Federico Semeraro

Publications

• 2.71

  Impact points

  Motion detection technology as a tool for cardiopulmonary resuscitation (CPR) quality improvement.

  Federico Semeraro, Luca Marchetti, Antonio Frisoli, Erga L Cerchiari, Gavin D Perkins

  Resuscitation. 09/2011; 83(1):e11-2.

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• 2.71

  Impact points

  iCPR: a new application of high-quality cardiopulmonary resuscitation training.

  Federico Semeraro, Floriana Taggi, Gaetano Tammaro, Guglielmo Imbriaco, Luca Marchetti, Erga L Cerchiari

  Resuscitation. 01/2011; 82(4):436-41.

  The present study evaluates a new CPR feedback application for the iPhone (iCPR) designed to improve chest compression performance tested in a cardiac arrest simulation to evaluate performance and acceptance by healthcare professionals and lay people. We built an application specifically dedicated t... [more] The present study evaluates a new CPR feedback application for the iPhone (iCPR) designed to improve chest compression performance tested in a cardiac arrest simulation to evaluate performance and acceptance by healthcare professionals and lay people. We built an application specifically dedicated to self-directed CPR training through a tutorial that includes a simple feedback module to guide training in order to improve the quality of chest compressions. We tested it in a sample of 50 users to evaluate the effect of iCPR on performance and it is acceptance. The participants were randomly assigned to one of the study groups and were asked to perform a trial of 2 min of chest compressions (CC), to answer a predefined set of questions and then to perform two more minutes of CC. The first group performing the sequence of CC with iCPR - questions - CC without feedback, and the second the sequence CC without feedback - questions CC with iCPR. The mean compression rate was 101±2.8 min(-1) when CC were performed with iCPR and 107.8±20.5 min(-1) when performed without iCPR (p<0.01). Overall, the participants considered iCPR useful to maintain CC at the desired rate of 100 compressions per minute. The iCPR feedback tool was able to significantly improve the performance of chest compressions in terms of the compression rate in a simulated cardiac arrest scenario. The participants also believed that iCPR helped them to achieve the correct chest compression rate and most users found this device easy to use.

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• 2.71

  Impact points

  Virtual reality enhanced mannequin (VREM) that is well received by resuscitation experts.

  Federico Semeraro, Antonio Frisoli, Massimo Bergamasco, Erga L Cerchiari

  Resuscitation. 03/2009;

  SUMMARY: The objective of this study was to test acceptance of, and interest in, a newly developed prototype of virtual reality enhanced mannequin (VREM) on a sample of congress attendees who volunteered to participate in the evaluation session and to respond to a specifically designed questionnaire... [more] SUMMARY: The objective of this study was to test acceptance of, and interest in, a newly developed prototype of virtual reality enhanced mannequin (VREM) on a sample of congress attendees who volunteered to participate in the evaluation session and to respond to a specifically designed questionnaire. METHODS: A commercial Laerdal HeartSim 4000 mannequin was developed to integrate virtual reality (VR) technologies with specially developed virtual reality software to increase the immersive perception of emergency scenarios. To evaluate the acceptance of a virtual reality enhanced mannequin (VREM), we presented it to a sample of 39 possible users. Each evaluation session involved one trainee and two instructors with a standardized procedure and scenario: the operator was invited by the instructor to wear the data-gloves and the head mounted display and was briefly introduced to the scope of the simulation. The instructor helped the operator familiarize himself with the environment. After the patient's collapse, the operator was asked to check the patient's clinical conditions and start CPR. Finally, the patient started to recover signs of circulation and the evaluation session was concluded. Each participant was then asked to respond to a questionnaire designed to explore the trainee's perception in the areas of user-friendliness, realism, and interaction/immersion. RESULTS: Overall, the evaluation of the system was very positive, as was the feeling of immersion and realism of the environment and simulation. Overall, 84.6% of the participants judged the virtual reality experience as interesting and believed that its development could be very useful for healthcare training. CONCLUSIONS: The prototype of the virtual reality enhanced mannequin was well-liked, without interfence by interaction devices, and deserves full technological development and validation in emergency medical training.

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• Simulazione: istruzioni per l'uso. Passato, presente e futuro della simulazione in medicina.

  Federico Semeraro

  01/2007;

• Post-Resuscitation Care

  Erga Cerchiari, Federico Semeraro

  12/2006: pages 304;

  ISBN: 9781841845784
• 2.71

  Impact points

  Retention of CPR performance in anaesthetists.

  Federico Semeraro, Luciano Signore, Erga L Cerchiari

  Resuscitation. 01/2006; 68(1):101-8.

