1
|
Camera M, Brambilla M, Canzano P, Becchetti A, Conti M, Agostoni PG, Pengo M, Tortorici E, Mancini ME, Andreini D, Bonomi A, Parati GF. Long COVID-19 syndrome: association of cardiopulmonary impairment with a persistent platelet activation. Eur Heart J 2022. [PMCID: PMC9619691 DOI: 10.1093/eurheartj/ehac544.3038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background A considerable proportion of patients do not fully recover from COVID-19 infection and report symptoms that persist beyond the initial phase of infection: this condition is defined long-COVID-19 syndrome (LCS). LCS can involve lungs as well as several extrapulmonary organs, including the cardiovascular system. The risk and 1-year burden of cardiovascular diseases (CVD) is increased in COVID-19 survivors, even in subjects at low risk of CVD. Recently, we documented that acute COVID-19 infection induces altered platelet activation state characterized by a prothrombotic phenotype and by the formation of platelet-leukocyte aggregates (PLA), that may be involved in the pulmonary microthrombi found in autoptic specimens. No data are yet available on the contribution of platelet activation to residual pulmonary impairment and procoagulant potential in LCS patients. Purpose To study platelet activation status, microvesicle (MV) profile, platelet thrombin generation capacity (pTGC) in LCS patients enrolled at 6 months after resolution of the acute phase (6mo-FU), compared to acute COVID-19 infection patients. Methods 6mo-FU COVID-19 patients (n=24) with established LCS were enrolled at Centro Cardiologico Monzino. Residual pulmonary impairment was assessed by Cardiopulmonary Exercise Testing (CPET) and 64-rows-CT scan evaluation. Platelet activation (P-selectin, Tissue Factor [TF] and PLA) and MV profile were assessed by flow cytometry; pTGC by calibrated automated thrombogram. 46 patients enrolled during acute COVID-19 infection and 46 healthy subjects (HS) were used for comparison. Results Dispnea in LCS patients was confirmed by CPET showing compromised alveolus-capillary membrane diffusion and residual pulmonary impairment. TF+-platelet and -MV levels were 3-fold (1.5% [1.2–2.9] vs 2.4% [1.6–5.7]) and 2-fold (217/μl [137–275] vs 435/μl [275–633]) lower at 6mo-FU compared to acute phase, being comparable to HS. pTGC behaved similarly. At 6mo-FU, the MV profile, in terms of total number and cell origin, returned to physiological levels. Conversely, although lower than that measured in acute phase, a 2.5-fold higher platelet P-selectin expression (6.9% [3–13.5] vs 11.7% [5.2–18.9]) and PLA formation (35.5% [27.4–46.8] vs 67.7% [45.7–85.3]) was observed at 6mo-FU compared to HS. Interestingly, a significant correlation between PLA formation and residual pulmonary impairment was observed (r=−0.423; p=0.02). Conclusion These data strengthen the hypothesis that the presence of PLA in the bloodstream, and thus also in the pulmonary microcirculation, may contribute to support pulmonary dysfunction still observed in LCS patients. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Italian Ministry of Health (Ricerca Corrente 2020 MPP COVID4)
Collapse
Affiliation(s)
- M Camera
- University of Milan, eDepartment of Pharmaceutical Sciences , Milan , Italy
| | | | - P Canzano
- Centro cardiologico Monzino , Milan , Italy
| | | | - M Conti
- Centro cardiologico Monzino , Milan , Italy
| | | | - M Pengo
- Italian Auxological Institute San Luca Hospital , Milan , Italy
| | - E Tortorici
- Italian Auxological Institute San Luca Hospital , Milan , Italy
| | | | - D Andreini
- Centro cardiologico Monzino , Milan , Italy
| | - A Bonomi
- Centro cardiologico Monzino , Milan , Italy
| | - G F Parati
- Italian Auxological Institute San Luca Hospital , Milan , Italy
| |
Collapse
|
2
|
Hsu A, Sasson C, Kudenchuk PJ, Atkins DL, Aziz K, Becker LB, Berg RA, Bhanji F, Bradley SM, Brooks SC, Chan M, Chan PS, Cheng A, Clemency BM, de Caen A, Duff JP, Edelson DP, Flores GE, Fuchs S, Girotra S, Hinkson C, Joyner BL, Kamath-Rayne BD, Kleinman M, Lasa JJ, Lavonas EJ, Lee HC, Lehotzky RE, Levy A, Mancini ME, McBride ME, Meckler G, Merchant RM, Moitra VK, Morgan RW, Nadkarni V, Panchal AR, Peberdy MA, Raymond T, Roberts K, Sayre MR, Schexnayder SM, Sutton RM, Terry M, Walsh B, Wang DS, Zelop CM, Topjian A. 2021 Interim Guidance to Health Care Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19. Circ Cardiovasc Qual Outcomes 2021; 14:e008396. [PMID: 34641719 PMCID: PMC8522336 DOI: 10.1161/circoutcomes.121.008396] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Antony Hsu
- Department of Emergency Medicine, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, MI (A.H.)
| | - Comilla Sasson
- ECC Science & Innovation, American Heart Association, Dallas, TX (C.S., R.E.L.)
| | - Peter J Kudenchuk
- Department of Medicine/Division of Cardiology (P.J.K.), University of Washington, Seattle
| | - Dianne L Atkins
- Stead Family Department of Pediatrics (D.L.A), Carver College of Medicine, University of Iowa
| | - Khalid Aziz
- Division of Newborn Medicine, Department of Pediatrics, University of Alberta, Edmonton, Canada (K.A.)
| | - Lance B Becker
- Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY (L.B.B.)
| | - Robert A Berg
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Farhan Bhanji
- Department of Pediatrics, McGill University, Montreal, QC, Canada (F.B.)
| | - Steven M Bradley
- Minneapolis Heart Institute, Healthcare Delivery Innovation Center, MN (S.M.B.)
| | - Steven C Brooks
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada (S.C.B.)
| | - Melissa Chan
- Department of Pediatrics and Department of Pediatric Emergency Medicine, BC Children's Hospital, University of British Columbia, Vancouver, Canada (M.C., G.M.)
| | - Paul S Chan
- Department of Internal Medicine, Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City (P.S.C.)
| | - Adam Cheng
- Department of Paediatrics, Alberta Children's Hospital, University of Calgary, Canada (A.C.)
| | - Brian M Clemency
- Department of Emergency Medicine, University at Buffalo, NY (B.M.C.)
| | - Allan de Caen
- Division of Critical Care, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada (A.d.C., J.P.D.)
| | - Jonathan P Duff
- Division of Critical Care, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada (A.d.C., J.P.D.)
| | - Dana P Edelson
- Section of Hospital Medicine, University of Chicago, IL (D.P.E.)
| | - Gustavo E Flores
- Emergency and Critical Care Trainings, San Juan, Puerto Rico (G.E.F.)
| | - Susan Fuchs
- Division of Emergency Medicine (S.F.), Department of Pediatrics, Northwestern University/Ann & Robert H. Lurie Children's Hospital, Chicago, IL
| | - Saket Girotra
- Department of Internal Medicine and Division of Cardiovascular Diseases (S.G.), Carver College of Medicine, University of Iowa
| | - Carl Hinkson
- Respiratory Care, Providence Regional Medical Center, Everett, WA (C.H.)
| | - Benny L Joyner
- Departments of Pediatrics, Anesthesiology & Social Medicine, University of North Carolina at Chapel Hill (B.L.J.)
| | - Beena D Kamath-Rayne
- Global Newborn and Child Health, American Academy of Pediatrics, Itasca, IL (B.D.K.-R.)
| | - Monica Kleinman
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, MA (M.K.)
| | - Javier J Lasa
- Cardiovascular Intensive Care Unit, Texas Children's Hospital, Baylor College Of Medicine, Houston (J.J.L.)
| | - Eric J Lavonas
- Department of Emergency Medicine, Denver Health and Hospital Authority, CO (E.J.L.)
| | - Henry C Lee
- Division of Neonatology, Stanford University, CA (H.C.L.)
