(1) Background: This study aimed to evaluate the effectiveness of using a pre-existing video on CPR to support preclinical resuscitation education for medical students; (2) Methods: In total, 129 students selected to learn CPR using a pre-existing YouTube video or the conventional screencast video by their university faculties. All students responded to the pre- and post-training multiple-choice questionnaire on the basic knowledge of CPR, and, based on their responses, an analysis of covariance (ANCOVA) was conducted to assess the comparability of effectiveness across learning modalities. (3) Results: Among the students, 49 (38.0%) students selected the YouTube video to learn about CPR and were treated as the intervention group. The mean pre-test scores and post-test scores of the YouTube and the instructor’s video groups were 6.43 and 6.64, and 9.06 and 9.09, respectively. After controlling for the pre-test score effects, the results of ANCOVA did not show statistically significant differences between groups (p = 0.927), indicating comparable performance between groups that used YouTube and the instructor’s videos. (4) Conclusion: Utilizing YouTube videos is a useful teaching strategy for teaching CPR knowledge, which would reduce the burden on faculty of creating screencast lecture videos for online learning on resuscitation.
To determine whether ketamine use for tracheal intubation, compared to other sedative use, is associated with a lower risk of post-intubation hypotension in hemodynamically-unstable patients in the emergency department (ED), we analyzed the data of a prospective, multicenter, observational study—the second Japanese Emergency Airway Network (JEAN-2) Study—from February 2012 through November 2017. The current analysis included adult non-cardiac-arrest ED patients with a pre-intubation shock index of ≥0.9. The primary exposure was ketamine use as a sedative for intubation, with midazolam or propofol use as the reference. The primary outcome was post-intubation hypotension. A total of 977 patients was included in the current analysis. Overall, 24% of patients developed post-intubation hypotension. The ketamine group had a lower risk of post-intubation hypotension compared to the reference group (15% vs 29%, unadjusted odds ratio [OR] 0.45 [95% CI 0.31–0.66] p < 0.001). This association remained significant in the multivariable analysis (adjusted OR 0.43 [95% CI 0.28–0.64] p < 0.001). Likewise, in the propensity-score matching analysis, the patients with ketamine use also had a significantly lower risk of post-intubation hypotension (OR 0.47 [95% CI, 0.31–0.71] P < 0.001). Our observations support ketamine use as a safe sedative agent for intubation in hemodynamically-unstable patients in the ED.
The mortality of the bath-related cardiac arrest (BRCA) is extremely high. While air temperature is reported to be associated with the BRCA occurrence, it is unclear whether daily minimum temperatures or the difference between maximum and minimum air temperatures influences BRCA occurrence the most.
A retrospective cohort study of adult patients was conducted between January 2015 and February 2020 at Hirosaki University Hospital Emergency Department. The following data were collected: age, sex, day of cardiac arrest event, location of the event, initial cardiac rhythm, presence of return of spontaneous circulation, and overall mortality (status at 1 month after cardiac arrest event). Based on the day of the event and the location in which the event occurred, daily minimum and maximum temperatures were obtained from the Japan Meteorological Agency database.
A total of 215 eligible cardiac arrest cases were identified, including 25 cases of BRCA. Comparing BRCA and non-BRCA, initial shockable cardiac rhythm (4.0% vs 44.7%), presence of return of spontaneous circulation (8.0% vs 34.7%), and overall mortality (96.0% vs 71.6%) differed significantly (
P
< .05 each). Daily minimum and maximum temperatures showed no significant relationships with BRCA or non-BRCA. Daily minimum temperature was a risk factor of BRCA occurrence after adjusting for age and temperature difference (risk ratio, 0.937; 95% confidence interval, 0.882–0.995).
Daily minimum temperature represents a potential risk factor for BRCA occurrence.
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