Checking the carotid pulse check: diagnostic accuracy of first responders in patients with and without a pulse

Eberle, Balthasar; Dick, W.; Schneider, Thomas; Wisser, G.; Doetsch, S.; Tzanova, Irene

doi:10.1016/s0300-9572(96)01016-7

Cited by 324 publications

(130 citation statements)

References 15 publications

Supporting

Mentioning

120

Contrasting

Unclassified

Order By: Relevance

“…114 But even health care professionals cannot rapidly and accurately determine if a victim is breathing or if a pulse is present. [115][116][117][118] Laymen have even more difficulty in verifying whether there is a pulse. 119 Laymen should not check for the absence of a pulse before initiating CPR.…”

Section: Ii-3 Inform Trainees About What To Expect During Resuscitatimentioning

confidence: 99%

Understanding and improving low bystander CPR rates: a systematic review of the literature

Vaillancourt

Stiell

Wells

2008

CJEM

139

107

View full text Add to dashboard Cite

Objectives: Cardiopulmonary resuscitation (CPR) is a crucial yet weak link in the chain of survival for out-of-hospital cardiac arrest. We sought to understand the determinants of bystander CPR and the factors associated with successful training. Methods: For this systematic review, we searched 11 electronic databases, 1 trial registry and 9 scientific websites. We performed hand searches and contacted 6 content experts. We reviewed without restriction all communications pertaining to who should learn CPR, what should be taught, when to repeat training, where to give CPR instructions and why people lack the motivation to learn and perform CPR. We used standardized forms to review papers for inclusion, quality and data extraction. We grouped publications by category and classified recommendations using a standardized classification system that was based on level of evidence. Results: We reviewed 2409 articles and selected 411 for complete evaluation. We included 252 of the 411 papers in this systematic review. Differences in their study design precluded a meta-analysis. We classified 22 recommendations; those with the highest scores were 1) 9-1-1 dispatchassisted CPR instructions, 2) teaching CPR to family members of cardiac patients, 3) Braslow's selftraining video, 4) maximizing time spent using manikins and 5) teaching the concepts of ambiguity and diffusion of responsibility. Recommendations not supported by evidence include mass training events, pulse taking prior to CPR by laymen and CPR using chest compressions alone. Conclusion:We evaluated and classified the potential impact of interventions that have been proposed to improve bystander CPR rates. Our results may help communities design interventions to improve their bystander CPR rates. RÉSUMÉ Objectifs : La réanimation cardio-respiratoire (RCR) est un maillon essentiel, quoique faible, de la chaîne de survie lors de la survenue d'un arrêt cardiaque hors de l'hôpital. Nous avons cherché à comprendre les déterminants du taux de passants pouvant administrer la RCR et les facteurs liés à une formation efficace. Méthodes : Dans le cadre de cette revue systématique, nous avons analysé 11 bases de données électroniques, un registre d'essais cliniques et neuf sites Web scientifiques. Nous avons réalisé des recherches manuelles et communiqué avec six experts du contenu. Nous avons examiné sans restriction toutes les communications portant sur les questions suivantes : qui devrait apprendre la RCR, ce qu'on devrait enseigner, QUAND la formation devrait être renouvelée, où les cours de

show abstract

Section: Ii-3 Inform Trainees About What To Expect During Resuscitatimentioning

confidence: 99%

Understanding and improving low bystander CPR rates: a systematic review of the literature

Vaillancourt

Stiell

Wells

2008

CJEM

139

107

View full text Add to dashboard Cite

show abstract

“…Eberle et al called the value of even this established method into question when they reported that 45% of emergency medical technicians and paramedics failed to recognize a carotid pulse in anesthetized patients. 86 They questioned whether overreliance on unrealistic manikins might work against the acquisition of clinical skills and increase error by training with inappropriate feedback. Other procedural uses of manikin simulators in EM include testing houseofficer and attending physician skill at auscultating cardiac murmurs and teaching the skills of cricothyroidotomy and thoracotomy.…”

