Construção e validação de cartilha educativa sobre suporte básico de vida para estudantes do ensino médio / Construction and validation of an educational booklet on basic life support for high school students / Construcción y validación de carpeta educativa sobre soporte vital básico para estudiantes de secundaria

O objetivo deste estudo é construir e validar uma cartilha educativa para estudantes do ensino médio sobre Suporte Básico de Vida nas escolas. Trata-se de uma pesquisa metodológica, realizada em três etapas. Na primeira etapa foi realizada revisão bibliográfica, na segunda etapa procedeu-se a elaboração da cartilha educativa e por fim, a validação do material por especialistas. Entre os resultados destaca-se que a cartilha aborda as principais recomendações acerca da segurança do socorrista e suporte básico de vida no adulto e possui 14 páginas. Conclui-se que todos os itens da cartilha educativa obtiveram índice de validade de conteúdo maior que 0,82 conseguindo a validação.

The objective of this study is to build and validate an educational booklet for high school students about Basic Life Support in schools. This is a methodological research, carried out in three stages. In the first stage, a bibliographic review was carried out, in the second stage, the educational booklet was elaborated and, finally, the material was validated by specialists in the subject. Among the results, it is highlighted that the booklet addresses the main recommendations regarding rescuer safety and basic adult life support and has 14 pages. It was concluded that all items in the educational booklet had a content validity index greater than 0.82, achieving validation.

El objetivo de este estudio es construir y validar una cartilla educativa para estudiantes de secundaria sobre Soporte Vital Básico en las escuelas. Se trata de una investigación metodológica, realizada en tres etapas. En la primera etapa se realizó una revisión bibliográfica, en la segunda etapa se elaboró la cartilla educativa y, finalmente, el material fue validado por especialistas en el tema. Entre los resultados, se destaca que la cartilla aborda las principales recomendaciones sobre seguridad del reanimador y soporte vital básico del adulto y tiene 14 páginas. Se concluyó que todos los ítems de la cartilla educativa tuvieron un índice de validez de contenido superior a 0,82, lográndose la validación.

Construção e validação de vídeo educativo para estudantes de enfermagem sobre a parada cardiorrespiratória obstétrica / Construcción y validación de un video educativo para estudiantes de enfermería sobre parada cardiorrespiratoria obstétrica / Construction and validation of an educational video for nursing students about obstetric cardiopulmonary arrest

RESUMO Objetivo construir, validar e avaliar vídeo educativo para estudantes de enfermagem sobre a parada cardiorrespiratória obstétrica. Método estudo metodológico, composto pela construção do vídeo, validação de conteúdo por 22 especialistas em parada cardiorrespiratória obstétrica e avaliação por 21 estudantes de graduação em enfermagem. Utilizou-se o Instrumento de Validação de Conteúdo Educacional em Saúde, para validação com os especialistas, e o questionário adaptado do Suitability Assessment of Materials, para avaliação dos estudantes. Na validação com juízes e com o público-alvo, foi considerado válido o item com concordância mínima de 80%, obtida a partir do Índice de Validação de Conteúdo e do Teste Binomial. Resultados o vídeo, com duração de 8 minutos e 53 segundos, contemplou as etapas da assistência de enfermagem na realização do suporte básico de vida à gestante acometida por parada cardiorrespiratória. Na validação de conteúdo, dos 18 itens avaliados, 16 tiveram concordância de 100%, um obteve 95% e o item restante obteve 81%. Na avaliação dos estudantes, dos 13 itens avaliados, 12 possuíram concordância de 100% e o item restante possuiu 95%. Conclusão e implicações para a prática o vídeo foi considerado válido pelos especialistas em parada cardiorrespiratória obstétrica e compreensível pelos estudantes de enfermagem, assim, trata-se de recurso educativo viável para contribuir com a formação da enfermagem.

