Questionnaire Survey on General Medicine and Pre-hospital First Aid Knowledge Among People in Ludian County,Yunnan Province / 昆明医科大学学报

Objective To explore the public's cognition and attitude towards general medicine,general practitioners,and pre-hospital first-aid knowledge in Ludian County,Yunnan Province,to find out the training and learning methods that are more acceptable to the public for this kind of related knowledge,and to propose targeted solutions.Methods A complete random sampling survey was conducted among the nucleic acid collection office at the gate of the vegetable market from October 15,2022,to December 30,2022,and the outpatient clinic of Wenping Street Health Center from January 1,2023,to February 28,2023,by using electronic questionnaire and paper questionnaire.Results Nearly 50%of the people in Ludian County of Yunnan Province lack the knowledge of general medicine and pre-hospital emergency care,especially the knowledge of electrical defibrillation.People with higher education and the medical profession have a higher understanding of general medicine,and people with a higher understanding of general medicine are more willing to participate in pre-hospital emergency care.The average Ridit value is:very familiar with general medicine(0.774)>Knowledge of some general practices(0.565)>Never heard of general practice(0.400).The higher education level and the more comprehensive understanding of general medicine had a positive impact on participation in pre-hospital emergency care,with B values of 0.624 and 0.619,OR 95%CI of 1.867(1.544～2.257)and 1.857(1.298～2.657),respectively.Taking medical staff as a reference,the B value of medical students was = 0.942,P = 0.234,the difference was not significant,and the B value of non-medical professional population was all less than 0,the effect is negative.In addition,most people have a positive attitude towards learning pre-hospital first aid,and more than 70%of people are willing to learn and train related knowledge of pre-hospital first aid.Conclusions People in urban areas of Ludian County,Yunnan Province have poor understanding of general practice,low recognition of general practitioners,low demand for general practitioners,and lack of awareness of the importance of pre-hospital emergency treatment.Because of the cognitive differences among different groups,it is necessary to conduct specific training for different groups.

Effect of repeated episodes of ventricular fibrillation and defibrillation on arterial acid-base and electrolytes changes in a swine model / 中华急诊医学杂志

Objective:To investigate changes in arterial acid-base and electrolytes after repeated episodes of ventricular fibrillation (VF) and defibrillation in a swine model.Methods:Sixteen Peking white swine, weighting (32±2.5) kg, were placed with temporary pacemaker electrodes via the left femoral vein into the right ventricle after anesthesia. Then VF was electrically induced by using a programmed electrical stimulation instrument. An arterial cannula was inserted into the left femoral artery to measure mean arterial blood pressure and cardiac output using a PiCCO monitor, with blood samples collected. The pigs were randomly divided into two group: the manual defibrillation group (MD, n=8) and the automated external defibrillation group (AED, n=8). The first defibrillation was attempted with the manufacturer’s dose (150 J) for 15 s after the successful induction of VF in the MD group. If spontaneous circulation was not recovered, 2-min chest compression and subsequent defibrillation (200 J) were attempted. For the AED group, the defibrillation was delivered following voice prompts of the AED. After the return of spontaneous circulation, the pig was allowed to stabilize for 30 min, followed by the induction of the next episode of VF. The above process was repeated five times. Arterial blood gas, cardiac biomarkers, and hemodynamic variables were measured at 30 min after the return of spontaneous circulation. Results:All pigs were successfully induced VF five times and defibrillated successfully. There were no significant changes in heart rate and mean arterial blood pressure between the two groups after repeated episodes of VF and defibrillation. Compared with baseline measurements, cardiac output tended to decrease after repeated episodes of VF and defibrillation but was not statistically significant (all P>0.05). There were no significant differences in arterial pH, HCO 3-, sodium, and lactic acid in the two groups between each measurement time point and baseline values after repeated VF (all P>0.05), but potassium levels in the two groups decreased with time, and the difference was statistically significant compared with the baseline measurement (all P<0.05). There were no significant differences in myoglobin, creatine kinase isoenzyme-MB, and cardiac troponin I for the two groups compared with baseline values after repeated episodes of VF and defibrillation or various episodes of VF between the two groups (all P > 0.05). Conclusions:Repeated episodes of VF and defibrillation have no significant effect on pH balance, but significantly decrease blood potassium. Clinical approaches (MD vs. AED) do not affect defibrillation effect, with no significant differences in hemodynamic variables and myocardial injuries.

