TY - JOUR A1 - Wurmb, Thomas A1 - Vollmer, Tina A1 - Sefrin, Peter A1 - Kraus, Martin A1 - Happel, Oliver A1 - Wunder, Christian A1 - Steinisch, Andrias A1 - Roewer, Norbert A1 - Maier, Sebastian T1 - Monitoring of in-hospital cardiac arrest events with the focus on Automated External Defibrillators – a retrospective observational study JF - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine N2 - Background Patients with cardiac arrest have lower survival rates, when resuscitation performance is low. In In-hospital settings the first responders on scene are usually nursing staff without rhythm analysing skills. In such cases Automated External Defibrillators (AED) might help guiding resuscitation performance. At the Wuerzburg University Hospital (Germany) an AED-program was initiated in 2007. Aim of the presented study was to monitor the impact of Automated External Defibrillators on the management of in-hospital cardiac arrest events. Methods The data acquisition was part of a continuous quality improvement process of the Wuerzburg University Hospital. For analysing the CPR performance, the chest compression rate (CCR), compression depth (CCD), the no flow fraction (NFF), time interval from AED-activation to the first compression (TtC), the time interval from AED-activation to the first shock (TtS) and the post schock pause (TtCS) were determined by AED captured data. A questionnaire was completed by the first responders. Results From 2010 to 2012 there were 359 emergency calls. From these 53 were cardiac arrests with an AED-application. Complete data were available in 46 cases. The TtC was 34 (32–52) seconds (median and IQR).The TtS was 30 (28–32) seconds (median and IQR) . The TtCS was 4 (3–6) seconds (median and IQR) . The CCD was 5.5 ± 1 cm while the CCR was 107 ± 11/min. The NFF was calculated as 41 %. ROSC was achieved in 21 patients (45 %), 8 patients (17 %) died on scene and 17 patients (37 %) were transferred under ongoing CPR to an Intensive Care Unit (ICU). Conclusion The TtS and TtC indicate that there is an AED-user dependent time loss. These time intervals can be markedly reduced, when the user is trained to interrupt the AED’s “chain of advices” by placing the electrode-paddles immediately on the patient’s thorax. At this time the AED switches directly to the analysing mode. Intensive training and adaption of the training contents is needed to optimize the handling of the AED in order to maximize its advantages and to minimize its disadvantages. KW - cardio-pulmonary resuscitation KW - team-training KW - chest-compression rate KW - automated external defibrillators KW - in-hospital cardiac arrest Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-125756 VL - 23 IS - 87 ER - TY - THES A1 - Happel, Oliver T1 - Körperhaltung von Experten und Anfängern während einer endotrachealen Intubation am Simulator – Ein Vergleich zwischen direkter Laryngoskopie mittels Macintosh-Spatel und Videolaryngoskopie mittels GlideScope® T1 - Body posture of experts and novices during simulated endotracheal intubation - A comparison between direct laryngoscopy with a Macintosh blade and videolaryngoscopy with the GlideScope® device N2 - Diese Arbeit untersucht den Einfluss der Laryngoskopietechnik (GlideScope® versus Macintosh-Spatel) und des Erfahrungsgrades der intubierenden Person (erfahren versus unerfahren) auf die während der endotrachealen Intubation spontan eingenommene Körperhaltung mittels der Methode des Rapid Entire Body Assessment. Hierzu wurden Videoaufnahmen von in der endotrachealen Intubation erfahrenen Ärzten und darin unerfahrenen Medizinstudierenden während endotrachealen Intubationen am Patientensimulator aufgenommen. Die Benutzung des GlideScope®-Videolaryngoskops war unabhängig vom Erfahrungsgrad mit einer, nach ergonomischen Gesichtspunkten, deutlich vorteilhafteren Körperhaltung und niedrigeren REBA-Aktionsschwellenwerten assoziiert. Unerfahrene Probanden nahmen im Gegensatz zu erfahrenen eine unvorteilhafte, überwiegend gebückte Körperhaltung während der endotrachealen Intubation ein, unabhängig welche der beiden Laryngoskopietechniken benutzt wurde. Aus ergonomischer Sicht sollte die Videolaryngoskopie für die endotracheale Intubation bevorzugt eingesetzt werden. N2 - This study compares the effects of laryngoscopy technique (GlideScope versus Macintosh blade) and experience (novices versus experts) on body posture during simulated endotracheal intubation using the Rapid Entire Body Assessment postural analysis method. Novices (medical students) and experts (anaesthetists) were video-recorded performing intubation in a manikin using both devices. The use of the GlideScope® resulted in a more ergonomic body posture and lower REBA action levels irrespective of expertise. Novices