| | - Rebecca E Lehotzky
- ECC Science & Innovation, American Heart Association, Dallas, TX (C.S., R.E.L.)
| | - Arielle Levy
- Department of Pediatrics and Department of Pediatric Emergency Medicine, Sainte-Justine Hospital University Center, University of Montreal, QC, Canada (A.L.)
| | - Mary E Mancini
- College of Nursing, University of Texas at Arlington (M.E. Mancini)
| | - Mary E McBride
- Divisions of Cardiology and Critical Care Medicine (M.E. McBride), Department of Pediatrics, Northwestern University/Ann & Robert H. Lurie Children's Hospital, Chicago, IL
| | - Garth Meckler
- Department of Pediatrics and Department of Pediatric Emergency Medicine, BC Children's Hospital, University of British Columbia, Vancouver, Canada (M.C., G.M.)
| | - Raina M Merchant
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia (R.M.M.)
| | - Vivek K Moitra
- Department of Anesthesiology, Division of Critical Care Medicine, Columbia University Irving Medical Center, New York, NY (V.K.M., D.S.W.)
| | - Ryan W Morgan
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Vinay Nadkarni
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Ashish R Panchal
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus (A.R.P.)
| | - Mary Ann Peberdy
- Division of Cardiology, Virginia Commonwealth University, Richmond (M.A.P.)
| | - Tia Raymond
- Department of Pediatrics and Pediatric Cardiac Critical Care, Medical City Children's Hospital, Dallas, TX (T.R.)
| | - Kathryn Roberts
- Center for Nursing Excellence, Education & Innovation, Joe DiMaggio Children's Hospital, Hollywood, FL (K.R.)
| | - Michael R Sayre
- Department of Emergency Medicine (M.R.S.), University of Washington, Seattle
| | - Stephen M Schexnayder
- Departments of Critical Care Medicine and Emergency Medicine, Arkansas Children's Hospital, Little Rock (S.M.S.)
| | - Robert M Sutton
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Mark Terry
- National Registry of Emergency Medical Technicians, Columbus, OH (M.T.)
| | - Brian Walsh
- Respiratory Care, Children's Hospital Colorado, Aurora (B.W.)
| | - David S Wang
- Department of Anesthesiology, Division of Critical Care Medicine, Columbia University Irving Medical Center, New York, NY (V.K.M., D.S.W.).,Department of Obstetrics and Gynecology, New York, NY (D.S.W.)
| | - Carolyn M Zelop
- NYU School of Medicine, New York, NY and The Valley Hospital, Ridgewood, NJ (C.M.Z.)
| | - Alexis Topjian
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| |
Collapse
|
3
|
Baggiano A, Del Torto A, Fusini L, Guglielmo M, Muscogiuri G, Andreini D, Mushtaq S, Conte E, Annoni AD, Formenti A, Mancini ME, Guaricci AI, Bartorelli AL, Pepi M, Pontone G. Resources and outcome impact of routine availability of computed tomography perfusion. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Stress computed tomography perfusion (Stress-CTP) is a functional technique that can be added to coronary computed tomography angiography (cCTA) to improve the management of patients with suspected coronary artery disease (CAD).
Purpose
To determine the impact of routine availability of Stress-CTP added to cCTA in terms of downstream testing, radiation exposure and outcome in patients with high risk or known CAD.
Methods
Patients symptomatic for chest pain, known for CAD, with previous revascularization or with increased pre-test likelihood of CAD, referred for clinically indicated cCTA with Stress-CTP were prospectively enrolled. Data regarding evaluability, overall radiation exposure, invasive and non-invasive downstream testing, hospitalizations, revascularizations, major adverse cardiac events (MACE) as unstable angina, non-fatal myocardial infarction and cardiovascular death after index test were collected at follow-up.
Results
263 consecutive patients were prospectively enrolled (mean age: 65 ± 9 years; male: 79%), of which 162 (62%) had previous revascularization. The mean follow-up was 323 ± 175 days. cCTA and Stress-CTP were fully evaluable in 95% and 99%, respectively. Obstructive CAD and inducible ischaemia were found in 170 (65%) and 129 (49%) subjects, respectively. No significant difference was found between patients with presence or absence of perfusion defects in terms of downstream non-invasive testing (p: 0.229), while patients with inducible ischaemia had more downstream invasive testing, increased overall radiation exposure, more hospitalizations for cardiovascular reasons and revascularization (all endpoints with p: < 0.001). No differences were detected between patients with inducible ischaemia treated with revascularization after index test and patients without inducible ischaemia, even if with obstructive CAD, treated medically in terms of MACE.
Conclusions
Routine implementation of cCTA with Stress-CTP is associated with subsequent low rate of other non-invasive testing, low overall radiation exposure in case of negative Stress-CTP and good prognosis if clinical management is based on combined anatomical and functional information.
Collapse
Affiliation(s)
- A Baggiano
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - A Del Torto
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - L Fusini
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - M Guglielmo
- Cardiology Center Monzino IRCCS, Milan, Italy
| | | | - D Andreini
- University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy
| | - S Mushtaq
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - E Conte
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - AD Annoni
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - A Formenti
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - ME Mancini
- Cardiology Center Monzino IRCCS, Milan, Italy
| | | | - AL Bartorelli
- University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, Milan, Italy
| | - M Pepi
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - G Pontone
- Cardiology Center Monzino IRCCS, Milan, Italy
| |
Collapse
|
4
|
Morley PT, Atkins DL, Finn JC, Maconochie I, Nolan JP, Rabi Y, Singletary EM, Wang TL, Welsford M, Olasveengen TM, Aickin R, Billi JE, Greif R, Lang E, Mancini ME, Montgomery WH, Neumar RW, Perkins GD, Soar J, Wyckoff MH, Morrison LJ. Evidence Evaluation Process and Management of Potential Conflicts of Interest: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2020; 156:A23-A34. [PMID: 33099418 DOI: 10.1016/j.resuscitation.2020.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
5
|
Nolan JP, Maconochie I, Soar J, Olasveengen TM, Greif R, Wyckoff MH, Singletary EM, Aickin R, Berg KM, Mancini ME, Bhanji F, Wyllie J, Zideman D, Neumar RW, Perkins GD, Castrén M, Morley PT, Montgomery WH, Nadkarni VM, Billi JE, Merchant RM, de Caen A, Escalante-Kanashiro R, Kloeck D, Wang TL, Hazinski MF. Executive Summary: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2020; 142:S2-S27. [PMID: 33084397 DOI: 10.1161/cir.0000000000000890] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
6
|
Cheng A, Magid DJ, Auerbach M, Bhanji F, Bigham BL, Blewer AL, Dainty KN, Diederich E, Lin Y, Leary M, Mahgoub M, Mancini ME, Navarro K, Donoghue A. Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S551-S579. [PMID: 33081527 DOI: 10.1161/cir.0000000000000903] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
7
|
Nolan JP, Maconochie I, Soar J, Olasveengen TM, Greif R, Wyckoff MH, Singletary EM, Aickin R, Berg KM, Mancini ME, Bhanji F, Wyllie J, Zideman D, Neumar RW, Perkins GD, Castrén M, Morley PT, Montgomery WH, Nadkarni VM, Billi JE, Merchant RM, de Caen A, Escalante-Kanashiro R, Kloeck D, Wang TL, Hazinski MF. Executive Summary 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2020; 156:A1-A22. [PMID: 33098915 PMCID: PMC7576314 DOI: 10.1016/j.resuscitation.2020.09.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
8
|
Greif R, Bhanji F, Bigham BL, Bray J, Breckwoldt J, Cheng A, Duff JP, Gilfoyle E, Hsieh MJ, Iwami T, Lauridsen KG, Lockey AS, Ma MHM, Monsieurs KG, Okamoto D, Pellegrino JL, Yeung J, Finn JC, Baldi E, Beck S, Beckers SK, Blewer AL, Boulton A, Cheng-Heng L, Yang CW, Coppola A, Dainty KN, Damjanovic D, Djärv T, Donoghue A, Georgiou M, Gunson I, Krob JL, Kuzovlev A, Ko YC, Leary M, Lin Y, Mancini ME, Matsuyama T, Navarro K, Nehme Z, Orkin AM, Pellis T, Pflanzl-Knizacek L, Pisapia L, Saviani M, Sawyer T, Scapigliati A, Schnaubelt S, Scholefield B, Semeraro F, Shammet S, Smyth MA, Ward A, Zace D. Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2020; 156:A188-A239. [PMID: 33098918 DOI: 10.1016/j.resuscitation.2020.09.014] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application.
