ContextCardiopulmonary resuscitation (CPR) guidelines recommend target values
for compressions, ventilations, and CPR-free intervals allowed for rhythm
analysis and defibrillation. There is little information on adherence to these
guidelines during advanced cardiac life support in the field.ObjectiveTo measure the quality of out-of-hospital CPR performed by ambulance
personnel, as measured by adherence to CPR guidelines.Design and SettingCase series of 176 adult patients with out-of-hospital cardiac arrest
treated by paramedics and nurse anesthetists in Stockholm, Sweden, London,
England, and Akershus, Norway, between March 2002 and October 2003. The defibrillators
recorded chest compressions via a sternal pad fitted with an accelerometer
and ventilations by changes in thoracic impedance between the defibrillator
pads, in addition to standard event and electrocardiographic recordings.Main Outcome MeasureAdherence to international guidelines for CPR.ResultsChest compressions were not given 48% (95% CI, 45%-51%) of the time
without spontaneous circulation; this percentage was 38% (95% CI, 36%-41%)
when subtracting the time necessary for electrocardiographic analysis and
defibrillation. Combining these data with a mean compression rate of 121/min
(95% CI, 118-124/min) when compressions were given resulted in a mean compression
rate of 64/min (95% CI, 61-67/min). Mean compression depth was 34 mm (95%
CI, 33-35 mm), 28% (95% CI, 24%-32%) of the compressions had a depth of 38
mm to 51 mm (guidelines recommendation), and the compression part of the duty
cycle was 42% (95% CI, 41%-42%). A mean of 11 (95% CI, 11-12) ventilations
were given per minute. Sixty-one patients (35%) had return of spontaneous
circulation, and 5 of 6 patients discharged alive from the hospital had normal
neurological outcomes.ConclusionsIn this study of CPR during out-of-hospital cardiac arrest, chest compressions
were not delivered half of the time, and most compressions were too shallow.
Electrocardiographic analysis and defibrillation accounted for only small
parts of intervals without chest compressions.

https://jamanetwork.com/journals/jama/articlepdf/200195/joc42116.pdf

Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest

Christensen, R. (2002), Plane Answers to Complex Questions: The Theory of Linear Models (3rd ed.), New York: Springer-Verlag. Crocker, D. C. (1980), Review of Linear Regression Analysis, by G. A. F. Seber, Technometrics, 22, 130. Datta, B. N. (1995), Numerical Linear Algebra and Applications, Paci c Grove, CA: Brooks/Cole. Draper, N. R. (2002), “Applied Regression Analysis Bibliography Update 2000–2001,” Communications in Statistics: Theory and Methods, 2051– 2075. Golub, G. H., and Van Loan, C. F. (1996), Matrix Computations (3rd ed.), Baltimore, MD: Johns Hopkins University Press. Graybill, F. A. (2000), Theory and Application of the Linear Model, Paci c Grove, CA: Brooks/Cole. Hocking, R. R. (2003), Methods and Applications of Linear Models: Regression and the Analysis of Variance (2nd ed.), New York: Wiley. Porat, B. (1993), Digital Processing of Random Signals, Englewood Cliffs, NJ: Prentice-Hall. Ravishanker, N., and Dey, D. K. (2002), A First Course in Linear Model Theory, Boca Raton, FL: Chapman and Hall/CRC. White, H. (1984), Asymptotic Theory for Econometricians, Orlando, FL: Academic Press.

Generalized Estimating Equations

http://degreesofclarity.com/emsbasics/library/kramer-johansen%20-%20Quality%20of%20out-of-hospital%20cardiopulmonary%20resuscitation%20with%20real%20time%20automated%20feedback-%20a%20prospective%20interventional%20study.pdf

Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: a prospective interventional study.

Purpose. The purpose of this study was to identify and analyze research into accreditation and accreditation processes. Data sources. A multi-method, systematic review of the accreditation literature was conducted from March to May 2007. The search identified articles researching accreditation. Discussion or commentary pieces were excluded. Study selection. From the initial identification of over 3000 abstracts, 66 studies that met the search criteria by empirically examining accreditation were selected. Data extraction and results of data synthesis. The 66 studies were retrieved and analyzed. The results, examining the impact or effectiveness of accreditation, were classified into 10 categories: professions’ attitudes to accreditation, promote change, organizational impact, financial impact, quality measures, program assessment, consumer views or patient satisfaction, public disclosure, professional development and surveyor issues. Results. The analysis reveals a complex picture. In two categories consistent findings were recorded: promote change and professional development. Inconsistent findings were identified in five categories: professions’ attitudes to accreditation, organizational impact, financial impact, quality measures and program assessment. The remaining three categories—consumer views or patient satisfaction, public disclosure and surveyor issues—did not have sufficient studies to draw any conclusion. The search identified a number of national health care accreditation organizations engaged in research activities. Conclusion. The health care accreditation industry appears to be purposefully moving towards constructing the evidence to ground our understanding of accreditation.

/pdf/health-sector-accreditation-research-a-systematic-review-qmeo6djyv0.pdf

Health sector accreditation research: a systematic review.

http://cdn.laerdal.com/downloads/f2644/ReviewCPRdevices06_09.pdf

The use of CPR feedback/prompt devices during training and CPR performance: A systematic review.

Quality of BLS decreases with increasing resuscitation complexity

Physician medical direction and clinical performance at an established emergency medical services system.

Differences in Paramedic Fatigue before and after Changing from a 24-hour to an 8-hour Shift Schedule: A Case Report.

This straightforward EMT-Basic textbook follows the U.S. Department of Transportation National Standard Curriculum (NSC) for the EMT-Basic closer than any other textbook. The long-awaited second edition includes four new chapters, as well as supplemental information requested by instructors. The clear, easy-to-read writing style and visually engaging design make this text a favorite among EMT-Basic students. Plus, an all-new companion DVD, featuring all of the skill sequences contained in the textbook, is included. Instructor resources are available.

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Feasibility of sternal intraosseous application by EMT-Basic students

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