RESUMEN Objetivo construir, validar y evaluar videos educativos para estudiantes de enfermería sobre parada cardiopulmonar obstétrica. Método estudio metodológico, consistente en la construcción del video, validación de contenido por 22 expertos en parada cardiorrespiratoria obstétrica y evaluación por 21 estudiantes de enfermería. Se utilizó el Instrumento de Validación de Contenidos Educativos en Salud, para la validación con los expertos, y el cuestionario adaptado del Suitability Assessment of Materials, para la evaluación de los estudiantes. En la validación con jueces y público objetivo, se consideró válido el ítem con una concordancia mínima del 80%, obtenido del Índice de Validación de Contenido y la Prueba Binomial. Resultados el video, de 8 minutos y 53 segundos, contempló los pasos del cuidado de enfermería en la realización de soporte vital básico a gestantes afectadas por paro cardíaco. En la validación de contenido, de los 18 ítems evaluados, 16 tuvieron un 100% de concordancia, uno tuvo un 95% y el restante un 81%. En la evaluación de los estudiantes, de los 13 ítems evaluados, 12 tuvieron un 100% de concordancia, y el ítem restante tuvo un 95%. Conclusión e implicaciones para la práctica el video fue considerado válido por especialistas en parada cardiopulmonar obstétrica y comprensible por estudiantes de enfermería, por lo que es un recurso educativo viable para contribuir a la formación en enfermería.

ABSTRACT Objective to construct, validate and assess educational video for nursing students about obstetric cardiopulmonary arrest. Method this is a methodological study consisting of video construction, content validation by 22 experts in obstetric cardiopulmonary arrest and assessment by 21 undergraduate nursing students. The Health Educational Content Validation Instrument was used for validation with experts, and a questionnaire adapted from the Suitability Assessment of Materials, for student assessment. In the validation with judges and the target audience, the item with a minimum agreement of 80% was considered valid, obtained from the Content Validation Index and the binomial test, was considered valid. Results video, lasting 8 minutes and 53 seconds, contemplated nursing care stages in carrying out basic life support to pregnant women affected by cardiac arrest. In content validation, of the 18 items assessed, 16 had 100% agreement, one had 95% and the remaining item had 81%. In students' assessment, of the 13 items assessed, 12 had 100% agreement, and the remaining item had 95%. Conclusion and implications for practice the video was considered valid by experts in obstetric cardiopulmonary arrest and understandable by nursing students, thus it is a viable educational resource to contribute to nursing education.

Conhecimento dos profissionais de enfermagem acerca do suporte básico de vida / Knowledge of nursing professionals about basic life support / Conocimiento de los profesionales de enfermería sobre soporte vital básico

Objective: to evaluate the knowledge of nursing professionals about Basic Support. Method: cross-sectional, quantitative-qualitative study, carried out in a Mixed Unit of a municipality in the interior of the Brazilian northeast, with 9 nursing professionals. A questionnaire was used as a collection instrument. Data were analyzed and interpreted using simple descriptive statistics. Results: professionals have knowledge on the subject, with a medium/high hit rate. The team follows some of the steps of the correct sequence of Cardiopulmonary Resuscitation. Errors concern the amount, depth, and correct location of chest compressions. In addition, it was found that the service does not train professionals. Conclusion: it is suggested that health services implement permanent education programs with the nursing team since the construction of knowledge reflects on the improvement of health care, since access to more complex health services in the countryside is scarce.

Objetivo: avaliar o conhecimento dos profissionais de enfermagem acerca do Suporte Básico. Método: estudo transversal, quanti-qualitativo, realizado em uma Unidade Mista de um município do interior do nordeste brasileiro, com 9 profissionais de enfermagem. Utilizou-se um questionário como instrumento de coleta. Os dados foram analisados e interpretados através da estatística descritiva simples. Resultados: os profissionais apresentam conhecimento sobre a temática, com uma taxa de acertos média/alta. A equipe segue alguns dos passos da sequência correta da Ressuscitação Cardiopulmonar. Os erros dizem respeito a quantidade, profundidade e o local correto das compressões torácicas. Além disso, foi constatado que o serviço não capacita os profissionais. Conclusão: sugere-se que os serviços de saúde implementem programas de educação permanente com a equipe de enfermagem visto que a construção de conhecimento reflete na melhoria da assistência à saúde, uma vez que o acesso à serviços de saúde de maior complexidade no interior são escassos.

Objetivo: evaluar el conocimiento de los profesionales de enfermería sobre el Soporte Básico. Método: estudio transversal, cuantitativo-cualitativo, realizado en una Unidad Mixta de un municipio del interior del nordeste brasileño, con 9 profesionales de enfermería. Se utilizó un cuestionario como instrumento de recolección. Los datos fueron analizados e interpretados utilizando estadísticas descriptivas simples. Resultados: los profesionales tienen conocimiento sobre el tema, con un índice de acierto medio/alto. El equipo sigue algunos de los pasos de la secuencia correcta de Reanimación Cardiopulmonar. Los errores se refieren a la cantidad, profundidad y ubicación correcta de las compresiones torácicas. Además, se constató que el servicio no forma profesionales. Conclusión: se sugiere que los servicios de salud implementen programas de educación permanente con el equipo de enfermería, ya que la construcción del conocimiento se refleja en la mejora de la atención a la salud, ya que el acceso a los servicios de salud más complejos en el campo es escaso.

