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Resusci anne

Manufactured by Laerdal
Sourced in Norway

Resusci Anne is a high-quality manikin designed for cardiopulmonary resuscitation (CPR) training. It provides a realistic simulation of human anatomy and physiological responses to aid in the development of essential lifesaving skills.

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12 protocols using resusci anne

1

Evaluating CPR Knowledge and Skills

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The knowledge questionnaire was used for the pre-test and the post-test. It consisted of 10 items and was prepared ad hoc. For its development, the recommendations on CPR made in 2015 by the European Resuscitation Council (ERC) were consulted. The questionnaire consisted of ten questions with four multiple-choice options, one being correct. The estimated time for completion was 7 minutes. After the questionnaire, a document was delivered with instructions to participants, where data confidentiality was guaranteed.
A standard manikin Resusci Anne (Laerdal®, Stavanger, Norway) was used for the practice and for results measurement. Data were obtained from the CPR Resusci Anne Skill Reporter (Laerdal®, Stavanger, Norway) meter, already employed in similar studies [13 (link),14 (link),15 (link)]. The system was programmed using the CPR parameters proposed by the ERC in 2015: 50–60 mm depth of compression, 100–120 compressions per minute of frequency, and 500–600 cm3 of inspiratory volume [1 (link)]. The information provided by the meter was not shown to the participants during the evaluation. The obtained data were used to create an individual report of CPR of each participant. In addition, the exertion applied by the participants was analysed after their performance by means of the Borg rating of perceived exertion scale (RPE scale) [16 (link)].
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2

Evaluating BLS Competence with Manikins

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For the procedure, 6 standard manikins Resusci Anne (Laerdal®, Stavanger, Norway), two torsos of CPR manikins without feedback, 3 AEDs, and 6 computers with the Resusci Anne Skill Reporter (Laerdal®, Stavanger, Norway) software were used as material resources. Human resources included 6 supervisors, two of them nurses and instructors in Basic Life Support (BLS) by the Spanish Society of Intensive Medicine, Critical Care and Coronary Units (SEMICYUC), two nurses and two nursing students with specific training in CPR. All of them had performed the correct BLS sequence and had obtained a QCPR higher than 95%.
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3

Standardized BLS Manikin Resuscitation Training

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Each participant was confronted with the same standardized scenario. They were expected to resuscitate a collapsed person represented by a BLS manikin (Resusci Anne™, Laerdal, Stavanger, Norway). None of the participants had received BLS training during their medical studies up to this point. Each student performance was recorded on videotape and performance data were obtained using Laerdal PC SkillReporting System Software (Version 2.4.1, Laerdal, Stavanger, Norway). The students were guided following a structured protocol and every student received exactly the same instructions. The scenario started equally every time, described as follows:

The participant was asked to enter a room in which a BLS manikin was lying on the floor with a zippered jacket covering the torso. No information about the scenario was provided in advance. The standardized text was read by the course instructor: “Imagine you are witnessing a person collapsing right in front of you. The manikin represents this person. There is no one else nearby. Please take all measures you would take if the manikin was a real person. Keep going until you receive a signal to stop.”

The performance was terminated 120 s after the first external chest compression (ECC). If the participant did not perform CPR, the scenario was stopped after 90 s. No further instructions were provided during the performance.
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4

Simulated Cardiac Arrest ALS Training

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The CPR scenario used for this study was designed as a monitored simulation tutorial to apply and discuss all previously learned ALS treatment elements. It took place in the training and simulation center for students (STÄPS) at the Georg-August University Medical School and was videotaped for later analysis. A resuscitation manikin (ResusciAnne®, Laerdal, Stavanger, Norway), lying on the floor in the middle of the training area, enabled realistic chest compression and ventilation.
The simulated scenario was a witnessed cardiac arrest at the ward of a large district hospital. The resuscitation team was summoned by a ward nurse and had immediate access to standard ALS equipment. The task of the resuscitation team was to apply ALS that adhered to the 2010 ERC guidelines until the return of spontaneous circulation (ROSC) [27 (link)]. In cases of successful application of the algorithm, the instructor ended the simulation after the fourth defibrillation. If a team failed to defibrillate the patient four times within 15 min, the instructor was obligated to end the simulation. At the end of the tutorial the students were asked to complete a questionnaire with demographic data.
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5