Collapse
|
9
|
Olasveengen TM, Mancini ME, Perkins GD, Avis S, Brooks S, Castrén M, Chung SP, Considine J, Couper K, Escalante R, Hatanaka T, Hung KK, Kudenchuk P, Lim SH, Nishiyama C, Ristagno G, Semeraro F, Smith CM, Smyth MA, Vaillancourt C, Nolan JP, Hazinski MF, Morley PT, Svavarsdóttir H, Raffay V, Kuzovlev A, Grasner JT, Dee R, Smith M, Rajendran K. Adult Basic Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2020; 142:S41-S91. [DOI: 10.1161/cir.0000000000000892] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This2020 International Consensus on Cardiopulmonary Resuscitation(CPR)and Emergency Cardiovascular Care Science With Treatment Recommendationson basic life support summarizes evidence evaluations performed for 22 topics that were prioritized by the Basic Life Support Task Force of the International Liaison Committee on Resuscitation. The evidence reviews include 16 systematic reviews, 5 scoping reviews, and 1 evidence update. Per agreement within the International Liaison Committee on Resuscitation, new or revised treatment recommendations were only made after a systematic review.Systematic reviews were performed for the following topics: dispatch diagnosis of cardiac arrest, use of a firm surface for CPR, sequence for starting CPR (compressions-airway-breaths versus airway-breaths-compressions), CPR before calling for help, duration of CPR cycles, hand position during compressions, rhythm check timing, feedback for CPR quality, alternative techniques, public access automated external defibrillator programs, analysis of rhythm during chest compressions, CPR before defibrillation, removal of foreign-body airway obstruction, resuscitation care for suspected opioid-associated emergencies, drowning, and harm from CPR to victims not in cardiac arrest.The topics that resulted in the most extensive task force discussions included CPR during transport, CPR before calling for help, resuscitation care for suspected opioid-associated emergencies, feedback for CPR quality, and analysis of rhythm during chest compressions. After discussion of the scoping reviews and the evidence update, the task force prioritized several topics for new systematic reviews.
Collapse
|
10
|
Morley PT, Atkins DL, Finn JC, Maconochie I, Nolan JP, Rabi Y, Singletary EM, Wang TL, Welsford M, Olasveengen TM, Aickin R, Billi JE, Greif R, Lang E, Mancini ME, Montgomery WH, Neumar RW, Perkins GD, Soar J, Wyckoff MH, Morrison LJ. Evidence Evaluation Process and Management of Potential Conflicts of Interest: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2020; 142:S28-S40. [DOI: 10.1161/cir.0000000000000891] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
11
|
Edelson DP, Sasson C, Chan PS, Atkins DL, Aziz K, Becker LB, Berg RA, Bradley SM, Brooks SC, Cheng A, Escobedo M, Flores GE, Girotra S, Hsu A, Kamath-Rayne BD, Lee HC, Lehotsky RE, Mancini ME, Merchant RM, Nadkarni VM, Panchal AR, Peberdy MAR, Raymond TT, Walsh B, Wang DS, Zelop CM, Topjian AA. Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With The Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association. Circulation 2020; 141:e933-e943. [PMID: 32270695 PMCID: PMC7302067 DOI: 10.1161/circulationaha.120.047463] [Citation(s) in RCA: 254] [Impact Index Per Article: 63.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | | | - Paul S. Chan
- Mid America Heart Institute and the University of Missouri–Kansas City (P.S.C.)
| | - Dianne L. Atkins
- Carver College of Medicine, University of Iowa, Iowa City (D.L.A., S.G.)
| | - Khalid Aziz
- University of Alberta, Edmonton, Canada (K.A.)
| | - Lance B. Becker
- Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY (L.B.B.)
| | - Robert A. Berg
- The Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.M.N., A.A.T.)
| | - Steven M. Bradley
- Minneapolis Heart Institute, Healthcare Delivery Innovation Center, MN (S.M.B.)
| | | | - Adam Cheng
- Alberta Children’s Hospital, University of Calgary, Calgary, Canada (A.C.)
| | | | | | - Saket Girotra
- Carver College of Medicine, University of Iowa, Iowa City (D.L.A., S.G.)
| | | | - Beena D. Kamath-Rayne
- Global Newborn and Child Health American Academy of Pediatrics, Itasca, IL (B.D.K.-R.)
| | | | | | | | | | - Vinay M. Nadkarni
- The Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.M.N., A.A.T.)
| | | | | | | | | | - David S. Wang
- Columbia University Irving Medical Center, New York, NY (D.S.W.)
| | | | - Alexis A. Topjian
- The Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.M.N., A.A.T.)
| |
Collapse
|
12
|
Mancini ME, LeFlore JL, Cipher DJ. Simulation and Clinical Competency in Undergraduate Nursing Programs: A Multisite Prospective Study. J Nurs Educ 2020; 58:561-568. [PMID: 31573644 DOI: 10.3928/01484834-20190923-02] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/24/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND In prelicensure nursing education, there is a need to better understand the roles that simulation and traditional clinical instruction play in the development of clinical competence. METHOD A prospective cohort study was conducted across four prelicensure nursing programs. Four undergraduate nursing programs tested an intervention cohort with a redesign of the use of simulation, a redistribution of clinical hours, and an implementation of these new educational approaches into simulation experiences. RESULTS The final sample consisted of 271 control students and 315 intervention students who were assessed at the end of five clinical courses. There was no significant difference between the control and intervention groups on licensure examination pass rates and no uniform differences in clinical competency. CONCLUSION These findings suggest that the redistribution of clinical hours from traditional to simulation did not affect clinical competency or licensure examination results. Such redistributions have the potential to yield comparable results. [J Nurs Educ. 2019;58(10):561-568.].
Collapse
|
13
|
Topjian A, Aziz K, Kamath-Rayne BD, Atkins DL, Becker L, Berg RA, Bradley SM, Bhanji F, Brooks S, Chan M, Chan P, Cheng A, de Caen A, Duff JP, Escobedo M, Flores GE, Fuchs S, Girotra S, Hsu A, Joyner BL, Kleinman M, Lasa JJ, Lee HC, Lehotzky RE, Levy A, Mancini ME, McBride ME, Meckler G, Merchant RM, Morgan RW, Nadkarni V, Panchal AR, Peberdy MA, Raymond T, Roberts K, Sasson C, Schexnayder SM, Sutton RM, Terry M, Walsh B, Wang DS, Zelop CM, Edelson DP. Interim Guidance for Basic and Advanced Life Support in Children and Neonates With Suspected or Confirmed COVID-19. Pediatrics 2020:e20201405. [PMID: 32366608 DOI: 10.1542/peds.2020-1405] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
14
|
Starodub R, Abella BS, Hoyt-Brennan AM, Leary M, Mancini ME, Chittams J, Riegel B. A comparative study of video lecture versus video lecture and high fidelity simulation for training nurses on the delivery of targeted temperature management after cardiac arrest. Int Emerg Nurs 2020; 49:100829. [PMID: 32029415 DOI: 10.1016/j.ienj.2019.100829] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 08/12/2019] [Accepted: 12/04/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Targeted temperature management (TTM) is recommended for cardiac arrest patients. Successful implementation of a TTM protocol depends on the nurses' knowledge and skills. The study's aim was to compare the level of knowledge, psychomotor skills, confidence and satisfaction before, immediately after and at 6 weeks after training nurses on the delivery of TTM with video lecture versus video lecture and high fidelity simulation. METHOD Demographic variables were compared across treatment groups using t-tests and Chi-square tests. Change over 6 weeks after intervention was tested with mixed effects model. RESULTS Fifty-two registered nurses were enrolled. Knowledge test scores, the primary outcome, did not differ between the groups immediately after the training (beta = 3.80, SE = 3.47, p = .27), but there was a strong trend 6 weeks after the training in favor of simulation (beta = 7.93, SE = 3.88, p = .04). Skills were significantly better immediately after the training in the simulation group, but no different 6 weeks later. No difference in confidence was found at either post-test point. Simulation-trained nurses were more satisfied with their training at both post-testing points. CONCLUSION In this study of training approaches to TTM after cardiac arrest, nurses trained with video lecture and high fidelity simulation benefitted from this approach by maintaining their TTM knowledge longer.
