A randomized controlled simulation trial comparing video-assisted with telephone-assisted and unassisted cardiopulmonary resuscitation performed by non-healthcare university students.

Our randomized controlled simulation study aimed to compare the CPR quality, time-related factors, attitude and self-assessment of non-healthcare university students (aged 18-25) compared video-assisted (V-CPR, n = 50) with telephone-assisted (T-CPR, n = 49) and unassisted (U-CPR, n = 48) CPR in a simulation setting. Regarding to chest compression depth, no difference was found between the three groups (p = 0.065): 41.8 mm, SD = 9.9 in the V-CPR; 35.9 mm, SD = 11.6 in the T-CPR; and 39.4 mm, SD = 15.6 in the U-CPR group. The mean chest compression rate was the best in the V-CPR group (100.9 min-1, SD = 17.1) which was superior to the T-CPR (82.4 min-1, SD = 35.4; p = 0.005), and the U-CPR (84.2 min-1, SD = 30.6; p = 0.013) groups. The overall proportion of correct hand position was the highest in the V-CPR group (48, 96%), compared to the T-CPR (28, 57.1%; p = 0.001), and the U-CPR (34, 70.8%; p = 0.001) groups. V-CPR led to a delay in the time to the first chest compression compared with the U-CPR group (77.5 s, SD = 19.2 vs. 31.3 s, SD = 13.3, p < 0.001). Although V-CPR technology holds the potential to improve overall CPR quality, the importance of appropriate chest compression depth should be emphasized in training for laypeople and dispatchers, as well. Our study was registered at ClinicalTrials.gov (NCT05639868, 06/12/2022).

[Help from a distance - The present and the future of video-assisted cardiopulmonary resuscitation]. / Segítség a távolból ­ A videoasszisztált újraélesztés jelene és jövoje.

Quick and high-quality cardiopulmonary resuscitation has an important role in the survival of out-of-hospital cardiac arrest. In the majority of the cases, the victim is detected by a layperson. Usually, the ratio of giving help is lower than expected. Dispatcher-assisted cardiopulmonary resuscitation can improve the helping attitude and the quality of cardiopulmonary resuscitation by giving instructions during the emergency call. Telephone-assisted cardiopulmonary resuscitation is widely available worldwide. In addition, video-assisted cardiopulmonary resuscitation provides the possibility of not only voice-based but also video-based communication. This can provide real-time feedback from the scene, the victim and the bystander. Previous simulation studies showed the advantages of video-assisted cardiopulmonary resuscitation. The technology is available in some countries in the real-life health care system. Despite positive effects, we need to examine also less studied aspects which can influence the effectiveness of the technology such as camera position, quality of the video, environmental factors, and the knowledge and attitude of dispatchers and bystanders related to video-assisted cardiopulmonary resuscitation. Clarifying these factors is important because the availability of technology in itself is not a guarantee of successful implementation. In conclusion, the establishment of a national CPR register is suggested. The introduction of the V-CPR method requires studies conducted in a domestic environment. It is recommended to form a professional consensus working group, involving all relevant experts to develop V-CPR guidelines. Orv Hetil. 2023; 164(1): 11-18.

Teaching cards as low-cost and brief materials for teaching basic life support to 6-10-year-old primary school children - a quasi-experimental combination design study.

AIM: Teaching Basic Life Support (BLS) in schools is a key initiative to improve the survival rates after out-of-hospital cardiac arrest. Low-cost training materials can reach a wider population. Our aim was to compare the effectiveness of using teaching cards with the traditional instructor-led and combined methods on BLS skills and attitude and to evaluate the long-term effects after two months. METHODS: A quasi-experimental combination design study. Two hundred sixty-three schoolchildren aged 6 to 10 years were assigned to three groups with different methods to teach BLS: teaching card group (n = 100), traditional instructor-led teaching group (n = 91), combined teaching group (n = 72). BLS skills and attitude were measured and compared before the training (T0), after the training (T1), and two months later (T2). RESULTS: BLS skills improved in every group at T1 compared to T0 (p < 0.001) and remained higher at T2 than at T0 in almost all cases (p < 0.001). Skill performance was similar in most of the skills between the three groups at T1. The best skill scores acquired were calling the ambulance and the correct hand position by chest compression. Positioning the head during check the breathing was more effective in the traditional group (48.4%) and combined group (61.1%) than in the teaching card group (19.0%) (p < 0.001) at T1. However, some skills improved significantly in the teaching card group at T2: check breathing for 10 s (p = 0.016); positioning the head by check breathing (p < 0.001); and positioning the head by ventilation (p = 0.011). Attitude did not change significantly in any of the groups (p > 0.05). Furthermore, the level of attitude was inferior in the teaching card group compared with the traditional (p = 0.005), and the combined groups (p = 0.049). CONCLUSION: Using low-cost materials for teaching BLS for young schoolchildren can improve their skills, however, could not improve attitudes. Teaching cards were not inferior compared to traditional and combined methods in some skills but inferior in others. Therefore, hands-on training opportunity is still important. Teaching cards are useful for long-term learning. To learn correctly the whole sequence of BLS is difficult for 6 to 10 years-old children, however, they are able to learn more BLS-related skills separately.