Predicting nurses' intentions in allowing family presence during resuscitation: A cross-sectional survey.

AIMS AND OBJECTIVES: This study examined nurses' intention to allow family presence during resuscitation (FPDR) by applying the theory of planned behaviour with an extended concept. BACKGROUND: Medical institutions, including nurses and other medical professionals working in emergency and intensive care units, are reluctant to allow FPDR. However, this practice reduces the family's anxiety and stress while fostering well-being and minimises their feelings of helplessness and distress by making them believe that they have helped the patient. DESIGN: A cross-sectional descriptive design was used in this study. METHODS: The participants were 252 nurses who had been working for at least 3 months in a general hospital in South Korea. Data were collected using self-report questionnaires in April 2020 and were analysed using descriptive statistics, Pearson's correlation analysis and multiple regression analysis. The instruments were intention to allow FPDR (five constructs: intention to allow FPDR, positive attitude, negative attitude, subjective norm and perceived behavioural control), perception of FPDR and self-confidence. The STROBE checklist was used for reporting this study. RESULTS: The mean score for the intention to allow FPDR was 3.47 out of 5. The regression analysis results indicated that perception of FPDR, positive attitude and negative attitude predicted the intention to allow FPDR. CONCLUSIONS: It is necessary to develop educational programmes to change the perceptions of and attitudes towards FPDR. Additionally, written policies and protocols for FPDR in South Korea are needed to develop systematic care for patients' families during cardiopulmonary resuscitation. RELEVANCE TO CLINICAL PRACTICE: The findings of this study provide baseline data for developing FPDR policies and guidelines that could minimise the family's distress and allow them to feel that they have helped the patient.

The inefficiency of ventilation in basic resuscitation. Should we improve mouth-to-mouth ventilation training of nursing students?

OBJECTIVE: To analyse the differences in the quality of the basic cardiopulmonary resuscitation (CPR) between the algorithms of compressions with rescue ventilation (CPR [30:2]) and chest compressions only (CPR [C/O]). In addition, the specific objective was to study the effectiveness of the physical manoeuvre of mouth-to-mouth ventilations performed by nursing students after the completion of a simulation training program in Basic Life Support (BLS) standardized in the study plan approved for the Nursing Degree at a Spanish university. RESEARCH METHODOLOGY: analytical, quasi-experimental, cross-sectional study with clinical simulation of 114 students enrolled in the third year of the Nursing Degree. RESULTS: the mean depth of chest compressions was 47.6 mm (SD 9.5) for CPR [30:2] and 45 mm (SD 8.8) when CPR [C/O] was performed (t = 5.39, p < 0.0001, CI95% 1.69-3.65). The compressions with complete chest re-expansion were 106 (SD 55) for CPR [30:2] and 138 (SD 85) for CPR [C/O] [t = -4.75, p < 0.0001, CI95% -44.6 - (-18.4)]. Of the participants, 28.1% correctly ventilated with the head-tilt/chin-lift manoeuvre (Fisher: p < 0.0001). CONCLUSIONS: As a whole, CPR with only chest compressions offers great advantages with respect to standard CPR, minimizing interruptions in compressions, maintaining coronary and cerebral perfusion and thus increasing the likelihood of return of spontaneous circulation. The problem of rescuers fatigue could be reduced with a greater number of relays between rescuers. We believe that is important to improve the acquisition of competencies in the management of the airway and the ventilation devices (such as the bag-valve mask).

Barriers to the success of cardiopulmonary resuscitation from the perspective of Iranian nurses: A qualitative content analysis.

BACKGROUND: The survival rate following Cardiopulmonary Resuscitation (CPR) has been reported to be 7-26.7%. Various studies have shown that CPR failure is high in many countries. This study was aimed to explore the barriers to the success of CPR from the perspective of Iranian nurses. METHODS: Participants were 14 Iranian nurses recruited through purposive sampling. In-depth semi-structured interviews were used to collect data. Data were analyzed using qualitative content analysis. RESULTS: The barriers to successful CPR were developed in three main categories and nine subcategories. Some of the barriers to CPR success were: "delayed attendance of the CPR team and start of CPR", "inadequate experience and skill of the CPR team", "poor access to special units", "insufficient and deficient CPR equipment", "poor CPR location", "critical clinical conditions of the patient", and "interference of the patient's family members. CONCLUSION: The results showed that human and environmental factors can result in CPR failure. These barriers can be minimized by measures such as empowerment of the CPR team, and providing the necessary facilities and equipment.

