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PubMedDate not supplied

Derivation of emergency medical services dispatch codes associated with low-acuity patients.

OBJECTIVE: To identify emergency medical services (EMS) dispatch codes associated with basic life support (BLS) level of prehospital care, a proxy for low illness acuity. METHODS: This retrospective cohort study was conducted in an urban city with a single advanced life support level EMS provider. The 911 center was certified in using dispatch protocols from Priority Dispatch Corporation (Salt Lake City, UT). Dispatch data on all transported EMS patients from August 2001 to April 2002 were abstracted. The authors prospectively defined a low-acuity patient as one who received BLS-level care and defined a low-acuity dispatch code as one in which at least 90% of coded patients required only BLS care. For each dispatch code or code group, the authors calculated the fraction of patients who received BLS-level care. For each "A"-level (lowest category) dispatch code group, the fraction of patients receiving BLS-level care was also evaluated. RESULTS: A total of 19,332 calls met inclusion criteria and were categorized into 118 dispatch codes or code groups. Twenty-eight codes or code groups with 7,801 patients met the authors' definition of low acuity. Overall, 7,394 patients received only BLS care (94.8%, 95% confidence interval: 94.3%-95.3%). Analysis of "A"-level dispatch code groups found BLS use rates of 52.8% to 99.3%. CONCLUSIONS: Certain dispatch codes are associated with the delivery of BLS-level care, indicating identification of patients likely to be low acuity. These codes are not necessarily "A"-level dispatch codes, which are commonly considered to represent the lowest-acuity patients. Future studies are needed to prospectively validate that these codes do represent low-acuity patients.

Acute Disease↗

PubMed1990

Molecular heterogeneity of basal laminae: isoforms of laminin and collagen IV at the neuromuscular junction and elsewhere.

Laminin and collagen IV are components of most basal laminae (BLs). Recently, both have been shown to be products of multigene families. The A, B1, and B2 subunits of the laminin trimer are products of related genes, and the BL components merosin M and s-laminin are homologues of the A and B1 subunits, respectively. Similarly, five related collagen IV chains, alpha 1(IV)-alpha 5(IV), have been described. Here, we used a panel of subunit-specific antibodies to determine the distribution of the laminin and collagen IV isoforms in adult BLs. First, we compared synaptic and extrasynaptic portions of muscle fiber BL, in light of evidence that axonal and muscle membranes interact selectively with synaptic BL during neuromuscular regeneration. S-laminin, laminin A, and collagens alpha 3(IV) and alpha 4(IV) are greatly concentrated in synaptic BL; laminin B1 is apparently absent from synaptic BL; collagens alpha 1(IV) and alpha 2(IV) are less abundant in synaptic than extrasynaptic BL; and laminin B2 and merosin M are present at similar levels synaptically and extrasynaptically. These results reveal widespread differences between synaptic and extrasynaptic BL, and implicate several novel polypeptides as candidate mediators of neuromuscular interactions. Second, we widened our inquiry to assess the composition of several other BLs: endoneurial and perineurial BLs in intramuscular nerves, BLs associated with intramuscular vasculature, and glomerular and tubular BLs in kidney. Of eight BLs studied, at least seven have distinct compositions, and of the nine BL components tested, at least seven have distinct distributions. These results demonstrate a hitherto undescribed degree of heterogeneity among BLs.

Adolescent↗

PubMed1994

Coordinate defects in human histocompatibility leukocyte antigen class II expression and antigen presentation in bare lymphocyte syndrome.

