The ability of COVID-19 to compromise the respiratory system has generated a substantial proportion of critically ill patients in need of invasive mechanical ventilation (IMV). The objective of this paper was to analyze the prognostic ability of the pulse oximetry saturation/fraction of inspired oxygen ratio (SpO2/FiO2) and the ratio of SpO2/FiO2 to the respiratory rate–ROX index–as predictors of IMV in an emergency department in confirmed COVID-19 patients. A multicenter, retrospective cohort study was carried out in four provinces of Spain between March and November 2020. The discriminative power of the predictive variable was assessed through a prediction model trained using a derivation sub-cohort and evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) on the validation sub-cohort. A total of 2040 patients were included in the study. The IMV rate was 10.1%, with an in-hospital mortality rate of 35.3%. The performance of the SpO2/FiO2 ratio was better than the ROX index–AUC = 0.801 (95% CI 0.746–0.855) and AUC = 0.725 (95% CI 0.652–0.798), respectively. In fact, a direct comparison between AUCs resulted in significant differences (p = 0.001). SpO2 to FiO2 ratio is a simple and promising non-invasive tool for predicting risk of IMV in patients infected with COVID-19, and it is realizable in emergency departments.

Background: The aim was to assess future schoolteachers’ basic life support (BLS) knowledge and willingness to include this content in school lessons. The aim was also to determine the learning effect of a brief BLS hands-on training session, supported by real-time feedback. Methods: A convenience sample of 98 University students of Educational Sciences and Sports were recruited. The training program consisted of brief theoretical and hands-on interactive sessions with a 2/10 instructor/participants ratio. Knowledge and willingness was assessed by means of a survey. Chest compressions (CC) and ventilation quality were registered in 47 cases during 1 min cardiopulmonary resuscitation (CPR) tests. Results: Fifty-eight percent of subjects declared to know how to perform CPR, 62% knew the correct chest compression/ventilation ratio but only one in four knew the CC quality standards. Eighty-eight percent knew what an automated external defibrillator (AED) was; willingness to use the device improved from 70% to 98% after training. Almost half of CCs were performed atan adequate rate. Men performed deeper compressions than women ( 56.1 ± 4.03 mm vs. 52.17 ± 5.51 mm, p = 0.007), but in both cases the mean value was within recommendations. Full chest recoil was better in women (72.2 ± 32.8% vs. 45.4 ± 32.9%, p = 0.009). All CCs were delivered with correct hand positions. Conclusions: Brief hands-on training supported by real-time feedback of CPR quality helps future schoolteachers improve their knowledge, self-confidence and CPR skills. BLS training should be implemented in University curricula for schoolteachers in order to promote their engagement in effective BLS training of schoolchildren. Background: The aim was to assess future schoolteachers’ basic life support (BLS) knowledge and willingness to include this content in school lessons. The aim was also to determine the learning effect of a brief BLS hands-on training session, supported by real-time feedback. Methods: A convenience sample of 98 University students of Educational Sciences and Sports were recruited. The training program consisted of brief theoretical and hands-on interactive sessions with a 2/10 instructor/participants ratio. Knowledge and willingness was assessed by means of a survey. Chest compressions (CC) and ventilation quality were registered in 47 cases during 1 min cardiopulmonary resuscitation (CPR) tests. Results: Fifty-eight percent of subjects declared to know how to perform CPR, 62% knew the correct chest compression/ventilation ratio but only one in four knew the CC quality standards. Eighty-eight percent knew what an automated external defibrillator (AED) was; willingness to use the device improved from 70% to 98% after training. Almost half of CCs were performed atan adequate rate. Men performed deeper compressions than women ( 56.1 ± 4.03 mm vs. 52.17 ± 5.51 mm, p = 0.007), but in both cases the mean value was within recommendations. Full chest recoil was better in women (72.2 ± 32.8% vs. 45.4 ± 32.9%, p = 0.009). All CCs were delivered with correct hand positions. Conclusions: Brief hands-on training supported by real-time feedback of CPR quality helps future schoolteachers improve their knowledge, self-confidence and CPR skills. BLS training should be implemented in University curricula for schoolteachers in order to promote their engagement in effective BLS training of schoolchildren.

Evaluating the usefulness of a chat bot as an assistant during CPR care by laypersons. Twenty-one university graduates and university students naive in basic life support participated in this quasi-experimental simulation pilot trial. A version beta chatbot was designed to guide potential bystanders who need help in caring for cardiac arrest victims. Through a Question-Answering (Q&A) flowchart, the chatbot uses Voice Recognition Techniques to transform the user's audio into text. After the transformation, it generates the answer to provide the necessary help through machine and deep learning algorithms. A simulation test with a Laerdal Little Anne manikin was performed. Participants initiated the chatbot, which guided them through the recognition of a cardiac arrest event. After recognizing the cardiac arrest, the chatbot indicated the start of chest compressions for 2 min. Evaluation of the cardiac arrest recognition sequence was done via a checklist and the quality of CPR was collected with the Laerdal Instructor App. 91% of participants were able to perform the entire sequence correctly. All participants checked the safety of the scene and made sure to call 112. 62% place their hands on the correct compression point. A media time of 158 s (IQR: 146-189) was needed for the whole process. 33% of participants achieved high-quality CPR with a median of 60% in QCPR (IQR: 9-86). Compression depth had a median of 42 mm (IQR: 33-53) and compression rate had a median of 100 compressions/min (IQR: 97-100). The use of a voice assistant could be useful for people with no previous training to perform de out-of-hospital cardiac arrest recognition sequence. Chatbot was able to guide all participants to call 112 and to perform continuous chest compressions. The first version of the chatbot for potential bystanders naive in basic life support needs to be further developed to reduce response times and be more effective in giving feedback on chest compressions.