Basic life support

基本生命支持
  • 文章类型: Journal Article
    背景:有证据支持基本生命支持的自主学习的好处,如快速结果和成本效益,正在增加。支持自主学习认知技能的基本生活支持报告存在。然而,目前没有报告支持在基本生命支持中自主学习精神运动技能。
    目的:本研究旨在评估在基本的生命支持训练中使用研究开发的枕头制人体模型如何影响精神运动技能的自主学习。
    方法:随机对照试验。
    方法:这项研究是在土耳其的一所护理学校进行的。
    方法:六十一(n=61)三年级正规科学本科生。
    方法:在XXX大学,将61名护生分为干预组(n=31)和对照组(n=30)。两组学生都接受了基本的生命支持训练,包括现场演示。干预组学生用人体模型练习15天。技能评估由两名独立评估者在15天后和6个月后使用真正的人体模型进行。研究人员使用清单来评估精神运动技能。
    结果:两组学生的社会人口统计学特征相似。混合训练后认知知识水平差异无统计学意义(p>0.05)。然而,在两次干预后评估中,15天后和6个月后,明显的技能差异出现在“将食指放在胸骨末端,\"\"结合中间的拇指,将胸骨下部定义为按摩点,\"\"将胸部的底部\"\"将较弱的手放在按摩点,将身体垂直于胸腔放置,\"和\"进行30次按压。“科恩的卡伯值计算为0.932。
    结论:人体模型的使用促进了精神运动技能的自主学习,并促进了准确的应用。
    背景:ClinicalTrials.govID:NCT05346003,08/02/2022。
    BACKGROUND: Evidence supporting the benefits of autonomous learning of basic life support, such as rapid outcomes and cost-effectiveness, is increasing. Reports supporting the autonomous learning of cognitive skills in basic life support exist. However, there is currently no report supporting the autonomous learning of psychomotor skills in basic life support.
    OBJECTIVE: This study aimed to assess how using a research-developed pillow-made mannequin affects autonomous learning of psychomotor skills in basic life support training.
    METHODS: Randomized controlled trial.
    METHODS: This study was conducted in a nursing school in Turkey.
    METHODS: Sixty-one (n = 61) third-year formal science undergraduate students.
    METHODS: At XXX University, 61 nursing students were divided into Intervention (n = 31) and Control Groups (n = 30). Students in both groups received basic life support training, including live demonstrations. Intervention Group students practiced with the mannequin for 15 days. Skill assessments were conducted by two independent evaluators using a real mannequin 15 days later and six months later. Researchers used a checklist to assess psychomotor skills.
    RESULTS: The sociodemographic characteristics of both student groups were similar. There was no significant difference in cognitive knowledge levels after the blended training (p > 0.05). However, at both post-intervention assessments, after 15 days and after 6 months, significant skill differences emerged in \"placing the index finger on the ends of the sternum,\" \"combining the thumbs in the middle,\" \"defining the lower sternum as a massage point,\" \"placing the base of the chest\" \"placing the weaker hand at the massage point,\" \"placing the body perpendicular to the ribcage,\" and \"performing 30 compressions.\" Cohen\'s kappa value was calculated as 0.932.
    CONCLUSIONS: Use of the mannequin facilitates autonomous learning of psychomotor skills and promotes accurate application.
    BACKGROUND: ClinicalTrials.gov ID: NCT05346003, 08/02/2022.
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  • 文章类型: Journal Article
    背景:在有限的临床前模型中,缺血后处理(IPoC)已被证明可以改善预后。由于停机时间通常是未知的,这种技术需要在一系列场景中进行研究。由于该工具限制了再灌注损伤,在短暂停搏和有限的缺血再灌注损伤后,可能会有有限的益处甚至伤害。
    方法:18只雄性Wistar大鼠经历了7分钟的窒息停滞。随机分配到IPoC的动物接受了20s的暂停,然后进行了20s的按压,重复四次,开始心肺复苏40秒。如果恢复了自主循环(ROSC),肾上腺素滴定至平均动脉压(MAP)为70mmHg。使用t检验或Mann-Whitney检验分析数据。显著性设置为p≤0.05。
    结果:两组的ROSC率相当,88%。ROSC时间差异无统计学意义,ROSC后需要肾上腺素,颈动脉血流,或在任何时间点达到乳酸峰值。IPoC的MAP明显升高,90.7mmHg(SD13.9),与标准心肺复苏相比,76.7mmHg(8.5),ROSC后2小时,p=0.03。
    结论:IPoC在大鼠模型中使用基于CPR的IPoC干预的新的停搏病因,在短期停搏模型中没有损害。
    BACKGROUND: Ischemic post-conditioning (IPoC) has been shown to improve outcomes in limited pre-clinical models. As down-time is often unknown, this technique needs to be investigated over a range of scenarios. As this tool limits reperfusion injury, there may be limited benefit or even harm after short arrest and limited ischemia-reperfusion injury.