Nivel cognitivo de reanimación cardiopulmonar cerebral en enfermeros / Cognitive level of cerebral cardiopulmonary resuscitation in nurses

Introducción: El nivel de conocimientos sobre reanimación cardiopulmonar cerebral es fundamental paraevaluar la competencia de enfermería en servicios de urgencias.Objetivo: Determinar el nivel cognitivo adquirido sobre reanimación cardiopulmonar cerebral despuésde la intervención educativa para los enfermeros de Mayabeque.Métodos: Intervención educativa cuasi-experimental sin grupo de control, en 71 enfermerosasistenciales de los Hospitales Leopoldito Martínez y Aleida Fernández Chardiet en elperíodo junio a octubre-2019. Se estudiaron las variables: edad, experiencia en el servicio;categoría profesional, nivel de conocimientos y estimación de la necesidad de actualizaciónsegún las guías de asociación Estadounidense del Corazón. Las variables cuantitativas seresumieron mediante media aritmética y desviación estándar y las cualitativas medianteporcentajes. Se estimó Odds Ratio (OR) con Intervalo de Confianza del 95 % y nivel deimportancia de P<0.05.Resultados: La media de edad fue 27.9 años y la experiencia en el servicio 10.6 años. Las calificaciones antes de la intervención se mantuvieron inferiores a 3.58 puntos se consideraron comoineficientes, después se logró un puntaje promedio superior sin llegar a ser excelente. Elconocimiento sobre AHA se mantuvo con mala calificación. El 94.36 por ciento de los enfermerosconsideraron necesario conocer las guías.Conclusiones: El nivel de conocimientos antes de la intervención es ineficiente, después se obtuvo unresultado regular en casi todos los ítems. La calificación de mala no fue modificada en elconocimiento sobre las guías de actualización 2018 de la AHA aún después de la intervencióneducativa. La mayoría de los enfermeros consideran importante el conocimiento de las guíasde actualización.(AU)

Introduction: The level of knowledge about cerebral cardiopulmonary resuscitation is essential forevaluating the competence of nursing in emergency services.Objective: To determine the acquired cognitive level about cerebral cardiopulmonary resuscitation afteran educative intervention for nurses in Mayabeque.Metods: A quasi-experimental educative intervention without control group was performed in 71nurses from Leopoldito Martínez and Aleida Fernández Chardiet hospitals from June toOctober, 2019. The variables: age, experience in the service; professional category, level ofknowledge and estimation of the necessity of up-dating according to the American HeartAssociation Guides were studied. The quantitative variables were done by media arithmetic andstandard deviation and the qualitative ones by percentages. Odds Ratio (OR) was estimatedwith trust interval of 95 per cent and level of importance of P<0.05.Results: The mean age was of 27.9 and the experience in the service 10.6 years. Qualification beforethe intervention was lower than 3.58 points which was considered as inefficient, after theintervention, higher average points were obtained without reaching excellent results.Knowledge about cerebral cardiopulmonary resuscitation kept on with bad records. The94.36 per cent of the nurses considered necessary to know the guides.Conclusions: The level of knowledge before the intervention was inefficient, later a regular result wasobtained in in almost all the items. Bad qualification was not modified in relation to knowledgeabout the Up-dating Guides 2018 of the American Heart Association even after the educativeintervention. Most of the nurses consider important the knowledge of the Up-dating Guides.(AU)

Comparação de competências relacionadas à Reanimação Cardiopulmonar de discentes de enfermagem / Comparison of skills related to Cardiopulmonary Resuscitation of nursing students

Resumo O estudo teve por objetivo comparar as competências de discentes de enfermagem em relação à reanimação cardiopulmonar. Trata-se de estudo descritivo e quantitativo realizado em Instituição de Ensino Superior Pública do Nordeste do Brasil, de abril a julho de 2018. Os participantes foram 80 discentes de enfermagem. Foi aplicada uma prova teórica e prática para analisar conhecimento e habilidade dos participantes. Utilizou-se o Teste de Mann Whitney e Qui-Quadrado de Pearson. Os discentes com participação em ligas acadêmicas apresentaram melhores médias de conhecimento para identificar a vítima em parada cardiopulmonar, verificar corretamente a presença de pulso, disposição da vítima e ofertar os primeiros cuidados, além da administração de fármacos perante uma parada cardiopulmonar, e nas habilidades de avaliar a vítima, iniciar as compressões e realizá-las sem interrupções, com movimentação do tronco para aplicação de força. Ligas acadêmicas de urgência e emergência apresentam contribuições significantes para a formação de competência dos discentes em ressuscitação cardiopulmonar.

