The efficacy of an ACLS training program for resuscitation from cardiac arrest in a rural community. Annals of Emergency Medicine, 23, 56-59

Department of Surgery, University of Arizona College of Medicine.
Annals of Emergency Medicine (Impact Factor: 4.68). 01/1994; 23(1):56-9. DOI: 10.1016/S0196-0644(94)70009-5
Source: PubMed


To determine whether an advanced cardiac life support (ACLS) course in a rural hospital will improve resuscitation success from cardiac arrest.
A retrospective case review of all patients in cardiac arrest during a 13-month period before and after the institution of an ACLS training program.
Emergency department of a 42-bed rural, community hospital in a community with no prehospital advanced life support or early defibrillation.
All patients in cardiac arrest were entered into the data base. Twenty-nine patients were included in the pre-ACLS period and 35 in the post-ACLS period. There were no significant differences in age, gender, initial rhythm, comorbid diseases, witnessed versus unwitnessed arrest, or total arrest time in the patients in the pre-ACLS period compared with those in the post-ACLS period.
ACLS provider training.
Patients in cardiac arrest who had ventricular fibrillation/tachycardia as their initial rhythm had significant improvement in resuscitation success compared with patients in ventricular fibrillation/tachycardia in the pre-ACLS period (six of 15 versus none of nine, P < .05). Out-of-hospital cardiac arrest resuscitation was more successful in the post-ACLS period than in the pre-ACLS period (five of 30 versus none of 25, P < .05). Overall, seven of 35 patients (20%) were resuscitated successfully in the post-ACLS period, with two patients surviving to hospital discharge. This was not significantly different than the two of 29 patients (7%) resuscitated in the pre-ACLS period, with one patient surviving to discharge.
The institution of an ACLS-provider course in a rural community hospital was associated with improvement in initial resuscitation for patients with ventricular fibrillation/tachycardia and out-of-hospital arrest.

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    • "The main point, however, is that only few studies explicitly tested the transfer into clinical practice (Camp et al. 1997 ; Makker et al. 1995 ; Pottle and Brant 2000 ; Sanders et al. 1994 ), although enhancing clinical practice and patient safety is the ultimate purpose of simulation learning in medicine (Perkins 2007 ). "
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    ABSTRACT: An overview is presented of the strengths and limitations of simulation learning, with a particular focus on simulation learning in medicine and health care. We present what simulation learning is about and what the main components of simulations are. The most important theoretical approaches are reviewed which were developed in order to explain why simulation learning is effective. The most prominent best-practice examples of simulation learning applications are presented, and a short overview on research fi ndings concerning simulation learning is given.
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    • "A Brazilian study by Moretti et al. also shows a significant increase in ROSC from 27.1% to 43.4% even on inclusion of a single ACLS-trained personnel in the resuscitation team.[12] Another study by Sanders’ also reported improved resuscitation success in a rural community hospital after an ACLS provider course.[13] A study by Borimnejad et al. also showed that initial survival after CPR improved significantly with the CPR-trained emergency team (18.4–30%).[6] "
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    ABSTRACT: Guidelines on performing cardiopulmonary resuscitation (CPR) have been published from time to time, and formal training programs are conducted based on these guidelines. Very few data are available in world literature highlighting the impact of these trainings on CPR outcome. The aim of our study was to evaluate the impact of the American Heart Association (AHA)-certified basic life support (BLS) and advanced cardiac life support (ACLS) provider course on the outcomes of CPR in our hospital. An AHA-certified BLS and ACLS provider training programme was conducted in our hospital in the first week of October 2009, in which all doctors in the code blue team and intensive care units were given training. The retrospective study was performed over an 18-month period. All in-hospital adult cardiac arrest victims in the pre-BLS/ACLS training period (January 2009 to September 2009) and the post-BLS/ACLS training period (October 2009 to June 2010) were included in the study. We compared the outcomes of CPR between these two study periods. There were a total of 627 in-hospital cardiac arrests, 284 during the pre-BLS/ACLS training period and 343 during the post-BLS/ACLS training period. In the pre-BLS/ACLS training period, 52 patients (18.3%) had return of spontaneous circulation, compared with 97 patients (28.3%) in the post-BLS/ACLS training period (P < 0.005). Survival to hospital discharge was also significantly higher in the post-BLS/ACLS training period (67 patients, 69.1%) than in the pre-BLS/ACLS training period (12 patients, 23.1%) (P < 0.0001). Formal certified BLS and ACLS training of healthcare professionals leads to definitive improvement in the outcome of CPR.
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    • "l CME / CPD was effective in increasing rural GPs ' knowledge and skills in the management of common palliative symptoms ( Reymond et al . 2005 ) . Two American studies described local ACLS training associated with improved initial resuscitation or survival rates in rural community hospitals or out - of - hospital cardiac arrests ( Birnbaum 1994 ; Sanders et al . 1994 ) . In developing countries , rural CME / CPD outreach has been effective in enhancing rural physician practice . A recent study of a rural CME / CPD outreach program on HIV / STI prevention and treatment in rural China found that rural physicians reported increased knowledge and improved patient outcomes including higher rates of HIV t"
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    ABSTRACT: Recruitment and retention of rural physicians is vital for rural health care. A key deterrent to rural practice has been identified as professional isolation and access to continuing medical education/continuing professional development (CME/CPD). The purpose of this article is to review and synthesize key themes from the literature related to CME/CPD and rural physicians to facilitate CME/CPD planning. A search of the peer-reviewed English language literature and a review of relevant grey literature (e.g., reports, conference proceedings) was conducted. There is robust evidence demonstrating that the CME/CPD needs of rural physicians are unique. Promising practices in regional CME/CPD outreach and advanced procedural skills training and other up-skilling areas have been reported. Distance learning initiatives have been particularly helpful in increasing access to CME/CPD. The quality of evidence supporting the overall effect of these different strategies on recruitment and retention is variable. Supporting the professional careers of rural physicians requires the provision of integrated educational programs that focus on specific information and skills. Future research should examine the linkage between enhanced CME/CPD access and its effect on factors related to retention of physicians in rural communities. A proposed framework is described to aid in developing CME/CPD for rural practitioners.
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