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Liou FY, Lin KC, Chien CS, Hung WT, Lin YY, Yang YP, Lai WY, Lin TW, Kuo SH, Huang WC. The impact of bystander cardiopulmonary resuscitation on patients with out-of-hospital cardiac arrests. J Chin Med Assoc 2021; 84:1078-1083. [PMID: 34610624 DOI: 10.1097/jcma.0000000000000630] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death around the world. Bystander cardiopulmonary resuscitation (CPR) is an independent factor to improve OHCA survival. However, the prevalence of bystander CPR remains low worldwide. Community interventions such as mandatory school CPR training or targeting CPR training to family members of high-risk cardiac patients are possible strategies to improve bystander CPR rate. Real-time feedback, hands-on practice with a manikin, and metronome assistance may increase the quality of CPR. Dispatcher-assistance and compression-only CPR for untrained bystanders have shown to increase bystander CPR rate and increase survival to hospital discharge. After return of spontaneous circulation, targeted temperature management should be performed to improve neurological function. This review focuses on the impact of bystander CPR on clinical outcomes and strategies to optimize the prevalence and quality of bystander CPR.
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Affiliation(s)
- Fang-Yu Liou
- Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Kun-Chang Lin
- Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Chian-Shiu Chien
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Wan-Ting Hung
- Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Yi-Ying Lin
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yi-Ping Yang
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Wei-Yi Lai
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Tzu-Wei Lin
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shu-Hung Kuo
- Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Wei-Chun Huang
- Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan, ROC
- Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
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Hawkes CA, Brown T, Noor U, Carlyon J, Davidson N, Soar J, Perkins GD, Smyth MA, Lockey A. Characteristics of Restart a Heart 2019 event locations in the UK. Resusc Plus 2021; 6:100132. [PMID: 34223389 PMCID: PMC8244288 DOI: 10.1016/j.resplu.2021.100132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction Restart a Heart (RSAH) is an annual CPR mass training initiative delivered predominantly by ambulance services in the UK. The aim of this study was to identify to what extent voluntary participation in the 2019 initiative delivered training to the population with the highest need. Methods A cross-sectional observational study of location characteristics for RSAH training events conducted by UK ambulance services. Descriptive statistics were used to analyse event and area characteristics. National cardiac arrest registry data were used to establish proportions of training coverage in “hot spot” areas with above national median incidence of cardiac arrest and below median bystander CPR rates. The significance of observed differences were tested using chi-square for proportions and t-test for means. Results Twelve of 14 UK ambulance services participated, training 236,318 people. Most of the events (82%) were held in schools, and schoolchildren comprised most participants (81%). RSAH events were held in areas that were less densely populated (p < 0.001), were more common in affluent areas (p < 0.001), and had a significantly lower proportion of black residents (p < 0.05) and higher proportion of white residents (p < 0.05). Events were held in 28% of known “hot spot” areas in England. Conclusion With mandatory CPR training for school children in England, Scotland and Wales there is an opportunity to re-focus RSAH resources to deliver training for all age groups in OHCA “hot spots”, communities with higher proportions of black residents, and areas of deprivation. In Northern Ireland, we recommend targeting schools in areas with similar characteristics.
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Affiliation(s)
- C A Hawkes
- University of Warwick, Warwick Clinical Trials Unit, Gibbet Hill, Coventry, CV4 7AL, UK
| | - T Brown
- University of Warwick, Warwick Clinical Trials Unit, Gibbet Hill, Coventry, CV4 7AL, UK
| | - U Noor
- University of Warwick, Warwick Clinical Trials Unit, Gibbet Hill, Coventry, CV4 7AL, UK
| | - J Carlyon
- Resuscitation Council UK 5th Floor Tavistock House North, Tavistock Square, London, WC1H 9H, UK.,Yorkshire Ambulance Service, Trust Headquarters, Brindley Way, Wakefield 41 Business Park, Wakefield, WF2 0XQ, UK
| | | | - J Soar
- Resuscitation Council UK 5th Floor Tavistock House North, Tavistock Square, London, WC1H 9H, UK.,North Bristol NHS Trust Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol, BS10 5NB, UK
| | - G D Perkins
- University of Warwick, Warwick Clinical Trials Unit, Gibbet Hill, Coventry, CV4 7AL, UK.,University Hospitals Birmingham, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK
| | - M A Smyth
- University of Warwick, Warwick Clinical Trials Unit, Gibbet Hill, Coventry, CV4 7AL, UK.,West Midlands Ambulance Service University NHS Foundation Trust, Trust Headquarters, Millennium Point, Waterfront Business Park, Waterfront Way, Brierley Hill, West Midlands, DY5 1LX, UK
