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Table of Content

    15 September 2018, Volume 9 Issue 3
    Original Articles
    Pre-recorded instructional audio vs. dispatchers’ conversational assistance in telephone cardiopulmonary resuscitation: A randomized controlled simulation study Open Access
    Alexei Birkun, Maksim Glotov, Herman Franklin Ndjamen, Esther Alaiye, Temidara Adeleke, Sergey Samarin
    2018, 9(3):  165-171.  doi:10.5847/wjem.j.1920-8642.2018.03.001
    Abstract    HTML    PDF (303KB)   

    BACKGROUND: To assess the effectiveness of the telephone chest-compression-only cardiopulmonary resuscitation (CPR) guided by a pre-recorded instructional audio when compared with dispatcher-assisted resuscitation.
    METHODS: It was a prospective, blind, randomised controlled study involving 109 medical students without previous CPR training. In a standardized mannequin scenario, after the step of dispatcher-assisted cardiac arrest recognition, the participants performed compression-only resuscitation guided over the telephone by either: (1) the pre-recorded instructional audio (n=57); or (2) verbal dispatcher assistance (n=52). The simulation video records were reviewed to assess the CPR performance using a 13-item checklist. The interval from call reception to the first compression, total number and rate of compressions, total number and duration of pauses after the first compression were also recorded.
    RESULTS: There were no significant differences between the recording-assisted and dispatcher-assisted groups based on the overall performance score (5.6±2.2 vs. 5.1±1.9, P>0.05) or individual criteria of the CPR performance checklist. The recording-assisted group demonstrated significantly shorter time interval from call receipt to the first compression (86.0±14.3 vs. 91.2±14.2 s, P<0.05), higher compression rate (94.9±26.4 vs. 89.1±32.8 min-1) and number of compressions provided (170.2±48.0 vs. 156.2±60.7).
    CONCLUSION: When provided by untrained persons in the simulated settings, the compression-only resuscitation guided by the pre-recorded instructional audio is no less efficient than dispatcher-assisted CPR. Future studies are warranted to further assess feasibility of using instructional audio aid as a potential alternative to dispatcher assistance.

    The effect of wilderness and medical training on injury and altitude preparedness among backcountry hikers in Rocky Mountain National Park Open Access
    Michael D.T. Yue, David W. Spivey, Daniel B. Gingold, Douglas G. Sward
    2018, 9(3):  172-177.  doi:10.5847/wjem.j.1920-8642.2018.03.002
    Abstract    HTML    PDF (265KB)   

    BACKGROUND: The purpose of this study was to document the correlation between medical and wilderness training with levels of preparedness for acute mountain sickness (AMS), illness, and injury among backcountry hikers.
    METHODS: We conducted a cross-sectional, convenience survey in Rocky Mountain National Park in July and August 2015. The study group consisted of 380 hikers who completed a written survey that collected information about demographics, wilderness experience, altitude experience, hiking equipment, communications devices, and trip planning.
    RESULTS: Factors such as wilderness training (wilderness first aid [WFA], wilderness first responder [WFR], or wilderness emergency medical technician [WEMT]), wilderness experience, and altitude experience all affected hikers’ emergency preparedness. Respondents with medical training were more prepared to avoid or respond to AMS (62.3% vs. 34.3% [P<0.001]). They were also more prepared to avoid or manage injury/illness than hikers without medical training (37.7% vs. 20.7% [P=0.003]). Participants with wilderness training were more likely to be prepared to avoid or respond to AMS (52.3% vs. 36.8% [P=0.025]) but not significantly more likely to be prepared to manage illness/injury (31.8% vs. 22.0% [P<0.11]). Adjusting for experience, wilderness training, ag