Abscract The study aimed to compare the skills of nursing students in relation to cardiopulmonary resuscitation. This is a descriptive and quantitative study carried out at a Public Higher Education Institution in Northeastern Brazil, from April to July 2018. Participants were 80 nursing students. A theoretical and practical test was applied to analyze the participants' knowledge and skills. Mann Whitney test and Pearson's chi-square test were used. Students with participation in academic leagues showed better averages of knowledge to identify the victim in cardiopulmonary arrest, correctly check the presence of a pulse, the victim's disposition and offer first care, in addition to the administration of drugs in the event of a cardiopulmonary arrest, and in the skills of assess the victim, start compressions and perform them without interruption, with movement of the trunk to apply force. Academic leagues of urgency and emergency make significant contributions to the formation of competence of students in cardiopulmonary resuscitation.

Resumen El objetivo de esta investigación fue comparar las habilidades de los estudiantes de enfermería en relación con la reanimación cardiopulmonar. Es un estudio descriptivo y cuantitativo realizado en una institución pública de educación superior en el noreste de Brasil, de abril a julio de 2018. Participaron 80 estudiantes de enfermería. Se aplicó una prueba teórica y práctica para analizar los conocimientos y habilidades de los participantes. Se utilizaron la prueba de Mann Whitney y la prueba de chi-cuadrado de Pearson. Los estudiantes con participación en ligas académicas mostraron mejores promedios de conocimiento para identificar a la víctima en un paro cardiopulmonar, verificar correctamente la presencia de pulso, la disposición de la víctima y ofrecer primeros cuidados, administración de drogas en caso de un paro cardiopulmonar, en las habilidades para evaluar a la víctima, iniciar compresiones y realizarlas sin interrupción, con movimiento del tronco para aplicar la fuerza. Las ligas académicas de urgencia y emergencia contribuyen significativamente a la formación de la competencia de los estudiantes en reanimación cardiopulmonar.

Simulation-Based Learning During COVID-19: A Teaching Strategy for Protected Code Blues.

In light of the COVID-19 pandemic and uncertainties around risk of transmission, urgent hospital resuscitation (also known as "Code Blue") efforts are needed, pivoting to protect health care workers. This article provides teaching tips for "Protected Code Blues." [J Contin Educ Nurs. 2020;51(9):399-401.].

Effect of providing basic life support for improving skills in first aid on cardiac arrest for student of senior high school in Kediri

Basic: Life support is an emergency measure to make the airway, breathing without obstruction and helps maintain blood circulation without using tools. Student nurses perform nursing profession must have the skills to perform basic life support basic life support. Help in improving basic life skills student nursing profession in the implementation of basic life support in RSU Karsa Husada Batu. The study design was quasi (quasi-experimental designs) to design one group pre test and post test. Data collection tools with observation sheet with a sample of 30 respondents using random sampling techniques. The independent variable in this study is the simulation simulated basic life support and the dependent variable in this study is the student skills in performing simulated basic life support. Data were analyzed using the Wilcoxon statistical test-signed rank test with α=0.05. RESULTS: showed before getting simulated basic life support skills of the respondents have enough skill as much as 46.7% (14 respondents) and after getting simulated basic life support skills of respondents, 76.73% (23 respondents). Based on Wilcoxon test signed rank test (Asym.p Sig. 2 tailed) earned value 0.000. Because the value of 0.000 is less than <0.05. It can be concluded that there effect simulation help in improving basic life skills nursing profession student assistance in implementing the basic life in RSU Karsa Husada Batu. Students of the nursing profession who have obtained basic aid simulation have good skills increases due to learning their simulations to the knowledge and practice in performing basic life support

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Update: AHA guidelines for CPR and emergency cardiovascular care.

Continuous review of current research and practice has resulted in updates to the American Heart Association guidelines for CPR and emergency cardiovascular care. This article examines the recommendations and their implementation into current healthcare practice.

Development of a "First Five Minutes" Program to Improve Staff Response to Pediatric Codes.