Collapse
Affiliation(s)
- Roksolana Starodub
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA.
| | - Benjamin S Abella
- University of Pennsylvania Center for Resuscitation Science, Ground Ravdin, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Ann Marie Hoyt-Brennan
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
| | - Marion Leary
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA; University of Pennsylvania Center for Resuscitation Science, Ground Ravdin, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Mary E Mancini
- University of Texas at Arlington College of Nursing, 411 S Nedderman Dr, Arlington, TX 76010, USA
| | - Jesse Chittams
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
| |
Collapse
|
15
|
Soar J, Maconochie I, Wyckoff MH, Olasveengen TM, Singletary EM, Greif R, Aickin R, Bhanji F, Donnino MW, Mancini ME, Wyllie JP, Zideman D, Andersen LW, Atkins DL, Aziz K, Bendall J, Berg KM, Berry DC, Bigham BL, Bingham R, Couto TB, Böttiger BW, Borra V, Bray JE, Breckwoldt J, Brooks SC, Buick J, Callaway CW, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Cheng A, Chung SP, Considine J, Couper K, Dainty KN, Dawson JA, de Almeida MF, de Caen AR, Deakin CD, Drennan IR, Duff JP, Epstein JL, Escalante R, Gazmuri RJ, Gilfoyle E, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Holmberg MJ, Hood N, Hosono S, Hsieh MJ, Isayama T, Iwami T, Jensen JL, Kapadia V, Kim HS, Kleinman ME, Kudenchuk PJ, Lang E, Lavonas E, Liley H, Lim SH, Lockey A, Lofgren B, Ma MHM, Markenson D, Meaney PA, Meyran D, Mildenhall L, Monsieurs KG, Montgomery W, Morley PT, Morrison LJ, Nadkarni VM, Nation K, Neumar RW, Ng KC, Nicholson T, Nikolaou N, Nishiyama C, Nuthall G, Ohshimo S, Okamoto D, O’Neil B, Yong-Kwang Ong G, Paiva EF, Parr M, Pellegrino JL, Perkins GD, Perlman J, Rabi Y, Reis A, Reynolds JC, Ristagno G, Roehr CC, Sakamoto T, Sandroni C, Schexnayder SM, Scholefield BR, Shimizu N, Skrifvars MB, Smyth MA, Stanton D, Swain J, Szyld E, Tijssen J, Travers A, Trevisanuto D, Vaillancourt C, Van de Voorde P, Velaphi S, Wang TL, Weiner G, Welsford M, Woodin JA, Yeung J, Nolan JP, Fran Hazinski M. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation 2019; 140:e826-e880. [DOI: 10.1161/cir.0000000000000734] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.
Collapse
|
16
|
Considine J, Gazmuri RJ, Perkins GD, Kudenchuk PJ, Olasveengen TM, Vaillancourt C, Nishiyama C, Hatanaka T, Mancini ME, Chung SP, Escalante-Kanashiro R, Morley P. Chest compression components (rate, depth, chest wall recoil and leaning): A scoping review. Resuscitation 2019; 146:188-202. [PMID: 31536776 DOI: 10.1016/j.resuscitation.2019.08.042] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/18/2019] [Accepted: 08/31/2019] [Indexed: 12/20/2022]
Abstract
AIM To understand whether the science to date has focused on single or multiple chest compression components and identify the evidence related to chest compression components to determine the need for a full systematic review. METHODS This review was undertaken by members of the International Liaison Committee on Resuscitation and guided by a specific methodological framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Studies were eligible for inclusion if they were peer-reviewed human studies that examined the effect of different chest compression depths or rates, or chest wall or leaning, on physiological or clinical outcomes. The databases searched were MEDLINE complete, Embase, and Cochrane. RESULTS Twenty-two clinical studies were included in this review: five observational studies involving 879 patients examined both chest compression rate and depth; eight studies involving 14,285 patients examined chest compression rate only; seven studies involving 12001 patients examined chest compression depth only, and two studies involving 1848 patients examined chest wall recoil. No studies were identified that examined chest wall leaning. Three studies reported an inverse relationship between chest compression rate and depth. CONCLUSION This scoping review did not identify sufficient new evidence that would justify conducting new systematic reviews or reconsideration of current resuscitation guidelines. This scoping review does highlight significant gaps in the research evidence related to chest compression components, namely a lack of high-level evidence, paucity of studies of in-hospital cardiac arrest, and failure to account for the possibility of interactions between chest compression components.
Collapse
Affiliation(s)
- Julie Considine
- Deakin University, School of Nursing and Midwifery/Centre for Quality and Patient Safety Research, 1 Gheringhap St, Geelong, Victoria, 3220, Australia; Centre for Quality and Patient Safety Research - Eastern Health Partnership, 5 Arnold St, Box Hill, Victoria, 3128, Australia; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States.
| | - Raúl J Gazmuri
- Resuscitation Institute, Rosalind Franklin University of Medicine and Science, United States; Captain James A. Lovell Federal Health Care Center, 3001 Green Bay Road, North Chicago, IL, United States; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States
| | - Gavin D Perkins
- Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK; Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B9 5SS, UK; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States
| | - Peter J Kudenchuk
- Division of Cardiology/Electrophysiology Services, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195-6422, United States; King County Medic One, Public Health, Seattle & King County, WA, United States; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States
| | - Theresa M Olasveengen
- Department of Anesthesiology, Oslo University Hospital, PO Box 4956 Nydalen, Oslo 0424, Norway; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States
| | - Christian Vaillancourt
- Emergency Medicine, University of Ottawa, United States; Ottawa Hospital Research Institute, Civic Campus, Clinical Epidemiology Unit, Rm F649, 1053 Carling Ave., Ottawa, Ontario, K1Y 4E9, Canada; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States
| | - Chika Nishiyama
- Department of Critical Care Nursing, Kyoto University Graduate School of Human Health Science, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States
| | - Tetsuo Hatanaka
- Emergency Life-Saving Technique Academy, 3-8-1 Oura, Yahatanishi, Kitakyushu, 800-0213 Fukuoka, Japan; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States
| | - Mary E Mancini
- The University of Texas at Arlington, College of Nursing and Health Innovation, 411 S. Nedderman Drive, Box 19407, Arlington, TX 76019-0407, United States; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States
| | - Sung Phil Chung
- Emergency Medicine, Gangnam Severance Hospital, Yonsei University, 211 Eonju-ro, Gangnam-gu, Seoul, Republic of Korea; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States
| | - Raffo Escalante-Kanashiro
- Departamento de Emergencias y Áreas Críticas, Unidad de Cuidados Intensivos, Instituto Nacional de Salud del Niño, Lima, Peru; InterAmerican Heart Foundation/Emergency Cardiovascular Care, Peru; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States
| | - Peter Morley
- Intensive Care, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria, 3050, Australia; Royal Melbourne Hospital Clinical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Grattan Street, Parkville, Victoria, 3010, Australia; International Liaison Committee on Resuscitation, Basic Life Support Task Force, Dallas, TX, United States
| |
Collapse
|
17
|
Cipher DJ, Urban RW, Mancini ME. Factors Associated with Student Success in Online and Face-to-Face Delivery of Master of Science in Nursing Programs. Teaching and Learning in Nursing 2019. [DOI: 10.1016/j.teln.2019.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
18
|
Muscogiuri G, Gatti M, Dell"aversana S, Andreini D, Guaricci AI, Guglielmo M, Baggiano A, Mushtaq S, Conte E, Annoni A, Mancini ME, Gripari P, Pepi M, Pontone G. 489Comparison of signal intensity ratio, diagnostic accuracy, transmurality and image quality between dark blood lge and bright blood lge in patients with ischemic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez123.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - M Gatti
