Ileana Lulic

Mobile phone in the Chain of Survival

Each day, approximately 750 Europeans suffer from an out-of-hospital cardiac arrest, which presents a large public health problem. In such circumstances, rapid activation of the Chain of Survival with effective and continuous realisation of its four links can have a large impact on survival. Mobile phones, which have become the most ubiquitous piece of modern technology, possess a strong potential to strengthen each link of the chain. Initially, they can be used to educate rescuers about appropriate actions performed in each step of the resuscitation process. However, mobile phones can also assume a more active role of helping the rescuer in a real medical emergency. They have a potential to allow for a faster and superior emergency medical services contact, assure a higher quality of cardiopulmonary resuscitation (CPR) and quicker retrieval of an automated external defibrillator and facilitate a finer post-resuscitation care through telemedical and clinical decision support systems. Smartphones, mobile phones with advanced computing abilities and connectivity, should be considered as medical devices, and their use, among lay rescuers and medical professionals in cardiovascular emergencies, further investigated and strongly encouraged.

Education first: Content analysis of #erc15prague tweets.

Twitter, as one of the most prominent social media has been idely used to cover conferences of a number of medical fields. ince no data is available on the use of Twitter in the context of a esuscitation meeting, we focused on the Twitter activity about the esuscitation 2015 – The Guidelines Congress. We downloaded 2149 tweets containing hashtag #erc15prague the official keyword) and posted between October 28 and ovember 1, 2015. The analyses were performed using the R proramming language,1 while the tweet’s subjects were categorised ased on a previously published sheme.2 The aforementioned tweets were created by 451 user accounts ith one third being original content (n = 714, by 114 users), while he others were retweets. The most popular tweet (69 retweets nd 30 favourites) was by @ANDYL0CKY: “Without good education verything else would be futile #erc15prague”. Following the exploratory analysis, our first text mining step as to create a word cloud of the most frequent words. As seen n Fig. 1A, quite prominent words were, e.g. “cpr”, “competition”,

Analysis of out-of-hospital cardiac arrest in Croatia - survival, bystander cardiopulmonary resuscitation, and impact of physician's experience on cardiac arrest management : a single center observational study

Aim To analyze the initial rhythm, bystander cardiopulmonary resuscitation (CPR) rate, and survival after out-of-hospital cardiac arrests (OHCA) in Varaždin County (Croatia), and to investigate whether physician’s inexperience in emergency medical services (EMS) has an impact on resuscitation management. Methods We reviewed clinical records and Revised Utstein cardiac arrest forms of all out-of-hospital resuscitations performed by EMS Varaždin (EMSVz), Croatia, from 2007-2013. To analyze the impact of physician’s inexperience in EMS (<1 year in EMS) on resuscitation management, we assessed physician’s turnover in EMSVz, as well as OHCA survival, airway management, and adherence to resuscitation guidelines in regard to physician’s EMS experience. Results Of 276 patients (median age 68 years, interquartile range [IQR] 16; 198 male; 37% ventricular fibrillation/ventricular tachycardia, bystander CPR rate 25%), 80 were transferred to hospital and 39 were discharged (median survival after discharge 23 months, IQR 46 months). During the 7-year study period, 29 newly graduated physicians inexperienced in EMS started to work in EMSVz (performing 77 resuscitations), while 48% of them stayed for less than one year. Airway management depended on physician’s EMS experience (P = 0.018): inexperienced physicians performed bag-valve-mask ventilation (BMV) more than the experienced, with no impact on survival rate. Physician’s EMS experience did not influence adherence to resuscitation guidelines (P = 0.668), survival to hospital discharge (P = 0.791), or survival time (P = 0.405). Conclusion OHCA survival rate of EMSVz resuscitations was higher than in Europe, but bystander CPR needs to be improved. Compared to experienced physicians, inexperienced physicians preferred BMV over intubation, but with similar adherence to resuscitation guidelines and survival after OHCA.

A new method of investigating the ergonomics of visual cardiopulmonary resuscitation (CPR) feedback delivery.

The latest European Resuscitation Council guidelines put great mphasis on the importance of delivering quality chest compresions (CC) during CPR in order to improve outcomes of cardiac rrest.1 However, the quality of CC has been found to be subopimal, even when performed by healthcare professionals adhering o older CPR guidelines, which mandated shallower and slower ompressions.2 For this reason, the latest guidelines encourage the se of devices delivering prompts and real-time feedback to resuers regarding the quality of CC.1 Such audiovisual CPR feedback an be incorporated into automatic external defibrillators, manual onitor-defibrillators, standalone devices, and even commercial evices like smartphones.3 Studies have demonstrated that the se of feedback influences CPR performance, in a way that it more losely conforms to recommended guidelines.4 Still, very few studes have investigated and compared different modes of delivering isual CPR feedback. We know little about the differences between PR feedback devices, rescuers’ preferences, as well as the impact n rescuers’ fatigue, pain or injuries potentially introduced by their sage. To simulate various devices offering visual CPR feedback, and nvestigate their ergonomics in diverse scenarios, we devised simple and versatile method based on a smartphone and a ablet computer (Fig. 1). We utilized a Laerdal Resusci Anne®