Characteristics and outcomes of pediatric and adult non-traumatic out-of-hospital cardiac arrest during the COVID-19 pandemic: Descriptive study

Background@#Due to the COVID-19 pandemic, health care for patients who experienced out-of-hospital cardiac arrest (OHCA) has been suboptimal.@*Objective@#To describe the demographic, clinical, and logistical characteristics of patients who experienced OHCA during the peak of the COVID-19 pandemic. @*Design@#Descriptive study. @*Participants@#136 males and 58 females, aged 8 days to 89 years old, who experienced OHCA and were subsequently sent to the emergency department of Southern Philippines Medical Center (SPMC). @*Setting@#Southern Philippines Medical Center, Davao City, March 15 to December 31, 2020. @*Main outcome measures@#Demographic, clinical, and logistical characteristics of patients. @*Main results@#Of the 194 patients, 149 (76.80%) experienced OHCA at home. Among them, 42 (21.65%) received initial CPR at the scene, with 36 (85.71%) of these procedures performed by ambulance crews. Only one (0.52%) patient received automated extracorporeal defibrillation performed by a bystander. There were 147 (75.77%) patients who were transported by private vehicles. The average times for dispatch, response and turnaround of the emergency medical services (EMS) were 8 minutes, 19 minutes, and 56 minutes, respectively. Of the 194 patients, 176 (90.72%) were transported without ongoing resuscitation. Upon arrival at the emergency department, 184 (94.84%) patients had unknown arrest rhythm. Only one (0.52%) patient had a return of spontaneous circulation and was admitted to the ICU. All the other patients expired within 10 to 15 minutes upon arriving at the emergency department.@*Conclusion@#In this study, most OHCAs happened at home, with few receiving CPR at the scene, primarily from ambulance crews. The average EMS response time was 19 minutes. Most patients were transported from the scene without ongoing resuscitation, and had an unknown arrest rhythm upon arrival at the emergency department. All patients expired shortly after arriving at the emergency department.

Research Progress and Prospect Analysis of Vascular Interventional Surgical Robot / 中国医疗器械杂志

Vascular interventional surgery is an important means to treat cardiovascular and cerebrovascular diseases, but the particularity of its working environment will bring greater radiation threat to doctors. Vascular interventional surgery robots can effectively improve the working environment of doctors and can provide more stable operations, improve the success rate of surgery. This study mainly introduces the current research status, key technologies, and future application of vascular interventional surgical robots.

Paro cardiorrespiratorio por electrocución tratado con éxito extrahospitalariamente / Cardiorespiratory Arrest Caused by Electrocution Successfully Treated in an Extra-Hospital Situation / Parada cardiorrespiratória por eletrocussão tratada com sucesso de maneira extra-hospitalar

Resumen Introducción: son pocos los datos documentados sobre los resultados de la reanimación cardiopulmonar en el paro cardiorrespiratorio extrahospitalario por causa de electrocución. El paro cardiorrespiratorio se produce cuando una descarga eléctrica interrumpe de forma abrupta la actividad eléctrica normal del corazón, lo que genera una electrocución y una alteración en los movimientos cardiacos y, por consiguiente, bombeo anormal de sangre y oxígeno a los tejidos. Ello constituye una emergencia clínica que puede ocasionar nefastas consecuencias de no tomarse medidas enérgicas e inmediatas. Presentación del caso: hombre con paro cardiorrespiratorio producido por electrocución y manejado en un ámbito extra-hospitalario, quien respondió con éxito a las maniobras aplicadas. Personal técnico y de salud iniciaron precozmente la reanimación cardiopulmonar y luego fue reforzada por personal médico, que aplicó desflbrilación en dos ocasiones con desflbrilador externo automático (DEA). Con ello se logró recuperar los signos vitales del paciente y trasladarlo a un centro asistencial para continuar su manejo intrahospitalario. Conclusión: la realización de una reanimación precoz y la desfibrilación de pacientes electrocutados, así como las medidas encaminadas a la protección del cerebro, son la norma prioritaria en la asistencia pre-hospitalaria de estos pacientes, quienes son potencialmente recuperables. Por tal razón, es importante que la comunidad, en general, esté preparada y que el personal de salud se reentrene en soporte vital básico, que incluye el manejo del DEA para dar oportunidad de sobrevivir a personas que sufran un paro cardiorrespiratorio extrahospitalario.

