Implementation of new guidelines into clinical practice is often incomplete. Direct mail is a simple way of providing information to physicians and may improve implementation of new guidelines on basic life support (BLS). The aim of this study was to describe knowledge of the most recent European Resuscitation Council (ERC) Guidelines for BLS among general practitioners (GPs) and investigate whether direct mail improves theoretical knowledge of these guidelines.
All general practice clinics (n=351) in Central Denmark Region were randomised to receive either direct mail (intervention) or no direct mail (control). The direct mail consisted of the official ERC BLS/AED poster and a cover letter outlining changes in compression depth and frequency in the new guidelines. In general practice clinics randomised to intervention, every GP received a direct mail addressed personally to him/her. Two weeks later, a multiple-choice questionnaire on demographics and BLS guidelines were mailed to GPs in both groups.
In total, 830 GPs were included in this study (direct mail, n=408; control, n=422). The response rate was 58%. The majority (91%) of GPs receiving direct mail were familiar with BLS Guidelines 2010 compared to 72% in the control group (P
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In-hospital cardiac arrests are treated by a team of health care providers. Improving team performance may increase survival. Currently, no international standards for cardiac arrest teams exist in terms of member composition and allocation of tasks.
To describe the composition of in-hospital cardiac arrest teams and review pre-arrest allocation of tasks.
A nationwide cross-sectional study was performed. Data on cardiac arrest teams and pre-arrest allocation of tasks were collected from protocols on resuscitation required for hospital accreditation in Denmark. Additional data were collected through telephone interviews and email correspondence. Psychiatric hospitals and hospitals serving outpatients only were excluded.
Data on the cardiac arrest team were available from 44 of 47 hospitals. The median team size was 5 (25th percentile; 75th percentile: 4; 6) members. Teams included a nurse anaesthetist (100%), a medical house officer (82%), an orderly (73%), an anaesthesiology house officer (64%) and a medical assistant (20%). Less likely to participate was a cardiology house officer (23%) or a cardiology specialist registrar (5%). Overall, a specialist registrar was represented on 20% of teams and 20% of cardiac arrest teams had a different team composition during nights and weekends. In total, 41% of teams did not define a team leader pre-arrest, and the majority of the teams did not define the tasks of the remaining team members.
In Denmark, there are major differences among cardiac arrest teams. This includes team size, profession of team members, medical specialty and seniority of the physicians. Nearly half of the hospitals do not define a cardiac arrest team leader and the majority do not define the tasks of the remaining team members.
In-hospital cardiac arrest carries a poor prognosis. Registries of in-hospital cardiac arrest provide the opportunity to improve quality of care and conduct research of disease mechanisms and treatment. This paper describes the preliminary experience with systematic registration of in-hospital cardiac arrest at Aarhus University Hospital, Denmark. Data from 102 patients are presented and practical aspects and challenges of establishing a registry and implementing the collection of data in daily clinical practice are discussed.
Comment In: Ugeskr Laeger. 2012 Mar 26;174(13):85422456170