The human immunodeficiency, type II bare lymphocyte syndrome (BLS), has been attributed to a defect in the transcription of class II histocompatibility genes. Immunocompetence, as assessed by functional exogenous antigen presentation, was not restored in immortalized B cells, derived from a BLS patient, after transfection with HLA-DR class II structural genes. Incubation of protein antigens, as well as infectious virus, with DR-transfected BLS cells failed to induce activation of antigen-specific helper T lymphocytes. Peptide antigens were presented by class II molecules displayed on BLS cells, although the conformation of these class II proteins was altered as indicated by epitope mapping. This defect in antigen presentation was independent of the specific class II DR allele transfected into BLS cells. Genetic complementation analysis has been used with BLS cells to demonstrate that the defect in class II gene transcription is linked to the absence of a trans-acting factor. Similarly, functional class II dimers were restored after in vitro fusion of cells derived from two distinct BLS complementation groups, implying that specific transcriptional control elements are shared by a gene critical for antigen presentation and genes encoding HLA class II antigens. Thus, two important functionally linked pathways of class II molecules, structural gene expression and antigen presentation, share a common regulatory pathway defective in BLS.

Alleles↗

PubMed2000

Cardiopulmonary resuscitation without ventilation.

Current resuscitation methods, although occasionally effective, rarely perform as well as initially anticipated. Some of the disappointment can be attributed to the difficulty of the task for many, including both professional and lay first responders. Significant attention has been paid recently to the need to simplify both the technique and the teaching of resuscitation. In considering simplification of the current resuscitation scheme, a logical start is an honest reappraisal of the importance and priorities of each of the once sacrosanct ABCs, specifically, establishment of an Airway, artificial Breathing (mouth-to-mouth breathing), and chest compressions for temporary Circulation. Experimental data continue to accumulate indicating that most important within this triad is circulation. Adequate oxygen exists within the blood during at least the first 10 mins of cardiac arrest. If circulation is provided to distribute such oxygen, no survival disadvantage results with chest compression-only basic life support (BLS) efforts. Even a totally occluded airway during the first 6 mins of cardiac arrest does not compromise survival if reasonable circulation is provided with chest compressions. Clinical studies support the same conclusion that what most influences survival in any BLS effort is circulation, not ventilation. Belgium investigators have shown equal survival rates among those treated with chest compressions plus ventilation and those who received chest compressions alone. Telephone dispatcher-guided BLS cardiopulmonary resuscitation (CPR) has likewise shown no survival disadvantage to chest compression-only CPR when compared with telephone-guided standard BLS CPR. Based on this reasoning, a new simplified BLS method has been proposed. "Staged" CPR consists of a strategy to initially teach laypersons a simplified approach to BLS, which requires only chest compressions and not mouth-to-mouth breathing. "Bronze" CPR, in which chest compression-only BLS is taught, was compared with the standard European Resuscitation Council BLS course for laypersons. Manikin "exit testing" at course completion has revealed significant advantages of the simplified approach compared with standard CPR courses for the lay public.

Animals↗

PubMed2002

A DNA vaccine encoding lumazine synthase from Brucella abortus induces protective immunity in BALB/c mice.

This study was conducted to evaluate the immunogenicity of the Brucella abortus lumazine synthase (BLS) gene cloned into the pcDNA3 plasmid, which is driven by the cytomegalovirus promoter. Injection of plasmid DNA carrying the BLS gene (pcDNA-BLS) into BALB/c mice elicited both humoral and cellular immune responses. Antibodies to the encoded BLS included immunoglobulin G1 (IgG1) IgG2a, IgG2b, IgG3, and IgM isotypes. Animals injected with pcDNA-BLS exhibited a dominance of IgG2a over IgG1. In addition, spleen cells from vaccinated animals produced interleukin-2 and gamma interferon but not IL-10 or IL-4 after in vitro stimulation with recombinant BLS (rBLS), suggesting the induction of a Th1 response. Protection was evaluated by comparing the levels of infection in the spleens of vaccinated mice challenged with B. abortus 544. Immunization with pcDNA-BLS- reduced the bacterial burden relative to those in the control groups. Mice immunized with rBLS produced a significant humoral response but did not show a specific cellular response or any protection from challenge. Altogether, these data suggest that pcDNA-BLS is a good immunogen for the production of humoral and cell-mediated responses in mice and is a candidate for use in future studies of vaccination against brucellosis.

Animals↗

PubMed1992

Role of stroma in oestrogen-induced epithelial proliferation.

