low. In patients who remain comatose after cardiac arrest, we recommend continuous monitoring of core temperature and actively preventing fever (defined as a temperature > 37.7 degrees C) for at least 72 hours. There was insufficient evidence to recommend for or against temperature control at 32-36 degrees C or early cooling after cardiac arrest. We recommend not actively rewarming comatose patients with mild hypothermia after return of spontaneous circulation (ROSC) to achieve normothermia. We recommend not using prehospital cooling with rapid infusion of large volumes of cold intravenous fluids immediately after ROSC.
- Published
- 2021
23. Facilitators and barriers for the implementation of resuscitation training programmes for schoolchildren: A systematic review
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Julia Jeck, Daniel C. Schroeder, Sabine Wingen, Sebastian M Wingen-Heimann, Ruben M W A Drost, and Bernd W. Böttiger
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Medical education ,Resuscitation ,Schools ,business.industry ,medicine.medical_treatment ,education ,English language ,Resuscitation training ,Cardiopulmonary Resuscitation ,Biology and political orientation ,Europe ,Anesthesiology and Pain Medicine ,Facilitator ,Health care ,medicine ,media_common.cataloged_instance ,Humans ,Cardiopulmonary resuscitation ,European union ,business ,Child ,media_common - Abstract
BACKGROUND: Training schoolchildren in resuscitation seems to improve rates of resuscitation by bystanders. Leading medical societies recommend comprehensive resuscitation education in schools. To date, no widespread implementation within the European Union has happened. OBJECTIVE: The study aim was to identify facilitators and barriers for the implementation of cardiopulmonary resuscitation training for schoolchildren within the European Union. DESIGN: Systematic review. DATA SOURCES: A literature search in PubMed was conducted between 1 January 1999 and 30 June 2020 in accordance with the PRISMA statement. The search terms 'resuscitation', 'children' and 'Europe' were combined with the Boolean Operator 'AND' and 'OR'. Medical subject heading terms were used in order to include relevant articles. ELIGIBILITY CRITERIA: Articles were included if cardiopulmonary resuscitation training specifically tailored for schoolchildren aged 12 to 18 years was considered in countries of the European Union. Articles that fulfilled the following criteria were excluded: duplicates, training methods only for specific patient groups, articles not accessible in the English language, and articles that did not include original data. Findings were structured by an evidence-based six-level approach to examine barriers and facilitators in healthcare. RESULTS: Thirty out of 2005 articles were identified. Large variations in cardiopulmonary resuscitation training approaches ranging from conventional to innovative training methods can be observed. Schoolteachers as resuscitation instructors act either as barrier or facilitator depending on their personal attitude and their exposure to training in resuscitation. Cardiopulmonary resuscitation training in schoolchildren is effective. The uncoordinated interplay between the generally motivated schools and the political orientation towards resuscitation training for schoolchildren serve as barrier. The lack of financial support, absent systematic organisation and standardisation of training create major barriers. CONCLUSION: Training schoolchildren in cardiopulmonary resuscitation is effective. More financial support and political guidance is needed. Until then, local initiatives, motivated teachers, and dedicated principles combined with innovative and low-cost training methods facilitate cardiopulmonary resuscitation training in schools.
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- 2021
24. State of Implementation of Telephone Cardiopulmonary Resuscitation by Rescue Coordination Centers in Germany
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Sabine, Wingen, Nadine, Rott, Nadja, Schittko, Achim, Hackstein, Uwe, Kreimeier, Bérénice, Bartholme, and Bernd W, Böttiger
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Germany ,Humans ,Cardiopulmonary Resuscitation ,Out-of-Hospital Cardiac Arrest ,Telephone - Published
- 2021
25. Criteria for the certification of Cardiac Arrest Centers in Germany
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Norbert Frey, Malte Kelm, H.-J. Busch, N. Rott, Bernd W. Böttiger, K. H. Scholz, and Holger Thiele
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Certification ,business.industry ,MEDLINE ,Emergency Nursing ,medicine.disease ,Heart Arrest ,Germany ,Emergency Medicine ,Medicine ,Humans ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
26. KIDS SAVE LIVES: a narrative review of associated scientific production
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Bernd W. Böttiger, Igor Caitano Salles, Naomi Kondo Nakagawa, and Federico Semeraro
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Medical education ,business.industry ,Scientific production ,MEDLINE ,International health ,Critical Care and Intensive Care Medicine ,Cardiopulmonary Resuscitation ,Bystander cardiopulmonary resuscitation ,Chain of survival ,Medicine ,Humans ,Narrative review ,business ,Child ,Out-of-Hospital Cardiac Arrest - Abstract
Purpose of review In sudden out-of-hospital cardiac arrest, bystander cardiopulmonary resuscitation (CPR) is one of the most important elements of the chain of survival. Since 2015, international health societies and associations have recognized KIDS SAVE LIVES (KSL) as an essential initiative on CPR principles dissemination among schoolchildren. Children can be potential multipliers of the CPR competencies by teaching families, relatives, and friends. This review aimed to determine the main CPR issues raised in the KSL-associated publications. Recent findings We found 12 Editorials, 9 Letters, 2 Special Reports, 4 Reviews, 2 Guidelines, 9 Original Articles and 17 Conference Presentations on KSL history, the schoolchildren CPR education, and KSL program implementation in several countries. In nine original studies, the main issues were instructors' and learners' CPR knowledge, skills, and retention, gender and physical aspects affecting CPR performance, types of KSL programs and new technologies to teach CPR. Summary The KSL-associated literature is limited to support KSL benefits. However, the KSL could potentially contribute to improve out-of-hospital CPR performed by lay people at earlier age in different countries. Children are an important target group to diffuse CPR principles ('CHECK-CALL-COMPRESS'), as they are curious, motivated and enjoy teaching others.