    METHODS: Eighteen male Wistar rats underwent 7 min of asphyxial arrest. Animals randomized to IPoC received a 20 s pause followed by 20 s of compressions, repeated four times, initiated 40 s into cardiopulmonary resuscitation. If return of spontaneous circulation (ROSC) was achieved, epinephrine was titrated to mean arterial pressure (MAP) of 70 mmHg. Data were analyzed using t-test or Mann-Whitney test. Significance set at p ≤ 0.05.
    RESULTS: The rate of ROSC was equivalent in both groups, 88%. There was no statistically significant difference in time to ROSC, epinephrine required post ROSC, carotid flow, or peak lactate at any timepoint. There was a significantly elevated MAP with IPoC, 90.7 mmHg (SD 13.9), as compared to standard CPR, 76.7 mmHg (8.5), 2 h after ROSC, p = 0.03.
    CONCLUSIONS: IPoC demonstrated no harm in a model of short arrest using a new arrest etiology for CPR based IPoC intervention in a rat model.
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  • 文章类型: Journal Article
    缺乏基本生命支持(BLS)知识会导致在提供及时干预方面犹豫不决,从而增加心脏骤停患者的死亡率。我们着手确定在尼日利亚教学医院工作的医生和护士的基本生命支持知识水平。
    自我管理问卷采用描述性问卷,横断面研究,以评估医生和护士的知识。总体知识得分和,分别计算医生和护士的分数.使用IBMSPSS版本20分析数据。
    对250名参与者(18-59岁)进行了评估。女性较多(153,61.2%),护士较多(149,59.8%)。60(24%)的参与者接受过至少一次BLS培训。101名(40.4%)参与者得分≥50%。总体平均得分为43.6%。医生和护士的平均得分分别为45.1%和42.7%。在某些领域的知识非常低,即:心肺复苏的顺序(2.8%),压缩呼吸比(2.8%)和压缩率(32.3%)。各专业知识得分无显著差异,性别,以前接触过BLS培训,合格后的年数和服务年数。
    尼日利亚的医护人员对BLS的了解不足。他们需要通过最适合资源贫乏国家的创造性和创新手段在BLS中进行培训和再培训。
    UNASSIGNED: Poor knowledge of Basic Life Support (BLS) can lead to hesitation in delivering prompt intervention, thus increasing mortality in people with cardiac arrest. We set out to determine level of knowledge of Basic Life Support among doctors and nurses working in a teaching hospital in Nigeria.
    UNASSIGNED: Self-administered questionnaires were employed in a descriptive, cross-sectional study to assess knowledge of doctors and nurses. The overall knowledge score and, separate scores for doctors and nurses were calculated. Data was analyzed using IBM SPSS version 20.
    UNASSIGNED: Two hundred and fifty participants (18-59) years were evaluated. There were more females (153, 61.2%) and more nurses (149, 59.8%). Sixty (24%) of the participants had received at least one previous BLS training. One hundred and one (40.4%) participants scored ≥50%. The overall average score was 43.6%. The average score for doctors and nurses were 45.1% and 42.7% respectively. Knowledge in some domains were very low viz: sequence in cardiopulmonary resuscitation (2.8%), compression-to-breath ratio (2.8%) and compression rate (32.3%). There was no significant difference in knowledge score by profession, gender, previous exposure to BLS training, number of years post-qualified and number of years in service.