BACKGROUND: Delayed or inadequate cardiopulmonary resuscitation during cardiopulmonary arrest is associated with adverse resuscitation outcomes in pediatric patients. Therefore, a "First Five Minutes" program was developed to train all inpatient acute care nurses in resuscitation skills. The program focused on steps to take during the first 5 minutes. OBJECTIVE: To improve response of bedside personnel in the first few minutes of a cardiopulmonary emergency. METHODS: A simulation-based in situ educational program was developed that focused on the components of the American Heart Association's "Get With the Guidelines" recommendations. The program was implemented in several phases to improve instruction and focus on necessary skills. RESULTS: The program garnered positive feedback from participants and was deemed helpful in preparing nurses and other staff members to respond to a patient in cardiopulmonary arrest. Time to chest compressions improved after training, and postintervention responses to questions regarding future code performance indicated participant recognition of the priority of the interventions addressed, such as backboard use, timely initiation of chest compressions, and timely administration of medications. Preliminary data show staff improvements in mock code performance. CONCLUSIONS: The First Five Minutes program has proved to be a successful educational initiative and is expected to be continued indefinitely, with additional phases incorporated as needed. A rigorous study on best teaching methods for the program is planned.

The advocacy role of nurses in cardiopulmonary resuscitation.

BACKGROUND: The decision whether to initiate cardiopulmonary resuscitation may sometimes be ethically complex. While studies have addressed some of these issues, along with the role of nurses in cardiopulmonary resuscitation, most have not considered the importance of nurses acting as advocates for their patients with respect to cardiopulmonary resuscitation. RESEARCH OBJECTIVE: To explore what the nurse's advocacy role is in cardiopulmonary resuscitation from the perspective of patients, relatives, and health professionals in the Basque Country (Spain). RESEARCH DESIGN: An exploratory critical qualitative study was conducted from October 2015 to March 2016. Thematic analysis was used to analyse the data. PARTICIPANTS: Four discussion groups were held: one with patients and relatives (n = 8), two with nurses (n = 7 and n = 6, respectively), and one with physicians (n = 5). ETHICAL CONSIDERATIONS: Approval was obtained from the Basque Country Clinical Research Ethics Committee. FINDINGS: Three significant themes were identified: (a) accompanying patients during end of life in a context of medical dominance, (b) maintaining the pact of silence, and (c) yielding to legal uncertainty and concerns. DISCUSSION: The values and beliefs of the actors involved, as well as pre-established social and institutional rules reduced nurses' advocacy to that of intermediaries between the physician and the family within the hospital environment. On the contrary, in primary health care, nurses participated more actively within the interdisciplinary team. CONCLUSION: This study provides key information for the improvement and empowerment for ethical nursing practice in a cardiac arrest, and provides the perspective of patients and relatives, nurses and physicians.

A Video-Based, Case-Control Study of Factors Associated With Intraosseous Catheterization During Pediatric Resuscitation.

STUDY OBJECTIVE: Factors associated with intraosseous (IO) catheterization are not well described. Our objective is to identify factors associated with the attempt and timing of IO catheterization in a pediatric emergency department (ED) resuscitation setting. METHODS: We completed a video-based, case-control study (1:3 ratio) of children undergoing IO catheterization in the resuscitation area of a high-volume, academic, pediatric ED. We selected 8 independent factors a priori for analysis: younger than 2 years, Glasgow Coma Scale score less than 8, cardiopulmonary resuscitation (CPR), parent or caregiver presence, physician team leader with greater than 5 years of pediatric ED experience, 2 or more IO-catheterization-capable staff, ultrasonographically trained nurse vascular access team presence, and resuscitation occurring during the evening (4 pm to midnight) or overnight (midnight to 8 am) shift. We fit linear regression models to analyze for associations with IO access attempts and timing. RESULTS: One hundred fourteen patients were enrolled; 40 encounters involved IO catheterization (35.1%). Only CPR was associated with IO catheterization (odds ratio 39.0; 95% confidence interval 12.5 to 121.6). Mean time to IO attempt was shorter with CPR (3.2 versus 14.2 minutes) and longer with vascular access team presence (23.5 versus 3.4 minutes) or caregiver presence (10.5 versus 2.6 minutes). Of resuscitations that achieved peripheral intravenous access, only 1 (1.1%) did so in less than 90 seconds. CONCLUSION: CPR was the only factor associated with IO access attempts, whereas providers may have been more hesitant to attempt IO catheterization with vascular access team or caregiver presence. Future studies should include a larger, multicenter sample and use qualitative methods to explore reasons for IO catheterization hesitancy, especially in the nonarrest scenario.