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- 2021
27. To ventilate or not to ventilate during bystander CPR — A EuReCa TWO analysis
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Jan Wnent, Ingvild Tjelmeland, Rolf Lefering, Rudolph W. Koster, Holger Maurer, Siobhán Masterson, Johan Herlitz, Bernd W. Böttiger, Fernando Rosell Ortiz, Gavin D. Perkins, Leo Bossaert, Maximilian Moertl, Pierre Mols, Irzal Hadžibegović, Anatolij Truhlář, Ari Salo, Valentine Baert, Eniko Nagy, Grzegorz Cebula, Violetta Raffay, Stefan Trenkler, Andrej Markota, Anneli Strömsöe, Jan-Thorsten Gräsner, Hajriz Alihodžić, Marios Ioannides, Mads Wissenberg, Josephine Escutnaire, Nikolaos Nikolaou, Bergthor Steinn Jonsson, Peter Wright, Federico Semeraro, Carlo Clarens, Steffie Beesems, Vitor H. Correia, Diana Cimpoesu, Roman Burkart, Scott Booth, Michael Baubin, Adolf Schinnerl, Gerhard Prause, Thomas Tschoellitsch, Helmut Trimmel, Rene Belz, Wolfgang Fleischmann, Magali Bartiaux, Koenraad Monsieurs, Stephan Wilmin, Mathias Faniel, Marie Vanhove, Pascale Lievens, Dominique Biarent, Marc Van Nuffelen, Ives Hubloue, Jean-Marie Jacques, Michèle Yerna, Robert Leach, Mathieu Jeanmaire, Paule Denoël, Frank Van Trimpont, Francis Desmet, Louise Delhaye, Vincent Van Belleghem, Ken Dewitte, Musa Abbasi, Simon Scheyltjens, Olivier Vermylen, Diane de Longueville, Stéphane Debaize, Silvija Hunyadi Antičević, Slobodanka Keleuva, Milan Lazarević, Radmila Majhen Ujević, Gordana Antić Šego, Branka Bardak, Domagoj Mišković, Monika Praunová, Ondřej Franěk, Jaroslav Kratochvíl, Jan Přikryl, Roman Sýkora, Tomáš Vaňatka, Marek Vašák, Petr Jaššo, Petr Šmejkal, Otomar Kušička, Robin Šín, Eva Smržová, Dorián Pfeifer, Heini Harve-Rytsälä, Pamela Hiltunen, Peter Holmström, Timo Iirola, Katja Jokela, Hetti Kirves, Pekka Korvenoja, Markku Kuisma, Jukka Laine, Markus Lyyra, Sami Länkimäki, Petra Portaankorva, Lasse Raatiniemi, Marko Sainio, Piritta Setälä, Tuukka Toivonen, Jan Uotinen, Jukka Vaahersalo, Taneli Väyrynen, David Hamdan, Jean-Marc Agostinucci, Fabienne Branche, François Revaux, Sébastien Jonquet, Richard Loubert, Marion Boursier, Bruno Simonnet, Jean-Charles Morel, Steven Lagadec, Aurélie Avondo, Emilie Gelin, Emanuel Morel-Maréchal, Cécile Ursat, Laurent Villain-Coquet, Marc Fournier, Romain Tabary, Philippe Le Pimpec, Delphine Hugenschmitt, Diego Abarrategui, Romain Blondet, Aurélie Arnaud, Sonia Sadoune, Julien Segard, Sophie Narcisse, Mélanie Laot, Thomas Pernot, Hubert Courcoux, Coralie Chassin, Benoît Jardel, Jeanne Picart, Franck Garden Brèche, Pierre-Alban Guenier, Renaud Getti, Alexandre Jeziorny, Antoine Leroy, Carine Vanderstraeten, Sébastien Dussoulier, Attila Haja, Dániel Németh, Andrea Válint, Gábor Csató, Gerda Lóczi, Péter Vörös, Zsuzsanna Németh, Ferenc Molnár, Ferenc Nagy, Henrietta Kádár, Julia Duda, Justyna Tęczar, Sylwia Dul, Grażyna Świtacz, Andrzej Raczynski, Zlatko Fiser, Zlatko Babic, Aleksandra Opacic, Kornelija Jaksic Horvat, Snezana Vukelic, Jelena Tijanic, Dusan Milenkovic, Sasa Milic, Deze Babinski, Cedomir Boskovic, Jovanka Koprivica, Erika Terek, Goran Provci, Dragana Jovic Zvijer, Ľubica Bajerovská, Miroslav Chabroň, Danka Pražienková, Renáta Kratochvílová, Radoslav Burian, Martin Dobrík, Juraj Patráš, Vladimír Šteflík, Peter Androvič, František Mičáň, Božena Horáňová, Július Pavčo, Monika Grochová, Táňa Bulíková, Rok Maček, Matej Rubelli Furman, Samo Podhostnik, Miha Oman, Klemen Lipovšek, Špela Baznik, Jurica Ferenčina, Matej Strnad, Edith Žižek, Miha Kodela, Alenka Antolinc Košat, Nina Lotrič, Jonny Lindqvist, Remy Stieglis, Anja Radstok, Cardiology, ACS - Heart failure & arrhythmias, Graduate School, ACS - Amsterdam Cardiovascular Sciences, EuReCa TWO, Supporting clinical sciences, and Emergency Medicine
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Emergency Medical Services ,Resuscitation ,medicine.medical_specialty ,Chest-compression only CPR ,medicine.medical_treatment ,EuReCa ,Subgroup analysis ,030204 cardiovascular system & hematology ,Emergency Nursing ,Return of spontaneous circulation ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Full CPR ,medicine ,Humans ,Registries ,Cardiopulmonary resuscitation ,Survival rate ,Out-of-hospital cardiac arrest ,business.industry ,Bystander CPR ,030208 emergency & critical care medicine ,Odds ratio ,Cardiopulmonary Resuscitation ,Ventilation ,Confidence interval ,3. Good health ,Survival Rate ,Emergency medicine ,Emergency Medicine ,Bystander cpr ,Human medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). Method In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. Results A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17–1.83). Conclusion In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both.
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- 2021
28. Reply to: Prognostication in postanoxic coma: Not too early, not too late
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Jerry P. Nolan, Tobias Cronberg, Jasmeet Soar, Claudio Sandroni, Bernd W. Böttiger, Alain Cariou, Hans Friberg, Cornelia Genbrugge, Kirstie Haywood, Gisela Lilja, Veronique R.M. Moulaert, Nikolaos Nikolaou, Theresa M. Olasveengen, Markus B. Skrifvars, and Fabio Taccone
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medicine.medical_specialty ,business.industry ,MEDLINE ,Electroencephalography ,Emergency Nursing ,Postanoxic coma ,Evoked Potentials, Somatosensory ,Emergency Medicine ,medicine ,Humans ,Coma ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business - Published
- 2021
29. European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021 : post-resuscitation care
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Jerry P. Nolan, Claudio Sandroni, Bernd W. Böttiger, Alain Cariou, Tobias Cronberg, Hans Friberg, Cornelia Genbrugge, Kirstie Haywood, Gisela Lilja, Véronique R. M. Moulaert, Nikolaos Nikolaou, Theresa Mariero Olasveengen, Markus B. Skrifvars, Fabio Taccone, Jasmeet Soar, Helsinki University Hospital Area, Department of Diagnostics and Therapeutics, HUS Emergency Medicine and Services, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service des urgences, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, and Faculteit Medische Wetenschappen/UMCG
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Adult ,33 DEGREES-C ,Consensus ,2015 INTERNATIONAL CONSENSUS ,Critical Care ,NEURON-SPECIFIC ENOLASE ,Resuscitation ,Conference Reports and Expert Panel ,Myocardial Reperfusion ,Prognostication ,030204 cardiovascular system & hematology ,Emergency Nursing ,Guidelines ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,TARGETED TEMPERATURE MANAGEMENT ,QUALITY-OF-LIFE ,Seizures ,Settore MED/41 - ANESTESIOLOGIA ,Humans ,Coma ,Post resuscitation care ,MEAN ARTERIAL-PRESSURE ,VENOUS THROMBOEMBOLISM PROPHYLAXIS ,Reuscitation ,HOSPITAL CARDIAC-ARREST ,030208 emergency & critical care medicine ,3126 Surgery, anesthesiology, intensive care, radiology ,Prognosis ,Cardiac arrest ,Cardiopulmonary Resuscitation ,3. Good health ,Heart Arrest ,Emergency Medicine ,BRAIN COMPUTED-TOMOGRAPHY ,MULTIMODAL OUTCOME PREDICTION ,Cardiology and Cardiovascular Medicine ,RC - Abstract
The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have collaborated to produce these post-resuscitation care guidelines for adults, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include the post-cardiac arrest syndrome, diagnosis of cause of cardiac arrest, control of oxygenation and ventilation, coronary reperfusion, haemodynamic monitoring and management, control of seizures, temperature control, general intensive care management, prognostication, long-term outcome, rehabilitation and organ donation. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-021-06368-4.
