Practical examination of bystanders performing Basic Life Support in Germany: a prospective manikin study

<p>Abstract</p> <p>Background</p> <p>In an out-of-hospital emergency situation bystander intervention is essential for a sufficient functioning of the chain of rescue. The basic measures of cardiopulmonary resuscitation (Basic Life Support – BLS) by lay people are therefore definitely part of an effective emergency service of a patient needing resuscitation. Relevant knowledge is provided to the public by various course conceptions. The learning success concerning a one day first aid course ("LSM" course in Germany) has not been much investigated in the past. We investigated to what extent lay people could perform BLS correctly in a standardised manikin scenario. An aim of this study was to show how course repetitions affected success in performing BLS.</p> <p>Methods</p> <p>The "LSM course" was carried out in a standardised manner. We tested prospectively 100 participants in two groups (<b>Group 1: </b>Participants with previous attendance of a BLS course; <b>Group 2: </b>Participants with no previous attendance of a BLS course) in their practical abilities in BLS after the course. Success parameter was the correct performance of BLS in accordance with the current ERC guidelines.</p> <p>Results</p> <p>Twenty-two (22%) of the 100 investigated participants obtained satisfactory results in the practical performance of BLS. Participants with repeated participation in BLS obtained significantly better results (<b>Group 1: </b>32.7% vs. <b>Group 2: </b>10.4%; p < 0.01) than course participants with no relevant previous knowledge.</p> <p>Conclusion</p> <p>Only 22% of the investigated participants at the end of a "LSM course" were able to perform BLS satisfactorily according to the ERC guidelines. Participants who had previously attended comparable courses obtained significantly better results in the practical test. Through regular repetitions it seems to be possible to achieve, at least on the manikin, an improvement of the results in bystander resuscitation and, consequently, a better patient outcome. To validate this hypothesis further investigations are recommended by specialised societies.</p

Diviseurs sur les courbes réelles

Dans un article sur les sommes de carrés, Scheiderer a prouvé que pour toute courbe algébrique, réelle, projective, irréductible, lisse, ayant des points réels, il existait un entier N tel que tout diviseur de degré plus grand que N soit linéairement équivalent à un diviseur dont le support est totalement réel. Ensuite Huisman et Monnier ont montré que dans le cas des courbes avec beaucoup de composantes connexes, ie. celle en ayant au moins autant que le genre g, ici supposé strictement positif, de la courbe, on pouvait prendre N égal à 2g 1. Monnier a également abordé la question pour les cas des courbes singulières : il en a exhibé pour lesquelles un tel entier n'existait pas et d'autres pour lesquelles il existait. Dans cette thèse on étend la classe des courbes singulières pour lesquelles un tel entier existe, essentiellement des courbes avec des noeuds ou des cusps, et on arrive dans certains cas a contrôlé explicitement cet entier en fonction du genre de la courbe et du nombre de ces singularités. Pour y parvenir on utilise d'une part une " singularisation successive " et d'autre part une variante de l'invariant où l'on demande qu'en plus les points du support soient deux-à-deux distincts. Pour ce nouvel invariant, on étend tel quel les résultats sur les courbes ayant beaucoup de composantes et on traite celui des courbes de genre 2 ayant une seule composante, le " premier " cas jusqu'alors inconnu : dans ce cas la borne 3 est impossible en général, mais par contre 5 convient.In an article about sums of squares, Scheiderer proved that for every real, algebraic, projective, irreducible, smooth curve with some real points, their exists an integer N such that every divisor of degre not lower than N is linearly equivalent to a divisor whose support is totally real. Then Huisman and Monnier proved that for real curves with many components, ie. those with at least as many components as the genus g, assumed here to be positive, of the curve, one can choose N equal to 2g 1. Monnier also dealed with singular curves: he showed that for some of them such an integer does not exist and gave some others where it does exist. In this thesis we extend the classe of singular curves for wich such an integer exists, essentially those with nodes and cusps, and we sometimes manage to bound such an integer in terms of the genus. To do so, an "iterative singularisation" is used and also a slightly different invariant where we ask the real points of the support to be distinct from each-other. We extend the results about curves with many components to that new invariant and deal with curves of genus 2 having only one component, which is the "very first" unknown case so far: in that case, 3 cannot bound the invariant, but 5 does.ANGERS-BU Lettres et Sciences (490072106) / SudocSudocFranceF

A survey of attitudes and factors associated with successful cardiopulmonary resuscitation (CPR) knowledge transfer in an older population most likely to witness cardiac arrest: design and methodology

<p>Abstract</p> <p>Background</p> <p>Overall survival rates for out-of-hospital cardiac arrest rarely exceed 5%. While bystander cardiopulmonary resuscitation (CPR) can increase survival for cardiac arrest victims by up to four times, bystander CPR rates remain low in Canada (15%). Most cardiac arrest victims are men in their sixties, they usually collapse in their own home (85%) and the event is witnessed 50% of the time. These statistics would appear to support a strategy of targeted CPR training for an older population that is most likely to witness a cardiac arrest event. However, interest in CPR training appears to decrease with advancing age. Behaviour surrounding CPR training and performance has never been studied using well validated behavioural theories.</p> <p>Methods/Design</p> <p>The overall goal of this study is to conduct a survey to better understand the behavioural factors influencing CPR training and performance in men and women 55 years of age and older. The study will proceed in three phases. In phase one, semi-structured qualitative interviews will be conducted and recorded to identify common categories and themes regarding seeking CPR training and providing CPR to a cardiac arrest victim. The themes identified in the first phase will be used in phase two to develop, pilot-test, and refine a survey instrument based upon the Theory of Planned Behaviour. In the third phase of the project, the final survey will be administered to a sample of the study population over the telephone. Analyses will include measures of sampling bias, reliability of the measures, construct validity, as well as multiple regression analyses to identify constructs and beliefs most salient to seniors' decisions about whether to attend CPR classes or perform CPR on a cardiac arrest victim.</p> <p>Discussion</p> <p>The results of this survey will provide valuable insight into factors influencing the interest in CPR training and performance among a targeted group of individuals most susceptible to witnessing a victim in cardiac arrest. The findings can then be applied to the design of trials of various interventions designed to promote attendance at CPR classes and improve CPR performance.</p> <p>Trial registration</p> <p>ClinicalTrials.gov NCT00665288</p

Kreislaufstillstand in besonderen Situationen

Truhlář A, Deakin CD, Soar J, et al. Kreislaufstillstand in besonderen Situationen. Notfall + Rettungsmedizin. 2015;18(8):833-903