| | - A Lockey
- Resuscitation Council UK 5th Floor Tavistock House North, Tavistock Square, London, WC1H 9H, UK.,Calderdale and Huddersfield NHS Foundation Trust, Salterhebble, Halifax, West Yorkshire HX3 0PW, UK
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Kim DK, Shin SD, Ro YS, Song KJ, Hong KJ, Joyce Kong SY. Place-provider-matrix of bystander cardiopulmonary resuscitation and outcomes of out-of-hospital cardiac arrest: A nationwide observational cross-sectional analysis. PLoS One 2020; 15:e0232999. [PMID: 32413089 PMCID: PMC7228068 DOI: 10.1371/journal.pone.0232999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 04/26/2020] [Indexed: 11/19/2022] Open
Abstract
AIMS This study aims to test the association between the place-provider-matrix (PPM) of bystander cardiopulmonary resuscitation (CPR) and outcomes of out-of-hospital cardiac arrest (OHCA). METHODS Adult patients with OHCA with a cardiac etiology from 2012 to 2017 in Korea were analyzed, excluding patients who had unknown information on place, type of bystander, or outcome. The PPM was categorized into six groups by two types of places (public versus home) and three types of providers (trained responder (TR), family bystander, and layperson bystander). Outcomes were survival to discharge and good cerebral performance category (CPC) of 1 or 2. Multivariable logistic regression analysis was performed to test the association between PPM group and outcomes with adjustment for potential confounders to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) (reference = Public-TR). RESULTS A total of 73,057 patients were analyzed and were categorized into Public-TR (0.6%), Home-TR (0.3%), Public-Family (1.8%), Home-Family (79.8%), Public-Layperson (9.9%), and Home-Layperson (7.6%) groups. Compared with the Public-TR group, the AORs (95% CIs) for survival to discharge were 0.61 (0.35-1.05) in the Home-TR group, 0.85 (0.62-1.17) in the Public-Family group, 0.38 (0.29-0.50) in the Home-Family group, 1.12 (0.85-1.49) in the Public-Layperson group, and 0.42 (0.31-0.57) in the Home-Layperson group. The AORs (95% CIs) for good CPC were 0.58 (0.27-1.25) in the Home-TR group, 0.88 (0.61-1.27) in the Public-Family group, 0.38 (0.28-0.52) in the Home-Family group, 1.20 (0.87-1.65) in the Public-Layperson group, and 0.42 (0.30-0.59) in the Home-Layperson group. CONCLUSION The OHCA outcomes of the Home-Family and Home-Layperson groups were worse than those of the Public-TR group. This finding suggests that OHCA occurring in private places with family or layperson bystanders requires a new strategy, such as dispatching trained responders to the scene to improve CPR outcomes.
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Affiliation(s)
- Dae Kon Kim
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- * E-mail:
| | - Young Sun Ro
- Laboratory of Emergency Medical Services, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Jun Song
- Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Ki Jeong Hong
- Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - So Yeon Joyce Kong
- Laboratory of Emergency Medical Services, Seoul National University College of Medicine, Seoul, Republic of Korea
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Blewer AL, Putt ME, McGovern SK, Murray AD, Leary M, Riegel B, Shea JA, Berg RA, Asch DA, Viera AJ, Merchant RM, Nadkarni VM, Abella BS. A pragmatic randomized trial of cardiopulmonary resuscitation training for families of cardiac patients before hospital discharge using a mobile application. Resuscitation 2020; 152:28-35. [PMID: 32376347 DOI: 10.1016/j.resuscitation.2020.04.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/06/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Abstract
AIM OF THE STUDY Since over 80% of sudden cardiac arrests occur in the home, cardiopulmonary resuscitation (CPR) training for family members of high-risk cardiac patients represents a promising intervention. The use of mobile application-based (mApp) CPR training may facilitate this approach, but evidence regarding its efficacy is lacking. METHODS We conducted a multicenter, pragmatic, cluster-randomized trial assessing CPR training for family members of cardiac patients. The interventions were mApp (video, no manikin) and VSI (video + manikin). CPR skills were evaluated 6-months post-training. We hypothesized that chest compression (CC) rate from training with an mApp would be no worse than 5 compressions per minute (CPM) lower compared to VSI. RESULTS From 01/2016 to 01/2018, we enrolled 1325 eligible participants (mean age 51.6 years, 68.2% female and 59.4% white). CPR skills were evaluated 6-months post-training in 541 participants (275 VSI, 266 mApp). Mean rate was 84.6 CPM (95% CI: 80.4, 88.6) in VSI, compared to 82.7 CPM (95% CI: 76.2, 89.1) in the mApp, and mean depth was 42.1 mm (95% CI: 40.3, 43.8) in VSI, compared to 38.9 mm (95% CI: 36.2, 41.6) in the mApp. After adjustment, the mean difference in CC rate was -2.3 CPM (95% CI -9.4, 4.8, p = 0.25, non-inferiority) and CC depth was -3.2 mm (95% CI -5.9, 0.1, p = 0.056). CONCLUSION In this large prospective trial of CPR skill retention for family members of cardiac patients, mApp training was associated with lower CC quality. Future work is required to understand additional approaches to improve CPR skill retention. CLINICAL TRIAL REGISTRATION URL: ClinicalTrials.gov, Identifier: NCT02548793.