Standardized CPR Training Protocol

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After the acclimatization period (50 min), a 20-min CPR test was performed on a Laerdal ResusciAnne® manikin (Stavanger, Norway) programmed according to ERCGR2015 [20 (link)]. The resuscitation variables were recorded with the SkillReporter QCPR software from Laerdal Medical (Stavanger, Norway). To administer the ventilations, a self-inflating adult-sized bag with a volume of 1500 mL was used. The brand of the bag valve mask was Ambu® Mark IV brand (Ballerup, Denmark) and it had a high efficiency particulate air filter (Clear-Guard™ midi filter with luer port, Intersurgical Ltd., Crane House, Molly Milars Lane, Wokingham, UK). Furthermore, a size 5 clear plastic face shield for adults, Ambu® Mark IV brand (Ballerup, Denmark) was used.
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6

Pair-based Simulation-based CPR Training

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Two hours after the training, participants were randomly divided into pairs. It was ensured that each pair did not complete the initial training together but had been randomized to the same study-group.
For data collection, four identical patient rooms on a simulated general hospital ward were equipped with a CPR-training manikin (Resusci Anne, Laerdal Medical GmbH, Puchheim) in a cardiac arrest scenario. The participants had access to a standardized set of drugs, airway management tools and a defibrillator. The time from entering the room, to first contact, to assessment and initiation of CPR was documented accordingly using video recording. The evaluation of the video documentation concerning specific time points was performed by an external person having not participated in teaching or data analysis using a checklist based evaluation protocol. The manikin data was collected by Laerdal PC SkillReporting System (Fa. Laerdal Medical GmbH, Puchheim). Each scenario and video-documentation lasted for 5 minutes.
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7

Cardiopulmonary Resuscitation Training Mannequin Setup

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As the basic setting, each volunteer was assigned to prepare the cardiopulmonary resuscitation training mannequin (Resusci Anne; Laerdal Medical, Wappingers Falls, NY, USA) for transport with equipment for electrocardiography, oxygen saturation, automated blood pressure, CVP, and continuous arterial pressure monitoring as well as an oxygen supplier and syringe pump. The conventional and the new method using ETAD were assigned. Each method consisted of four, five, or six fluids, resulting in a total of six basic conditions (one fluid for CVP, one fluid for maintaining an arterial catheter, and one fluid for peripheral veins were included in each condition). The mannequin’s artificial skin was pierced to insert the CVP and arterial pressure catheters (Fig. 3).
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8

Hospital-Based Simulation for Emergency Care

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The setting was a multiuse conference room in the hospital with a projector and six large tables. The simulation equipment available included one full-sized cardiopulmonary resuscitation (CPR) manikin (Resusci Anne, Laerdal Medical), and one intubation trainer (Ambu). The same equipment available in the ED was also made available in the simulation cases. This included a desktop computer and projector to simulate the patient cardiac monitor,14 as well as a bag valve mask, different-sized endotracheal tubes with stylets, oral airways, one bougie, and one curved laryngoscope with size 3 and 4 blades. The Table lists the items and where each was acquired. None of the items were purchased as all were available at Patan Hospital.
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9

Evaluation of CPR Quality Using QCPR System

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Figure 1 shows the diagrams of the study setting. CPR quality was measured using the QCPR® System, which consisted of a simulation mannequin (Resusci Anne®, Laerdal Medical, Norway) and real-time training software (QCPR®). The system can measure and assess hand positions and compression rate and depth, being able to distinguish between fully released, shallow, and sufficiently deep compressions, and can provide a comprehensive qualitative assessment of CPR in the form of a compression score (also called Q-CPR) (in %) [14 (link)]. Because this study focused on chest compressions, parameters related to chest compressions were studied using a mode to assess chest compressions only. The parameters were set according to the Japan Resuscitation Council. The participants only performed CPR. The duration of each CPR procedure was 2 minutes.
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10

Comparative CPR Simulation Study

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A simulation was conducted using a crossover design. Participants performed CPR using ACDA and CPR using MCCD and AED on a CPR manikin (Laerdal Resusci Anne®, Laerdal Medical, Stavanger, Norway) at 1-day intervals. Emergency medical technicians or nurses with BLS qualifications who voluntarily agreed to participate were included in the simulation study. To randomize which simulation to start first, participants selected and opened a sealed envelope containing the simulation type of the first day. The simulation protocol consisted of a scenario in which CPR was performed using an ACDA or MCCD and an AED under the assumption that cardiac arrest was confirmed. Before participating in this study, participants were instructed to watch a video explaining how to use each device and the study protocol. The CPR simulation was started by installing the ACDA or MCCD and finished when the voice prompted a second shock delivery from the ACDA or AED (Supplementary Figure S2).
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