To examine the role of stromal-epithelial interactions in the response of epithelial cells to oestrogens, tissue recombinations were prepared with epithelium (E) and stroma (S) from the vagina (V) and urinary bladder (BL), that is between oestrogen target tissues (VS and VE) and non-target tissues (BLS and BLE). Following 3 weeks of growth in intact female hosts, ovariectomy was performed and 1 week later the hosts subjected to various hormonal treatments. Whereas homotypic vaginal tissue recombinations (VS+VE) exhibited epithelial cornification and mucification (cycling), this activity was not observed in homotypic bladder recombinants (BLS+BLE) or in heterotypic tissue recombinants between vaginal and bladder tissues (VS+BLE and BLS+VE). In BLS+VE recombinants the epithelium remained atrophic and failed to respond to exogenous oestrogen alone or in combination with progesterone. This lack of hormonal responsiveness of vaginal epithelium was completely reconstituted when the epithelium of BLS+VE recombinants was recovered and reassociated with fresh vaginal stroma (VS). Examination of epithelial proliferative activity ([3H]thymidine labelling index) demonstrated a marked oestrogen-induced increase in epithelial proliferation in VS+VE recombinants. BLS+BLE recombinants were unresponsive to oestrogen as were recombinants composed of BLS+VE. However, when bladder epithelium was grown in association with vaginal stroma (VS+BLE) the epithelium exhibited an 8-fold oestrogen-induced increase in labelling index over oil-treated specimens. The lack of an oestrogen-induced proliferative response of vaginal epithelium in BLS+VE recombinants was reversed when the vaginal epithelium of these recombinants was recovered and reassociated with fresh vaginal stroma. These results indicate that the effects of oestrogen and progesterone on both epithelial differentiation and proliferation are critically dependent upon the appropriate stromal environment.

Animals↗

PubMed2026

Identification of Novel Sources and Genetic Mapping for Bacterial Leaf Streak Resistance in a Geographically Diverse Panel of Wheat.

Bacterial leaf streak (BLS), caused by Xanthomonas translucens pv. undulosa (Xtu), has recently emerged as a significant threat to wheat production in the Northern Great Plains region of the United States. Deploying resistant cultivars is an economical and practical method of controlling BLS. To identify novel sources of BLS resistance, we screened a set of 355 bread wheat landraces and cultivars representing global diversity for their response to BLS. A wide distribution of seedling responses against BLS was observed, with most genotypes displaying a moderately to highly susceptible response. Notably, we identified 5 resistant and 33 moderately resistant responses. A high-resolution genome-wide association study using 302,524 high-quality single-nucleotide polymorphisms (SNPs) identified 10 significant marker-trait associations (MTAs) on chromosomes 1A, 1D, 3B, 4A, and 5A corresponding to unique genomic regions associated with BLS resistance. Compared with previous studies, four of these genomic regions are likely novel. Of these, MTA 'scaffold15531_2782724' associated with q5A.1 was highly significant (-log10P = 9.39) and exhibited the highest SNP effect (0.35). An association on chromosome 3B validated a previously identified 3B quantitative trait locus (QTL) mapped at approximately 6 Mbp in the hard red spring wheat cultivar 'Boost', and the high-resolution mapping from our study further refined the interval for this QTL. Furthermore, the narrow haplotype blocks reported in this study could be valuable for fine mapping of important regions. The novel resistant sources, along with identified genomic loci and corresponding SNP markers from this study, would be helpful for wheat-breeding programs to enhance BLS resistance.[Formula: see text] Copyright © 2026 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.

BLS↗

PubMed1993

T cell development in a major histocompatibility complex class II-deficient patient.

