Background Endomyocardial biopsy has long been a useful tool to evaluate myocardial diseases. It is a gold standard in diagnosing cardiac rejection and certain types of myocarditis, but there is always a risk for related complications. We have assessed the safety and feasibility of applying long sheaths in endomyocardial biopsy via the femoral approach. Methods We performed endomyocardial biopsy in 63 patients via the femoral approach and used a long sheath to guide bioptome from the venous access to the interventricular septum and evaluate the procedure success and complications. Results Success rate (acceptable endomyocardial specimen) was 96%, and there were no complications (death, no death, urgent cardiac surgery, advanced cardiac life support, hemothorax, and pneumothorax). Conclusions Using long sheaths for the femoral approach seems to be safe and feasible; it confers an acceptable room to grab the endomyocardial samples while obviating the possibility of complications.

Inadequate knowledge of midwives about cardiopulmonary resuscitation in pregnancy has been shown that application of appropriate method is necessary for training of midwifery students. Peer led training is an effective educational method with active collaboration of trainer and trainee.The aim of this study was to determin the effect of this method in education of cardiopulmonary resuscitation in pregnancy by midwifery students. All senior midwifery students were invited for participating in this study as tutors to their junior peers. The knowledge of senior student was assessed in pre and post instruction using questionnaire. A paired t-test was used to compare pre and post knowledge scores of senior midwifery students. The mean of knowledge scores about cardiopulmonary resuscitation pregnancy before and after peer education was different; there also was significant difference between pretest and posttest scores in domains of physiologic changes of pregnancy, recommendation in unsuccessful resuscitation, and advanced cardiac life support in pregnancy. Peer led training appears to be a valid method in order to improving midwifery students’ knowledge about resuscitation in pregnancy.

Cardiopulmonary arrest is a devastating outcome of some clinical situationsand requires strict implementation of cardiopulmonary resuscitation (CPR) protocols.Since ultrasound is one of the recommended tools to determine the presence of cardiacmovements and may be a predictor of the outcome, this study examined the relationshipbetween echocardiographic findings during CPR with patients’ outcomes. This cross-sectional prospective observational study was conducted on patientswith cardio-respiratory arrest in the emergency department of Shariaty hospital during2019. sampling method was random. Echocardiography was done at the patient’s bedsideduring the CPR process in accordance with the last advanced cardiac life support (ACLS)guidelines, on two points, after the end of the second and 10th minutes from the start ofCPR. The echocardiography findings (cardiac movement vs standstill) were recorded, andpatient outcomes were followed. Thirty-two patients enrolled in this study with a meanage of 56.9±15.3 years. Chi-square and Mann-Whitney U tests were used to calculate theassociation between heart contractions during resuscitation and the outcomes via SPSSV.22. Fisher’s exact test and Kruskal-Wallis test were used to evaluate the relationshipbetween heart rhythm in the second and tenth minutes with the outcomes of CPR. The presence of cardiac movement in the 10th minute of CPR, in contrast to thefindings of the second minute, had a significant correlation with the success rate of CPRand outcomes (P<0.05). Moreover, patients with ventricular tachycardia (VT)/ventricularfibrillation (VF) cardiac rhythm had a better resuscitation rate, 24-hour survival rate, andbetter outcome than patients with other cardiac rhythms and asystole (P<0.05). Echocardiographic findings in the 10th minute of the CPR process can beused as a prognostic factor for cardiac arrest

One of the most important issues in order to save life in patients with cardiac arrest is cardiopulmonary resuscitation (CPR). This study evaluated the performance of resuscitation team in Chamran hospital, Isfahan, Iran, in 2015.
This cross-sectional study included 211 patients undergone CPR, in or out of the Chamran hospital. The CPR process data were collected from patient's files and the CPR heads filled out the checklists.
Findings: The patients were 140 men (66.35%) and 71 women (33.65%). The age, sex, and location of CPR had not significant effect on the outcome of CPR (P > 0.050 for all). Use of advanced life support, the time between cardiac arrest and start of advanced life support, the time between cardiac arrest and applying first shock, use of electroshock, CPR due to basic life support (BLS), CPR due to advanced life support (ALS), and duration of CPR had significant effect in primary survey of CPR (P In our study, demographic indices did not have significant effect on primary CPR outcome but need to basic and advanced life supports, applying shock to shockable rhythm and also the time between cardiac arrest and applying first shock had significant effect on primary successful CPR. Incompatibility in the percentage of CPR cases with American Heart Association (AHA) guideline notes the necessity of regular and continuous retraining.

Cardio-Pulmonary Cerebral Resuscitation (CPCR) is a systematic and purposeful series of action has been using by nurses for restoring the vital function of central body organs such as heart, lung and brain. Apply of teaching is a numerous recommended method for improving nurses knowledge and skill related to PCPR in majority of published papers. Therefore, the aim of this study was to assessment of CPCR educational workshops effect on nurses knowledge based on American Heart Association (AHA) guideline that has been done in 2010. Using a quasi-experimental study, the knowledge level of 130 nurses of Tehran university medical sciences was assessed in three steps including before, after, and 2 months later of holding the teaching workshop. Using a 20-item questionnaire on basic, advanced cardiac life support and CPCR according to AHA 2010 guideline, data were gathered. The method of teaching workshop was two integrated sections including lecturing and practical demonstration on basic and advanced CPCR concept during two days (16 hr). Using SPSS, the data were analyzed by applying descriptive and analytical statistical tests. The discrepancy of average knowledge scores related to basic and advanced before teaching workshop (8.6), after (14.9), and 2 month later to the workshop (13.2) indicated the effect of teaching workshop. Comparing the means of the pre- test, post- test and test after 2 months was statistically significant. Nevertheless, in some parts such as on time applying of defibrillation and do the first step in patient with cardio respiratory arrest had the minimal effect from teaching workshop. Since the results indicated that the teaching workshop on basic and advanced CPCR can improve nursing related knowledge; therefore, holding the similar means as theoretical and practical courses in a regular base is recommended.