Understanding Health Literacy among University Health Science Students of Different Nationalities.

An adequate level of health literacy is essential for clear communication between patients and health care workers. The internationalization of universities is increasing in the field of health care. The aims of our research were to measure (1) the level of health literacy and its correlation among university students and (2) the relationship between the different instruments measuring health literacy. A cross-sectional study was conducted in the 2020/2021 academic year. The questionnaire included questions on sociodemographic status, study data, health status, and health literacy level. According to the HLS-EU-Q16 health literacy questionnaire, more than half of the students had a limited HL level in disease prevention (52.4%) and health promotion (58.4%) subindexes. Nationality was found to be an influencing factor (p < 0.001). According to the NVS, 80.1% of the students had an adequate HL level. A significant correlation was found between the results and nationality (p = 0.005). None of the Chew questions demonstrated a correlation with nationality (q1 p = 0.269, q2 p = 0.368, q3 p = 0.528). Nationality is a key factor in the level of subjective and functional health literacy. We need to measure both types of levels to see the real results.

Health Literacy in Early Childhood: A Systematic Review of Empirical Studies.

Early childhood plays a key role in the formation of healthy habits and the establishment of health literacy. Nonetheless, there are only a few research studies focusing on the health literacy level of children under the age of eight. The aim of our systematic review is to explore empirical research on health literacy related to early childhood. The research was conducted in accordance with the PRISMA protocol. This systematic review examines 12 studies published between 2013-2022. Results show that research focuses on different domains of health literacy for children. In relation to children's food literacy, children understand the relationship between health and nutrition and they realize the health impact of obesity. The habits connected to oral health are strongly associated with parents' knowledge of and behaviours around oral health. Results related to health care situations show that children are able to be actively involved in decision-making processes in connection with their health. Exploring young children's health literacy is essential in order to be able to plan health promotion interventions, embedded into early childhood education. Picture-based messages or story-based messages supported by illustrations can help measure health literacy in early childhood and can support the formation of health literacy.

How effective are chest compressions when wearing mask? A randomised simulation study among first-year health care students during the COVID-19 pandemic.

BACKGROUND: The resuscitation guidelines provided for the COVID-19 pandemic strongly recommended wearing personal protective equipment. The current study aimed to evaluate and compare the effectiveness of chest compressions and the level of fatigue while wearing two different types of mask (surgical vs. cloth). METHODS: A randomized, non-inferiority, simulation study was conducted. Participants were randomised into two groups: surgical mask group (n = 108) and cloth mask group (n = 108). The effectiveness (depth and rate) of chest compressions was measured within a 2-min continuous chest-compression-only CPR session. Data were collected through an AMBU CPR Software, a questionnaire, recording vital parameters, and using Borg-scale related to fatigue (before and after the simulation). For further analysis the 2-min session was segmented into 30-s intervals. RESULTS: Two hundred sixteen first-year health care students participated in our study. No significant difference was measured between the surgical mask and cloth mask groups in chest compression depth (44.49 ± 10.03 mm vs. 45.77 ± 10.77 mm), rate (113.34 ± 17.76/min vs. 111.23 ± 17.51/min), and the level of fatigue (5.72 ± 1.69 vs. 5.56 ± 1.67) (p > 0.05 in every cases). Significant decrease was found in chest compression depth between the first 30-s interval and the second, third, and fourth intervals (p < 0.01). CONCLUSION: The effectiveness of chest compressions (depth and rate) was non-inferior when wearing cloth mask compared to wearing surgical mask. However, the effectiveness of chest compressions decreased significantly in both groups during the 2-min chest-compression-only CPR session and did not reach the appropriate chest compression depth range recommended by the ERC.

Changes of first-aid attitude during the COVID­19 pandemic / Az elsosegélynyújtási attitud változása a COVID-19-járvány idején.

