Background: Virtual reality (VR) is an interesting and promising way to teach cardiopulmonary resuscitation (CPR) to adult laypersons as its high immersive characteristics could improve the level of skills and acquired knowledge in learning basic life support (BLS). Methods: This systematic review assesses current literature about BLS training with VR and its possible effect on CPR-quality parameters, self-efficacy, perceived learning, and learners’ satisfaction and short and long-term patients’ outcome. We screened the Cochrane Library, PubMed, CINAHL, MEDLINE Ovid, Web of Science, and Scopus databases and included only clinical trials and quasi-experimental studies published from inception to October 1, 2021, which analyzed adult laypersons’ BLS training with the use of VR. Primary outcomes were CPR parameters (chest compression rate and depth, Automated External Defibrillator use). Secondary outcomes were self-efficacy, perceived learning and learners satisfaction, and patients’ outcomes (survival and good neurologic status). The risk of bias of included study was assessed using the Cochrane Handbook for Systematic Reviews of Interventions tool to evaluate randomized control trials and the transparent reporting of evaluations with nonrandomized designs checklist for nonrandomized studies. Results: After full article screening, 6 studies were included in the systematic review (731 participants) published between 2017 and 2021. Because of the heterogeneity of the studies, we focused on describing the studies rather than meta-analysis. The assessment of the quality of evidence revealed overall a very low quality. Training with VR significantly improved the rate and depth of chest compressions in 4 out of 6 articles. VR was described as an efficient teaching method, exerting a positive effect on self-efficacy, perception of confidence, and competence in 2 articles. Conclusion: VR in BLS training improves manual skills and self-efficacy of adult laypersons and may be a good teaching method in a blended learning CPR training strategy. VR may add another way to divide complex parts of resuscitation training into easier individual skills. However, the conclusion of this review suggests that VR may improve the quality of the chest compressions as compared to instructor-led face-to-face BLS training.

Background: In recent years, the use of peripheral transluminal angioplasty (PTA) procedures for revascularization of an ischemic limb has increased. Evaluation of reperfusion has been carried out by Doppler scan; however, a successful PTA does not necessarily result in improved oxygen delivery to the distal parts of the limb. Purpose: To evaluate the efficacy of the revascularization in diabetic patients with critical limb ischemia after treatment with PTA by comparing transcutaneous oxygen tension (TcpO₂) with the ankle-brachial index (ABI) post PTA. Material and Methods: This prospective study included 151 consecutive diabetic patients. We evaluated the posterior tibial and dorsalis pedis Doppler, ABI, TcpO₂, and duplex scan results. If two of these four examinations were abnormal, arteriography was carried out and PTA was performed concomitantly. At least 64 patients were considered suitable candidates for PTA. Results: The ABI increased from 0.67±0.25 to 0.84±0.25 following PTA ( P<0.001). TcpO₂ increased from 27.20±11.10 mm Hg to 40±12.10 mm Hg after PTA ( P<0.001). While the TcpO₂ could be measured in all patients, the ABI was not measurable in 25.37% pretreatment and in 17.91% post treatment. Statistical analysis revealed a scant correlation between the techniques used: TcpO₂ and ABI ( P=0.20). Conclusion: Our study confirms that the increase in TcpO₂ in diabetic patients following PTA points to the physiologic significance of microvascular revascularization achieved in the treated limb and serves to assess functional improvement in tissue oxygenation obtained by PTA. The use of TcpO₂ may represent an alternative to traditional assessment of peripheral transluminal angioplasty results.

Qualitative study. To detect the major challenges and needs reported by family member caregivers of people with spinal cord injury (SCI). Family member caregivers of people with SCI and expert professionals were evaluated. This study was conducted in Spain, and most of the participants attended the National Paraplegics Hospital of Toledo. We performed 25 semi-structured interviews. The data were analyzed from a phenomenological perspective using the Colaizzi method. The metamorphosis of the caregiver is a complex personal and family-related process. Analysis of the adjustment phase of the caregiving role allowed us to describe three stages, patterns, and trends. Five basic needs were identified. People with SCI and their primary caregivers experienced changes in every sphere of their lives. Their most important needs were psychological support, social support, economic resources, information, training throughout the process of suffering, and the creation of informal groups of mutual aid.