Aprendizagem de estudantes de técnico em enfermagem sobre as manobras de ressuscitação cardiopulmonar em suporte básico de vida / Learning from nursing technician students about cardiopulmonary resucitation maneuvers in basic life support / Aprendizaje de estudiantes técnicos de enfermería sobre maniobras de resucitación cardiopulmonar en apoyo básico a la vida

Introdução: É fundamental salvar vidas por meio de atendimento rápido e adequado em parada cardiorrespiratória e manobras de reanimação, considerando-se, principalmente, os danos cerebrais. Objetivo: Identificar o conhecimento de estudantes de ensino técnico em Enfermagem sobre parada cardiorrespiratória e reanimação cardiopulmonar em duas escolas, uma pública e outra privada, antes, após aula teórica e prática no atendimento precoce em situação de emergência e aferir o conhecimento após três meses. Método: Estudo descritivo, longitudinal com abordagem quantitativa. A amostragem compreendeu 161 estudantes e os dados foram coletados por meio de questionário com questões sobre atendimento precoce em situação de emergência no atendimento a parada cardiorrespiratória. Resultados: Constatou-se eficácia no treinamento por meio da análise do score pós imediato nas duas escolas, entretanto, só mantiveram o nível de acertos das questões, demonstrando aprendizado após três meses, os estudantes da escola privada. Para algumas questões específicas houve melhor absorção do aprendizado nos dois períodos analisados (imediato e tardio). Entre as duas instituições, a questão sobre posição correta da vítima para realização da RCP destacou-se com maior número de acerto sobre as outras, e a sequência correta da utilização do DEA mostrou-se com menor acerto. O uso do desfibrilador automático obteve menor número de acertos pelos estudantes das duas instituições. Conclusão: Aula teórica e prática realizadas por profissionais especializados em treinamento de parada cardiorrespiratória e reanimação cardiopulmonar para estudantes de ensino técnico em Enfermagem contribuem para melhorar o conhecimento e, consequentemente, oferecer um bom atendimento diante da ocorrência desses eventos.(AU)

Introduction: It is essential to save lives through rapid and adequate care in cardiorespiratory arrest and resuscitation maneuvers, considering mainly brain damage. Objective: To identify the knowledge of students of technical education in Nursing about cardiopulmonary arrest and cardiopulmonary resuscitation in two schools, one public and one private, before, after theoretical and practical classes in early care in an emergency situation and to measure knowledge after three months. Method: Descriptive, longitudinal study with a quantitative approach. The sample comprised 161 students and data were collected through a questionnaire with questions about early care in an emergency situation when attending cardiopulmonary arrest. Results: Efficacy in training was found through the analysis of the post-immediate score in the two schools, however, only the level of correctness of the questions remained, demonstrating learning after three months, the students of the private school. For some specific issues, there was a better absorption of learning in the two periods analyzed (immediate and late). Between the two institutions, the question about the correct position of the victim to perform CPR stood out with the highest number of correct answers over the others, and the correct sequence of the use of the AED was less correct. The use of the automatic defibrillator obtained a lower number of correct answers by students from both institutions. Conclusion: Theoretical and practical classes carried out by professionals specialized in cardiopulmonary arrest and cardiopulmonary resuscitation training for students in technical nursing education contribute to improve knowledge and, consequently, offer a good service in the face of these events.(AU)

Introducción: Es esencial salvar vidas a través de una atención rápida y adecuada en el paro cardiorrespiratorio y las maniobras de reanimación, considerando principalmente el daño cerebral. Objetivo: Identificar el conocimiento de los estudiantes de educación técnica en enfermería sobre el paro cardiopulmonar y la reanimación cardiopulmonar en dos escuelas, una pública y otra privada, antes, después de las clases teóricas y prácticas de atención temprana en una situación de emergencia, y evaluar el conocimiento después de tres meses. Método: Estudio descriptivo longitudinal con enfoque cuantitativo. La muestra estaba compuesta por 161 estudiantes y los datos fueron recolectados a través de un cuestionario con preguntas sobre la atención temprana en una situación de emergencia cuando asistían a un paro cardiopulmonar. Resultados: La eficacia en la capacitación se verificó a través del análisis de la puntuación post-inmediata en las dos escuelas, sin embargo, solo se mantuvo el nivel de respuestas correctas de las preguntas, lo que demuestra el aprendizaje después de tres meses, los estudiantes de la escuela privada. Para algunos problemas específicos, hubo una mejor absorción del aprendizaje en los dos períodos analizados (inmediato y tardío). Entre las dos instituciones, la pregunta sobre la posición correcta de la víctima para realizar la RCP se destacó con el mayor número de respuestas correctas sobre las demás, y la secuencia correcta del uso del DEA fue menos correcta. El uso del desfibrilador automático obtuvo un menor número de respuestas correctas por parte de los estudiantes de ambas instituciones. Conclusión: Las clases teóricas y prácticas impartidas por profesionales especializados en detención cardiopulmonar y entrenamiento de reanimación cardiopulmonar para estudiantes de educación técnica en enfermería contribuyen a mejorar el conocimiento y, en consecuencia, ofrecen un buen servicio frente a estos eventos.(AU)