    UNASSIGNED: Healthcare workers in Nigeria have poor knowledge of BLS. They require training and re-training in BLS via creative and innovative means that are best suited for resource poor countries.
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  • 文章类型: Journal Article
    与传统指导或其他形式的学习相比,评估快速周期故意练习(RCDP)在复苏培训结果以及临床和/或患者相关结果方面的有效性。
    作为国际复苏联络委员会持续证据评估过程的一部分,进行了这次审查,并搜索了Medline,Embase和Cochrane从成立到2月12日,2024.使用非随机干预研究中的偏倚风险评估工具和经修订的Cochrane偏倚风险评估工具进行偏倚风险评估。等级方法用于评估每个结果的证据的总体确定性。
    通过初始搜索检索了4420份摘要,并通过其他资源确定了10项其他研究。选择了65项研究的资格,其中9项模拟研究符合纳入标准。对三个结果进行了荟萃分析:胸部按压时间,除颤时间和第一次给予肾上腺素的时间,这表明RCDP的除颤时间和肾上腺素给药时间明显短于对照组。由于偏见的风险,所有结果的证据总体确定性都很低,不一致,间接性,和不精确。
    将RCDP作为基本和高级生命支持培训的教学设计功能包括在内可能是合理的。然而,提供RCDP存在很大差异,并且没有统一使用RCDP。需要进一步研究RCDP培训的中长期影响,以及对不同目标群体的训练效果。
    UNASSIGNED: To evaluate the effectiveness of Rapid Cycle Deliberate Practice (RCDP) compared to traditional instruction or other forms of learning on resuscitation training outcomes and on clinical and/or patient-related outcomes.
    UNASSIGNED: As part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation it was conducted this review and searched Medline, Embase and Cochrane from inception to Feb 12th, 2024. Risk of bias assessment was performed with the Risk of Bias in Non-randomized Studies of Interventions assessment tool and the Revised Cochrane risk-of-bias tool for randomized trials. The GRADE approach was used to evaluate the overall certainty of evidence for each outcome.
    UNASSIGNED: 4420 abstracts were retrieved by the initial search and 10 additional studies were identified through other resources. Sixty-five studies were selected for eligibility and nine simulated studies met the inclusion criteria. A meta-analysis was performed on three outcomes: time to chest compressions, time to defibrillation and time to first epinephrine given, which showed that RCDP had significantly shorter time to defibrillation and time to administration of epinephrine than controls. The overall certainty of evidence was very low across all outcomes due to risk of bias, inconsistency, indirectness, and imprecision.
    UNASSIGNED: It may be reasonable to include RCDP as an instructional design feature of basic and advanced life support training. However, substantial variations of delivering RCDP exist and there is no uniform use of RCDP. Further research is necessary on medium/long-term effects of RCDP training, and on the effects on different target groups of training.
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  • 文章类型: Journal Article
    背景:执行CPR(心肺复苏)是一项极其复杂的技能,其成功在很大程度上取决于麻醉学学生的知识和技能水平。因此,本研究旨在比较基于情景的培训方法与视频培训方法对麻醉护士学生BLS(基本生命支持)知识和技能的影响.
    方法:这项随机准实验研究涉及45名来自AhvazJundishapur医科大学的护士麻醉学生,Ahvaz,伊朗2022-2023年。大学的实践室形成了研究环境。参与者被随机分为三组基于情景的训练,视频培训,和控制。在干预前后,通过知识问卷和BLS技能评估清单收集数据。
    结果:在SG(情景组)(p<0.001)和VG(视频组)(p=0.008)(p<0.001)的教育干预前后,学生的BLS知识和技能得分之间存在显着差异。然而,在CG(对照组)中,在这方面没有观察到显着差异(p=0.37)(p=0.16)。此外,SG的BLS知识和技能的平均得分高于VG(p<0.001)。
    结论:鉴于情景教育对促进积极参与的有益影响,批判性思维,利用智力,和学习者的创造力,这种方法似乎比视频训练更有优势,特别是在教授基本生命支持等关键科目时。
    BACKGROUND: Performing CPR (Cardiopulmonary Resuscitation) is an extremely intricate skill whose success depends largely on the level of knowledge and skill of Anesthesiology students. Therefore, this research was conducted to compare the effect of the scenario-based training method as opposed to video training method on nurse anesthesia students\' BLS (Basic Life Support) knowledge and skills.