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Affiliation(s)
- Audrey L Blewer
- Department of Family Medicine and Community Health, Duke University, Durham, NC, USA.
| | - Mary E Putt
- Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Shaun K McGovern
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew D Murray
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Marion Leary
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Judy A Shea
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert A Berg
- Department of Anesthesiology and Critical Care; University of Pennsylvania, Philadelphia, PA, USA; The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - David A Asch
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Anthony J Viera
- Department of Family Medicine and Community Health, Duke University, Durham, NC, USA
| | - Raina M Merchant
- Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Vinay M Nadkarni
- Department of Anesthesiology and Critical Care; University of Pennsylvania, Philadelphia, PA, USA; The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Benjamin S Abella
- Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, PA, USA
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Sawyer KN, Camp-Rogers TR, Kotini-Shah P, Del Rios M, Gossip MR, Moitra VK, Haywood KL, Dougherty CM, Lubitz SA, Rabinstein AA, Rittenberger JC, Callaway CW, Abella BS, Geocadin RG, Kurz MC. Sudden Cardiac Arrest Survivorship: A Scientific Statement From the American Heart Association. Circulation 2020; 141:e654-e685. [DOI: 10.1161/cir.0000000000000747] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cardiac arrest systems of care are successfully coordinating community, emergency medical services, and hospital efforts to improve the process of care for patients who have had a cardiac arrest. As a result, the number of people surviving sudden cardiac arrest is increasing. However, physical, cognitive, and emotional effects of surviving cardiac arrest may linger for months or years. Systematic recommendations stop short of addressing partnerships needed to care for patients and caregivers after medical stabilization. This document expands the cardiac arrest resuscitation system of care to include patients, caregivers, and rehabilitative healthcare partnerships, which are central to cardiac arrest survivorship.
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6
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González-Salvado V, Rodríguez-Ruiz E, Abelairas-Gómez C, Ruano-Raviña A, Peña-Gil C, González-Juanatey JR, Rodríguez-Núñez A. Formación de población adulta lega en soporte vital básico. Una revisión sistemática. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2018.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Alqahtani SE, Alhajeri AS, Ahmed AA, Mashal SY. Characteristics of Out of Hospital Cardiac Arrest in the United Arab Emirates. Heart Views 2019; 20:146-151. [PMID: 31803370 PMCID: PMC6881873 DOI: 10.4103/heartviews.heartviews_80_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/16/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Out of hospital cardiac arrest is one of the leading causes of death globally. This study aimed to identify the characteristics of out of hospital cardiac arrest patients who were attended and treated by the National Ambulance crew. A lot of studies reported the importance of implementing chain of survival to increase survival rates from cardiac arrest. To be implemented in United Arab Emirates (UAE), it required a detailed study of the community engagement. The study aimed to explore the demography of the incidences, location, age, gender epidemiology of the patients who had their cardiac arrest witnessed along with their Bystander cardiopulmonary resuscitation (CPR) performed prior to the arrival of National Ambulance and public access to an automated external defibrillator. The return of spontaneous circulation was also explored prior to their arrival to the emergency department. Methods: The research is a prospective descriptive cohort study of out of hospital cardiac arrest patients attended by National Ambulance between July 2017 and June 2018. The National Ambulance provides emergency medical services for public and private hospitals in the Emirates of Sharjah, Ajman, Ras-al-Khaimah, Fujairah, and Umm Al-Quwain and its clients in Abu Dhabi in UAE. Data for the study were collected by the National Ambulance crew attending the OHCA patients, using a structured questionnaire. Results: In this 1-year period, a total of 715 out of hospital cardiac arrest cases were attended by the National Ambulance with higher percentage (77%) of male patients. Resuscitation and transportation were attempted for 95% whereas 5% were pronounced dead on the spot. In this study, the median age of the patients was 50 years. Majority of the patients were Asians 55% (n = 395) followed by Arabs non-UAE citizens 19.4% (n = 139) and UAE citizens 16% (n = 113). Patients facing sudden cardiac arrest in their homes or residences represented 69.9% (n = 500), street and public places 22.5% (n = 161), and workplace 6.8% (n = 49). The percentage of patients who had witnessed cardiac arrest was 51.7% (n = 370) only 197 had CPR performed on them prior to the arrival of National Ambulance. Low public access to AED was found in this population that is 1.8% (n = 13). A majority of the participants in this study had nonshockable rhythms 84.3% (n = 603) whereas shockable rhythms presented on 11% (n = 80). The percentage of patients who had ROSC at the scene or en route to the hospitals was found 9.2% (n = 66). Conclusion: In this 1-year study, the result showed that cardiac arrest was recognized and witnessed in about half of the cases, but low bystander CPR was performed. Low public access and use of AED were found. Data on hospitalized and discharged OHCA patients were not available and required further linkage and corporation between ambulance services and hospitals to ensure data continuity of OHCA cases. This study is essential for the implementation of proper chain of survival and reduction in mortality rates in UAE.