Abstract Introduction: There are few the documented data about the cardiopulmonary resuscitation results in the cardiorespiratory arrest extra-hospital due to the electrocution. The cardiorespiratory arrest occurs when the heart's normal electrical activity is abruptly interrupted by electric shocks generated by electrocution, causing the disturbance in the cardiac movements and, consequently, abnormal pumping of blood and oxygen to the tissues. The cardiorespiratory arrest due to electrocution is one clinic emergency that can cause disastrous consequences, if energetic measures are not taken immediately. Case presentation: A man with cardiorespiratory arrest produced by electrocution and managed in an extra-hospital area, who responded successfully to the maneuvers applied. The cardiopulmonary resus-citation maneuvers were precociously started by the health technical staff; next, reinforced by medical it, applying the defibrillation on two occasions, with external automatic defibrillator (AED), recovering the patient's vital signs and allowing his transfer to a healthcare center to continue in-hospital management. Conclusion: The performing of early resuscitation and defibrillation of electrocuted patients, as well as the measures aimed at protecting the brain, are the priority rules in the pre-hospital scene of these patients, who are potentially recoverable. For this reason, it is important that the community, in general, be ready, and the health staff gets trained in basic vital support that includes the management of AED to give the opportunity of surviving to people that suffer a cardiorespiratory arrest.

Resumo Introdução: são poucos os dados documentados sobre os resultados da reanimação cardiopulmonar na parada cardiorrespiratória extra-hospitalar por causa de eletrocussão. A parada cardiorrespiratória se produz quando a atividade elétrica normal do coração é interrompida abruptamente pela descarga elétrica que gera a eletrocussão causando alterado nos movimentos cardíacos e por conseguinte bombeamento anormal de sangue e oxigeno aos tecidos. A parada cardiorrespiratória causada por eletrocussão é uma emergência clínica que pode ocasionar nefastas consequências, de não tomar medidas enérgicas e imediatas. Apresentação do caso: homem com parada cardiorrespiratória, produzida por eletrocussão e manejado em um âmbito extra-hospitalar, quem respondeu com sucesso ás manobras aplicadas. A rearrumação cardiopulmonar foi iniciada precocemente por pessoal técnico de saúde, posteriormente reforjadas por pessoal médico, aplicando a desfibrilação em duas ocasiões, com desfibrilador automático externo (DEA), recuperando os signos vitais do paciente e permitindo seu traslado e um centro assistencial para continuar manejo intra-hospitalar. Conclusão: a realizado de uma rearrumação precoce e desfibrilação de pacientes eletrocutados, assim como as medidas encaminhadas á proteção do cérebro, são a norma prioritária na assistência pré-hospitalar destes pacientes, os quais são potencialmente recuperáveis; por esta razão é importante que a comunidade, em geral, esteja preparada e que o pessoal de saúde se retreine em suporte vital básico que inclua o manejo do DEA para dar oportunidade de sobrevida a pessoas que sofram uma parada cardiorrespiratória extra-hospitalar.