    METHODS: This randomized quasi-experimental study involved 45 nurse anesthesia students of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran in 2022-2023. The practical room of the university formed the research environment. The participants were randomly divided into three groups of scenario-based training, video training, and control. Data were collected by a knowledge questionnaire and a BLS skill assessment checklist before and after the intervention.
    RESULTS: There was a significant difference between the students\' scores of BLS knowledge and skill before and after the educational intervention in both SG (scenario group) (p < 0.001) and VG (video group) (p = 0.008) (p < 0.001). However, no significant difference was observed in this regard in the CG (control group) (p = 0.37) (p = 0.16). Also, the mean scores of BLS knowledge and skills in the SG were higher than those in the VG (p < 0.001).
    CONCLUSIONS: Given the beneficial impact of scenario-based education on fostering active participation, critical thinking, utilization of intellectual abilities, and learner creativity, it appears that this approach holds an advantage over video training, particularly when it comes to teaching crucial subjects like Basic Life Support.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    要探索文学,护理提供者可获得的关于如何向残疾人提供CPR和BLS的政策或程序,目前的标准指南不适合他们的目的。
    使用四个数据库进行了范围审查,即,CINHAL,PubMed,Scopus,Medline和谷歌学者。使用的关键字包括,disab*,轮椅,心肺,复苏,“基本生命支持”,生命支持护理,和旁观者心肺复苏术。检索了1119篇论文,并在删除76篇重复后筛选了1043篇。回顾了18篇全文,5篇符合纳入标准。
    这五篇文章来自三个县,包括一个案例研究,三份专家意见文件和一份干预研究。其中四篇论文主张改进CPR和BLS指南,其中三篇论文讨论了补充标准CPR和BLS的技术和想法。
    范围审查发现缺乏证据来解释为残疾人提供CPR和BLS,并强调需要进一步研究。在没有进一步证据的情况下,教育工作者有理由向照顾者提供有关为残疾人补充CPR和BLS的想法和讨论。
    残疾人和轮椅使用者面临过早死亡或可预防死亡的高风险。建议改善急救反应是减轻过早和可预防死亡的因素。改善急救反应将为残疾人和轮椅使用者提供与无残疾人相同的护理和康复机会。正式和非正式的照顾者目前没有规定的指导方针来提高他们对残疾人紧急事件的应对知识。建议制定改进的指南,以减少正式和非正式护理人员的恐惧和焦虑,同时增加他们应对紧急情况的信心。
    UNASSIGNED: To explore literature, policies or procedures available to care providers on how to deliver CPR and BLS to people with a disability, for whom the current standard guidelines are not fit for purpose.
    UNASSIGNED: A scoping review was conducted using four databases, namely, CINHAL, PubMed, Scopus, Medline and Google Scholar. Keywords used included, disab*, wheelchairs, cardiopulmonary, resuscitation, \"basic life support\", life support care, and bystander CPR. 1119 papers were retrieved and 1043 were screened following removal of 76 for duplication. 18 full text articles were reviewed and 5 met the inclusion criteria.
    UNASSIGNED: The five articles were from three counties and included one case study, three expert opinion papers and one intervention study. Four of the papers advocated in favour of improved CPR and BLS guidelines and three of the papers discussed techniques and ideas for supplementation of standard CPR and BLS.
    UNASSIGNED: The scoping review has uncovered a paucity of evidence explaining delivery of CPR and BLS for people with disability and highlights the need for further research. In the absence of further evidence, it is reasonable for educators to provide ideas and discussion about supplementing CPR and BLS for people with disability to carers.
    People with disability and wheelchair users are at a high risk for premature or preventable deaths.Improved first aid responses are proposed to be a mitigating factor for premature and preventable deaths.Improved first aid responses will afford people with disability and wheelchair users the same opportunities for care and rehabilitation as people without disability.Formal and informal carers do not currently have prescriptive guidelines to improve their knowledge on responding to emergency events for people with disabilities.Development of improved guidelines is recommended to reduce fear and anxiety for formal and informal carers whilst also increasing their confidence to respond to emergency situations.
