The investigation of the efficiency of basic life support education among high school students: Protocol, design and implementation of an interventional, prospective longitudinal, individually randomised, parallel 1:1 grouped trial.

Background: Basic life support (BLS) skills are crucial not only for healthcare workers but for all lay people as well. Timely recognition of out-of-hospital cardiac arrest (OHCA) and the initiation of BLS by bystanders before the arrival of healthcare personnel may improve survival. There are several methods of spreading BLS skills and improve BLS skill retention among lay people. One of these methods can be the education of adolescent school children. The introduction of mandatory BLS education in schools was very effective in some European countries to increase the rate of bystander BLS. Methods/design: The current study aims to investigate the efficacy of a BLS training and BLS curriculum among high school children in Hungary. Moreover, the investigators would like to optimise factors influencing skill retention in this first responder group and aim to compare two types of teaching methods: feedback given by the instructor or software-based feedback on the efficacy of chest compressions during the course. This study will be an interventional, assessor blinded, individually randomised parallel group trial recruiting 360 students. BLS skill retention will be assessed at the end of the course, two months after the training and six months after training. Discussion: The current study will increase our knowledge on the methods educating BLS among high school children. The results will help us to create an effective BLS curriculum at schools.Trial registration: ClinicalTrials.gov: NCT06016153. Prospectively registered on 08/2023.

[The impact of the coronavirus pandemic on the mental health of critical care workers]. / A koronavírus-világjárvány hatása az intenzív ellátásban dolgozók mentális egészségére.

INTRODUCTION: The coronavirus pandemic has focused attention on the importance of critical care and highlighted the shortage of critical care specialists. Due to increasing workloads and high mortality rates, healthcare professionals were exposed to higher levels of physical and psychological stress during the pandemic than before. OBJECTIVE: Our study investigated the effects of the coronavirus outbreak on the emotional, mental and moral stress of intensive care professionals. METHOD: Our workgroup performed paper-based surveys among caregivers in the Department of Anaesthesiology and Intensive Therapy at Semmelweis University. The first survey was conducted at the start of the pandemic in 2020, the second survey was conducted after the third wave in 2021. We applied validated questionnaires (Professional Quality of Life, Demoralization Scale, Perceived Stress Scale, Impact of Event Scale, and Posttraumatic Growth Inventory), collected demographic data and information on lifestyle, recreation, dietary habits, and accepting psychological support. RESULTS: The number and demographic characteristics of the participants in the two studies are different, reflecting the changes in the workforce during the pandemic. Our results revealed no differences between the working and socio-demographic groups before the outbreak, however, one year later, nurses scored significantly higher on all negative psychological scales compared to other groups. Only a minority of the respondents had sought psychological support (9.5-12.7%), although more than a third of respondents reported the need for psychological support. Employees in new work positions showed significantly increased posttraumatic growth (2.91 ± 0.82 vs. 2.20 ± 1.06, p = 0.016). DISCUSSION: These findings demonstrate that nurses are the most strained workgroup during an uncertain and stressful period. The available mental support alone is not enough to help caregivers. CONCLUSION: Further steps are needed to improve the mental health of critical care workers. Orv Hetil. 2023; 164(42): 1646-1655.

[Cardiopulmonary resuscitation in special circumstances]. / Újraélesztés speciális körülmények között.

The standard process of basic and advanced life support can be complicated by a number of special circumstances. Over the last decade, the European Resuscitation Council developed an increasingly detailed guideline regarding the diagnosis and therapy of these situations. In our short review, we summarize the most important recommendations for the management of cardiopulmonary resuscitation in special circumstances. The proper training in non-technical skills and teamwork is crucial in the management of these situations. In addition, extracorporeal circulatory and respiratory support play an increasingly important role in some special circumstances with appropriate patient selection and timing. We also summarize the therapeutic options regarding the reversible causes of cardiac arrest as well as the steps of diagnostic and treatment methods in some special situations (cardiopulmonary resuscitation in the operating room, after cardiac surgery, in a catheterisation laboratory, after sudden cardiac arrest at dentistry or dialysis station) and among special patient populations (patient with asthma or COPD, neurologic disorders, obese patient, pregnant woman). Orv Hetil. 2023; 164(13): 488-498.

[The role of extracorporeal life support in cardiopulmonary resuscitation]. / Az extracorporalis keringéstámogatás helye az újraélesztésben.

The frequency of the administration of extracorporeal cardiopulmonary resuscitation is increasing both in the treatment of in-hospital and out-of-hospital cardiac arrest. The latest resuscitation guidelines support the use of mechanical circulatory support devices in the cases of prolonged cardiopulmonary resuscitation in certain selected patient groups. However, only little evidence is available regarding the effectiveness of extracorporeal cardiopulmonary resuscitation, and many open questions remained unanswered regarding the adequate conditions of this modality. The timing and location of extracorporeal cardiopulmonary resuscitation are important factors, as well as the appropriate training of the personnel using extracorporeal techniques. Our review briefly summarizes, according to the current literature and recommendations, in which cases extracorporeal resuscitation may be beneficial, which type of mechanical circulatory support is the first choice of extracorporeal cardiopulmonary resuscitation, which factors influence the efficacy of this supportive treatment, and which complications may be expected during mechanical circulatory support during resuscitation. Orv Hetil. 2023; 164(13): 510-514.