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- 2021
30. Using a smartphone application (PocketCPR) to determine CPR quality in a bystander CPR scenario — A manikin trial
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Miriam Stolz, Tobias Warnecke, Oliver Spelten, Bernd W. Böttiger, Jochen Hinkelbein, Susanne Steinhauser, Christopher Plata, and Wolfgang A. Wetsch
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Adult ,medicine.medical_specialty ,Adolescent ,030204 cardiovascular system & hematology ,Emergency Nursing ,Smartphone application ,Manikins ,Hand position ,03 medical and health sciences ,0302 clinical medicine ,Germany ,medicine ,Humans ,Single-Blind Method ,Prospective Studies ,Aged ,business.industry ,Significant difference ,030208 emergency & critical care medicine ,Bystander Effect ,Middle Aged ,Mobile Applications ,Cardiopulmonary Resuscitation ,Emergency Medicine ,Physical therapy ,Bystander cpr ,Smartphone ,Cpr quality ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest - Abstract
Feedback devices and dispatcher assistance increase CPR quality in bystander resuscitation. Yet, there is no data comparing both approaches with uninstructed CPR. The present prospective, randomized, controlled, manikin trial aims to determine the effects of the use of a smartphone application (PocketCPR) on CPR quality in a bystander CPR scenario compared to dispatcher-assisted telephone CPR and uninstructed CPR.100 laypersons were included to perform 8-min CPR on a manikin. Volunteers were randomly assigned to one of four groups: (1) uninstructed CPR (uninstructed group), (2) dispatcher-assisted telephone CPR (telephone-group), (3) guidance and feedback through a smartphone application (app-group) and (4) dispatcher-assisted telephone CPR combined with the smartphone-app (telephone + app-group).There was no significant difference in the time to first compression between the uninstructed and the app-group (p = 0.052), likewise between the telephone- and the telephone + app-group (p = 0.193). The no-flow-time of the uninstructed group was significantly longer compared to all other groups (p 0.001). Median compression rate was significantly higher and within the recommended range in the app- and the telephone + app-group. There was no significant difference regarding correct compression depth between the four groups. Correct hand position and complete thorax release was found significantly more frequently in groups with smartphone-app support.Feedback by a smartphone application can improve bystander CPR quality in terms of no-flow-time, compression rate, correct hand position, thorax release and does not delay CPR onset. However, the use of a smartphone application does not improve compression depth significantly.
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- 2019
31. Incidence of peri-operative paediatric cardiac arrest and the influence of a specialised paediatric anaesthesia team
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Thorsten Annecke, Bernd W. Böttiger, Andreas Hohn, Jochen Hinkelbein, Uwe Trieschmann, Jost Kaufmann, Holger Herff, Jan-Nicolas Machatschek, Jeremy Franklin, and Stephan A. Padosch
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Male ,medicine.medical_specialty ,Adolescent ,Pediatrics ,Perioperative Care ,Cohort Studies ,Anesthesiology ,Risk Factors ,Germany ,Health care ,medicine ,Humans ,Anesthesia ,Risk factor ,Child ,Adverse effect ,Retrospective Studies ,Patient Care Team ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant ,Retrospective cohort study ,Odds ratio ,Perioperative ,Heart Arrest ,Anesthesiology and Pain Medicine ,Child, Preschool ,Emergency medicine ,Female ,business ,Cohort study - Abstract
Background Peri-operative critical events are still a major problem in paediatric anaesthesia care. Access to more experienced healthcare teams might reduce the adverse event rate and improve outcomes. Objective The current study analysed incidences of peri-operative paediatric cardiac arrest before and after implementation of a specialised paediatric anaesthesia team and training programme. Design Retrospective cohort study with before-and-after analysis. Setting Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany. Patients A total of 36 243 paediatric anaesthetics (0 to 18 years) were administered between 2008 and 2016. Intervention Implementation of a specialised paediatric anaesthesia team and training programme occurred in 2014 This included hands-on supervised training in all fields of paediatric anaesthesia, double staffing for critical paediatric cases and a 24/7 emergency team. A logistic regression analysis with risk factors (age, ASA physical status, emergency) was used to evaluate the impact of implementation of the specialised paediatric anaesthesia team. Main outcome measures Incidences of peri-operative paediatric cardiac arrest and anaesthesia-attributable cardiac arrest before and after the intervention. Results Twelve of 25 paediatric cardiac arrests were classified as anaesthesia-attributable. The incidence of overall peri-operative paediatric cardiac arrest was 8.1/10 000 (95% CI 5.2 to 12.7) in the period 2008 to 2013 and decreased to 4.6/10 000 (95% CI 2.1 to 10.2) in 2014 to 2016. Likewise, the incidence of anaesthesia-attributable cardiac arrest was lower after 2013 [1.6/10 000 (95% CI 0.3 to 5.7) vs. 4.3/10 000 (95% CI 2.3 to 7.9)]. Using logistic regression, children anaesthetised after 2013 had nearly a 70% lower probability of anaesthesia-attributable cardiac arrest (odds ratio 0.306, 95% CI 0.067 to 1.397; P = 0.1263). For anaesthesia-attributable cardiac arrest, young age was the most contributory risk factor, whereas in overall paediatric cardiac arrest, ASA physical statuses 3 to 5 played a more important role. Conclusion In this study on incidences of peri-operative paediatric cardiac arrest from a European tertiary care university hospital, implementation of a specialised paediatric anaesthesia team and training programme was associated with lower incidences of peri-operative paediatric cardiac arrest and a reduced probability of anaesthesia-attributable cardiac arrest.