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Affiliation(s)
- Saad Essa Alqahtani
- Department of Research and Development, National Ambulance, Abu Dhabi, United Arab Emirates
| | - Ahmed Saleh Alhajeri
- Department of Research and Development, National Ambulance, Abu Dhabi, United Arab Emirates.,Department of Clinical Services, National Ambulance, Abu Dhabi, United Arab Emirates
| | - Ayman Adel Ahmed
- Department of Clinical Services, National Ambulance, Abu Dhabi, United Arab Emirates
| | - Sahar Yousef Mashal
- Department of Clinical Services, National Ambulance, Abu Dhabi, United Arab Emirates
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Li F, Zhang JS, Sheng XY, Wang JL, Shen XM, Xia WP, Shen LX, Jiang F. Effects of three different first-aid training methods on knowledge retention of caregivers and teachers: a randomized and longitudinal cohort study in China. Public Health 2019; 178:97-104. [PMID: 31648067 DOI: 10.1016/j.puhe.2019.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/27/2019] [Accepted: 08/23/2019] [Indexed: 12/09/2022]
Abstract
OBJECTIVES The purpose of this study was to assess the effects of pediatric first-aid training methods on caregivers' and teachers' knowledge retention. STUDY DESIGN This was a randomized longitudinal cohort study. METHODS A stratified random sampling method was used to select 1282 caregivers and teachers with the help of local education authorities in 18 districts and 1 county of Shanghai, China. The selected caregivers and teachers were randomly allocated into groups that were exposed to 3 models of training, including an interactive training model (group A), lecture-based training model (group B), and video instruction training model (group C), for pediatric first-aid training for caregivers and teachers (PedFACTs). Before and after the training, a descriptive questionnaire composed of demographic information and 37 simple-choice questions about first aid was administered. During the follow-up, 120 caregivers and teachers from each of the three methods were randomized and retested 9 months after their training and 120 caregivers and teachers were randomly reselected in each of the three methods and retested 4 years after their training. RESULTS Immediately after training, there was a significant difference in the postassessment results between groups A and B (P = 0.002) as well as between groups A and C (P < 0.001). The average interactive training model score was the highest, followed by the instruction training model and video instruction training model. There was no significant difference among the three groups in the reassessment scores at 9 months and 4 years after training (P = 0.744, P = 0.595). The difference in passing the assessment among the three groups at 9 months or 4 years after training was not maintained at a significant level. CONCLUSION The three training methods did not affect knowledge retention of the caregivers and teachers at nine months or four years after training completion. Video instruction may be an effective, convenient, and feasible method to train caregivers and teachers.
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Affiliation(s)
- F Li
- Department of Developmental Behavioral Pediatric & Children Healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China.
| | - J S Zhang
- Department of Medical psychology, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China.
| | - X Y Sheng
- Department of Developmental Behavioral Pediatric & Children Healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China.
| | - J L Wang
- Department of Developmental Behavioral Pediatric & Children Healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China.
| | - X M Shen
- Department of Developmental Behavioral Pediatric & Children Healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China.
| | - W P Xia
- Department of Medical psychology, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China.
| | - L X Shen
- Department of Developmental Behavioral Pediatric & Children Healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China.
| | - F Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Pediatric Translational Research Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University, MOE-Shanghai Key Laboratory of Children's Environmental Health, 1678 Dongfang Rd, Shanghai, 200127, China.
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10
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González-Salvado V, Rodríguez-Ruiz E, Abelairas-Gómez C, Ruano-Raviña A, Peña-Gil C, González-Juanatey JR, Rodríguez-Núñez A. Training adult laypeople in basic life support. A systematic review. ACTA ACUST UNITED AC 2019; 73:53-68. [PMID: 30808611 DOI: 10.1016/j.rec.2018.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 11/07/2018] [Indexed: 02/03/2023]
Abstract
INTRODUCTION AND OBJECTIVES Bystander assistance is decisive to enhance the outcomes of out-of-hospital cardiac arrest. Despite an increasing number of basic life support (BLS) training methods, the most effective formula remains undefined. To identify a gold standard, we performed a systematic review describing reported BLS training methods for laypeople and analyzed their effectiveness. METHODS We reviewed the MEDLINE database from January 2006 to July 2018 using predefined inclusion and exclusion criteria, considering all studies training adult laypeople in BLS and performing practical skill assessment. Two reviewers independently extracted data and evaluated the quality of the studies using the MERSQI (Medical Education Research Study Quality Instrument) scale. RESULTS Of the 1263 studies identified, 27 were included. Most of them were nonrandomized controlled trials and the mean quality score was 13 out of 18, with substantial agreement between reviewers. The wide heterogeneity of contents, methods and assessment tools precluded pooling of data. Nevertheless, there was an apparent advantage of instructor-led methods, with feedback-supported hands-on practice, and retraining seemed to enhance retention. Training also improved attitudinal aspects. CONCLUSIONS While there were insufficiently consistent data to establish a gold standard, instructor-led formulas, hands-on training with feedback devices and frequent retraining seemed to yield better results. Further research on adult BLS training may need to seek standardized quality criteria and validated evaluation instruments to ensure consistency.