In this report we show that the major histocompatibility complex (MHC) class II-negative thymus of a bare lymphocyte syndrome (BLS) patient contains a reduced CD4+ CD8- T cell population when compared to thymocytes derived from a MHC class II-expressing thymus. Of these CD4+ CD8- BLS thymocytes, approximately only one third co-expressed the CD3 antigen, moreover at a lower expression level when compared to control thymocytes. This suggests a partial maturation of the CD4+ CD8- T cells in the absence of MHC class II expression. Among the BLS thymocytes, CD4+ CD8+ thymocytes could easily be detected. Noteworthy, the number of CD4- CD8+ thymocytes was significantly increased. CD4+ CD8- T cells could also be found among the BLS peripheral blood mononuclear cells, albeit at reduced numbers. Despite the absence of peripheral MHC class II expression, the majority of these CD4+ CD8- T cells co-expressed the CD45RO marker. In the BLS patient, thymocytes as well as peripheral CD4+ CD8- T cells were not restricted in the use of the available T cell receptor (TcR) V gene family pool. However, the lack of detectable levels of thymic and peripheral MHC class II antigen expression in the BLS patient had altered the CD4-skewing patterns of TcR V gene families which were present in normal individuals. In conclusion, the lack of MHC class II expression in the BLS patient does not completely inhibit the CD4+ CD8- T cell development.

CD4 Antigens↗

PubMed1989

Bare lymphocyte syndrome: altered HLA class II expression in B cell lines derived from two patients.

Types II and III bare lymphocyte syndrome (BLS) are severe or lethal congenital immunodeficiencies characterized by defective cell surface expression of HLA class II antigens. We have analyzed by Southern and Northern blotting B-lymphoblastoid cell lines derived by Epstein-Barr virus (EBV) transformation from peripheral blood lymphocytes of two unrelated BLS patients and their families. While DNA analyses of both families showed no indication of rearrangement or alteration of HLA region genes, class II mRNAs were virtually absent in the patients' cell lines (BLS-1 and BLS-2). This is consistent with previous observations of different BLS patients and their families. An exception to the absence of class II mRNAs in BLS was the detection of low quantities of HLA-DQ alpha transcripts in the cell lines BLS-1. This finding provides further evidence that factors regulating HLA-DQ expression may differ from those governing expression of the other class II genes.

B-Lymphocytes↗

PubMed2005

[Evaluation of a continuous training program at Bichat hospital for in-hospital cardiac arrest resuscitation].

UNLABELLED: Management of in-hospital cardiac arrest is now considered as a hospital quality indicator. Such management actually requires training health care workers (HCWs) for basic life support (BLS). OBJECTIVE: To assess the usefulness and efficacy of a short mandatory BLS training course amongst general ward HCWs in a 1,200 bed teaching hospital. STUDY DESIGN: The in-hospital medical emergency team (MET) established a 45-min BLS training course comprising 10 goals for basic CPR and preparing for the arrival of the MET. Assessment was based on satisfaction questionnaires, cross-sectional evaluation of knowledge and skills of HCWs before and 1 year after the start of the training course. Efficacy of BLS performed on ward was assessed by the MET on scene. RESULTS: One year after, 68 training sessions had been fulfilled and 522 HCWs had been trained (46.27% of total HCWs). HCWs were satisfied with the teaching course. Instant retention of objectives was over 90%. Cross-sectional surveys showed an improvement of BLS knowledge and skills. The knowledge of initial clinical assessment remained low. Knowledge and skills were significantly higher amongst HCWs who had been trained than amongst those who had not. Unfortunately, general ward BLS performance showed no improvement. CONCLUSION: Short mandatory training courses are stimulating and well appreciated amongst HCWs. Although basic knowledge and skills improve dramatically, no improvement of on-scene BLS performance occurs.

Cardiopulmonary Resuscitation↗

PubMed2004

Light scattering and optical aberrations as objective parameters to predict visual deterioration in eyes with cataracts.