Reanimación cardiopulmonar en pacientes con enfermedad por COVID-19 en el ambiente hospitalario / Cardiopulmonary resuscitation in patients with COVID-19 in the hospital environment

Resumen: La pandemia COVID-19 nos ha obligado a replantearnos la manera en la que practicamos algunos aspectos de la medicina. La reanimación cardiopulmonar es una práctica que genera partículas en aerosol provenientes de la vía aérea, lo cual incrementa el riesgo de contagio por SARS-CoV-2. En esta revisión se consultan las recomendaciones internacionales sobre el tema, se definen momentos de alto riesgo y se establecen recomendaciones sobre compresiones, ventilación, terapia eléctrica e incluso farmacológica en pacientes con paro cardíaco y con diagnóstico de COVID-19, buscando no sólo el bienestar del paciente, sino también la seguridad del personal de salud.

Abstract: The COVID-19 pandemic has forced us to rethink the way we practice some aspects of medicine. Cardiopulmonary resuscitation is a practice that generates aerosol particles from the airway, which increases the risk of SARS-CoV-2 infection. In this review, the international recommendations on the subject are consulted, high-risk moments are defined and recommendations are established on compressions, ventilation, electrical therapy and even pharmacology in patients with cardiac arrest and with a diagnosis of COVID-19, seeking not only the well-being of the patient, but also the safety of health personnel.

Cardio protected areas in Mexico / Áreas cardioprotegidas en México

Abstract Sudden cardiac death (SCD) remains a major public health problem. Fortunately, with timely access to early defibrillation and high-quality cardiopulmonary resuscitation, an improvement in survival of victims of sudden death has been demonstrated. Efforts made in different countries to create programs for access to public defibrillation have shown great benefits in counteracting mortality associated with this type of event. Hence, we need more programs (such as cardio protected environments) and changes in public health policies. The objective of this work is to raise awareness among the population and decision makers, of importance establishing this type of programs in our country since there continues to be high mortality associated with SCD in our countrymen.

Resumen La muerte súbita cardíaca es todavía un problema importante de salud pública. Por fortuna, con un acceso oportuno a una desfibrilación temprana y una reanimación cardiopulmonar de alta calidad, se ha demostrado una mejoría en la sobrevida de las víctimas de muerte súbita. Los esfuerzos realizados en deferentes países para crear programas de acceso a la desfibrilación pública han mostrado grandes beneficios en contrarrestar la mortalidad relacionada con este tipo de episodios. Se necesitan más programas (como espacios cardioprotegidos) y cambios en las políticas de salud pública. El objetivo de este trabajo es poder concientizar a la población y a los tomadores de decisiones de la importancia de establecer este tipo de programas en el país, ya que aún existe una alta mortalidad relacionada con la muerte cardíaca súbita.

Recent advances in external cardiac defibrillation techniques / 生物医学工程学杂志

As an important medical electronic equipment for the cardioversion of malignant arrhythmia such as ventricular fibrillation and ventricular tachycardia, cardiac external defibrillators have been widely used in the clinics. However, the resuscitation success rate for these patients is still unsatisfied. In this paper, the recent advances of cardiac external defibrillation technologies is reviewed. The potential mechanism of defibrillation, the development of novel defibrillation waveform, the factors that may affect defibrillation outcome, the interaction between defibrillation waveform and ventricular fibrillation waveform, and the individualized patient-specific external defibrillation protocol are analyzed and summarized. We hope that this review can provide helpful reference for the optimization of external defibrillator design and the individualization of clinical application.

Assessment of Awareness and Attitudes Regarding Automated External ‎Defibrillators (AED) In Sports Facilities in Jeddah, Saudi Arabia