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Affiliation(s)
- Violeta González-Salvado
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
| | - Emilio Rodríguez-Ruiz
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Servicio de Medicina Intensiva, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Cristian Abelairas-Gómez
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Facultad de Ciencias de la Educación, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Alberto Ruano-Raviña
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Carlos Peña-Gil
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
| | - José Ramón González-Juanatey
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
| | - Antonio Rodríguez-Núñez
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Unidad de Cuidados Intensivos Pediátricos, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Escuela de Enfermería, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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Self-teaching to improve patient confidence in resuscitation skills: A quality improvement project. J Am Assoc Nurse Pract 2018; 30:603-605. [DOI: 10.1097/jxx.0000000000000089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cartledge S, Finn J, Bray JE, Case R, Barker L, Missen D, Shaw J, Stub D. Incorporating cardiopulmonary resuscitation training into a cardiac rehabilitation programme: A feasibility study. Eur J Cardiovasc Nurs 2017; 17:148-158. [DOI: 10.1177/1474515117721010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Patients with a cardiac history are at future risk of cardiac events, including out-of-hospital cardiac arrest. Targeting cardiopulmonary resuscitation (CPR) training to family members of cardiac patients has long been advocated, but is an area in need of contemporary research evidence. An environment yet to be investigated for targeted training is cardiac rehabilitation. Aim: To evaluate the feasibility of providing CPR training in a cardiac rehabilitation programme among patients, their family members and staff. Methods: A prospective before and after study design was used. CPR training was delivered using video self-instruction CPR training kits, facilitated by a cardiac nurse. Data was collected pre-training, post-training and at one month. Results: Cardiac patient participation rates in CPR classes were high ( n = 56, 72.7% of eligible patients) with a further 27 family members attending training. Patients were predominantly male (60.2%), family members were predominantly female (81.5%), both with a mean age of 65 years. Confidence to perform CPR and willingness to use skills significantly increased post-training (both p<0.001). Post training participants demonstrated a mean compression rate of 112 beats/min and a mean depth of 48 mm. Training reach was doubled as participants shared the video self-instruction kit with a further 87 people. Patients, family members and cardiac rehabilitation staff had positive feedback about the training. Conclusions: We demonstrated that cardiac rehabilitation is an effective and feasible environment to provide CPR training. Using video self-instruction CPR training kits enabled further training reach to the target population.
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Affiliation(s)
- Susie Cartledge
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Alfred Hospital, Melbourne, Australia
| | - Judith Finn
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia
| | - Janet E Bray
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Alfred Hospital, Melbourne, Australia
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia
| | - Rosalind Case
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Institute for Social Neuroscience, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | | | | | - James Shaw
- Alfred Hospital, Melbourne, Australia
- Cabrini Health, Melbourne, Australia
| | - Dion Stub
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Alfred Hospital, Melbourne, Australia
- Cabrini Health, Melbourne, Australia
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Western Health, Melbourne, Australia
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13
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Blewer AL, Putt ME, Becker LB, Riegel BJ, Li J, Leary M, Shea JA, Kirkpatrick JN, Berg RA, Nadkarni VM, Groeneveld PW, Abella BS. Video-Only Cardiopulmonary Resuscitation Education for High-Risk Families Before Hospital Discharge: A Multicenter Pragmatic Trial. Circ Cardiovasc Qual Outcomes 2016; 9:740-748. [PMID: 27703033 DOI: 10.1161/circoutcomes.116.002493] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 08/23/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Cardiopulmonary resuscitation (CPR) training rates in the United States are low, highlighting the need to develop CPR educational approaches that are simpler, with broader dissemination potential. The minimum training required to ensure long-term skill retention remains poorly characterized. We compared CPR skill retention among laypersons randomized to training with video-only (VO; no manikin) with those trained with a video self-instruction kit (VSI; with manikin). We hypothesized that VO training would be noninferior to the VSI approach with respect to chest compression (CC) rate. METHODS AND RESULTS We performed a prospective, cluster randomized trial of CPR education for family members of patients with high-risk cardiac conditions on hospital cardiac units, using a multicenter pragmatic design. Eight hospitals were randomized to offer either VO or VSI training before discharge using volunteer trainers. CPR skills were assessed 6 months post training. Mean CC rate among those trained with VO compared with those trained with VSI was assessed with a noninferiority margin set at 8 CC per min; as a secondary outcome, mean differences in CC depth were assessed. From February 2012 to May 2015, 1464 subjects were enrolled and 522 subjects completed a skills assessment. The mean CC rates were 87.7 (VO) CC per min and 89.3 (VSI) CC per min; we concluded noninferiority for VO based on a mean difference of -1.6 (90% confidence interval, -5.2 to 2.1). The mean CC depth was 40.2 mm (VO) and 45.8 mm (VSI) with a mean difference of -5.6 (95% confidence interval, -7.6 to -3.7). Results were similar after multivariate regression adjustment. CONCLUSIONS In this large, prospective trial of CPR skill retention, VO training yielded a noninferior difference in CC rate compared with VSI training. CC depth was greater in the VSI group. These findings suggest a potential trade-off in efforts for broad dissemination of basic CPR skills; VO training might allow for greater scalability and dissemination, but with a potential reduction in CC depth. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01514656.