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  • 文章类型: Journal Article
    应将除颤器连接到所有接受心肺复苏(CPR)的患者,以允许早期除颤。除颤器将收集信号数据,例如心电图(ECG),胸阻抗和呼气末CO2,这允许研究患者如何表现出对CPR的不同反应。这篇综述的目的是概述使用除颤器数据进行研究的方法学挑战和机遇。
    成功收集除颤器文件有几个挑战。如何存储这些数据没有科学标准,这导致了几个专有的工业解决方案。需要将数据导出到软件环境中,在该环境中可以执行信号过滤和ECG节律分类。这可以使用不同的算法和人工智能(AI)来自动化。患者可以被分类为心室纤颤或心动过速,心搏停止,无脉电活动或已恢复自发循环。这种动态响应是如何依赖于时间并且与协变量相关的,可以通过几种方式来处理。这些包括Aalen的线性模型,威布尔回归和联合模型。
    来自除颤器的大量信号数据代表了使用AI和统计分析来评估患者对CPR的反应的有希望的机会。这可以提供流行病学基础,以改善复苏指南并提供更个性化的护理。我们建议成立一个国际工作组,以促进关于如何实现除颤器数据的开放格式的讨论,这迫使工业合作伙伴进一步开发他们目前的技术解决方案。
    UNASSIGNED: A defibrillator should be connected to all patients receiving cardiopulmonary resuscitation (CPR) to allow early defibrillation. The defibrillator will collect signal data such as the electrocardiogram (ECG), thoracic impedance and end-tidal CO2, which allows for research on how patients demonstrate different responses to CPR. The aim of this review is to give an overview of methodological challenges and opportunities in using defibrillator data for research.
    UNASSIGNED: The successful collection of defibrillator files has several challenges. There is no scientific standard on how to store such data, which have resulted in several proprietary industrial solutions. The data needs to be exported to a software environment where signal filtering and classifications of ECG rhythms can be performed. This may be automated using different algorithms and artificial intelligence (AI). The patient can be classified being in ventricular fibrillation or -tachycardia, asystole, pulseless electrical activity or having obtained return of spontaneous circulation. How this dynamic response is time-dependent and related to covariates can be handled in several ways. These include Aalen\'s linear model, Weibull regression and joint models.
    UNASSIGNED: The vast amount of signal data from defibrillator represents promising opportunities for the use of AI and statistical analysis to assess patient response to CPR. This may provide an epidemiologic basis to improve resuscitation guidelines and give more individualized care. We suggest that an international working party is initiated to facilitate a discussion on how open formats for defibrillator data can be accomplished, that obligates industrial partners to further develop their current technological solutions.
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  • 文章类型: Journal Article
    简介:旁观者心肺复苏(CPR)的表现可提高心脏骤停患者的生存率。基本生命支持(BLS)的近同伴教学可能是提供复苏教育的有效方法。本文旨在评估由学生药剂师领导的美国心脏协会(AHA)BLS课程对高中学生的知识和技能成就的有效性。方法:对学生药剂师进行AHA讲师培训,并向高中生提供BLS认证课程。参与者完成了根据课程学习目标改编的评估前和评估后。使用AHA的标准化表格评估技能表现。参与者完成了有关他们对药剂师在BLS中的作用以及对从事医疗保健事业的信心的看法的问题。结果:有321名参与者,其中大多数在11或12年级(86.6%)和上公立学校(99.1%)。完成培训后,正确评估应答的平均百分比从41.2%增加到89%(p<0.0001).所有参与者都正确执行了BLS技能。大多数参与者强烈同意或同意,该课程改变了他们对BLS期间药剂师角色的看法(74.8%),并增加了他们决定追求未来医疗保健职业的信心(61.7%)。结论:学生药剂师主导的BLS培训,使用近对等交付,提高高中生的知识和技能成就。这一策略促进高中生对药剂师及其在BLS中的作用的积极看法,以及他们对从事医疗保健事业的信心。
    Introduction: The performance of bystander cardiopulmonary resuscitation (CPR) improves survival among cardiac arrest victims. Near-peer teaching of Basic Life Support (BLS) may be an effective way to deliver resuscitation education. This article aims to assess the effectiveness of a student pharmacist-led American Heart Association (AHA) BLS course on high school students\' knowledge and skill achievement. Methods: Student pharmacists were trained as AHA instructors and delivered BLS certification courses to high school students. Participants completed pre- and post-assessments adapted from the course learning objectives. Skills performance was evaluated using the AHA\'s standardized forms. Participants completed questions regarding their perceptions of the pharmacist\'s role in BLS and confidence in pursuing a career in healthcare. Results: There were 321 participants with the majority in 11th or 12th grade (86.6%) and attending public school (99.1%). After completing the training, the mean percentage of correct assessment responses increased from 41.2% to 89% (p <0.0001). All participants correctly performed BLS skills. Most participants strongly agreed or agreed that the course changed their perspective of the pharmacist\'s role during BLS (74.8%) and increased their confidence in their decision to pursue future careers in healthcare (61.7%). Conclusion: Student pharmacist-led BLS training, using near-peer delivery, improves high school students\' knowledge and skill achievement. This strategy promotes high school students\' positive perceptions regarding pharmacists and their role in BLS, as well as their confidence in pursuing careers in healthcare.