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- 2019
32. Acute Exercise Increases the Expression of KIR2DS4 by Promoter Demethylation in NK Cells
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Alexander Schenk, Christine Koliamitra, Philipp Zimmer, Claus Juergen Bauer, Walter Pulverer, Wilhelm Bloch, Volker Schick, Clarissa Gerhäuser, Rudolf Heer, Suzana Ilic, Robert Schier, and Bernd W. Böttiger
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Gene Expression ,Physical Therapy, Sports Therapy and Rehabilitation ,030204 cardiovascular system & hematology ,Epigenesis, Genetic ,03 medical and health sciences ,0302 clinical medicine ,Receptors, KIR ,Gene expression ,Humans ,Aerobic exercise ,Medicine ,Orthopedics and Sports Medicine ,Epigenetics ,Promoter Regions, Genetic ,Exercise ,business.industry ,Promoter ,030229 sport sciences ,Methylation ,DNA Methylation ,Middle Aged ,Demethylation ,Killer Cells, Natural ,DNA methylation ,Exercise Test ,Cancer research ,Female ,business ,KIR3DL1 ,KIR2DS4 - Abstract
Positive effects of exercise on cancer prevention and progression have been proposed to be mediated by stimulating natural killer (NK) cells. Because NK cell receptors are regulated by epigenetic modifications, we investigated whether acute aerobic exercise and training change promoter DNA methylation and gene expression of the activating KIR2DS4 and the inhibiting KIR3DL1 gene. Sixteen healthy women (50–60 years) performed a graded exercise test (GXT) and were randomized into either a passive control group or an intervention group performing a four-week endurance exercise intervention. Blood samples (pre-, post-GXT and post-training) were used for isolation of DNA/RNA of NK cells to assess DNA promoter methylation by targeted deep-amplicon sequencing and gene expression by qRT-PCR. Potential changes in NK cell subsets were determined by flow cytometry. Acute and chronic exercise did not provoke significant alterations of NK cell proportions. Promoter methylation decreased and gene expression increased for KIR2DS4 after acute exercise. A high gene expression correlated with a low methylation of CpGs that were altered by acute exercise. Chronic exercise resulted in a minor decrease of DNA methylation and did not alter gene expression. Acute exercise provokes epigenetic modifications, affecting the balance between the activating KIR2DS4 and the inhibiting KIR3DL1, with potential benefits on NK cell function.
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- 2018
33. European Resuscitation Council Guidelines 2021: Adult advanced life support
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Charles D. Deakin, Jasmeet Soar, Pierre Carli, Bernd W. Böttiger, Keith Couper, Claudio Sandroni, Theresa M. Olasveengen, Carsten Lott, Therese Djärv, Peter Paal, Tommaso Pellis, Gavin D. Perkins, Jerry P. Nolan, CHU Necker - Enfants Malades [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
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Adult ,Resuscitation ,Consensus ,Cardiac arrest ,resuscitation ,coma ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,education ,MEDLINE ,030204 cardiovascular system & hematology ,Emergency Nursing ,03 medical and health sciences ,0302 clinical medicine ,Settore MED/41 - ANESTESIOLOGIA ,medicine ,Humans ,Cardiopulmonary resuscitation ,Coma ,ComputingMilieux_MISCELLANEOUS ,business.industry ,030208 emergency & critical care medicine ,medicine.disease ,Prognosis ,Cardiopulmonary Resuscitation ,3. Good health ,Advanced life support ,Emergency Medicine ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest - Abstract
These European Resuscitation Council Advanced Life Support guidelines, are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the prevention of and ALS treatments for both in-hospital cardiac arrest and out-of-hospital cardiac arrest.
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- 2021
34. European Resuscitation Council Guidelines 2021: Systems saving lives
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Theresa M. Olasveengen, Marios Georgiou, Freddy Lippert, Joyce Yeung, Giuseppe Ristagno, Joachim Schlieber, Federico Semeraro, Robert Greif, Koenraad G. Monsieurs, Sebastian Schnaubelt, Diana Cimpoesu, Bernd W. Böttiger, Andrew Lockey, Roman Burkart, and Andrea Scapigliati
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Resuscitation ,medicine.medical_treatment ,education ,MEDLINE ,Settore MED/41 - Anestesiologia ,030204 cardiovascular system & hematology ,Emergency Nursing ,Hospital ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Research Letter ,Chain of survival ,Humans ,Social media ,Emergency Service, Hospital ,Cardiopulmonary Resuscitation ,Heart Arrest ,Cardiopulmonary resuscitation ,Rapid response ,Emergency Service ,Warning system ,business.industry ,030208 emergency & critical care medicine ,medicine.disease ,3. Good health ,Alliance ,Emergency Medicine ,Human medicine ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business - Abstract
The European Resuscitation Council (ERC) has produced these Systems Saving Lives guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include chain of survival, measuring performance of resuscitation, social media and smartphones apps for engaging community, European Restart a Heart Day, World Restart a Heart, KIDS SAVE LIVES campaign, lower-resource setting, European Resuscitation Academy and Global Resuscitation Alliance, early warning scores, rapid response systems, and medical emergency team, cardiac arrest centres and role of dispatcher.
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- 2021
35. European Resuscitation Council Guidelines 2021: Epidemiology of cardiac arrest in Europe
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Gavin D. Perkins, Gisela Lilja, Johan Herlitz, Leo Bossaert, Jerry P. Nolan, Ingvild Tjelmeland, Bernd W. Böttiger, B. Bein, Fernando Rosell-Ortiz, Siobhán Masterson, Jan Thorsten Gräsner, and Jan Wnent
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Resuscitation ,medicine.medical_specialty ,Quality management ,business.industry ,Emergency Nursing ,medicine.disease ,Out of hospital cardiac arrest ,Cardiopulmonary Resuscitation ,Europe ,Epidemiology ,Emergency Medicine ,medicine ,Humans ,Medical emergency ,Human medicine ,Registries ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest ,Healthcare system - Abstract
In this section of the European Resuscitation Council Guidelines 2021, key information on the epidemiology and outcome of in and out of hospital cardiac arrest are presented. Key contributions from the European Registry of Cardiac Arrest (EuReCa) collaboration are highlighted. Recommendations are presented to enable health systems to develop registries as a platform for quality improvement and to inform health system planning and responses to cardiac arrest.
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- 2021
36. The ERC Research NET — Success, current status and perspectives of the international network for cardiac arrest, resuscitation and post-resuscitation care research
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Bernd W. Böttiger, Koenraad G. Monsieurs, Gavin D. Perkins, Hanno L. Tan, Federico Semeraro, Cardiology, ACS - Heart failure & arrhythmias, and APH - Methodology
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International network ,Resuscitation ,business.industry ,030208 emergency & critical care medicine ,030204 cardiovascular system & hematology ,Emergency Nursing ,medicine.disease ,Cardiopulmonary Resuscitation ,3. Good health ,Heart Arrest ,03 medical and health sciences ,0302 clinical medicine ,Emergency Medicine ,Post resuscitation ,Medicine ,Humans ,Human medicine ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business - Abstract
Cardiac arrest is the third leading cause of death in industrialised nations.1 To improve survival, science and research in cardiac arrest, cardiopulmonary resuscitation (CPR) and post-resuscitation care are major goals and objectives of the European Resuscitation Council (ERC) with its mission “ To preserve human life by making high quality resuscitation available to all” [www.erc.edu]. And according to the “Formula for Survival” in cardiac arrest: Survival = Science/Research Education Implementation.2 Therefore, science and research is the basis for success in CPR and for good survival of our patients.3,4 To further develop and improve research in this area, the ERC Research NET has been founded by 78 international members during the ERC congress “Resuscitation 2013” in Krakow.5 The ERC Research NET was established as an international, interdisciplinary and inter-professional group for clinical and experimental research in Europe and beyond.6
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- 2021
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37. Recommendations for treatment of critically ill patients with COVID-19 : Version 3 S1 guideline
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Bernd W. Böttiger, Gereon Schälte, F. Langer, Florian Hoffmann, Stefan Kluge, Michael Westhoff, Steffen Weber-Carstens, Tobias Welte, Christian Karagiannidis, Gernot Marx, Bernd Salzberger, M. Welper, Michael Pfeifer, Petra Gastmeier, and U. Janssens
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medicine.medical_specialty ,ARDS ,medicine.medical_treatment ,Critical Illness ,medicine.disease_cause ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,law ,Anesthesiology ,medicine ,Infection control ,Humans ,Intensive care medicine ,Coronavirus ,Mechanical ventilation ,business.industry ,SARS-CoV-2 ,COVID-19 ,030208 emergency & critical care medicine ,General Medicine ,Guideline ,medicine.disease ,Intensive care unit ,Leitlinien und Empfehlungen ,Prone position ,Anesthesiology and Pain Medicine ,business - Abstract
Since December 2019 a novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) has rapidly spread around the world resulting in an acute respiratory illness pandemic. The immense challenges for clinicians and hospitals as well as the strain on many healthcare systems has been unprecedented. The majority of patients present with mild symptoms of coronavirus disease 2019 (COVID-19); however, 5–8% become critically ill and require intensive care treatment. Acute hypoxemic respiratory failure with severe dyspnea and an increased respiratory rate (>30/min) usually leads to intensive care unit (ICU) admission. At this point bilateral pulmonary infiltrates are typically seen. Patients often develop a severe acute respiratory distress syndrome (ARDS). So far, remdesivir and dexamethasone have shown clinical effectiveness in severe COVID-19 in hospitalized patients. The main goal of supportive treatment is to ascertain adequate oxygenation. Invasive mechanical ventilation and repeated prone positioning are key elements in treating severely hypoxemic COVID-19 patients. Strict adherence to basic infection control measures (including hand hygiene) and correct use of personal protection equipment (PPE) are essential in the care of patients. Procedures that lead to formation of aerosols should be carried out with utmost precaution and preparation.
