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Evaluation of knowledge about cardiopulmonary resuscitation in Tîrgu Mures

Irodalom 1. Wilkins E, Wilson L, Wickramasinghe K, Bhatnagar P, Leal J, Fernandez-Luengo R, et al. European Cardiovascular Disease Statistics 2017. European Heart Network . 2017 Available from: [Accessed 2017 November 15] 2. Ibrahim WH. Recent advances and controversies in adult cardiopulmonary resuscitation. Postgrad Med J . 2007,83:649-654 3. Gräsner JT, Lefering R, Koster RW, Masterson S, Böttiger BW, Herlitz J, et al. A prospective one months analysis of out

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The effectiveness of using medical students for training high school students in cardiopulmonary resuscitation


Introduction: Training for cardiopulmonary resuscitation is a very important topic for society, trainers and researchers. However it is not yet established who should be trained and by whom nor how the training programmes should be accomplished. We developed a study to evaluate an existing programme where medical students train high school students in cardiopulmonary resuscitation using instrumented mannequins to teach and collect performance data.

Method: The students of four randomly selected high school classes were trained by four randomly selected medical students and were evaluated by an independent evaluator. The level of knowledge provided and the level of technical skills acquired were analysed.

Results: One hour of lecturing was enough to increase the mean of correct answers from 39.52% to 78.48% when we tested knowledge. Testing for skills retention we found that that 92.75% of trained students taped the shoulder; 95.65% asked loudly “Are you all right?” at the right moment; 97.1% shouted for help at the right moment, the entire group remembered to check the breathing at the right moment, and 92.75% executed a correct head tilt chin lift manoeuvre; 86.9% remembered to call 112 at the right moment. Automatic recordings showed that mean flow fraction was 80.74%, mean no flow time was 18.9 seconds, mean frequency of chest compressions was 134.7/min and mean compression depth was 39.06 mm.

Conclusions: The results showed that high school students achieved a good level of knowledge and acceptable cardiopulmonary resuscitation skills when trained by medical students.

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Extracorporeal Life Support and New Therapeutic Strategies for Cardiac Arrest Caused by Acute Myocardial Infarction - a Critical Approach for a Critical Condition

, et al. Favourable survival of in-hospital compared to out-of-hospital refractory cardiac arrest patients treated with extracorporeal membrane oxygenation: an Italian tertiary care centre experience. Resuscitation. 2012;83:579-83. doi: 10.1016/j.resuscitation.2011.10.013. 6. Dworschak M. Is extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest superior compared with conventional resuscitation? Crit Care Med. 2013;41:1365-6. doi: 10.1097/CCM.0b013e31828044c0. 7. Le Guen M, Nicolas-Robin A, Carreira S, et al. Extracorporeal life

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Factors Affecting a Successful Out-Of-Hospital Cardiopulmonary Resuscitation / Pirmsslimnīcas Etapa Kardiopulmonālo Reanimāciju Rezultātus Ietekmējošie Faktori


A retrospective patient record analysis of the Emergency Medial Service’s Rîga City Regional Centre was provided from January 2012 through December 2013. 1359 adult patients were CPR treated for out-of-hospital cardiac arrest according to ERC Guidelines 2010. A total of 490 patients were excluded from the study. The main outcome measure was survival to hospital admission. Of 869 CPR-treated patients, 60% (n = 521) were men. The mean age of patients was 66.68 ± 15.28 years. The survival rate to hospital admission was 12.9% (n = 112). 54 of survived patients were women. Mean patient age of successful CPR was 63.22 ± 16.21 and unsuccessful CPR 67.20 ± 15.09. At least one related illness was recorded with 63.4% (n = 551) patients. There were 61 survivors in bystander witnessed OHCA and nine survivors in unwitnessed OHCA. The rate of bystander CPR when CA (cardiac arrest) was witnessed was 24.8%. Ventricular fibrillation (VF) as initial heart rhythm was significantly associated with survival to hospital admission in 54 cases (p < 0.0001). Age and gender affected return of spontaneous circulation. Survival to hospital admission had rhythm-specific outcome. Presence of OHCA witnesses improved outcome compared to bystander CPR. The objective of this study was to report patient characteristics, the role of witnesses in out-of-hospital cardiac arrest (OHCA) and outcome of adult cardiopulmonary resuscitation

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A Study of the Factors Related to Cardiopulmonary Resuscitation Physical Fatigue and the Quality of Resuscitation

References 1. Salari A, Mohammadnejad E, Vanaki Z, Ahmadi F. Survival rate and outcomes of cardiopulmonary resuscitation. Iran J Critical Care Nurs 2010;3(2):45-9. 2. Berg RA, Hemphill R, Abella BS, Aufderheide TP, Cave DM, Hazinski MF, et al. Part 5: Adult basic life support 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2010;122(18 suppl 3):S685-S705. 3. Hasegawa T, Daikoku R, Saito S, Saito Y. Relationship between

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Case Report of the Patient with Acute Myocardial Infarction: “From Flatline to Stent Implantation”


Asystole is a rare primary manifestation in the development of sudden cardiac death (SCD), and survival during cardiac arrest as the consequence of asystole is extremely low. The aim of our paper is to illustrate successful cardiopulmonary resuscitation (CPR) in patients with acute myocardial infarction (AMI) and rare and severe form of cardiac arrest - asystole. A very short time between cardiac arrest in acute myocardial infarction, which was manifested by asystole, and the adequate CPR measures that have been taken are of great importance for the survival of our patient.

