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Leo L Bossaert

Publications and source records attributed to Leo L Bossaert.

6 recordsLinked to original sources
PubMed2005

A study comparing the usability of fully automatic versus semi-automatic defibrillation by untrained nursing students.

INTRODUCTION: Current international guidelines prefer the use of semi-automatic external defibrillators (SAEDs) over fully automatic external defibrillators (FAEDs). However, there is a lack of evidence supporting this recommendation. We conducted a study of usability with nursing students comparing the FAED version against the SAED version of the Lifepak CR Plus AED (Medtronic, Redmond, USA). We hypothesized that FAED use would limit the number of operator-device interactions, thereby increasing compliance by the rescuer, safety and speed. METHODS: Sixty-two untrained first year nursing students were randomized to use the FAED or the SAED in a simulated cardiac arrest scenario. During analysis and delivery of three shocks, the AED guided the user with six voice prompts per shock (18 voice prompts per student). Their performance with regard to efficacy and safety was assessed using video recording. RESULTS: All rescuers except for two were able to attach electrodes and deliver a series of three shocks. During rhythm analysis by the device, FAED users made 30/372 (8%) errors against 62/360 (17%) errors for SAED users (P < 0.001). During shock delivery, FAED users made 0/186 errors against 12/180 (7%) for SAED users (P < 0.001). FAED use eliminated long time intervals between the first to the third shock (range 47-49s for FAED versus 41-90s for SAED). CONCLUSION: Despite a lack of BLS skills and AED training, the majority of students demonstrated safe and effective use of the AED. The use of the FAED version of the CR Plus resulted in increased compliance with the protocol and reduced variability in time to deliver three shocks. Further research is needed to confirm these findings in other groups of first responders.

Adult↗
PubMed2004

Learning effect of a novel interactive basic life support CD: the JUST system.

INTRODUCTION: Electronic interactive learning environments can enhance the learning experience and may prove beneficial in basic life support (BLS) training. As part of the European Union funded project "JUST-in-time health emergency interventions-training of non-professionals by virtual reality and advanced IT tools", an innovative interactive CD-ROM on BLS and other emergency medicine topics was developed. We hypothesised that individuals without previous BLS training could learn CPR techniques from this CD. METHODS: Sixty-two students were randomised into a group studying the JUST CD in a computer class room for up to 60 min, and a control group who did not receive any training (serving as a reference). CD users also completed a satisfaction questionnaire immediately after studying the CD. The BLS skills of both groups were assessed in a mock BLS scenario on a training manikin. BLS performance was video recorded and analysed. RESULTS: After studying the CD for a mean period of 42 min, users of the CD had better assessment skills and were more likely to show a positive helping attitude, but chest compression and breathing techniques were ineffective. Most users rated the CD as very good and a positive learning tool. CONCLUSION: Individuals without prior BLS training showed improved behaviour and assessment skills after exposure to the CD, but motor skill acquisition requires alternative learning strategies.

CD-ROM↗
PubMed2003

Herpes simplex virus in the respiratory tract of critical care patients: a prospective study.

BACKGROUND: Herpes simplex virus (HSV) is occasionally detected in the lower respiratory tract of patients in intensive care, but its clinical importance in such situations remains unclear. We did a prospective cohort study to define the prevalence, origin, risk factors, and clinical relevance of HSV in the respiratory tract of patients undergoing critical care. METHODS: We tested 764 patients admitted to intensive care for the presence of HSV in the respiratory tract, and assessed statistical relations between this virus and clinical variables. FINDINGS: HSV was detected by oropharyngeal swab in the upper respiratory tract of 169 (22%) of 764 patients, within 10 days of admission for 150 (89%) of these individuals. The virus was isolated in 58 (16%) of 361 patients whose lower respiratory tract was sampled. The presence of HSV in the throat was a risk factor for development of HSV infections in the lower respiratory tract (p<0.001). HSV was isolated most frequently in patients with severe disease. HSV in the throat was associated with acute respiratory distress syndrome (p<0.001) and with increased length of stay in intensive care (p<0.001). INTERPRETATION: Our data suggest that HSV reactivation or infection of the upper respiratory tract is frequent among patients in intensive care, and is a risk factor for development of lower respiratory tract infection with this virus, possibly by means of aspiration.

Adolescent↗
PubMed2002

Advanced life support drugs: do they really work?

Basic life support and rapid defibrillation for ventricular fibrillation or pulseless ventricular tachycardia are the only two interventions that have been shown unequivocally to improve survival after cardiac arrest. Several drugs are advocated to treat cardiac arrest, but despite very encouraging animal data, no drug has been reliably proven to increase survival to hospital discharge after cardiac arrest. This review focuses on recent experimental and clinical data concerning the use of vasopressin, amiodarone, magnesium, and fibrinolytics during advanced life support (ALS). Animal data indicate that, in comparison with epinephrine (adrenaline), vasopressin produces better vital organ blood flow during cardiopulmonary resuscitation (CPR). These apparent advantages have yet to be converted into improved survival in large-scale trials of cardiac arrest in humans. Data from two prospective, randomized trials suggest that amiodarone may improve short-term survival after out-of-hospital ventricular fibrillation cardiac arrest. On the basis of anecdotal data, magnesium is recommended therapy for torsades de pointes and for shock-resistant ventricular fibrillation associated with hypomagnesemia. In the past, CPR has been a contraindication to giving fibrinolytics, but several studies have demonstrated the relative safety of fibrinolysis during and after CPR. Fibrinolytics are likely to be beneficial when cardiac arrest is associated with plaque rupture and fresh coronary thrombus or massive pulmonary embolism. Fibrinolysis may also improve cerebral microcirculatory perfusion once a spontaneous circulation has been restored. A planned, prospective, randomized trial may help to define the role of fibrinolysis during out-of-hospital CPR.

Advanced Cardiac Life Support↗