Effects of repetitive training on retention of basic life support skills
Kazuhiko Nakakimura, Hiroshi Saeki, Mariko Saeki, Yumiko Shirasawa, Satoko Nakano
Yamaguchi Rosai Hospital of the Japan Labor Health and Safety Organization
1315-4 Onoda, Sanyoh-onoda-city, Yamaguchi Prefecture, Japan
This study examined the effects of repetitive brief practice on retention of hospital staffs' cardiopulmonary resuscitation (CPR) skill performance. After training of basic life support (BLS) and AED use with a training manikin, 36 participants were assigned to either of 4-month, 6-month and 12-month groups. 4-month and 6-month groups were received repetitive brief 5 min test and training every 4 months and 6 months, respectively, and all were retested at 12 months. In each group, quality of chest compression (depth, rate and recoil) did not differ between immediately after course completion and at 12 months. However, only in the 4-month group, BLS/AED psychomotor skills were well maintained, while the other two groups showed significant decline in the CPR skills over the 12-months period.
These results indicates triannual refreshing training, even briefly, of CPR performance is necessary for retention of BLS/AED psychomotor skills.
Key words：cardiopulmonary resuscitation, basic life support, repetitive training, skill retention, chest compression
The effect of mechanical chest compression devices in a peripheral intravenous cannulation by paramedics
Hideaki Nakamura1), Ryo Sagisaka2), Namiko Sakamoto1), Risuke Karima1), Hiromasa Suzuki1, 3)
1) Graduate School of Health Science, Major of Paramedic, Teikyo Heisei University.
2-51-4 Higashi-Ikebukuro, Toshima, Tokyo, Japan
2) Faculty of Science and Engineering, Chuo University.
1-13-27 Kasuga, Bunkyo, Tokyo, Japan
3) BANDO-Medical Control Council.
2190 Sakaimachi, Sashima, Ibaraki, Japan
【OBJECTIVES】This study aims to identify the factors related to mechanical chest compression devices and effect of it in peripheral intravenous cannulation（PIVC）by paramedics.
【METHODS】321records of PIVC with cardio pulmonary arrest patient cases, from the data base of BANDO-Medical Control Council (Ibarakiseinan Fire Department, Saitamatobu Fire Bureau, Noda-city Fire Department, and Tatebayashi Fire Department) between August 2018 to February 2019, were enrolled.
【RESULT】We found that the factors associated with mechanical chest compression devices in the pre-hospital setting. Paramedic age：AOR 0.91, 95% CI 0.882 to 0.953；p<0.01 and experience of two new conditions for intravenous approach：AOR 1.98, 95% CI 1.561 to 2.556；p<0.01. patient age also associated：AOR 0.98, 95% CI 0.960 to 0.996；p=0.02. In patient sex were related to mechanical chest compression devices (AOR 2.00, 95% CI 1.210 to 3.338；p<0.01）. PIVC success rate in mechanical chest compression devices group was significantly lower than manual chest compression group（44.6％ vs 62.6%：p<0.05）after propensity score matching. There was no statistically significant difference in the properties of the veins and the required PIVC time.
【CONCLUSION】The mechanical chest compression devices did not improve the success rate of PIVC. The use of mechanical chest compression devices requires some ingenuity.
Key words：Pramedic, cardiopulmonary arrest, Peripheral intravenous cannulation, Success factor of Peripheral intravenous cannulation, Mechanical chest compression devices
A case of cardiopulmonary arrest due to drowning with a good neurological outcome.
Masaki Nagama1), Yutaka Sakuda2), Takehiro Umemura1)
1) Department of Emergency Medicine, Okinawa Prefectural Nambu Medical Center
118-1 Arakawa, Haebaru-cho, Shimajiri-gun, Okinawa Prefecture, Japan
2) Department of Emergency and Intensive Care Medicine, Okinawa Kyoudou Hospital
4-10-55 Kohagura, Naha City, Okinawa Prefecture, Japan
A 50-year-old woman entered the sea at a beach which she was visiting with an acquaintance. She was later discovered in the state that floated in a prone position on the sea surface. She was immediately rescued to the beach but had been in cardiopulmonary arrest due to drowning. She was given cardiopulmonary resuscitation and had return of spontaneous circulation. It was confirmed that the shortest cardiac arrest time was 27 minutes and the submersion duration was 8 to 18 minutes. This patient remained comatose after returned of spontaneous circulation, but her consciousness improved after admission to the ICU；therefore, we did not perform the planned targeted temperature management. The neurological outcome was good, and the patient was discharged on the fourth day of hospitalization at her request. After the resuscitation of cardiopulmonary arrest due to drowning, submersion duration was useful as a factor to predict the neurological prognosis.
Key words：Drowning, Cardiopulmonary arrest, Neurological prognosis, Submersion duration
Three cases of noncardiac surgery performing perioperative management carefully under IABP for significant stenosis at preoperative scrutiny of coronary artery
JA Aichi Koseiren Konan Kosei Hospital Department of anesthesiology
137 Omatsubara, Takaya town, Konan city, Aichi prefecture, Japan
There is no obvious evidence about indication and usefulness of intra-aortic balloon pumping (IABP) insertion in perioperative noncardiac surgery.
This time, we performed noncardiac surgery against a case of Revised Cardiac Risk Index (RCRI) one, two branch lesions not involved of left anterior descending（LAD）and a case of three branch lesions involved of proximal LAD but RCRI two with prophylactically IABP.
Another case is two branch lesions involved of proximal LAD judging of IABP indication suspected of extensive cardiomyocyte ischemia, accordingly, we performed noncardiac surgery with IABP.
In all cases, we could complete operation without leading to cardiac complication. We are only found here and there of case report about cases of cardiac surgery but we consider that it allows to operate with IABP according to cases. After this, it needs to be further examined about indication of IABP in noncardiac surgery in consideration of risk and benefit.
Key words：IABP, noncardiac surgery, indication