111 research outputs found
Real-time compression feedback for patients with in-hospital cardiac arrest: a multi-center randomized controlled clinical trial
Objective: To determine if real-time compression feedback using a non-automated hand-held device improves
patient outcomes from in-hospital cardiac arrest (IHCA).
Methods: We conducted a prospective, randomized, controlled, parallel study (no crossover) of patients with IHCA in
the mixed medicalââŹâsurgical intensive care units (ICUs) of eight academic hospitals. Patients received either standard
manual chest compressions or compressions performed with real-time feedback using the Cardio First Angelâ⢠(CFA)
device. The primary outcome was sustained return of spontaneous circulation (ROSC), and secondary outcomes were
survival to ICU and hospital discharge.
Results: One thousand four hundred fifty-four subjects were randomized; 900 were included. Sustained ROSC was
significantly improved in the CFA group (66.7% vs. 42.4%, P < 0.001), as was survival to ICU discharge (59.8% vs. 33.6%)
and survival to hospital discharge (54% vs. 28.4%, P < 0.001). Outcomes were not affected by intra-group comparisons
based on intubation status. ROSC, survival to ICU, and hospital discharge were noted to be improved in inter-group
comparisons of non-intubated patients, but not intubated ones.
Conclusion: Use of the CFA compression feedback device improved event survival and survival to ICU and hospital
discharge
Causes of rail staff fatigue: results of qualitative analysis and a diary study
The purpose of this study was to investigate the causes of fatigue among rail staff by analysing qualitative data and conducting an online diary study. It had a closer look at the experience of fatigue among rail staff and brought a more detailed blueprint picture of fatigue and its causes in the rail staffâs real-life. Study 1 analysed 133 responses of qualitative data from rail staff, and Study 2 was a diary study examining fatigue and its related risk factors before and after work, on the first and the last day of a working week in 19 rail staff. The findings from the two studies, using different methodologies, showed similar results that fatigue among rail staff was a result of heavy workload and a high workload would further increase fatigue. Fatigue before work mainly resulted from sleep quality, length of sleep, and the time spent on commute, while fatigue after work resulted from the perceived workload and shift type. Evidence has demonstrated that overtime work, specific shift patterns, insufficient rest days between opposed shifts, and poor timing of breaks during work were also associated with fatigue
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