Background: Sudden cardiac death (SCD) is a leading cause of death in young athletes. Most of those events occur during exercise and insports facilities. We sought to assess awareness and attitudes towards automated external defibrillators (AED) in sports facilities in Jeddah,Saudi Arabia. Methods: The survey included 293 individuals who attend 18 different sports facilities in Jeddah, Saudi Arabia to estimatethe overall knowledge level of CPR and AED usage and determine general attitudes toward intervening in the setting of sudden cardiacarrest (SCA). We included adult participants who were 18 years of age or older. After explaining the aim of our study, each participant wasconsented to participate in the survey. The survey included 33 questions to assess demographic characteristics, knowledge, and skills ofCPR, confidence to perform CPR and to use AED. Results: A total of 293 candidates completed the questionnaire. Mean age was 28.33 ±8.22 years. Only 19 candidates who worked in sports facilities agreed to participate in our survey, of those only 10 participants hadprevious CPR training but only 8 (42.1%) had the self-confidence to do CPR and use AED. Of individuals who participated in the survey,110 (37%) of them indicated that they were more likely to intervene in an SCA after receiving the proper training. 140 (47.7%) participantsof our cohort were reluctant to perform CPR because they were anxious about harming the arrested patient. 108 (36%) of our cohort couldexplain the purpose of using AED. Unfortunately, 101 (34.5%) of our sample did not know the number of Red Crescent for emergency calls.73 (53.7%) of the total 136 participants who received CPR training before stated that they are able to use AED. Our survey showed that264 (90.1%) wished to receive BLS training course if it was announced in order to qualify them for performing CPR and applying AED.Conclusion: Our survey showed insufficient knowledge in all aspects of CPR skills and inadequate knowledge of AED and its purpose ofuse in sports facilities in Jeddah. We recommend initiating an effective national public campaign to increase the public awareness of theimportance of CPR and AED performance using different pathways for education through media and new legislations.

Pre-hospital epidemiological characteristics in out-of-hospital cardiac arrest: who had shockable initial rhythms / 中华急诊医学杂志

Objective Victims with shock-able initial arrest rhythms (ventricular fibrillation or pulse-less ventricular tachycardia,VF/VT) have much better outcomes from out-of-hospital cardiac arrest (OHCA) than those with non-shock-able initial rhythms (pulse-less electrical activities,PEA or asystole).Prompt defibrillation is believed pivotal to terminate lethal shock-able arrest rhythms.In this study,we were to identify those pre-hospital epidemiological factors which were associated with likelihood of shock-able rhythms first recorded when out-of-hospital cardiac arrest occurred.Methods A multicenter,secondary,retrospective and observational analysis was performed on all adult non-traumatic OHCA in the Resuscitation Outcome Consortium (ROC) PRIMED study from June 2007 through November 2009.Of a total of 17 177 OHCA cases in PRIMED study,13 421 of them were enrolled in this study when those OHCA patients with DNR order,or initial rhythms unknown,or arrest caused by obvious cause were excluded.We reported their demographics and episode characteristics for all enrolled cases.Multivariable logistic regression was employed to identify factors which were associated with likelihood of VF/VT recorded as shock-able initial rhythms.Results Among 13 421 adult non-traumatic OHCA cases with initial rhythms recorded,3 527 (26.3％) of them had shock-able rhythms,while 9 894 (73.7％) patients were in non-shock-able rhythms.Of the OHCA with shock-able arrest rhythms,1 850(52.5％) obtained return of spontaneous circulation (ROSC) in the field,while 912 (25.9％) survived to hospital discharge.On the other hand,2489(25.2％) of the OHCA with non-shock-able arrest rhythms obtained ROSC in the field,while 325 (3.3％) of them survived to hospital discharge.Multivariable regression analysis revealed those factors which indicated likelihood of shock-able rhythms recorded were:age(OR:0.991,95％CI 0.988-0.993),male gender (OR1.887,95％CI1.718-2.073),pre-hospital Emergency Medical System(EMS) response time(OR0.950,95％CI 0.931-0.970),cardiac arrest witnessed by EMS providers(OR 1.709,95％CI 1.423-2.054) or bystander(OR3.199,95％CI 2.921-3.504) and those with bystanders CPR (OR1.357,95％CI 1.239-1.487),public place of cardiac arrest (OR2.705,95％CI 2.437-3.003).Conclusions Some demographics and pre-hospital characteristics were proved associated with likelihood of shock-able arrest rhythms first recorded in OHCA victims,which might help develop corresponding strategies to deliver prompt shock on initially shock-able patients and improve their outcomes.