- University of Turin, Turin, Italy
| | | | - D Andreini
- Cardiology Center Monzino IRCCS, Milan, Italy
| | | | - M Guglielmo
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - A Baggiano
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - S Mushtaq
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - E Conte
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - A Annoni
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - M E Mancini
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - P Gripari
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - M Pepi
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - G Pontone
- Cardiology Center Monzino IRCCS, Milan, Italy
| |
Collapse
|
19
|
Muscogiuri G, Gatti M, Dell"aversana S, Andreini D, Guaricci AI, Guglielmo M, Baggiano A, Mushtaq S, Conte E, Formenti A, Mancini ME, Gripari P, Rabbat MG, Pepi M, Pontone G. 491Diagnostic accuracy of single-shot two-dimensional multisegment late gadolinium enhancement in ischemic and non-ischemic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez123.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - M Gatti
- University of Turin, Turin, Italy
| | - S Dell"aversana
- Cardiology Center Monzino IRCCS, Department of Imaging, Milan, Italy
| | - D Andreini
- Cardiology Center Monzino IRCCS, Department of Imaging, Milan, Italy
| | | | - M Guglielmo
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - A Baggiano
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - S Mushtaq
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - E Conte
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - A Formenti
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - M E Mancini
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - P Gripari
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - M G Rabbat
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - M Pepi
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - G Pontone
- Cardiology Center Monzino IRCCS, Milan, Italy
| |
Collapse
|
20
|
Abstract
As a result of the Post-9/11 Veterans Assistance Act, academic programs aimed at assisting student veterans to become Registered Nurses (RN) are increasing. Accordingly, the number of nursing academic programs being offered online are increasing, yet little is known about online student veterans’ behaviors within learning management systems (LMS). This study examined the patterns of LMS use among student veterans who are pursuing a Bachelor of Science in Nursing (BSN) and the association between these behaviors and academic success. A retrospective associational analysis was conducted with data collected from students enrolled in courses in an online BSN program. The multilevel data consisted of 528 students who took one or more of twelve courses. The sample consisted of 23 veterans and 505 non-veteran BSN (non-VBSN) students in 3,793 course enrollments. Veterans were more likely to be male and were less likely to be classified as an in-state resident. Overall, the students engaged in their LMS early and most did not have missing or late assignments. The amount of online time spent in each course and the number of late assignment submissions significantly predicted course grades. No other significant predictors of graduation, discontinuation, or grades emerged. Notwithstanding some demographic differences, veterans appeared to be comparable to their non-VBSN counterparts overall, in terms of both academic performance and online engagement. These results indicate that the time students spend in their online courses can predict program success. The creation of an early-identification process for at-risk students who are not engaging in their LMS might have the potential to enhance educational outcomes even further.
Collapse
|
21
|
Cipher DJ, Urban RW, Mancini ME. Characteristics of Academic Coaches in an Online RN-to-BSN Program. J Nurs Educ 2018; 57:520-525. [DOI: 10.3928/01484834-20180815-03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/12/2018] [Indexed: 11/20/2022]
|
22
|
Olasveengen TM, de Caen AR, Mancini ME, Maconochie IK, Aickin R, Atkins DL, Berg RA, Bingham RM, Brooks SC, Castrén M, Chung SP, Considine J, Couto TB, Escalante R, Gazmuri RJ, Guerguerian AM, Hatanaka T, Koster RW, Kudenchuk PJ, Lang E, Lim SH, Løfgren B, Meaney PA, Montgomery WH, Morley PT, Morrison LJ, Nation KJ, Ng KC, Nadkarni VM, Nishiyama C, Nuthall G, Ong GYK, Perkins GD, Reis AG, Ristagno G, Sakamoto T, Sayre MR, Schexnayder SM, Sierra AF, Singletary EM, Shimizu N, Smyth MA, Stanton D, Tijssen JA, Travers A, Vaillancourt C, Van de Voorde P, Hazinski MF, Nolan JP. 2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary. Resuscitation 2017; 121:201-214. [DOI: 10.1016/j.resuscitation.2017.10.021] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
23
|
Olasveengen TM, de Caen AR, Mancini ME, Maconochie IK, Aickin R, Atkins DL, Berg RA, Bingham RM, Brooks SC, Castrén M, Chung SP, Considine J, Couto TB, Escalante R, Gazmuri RJ, Guerguerian AM, Hatanaka T, Koster RW, Kudenchuk PJ, Lang E, Lim SH, Løfgren B, Meaney PA, Montgomery WH, Morley PT, Morrison LJ, Nation KJ, Ng KC, Nadkarni VM, Nishiyama C, Nuthall G, Ong GYK, Perkins GD, Reis AG, Ristagno G, Sakamoto T, Sayre MR, Schexnayder SM, Sierra AF, Singletary EM, Shimizu N, Smyth MA, Stanton D, Tijssen JA, Travers A, Vaillancourt C, Van de Voorde P, Hazinski MF, Nolan JP. 2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary. Circulation 2017; 136:e424-e440. [PMID: 29114010 DOI: 10.1161/cir.0000000000000541] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The International Liaison Committee on Resuscitation has initiated a near-continuous review of cardiopulmonary resuscitation science that replaces the previous 5-year cyclic batch-and-queue approach process. This is the first of an annual series of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations summary articles that will include the cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation in the previous year. The review this year includes 5 basic life support and 1 pediatric Consensuses on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Each of these includes a summary of the science and its quality based on Grading of Recommendations, Assessment, Development, and Evaluation criteria and treatment recommendations. Insights into the deliberations of the International Liaison Committee on Resuscitation task force members are provided in Values and Preferences sections. Finally, the task force members have prioritized and listed the top 3 knowledge gaps for each population, intervention, comparator, and outcome question.
Collapse
|
24
|
Cipher DJ, Shrestha S, Mancini ME. Demographic and Academic Factors Associated With Enrollment in Online MSN Programs. J Nurs Educ 2017; 56:670-674. [PMID: 29091236 DOI: 10.3928/01484834-20171020-06] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/30/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND There is a need to better understand the demographic and academic characteristics of individuals enrolled in online Master of Science in Nursing (MSN) programs. METHOD This article reports a retrospective analysis of 4,079 students enrolled in one of three MSN programs: family nurse practitioner (FNP), nurse educator, and nursing administration. Demographic characteristics (i.e., gender, race, age) and academic variables (i.e., academic load, past undergraduate/graduate enrollment at the university) were examined for all enrollees. RESULTS Students in the MSN programs were younger than the national mean age for RNs, were primarily White, and were enrolled part time. The sample was composed of a disproportionately higher percentage of students from ethnic minority backgrounds than national RN profiles. CONCLUSION Study implications indicate that understanding the commonalities, differences, and educational experiences of students in on-campus and online MSN programs is important. The finding that almost 90% of online graduate nursing students enroll as part time has significant financial, family, and career implications. [J Nurs Educ. 2017;56(11):670-674.].