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  • 文章类型: Journal Article
    阐明从心肺复苏开始到自发循环恢复(ROSC)的间隔与神经系统上有利的1个月生存率之间的关系,以确定无需高级干预的基本生命支持(BLS)的适当持续时间。这项基于人群的队列研究纳入了年龄≥18岁的患者,其中9132例推测是心脏起源的院外心脏骤停,这些患者是旁观者目击的,并且在2018年至2020年之间实现了ROSC。根据复苏方法将患者分为两组,即“仅BLS”和“给予肾上腺素的BLS(BLS-AE)”组。受试者工作特征(ROC)曲线分析表明,对具有可电击节律的患者[敏感性,0.42;特异性,0.27;ROC曲线下面积(AUC),0.60]在仅BLS组中。相反,对于有不可电击节律的患者,进行BLS6分钟可产生最佳的神经系统结局(敏感性,0.65;特异性,0.43;AUC,0.63)。在倾向得分匹配后,多变量分析显示,仅BLS复苏[6.44(5.34-7.77)]与神经系统有利的1个月生存率相关。这项回顾性研究表明,仅BLS干预在CPR开始后的最初几分钟内产生了重大影响。然而,此后其有效性明显下降。有效的仅BLS干预的最佳持续时间取决于患者的初始心律。因此,先进的干预措施应在最初的几分钟内进行,以抵消仅BLS干预的有效性下降.
    To elucidate the relationship between the interval from cardiopulmonary resuscitation initiation to return of spontaneous circulation (ROSC) and neurologically favourable 1-month survival in order to determine the appropriate duration of basic life support (BLS) without advanced interventions. This population-based cohort study included patients aged ≥ 18 years with 9132 out-of-hospital cardiac arrest of presumed cardiac origin who were bystander-witnessed and had achieved ROSC between 2018 and 2020. Patients were classified into two groups based on the resuscitation methods as the \"BLS-only\" and the \"BLS with administered epinephrine (BLS-AE)\" groups. Receiver operating characteristic (ROC) curve analysis indicated that administering BLS for 9 min yielded the best neurologically outcome for patients with a shockable rhythm [sensitivity, 0.42; specificity, 0.27; area under the ROC curve (AUC), 0.60] in the BLS-only group. Contrastingly, for patients with a non-shockable rhythm, performing BLS for 6 min yielded the best neurologically outcome (sensitivity, 0.65; specificity, 0.43; AUC, 0.63). After propensity score matching, multivariate analysis revealed that BLS-only resuscitation [6.44 (5.34-7.77)] was associated with neurologically favourable 1-month survival. This retrospective study revealed that BLS-only intervention had a significant impact in the initial minutes following CPR initiation. Nevertheless, its effectiveness markedly declined thereafter. The optimal duration for effective BLS-only intervention varied depending on the patient\'s initial rhythm. Consequently, advanced interventions should be administered within the first few minutes to counteract the diminishing effectiveness of BLS-only intervention.
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