PURPOSE: To predict the visual deterioration of eyes with cortical (CC) or nuclear (NC) cataract from objective data on ocular higher-order aberration (HOA) and forward (FLS) and backward light scattering (BLS). SETTING: Osaka University Medical School, Osaka, Japan. METHODS: Twenty-two eyes with mild NC, 41 eyes with mild CC, and 11 normal eyes were examined. Higher-order aberrations were calculated with the Zernike polynomials up to the fourth order from the values obtained by wavefront analysis using the Hartmann-Shack aberrometer. Forward light scattering was calculated from the size of the aberrometer spot images for the central 4 mm, and backward light scattering (BLS) was calculated from the optical density of the Scheimpflug images. The relationship between the area under the log contrast sensitivity function (AULCSF) curve and HOAs, FLS, and BLS was examined. RESULTS: Area under the log contrast sensitivity function was moderately correlated with the HOAs, FLS, and BLS. Multiple linear regression analysis revealed that the AULCSF was predicted by the linear combination of these variables (R(2)=.484, P<.001). Area under the log contrast sensitivity was predicted by BLS and HOA (R(2)=.555) in the NC group and by FLS and HOAs (R(2)=.540) in the CC group. CONCLUSIONS: Loss of contrast sensitivity was predominantly due to BLS and HOA in eyes with NC and FLS and HOA in eyes with CC. Higher-order aberrations, FLS, and BLS, variables that are obtained objectively, can be used to predict quantitatively the visual deterioration in cataractous eyes.

Adult↗

PubMed2004

Learning effect of a novel interactive basic life support CD: the JUST system.

INTRODUCTION: Electronic interactive learning environments can enhance the learning experience and may prove beneficial in basic life support (BLS) training. As part of the European Union funded project "JUST-in-time health emergency interventions-training of non-professionals by virtual reality and advanced IT tools", an innovative interactive CD-ROM on BLS and other emergency medicine topics was developed. We hypothesised that individuals without previous BLS training could learn CPR techniques from this CD. METHODS: Sixty-two students were randomised into a group studying the JUST CD in a computer class room for up to 60 min, and a control group who did not receive any training (serving as a reference). CD users also completed a satisfaction questionnaire immediately after studying the CD. The BLS skills of both groups were assessed in a mock BLS scenario on a training manikin. BLS performance was video recorded and analysed. RESULTS: After studying the CD for a mean period of 42 min, users of the CD had better assessment skills and were more likely to show a positive helping attitude, but chest compression and breathing techniques were ineffective. Most users rated the CD as very good and a positive learning tool. CONCLUSION: Individuals without prior BLS training showed improved behaviour and assessment skills after exposure to the CD, but motor skill acquisition requires alternative learning strategies.

CD-ROM↗

PubMed2004

Single-rescuer cardiopulmonary resuscitation: 'two quick breaths'--an oxymoron.

The Guidelines 2000 for CPR and ECC recommend for single lay-rescuers performing basic life support, "two quick breaths followed by 15 chest compressions", repeated until professional help arrives. It is uncertain that this can actually be accomplished by the majority of lay rescuers. We evaluated 53 first-year medical students after completing BLS CPR training to determine if they could deliver the goal of 80 compressions per minute when following this AHA BLS recommendation. Alternatively, a simplified technique of uninterrupted chest compression (UCC) BLS CPR was also taught and compared with standard BLS CPR (STD). The mean number of chest compressions/minute delivered with AHA BLS CPR was only 43 +/- 1 immediately after initial training and 49 +/- 2 when tested 6 months later. Uninterrupted chest compression BLS resulted in 113 +/- 2 compressions/min delivered immediately after training and 91 +/- 4 six months later (STD versus UCC; P < 0.0001). The mean length of time needed to provide the two breaths during STD-CPR was 14 +/- 1 and 12 +/- 1s (immediately after first training and six months after training). For STD-CPR, the mean minute ventilation was poor immediately after initial training (3.3 +/- 0.3 l/min) and further declined (1.9 +/- 0.4 l/min) at 6 months (P = 0.003). For single rescuer basic cardiopulmonary resuscitation, motivated BLS CPR-trained medical students take nearly as long as previously reported for middle-aged lay individuals to deliver these "two quick breaths". The "Guidelines 2000" recommendation for "two quick breaths" is an oxymoron, as it averages more than 13s. New recommendations for single-rescuer CPR should be considered that emphasize uninterrupted chest compressions.