Összefoglaló. Az új típusú koronavírus (SARS-CoV-2 ) okozta járvány hirtelen megnövekedett betegszámai és halálozásai komoly kihívás elé állították az egészségügyi ellátás minden színterét. A magas idofaktorú kórképek ellátásában a laikusok által végzett elsosegélynyújtás alapveto fontosságú a beteg túlélése és maradandó egészségkárosodásának elkerülése szempontjából. Az áttekintés célja rávilágítani arra, hogy a SARS-CoV-2 okozta járvány idején az elso észlelok által megkezdett azonnali beavatkozások késlekedése mögött az elsosegélynyújtói attitud változása feltételezheto. A társadalmilag fontos elsosegélynyújtás fenntartása érdekében az Európai Újraélesztési Tanács is módosította az elsosegélyre, az alapveto, eszköz nélküli újraélesztésre vonatkozó irányelveit, továbbá ajánlásokat fogalmazott meg a járvány idején a biztonságos elsosegélynyújtás oktatásával kapcsolatban. A hazai adaptáció érdekében a jelen áttekintés összefoglalja a legfontosabb eljárásrendi szempontokat, kiegészítéseket, és kitér azok gyakorlati alkalmazhatóságára is. Az eljárásrendek változásának legfobb célja, hogy a segítségnyújtói szándékot a koronavírus-járvány elotti motiváltsági szintre lehessen visszahozni és azt tovább fokozni szakszeru oktatási anyagok és korszeru módszerek révén. Orv Hetil. 2021; 162(15): 571-578. Summary. The sudden increase in the number of patients and deaths from this novel type of coronavirus (SARS-CoV-2) pandemic poses a serious challenge to all arenas of health care delivery system. The care of high-time dependent-factor illnesses is essential for the survival of a patient and the need for avoiding impairment of health. The purpose of the review is to highlight that a change in first-aid attitudes can be assumed behind the delay in immediate interventions initiated by first responders during the SARS-CoV-2 pandemic. To maintain socially important first aid, the European Resuscitation Council amended its guidelines on first aid, basic life support and made further recommendations at the time of pandemic on first-aid education, too. For effective domestic adaptation, the present overview summarises the most important aspects of guidelines and their supplements and also covers their practical implementations. The main purpose of the change in guidelines is to bring the willingness of the first responders back to the level before the coronavirus pandemic, and to further enhance it with professional educational materials and modern methods. Orv Hetil. 2021; 162(15): 571-578.

Health literacy among participants from neighbourhoods with different socio-economic statuses in the southern region of Hungary: a pilot study.

BACKGROUND: Health literacy (HL) has a deep impact on people's decisions about their health and health care system. Measurement and improvement of HL level is essential to develop an appropriate health care system. The aim of the study was to (1) conduct a pilot study among the population of Baranya County in Hungary with different socio-economic statuses, (2) evaluate the HL level and (3) found the correlations between socio-economic data, emergency departments' visits, medical history and HL. METHODS: In a cross-sectional study conducted in 2019 with 186 participants, socio-economic status, health status, HL level and knowledge about the triage system were measured. The questionnaire included questions on socio-economic status, previous chronic diseases, and satisfaction with the emergency care system as well as the standardised European Health Literacy Survey Questionnaire (HLS-EU-Q47). Descriptive statistical analysis (mean, SD, mode) and mathematical statistical analysis (ANOVA, chi2 test, Pearson Correlations, Two sample t-test) were applied. SPSS 24.0 statistical software was used to analyse the data. Relationships were considered significant at the p < 0.05 level. RESULTS: One hundred and eighty-six people were involved in the research, but 45 of them were excluded (N = 141). The participation rate was 75.8%. There were significant differences in HL levels by gender and educational level (p = 0.017), health education (p = 0.032) and presence of children in the household (p = 0.049). Educational level (p = 0.002) and type of settlement (p = 0.01) had strong impacts on economic status. We found that 46.1% of the participants had limited comprehensive HL (cHL) level. This proportion was slightly lower for the disease prevention sub-index (33.3%). The average cHL index score was 34.8 ± 8.7 points, the average health care sub-index score was 34.6 ± 9.7 points, the average disease prevention sub-index score was 35.8 ± 9.9 points, and the average health promotion sub-index score was 34.2 ± 9.4 points. 46.1% of the examined population in Hungary had limited HL level. CONCLUSIONS: Socio-economic status has a strong influence on HL level. It is not enough to improve awareness but we need to improve knowledge and cooperation with the doctors and health care system.

[Do we know the limits? - Overview of cases related to acut alcohol intoxication in emergency department]. / Tudjuk, hol a határ? ­ A Sürgosségi Betegellátó Osztályt akut alkoholintoxikáció miatt felkereso betegek ellátásának elemzése.

Introduction: According to WHO data, more than 2 million people die because of alcohol consumption during one year. One part of these people are displayed in the emergency departments. There are those who are just about to be detoxicated, those who suffered alcohol-related accidents or alcohol-related internal illness. Aim: To find out how many alcohol-influencing patients are being in the emergency care system and how much of the financing are used for these patients. Method: Our research was conducted at the Department of Emergency Medicine, Clinical Centre, University of Pécs. The research period was between January 1 and December 31, 2016. Our sample was made up of patients who were exposed due to alcohol in the emergency room (n = 1326). We made document analysis. We analysed data using statistical software SPSS 22.0. Results: 78% of the patients were male. The mean age of the sample was 49.78 ± 14.215 years. 71.1% of patients had a home, but 28.9% were homeless. According to the Triage scale, 608 patients were in category T5 because they needed only detoxification. In terms of the level of consciousness, 93.7% of patients had 14 or 15 points according to the Glasgow Coma Scale. 14.6% of patients did not expect a medical examination. Within the framework of incoming and outpatient care, the provision of these patients is profitable. Conclusion: The diagnosis and care of the injuries is done in accordance with the domestic guidelines. Contrary to expectations, the care of these patients is profitable for the emergency department, although only fixed costs were included. Orv Hetil. 2019; 160(43): 1698-1705.