View clinical trials related to Heart Arrest.
Filter by:Clinical audit of in-hospital cardiac arrest management by in situ simulation Objectives: correct latent safety threats, knowledge gap, and crisis resource management (CRM) Design: clinical audit, observational sudy. Primary outcome: In Hospital resuscitation scale. Exploratory outcomes: non technical skills, validated stress inventory, and questionnaire on perceptions of the simulation and organisational changes needed.
Background: In cardiac arrest survival rates dramatically increase when bystanders are present and initiate Basic Life Support (BLS). However, even though serious efforts have been made, skill retention after a traditional time-based BLS course for laypeople remains suboptimal. In contrast, a mastery learning-based educational approach was shown to be efficacious and might be promising even for laypersons. Therefore the investigators aim to evaluate the impact of a mastery learning-based BLS course on skills retention of BLS in laypeople. Methods: Forty laypeople without previous BLS experiences will be randomized into the traditional time-based BLS course group (Control - TB group) or mastery learning-based group (Intervention - ML group). Both groups will receive BLS training consisting of 6 successive stations including diagnosis of cardiac arrest, chest compression, ventilation, one-rescuer BLS, two-rescuer BLS and AED use. In the ML group, subjects will deliberately practice and receive feedback at each station until a pre-set target level is reached. Subjects will be allowed to proceed to the next station only when they achieve the required target level of performance. In contrast, participants of the TB group will be taught the same 6 stations in two hours, according to standard American Heart Association BLS criteria. All subjects will have an assessment of knowledge and skills immediately after teaching (immediate post-test) and at four months (retention post-test). Implications: Previous research has shown that mastery learning-based education improves learners' procedural skill performance. The investigators study will determine the impact of a mastery learning-based BLS course on skill retention in laypeople.
Airway management and maintaining adequate ventilation during cardiopulmonary resuscitation (CPR) are important. The rule of 30:2 compression-to-ventilation ratios before endotracheal intubation and keeping 1 breath every 6-8 seconds with advanced airway are generally accepted according to 2010 Advanced Cardiac Life Support (ACLS) guideline. This recommendation emphasizes on the timing and frequency of ventilation during CPR. However, poor clinical evidence had been established concerning adequate volume, airway flow and pressure in each cycle. There are increasing evidence that hyperventilation during resuscitation reduces pulmonary venous return and, therefore, compromises cardiac output and circulation. Another research reported that using high flow oxygen mask alone during basic life support (BLS) results in better survival rate and overall outcome compared with conventional positive pressure ventilation. Our study applies flowmeter to measure ventilation parameters as frequency, duration, exhaled volume and airway pressure on intubated patients who received artificial ventilation during CPR. The parameters will correlate with information from accelerometry and capnometry simultaneously during resuscitation. . Investigators also focus on the influence of chest compression, which increases intra-thoracic pressure considerably. This effect may act against positive pressure ventilation and probably minimize the efficiency in each ventilation or circulation.. Details about how to ventilate one patient during CPR include right timing, duration, adequate volume and coordination are in debate. Unfortunately, current practice based on clinical guidelines emphasizes little on this issue. Investigators are committed to refine contemporary practices and hopefully improve qualities of resuscitation. Investigators proposed the hypothesis that coordinate chest compression and ventilation may minimize the increasement of airway pressure and improve the effect of circulation
The purpose of this study is to estimate the effect of medical treatment of electro-encephalographic status epilepticus on neurological outcome of patients with postanoxic encephalopathy after cardiac arrest.
Cardiac arrest is a major public health problem, with 700 000 cases per year , and a survival ranging from 4 to 33%. The post- anoxic encephalopathy remains the most serious complication with only a third of survivors . It is due to a series of phenomena involving microcirculation disorders . Cerebral oximetry is a new technique to evaluate the microcirculatory status . To this day it is used in cardiovascular surgery at risk of cerebral hypoperfusion where desaturation of cerebral oximetry is synonymous with ischemia and microcirculatory disorders. Therapeutic hypothermia is the only treatment improves the outcome of patients after extra- hospital cardiac arrest resuscitation . Its mechanisms of action seem to change all the phenomena responsible for microcirculatory reperfusion disorders . Currently it is recommended to practice hypothermia between 32 and 34 ° C. However, a recent study suggests a superiority of hypothermia at 32 ° C rather than 34 ° C. The hypothesis of this study is that cerebral oximetry value will be different in patients subjected to two different levels of therapeutic hypothermia in the aftermath of an extra- hospital cardiac arrest. These data allow a better understanding of the mechanisms underlying the benefit of this technique.
Compare the quality performance of rescuers and resuscitation outcomes of cardiac arrest patients in both groups with and without capnography feedback
To perform chest compression (CC) in the kneeling posture in hospital, we designed a stage with stairs, named the 'kneeling stool', on which a CC performer kneels beside a patient on a bed.This work is the validation study to demonstrate that the kneeling stool could be used for high quality hospital cardiopulmonary resuscitation (CPR) with the kneeling posture. We hypothesized that the quality of chest compression with a kneeling posture using the kneeling stool is equal to or superior to CC with a standing posture using the height adjustment mechanism of the bed.
To assess the fraction of subjects surviving with good neurological outcome at 90 days for 3 different levels of hypothermia, in comatose survivors from out-of-hospital cardiac arrest.
After successful resuscitation from cardiac arrest, cooling the whole body is a well established treatment that improves the chances of the brain recovering. This however, has to be done within a certain time-frame from the arrest. The purpose of this study is to explore the best way of dosing the muscle relaxing medications that are given during the cooling process. Hypothesis: In the context of our institutional therapeutic hypothermia protocol, cisatracurium infusions lead to faster drops in core temperature when compared to cisatracurium prn boluses alone.
After successful resuscitation from certain types of cardiac arrest, total body cooling is now a well established treatment that improves the chances of the brain recovering. This however, has only been definitively proven after a certain type of cardiac arrest that is "ventricular fibrillation / ventricular tachycardia". The purpose of this study is to explore if total body cooling is beneficial for patients recovering from another type of cardiac arrest that is "pulseless electrical activity". HYPOTHESIS: Patients undergoing post-cardiac arrest therapeutic hypothermia have better neurological outcomes if their initial arrest rhythm is pulseless electrical activity (PEA) in comparison to asystole.