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- 2020
38. Impact of video quality when evaluating video-assisted cardiopulmonary resuscitation: a randomized, controlled simulation trial
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Johannes Löser, Rebecca Roth, Martin Nellessen, Bernd W. Böttiger, Christopher Plata, Hannes Ecker, and Wolfgang A. Wetsch
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medicine.medical_specialty ,Emergency Medical Services ,medicine.medical_treatment ,media_common.quotation_subject ,education ,Video Recording ,Subgroup analysis ,Video quality ,Video-assisted CPR ,Hand position ,Medicine ,Humans ,Video assisted ,Quality (business) ,Cardiopulmonary resuscitation ,V-CPR ,Simulation Training ,media_common ,RC86-88.9 ,business.industry ,Significant difference ,RC952-1245 ,Medical emergencies. Critical care. Intensive care. First aid ,Data compression ratio ,Special situations and conditions ,Emergency Medicine ,Physical therapy ,OHCA ,CPR ,business ,Out-of-Hospital Cardiac Arrest ,Research Article - Abstract
Background Although not routinely established during cardiopulmonary resuscitation (CPR), video-assisted CPR has been described as beneficial in the communication with emergency medical service (EMS) authorities in out-of-hospital cardiac arrest scenarios. Since the influence of video quality has not been investigated systematically and due to variation of quality of a live-stream video during video-assisted CPR, we investigated the influence of different video quality levels during the evaluation of CPR performance in video sequences. Methods Seven video sequences of CPR performance were recorded in high quality and artificially reduced to medium and low quality afterwards. Video sequences showed either correct CPR performance or one of six typical errors: too low and too high compression rate, superficial and increased compression depth, wrong hand position and incomplete release. Video sequences were randomly assigned to the different quality levels. During the randomised and double-blinded evaluation process, 46 paramedics and 47 emergency physicians evaluated seven video sequences of CPR performance in different quality levels (high, medium and low resolution). Results Of 650 video sequences, CPR performance was evaluable in 98.2%. CPR performance was correctly evaluated in 71.5% at low quality, in 76.8% at medium quality, and in 77.3% at high quality level, showing no significant differences depending on video quality (p = 0.306). In the subgroup analysis, correct classification of increased compression depth showed significant differences depending on video quality (p = 0.006). Further, there were significant differences in correct CPR classification depending on the presented error (p p = 0.468). Conclusion Video quality has no significant impact on the evaluation of CPR in a video sequence. Even low video quality leads to an acceptable rate of correct evaluation of CPR performance. There is a significant difference in evaluation of CPR performance depending on the presented error in a video sequence. Trial registration German Clinical Trial Register (Registration number DRKS00015297) Registered on 2018-08-21.
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- 2020
39. The lack of knowledge on acute stroke in Brazil: A cross-sectional study with children, adolescents, and adults from public schools
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Marcelo Calderaro, Igor C. Salles, Gabriela B. Gouvêa, Vinícius S. Monteiro, Antonio P. Mansur, Henrique N.I. Shinohara, Priscila Aikawa, Iracema I.K. Umeda, Federico Semeraro, Maria José C. Carmona, Bernd W. Böttiger, and Naomi K. Nakagawa
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Adult ,Male ,Health Knowledge, Attitudes, Practice ,Schools ,Adolescent ,General Medicine ,Awareness ,Adolescents ,Stroke ,Cross-Sectional Studies ,Risk factors ,Risk Factors ,Surveys and Questionnaires ,FAST ,Humans ,Female ,Child ,Signs and symptoms ,Children ,Brazil - Abstract
Objective: Stroke is an important cause of disability and death in adults worldwide. However, it is preventable in most cases and treatable as long as patients recognize it and reach capable medical facilities in time. This community-based study investigated students' stroke knowledge, Emergency Medical Services (EMS) activation, associated risk factors, warning signs and symptoms, and prior experience from different educational levels in the KIDS SAVE LIVES BRAZIL project. Methods: The authors conducted the survey with a structured questionnaire in 2019‒2020. Results: Students from the elementary-school (n = 1187, ~13 y.o., prior experience: 14%, 51% women), high-school (n = 806, ~17 y.o., prior experience: 13%, 47% women) and University (n = 1961, ~22 y.o., prior experience: 9%, 66% women) completed the survey. Among the students, the awareness of stroke general knowledge, associated risk factors, and warning signs and symptoms varied between 42%‒66%. When stimulated, less than 52% of the students associated stroke with hypercholesterolemia, smoking, diabetes, and hypertension. When stimulated, 62%‒65% of students recognized arm weakness, facial drooping, and speech difficulty; only fewer identified acute headache (43%). Interestingly, 67% knew the EMS number; 81% wanted to have stroke education at school, and ~75% wanted it mandatory. Women, higher education, and prior experience were associated with higher scores of knowing risk factors (OR = 1.28, 95% CI: 1.10‒1.48; OR = 2.12, 95% CI: 1.87‒2.40; OR = 1.46, 95% CI: 1.16‒1.83; respectively), and warning signs- symptoms (OR = 2.22, 95% CI: 1.89‒2.60; OR = 3.30, 95% CI: 2.81‒3.87; OR = 2.04, 95% CI: 1.58‒2.63; respectively). Conclusion: Having higher education, prior experience, and being a woman increases stroke-associated risk factors, and warning signs and symptoms identification. Schoolchildren and adolescents should be the main target population for stroke awareness. HIGHLIGHTS Higher education, prior experience, and being women improved the odds of identifying stroke warning signs and symptoms as associated risk factors Improving knowledge, skills, and attitude on acute stroke in the school community may represent a significant advance in public health management Future stroke awareness campaigns and educational efforts should focus on schoolchildren and adolescents, especially in low-income countries
