The willingness of final year medical and dental students to perform bystander cardiopulmonary resuscitation in an Asian community

Background Despite the importance of early effective chest compressions to improve the chance of survival of an out-of-hospital cardiac arrest victim, it is still largely unknown how willing our Malaysian population is to perform bystander cardiopulmonary resuscitation (CPR). Aims We conducted a voluntary, anonymous self-administered questionnaire survey of a group of 164 final year medical students and 60 final year dental students to unravel their attitudes towards performing bystander CPR. Methods Using a 4-point Likert scale of “definitely yes,” “probably yes,” “probably no,” and “definitely no,” the students were asked to rate their willingness to perform bystander CPR under three categories: chest compressions with mouth-to-mouth ventilation (CC + MMV), chest compressions with mask-to-mouth ventilation (CC + PMV), and chest compressions only (CC). Under each category, the students were given ten hypothetical victim scenarios. Categorical data analysis was done using the McNemar test, chi-square test, and Fisher exact test where appropriate. For selected analysis, “definitely yes” and “probably yes” were recoded as a “positive response.” Results Generally, we found that only 51.4% of the medical and 45.5% of the dental students are willing to perform bystander CPR. When analyzed under different hypothetical scenarios, we found that, except for the scenario where the victim is their own family member, all other scenarios showed a dismally low rate of positive responses in the category of CC + MMV, but their willingness was significantly improved under the CC + PMV and CC categories. Conclusion This study shows that there are unique sociocultural factors that contribute to the reluctance of our students to perform CC + MMV. Keywords Cardiopulmonary resuscitation Mouth-to-mouth resuscitation Basic cardiac life support Asian communit

An evaluation of 9-1-1 calls to assess the effectiveness of dispatch-assisted cardiopulmonary resuscitation (CPR) instructions: design and methodology

<p>Abstract</p> <p>Background</p> <p>Cardiac arrest is the leading cause of mortality in Canada, and the overall survival rate for out-of-hospital cardiac arrest rarely exceeds 5%. Bystander cardiopulmonary resuscitation (CPR) has been shown to increase survival for cardiac arrest victims. However, bystander CPR rates remain low in Canada, rarely exceeding 15%, despite various attempts to improve them. Dispatch-assisted CPR instructions have the potential to improve rates of bystander CPR and many Canadian urban communities now offer instructions to callers reporting a victim in cardiac arrest. Dispatch-assisted CPR instructions are recommended by the International Guidelines on Emergency Cardiovascular Care, but their ability to improve cardiac arrest survival remains unclear.</p> <p>Methods/Design</p> <p>The overall goal of this study is to better understand the factors leading to successful dispatch-assisted CPR instructions and to ultimately save the lives of more cardiac arrest patients. The study will utilize a before-after, prospective cohort design to specifically: 1) Determine the ability of 9-1-1 dispatchers to correctly diagnose cardiac arrest; 2) Quantify the frequency and impact of perceived agonal breathing on cardiac arrest diagnosis; 3) Measure the frequency with which dispatch-assisted CPR instructions can be successfully completed; and 4) Measure the impact of dispatch-assisted CPR instructions on bystander CPR and survival rates.</p> <p>The study will be conducted in 19 urban communities in Ontario, Canada. All 9-1-1 calls occurring in the study communities reporting out-of-hospital cardiac arrest in victims 16 years of age or older for which resuscitation was attempted will be eligible. Information will be obtained from 9-1-1 call recordings, paramedic patient care reports, base hospital records, fire medical records and hospital medical records. Victim, caller and system characteristics will be measured in the study communities before the introduction of dispatch-assisted CPR instructions (before group), during the introduction (run-in phase), and following the introduction (after group).</p> <p>Discussion</p> <p>The study will obtain information essential to the development of clinical trials that will test a variety of educational approaches and delivery methods for telephone cardiopulmonary resuscitation instructions. This will be the first study in the world to clearly quantify the impact of dispatch-assisted CPR instructions on survival to hospital discharge for out-of-hospital cardiac arrest victims.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov NCT00664443</p

Application of airborne LiDAR data and airborne multispectral imagery to structural mapping of the upper section of the Troodos ophiolite, Cyprus

Structural maps are traditionally produced by mapping features such as faults, folds, fabrics, fractures and joints in the field. However, large map areas and the spatially limited ground perspective of the field geologist can potentially increase the likelihood that not all structural features will be identified within a given area. The ability to recognise and map both local and regional structural features using high-resolution remote sensing data provides an opportunity to complement field-based mapping to help generate more comprehensive structural maps. Nonetheless, vegetation cover can adversely affect the extraction of structural information from remotely sensed data as it can mask the appearance of subtle spectral and geomorphological features that correspond to geological structures. This study investigates the utility of airborne Light Detection And Ranging (LiDAR) data and airborne multispectral imagery for detailed structural mapping in vegetated ophiolitic rocks and sedimentary cover of a section of the northern Troodos ophiolite, Cyprus. Visual enhancement techniques were applied to a 4-m airborne LiDAR digital terrain model and 4-m airborne multispectral imagery to assist the generation of structural lineament maps. Despite widespread vegetation cover, dykes and faults were recognisable as lineaments in both data sets, and the predominant strike trends of lineaments in all resulting maps were found to be in agreement with fieldbased structural data. Interestingly, prior to fieldwork, most lineaments were assumed to be faults, but were ground verified as dykes instead, emphasising the importance of ground-truthing. Dyke and fault trends documented in this study define a pervasive structural fabric in the upper Troodos ophiolite that reflects the original sea-floor spreading history in the Larnaca graben. This structural fabric has not previously been observed in such detail and is likely to be continuous in adjacent regions under sedimentary cover. This information may be useful to future exploration efforts in the region focused on identification of structurally controlled mineral and groundwater resources. Overall, our case study highlights the efficacy of airborne LiDAR data and airborne multispectral imagery for extracting detailed and accurate structural information in hard-rock terrain to help complement field-based mapping