DVD-based or instructor-led CPR education - a comparison.
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CD-I↗
Biomedical subjects
Ann-Britt Thorén
Publications and source records attributed to Ann-Britt Thorén.
A nationwide survey of CPR training in Sweden: foreign born and unemployed are not reached by training programmes.
AIM: To determine the number of CPR trained adults in Sweden, and the willingness of the non-trained population to attend a CPR course. An additional purpose was to investigate differences related to sex, age, residential area, socio-economic classification and country of origin. METHODS: Five thousand adults in Sweden were surveyed, which yielded 3167 valid responses, a response rate of 63%. The sample was selected at random and stratified to correlate to the geographic distribution of the population. RESULTS: The mean (S.D.) age was 46 (16) years, 54% of the respondents were females and 11% were people of foreign origin. Forty-five percent had participated in some form of CPR training. Younger respondents, those living in rural areas, those born in Sweden, employees, students and military conscripts were trained more frequently in CPR. Of the respondents with no CPR training, 50% expressed a willingness to attend a course. The most common reason for not being trained in CPR was that the respondent did not know such courses existed or that they did not know where to go for training. CONCLUSION: Somewhere between 30 and 45% of the adult population of Sweden had participated in CPR training. Half of the non-trained population was willing to learn CPR but frequently did not know that such courses existed or where they were held. Elderly people, people of foreign origin, or those not included in the workforce were less likely to have participated in CPR training.
Adolescent↗
Characteristics and outcome of false cardiac arrests in hospital.
BACKGROUND: Not all hospitalised patients with symptoms of a presumed or threatened cardiac arrest, for whom the rescue team is alerted, eventually suffer a cardiac arrest. This article aims to describe the characteristics and outcome of "false cardiac arrests". METHODS: All patients hospitalised at Sahlgrenska University Hospital for whom the rescue team was alerted between 1 November 1994 and 15 October 2002 were included. RESULTS: In all, there were 1538 calls for the rescue team, of which 70% were caused by cardiac arrest, 9% by respiratory arrest and 21% by "other causes". Survival to discharge was 36% among patients with cardiac arrest, 64% among patients with respiratory arrest and 77% among patients with "other reasons for calling" (p<0.0001 for trend). Among survivors, a cerebral performance categories (CPC) score of 1 at hospital discharge was found in 83% of those with a cardiac arrest, 59% with respiratory arrest and 82% with other reasons for calling (NS for trend). CONCLUSION: Among patients at a Swedish university hospital for whom the rescue team was alerted, about one-third have a "false cardiac arrest". These patients had a survival rate which was about twice that of patients with a "true cardiac arrest". However, among survivors, cerebral function at discharge was similar, regardless of "false" or "true" cardiac arrest.
Aged↗
In-hospital cardiac arrest--an Utstein style report of seven years experience from the Sahlgrenska University Hospital.
BACKGROUND: In-hospital cardiac arrest is one of the most stressful situations in modern medicine. Since 1997, there has been a uniform way of reporting - the Utstein guidelines for in-hospital cardiac arrest reporting. MATERIAL AND METHODS: We have studied all consecutive cardiac arrest in the Sahlgrenska University Hospital (SU) between 1994 and 2001 for who the rescue team was alerted in all 833 patients. The primary endpoint for this study was survival to discharge. RESULTS: Thirty-seven percent survived to hospital discharge. Among patients who were discharged alive, 86% were alive 1 year later. The survivors have a good cerebral outcome (94% among those who were discharged alive had cerebral performance category (CPC) score 1 or 2). The organization at SU is efficient; 80% of the cardiac arrest had CPR within 1 min. Time from cardiac arrest to first defibrillation is a median of 2 min. Almost two-thirds of the patients were admitted for cardiac related diagnoses. CONCLUSION: The current study is the largest single-centre study of in hospital cardiac arrest reported according to the Utstein guidelines. We report a high survival for in-hospital cardiac arrest. We have pointed out that a functional chain of survival, short intervals before the start of CPR and defibrillation are probably contributing factors for this.
Adolescent↗
Possibilities for, and obstacles to, CPR training among cardiac care patients and their co-habitants.
AIM: To investigate the level of cardiopulmonary resuscitation (CPR) training among cardiac patients and their co-habitants and to describe the possibilities for, and obstacles to, CPR training among this group. METHODS: All patients admitted to a coronary care unit during a four-month period were considered for participation in an interview study. Out of 401 patients, 268 were co-habiting. This study deals with these subjects. RESULTS: According to the answers given by the patients, 46% of the patients and 33% of the co-habitants had attended a CPR course at some time. Among those who had not previously attended a course, 58% were willing to attend, and 60% of the patients whose co-habitant had not received CPR education, wanted him or her to attend a course. The major obstacle to CPR training was the patient's own medical status. The major obstacle to the co-habitant's participation was the patient's doubts concerning their partner's physical ability or willingness to participate. Younger persons were more often willing to undergo training than older persons (p < 0.0001). Of those patients who had previously attended a course or who were willing to undergo training, 72% were prepared to do so together with their co-habitant. A course specially designed for cardiac patients and their relatives was a possible alternative for 75% of those willing to participate together with their co-habitant. CONCLUSIONS: Two-thirds of the patients did not believe that their co-habitant had taken part in CPR training. More than half of these would like their co-habitant to attend such a course. Seventy-two percent were willing to participate in CPR instruction together with their co-habitant. Major obstacles to CPR training were doubts concerning the co-habitant's willingness or physical ability and their own medical status.