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- 2022
40. KIDS SAVE LIVES in schools: cross-sectional survey of schoolteachers
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Cristian, Abelairas-Gómez, Daniel C, Schroeder, Aida, Carballo-Fazanes, Bernd W, Böttiger, Sergio, López-García, Santiago, Martínez-Isasi, and Antonio, Rodríguez-Núñez
- Subjects
Cross-Sectional Studies ,Schools ,Spain ,Surveys and Questionnaires ,Humans ,Child ,Cardiopulmonary Resuscitation ,Heart Arrest - Abstract
Training schoolchildren in basic life support (BLS) is strongly recommended to effectively increase bystander cardiopulmonary resuscitation (CPR) rates. Paediatricians and other health staff members used to be involved in BLS training, but the wide dissemination of BLS skills would need additional support; as a solution, schoolteachers might have enough knowledge necessary to help to achieve this goal. The aim of this cross-sectional survey study, which involved 3423 schoolteachers, was to evaluate the knowledge related to first aid (FA) and BLS of schoolteachers in Spain. In addition, the study aimed to evaluate the content taught to the schoolchildren regarding FA and teachers' attitudes towards teaching FA. Three-quarters of the surveyed schoolteachers reported knowing FA, and 17% reported teaching it. The emergency medical telephone number and CPR were the subjects taught most often by schoolteachers. However, the schoolteachers demonstrated a lack of knowledge in the identification of cardiac arrest and in CPR. Ninety-eight percent of the respondents agreed with including FA training in schools and as part of university degree programmes and supported the KIDS SAVE LIVES statement. Teaching FA was a positive predictor to be willing to perform CPR (OR: 1.7; 95% CI 1.32-2.31) and to use a defibrillator (OR: 1.4; 95% CI 1.10-1.67).Conclusions: Schoolteachers are willing to teach FA in schools. However, more training and specific curricula are needed to increase the quality of schoolchildren's CPR training. The training of schoolteachers in CPR might be the foundation for the sustainable transfer of CPR-related knowledge to schoolchildren. Therefore, the inclusion of FA and BLS in university degree programmes seems to be essential. What is Known: • Bystander cardiopulmonary resuscitation rates are associated with improved survival rates. • Resuscitation training in schools increases the bystander cardiopulmonary resuscitation rate. What is New: • Schoolteachers are willing to teach basic life support, but they need more and better training. • Schoolteachers agreed with the inclusion of first aid training in schools and university degree programmes aimed at training teachers/undergraduate teaching degrees.
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- 2020
41. Cardiac Arrest Center Certification for out-of-hospital cardiac arrest patients successfully established in Germany
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Norbert Frey, H.-J. Busch, N. Rott, Holger Thiele, Bernd W. Böttiger, Malte Kelm, and K. H. Scholz
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medicine.medical_specialty ,Certification ,business.industry ,Emergency Nursing ,Out of hospital cardiac arrest ,Cardiopulmonary Resuscitation ,Article ,Germany ,Emergency medicine ,Emergency Medicine ,medicine ,Humans ,Center (algebra and category theory) ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest - Published
- 2020
42. Up to 206 Million People Reached and Over 5.4 Million Trained in Cardiopulmonary Resuscitation Worldwide: The 2019 International Liaison Committee on Resuscitation World Restart a Heart Initiative
- Author
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Cristina Toporas, Bernd W. Böttiger, Karl B. Kern, Heleen van Grootven, Raffo Escalante, Naomi Kondo Nakagawa, Kevin Nation, Swee Ho Lim, Cianna Levi, Marios Georgiou, Federico Semeraro, Pascal Cassan, Allan de Caen, Robert W. Neumar, Abdul Majeed S. Khan, Andrew Lockey, Jacopo Pagani, Jannicke Mellin-Olsen, David Stanton, Maria José Carvalho Carmona, Amber V. Hoover, Nilmini Wijesuriya, Maaret Castrén, Monica Sales, Ssc Chakra Rao, Richard Aickin, Tzong-Luen Wang, Gillian Wong, Gavin D. Perkins, Vinay M. Nadkarni, Jerry P. Nolan, HUS Emergency Medicine and Services, Department of Diagnostics and Therapeutics, University of Helsinki, and Helsinki University Hospital Area
- Subjects
Liaison committee ,Resuscitation ,medicine.medical_specialty ,medicine.medical_treatment ,education ,lay resuscitation ,cardiac arrest ,030204 cardiovascular system & hematology ,Global Health ,cardiopulmonary resuscitation ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Bystander cardiopulmonary resuscitation ,Cardiopulmonary resuscitation ,health care economics and organizations ,Cause of death ,business.industry ,Correction ,030208 emergency & critical care medicine ,3126 Surgery, anesthesiology, intensive care, radiology ,“World Restart a Heart” ,3. Good health ,3121 General medicine, internal medicine and other clinical medicine ,"World Restart a Heart" ,Emergency medicine ,International Liaison Committee on ,Cardiology and Cardiovascular Medicine ,business ,Developed country ,Out-of-Hospital Cardiac Arrest ,International Liaison Committee on Resuscitation - Abstract
Sudden out‐of‐hospital cardiac arrest is the third leading cause of death in industrialized nations. Many of these lives could be saved if bystander cardiopulmonary resuscitation rates were better. “All citizens of the world can save a life—CHECK—CALL—COMPRESS.” With these words, the International Liaison Committee on Resuscitation launched the 2019 global “World Restart a Heart” initiative to increase public awareness and improve the rates of bystander cardiopulmonary resuscitation and overall survival for millions of victims of cardiac arrest globally. All participating organizations were asked to train and to report the numbers of people trained and reached. Overall, social media impact and awareness reached up to 206 million people, and >5.4 million people were trained in cardiopulmonary resuscitation worldwide in 2019. Tool kits and information packs were circulated to 194 countries worldwide. Our simple and unified global message, “CHECK—CALL—COMPRESS,” will save hundreds of thousands of lives worldwide and will further enable many policy makers around the world to take immediate and sustainable action in this most important healthcare issue and initiative.