Pre-hospital epidemiological characteristics in out-of-hospital cardiac arrest: who had shockable initial rhythms / 中华急诊医学杂志

Objective@#Victims with shock-able initial arrest rhythms (ventricular fibrillation or pulse-less ventricular tachycardia, VF/VT) have much better outcomes from out-of-hospital cardiac arrest (OHCA) than those with non-shock-able initial rhythms (pulse-less electrical activities, PEA or asystole). Prompt defibrillation is believed pivotal to terminate lethal shock-able arrest rhythms. In this study, we were to identify those pre-hospital epidemiological factors which were associated with likelihood of shock-able rhythms first recorded when out-of-hospital cardiac arrest occurred.@*Methods@#A multicenter, secondary, retrospective and observational analysis was performed on all adult non-traumatic OHCA in the Resuscitation Outcome Consortium (ROC) PRIMED study from June 2007 through November 2009. Of a total of 17 177 OHCA cases in PRIMED study, 13 421 of them were enrolled in this study when those OHCA patients with DNR order, or initial rhythms unknown, or arrest caused by obvious cause were excluded. We reported their demographics and episode characteristics for all enrolled cases. Multivariable logistic regression was employed to identify factors which were associated with likelihood of VF/VT recorded as shock-able initial rhythms.@*Results@#Among 13 421 adult non-traumatic OHCA cases with initial rhythms recorded, 3 527 (26.3%) of them had shock-able rhythms, while 9 894 (73.7%) patients were in non-shock-able rhythms. Of the OHCA with shock-able arrest rhythms, 1 850(52.5%) obtained return of spontaneous circulation (ROSC) in the field, while 912 (25.9%) survived to hospital discharge. On the other hand, 2489(25.2%) of the OHCA with non-shock-able arrest rhythms obtained ROSC in the field, while 325 (3.3%) of them survived to hospital discharge. Multivariable regression analysis revealed those factors which indicated likelihood of shock-able rhythms recorded were: age(OR: 0.991,95%CI 0.988-0.993), male gender (OR1.887,95%CI1.718-2.073), pre-hospital Emergency Medical System(EMS) response time(OR0.950,95%CI 0.931-0.970), cardiac arrest witnessed by EMS providers(OR1.709,95%CI 1.423-2.054) or bystander(OR3.199,95%CI 2.921-3.504) and those with bystanders CPR (OR1.357,95%CI 1.239-1.487),public place of cardiac arrest (OR2.705,95%CI 2.437-3.003).@*Conclusions@#Some demographics and pre-hospital characteristics were proved associated with likelihood of shock-able arrest rhythms first recorded in OHCA victims, which might help develop corresponding strategies to deliver prompt shock on initially shock-able patients and improve their outcomes.

Design of intelligent detecting system for defibrillator battery / 中国医学装备

Objective:To construct intelligent detecting system for defibrillator battery so as to enhance detection efficiency of battery and ensure the therapeutic effect in clinical works.Methods:Based on the analysis for the demand of defibrillator battery, the intelligent detection system of the defibrillator battery was constructed by means of automatic program control, database management, signal collection with high precision and so on.Results:The system realized series of functions included of parameter setting, planning, parameter collection and report management in the process of detecting defibrillator battery.The whole process standardization management was realized in defibrillator battery management, so the automatic level of detection was improved.Conclusion:The designed detection system of defibrillator battery can standardize the management of defibrillator battery, and can enhance the qualities of diagnosis and treatment of hospital and the work efficiency of hospital.

New insight on the relationship between lethal electrical fields versus cardiomyocyte orientation

Abstract Introduction Cardiovascular diseases represent a major cause of death world-wide and one of their greatest complications is the development of cardiac arrhythmias, in which ventricular fibrillation (VF) stands out as the most severe one. The only therapy that reverses VF is defibrillation. However defibrillatory shock is capable of killing heart cells and it is known that the orientation of the cell major axis with respect to the electrical field (E) direction is a determining factor for cellular excitation and injury, which is leading to the development of new defibrillation protocols. The aim of this work is to fill the gap in information about cell lethality for intermediate cell orientation angles. Methods Ventricular myocytes were extracted from adult male Wistar rats and the cells were plated in a chamber for perfusion and stimulation with bipolar voltage pulses to determine the stimulation threshold (ET). Then, monopolar stimulus was applied and amplitude was increased until cell lethal injury. This protocol was performed on four experimental groups: cells oriented at 0°, 30°, 60° and 90°, with respect to E direction. Results 87 cells were analyzed and an increase in amplitude of E associated with 50% lethality (E50) was verified as the direction of E application and cell major axis orientation departed. Conclusion Taken the same probability of lethality, our data suggest a nonlinear increase of E amplitude from 0° to 90° similar to that of ET. These in-between data had not yet been shown and are important for service-based future defibrillation protocols.