Collapse
|
25
|
Cipher DJ, Mancini ME, Shrestha S. Predictors of Persistence and Success in an Accelerated Online RN-to-BSN Program. J Nurs Educ 2017; 56:522-526. [DOI: 10.3928/01484834-20170817-02] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 04/06/2017] [Indexed: 11/20/2022]
|
26
|
Choi W, Dyens O, Chan T, Schijven M, Lajoie S, Mancini ME, Dev P, Fellander-Tsai L, Ferland M, Kato P, Lau J, Montonaro M, Pineau J, Aggarwal R. Engagement and learning in simulation: recommendations of the Simnovate Engaged Learning Domain Group. BMJ STEL 2017. [DOI: 10.1136/bmjstel-2016-000177] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundHealth professions education (HPE) is based on deliberate learning activities and clinical immersion to achieve clinical competence. Simulation is a tool that helps bridge the knowledge-to-action gap through deliberate learning. This paper considers how to optimally engage learners in simulation activities as part of HPE.MethodsThe Simnovate Engaged Learning Domain Group undertook 3 teleconferences to survey the current concepts regarding pervasive learning. Specific attention was paid to engagement in the learning process, with respect to fidelity, realism and emotions, and the use of narratives in HPE simulation.ResultsThis paper found that while many types of simulation exist, the current ways to categorise the types of simulation do not sufficiently describe what a particular simulation will entail. This paper introduces a novel framework to describe simulation by deconstructing a simulation activity into 3 core characteristics (scope, modality and environment). Then, the paper discusses how engagement is at the heart of the learning process, but remained an understudied phenomenon with respect to HPE simulation. Building on the first part, a conceptual framework for engaged learning in HPE simulation was derived, with potential use across all HPE methods.DiscussionThe framework considers how the 3 characteristics of simulation interplay with the dimensions of fidelity (physical, conceptual and emotional), and how these can be conveyed by and articulated through beauty (as a proxy for efficiency) as coexisting factors to drive learner engagement. This framework leads to the translation of deliberately taught knowledge, skills and attitudes into clinical competence and subsequent performance.
Collapse
|
27
|
Coffey DS, Elliot K, Goldblatt E, Grus C, Kishore SP, Mancini ME, Valachovic R, Walker PH. A Multifaceted Systems Approach to Addressing Stress Within Health Professions Education and Beyond. NAM Perspect 2017. [DOI: 10.31478/201701e] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
28
|
Hooper JI, Benton KK, Mancini ME, Yoder-Wise PS. Optimal Clinical Instruction in Nursing Education Programs: Recommendations From the Field. Journal of Nursing Regulation 2016. [DOI: 10.1016/s2155-8256(16)31078-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
29
|
Mancini ME. Economics of NP primary care. JAAPA 2016; 29:1-2. [PMID: 27476198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
|
30
|
Mancini ME, Diekema DS, Hoadley TA, Kadlec KD, Leveille MH, McGowan JE, Munkwitz MM, Panchal AR, Sayre MR, Sinz EH. Part 3: Ethical Issues: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2016; 132:S383-96. [PMID: 26472991 DOI: 10.1161/cir.0000000000000254] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
31
|
Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, Brooks SC, de Caen AR, Donnino MW, Ferrer JME, Kleinman ME, Kronick SL, Lavonas EJ, Link MS, Mancini ME, Morrison LJ, O'Connor RE, Samson RA, Schexnayder SM, Singletary EM, Sinz EH, Travers AH, Wyckoff MH, Hazinski MF. Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132:S315-67. [PMID: 26472989 DOI: 10.1161/cir.0000000000000252] [Citation(s) in RCA: 490] [Impact Index Per Article: 54.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
32
|
Lopalco G, Iannone F, Rigante D, Vitale A, Mancini ME, Covelli M, Lapadula G, Cantarini L. Coexistence of axial spondyloarthritis and thromboangiitis obliterans in a young woman. Reumatismo 2015; 67:17-20. [PMID: 26150270 DOI: 10.4081/reumatismo.2015.810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 05/13/2015] [Accepted: 05/13/2015] [Indexed: 11/23/2022] Open
Abstract
A peculiar coexistence of axial spondyloarthritis and ischemia of the feet and the fourth finger of the left hand in a young woman, who was a heavy smoker, is discussed in this report. This picture was considered within the context of thromboangiitis obliterans. Positivity of anti-nuclear antibodies and mild elevation of inflammatory parameters were noted. Computed tomography angiograms of upper and lower limbs showed luminal narrowing and occlusion of the left humeral, left anterior/posterior tibial and right anterior tibial arteries. Daily iloprost perfusions were started, and smoking cessation was strongly recommended. Coldness and rest pain in the distal extremities improved within a few weeks. The possibility that spondyloarthritis might precede the clinical picture of thromboangiitis obliterans should be considered in heavy smokers.
Collapse
Affiliation(s)
- G Lopalco
- Interdisciplinary Department of Medicine, Rheumatology Unit, Policlinico of Bari.
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Mancini ME, Ashwill J, Cipher DJ. A comparative analysis of demographic and academic success characteristics of on-line and on-campus RN-to-BSN students. J Prof Nurs 2014; 31:71-6. [PMID: 25601248 DOI: 10.1016/j.profnurs.2014.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Indexed: 10/25/2022]
Abstract
Despite their proliferation, little is known about how registered nurse-to-bachelor of science in nursing (RN-to-BSN) students enrolled in on-line programs compare to those in on-campus programs. This article reports on a comparative analysis of 3,802 students (332 on-campus, 3,470 on-line) conducted to better understand characteristics and educational outcomes of individuals who select on-line learning options. Programs were compared for student demographic characteristics (gender, race, age, and prior degree status) and outcome variables (progression to graduation and time to completion). Students in the on-line program were significantly older than on-campus students, and significantly more Caucasian/White students were in the on-line program. There were no significant differences in gender between groups. Among only those students who had already graduated, on-campus students took significantly less time to graduate than on-line students and had a higher graduation rate. However, the rate of program discontinuation was similar in both groups, and most on-line students who had not graduated were still progressing in the program. Implications of these findings are that students enrolled in an on-line RN-to-BSN program specifically designed to provide them with flexible 5-week terms and substantive student supports can have similar educational outcomes.
Collapse
Affiliation(s)
- Mary E Mancini
- Professor, Associate Dean and Chair, Undergraduate Nursing Programs, Baylor Professor for Healthcare Research, The University of Texas at Arlington College of Nursing, Arlington, TX 76019.
| | - Jean Ashwill
- Assistant Dean, Undergraduate Student Services, The University of Texas at Arlington College of Nursing, Arlington, TX 76019.
| | - Daisha J Cipher
- Associate Director of the Center for Nursing Research, The University of Texas at Arlington College of Nursing, Arlington, TX 76019.
| |
Collapse
|
34
|
Edelson DP, Yuen TC, Mancini ME, Davis DP, Hunt EA, Miller JA, Abella BS. Hospital cardiac arrest resuscitation practice in the United States: a nationally representative survey. J Hosp Med 2014; 9:353-7. [PMID: 24550202 PMCID: PMC4144704 DOI: 10.1002/jhm.2174] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 01/22/2014] [Accepted: 01/28/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND In-hospital cardiac arrest (IHCA) outcomes vary widely between hospitals, even after adjusting for patient characteristics, suggesting variations in practice as a potential etiology. However, little is known about the standards of IHCA resuscitation practice among US hospitals. OBJECTIVE To describe current US hospital practices with regard to resuscitation care. DESIGN A nationally representative mail survey. SETTING A random sample of 1000 hospitals from the American Hospital Association database, stratified into 9 categories by hospital volume tertile and teaching status (major teaching, minor teaching, and nonteaching). SUBJECTS Surveys were addressed to each hospital's cardiopulmonary resuscitation (CPR) committee chair or chief medical/quality officer. MEASUREMENTS A 27-item questionnaire. RESULTS Responses were received from 439 hospitals with a similar distribution of admission volume and teaching status as the sample population (P = 0.50). Of the 270 (66%) hospitals with a CPR committee, 23 (10%) were chaired by a hospitalist. High frequency practices included having a rapid response team (91%) and standardizing defibrillators (88%). Low frequency practices included therapeutic hypothermia and use of CPR assist technology. Other practices such as debriefing (34%) and simulation training (62%) were more variable and correlated with the presence of a CPR committee and/or dedicated personnel for resuscitation quality improvement. The majority of hospitals (79%) reported at least 1 barrier to quality improvement, of which the lack of a resuscitation champion and inadequate training were the most common. CONCLUSIONS There is wide variability among hospitals and within practices for resuscitation care in the United States with opportunities for improvement.