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- 2020
43. Effectiveness of the 40-Minute Handmade Manikin Program to Teach Hands-on Cardiopulmonary Resuscitation at School Communities
- Author
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Regiani Carvalho-Oliveira, Sergio Timerman, Marcelo Calderaro, Eduardo V. Motta, Mariangela Macchione, Andrew Lockey, Maria José Carvalho Carmona, Adalgisa I. Maiworm, Bernd W. Böttiger, Thatiane Facholi Polastri, Priscila Aikawa, Ana Paula Boaventura, Katia M.G. Oliveira, Heraldo P. Souza, Naomi Kondo Nakagawa, Federico Semeraro, Luiz Fernando Ferraz da Silva, Gabriela B. Gouvêa, Ludhmila Abrahão Hajjar, and Carmen Diva Saldiva de André
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,medicine.medical_treatment ,education ,030204 cardiovascular system & hematology ,Cpr training ,Manikins ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Quality of life ,Internal medicine ,medicine ,Humans ,Cardiopulmonary resuscitation ,health care economics and organizations ,Schools ,business.industry ,030208 emergency & critical care medicine ,Mean age ,Pass rate ,Sudden cardiac arrest ,Hand ,Cardiopulmonary Resuscitation ,Cardiology ,Physical therapy ,Observational study ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest - Abstract
Bystander training in cardiopulmonary resuscitation (CPR) is crucial to improve the victims' survival and quality of life after sudden cardiac arrest. This observational study aimed to determine the success rate of 2 different programs of CPR training for children, adolescents, and adults in school communities. We assessed the development and acquisition of the following CPR skills: checking local safety, assessing victim's responsiveness, calling for help, assessing victim's breathing, and performing chest compression (hands and straight arms placement on the chest, compression velocity, depth, and chest release) using a 40-minute program with handmade manikins or the 120-minute program using intermediate-fidelity manikins. There were 1,630 learners (mean age 16 years, 38% male) in the 40-minute program, and 347 learners (mean age 27 years, 32% male) in the 120-minute program. The lowest successful pass rate of learners that developed CPR skills was 89.4% in the 40-minute program and 84.5% in the 120-minute program. The chances of success increased with age in the same program (compression rate and depth). The success rate also increased with the more extended and intermediate-cost program at the same age (assessing victim's responsiveness, calling for help, and assessing the victim's respiration). In conclusion, a 40-minute and cheaper (low-cost handmade manikin) CPR program was adequate to develop and acquire the overall CPR skills for ≥89% at school communities, independently of gender. However, some individual CPR skills can be further improved with increasing age and using the longer and intermediate-cost program.
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- 2020
44. The need to overcome the lack of CPR competencies in healthcare students in Europe
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Enrico Contri, Enrico Baldi, and Bernd W. Böttiger
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Students, Medical ,business.industry ,medicine.disease ,Cardiopulmonary Resuscitation ,Heart Arrest ,Europe ,Cardio-pulmonary resuscitation ,Health care ,medicine ,Humans ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business ,Delivery of Health Care - Published
- 2020
45. Resuscitation of the patient with suspected/confirmed COVID-19 when wearing personal protective equipment: A randomized multicenter crossover simulation trial
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Marek Malysz, Kurt Ruetzler, Jerzy Robert Ladny, Miłosz Jaguszewski, Krzysztof J. Filipiak, Marek Dabrowski, Klaudia Kulak, Lukasz Szarpak, Agnieszka Szarpak, Bernd W. Böttiger, and Jacek Smereka
- Subjects
Adult ,Male ,Resuscitation ,medicine.medical_specialty ,Infectious Disease Transmission, Patient-to-Professional ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,medicine.medical_treatment ,Pneumonia, Viral ,Context (language use) ,030204 cardiovascular system & hematology ,Betacoronavirus ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Single-Blind Method ,Cardiopulmonary resuscitation ,Pandemics ,Personal Protective Equipment ,Personal protective equipment ,Aerosols ,Cross-Over Studies ,SARS-CoV-2 ,business.industry ,COVID-19 ,Data compression ratio ,General Medicine ,Cardiopulmonary Resuscitation ,Patient Simulation ,Anesthesia ,Life support ,Cardiology ,Female ,Coronavirus Infections ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: The aim of the study was to evaluate various methods of chest compressions in patients with suspected/confirmed SARS-CoV-2 infection conducted by medical students wearing full personal protective equipment (PPE) for aerosol generating procedures (AGP). Methods: This was prospective, randomized, multicenter, single-blinded, crossover simulation trial. Thirty-five medical students after an advanced cardiovascular life support course, which included performing 2-min continuous chest compression scenarios using three methods: (A) manual chest compression (CC), (B) compression with CPRMeter, (C) compression with LifeLine ARM device. During resuscitation they are wearing full personal protective equipment for aerosol generating procedures. Results: The median chest compression depth using manual CC, CPRMeter and LifeLine ARM varied and amounted to 40 (38–45) vs. 45 (40–50) vs. 51 (50–52) mm, respectively (p = 0.002). The median chest compression rate was 109 (IQR; 102–131) compressions per minute (CPM) for manual CC, 107 (105–127) CPM for CPRMeter, and 102 (101–102) CPM for LifeLine ARM (p = 0.027). The percentage of correct chest recoil was the highest for LifeLine ARM — 100% (95–100), 80% (60–90) in CPRMeter group, and the lowest for manual CC — 29% (26–48). Conclusions: According to the results of this simulation trial, automated chest compression devices (ACCD) should be used for chest compression of patients with suspected/confirmed COVID-19. In the absence of ACCD, it seems reasonable to change the cardiopulmonary resuscitation algorithm (in the context of patients with suspected/confirmed COVID-19) by reducing the duration of the cardiopulmonary resuscitation cycle from the current 2-min to 1-min cycles due to a statistically significant reduction in the quality of chest compressions among rescuers wearing PPE AGP.
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- 2020
46. Evaluation Of CPR Quality Via Smartphone With A Video Livestream - A Study In A Metropolitan Area
- Author
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Hannes Ecker, Sabine Wingen, Stefanie Hamacher, Bernd W. Böttiger, Falko Lindacher, and Wolfgang A. Wetsch
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Resuscitation ,medicine.medical_specialty ,Emergency Medical Services ,health care facilities, manpower, and services ,medicine.medical_treatment ,education ,030204 cardiovascular system & hematology ,Emergency Nursing ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,Cardiopulmonary resuscitation ,health care economics and organizations ,business.industry ,030208 emergency & critical care medicine ,Patient survival ,Metropolitan area ,Cardiopulmonary Resuscitation ,Emergency Medical Dispatcher ,Emergency medicine ,Emergency Medicine ,Cpr quality ,Smartphone ,business ,Out-of-Hospital Cardiac Arrest - Abstract
Telephone-assisted cardiopulmonary resuscitation (CPR) is an effective and proven tool to improve patient survival and outcome after cardiac arrest, and is therefore recommended in international resuscitation guidelines. A new technology that provides the emergency medical services (EMS) dispatcher with a video livestream from a smartphone during telephone-assisted CPR was investigated to assess whether a correct judgment of CPR quality is feasible.After Ethics Committee approval, we conducted this study from August to September 2018 in the University Hospital of Cologne and its metropolitan area. Our study team set up a full-scale resuscitation mannequin on 54 study sites. Video telephony between caller and EMS dispatcher was established, and CPR was initiated with randomized common quality issues concerning compression frequency, compression depth, and compression point. It was evaluated whether the dispatcher recognized correct and incorrect resuscitation performance.Forty-six video calls were established successfully. EMS dispatching staff identified correct compression frequency (100-120/min) in 87.5% of the cases, too low frequency (80/min) was correctly identified in 92%, and too high frequency (140/min) in 58.5%, respectively. Correct compression depth (5-6 cm) was identified in 70.6%, shallow compressions (3cm) in 92.9% and a continuous decrease of depth in 100% of all cases. Correct compression point was identified in 87.5%, incorrect epigastric compression in 92.3%, incomplete release in 58.8%.A video livestream from a smartphone can support an EMS dispatcher's assistance in resuscitation. Typical resuscitation mistakes, like incorrect compression frequency or depth, and incorrect compression points could be recognized and corrected efficiently via video livestream.