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Affiliation(s)
- Audrey L Blewer
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.)
| | - Mary E Putt
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.)
| | - Lance B Becker
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.)
| | - Barbara J Riegel
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.)
| | - Jiaqi Li
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.)
| | - Marion Leary
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.)
| | - Judy A Shea
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.)
| | - James N Kirkpatrick
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.)
| | - Robert A Berg
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.)
| | - Vinay M Nadkarni
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.)
| | - Peter W Groeneveld
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.)
| | - Benjamin S Abella
- From the Department of Emergency Medicine and Center for Resuscitation Science (A.L.B., L.B.B., M.L., B.S.A.), Department of Biostatistics and Epidemiology (A.L.B., M.E.P., J.L.), School of Nursing (B.J.R., M.L.), New Courtland Center for Transitions and Healthy (B.J.R.), Department of Medicine (J.A.S., J.N.K., P.W.G.), Department of Anesthesiology and Critical Care (R.A.B.), University of Pennsylvania, Philadelphia; The Children's Hospital of Philadelphia, Pennsylvania (R.A.B., V.M.N.); and Philadelphia Veterans Affairs Medical Center, Pennsylvania (P.W.G.).
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14
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Blewer AL, Li J, Ikeda DJ, Leary M, Buckler DG, Riegel B, Desai S, Groeneveld PW, Putt ME, Abella BS. Recruitment for a hospital-based pragmatic clinical trial using volunteer nurses and students. Clin Trials 2016; 13:425-33. [PMID: 27094486 PMCID: PMC4942370 DOI: 10.1177/1740774516643265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND/AIMS Recruitment of subjects is critical to the success of any clinical trial, but achieving this goal can be a challenging endeavor. Volunteer nurse and student enrollers are potentially an important source of recruiters for hospital-based trials; however, little is known of either the efficacy or cost of these types of enrollers. We assessed volunteer clinical nurses and health science students in their rates of enrolling family members in a hospital-based, pragmatic clinical trial of cardiopulmonary resuscitation education, and their ability to achieve target recruitment goals. We hypothesized that students would have a higher enrollment rate and are more cost-effective compared to nurses. METHODS Volunteer nurses and student enrollers were recruited from eight institutions. Participating nurses were primarily bedside nurses or nurse educators while students were pre-medical, pre-nursing, and pre-health students at local universities. We recorded the frequency of enrollees recruited into the clinical trial by each enroller. Enrollers' impressions of recruitment were assessed using mixed-methods surveys. Cost was estimated based on enrollment data. Overall enrollment data were analyzed using descriptive statistics and generalized estimating equations. RESULTS From February 2012 to November 2014, 260 hospital personnel (167 nurses and 93 students) enrolled 1493 cardiac patients' family members, achieving target recruitment goals. Of those recruited, 822 (55%) were by nurses, while 671 (45%) were by students. Overall, students enrolled 5.44 (95% confidence interval (CI): 2.88, 10.27) more subjects per month than nurses (p < 0.01). After consenting to participate in recruitment, students had a 2.85 (95% CI: 1.09, 7.43) increased chance of enrolling at least one family member (p = 0.03). Among those who enrolled at least one subject, nurses enrolled a mean of 0.51(95% CI: 0.42, 0.59) subjects monthly, while students enrolled 1.63 (95% CI: 1.37, 1.90) per month (p < 0.01). Of 198 surveyed hospital personnel (127 nurses, 71 students), 168/198 (85%) felt confident conducting enrollment. The variable cost per enrollee recruited was $25.38 per subject for nurses and $23.30 per subject for students. CONCLUSIONS Overall, volunteer students enrolled more subjects per month at a lower cost than nurses. This work suggests that recruitment goals for a pragmatic clinical trial can be successfully obtained using both nurses and students.