The detection and data analysis of delivered energy of cardiac defibrillator / 中国医学装备

Objective:To adopt defibrillation analyzer to detect performance of delivered energy of cardiac defibrillator and to reveal its relevant changing regular, and carry out scientific verification so as to take the detection data to play a role in the maintenance work of equipment.Methods: According to National Metrological technical specification "JJF 1149-2014 Calibration Specification for Cardiac Defibrillators", the FLUKE IMPULSE 7000DP Defibrillator Analyzer was applied to obtain data, and then a comprehensive analysis method with graphs and table was used to analyze these test data.Results: Through analyzed the detection data of delivered energy to grasp the whole performance situation of using equipment and to enhance the cognition of technique and application level for Defibrillator Analyzer.Conclusion: Through analyzes data to find out the changing regular of delivered energy and the difference phenomenon of detection data distribution, and to elaborate the reason of phenomenon or influence factor. Through detects performance to screen out the poorest equipment of delivered energy so as to avoid medical risk that comes from hidden danger of equipment performance in the process of clinical therapy.

Research Progress of External Defibrillation Technique and Its Application / 中国医疗器械杂志

Defibrillator is an important first aid equipment with people attach importance to life and health in today, people pay more attention to the development of defibrillator. This paper reviews the development history of the defibrillator, gives a brief introduction to the structure and working principle of the defibrillator, and then analyzes the key technology of defibrillator, compares the mainstream products on the market and prospects the development trend of defibrillator.

Effect analysis and thinking of training and assessment of Cardiopulmonary Resuscitation and Electric Defibrillation skills on nurses / 中华医学教育探索杂志

Objective To explore the better strategy of cardiopulmonary resuscitation (CPR) and electric defibrillation skills training and assessment on nurses in order to improve the first-aid level of nursing staff.Methods 1 258 nurses of a hospital were trained and assessed in batches.Core group and instruc -tor team were established,multimedia lecture,situation simulation training ahd network self-learning were available.Paperless examinations were conducted.Results of the examinations were analyzed by SPSS19.0,and the comparison between the two groups of independent samples were analyzed by Mann-Whitney U test.Results All the 1 258 nurses were qualified,for the median score was 88.0 and the quartile spacing was 7.5.The step-scores of step1-3,13,14,22,23 were high,while the step-scores of step5,7-17,16-21,24,25 were low.Compared with nurses without professional-titles,nurses with professional-titles got better results in total score,step 8-12 and step17-21,and the differences were statistically significant(P＜0.05).Conclusions It is necessary to pay attention to the training and assessment of CPR and electric defibrillation skills on nurses.Advanced and effective training methods need to be used to carry on regular training and assessment.For the weak links and low-grade nursing staff,intensive training needs to be conducted to improve the entire skill level of nurses.

Effect of potassium chloride on restoration of spontaneous circulation and survival rate in rat with ventricular fibrillation / 中华急诊医学杂志