Section: Teaching About Errormentioning

confidence: 99%

Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Schenkel

2000

Academic Emergency Medicine

130

View full text Add to dashboard Cite

Abstract. An estimated 108,000 people die each year from potentially preventable iatrogenic injury. One in 50 hospitalized patients experiences a preventable adverse event. Up to 3% of these injuries and events take place in emergency departments. With long and detailed training, morbidity and mortality conferences, and an emphasis on practitioner responsibility, medicine has traditionally faced the challenges of medical error and patient safety through an approach focused almost exclusively on individual practitioners. Yet no matter how well trained and how careful health care providers are, individuals will make mistakes because they are human. In general medicine, the study of adverse drug events has led the way to new methods of error detection and error prevention. A combination of chart reviews, incident logs, observation, and peer solicitation has provided a quantitative tool to demonstrate the effectiveness of interventions such as computer order entry and pharmacist order review. In emergency medicine (EM), error detection has focused on subjects of high liability: missed myocardial infarctions, missed appendicitis, and misreading of radiographs. Some system-level efforts in error prevention have focused on teamwork, on strengthening communication between pharmacists and emergency physicians, on automating drug dosing and distribution, and on rationalizing shifts. This article reviews the definitions, detection, and presentation of error in medicine and EM. Based on review of the current literature, recommendations are offered to enhance the likelihood of reduction of error in EM practice.

show abstract

“…Lay rescuers fail to recognize the absence of a pulse in 10% of pulseless victims and fail to detect a pulse in 40% of victims with a pulse. 7,77 The updated AHA CPR guidelines eliminate lay rescuer assessment of pulse and recommend that cardiac arrest be assumed if the unresponsive victim does not demonstrate normal breathing. 4 Health care providers may also have difficulty accurately determining if a pulse is present or take too long in their assessment.…”

Section: Recognition Of Sudden Cardiac Arrestmentioning

confidence: 99%

Inter Association Task Force Recommendations on Emergency Preparedness andManagement of Sudden Cardiac Arrest in High School andCollege Athletic Programs: A Consensus Statement

Drezner

Courson

Roberts

et al. 2007

Prehospital Emergency Care

View full text Add to dashboard Cite

Objective: To assist high school and college athletic programs prepare for and respond to a sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA.Background: Sudden cardiac arrest is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes.Recommendations: Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishment of an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination and integration of on-site responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated.Key Words: sudden cardiac death, athletes, emergency action plan, automated external defibrillators S udden cardiac arrest (SCA) is the leading cause of death in young athletes. 1,2 Athletes are considered the healthiest members of our society, and their unexpected death during training or competition is a catastrophic event that stimulates debate regarding both preparticipation screening evaluations and appropriate emergency planning for athletic events. Despite preparticipation screening, healthy-appearing competitive athletes may harbor unsuspected cardiovascular diseases with the potential to cause sudden death. 3 With the increasing availability of automated external defibrillators (AEDs) at athletic events, there is potential for effective secondary prevention of sudden cardiac death (SCD). The presence and timely access of AEDs at sporting venues provide a means of early defibrillation not only for athletes but also for spectators, coaches, officials, event staff, and other attendees on campus in the case of an unexpected SCA.Many health-related organizations have guidelines for managing SCA during athletic practices and competitions. However, these guidelines have not directly linked emergency planning and...

show abstract

Checking the carotid pulse check: diagnostic accuracy of first responders in patients with and without a pulse

Cited by 324 publications

References 15 publications

Understanding and improving low bystander CPR rates: a systematic review of the literature

Understanding and improving low bystander CPR rates: a systematic review of the literature

Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Inter Association Task Force Recommendations on Emergency Preparedness andManagement of Sudden Cardiac Arrest in High School andCollege Athletic Programs: A Consensus Statement

Contact Info

Product

Resources

About