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Affiliation(s)
- Audrey L Blewer
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA, USA Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Jiaqi Li
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA, USA Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel J Ikeda
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Marion Leary
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA, USA School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - David G Buckler
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Sunita Desai
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Peter W Groeneveld
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Mary E Putt
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Benjamin S Abella
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA, USA
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15
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Abstract
Although the occurrence of sudden cardiac death (SCD) in a young person is a rare event, it is traumatic and often widely publicized. In recent years, SCD in this population has been increasingly seen as a public health and safety issue. This review presents current knowledge relevant to the epidemiology of SCD and to strategies for prevention, resuscitation, and identification of those at greatest risk. Areas of active research and controversy include the development of best practices in screening, risk stratification approaches and postmortem evaluation, and identification of modifiable barriers to providing better outcomes after resuscitation of young SCD patients. Institution of a national registry of SCD in the young will provide data that will help to answer these questions.
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Affiliation(s)
- Michael Ackerman
- From Departments of Internal Medicine, Pediatrics, and Molecular Pharmacology & Experimental Therapeutics; Divisions of Cardiovascular Diseases and Pediatric Cardiology; Windland Smith Rice Sudden Death Genomics Laboratory; Mayo Clinic, Rochester, MN (M.A.);Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa, City (D.L.A.); andDepartment of Cardiology, Boston Children's Hospital, MA (J.K.T.)
| | - Dianne L Atkins
- From Departments of Internal Medicine, Pediatrics, and Molecular Pharmacology & Experimental Therapeutics; Divisions of Cardiovascular Diseases and Pediatric Cardiology; Windland Smith Rice Sudden Death Genomics Laboratory; Mayo Clinic, Rochester, MN (M.A.);Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa, City (D.L.A.); andDepartment of Cardiology, Boston Children's Hospital, MA (J.K.T.)
| | - John K Triedman
- From Departments of Internal Medicine, Pediatrics, and Molecular Pharmacology & Experimental Therapeutics; Divisions of Cardiovascular Diseases and Pediatric Cardiology; Windland Smith Rice Sudden Death Genomics Laboratory; Mayo Clinic, Rochester, MN (M.A.);Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa, City (D.L.A.); andDepartment of Cardiology, Boston Children's Hospital, MA (J.K.T.).
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16
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Cartledge SH, Bray JE, Stub D, Krum H, Finn J. Do Cardiac Rehabilitation Programs Offer Cardiopulmonary Resuscitation Training in Australia and New Zealand? Heart Lung Circ 2016; 25:607-12. [DOI: 10.1016/j.hlc.2015.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/22/2015] [Accepted: 11/30/2015] [Indexed: 12/20/2022]
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Ikeda DJ, Buckler DG, Li J, Agarwal AK, Di Taranti LJ, Kurtz J, Reis RD, Leary M, Abella BS, Blewer AL. Dissemination of CPR video self-instruction materials to secondary trainees: Results from a hospital-based CPR education trial. Resuscitation 2016; 100:45-50. [PMID: 26776900 DOI: 10.1016/j.resuscitation.2015.12.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 11/30/2015] [Accepted: 12/19/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cardiopulmonary resuscitation (CPR) video self-instruction (VSI) materials have been promoted as a scalable approach to increase the prevalence of CPR skills among the lay public, in part due to the opportunity for secondary training (i.e., sharing of training materials). However, the motivations for, and barriers to, disseminating VSI materials to secondary trainees is poorly understood. METHODS This work represents an ancillary investigation of a prospective hospital-based CPR education trial in which family members of cardiac patients were trained using VSI. Mixed-methods surveys were administered to primary trainees six months after initial enrollment. Surveys were designed to capture motivations for, and barriers to, sharing VSI materials, the number of secondary trainees with whom materials were shared, and the settings, timing, and recipients of trainings. RESULTS Between 07/2012 and 05/2015, 653 study participants completed a six-month follow-up interview. Of those, 345 reported sharing VSI materials with 1455 secondary trainees. Materials were shared most commonly with family members. In a logistic regression analysis, participants in the oldest quartile (age >63 years) were less likely to share materials compared to those in the youngest quartile (age ≤ 44 years, OR 0.58, CI 0.37-0.90, p=0.02). Among the 308 participants who did not share their materials, time constraints was the most commonly cited barrier for not sharing. CONCLUSIONS VSI materials represent a strategy for secondary dissemination of CPR training, yet older individuals have a lower likelihood of sharing relative to younger individuals. Further work is warranted to remedy perceived barriers to CPR dissemination among the lay public using VSI approaches.