Background and Cardiopulmonary resuscitation (CPR) training for undergraduate medical students has been noted to be poor in the past. Attempts have been made The aim of this study is to determine effect of CPR training in the anesthetic ward to improve knowledge and practice undergraduate medical student of CPR. A 12 month Educational experimental study with self control was done on all undergraduate medical student (n=30) at the medical university of Ardabil in 2006-2007. During I month of program all this students have undergone CPR training including basic life support (BLS), advanced cardiac life support (ACLS) and practical skills. Data were collected via questionnaire, demographic, pre/post knowledge and practice. After training the acceptable score (good and very good) about knowledge of BLS, ACLS and practical skill significantly increased %6.7 to %50 (p=0.0001), %13.3 to %53.4 (p=0.001) and %3.3 to %100 (p=0.001) respectively. A significant relationship between knowledge of ACLS and practical skills was shown (p=0.005). The CPR training course in anesthetic ward leads to a significant increased in skills and knowledge. Adding this course to undergraduate curriculum of medical students especially in operatically wards (e.g. Anesthetic ward) is essential.

Since only the correct and effective Cardiopulmonary Resuscitation (CPR) can increase the survival of patients with cardiopulmonary arrest, the aim of this study is to determine the effects of CPR training in the anesthetioligy ward to improve CPR knowledge and clinical skills of interns of Lorestan university of medical sciences. A 10-month Educational experimental study was done on 31 undergraduate medical students at Lorestan university of medical sciences in 2013. During a period of 15 days of anesthesiology internship course, all these students underwent CPR training including Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS) and practical skills. Data were collected via a questionnaire with 4 parts including demographic, pre and post knowledge and skills as standpoint of interns and ward,s professor. After training the mean of score about knowledge of CPR and its practical skills significantly increased from 5.68 to 7.94 and 10.65 to 23.45 respectivly (PV=0.0001). A significant relationship between preinternship exam score and knowledge of CPR before anesthesiology internship course was shown (PV=0.001), but there was no significant relationship with practical skills score pre and post CPR training in anesthesilogy ward.(PV=0.38) The CPR training course in anesthetiology ward leads to significant increase in CPR skills and Knowledge of medical interns. Adding this course to undergraduated medical students is essential.

Passing through intrauterine phase to the extra uterine world is probably the most risky event in everybody’s life. About 1% of them need advanced cardiac life support to continue life. By implementing professional methods of resuscitation, the prognosis will improve more than one million neonatal deaths annually. This study was designed to assess the effect of education on midwifery students’ neonatal resuscitation knowledge and skill. In this interventional (pretest and posttest design) study, 81 midwifery students participated. The data was collected using a questionnaire for assessing knowledge and a check list for skill evaluation. The validity and reliability of the questionnaire and the check list were approved before data collection. Our findings showed that all students’ level of knowledge was weak to moderate before education while it turned into good after education. Mean knowledge score before education was 24.46 which increased to 29.34 after education. Skill related mean score before and after education was 13.83 and 91.75, respectively. Comparison between knowledge and skill related scores showed significant difference before and after education (p=0.003 and p=0.0001 respectively). Midwifery students’ knowledge and skill in neonatal resuscitation was low before education and there was a significant difference in mentioned items before and after education. Considering the effect of resuscitation in decreasing neonatal death index, implementation of scientific and practical education using developed techniques and tools is necessary.

Long-term mechanical circulatory support is a life-saving technology while briding to heart transplantation. It increases the quality of life and preserves end-organ function for patients with advanced heart failure. The number of patients with advanced heart failure scheduled for heart transplantation before comorbidities escalate is on the rise. However, the device function is complicated by the bleeding-thrombosis and infection paradigm, hence the interest in understanding device thrombosis and infection. We describe a 27-year-old man with idiopathic cardiomyopathy, advanced end-organ failure, and severe infection, who was bridged to heart transplantation after 8 months on the Berlin Heart EXCOR (Berlin Heart AG, Berlin, Germany) biventricular support. The patient was discharged from the hospital in the third postoperative week after the recovery of his end-organ functions. At 29 months’ post-transplantation follow-up, his last cardiac biopsy was grade 0, his ejection fraction was 60%, and he was enjoying a good quality of life.

People with Chagas disease are at a higher risk of death due to cardiac arrest (CA). Considering that Chagas disease remains a serious health problem in Latin America, studies in this regard are still needed. The aim of this study was to present 2 patients with Chagas that developed CA and were treated at the emergency department of a reference hospital in Brazil (Sao Paulo city). Case one: Male (73 years old and Caucasian) with a history of systemic arterial hypertension, diabetes mellitus, liver cirrhosis, and Chagas disease associated with megacolon and megaesophagus. After cardiac collapse and 30 minutes of cardiopulmonary resuscitation (CPR), unfortunately the patient died. Case two: A female patient (64 years old and Caucasian), with a history of systemic arterial hypertension, obesity, and Chagas disease. After 23 days of hospitalization, pharmacological therapy, and implantation of a cardioverter defibrillator, the patient was discharged. People with Chagas disease are at a higher risk of CA. The researchers believe that a prompt and efficient treatment (advanced life support) allied with educational programs on CA recognition targeted at health professionals and caregivers (basic life support knowledge) could improve the prognoses of these patients.