Effect Of The Cardio First Angel™ Device On CPR Indices: A Randomized Controlled Clinical Trial

Background: A number of cardiopulmonary resuscitation (CPR) adjunct devices have been developed to improve the consistency and quality of manual chest compressions. We investigated whether a CPR feedback device would improve CPR quality and consistency, as well as patient survival. Methods: We conducted a randomized controlled study of patients undergoing CPR for cardiac arrest in the mixed medical-surgical intensive care units of four academic teaching hospitals. Patients were randomized to receive either standard manual CPR or CPR using the Cardio First Angel™ CPR feedback device. Recorded variables included guideline adherence, CPR quality, return of spontaneous circulation (ROSC) rates, and CPR-associated morbidity. Results: A total of 229 subjects were randomized; 149 were excluded; and 80 were included. Patient demographics were similar. Adherence to published CPR guidelines and CPR quality was significantly improved in the intervention group (p \u3c 0.0001), as were ROSC rates (72 % vs. 35 %; p = 0.001). A significant decrease was observed in rib fractures (57 % vs. 85 %; p = 0.02), but not sternum fractures (5 % vs. 17 %; p = 0.15). Conclusions: Use of the Cardio First Angel™ CPR feedback device improved adherence to published CPR guidelines and CPR quality, and it was associated with increased rates of ROSC. A decrease in rib but not sternum fractures was observed with device use. Further independent prospective validation is warranted to determine if these results are reproducible in other acute care settings

Sudden Cardiac Arrest due to Brugada Syndrome: a Case Report and Literature Review

Brugada Syndrome is a rare cause of sudden cardiac arrest and has a unique ECG pattern. In fact, with ST-segment elevation down sloping in the right precordial leads (v1-v3), RBBB pattern in lateral leads and J-point elevation is revealed. We must notice and avoid trigger factors of this syndrome during general anesthesia. Patient is a 39 old man who attended to emergency department with sudden cardiac arrest and resuscitate. He was transferred to ICU for management of hypoxic ischemic encephalopathy. Complementary studies concluded the diagnosis of Brugada syndrome. We must consider Brugada syndrome within patients with family history of sudden cardiac arrest. Moreover, we must avoid trigger factors of this syndrome such as fever, bradicardia and electrolyte abnormality (specialy Na, Ca abnormalities) during general anesthesia and if they appear, we should treat them

Hsa-miR-27a-3p and epidermal growth factor receptor expression analysis in glioblastoma FFPE samples

Aim: Glioblastoma multiforme (GBM) is the most invasive type of glial tumors. MicroRNAs as the small, noncoding RNAs have been revealed that play an important role in tumorigenic processes. So, they may be used as potential biomarkers for detection and prognosis of cancers at the early stages. In addition, they can be applied as therapeutic targets. In the present study, the expression levels of hsa-miR-27a-3p and EGFR were investigated in GBM. Methods: Real-time RT-PCR was applied to evaluate hsa-miR-27a-3p and EGFR expressions in the formalin-fixed paraffin-embedded (FFPE) tissue samples obtained from 50 GBM and 50 normal people. Results: The expression level of hsa-miR-27a-3p and EGFR was significantly different between cases and controls. Positive association was found between gene expressions and immunohistochemistry markers, such as Ki67 and glial fibrillary acidic protein, except for IDH1 status. Conclusion: We showed the association of hsa-miR-27a-3p and EGFR with GBM and it can be concluded that they have a promising potential to use as primary cancer biomarkers. © 2020 John Wiley & Sons Australia, Lt

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 improvespatient outcomes from in-hospital cardiac arrest (IHCA).Methods: We conducted a prospective, randomized, controlled, parallel study (no crossover) of patients with IHCA inthe mixed medical--surgical intensive care units (ICUs) of eight academic hospitals. Patients received either standardmanual 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 weresurvival to ICU and hospital discharge.Results: One thousand four hundred fifty-four subjects were randomized; 900 were included. Sustained ROSC wassignificantly 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 comparisonsbased on intubation status. ROSC, survival to ICU, and hospital discharge were noted to be improved in inter-groupcomparisons of non-intubated patients, but not intubated ones.Conclusion: Use of the CFA compression feedback device improved event survival and survival to ICU and hospitaldischarge

The relationship between organizational learning and staff empowerment in hospital: A correlational study in Iran

One of the newest and most effective strategies to empower staff is building the infrastructure and platform for strengthening organizational learning. This study has conducted about the relationship between organizational learning and staff empowerment. This correlational study was conducted among the staff of a Children's Hospital affiliated to Tehran University of Medical Sciences, Iran in 2012. Numbers of 145 staff in this hospital has selected and enrolled by simple random sampling. The data collection tools were tow questionnaires for organizational learning and staff empowerment which approved their validities and reliabilities. Finally, collected data were analyzed by Spearman correlation test. Among the dimensions of organizational learning, knowledge transfer and integration with 3.47 and system perspective with 3.16 obtained highest and lowest scores respectively. Generally, overall rating of organizational learning and the staff empowerment variables were determined 3.25±0.71 and 3.74±0.59 respectively. Between the four dimensions of organizational learning (managerial commitment, system perspective, openness and experimentation, knowledge transfer and integration) and staff empowerment, was observed a significant correlation. According to the findings, the current situation of organizational learning and staff empowerment in studied hospital is relatively acceptable. It recommended that hospital systems can improve staff empowerment by developing organizational learning environment, creating experience and knowledge exchange platforms, using material incentives and specially focusing on the intrinsic motivation