Objective To study the effect of potassium chloride (KCl) before CPR on successful resuscitation of rats with ventricular fibrillation (VF).Methods Sprague-Dawley (SD) rats with VF induced by alternating electricity current were randomly (ramdam runmber) divided into KCl group and normal saline (NS) group.Rats of two groups were prepared with 0.8 mL/kg of 2.5％ KCl in KCI group and equivalent volume of NS in NS group instead before CPR.The resuscitation was considered to be failure if ROSC was absent for 10 min.The comparisons of time required for ROSC,the average attempt of defibrillation,the average joule used for defibrillation,ROSC rate and 72 h survival rate were carried out between the two groups.Results The length of time required for ROSC in the KCl group (n =10) was shorter than that in NS group (n=10) [(283.89±152.44) svs.(404.38±164.27) s] (t=1.369,P =0.196).The average attempt of defibrillation in KCl group were fewer compared to the NS group [(1.50 ± 0.75) times vs.(2.66 ± 0.57) times,(t =2.701,P =0.022)],the average joule used for defibrillation in KCl group were less compared to NS group [(3.75 ± 2.86) J vs.(8.33 ± 2.88) J,(t =2.78,P =0.019)].The ROSC rate in the KCl group was higher than that in NS group (P =0.011).The 72 h survival rate in KCl group was higher than that in NS group (P =0.001).Conclusions Increasing plasma potassium level before CPR could increase the ROSC rate and survival rate in rats with VF.

Effect of transthoracic impedance on defibrillation efficacy and safety in a porcine model / 中华急诊医学杂志

Objective Two different transthoracic impedances were made with an adjustable impedance instrument to compare the success rate of defibrillation,heart and skin damage in a porcine model.Methods A total of sixteen pigs were randomly (random number) divided into two groups:low impedance group (about 50 Ω,n =8) and high impedance group (about 100 Ω,n =8).Defibrillation (recommended 150 J) was first attempted at 15 s after induction of ventricular fibrillation (VF).If spontaneous circulation was not recovered,2-minute chest compression and subsequent defibrillation attempts (maximum 200 J) were attempted.Model animal kept stabilization for 30 min after return of spontaneous circulation before induction of the next episode of VF,which was induced five episodes in each pig.Results In the low impedance group,VF was induced 39 times,39 of 43 attempted defibrillations were successful.In the high impedance group,VF was induced 40 times,40 of 70 attempted defibrillations were successful.The current and success rate of the first defibrillation were (34.9 ±3.2) A and 94.9％ respectively in the low impedance group,while those of the high impedance group were (19.1 ±2.1) A and 50％ respectively (both P ＜ 0.05).There were no significant differences in skin damage between two groups,but myocardial injury was lighter in the high impedance group.Conclusions Success rate of the first defibrillation with recommend 150 J obviously decreases with the increase of transthoracic impedance.The main factor of myocardial injury is current instead of the numbers of defibrillation.

Defibrillation energy measurement and result uncertainty assessment in quality control of defibrillator / 医疗卫生装备

Objective To explore the application of defibrillation energy measurement and result uncertainty assessment to defibrillator quality control.Methods The released energy of the defibrillator was measured in standardized technology and environmental conditions,and uncertainty assessment was carried out according to the criteria JJF 1059-2012 Assessment and expression of measurement uncertainty,and then the quality of the defibrillator was executed based on uncertainty.Results Uncertainty assessment contributed to the evaluation of the defibrillator quality,and provided guidance to medical engineering departments in the defibrillator quality control.Conclusion Uncertainty assessment of the defibrillation energy measurement facilitates the quality control,and thus can be promoted in the quality control of other likely medical devices such as respirator,infusion pump and electrosphygmomanometer.

Rhythm analysis in CPR / 中华危重病急救医学

It's necessary to interrupt cardiopulmonary resuscitation (CPR) for a reliable automatic external defibrillator (AED) rhythm analysis, because the mechanical activity from the chest compressions introduces artifacts in the electrocardiogram (ECG) that substantially lower the capacity of an AED to judge cardio-electric rhythm. However, repeated interruptions of compression will reduce the quality of CPR, which in turn affect the prognosis of patients with cardiac arrest (CA). In order to improve the quality of CPR, reduce the interruptions of chest compression and implement accurate defibrillation, people have made many efforts on identifying ECG rhythm in CPR. The studies can be grouped into two broad categories: those based on the artificial mixture of ECG data and CPR artifacts and those based on CA data recorded during CPR. This article introduced researches for rhythm recognition in CPR, including sources and characteristics of CPR artifacts, methods of rhythm analysis, and provided a basis for the study of how to improve the accuracy of cardio-electric rhythm recognition.