Adult↗

PubMed2006

Single rescuer cardiopulmonary resuscitation: can anyone perform to the guidelines 2000 recommendations?

BACKGROUND: The Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care recommend that for adult cardiac arrest the single rescuer performs "two quick breaths followed by 15 chest compressions." This cycle is continued until additional help arrives. Previous studies have shown that lay persons and medical students take 16 +/- 1 and 14 +/- 1 s, respectively, to perform these "two quick breaths." The purpose of this study was to determine the time required for trained professional paramedic firefighters to deliver these two breaths and the effects that any increase in the time it takes to perform rescue breathing would have on the number of chest compressions delivered during single rescuer BLS CPR. We hypothesized that trained professional rescuers would also take substantially longer then the Guidelines recommendation for delivering the two rescue breaths before every 15 compressions during simulated single rescuer BLS CPR. METHODS: Twenty-four paramedic firefighters currently certified to perform BLS CPR were evaluated for their ability to deliver the two recommended breaths within 4 s according to the AHA 2000 CPR Guidelines. Alternatively, a simplified technique of continuous chest compression BLS CPR (CCC) was also taught and compared with standard BLS CPR (STD). Without revealing the purpose of the study the paramedics were asked to perform single rescuer BLS CPR on a recording Resusci Anne while being videotaped. RESULTS: The mean length of time needed to provide the "two quick breaths" during STD-CPR was 10 +/- 1 s. The mean number of chest compressions/min delivered with AHA BLS CPR was only 44 +/- 2. Continuous chest compression CPR resulted in 88 +/- 5 compressions delivered per minute (STD versus CCC; p < 0.0001). CONCLUSIONS: Trained professional emergency rescue workers perform rescue breathing somewhat faster than lay rescuers or medical students, but still require two and one half times longer than recommended. The time required to perform these breaths significantly decreases the number of chest compressions delivered per minute. This may affect outcome as experimental studies have shown that more than 80 compressions delivered per minute are necessary for survival from prolonged cardiac arrest.

Allied Health Personnel↗

PubMed1995

Strengthening the in-hospital chain of survival with rapid defibrillation by first responders using automated external defibrillators: training and retention issues.

STUDY OBJECTIVE: To determine whether staff outside critical care areas who were proficient in basic life support (BLS) could be easily trained to use automated external defibrillators (AEDs) and whether they would retain these skills. DESIGN: Prospective, longitudinal cohort series. SETTING: Two university teaching hospitals. PARTICIPANTS: One hundred forty nurses who had previously learned BLS and constituted the staff from three medical/surgical nursing units from each study hospital. INTERVENTIONS: The nurses were taught how to use the Heartstart 1000s, a lightweight portable shock-advisory AED, in a 2-hour class with an instructor and manikin-to-student ratio of 1:5. The course emphasized hands-on practice of the BLS-AED algorithm on a computerized manikin. RESULTS: Using a similar scenario, each nurse was evaluated on the computerized manikin immediately after training (posttest). At 1 to 3, 4 to 6, and 7 to 9 months after the initial training, convenience samples of the cohort in three different groups were evaluated for retention. Satisfactory performance was defined as delivery of the first AED shock within 2 minutes of recognition of the arrest. At the posttest after training, 139 of 140 nurses (99%) demonstrated satisfactory performance. Of 77 nurses evaluated, 31 of 32 at 1 to 3 months, 18 of 18 at 4 to 6 months, and 24 of 27 at 7 to 9 months after initial training (95% overall) performed satisfactorily. CONCLUSION: As has been demonstrated with prehospital emergency personnel, nurses outside critical care areas who are proficient in BLS can easily learn and retain the knowledge and skills to use AEDs. Automated external defibrillation, a BLS skill, should be incorporated into BLS programs (BLS-AED) for all hospital personnel expected to respond to a patient in cardiac arrest, with rapid defibrillation taking priority over CPR.

