Effects of anxiety on family members of patients with cardiac disease learning cardiopulmonary resuscitation

Article Abstract:

Cardiopulmonary resuscitation (CPR) can save lives, but it is not generally offered to the relatives or friends of heart patients, who are probably more likely to need to perform the procedure. Many health care professionals believe that the relatives of heart patients would be unable to learn the technique because of the emotional impact of even the mere suggestion that they may need to know CPR. The conclusion is that this type of intervention would be both futile and anxiety-provoking. If this is true, then the logical step would be to inaugurate programs dealing with this anxiety. In order to determine the effects of anxiety on relatives' ability to learn CPR, 50 subjects were divided into three groups: family members of hospitalized patients, family members of nonhospitalized patients, and a control group of people who did not have a family member with heart disease. The subjects' anxiety levels were tested before, immediately after, and two months after the CPR course. As expected, the anxiety levels of the controls did not vary. Family members of hospitalized patients were offered the Heart Saver course. They exhibited the highest level of anxiety before the CPR course, but there was a definite decrease in anxiety over the three tests. Family members of nonhospitalized heart patients showed some increase in anxiety just after the course, but their anxiety levels dropped below those of the controls two months later. In no case did anxiety interfere with the ability to learn CPR, and the course may in fact have been therapeutic for many family members by providing them with some measure of control during a period of high anxiety. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Medical care, Caregivers, Training, Family, Cardiac patients

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Potential for injury: trauma after cardiopulmonary resuscitation

Article Abstract:

Cardiopulmonary resuscitation (CPR) is a life-saving procedure that is used on thousands of critically ill people every year. Although this important technique can save lives, it can also cause injuries to the patient. Several studies examining the incidence of injuries caused by CPR have estimated that injuries can occur in 20 to 65 percent of the patients receiving CPR. The skin and the upper body are the two regions that are injured most frequently. The most common types of skin injuries are bruises caused by placing pressure on the chest, and electrical burns caused by defibrillator paddles that are placed on the skin to deliver an electrical shock to the chest. Applying pressure to the chest can bruise and fracture the ribs, and can cause internal bleeding. Applying pressure too high or too low on the chest increases the risk of rib fracture. However, even if CPR is performed properly, there is always a possibility of rib fracture. Autopsies performed on patients who failed to respond to CPR showed that between 20 and 50 percent of the patients had at least one rib fracture. Improper placement of the hands on the chest during CPR can cause damage to the heart and blood vessels. These types of injuries are estimated to occur in up to 11 percent of all patients resuscitated by CPR. Damage to the lungs and lung airways can occur as a result of the pressure applied to the outside of the chest. The third most common type of injury during CPR is abdominal injury involving rupture of the liver and spleen and internal bleeding. Even though CPR is associated with the risk of injuring the patient, it should be performed without hesitation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Prevention, Complications and side effects, Wounds and injuries, Injuries, Resuscitation

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Retention of cardiopulmonary resuscitation skills among nursing personnel: what makes the difference?

Article Abstract:

Cardiopulmonary resuscitation (CPR) initiated within four minutes of a heart attack is the most effective way to improve the chance of survival of patients with cardiac arrest. Since 30 to 40 percent of all sudden deaths occur in the hospital, and 60 percent of those are first recognized by nurses, it is important that the nursing staff be adequately prepared to initiate CPR. Methods of teaching CPR include Basic Life Support-A (BLS-A), Heartsaver (a short one-person CPR course) and Basic Cardiac Life Support (BCLS), a more detailed and lengthy course. The retention of information provided by two CPR instruction methods, Heartsaver (BLS-A) and BCLS, were evaluated in 106 nurses four and eight months after the initial class. CPR skills were evaluated for three levels of care; critical, medical-surgical, and obstetrical/psychiatric services. The number of years in nursing, educational levels, previous CPR training, and subjective level of competence of the nurses were considered in the analysis. Nurses who took the more detailed BCLS course scored higher in CPR retention and CPR skills when assessed at both time intervals when compared with the nurses who received the Heartsaver CPR training. This was independent of area of service, skills, and years of practice. The skill in which most nurses were deficient was following the prescribed CPR sequence in the correct order, which is as follows: finding the patient, shaking, ascertaining responsiveness, calling for help, opening airway, checking for breathing and pulse check. It is suggested that nurses have more frequent CPR review, recertification, or both. (Consumer Summary produced by Reliance Medical Information, Inc.)

Nurses, Study and teaching, Cardiac arrest

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