After successful reanimation, the diagnosis of anterior wall AMI with ST segment elevation was established. The right therapeutic strategy is certainly the early primary percutaneous coronary intervention (PPCI). In less than two hours, after recording the “flatline” and successful reanimation, the patient was in the catheterization laboratory, where a successful PPCI of LAD was performed, after emergency coronary angiography. In the further treatment course of the patient, the majority of risk factors were corrected, except for smoking, which may be the reason for newly discovered lung tumor disease. Early recognition and properly applied treatment of CPR can produce higher rates of survival.

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Sudden Cardiac Death and Post Cardiac Arrest Syndrome. An Overview


A satisfactory neurologic outcome is the key factor for survival in patients with sudden cardiac death (SCD), however this is highly dependent on the haemodynamic status. Short term cardiopulmonary resuscitation and regained consciousness on the return of spontaneous circulation (ROSC) is indicative of a better prognosis. The evaluation and treatment of SCD triggering factors and of underlying acute and chronic diseases will facilitate prevention and lower the risk of cardiac arrest. Long term CPR and a prolonged unconscious status after ROSC, in the Intensive Care Units or Coronary Care Units, indicates the need for specific treatment and supportive therapy including efforts to prevent hyperthermia. The prognosis of these patients is unpredictable within the first seventy two hours, due to unknown responses to therapeutic management and the lack of specific prognostic factors. Patients in these circumstances require the highest level of intensive care and aetiology driven treatment without any delay, independently of their coma state. Current guidelines sugest the use of multiple procedures in arriving at a diagnosis and prognosis of these critical cases.

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New Developments in the Treatment of Acute Myocardial Infarction Associated with Out-of-Hospital Cardiac Arrest. A Review

associated with an increase in proportion of emergency crew–witnessed cases and bystander cardiopulmonary resuscitation. Circulation. 2008;118:389-396. doi: 10.1161/CIRCULATIONAHA.107.734137. 42. Vaahersalo J, Hiltunen P, Tiainen M, et al. Therapeutic hypothermia after out-of-hospital cardiac arrest in Finnish intensive care units: the FINNRESUSCI study. Intensive Care Med. 2013;39:826–837. doi: 10.1007/s00134-013-2868-1. 43. Nielsen N, Wetterslev J, Cronberg T, et al. Targeted temperature management at 33 C versus 36 C after cardiac arrest. N Engl J Med. 2013

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Public awareness about the use of automatic external defibrillator (AED) in giving first aid


Introduction. Chances for survival of a patient who has suffered from sudden cardiac arrest (SCA) depend on a number of factors. One of the most important however, is the time within which the patient is provided with actions to restore normal heart function. In the Guidelines for Resuscitation 2015, The European Resuscitation Council states that defibrillation done within 3-5 minutes since a patient with SCA lost his/her consciousness can increase the survival rate up to 50-70%. However, such a short time of providing help is only achievable through the implementation of universal defibrillation programs and the automatic external defibrillator (AED) devices densely distributed in public places. By contrast, every minute of delay in defibrillation reduces the probability of survival by approximately 10-12% until the hospital discharge.

Aim. The purpose of the research was to elicit the opinions of adult respondents on first aid and the use of automatic external defibrillator (AED).

Material and methods. The research method used in this paper was a diagnostic survey, the technique was a web-based questionnaire, and a research tool was the authors’ own questionnaire survey. The survey was active between April 8, 2016 and May 20, 2016. During this time, 116 opinions were collected.

Results. As many as 77% of respondents declared that they had attended a first aid course, but 21% of them stated that they no longer remembered the knowledge acquired. The number of 63% of respondents did not know what an automatic external defibrillator is. Only 27% of respondents knew that AEDs are public devices, and only 47% believed that using an AED would not worsen the health of the victim.

Conclusions. The availability of AEDs and knowledge of their use are insufficient. Low social awareness and irrational fear of using an AED (fear of deterioration of the victim’s health) support the need for continuing education in this area.

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Isolated right atrial rupture because of external cardiac massage after coronary artery bypass grafting

References 1. Baringer JR, Salzman EW, Jones WA, Friedlich AL. External cardiac massage. New Eng J Med. 1961; 265: 62-5. 2. Machii M, Inaba H, Nakae H, Suzuki I, Tanaka H. Cardiac rupture by penetration of fractured sternum: a rare complication of cardiopulmonary resuscitation. Resuscitation. 2000; 43:151-3. 3. Noffsinger AE, Blisard KS, Balko MG. Cardiac laceration and pericardial tamponade due to cardiopulmonary resuscitation after myocardial infarction. J Forensic Sci. 1991; 36:1760-4. 4

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