Aged↗
A history of diabetes is associated with an adverse outcome among patients admitted to hospital alive after an out-of-hospital cardiac arrest.
BACKGROUND: Factors of importance for the outcome among patients who are admitted to hospital alive after an out-of-hospital cardiac arrest are not well described in the literature. The importance of a history of diabetes for the outcome among these patients has not been reported in detail previously. This survey aims to describe the outcome among patients who were admitted to hospital after an out-of-hospital cardiac arrest in relation to whether they had a history of diabetes. METHODS: All patients who were admitted to hospital alive after an out-of-hospital cardiac arrest in the two city hospitals in the Municipality of Göteborg between 1980 and 2002 were included in the survey. RESULTS: In all, 1377 patients fulfilled the inclusion criteria and 187 (14%) of them had a history of diabetes. Patients with diabetes differed from those without diabetes by having a previous history of myocardial infarction, angina pectoris, hypertension and heart failure more frequently. Furthermore, they were older, with a mean age of 70 years versus 66 years for patients without diabetes. Among patients with diabetes, 25% were discharged alive, as compared with 37% of patients without diabetes (p=0.002). When adjusting for differences at baseline, the adjusted odds ratio for diabetic patients being discharged alive (versus no diabetes) was 0.57 (95% confidence interval, 0.39-0.80). CONCLUSION: Among patients admitted to hospital after an out-of-hospital cardiac arrest, 14% had a history of diabetes. These patients had a lower survival rate compared with those without diabetes, even after correcting for dissimilarities at baseline. It remains to be determined whether an early metabolic intervention in these patients will improve survival.
Age Distribution↗
Very high survival among patients defibrillated at an early stage after in-hospital ventricular fibrillation on wards with and without monitoring facilities.
BACKGROUND: The association between the interval between collapse and defibrillation and outcome is well described in out of hospital cardiac arrest but not as well in in-hospital cardiac arrest. We report the outcome among patients who suffered an in-hospital cardiac arrest and were found in ventricular fibrillation (VF) with the emphasis on the delay to defibrillation. METHODS AND RESULTS: In patients who suffered an in-hospital cardiac arrest at Sahlgrenska University Hospital in Göteborg between 1994 and 2002 there were 1.570 calls for the rescue team of which 71% had suffered a cardiac arrest. Among cardiac arrests 47% took place on monitored wards. The proportion of patients found in VF was 59% on wards with monitoring facilities and 45% on wards without (p<0.0001). Approximately 90% of these patients were defibrillated 12 min. On monitored wards, the survival was 63% if defibrillated 3 min after collapse (NS). The corresponding values for non-monitored wards were 72% and 35%, respectively (p=0.0003). Cerebral function among survivors at discharge appeared to be good among the majority of patients both in monitored and non monitored wards. CONCLUSION: If patients with in hospital VF were defibrillated early in both monitored and non monitored wards survival to hospital discharge was high. This highlights the importance of being prepared for the rapid defibrillation on wards without monitoring facilities.
Aged↗
The attitude of cardiac care patients towards CPR and CPR education.
The recommended targeting of the elderly, those with heart conditions and their family members for CPR education remains unaccomplished. Little is known about cardiac patients' knowledge of and attitude towards CPR and CPR education. This study aimed to investigate cardiac care patients' attitude towards CPR and interest in CPR education. An interview, based on a questionnaire, was conducted with 401 consecutive patients admitted to a coronary care unit. Most participants had heard about the concept of CPR and 64% were aware of its content. In the event of an emergency, 96% were willing to undergo CPR. Age, previous myocardial infarction and heart failure were significantly associated with the willingness or lack of willingness to undergo CPR. Forty percent of the participants had attended one or more courses but only a few within the last two years. The major reasons for not being educated in CPR were a lack of awareness of the availability of CPR training for the public, lack of interest or lack of enterprise. Among those not educated in CPR, 46% would like to attend a course. A hospital was the preferred location for the course, often due to the perceived higher competence of the instructors, but sometimes, because it offered a safe environment. The primary health care centre was preferred because of its location near the participants' homes. In order to increase the proportion of people trained in CPR in target groups such as cardiac care patients and their family members, healthcare professionals should provide patients with information and opportunities to attend locally situated, professionally led courses.
Age Factors↗