showed an unfavourable and more crouched body posture during endotracheal intubation than experts irrespective of which laryngoscopy technique was used. From an ergonomic point of view, videolaryngoscopy should be the preferred technique for endotracheal intubation. KW - Endotracheale Intubation KW - Laryngoskopie KW - Haltung KW - Expertise KW - Rapid Entire Body Assessment KW - Videolaryngoskopie Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-178891 ER - TY - JOUR A1 - Hohm, Anna A1 - Happel, Oliver A1 - Hurtienne, Jörn A1 - Grundgeiger, Tobias T1 - User experience in safety–critical domains: a survey on motivational orientations and psychological need satisfaction in acute care JF - Cognition, Technology & Work N2 - The relevance of user experience in safety–critical domains has been questioned and lacks empirical investigation. Based on previous studies examining user experience in consumer technology, we conducted an online survey on positive experiences with interactive technology in acute care. The participants of the study consisted of anaesthesiologists, nurses, and paramedics (N = 55) from three German cities. We report qualitative and quantitative data examining (1) the relevance and notion of user experience, (2) motivational orientations and psychological need satisfaction, and (3) potential correlates of hedonic, eudaimonic, and extrinsic motivations such as affect or meaning. Our findings reveal that eudaimonia was the most salient aspect in these experiences and that the relevance of psychological needs is differently ranked than in experiences with interactive consumer technology. We conclude that user experience should be considered in safety–critical domains, but research needs to develop further tools and methods to address the domain-specific requirements. KW - user experience KW - healthcare KW - eudaimonia KW - hedonia KW - need satisfaction KW - meaning Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324486 SN - 1435-5558 VL - 24 IS - 2 ER - TY - JOUR A1 - Schmid, Benedikt A1 - Eckert, Dominik A1 - Meixner, Andreas A1 - Pistner, Paul A1 - Malzahn, Uwe A1 - Berberich, Monika A1 - Happel, Oliver A1 - Meybohm, Patrick A1 - Kranke, Peter T1 - Conventional versus video-assisted laryngoscopy for perioperative endotracheal intubation (COVALENT) - a randomized, controlled multicenter trial JF - BMC Anesthesiology N2 - Background Data on the routine use of video-assisted laryngoscopy in peri-operative intubations are rather inconsistent and ambiguous, in part due to small populations and non-uniform outcome measures in past trials. Failed or prolonged intubation procedures are a reason for relevant morbidity and mortality. This study aims to determine whether video-assisted laryngoscopy (with both Macintosh-shaped and hyperangulated blades) is at least equal to the standard method of direct laryngoscopy with respect to the first-pass success rate. Furthermore, validated tools from the field of human factors will be applied to examine within-team communication and task load during this critical medical procedure. Methods In this randomized, controlled, three-armed parallel group design, multi-centre trial, a total of more than 2500 adult patients scheduled for perioperative endotracheal intubation will be randomized. In equally large arms, video-assisted laryngoscopy with a Macintosh-shaped or a hyperangulated blade will be compared to the standard of care (direct laryngoscopy with Macintosh blade). In a pre-defined hierarchical analysis, we will test the primary outcome for non-inferiority first. If this goal should be met, the design and projected statistical power also allow for subsequent testing for superiority of one of the interventions. Various secondary outcomes will account for patient safety considerations as well as human factors interactions within the provider team and will allow for further exploratory data analysis and hypothesis generation. Discussion This randomized controlled trial will provide a solid base of data in a field where reliable evidence is of major clinical importance. With thousands of endotracheal intubations performed every day in operating rooms around the world, every bit of performance improvement translates into increased patient safety and comfort and may eventually prevent significant burden of disease. Therefore, we feel confident that a large trial has the potential to considerably benefit patients and anaesthetists alike. Trial registration ClincalTrials.gov NCT05228288. Protocol version 1.1, November 15, 2021. KW - anaesthesiology KW - laryngoscopy KW - video-assisted laryngoscopy KW - intubation KW - airway management KW - patient safety KW - human factors Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357207 VL - 23 ER -