We investigated effects of intensified wording and/or repetitive target depth instructions on compression depth in telephone-assisted, protocol driven,
bystander CPR on a simulation manikin.
Methods: Thirty-two volunteers performed 10 min of compression only-CPR in a prospective, investigator-blinded, 4-armed, factorial setting. Participants were randomized either to standard wording (“”push down firmly 5 cm”"), intensified wording (“”it is very important to push down 5 cm every time”") or standard or intensified wording repeated every 20 PF-00299804 in vitro s. Three dispatchers were randomized to give these instructions. Primary outcome was relative compression depth (absolute compression depth minus leaning depth). Secondary outcomes were absolute distance, hands-off times as well as BORG-scale and nine-hole peg CH5183284 test (NHPT), pulse rate and blood pressure to
reflect physical exertion. We applied a random effects linear regression model.
Results: Relative compression depth was 35 +/- 10 mm (standard) versus 31 +/- 11 mm (intensified wording) versus 25 +/- 8 mm (repeated standard) and 31 +/- 14 mm (repeated intensified wording). Adjusted for design, body mass index and female sex, intensified wording and repetition led to decreased compression depth of 13 (95%CI -25to -1) mm (p = 0.04) and 9 (95%CI -21 to 3) mm (p = 0.13), respectively. Secondary outcomes regarding intensified wording showed significant differences for absolute distance (43 +/- 2 versus 20 (95%CI 3-37) mm; p = 0.01) and hands-off times (60 +/- 40 versus 157 (95%CI 63-251) s; p = 0.04).
Conclusion: In protocol driven, telephone-assisted, bystander CPR, intensified wording and/or repetitive
target depth instruction will not improve compression depth compared to the standard instruction. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“Background: In chest pain, physicians are confronted with numerous interrelationships between symptoms and with evidence for or against classifying a patient into OICR-9429 different diagnostic categories. The aim of our study was to find natural groups of patients on the basis of risk factors, history and clinical examination data which should then be validated with patients’ final diagnoses.
Methods: We conducted a cross-sectional diagnostic study in 74 primary care practices to establish the validity of symptoms and findings for the diagnosis of coronary heart disease. A total of 1199 patients above age 35 presenting with chest pain were included in the study. General practitioners took a standardized history and performed a physical examination. They also recorded their preliminary diagnoses, investigations and management related to the patient’s chest pain.