  The objective of this study was to evaluate retention of ALS knowledge and performance among anaesthesiologists, who, in Italy, respond to in-hospital emergencies as team leaders. METHODS: 47 anaesthesiologists (23 consultants and 24 residents) were invited at one weeks notice to attend a re-evaluat... [more] The objective of this study was to evaluate retention of ALS knowledge and performance among anaesthesiologists, who, in Italy, respond to in-hospital emergencies as team leaders. METHODS: 47 anaesthesiologists (23 consultants and 24 residents) were invited at one weeks notice to attend a re-evaluation session, 6 months after successful completion of an ERC ALS course. Knowledge retention was assessed by a multiple choice question test, and skills and management by evaluation of performance as team leader in one of the six standardized CAStest scenarios. During the performance, the timeliness of first defibrillation, completion of the three shock sequence, adrenaline (epinephrine) administration and intubation were recorded. Results were compared between consultants and residents. RESULTS: Compared to the results at the end of the ALS course, the percent of correct answers to the multiple choice question test decreased from 85.89 +/- 5.28% to 79.45 +/- 6.62% (P < 0.001), the number of candidates achieving a pass performance decreased from 47/47 to 30/47 (P < 0.001). Time to first defibrillation was 73.38 +/- 18.72 s, time for completion of the third defibrillation was 113.04 +/- 35.58 s and subsequent ALS interventions were very delayed or forgotten. Comparison between consultants and residents showed that consultants retained knowledge information better, skills decreased comparably in both groups and residents performed tasks faster. CONCLUSIONS: The significant decay of ALS skills 6 months post-ALS recorded among anaesthesiologists supports the need for periodical reinforcement during intervals before recertification.

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• 4.10

  Impact points

  High levels of morphine-6-glucuronide in street heroin addicts.

  Letizia Antonilli, Federico Semeraro, Carmen Suriano, Luciano Signore, Paolo Nencini

  Psychopharmacology. 12/2003; 170(2):200-4.

  RATIONALE: In the body, heroin is rapidly transformed to 6-acetylmorphine (6-AM) and then to morphine, that in turn is mainly metabolized to morphine-3-glucuronide (M3G) and, at lesser extent, to morphine-6-glucuronide (M6G). Unlike M3G, M6G is a potent opioid agonist. Intravenous heroin abusers (IH... [more] RATIONALE: In the body, heroin is rapidly transformed to 6-acetylmorphine (6-AM) and then to morphine, that in turn is mainly metabolized to morphine-3-glucuronide (M3G) and, at lesser extent, to morphine-6-glucuronide (M6G). Unlike M3G, M6G is a potent opioid agonist. Intravenous heroin abusers (IHU) are exposed to a wide array of drugs and contaminants that might affect glucuronidation. OBJECTIVES: We assessed plasma and urine concentrations of M3G and M6G in four groups of subjects: the first two included long-term IHU either exposed to street heroin ( n=8) or receiving a single IV injection of morphine ( n=4), while the other two groups included non-IHU patients receiving acute IV ( n=8) or chronic oral ( n=6) administrations of morphine. METHODS: After solid phase extraction plasma and urine concentrations of morphine metabolites were determined by HPLC analyses. RESULTS: M3G accounted for the greater part of morphine glucuronides detected in body fluids of non-IHU patients treated with morphine. This pattern of metabolism remained stable across 15 days of oral administration of incremental doses of morphine. In contrast, the two groups of IHU (street heroin taking or morphine-treated subjects) showed a reduction of blood and urine M3G concentrations in favor of M6G. Consequently, M6G/M3G ratio was significantly higher in the two IHU groups in comparison with the non-IHU groups. CONCLUSIONS: Chronic exposure to street heroin causes a relative increase in concentrations of the active metabolite, M6G. Since the pattern of M6G action seems closer to heroin than to morphine, the increased synthesis of M6G observed in IHU may prolong the narrow window of heroin effects.
• 5.17

  Impact points

  Successful treatment of a complicated case of neuroleptic malignant syndrome.

  A Lappa, M Podestà, O Capelli, A Castagna, G Di Placido, D Alampi, F Semeraro

  Intensive care medicine. 08/2002; 28(7):976-7.

  Neuroleptic malignant syndrome (NMS) is a life-threatening reaction often related to neuroleptic drugs, characterized by rigidity, hyperthermia, altered consciousness, and fluctuating blood pressure. We present a case of NMS that followed a doubled oral dose of a drug compound: tranylcypromine sulfa... [more] Neuroleptic malignant syndrome (NMS) is a life-threatening reaction often related to neuroleptic drugs, characterized by rigidity, hyperthermia, altered consciousness, and fluctuating blood pressure. We present a case of NMS that followed a doubled oral dose of a drug compound: tranylcypromine sulfate, a monoamine oxidase inhibitor, and trifluoperazine (neuroleptic). The case was complicated by rhabdomyolisis and disseminated intravascular coagulation. It was treated successfully with dantrolene sodium and generous fluid therapy without using neuromuscular blocking agents or dopamine agonists.