Collapse
Affiliation(s)
- Dana P. Edelson
- Department of Medicine, University of Chicago, Chicago, IL
- Corresponding author and requests for reprints (Dana P. Edelson) Address: Section of Hospital Medicine, University of Chicago 5841 S. Maryland Avenue, MC 5000 Chicago, Illinois 60637 Telephone: (773) 834-2191 Fax: (773) 795-7398
| | - Trevor C Yuen
- Department of Medicine, University of Chicago, Chicago, IL
| | - Mary E Mancini
- College of Nursing, University of Texas at Arlington, Arlington, TX
| | - Daniel P Davis
- Department of Emergency Medicine, University of California, San Diego, San Diego, CA
| | - Elizabeth A Hunt
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Benjamin S Abella
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
| |
Collapse
|
35
|
|
36
|
Meaney PA, Bobrow BJ, Mancini ME, Christenson J, de Caen AR, Bhanji F, Abella BS, Kleinman ME, Edelson DP, Berg RA, Aufderheide TP, Menon V, Leary M. Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation 2013; 128:417-35. [PMID: 23801105 DOI: 10.1161/cir.0b013e31829d8654] [Citation(s) in RCA: 631] [Impact Index Per Article: 57.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The "2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" increased the focus on methods to ensure that high-quality cardiopulmonary resuscitation (CPR) is performed in all resuscitation attempts. There are 5 critical components of high-quality CPR: minimize interruptions in chest compressions, provide compressions of adequate rate and depth, avoid leaning between compressions, and avoid excessive ventilation. Although it is clear that high-quality CPR is the primary component in influencing survival from cardiac arrest, there is considerable variation in monitoring, implementation, and quality improvement. As such, CPR quality varies widely between systems and locations. Victims often do not receive high-quality CPR because of provider ambiguity in prioritization of resuscitative efforts during an arrest. This ambiguity also impedes the development of optimal systems of care to increase survival from cardiac arrest. This consensus statement addresses the following key areas of CPR quality for the trained rescuer: metrics of CPR performance; monitoring, feedback, and integration of the patient's response to CPR; team-level logistics to ensure performance of high-quality CPR; and continuous quality improvement on provider, team, and systems levels. Clear definitions of metrics and methods to consistently deliver and improve the quality of CPR will narrow the gap between resuscitation science and the victims, both in and out of the hospital, and lay the foundation for further improvements in the future.
Collapse
|
37
|
Yang CW, Yen ZS, McGowan JE, Chen HC, Chiang WC, Mancini ME, Soar J, Lai MS, Ma MHM. A systematic review of retention of adult advanced life support knowledge and skills in healthcare providers. Resuscitation 2012; 83:1055-60. [PMID: 22391016 DOI: 10.1016/j.resuscitation.2012.02.027] [Citation(s) in RCA: 182] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 01/06/2012] [Accepted: 02/22/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Advanced life support (ALS) guidelines are widely adopted for healthcare provider training with recommendations for retraining every two years or longer. This systematic review studies the retention of adult ALS knowledge and skills following completion of an ALS course in healthcare providers. METHODS We retrieved original articles using Medline, CINAHL, Cochrane Library, and PubMed, and reviewed reference citations to identify additional studies. We extracted data from included articles using a structured approach and organized outcomes by evaluation method, and knowledge and skills retention. RESULTS Among 336 articles retrieved, 11 papers were included. Most studies used multiple-choice questionnaires to evaluate knowledge retention and cardiac arrest simulation or other skills tests to evaluate skills retention. All studies reported variable rates of knowledge or skills deterioration over time, from 6 weeks to 2 years after training. Two studies noted retention of knowledge at 18 months and up to 2 years, and one reported skills retention at 3 months. Clinical experience, either prior to or after the courses, has a positive impact on retention of knowledge and skills. CONCLUSION There is a lack of large well-designed studies examining the retention of adult ALS knowledge and skills in healthcare providers. The available evidence suggests that ALS knowledge and skills decay by 6 months to 1 year after training and that skills decay faster than knowledge. Additional studies are needed to help provide evidence-based recommendations for assessment of current knowledge and skills and need for refresher training to maximize maintenance of ALS competency.
Collapse
Affiliation(s)
- Chih-Wei Yang
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Mancini ME. Working together, nurses can make a difference in resuscitation outcomes: an update on the American Heart Association's 2010 guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Jpn J Nurs Sci 2011; 8:7-10. [PMID: 21615693 DOI: 10.1111/j.1742-7924.2011.00183.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The International Liaison Committee on Resuscitation (ILCOR) was formed in 1992 to provide a forum for resuscitation organizations worldwide. According to its mission, ILCOR provides a mechanism by which international science and knowledge that are relevant to cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) can be identified, reviewed, and evaluated. Every 5 years, based on a rigorous review of the published, peer-reviewed science, ILCOR develops a consensus on resuscitation science and carries that forward into internationally agreed-on treatment recommendations. As part of the 2010 evidence-evaluation process, ILCOR published an updated consensus on science and treatment recommendations (CoSTR). Based on the CoSTR, the American Heart Association (AHA) developed and disseminated guidelines for ECC and CPR. Nursing has unique responsibilities in the chain of survival. This article reviews the major elements of AHA's 2010 guidelines and discusses the critical role that nurses play in the development, dissemination, and implementation of resuscitation science. By making the connection in resuscitation science, nurses can help to save more lives.
Collapse
Affiliation(s)
- Mary E Mancini
- College of Nursing, The University of Texas-Arlington, Arlington, Texas, USA.
| |
Collapse
|
39
|
Mancini ME, Soar J, Bhanji F, Billi JE, Dennett J, Finn J, Ma MHM, Perkins GD, Rodgers DL, Hazinski MF, Jacobs I, Morley PT. Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2010; 122:S539-81. [PMID: 20956260 DOI: 10.1161/circulationaha.110.971143] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
40
|
Chan PS, Krumholz HM, Spertus JA, Jones PG, Cram P, Berg RA, Peberdy MA, Nadkarni V, Mancini ME, Nallamothu BK. Automated external defibrillators and survival after in-hospital cardiac arrest. JAMA 2010; 304:2129-36. [PMID: 21078809 PMCID: PMC3587791 DOI: 10.1001/jama.2010.1576] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Automated external defibrillators (AEDs) improve survival from out-of-hospital cardiac arrests, but data on their effectiveness in hospitalized patients are limited. OBJECTIVE To evaluate the association between AED use and survival for in-hospital cardiac arrest. DESIGN, SETTING, AND PATIENTS Cohort study of 11,695 hospitalized patients with cardiac arrests between January 1, 2000, and August 26, 2008, at 204 US hospitals following the introduction of AEDs on general hospital wards. MAIN OUTCOME MEASURE Survival to hospital discharge by AED use, using multivariable hierarchical regression analyses to adjust for patient factors and hospital site. RESULTS Of 11,695 patients, 9616 (82.2%) had nonshockable rhythms (asystole and pulseless electrical activity) and 2079 (17.8%) had shockable rhythms (ventricular fibrillation and pulseless ventricular tachycardia). AEDs were used in 4515 patients (38.6%). Overall, 2117 patients (18.1%) survived to hospital discharge. Within the entire study population, AED use was associated with a lower rate of survival after in-hospital cardiac arrest compared with no AED use (16.3% vs 19.3%; adjusted rate ratio [RR], 0.85; 95% confidence interval [CI], 0.78-0.92; P < .001). Among cardiac arrests due to nonshockable rhythms, AED use was associated with lower survival (10.4% vs 15.4%; adjusted RR, 0.74; 95% CI, 0.65-0.83; P < .001). In contrast, for cardiac arrests due to shockable rhythms, AED use was not associated with survival (38.4% vs 39.8%; adjusted RR, 1.00; 95% CI, 0.88-1.13; P = .99). These patterns were consistently observed in both monitored and nonmonitored hospital units where AEDs were used, after matching patients to the individual units in each hospital where the cardiac arrest occurred, and with a propensity score analysis. CONCLUSION Among hospitalized patients with cardiac arrest, use of AEDs was not associated with improved survival.