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- 2020
47. Video-assisted cardiopulmonary resuscitation via smartphone improves quality of resuscitation: A randomised controlled simulation trial
- Author
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Hannes Ecker, Wolfgang A. Wetsch, Niels Adams, Robert Schier, Stefanie Hamacher, Sabine Wingen, Bernd W. Böttiger, and Falko Lindacher
- Subjects
Adult ,Resuscitation ,medicine.medical_specialty ,Emergency Medical Services ,medicine.medical_treatment ,education ,Manikins ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,health services administration ,Statistical significance ,medicine ,Clinical endpoint ,Humans ,Video assisted ,cardiovascular diseases ,Cardiopulmonary resuscitation ,health care economics and organizations ,Cause of death ,business.industry ,030208 emergency & critical care medicine ,Cardiopulmonary Resuscitation ,Layperson ,Anesthesiology and Pain Medicine ,Physical therapy ,Smartphone ,business ,therapeutics ,Out-of-Hospital Cardiac Arrest ,First aid - Abstract
BACKGROUND Despite intensive research, cardiac arrest remains a leading cause of death. It is of paramount importance to undertake every possible effort to increase the overall quality of cardiopulmonary resuscitation (CPR) and improve patient outcome. CPR initiated by a bystander is one of the key factors in survival of such an incident. Telephone-assisted CPR (T-CPR) has proved to be an effective measure in improving layperson resuscitation. OBJECTIVE We hypothesised that adding video-telephony to the emergency call (video-CPR, V-CPR) enhances the quality of layperson resuscitation. DESIGN This randomised controlled simulation trial was performed from July to August 2018. Laypersons were randomly assigned to video-assisted (V-CPR), telephone-assisted (T-CPR) or control (unassisted CPR) groups. Participants were instructed to perform first aid on a mannequin during a simulated cardiac arrest. SETTING This study was conducted in the Skills Lab of the University Hospital of Cologne. PARTICIPANTS One hundred and fifty healthy adult volunteers. INTERVENTION The participants received a smartphone to call emergency services, with Emergency Eye video-call in V-CPR group, and normal telephone functionality in the other groups. T-CPR and V-CPR groups received standardised CPR assistance via phone. MAIN OUTCOME MEASURES Our primary endpoint was resuscitation quality, quantified by compression frequency and depth, and correct hand position. RESULTS Mean compression frequency of V-CPR group was 106.4 ± 11.7 min, T-CPR group 98.9 ± 12.3 min (NS), unassisted group 71.6 ± 32.3 min (P
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- 2020
48. Intraoperative Cardiac Arrest: Of Utmost Importance and a Stepchild at the Same Time
- Author
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Bernd W. Böttiger and Jochen Hinkelbein
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Anesthesiology and Pain Medicine ,business.industry ,Cardiovascular Diseases ,Anesthesia ,MEDLINE ,Medicine ,Humans ,Intraoperative cardiac arrest ,business ,United States ,Heart Arrest - Published
- 2020
49. Healthcare professionals' knowledge on cardiopulmonary resuscitation correlated with return of spontaneous circulation rates after in-hospital cardiac arrests: A multicentric study between university hospitals in 12 European countries
- Author
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Robert Greif, Nicolas Mongardon, György Barczy, Francesc Carmona-Jiménez, Dimitrios Dougenis, Elena Corrada, Marc Van de Velde, Andrea Scapigliati, Christos Kourek, Georgios Georgiopoulos, Gert Jan Scheffer, Michał Marchel, Maaret Castrén, Juraj Koutun, Bernd W. Böttiger, Jochen Hinkelbein, and Theodoros Xanthos
- Subjects
Male ,Health Knowledge, Attitudes, Practice ,medicine.medical_treatment ,Cancer development and immune defence Radboud Institute for Molecular Life Sciences [Radboudumc 2] ,030204 cardiovascular system & hematology ,Hospitals, University ,0302 clinical medicine ,Belgium ,Germany ,Odds Ratio ,Hospital Mortality ,Finland ,Cause of death ,Netherlands ,Greece ,Middle Aged ,University hospital ,3. Good health ,Medical–Surgical Nursing ,Italy ,Female ,Clinical Competence ,France ,Return of Spontaneous Circulation ,Cardiology and Cardiovascular Medicine ,Switzerland ,Adult ,medicine.medical_specialty ,Slovakia ,Adolescent ,Health Personnel ,Return of spontaneous circulation ,03 medical and health sciences ,Young Adult ,medicine ,Humans ,Cardiopulmonary resuscitation ,Advanced and Specialized Nursing ,Hungary ,Health professionals ,business.industry ,Basic life support ,030208 emergency & critical care medicine ,Cardiopulmonary Resuscitation ,Advanced life support ,Heart Arrest ,Spain ,Emergency medicine ,Poland ,business ,Delivery of Health Care - Abstract
Background: In-hospital cardiac arrest is a major cause of death in European countries, and survival of patients remains low ranging from 20% to 25%. Aims: The purpose of this study was to assess healthcare professionals’ knowledge on cardiopulmonary resuscitation among university hospitals in 12 European countries and correlate it with the return of spontaneous circulation rates of their patients after in-hospital cardiac arrest. Methods and results: A total of 570 healthcare professionals from cardiology, anaesthesiology and intensive care medicine departments of European university hospitals in Italy, Poland, Hungary, Belgium, Spain, Slovakia, Germany, Finland, The Netherlands, Switzerland, France and Greece completed a questionnaire. The questionnaire consisted of 12 questions based on epidemiology data and cardiopulmonary resuscitation training and 26 multiple choice questions on cardiopulmonary resuscitation knowledge. Hospitals in Switzerland scored highest on basic life support ( P=0.005) while Belgium hospitals scored highest on advanced life support ( PConclusion: Differences in knowledge about resuscitation and course attendance were found between university hospitals in 12 European countries. Education in cardiopulmonary resuscitation is considered to be vital for patients’ return of spontaneous circulation rates after in-hospital cardiac arrest. A higher level of knowledge in advanced life support results in higher return of spontaneous circulation rates.
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- 2020
50. Mandatory cardiopulmonary resuscitation competencies for undergraduate healthcare students in Europe: A European Resuscitation Council guidance note
- Author
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Diana Cimpoesu, Andrew Lockey, Patricia Conaghan, Jonathan Hulme, Ian Maconochie, Enrico Contri, Bernd W. Böttiger, Enrico Baldi, Robert Greif, and Simone Savastano
- Subjects
Resuscitation ,business.industry ,medicine.medical_treatment ,MEDLINE ,medicine.disease ,Cardiopulmonary Resuscitation ,Heart Arrest ,Europe ,Anesthesiology and Pain Medicine ,Health care ,medicine ,Humans ,Cardiopulmonary resuscitation ,Medical emergency ,business ,Students ,610 Medicine & health ,Delivery of Health Care - Published
- 2020
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