Algorithms↗

PubMed2003

Knowledge of basic life support: a pilot study of the Turkish population by Baskent University in Ankara.

A total of 494 participants who were scheduled to take Baskent University's basic life support (BLS) training programme in 2001-02 were asked to complete a 25-item questionnaire prior to the course. The questionnaire investigated the demographic characteristics of the subjects, their knowledge of the theoretical and practical aspects of BLS, and personal experience and attitudes related to BLS. The 'non-medical group' included 179 laypersons, and the 'medical group' was composed of medical students (n=220), residents (n=69) and clinical nurses (n=26). One-hundred and twenty-six (25.5%) of the participants had an encounter with some form of medical emergency event in their past and 207 (41.9%) had taken a BLS course previously. The most commonly cited anxiety about performing BLS was the fear of further harming the victim (56.9%). Nine of the participants said they would not perform mouth-to-mouth ventilation (1.8%). Compared to the other participants, individuals with previous emergency experience, and those who had previous BLS training answered significantly more of the theoretical questions correctly. However, neither of these groups performed significantly better than the other participants in the practical questions (P>0.05 for both comparisons). Based on our findings, we recommend that BLS training for medical undergraduates, other medical personnel and laypersons be improved and standardized throughout Turkey.

Adult↗

PubMed2004

The use of basic life support skills by hospital staff; what skills should be taught?

OBJECTIVES: To assess the frequency of use of basic life support (BLS) skills among hospital staff of all disciplines. DESIGN: Postal survey of 9600 teaching hospital staff. PARTICIPANTS: 3807 respondents from all disciplines. MAIN OUTCOME MEASURES: Frequency of attendance, and the use of BLS skills, at patients with cardiopulmonary arrest. RESULTS: Most respondents reported having attended BLS training previously: 27.9% in the prior 6 months; 24.5% 6-12 months previously; 17.1% over 1 year ago; and 11.5% over 2 years ago. 17.1% reported never having received BLS training. 1.9% gave no valid response. Nearly half of all respondents had never attended a cardiopulmonary arrest. Among those most likely to have attended, i.e. qualified nursing and medical staff, the median frequency of attendance was less than once per year. Ventilation delivered using a pocket mask or bag-valve-mask was reported by 9.4 and 29.2% of respondents, respectively. Less than 7% reported the use of mouth-to-mouth ventilation. Only among qualified nursing (8.8%) and medical (24.7%) staff did this proportion exceed 5%. The vast majority of non-qualified nursing staff (84.9%), allied health professionals (86%) and administrative and clerical staff (98%) had used neither chest compressions nor mouth-to-mouth ventilation. CONCLUSIONS: Some skills taught during BLS training are used infrequently in the in-hospital situation. The likelihood of attendance at arrest events and of the use of BLS skills is extremely low among some identified professional groups. BLS skills teaching should be targeted at those groups most likely to actually use them in order to make best use of the resources available.

Administrative Personnel↗

PubMed1997

The teaching of cardiopulmonary resuscitation in schools in Hampshire.

In order to maximise the number of potential providers of cardiopulmonary resuscitation (CPR) in the community, it has been suggested that a programme of basic life support (BLS) training should be included within the school curriculum. Using a questionnaire sent to 275 schools in south east Hampshire (representing 71,716 pupils), we discovered that BLS was taught at only 26% of schools which replied. The age at which teaching commenced ranged from 7-16 years (mode = 10 years). We estimated that almost 5000 children might currently be trained annually in these schools. Consequently, each year approximately 40% of children in south east Hampshire schools might be exposed to BLS training. On average, schools offering BLS tuition were larger, had more teaching staff and employed a higher proportion of staff who were themselves BLS providers. The majority of BLS teaching was undertaken by school staff (50.9% of schools) and members of the Red Cross, The St. John Ambulance Brigade or statutory ambulance service (30.9%). One school utilised members of the local fire brigade. Only one school offering BLS training to its pupils did not have a staff member trained in CPR.

Adolescent↗