Collapse
Affiliation(s)
- Paul S Chan
- Saint Luke's Mid America Heart Institute, 4401 Wornall Rd, Fifth Floor, Kansas City, MO 64111, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
|
42
|
Hazinski MF, Nolan JP, Billi JE, Böttiger BW, Bossaert L, de Caen AR, Deakin CD, Drajer S, Eigel B, Hickey RW, Jacobs I, Kleinman ME, Kloeck W, Koster RW, Lim SH, Mancini ME, Montgomery WH, Morley PT, Morrison LJ, Nadkarni VM, O'Connor RE, Okada K, Perlman JM, Sayre MR, Shuster M, Soar J, Sunde K, Travers AH, Wyllie J, Zideman D. Part 1: Executive Summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2010; 122:S250-75. [PMID: 20956249 DOI: 10.1161/circulationaha.110.970897] [Citation(s) in RCA: 282] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
43
|
Soar J, Mancini ME, Bhanji F, Billi JE, Dennett J, Finn J, Ma MHM, Perkins GD, Rodgers DL, Hazinski MF, Jacobs I, Morley PT. Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2010; 81 Suppl 1:e288-330. [PMID: 20956038 PMCID: PMC7184565 DOI: 10.1016/j.resuscitation.2010.08.030] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol,United Kingdom.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Shuster M, Billi JE, Bossaert L, de Caen AR, Deakin CD, Eigel B, Hazinski MF, Hickey RW, Jacobs I, Kleinman ME, Koster RW, Mancini ME, Montgomery WH, Morley PT, Morrison LJ, Munoz H, Nadkarni VM, Nolan JP, O’Connor RE, Perlman JM, Richmond S, Sayre MR, Soar J, Wyllie J, Zideman D. Part 4: Conflict of interest management before, during, and after the 2010 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2010; 81 Suppl 1:e41-7. [DOI: 10.1016/j.resuscitation.2010.08.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
45
|
Nolan JP, Hazinski MF, Billi JE, Boettiger BW, Bossaert L, de Caen AR, Deakin CD, Drajer S, Eigel B, Hickey RW, Jacobs I, Kleinman ME, Kloeck W, Koster RW, Lim SH, Mancini ME, Montgomery WH, Morley PT, Morrison LJ, Nadkarni VM, O'Connor RE, Okada K, Perlman JM, Sayre MR, Shuster M, Soar J, Sunde K, Travers AH, Wyllie J, Zideman D. Part 1: Executive summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2010; 81 Suppl 1:e1-25. [PMID: 20956042 PMCID: PMC7115798 DOI: 10.1016/j.resuscitation.2010.08.002] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
46
|
Cason CL, Cazzell MA, Nelson KA, Hartman V, Roye J, Mancini ME. Improving Learning of Airway Management with Case-based Computer Microsimulations. Clin Simul Nurs 2010. [DOI: 10.1016/j.ecns.2009.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
47
|
Mancini ME, Cazzell M, Kardong-Edgren S, Cason CL, Berryman P, Lukes E. Improving Workplace Safety Training Using a Self-Directed CPR-AED Learning Program. ACTA ACUST UNITED AC 2009. [DOI: 10.1177/216507990905700406] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
RESEARCH ABSTRACT Adequate training in cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED) is an important component of a workplace safety training program. Barriers to traditional in-classroom CPR-AED training programs include time away from work to complete training, logistics, learner discomfort over being in a classroom setting, and instructors who include information irrelevant to CPR. This study evaluated differences in CPR skills performance between employees who learned CPR using a self-directed learning (SDL) kit and employees who attended a traditional instructor-led course. The results suggest that the SDL kit yields learning outcomes comparable to those obtained with traditional instructor-led courses and is a more time-efficient tool for CPR-AED training. Furthermore, the SDL kit overcomes many of the barriers that keep individuals from learning CPR and appears to contribute to bystanders' confidently attempting resuscitation.
Collapse
|
48
|
Mancini ME, Cazzell M, Kardong-Edgren S, Cason CL. Improving Workplace Safety Training Using a Self-Directed CPR-AED Learning Program. ACTA ACUST UNITED AC 2009; 57:159-67; quiz 168-9. [DOI: 10.3928/08910162-20090401-02] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Adequate training in cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED) is an important component of a workplace safety training program. Barriers to traditional in-classroom CPR-AED training programs include time away from work to complete training, logistics, learner discomfort over being in a classroom setting, and instructors who include information irrelevant to CPR. This study evaluated differences in CPR skills performance between employees who learned CPR using a self-directed learning (SDL) kit and employees who attended a traditional instructor-led course. The results suggest that the SDL kit yields learning outcomes comparable to those obtained with traditional instructor-led courses and is a more time-efficient tool for CPR-AED training. Furthermore, the SDL kit overcomes many of the barriers that keep individuals from learning CPR and appears to contribute to bystanders' confidently attempting resuscitation.
Collapse
|
49
|
Nadkarni VM, Larkin GL, Peberdy MA, Carey SM, Kaye W, Mancini ME, Nichol G, Lane-Truitt T, Potts J, Ornato JP, Berg RA. First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults. JAMA 2006; 295:50-7. [PMID: 16391216 DOI: 10.1001/jama.295.1.50] [Citation(s) in RCA: 802] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT Cardiac arrests in adults are often due to ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT), which are associated with better outcomes than asystole or pulseless electrical activity (PEA). Cardiac arrests in children are typically asystole or PEA. OBJECTIVE To test the hypothesis that children have relatively fewer in-hospital cardiac arrests associated with VF or pulseless VT compared with adults and, therefore, worse survival outcomes. DESIGN, SETTING, AND PATIENTS A prospective observational study from a multicenter registry (National Registry of Cardiopulmonary Resuscitation) of cardiac arrests in 253 US and Canadian hospitals between January 1, 2000, and March 30, 2004. A total of 36,902 adults (> or =18 years) and 880 children (<18 years) with pulseless cardiac arrests requiring chest compressions, defibrillation, or both were assessed. Cardiac arrests occurring in the delivery department, neonatal intensive care unit, and in the out-of-hospital setting were excluded. MAIN OUTCOME MEASURE Survival to hospital discharge. RESULTS The rate of survival to hospital discharge following pulseless cardiac arrest was higher in children than adults (27% [236/880] vs 18% [6485/36,902]; adjusted odds ratio [OR], 2.29; 95% confidence interval [CI], 1.95-2.68). Of these survivors, 65% (154/236) of children and 73% (4737/6485) of adults had good neurological outcome. The prevalence of VF or pulseless VT as the first documented pulseless rhythm was 14% (120/880) in children and 23% (8361/36,902) in adults (OR, 0.54; 95% CI, 0.44-0.65; P<.001). The prevalence of asystole was 40% (350) in children and 35% (13 024) in adults (OR, 1.20; 95% CI, 1.10-1.40; P = .006), whereas the prevalence of PEA was 24% (213) in children and 32% (11,963) in adults (OR, 0.67; 95% CI, 0.57-0.78; P<.001). After adjustment for differences in preexisting conditions, interventions in place at time of arrest, witnessed and/or monitored status, time to defibrillation of VF or pulseless VT, intensive care unit location of arrest, and duration of cardiopulmonary resuscitation, only first documented pulseless arrest rhythm remained significantly associated with differential survival to discharge (24% [135/563] in children vs 11% [2719/24,987] in adults with asystole and PEA; adjusted OR, 2.73; 95% CI, 2.23-3.32). CONCLUSIONS In this multicenter registry of in-hospital cardiac arrest, the first documented pulseless arrest rhythm was typically asystole or PEA in both children and adults. Because of better survival after asystole and PEA, children had better outcomes than adults despite fewer cardiac arrests due to VF or pulseless VT.
Collapse
Affiliation(s)
- Vinay M Nadkarni
- Departments of Anesthesia, Critical Care, and Pediatrics, University of Pennsylvania School of Medicine, Philadelphia 19104-4399, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Kaye W, Nadkarni V, Mancini ME, Copes W, Carey S, Ornato JP, Truitt TL, Peberdy MA. The national registry of cardiopulmonary resuscitation: a preliminary report of 5,030 adult in-hospital cardiac arrests. J Am Coll Cardiol 2002. [DOI: 10.1016/s0735-1097(02)81510-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|