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Cardiopulmonary Resuscitation I: Adult

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Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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Related Experiment Video

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Translating Neonatal Resuscitation Guidelines Into Practice in Brazil.

Maria Fernanda B de Almeida1, Ruth Guinsburg1, Gary M Weiner2

  • 1Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.

Pediatrics
|May 5, 2022
PubMed
Summary

Brazilian Neonatal Resuscitation Program guidelines for preterm infants improved clinical practice between 2014-2020. Key improvements included thermal care and T-piece positive pressure ventilation (PPV), with reduced use of high Fio2 during PPV.

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Area of Science:

  • Neonatology
  • Pediatric Resuscitation
  • Clinical Practice Guidelines

Background:

  • The Brazilian Neonatal Resuscitation Program adapts international guidelines for local practice.
  • Analysis of guideline adherence for preterm newborns in a middle-income country is crucial.

Purpose of the Study:

  • To evaluate the implementation of Brazilian guidelines for preterm infant resuscitation.
  • To assess practice changes in 20 research centers from 2014 to 2020.

Main Methods:

  • Prospective data from 8514 infants (23-31 weeks' gestation) were analyzed.
  • Frequencies of thermal care, positive pressure ventilation (PPV) methods, oxygen use, intubation, chest compressions, and medications were assessed.
  • Logistic regression analyzed the probability of receiving guideline-consistent care.

Main Results:

  • Care consistent with guidelines increased for thermal care and T-piece PPV in both preterm groups (23-27 and 28-31 weeks' gestation).
  • The probability of using fraction of inspired oxygen (Fio2) 1.00 during PPV decreased significantly in both gestational age groups.
  • Odds ratios demonstrated significant improvements in adherence to recommended practices.

Conclusions:

  • Brazilian clinical practice for preterm infant resuscitation improved between 2014 and 2020.
  • Adoption of thermal care, T-piece PPV, and reduced Fio2 1.00 reflects successful guideline implementation.
  • These findings highlight the translation of evidence-based recommendations into neonatal care settings.