Physiological responses in female rescuers during 30 minutes sustained CPR with feedback: a comparison between medicine and physical education students.

OBJECTIVES: Since fatigue seems related to poorer physical fitness rather than to gender, we analyzed the physiological responses in female medicine and physical education students during a 30 minutes sustained cardiopulmonary resuscitation (CPR) sequence. METHODS: Handgrip strength and maximal aerobic power (V02 max) determined strength and endurance. Twenty-three medicine (M) and 27 physical education (PE) female students performed 30 minutes CPR. Compression quality and ECG were continuously monitored, heart rate and non-invasive blood pressure (NIBP) every 2 minutes. Capillary pH, PcCO2, lactate, potassium and sodium bicarbonate were analyzed every 10 minutes. RESULTS: Handgrip strength (PE 37 kg vs. M 35 kg; p<0.05) and V02 max (PE 50 ml/kg/min vs. M 44 ml/ kg/min; p<0.05) revealed a better strength and endurance in PE students. Six medicine and 1 PE student did not complete the entire 30 minutes of CPR. Percentage compressions >5 cm was comparable in both groups (PE 80%; M 79%; p=0.67). Mean heart rate during CPR was higher in the M group (148 bpm) compared to the PE group (132 bpm; p<0.05). No intergroup differences in NIBP, pH, PcCO2, potassium and sodium bicarbonate were observed. Mean lactate during CPR was higher in the M group: 3.5 mmol/l (SD 1.4) compared to the PE group: 2.5 mmol/I (SD 0.7) (p<0.05). CONCLUSION: A high quality sustained CPR effort was well tolerated by all female rescuers. Poorer physical condition (M group) resulted in more drop out after 10 and 20 minutes and in a higher heart rate and blood lactate over time. Improving physical condition may result in less physiological strain and lower perceived exertion.

Civilian law: from occupational medicine to occupational event.

Civilian law:from occupational medicine to occupational event. Despite the growing importance of objective measurements, the health effects of many occupational risk factors are currently not fully quantified. Occupational noise, as a widespread risk factor, is illustrative in this regard; there is a strong body of evidence linking it to an important health outcome (hearing loss), but it is less decisively associated with others (such as psychological disorders). It is also distinct from environmental noise, and therefore falls under the responsibility of employers as well as individuals. Noise-induced hearing loss (NIHL) is, at present, incurable and irreversible. However, it is preventable, if effective and global hearing conservation programmes can be implemented. These programmes should not be isolated efforts, but should be integrated into the overall hazard prevention and control programme of the workplace. Belgian law encompasses a set of provisions for prevention and the protection of the health and safety of workers within the workplace, including aspects pertaining to the hygiene of the workplace and psychosocial aspects at work (stress, violence, bullying and sexual harassment, among others). In principle, combating environmental noise is fully addressed in this country. However, other levels of policy-making also play an important role in this regard. For example, the federal government is in charge of product standards, and therefore also of noise emission standards for products. The interpretation and enforcement of Belgian legislation on well-being at work converts European directives and international agreements on well-being at work into Belgian law.

Alcohol-related emergency department admissions among adolescents in the Ghent and Sint-Niklaas areas.

Alcohol abuse is a major health concern. The aim of this retrospective study was to analyse the alcohol-related emergency department (ED) admissions among adolescents in all hospitals of distinct areas during a 1-year period. In each hospital, all ED patients with a blood alcohol concentration (BAC) of at least 0.5 g/l were surveyed in a standardised way. Of the 3918 included patients, only 146 (3.7%) were < 18  years. The male-to-female ratio was 1.5:1. There was a strong preponderance of weekend and night time admissions. Most of the patients were transported by ambulance (77% of 138 patients with information on this item). The main reason for ED admittance was depressed level of consciousness (64%), trauma (12%), vomiting and/or abdominal pain (12%), agitation or aggression (4%), syncope (4%) and psychological problems (4%). The context of the alcohol intoxication was related to some kind of festivity in 85%, mental problems in 14% and chronic abuse in 1%. Median BAC values (and range) were 2.08 g/l (0.73-3.70 g/l) for boys and 1.51 g/l (0.73-2.90 g/l) for girls. Most patients (87%) could be discharged home within 24  hours. Our study confirms that problematic alcohol use leading to ED admissions starts in adolescence. Although the numbers of cases below 18 years are low when compared to adults, the phenomenon is alarming as it is associated with substantial health problems. Therefore, Belgium urgently needs a global national alcohol plan, with youngsters being one of the target groups.

Training to deeper compression depth reduces shallow compressions after six months in a manikin model.

INTRODUCTION: Studies show that students, trained to perform compressions between 40 and 50mm deep, often do not achieve sufficient depth at retention testing. We hypothesized that training to achieve depths >50mm would decrease the proportion of students with depth <40mm after 6 months, compared to students trained to a depth interval of 40-50mm. METHODS: A basic life support (BLS) self-learning station was attended by 190 third year medicine students. They were first offered the possibility to refresh their skills, following the instructions of a 15min abbreviated Mini Anne™ video (Laerdal, Norway) using a full size torso and a face shield. This was followed by further training using Resusci Anne Skills Station™ software (Laerdal, Norway). Voice feedback was provided according to randomisation to a standard group (SG) 40-50mm and a deeper group (DG) >50mm. Quality of compressions was tested after 6 months. RESULTS: The SG and DG groups consisted of 90 (67% female) and 100 (58% female) participants respectively. At the end of training, all students reached the target depth without overlap between groups. After 6 months, the proportion of students achieving a depth <40mm was 26/89 (29%) in the SG vs. 12/89 (14%) in the DG (P=0.01). The proportion of students with a depth >50mm was 5/89 (6%) for the SG and 44/89 (49%) in the DG (P<0.001). CONCLUSIONS: The educational strategy to train students to a deeper depth, reduced shallow compressions 6 months after training.