Nursing students' knowledge, attitude, self-efficacy in blended learning of cardiopulmonary resuscitation: a randomized controlled trial.

BACKGROUND: Although various forms of online education are on the rise worldwide, effects of such innovative approach are yet to be validated. This study analyzes whether blended learning cardiopulmonary resuscitation (CPR) education that integrates e-learning and face-to-face education is effective in improving nursing students' knowledge, attitude, and self-efficacy. METHODS: A randomized controlled design was used. The participants of this study were 120 nursing students randomly assigned to the intervention group (n = 60) or the control (n = 60). The intervention group was trained using a blended learning CPR education program. Self report questionnaires with knoweldge, attitude, and self-efficacy were all used in the pre and post intervention. Differences before and after the education of each group were analyzed with a paired t-test, and the differences between the two groups were analyzed with ANCOVA with knowledge as the covariate. RESULTS: The findings indicated that the intervention group had significantly higher knowledge scores (intervention: 16.40 ± 1.56, control: 6.46 ± 2, p < .001), and emotional attitude (intervention: 40.85 ± 8.01, control: 36.05 ± 6.87, p = .002) about CPR than the control group, but other outcomes did not differ between groups. CONCLUSIONS: In this monocentric study, a blended learning CPR program that integrated videos and face to face lecture was found effective in improving nursing students' knowledge and attitudes regarding CPR.

Basic life support for the child and infant.

The majority of cardiorespiratory arrests in children and infants are caused by respiratory insufficiency rather than cardiac problems; therefore, the order of delivering resuscitation is different to the delivery of basic life support to adults. The Nursing and Midwifery Council has stated that all nurses must be able to provide basic life support. This article will explain the process for recognising the need for, and delivering, basic life support to infants and children.

Nursing roles for in-hospital cardiac arrest response: higher versus lower performing hospitals.

BACKGROUND: Good outcomes for in-hospital cardiac arrest (IHCA) depend on a skilled resuscitation team, prompt initiation of high-quality cardiopulmonary resuscitation and defibrillation, and organisational structures to support IHCA response. We examined the role of nurses in resuscitation, contrasting higher versus lower performing hospitals in IHCA survival. METHODS: We conducted a descriptive qualitative study at nine hospitals in the American Heart Association's Get With The Guidelines-Resuscitation registry, purposefully sampling hospitals that varied in geography, academic status, and risk-standardised IHCA survival. We conducted 158 semistructured interviews with nurses, physicians, respiratory therapists, pharmacists, quality improvement staff, and administrators. Qualitative thematic text analysis followed by type-building text analysis identified distinct nursing roles in IHCA care and support for roles. RESULTS: Nurses played three major roles in IHCA response: bedside first responder, resuscitation team member, and clinical or administrative leader. We found distinctions between higher and lower performing hospitals in support for nurses. Higher performing hospitals emphasised training and competency of nurses at all levels; provided organisational flexibility and responsiveness with nursing roles; and empowered nurses to operate at a higher scope of clinical practice (eg, bedside defibrillation). Higher performing hospitals promoted nurses as leaders-administrators supporting nurses in resuscitation care at the institution, resuscitation team leaders during resuscitation and clinical champions for resuscitation care. Lower performing hospitals had more restrictive nurse roles with less emphasis on systematically identifying improvement needs. CONCLUSION: Hospitals that excelled in IHCA survival emphasised mentoring and empowering front-line nurses and ensured clinical competency and adequate nursing training for IHCA care. Though not proof of causation, nurses appear to be critical to effective IHCA response, and how to support their role to optimise outcomes warrants further investigation.

Consultation before 'do not attempt resuscitation' orders.

Richard Griffith, Senior Lecturer in Health Law at Swansea University, set out the steps nurses must take to ensure that a DNACPR notice is lawful.