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Affiliation(s)
- Daniel J Ikeda
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David G Buckler
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jiaqi Li
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amit K Agarwal
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura J Di Taranti
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - James Kurtz
- Penn Presbyterian Medical Center, Philadelphia, PA, USA
| | - Ryan Dos Reis
- Penn Presbyterian Medical Center, Philadelphia, PA, USA
| | - Marion Leary
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA; School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Benjamin S Abella
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Audrey L Blewer
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
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18
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Blewer AL, Buckler DG, Li J, Leary M, Becker LB, Shea JA, Groeneveld PW, Putt ME, Abella BS. Impact of the 2010 resuscitation guidelines training on layperson chest compressions. World J Emerg Med 2015; 6:270-6. [PMID: 26693261 DOI: 10.5847/wjem.j.1920-8642.2015.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Survival from cardiac arrest is sensitive to the quality of delivered CPR. In 2010, updated international resuscitation guidelines emphasized deeper chest compressions and faster rates, yet it is unknown whether training laypersons using updated guidelines resulted in changed CPR performance. We hypothesized that laypersons taught CPR using the 2010 guidelines performed deeper and faster compressions than those taught using the 2005 materials. METHODS This work represents a secondary analysis of a study conducted at eight hospitals where family members of hospitalized cardiac patients were trained in CPR. An initial cohort was trained using the 2005 guidelines, and a subsequent cohort was trained using the 2010 guideline materials. Post training, CPR skills were quantified using a recording manikin. RESULTS Between May 2009 to August 2013, 338 subjects completed the assessment. Among the subjects, 176 received 2005 training and 162 underwent 2010 training. The mean compression rate in the 2005 cohort was 87 (95%CI 83-90) per minute, and in the 2010 cohort was 86 (95%CI 83-90) per minute (P=ns), while the mean compression depth was 34 (95%CI 32-35) mm in the 2005 cohort and 46 (95%CI 44-47) mm in the 2010 cohort (P<0.01). CONCLUSIONS Training with the 2010 CPR guidelines resulted in a statistically significant increase in trainees' compression depth but there was no change in compression rate. Nevertheless, the majority of CPR performed by trainees in both cohorts was below the guideline recommendation, highlighting an important gap between training goals and trainee performance.
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Affiliation(s)
- Audrey L Blewer
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David G Buckler
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jiaqi Li
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Marion Leary
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA 19104, USA ; School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Lance B Becker
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Judy A Shea
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Peter W Groeneveld
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mary E Putt
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Benjamin S Abella
- Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA 19104, USA
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Schoolchildren as BLS instructors for relatives and friends: Impact on attitude towards bystander CPR. Resuscitation 2015; 85:1769-74. [PMID: 25447432 DOI: 10.1016/j.resuscitation.2014.10.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 10/06/2014] [Accepted: 10/15/2014] [Indexed: 11/21/2022]
Abstract
INTRODUCTION We investigated the impact of Cardio-Pulmonary Resuscitation (CPR) instruction by children on the attitude of people to perform bystander CPR. METHODS In 2012, children from primary and secondary school (age span 11–13 years) received a free individual CPR training package containing an inexpensive manikin and a training video. After a CPR training session by their class teacher, they were invited to teach their relatives and friends. After the training, the trainees of the children were invited to participate in a web survey, containing a test and questions about prior CPR training and about their attitude towards bystander CPR (BCPR) before and after the training. We measured the impact on the attitude to perform BCPR and the theoretical knowledge transfer by the children. RESULTS A total of 4012 training packages were distributed to 72 schools of which 55 class teachers subscribed their students (n = 822) for the training programme for relatives and friends. After a validation procedure, 874 trainees of 290 children were included in the study. In comparison to trainees of secondary schoolchildren, trainees of primary schoolchildren scored better for the test as well as for a positive change of attitude towards future BCPR (P < 0.001). For every child-instructor 1.7 people changed their attitude towards BCPR positively. CONCLUSIONS Instructing schoolchildren to teach their relatives and friends in Basic Life Support (BLS) led to a more positive attitude towards BCPR. The results were more positive with trainees from primary schoolchildren than with trainees from secondary schoolchildren.
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Atkins DL. Bystander CPR: How to best increase the numbers. Resuscitation 2012; 83:1049-50. [DOI: 10.1016/j.resuscitation.2012.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 06/06/2012] [Indexed: 11/24/2022]
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Continuous chest compression cardiopulmonary resuscitation training promotes rescuer self-confidence and increased secondary training: a hospital-based randomized controlled trial*. Crit Care Med 2012; 40:787-92. [PMID: 22080629 DOI: 10.1097/ccm.0b013e318236f2ca] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Recent work suggests that delivery of continuous chest compression cardiopulmonary resuscitation is an acceptable layperson resuscitation strategy, although little is known about layperson preferences for training in continuous chest compression cardiopulmonary resuscitation. We hypothesized that continuous chest compression cardiopulmonary resuscitation education would lead to greater trainee confidence and would encourage wider dissemination of cardiopulmonary resuscitation skills compared to standard cardiopulmonary resuscitation training (30 compressions: two breaths). DESIGN Prospective, multicenter randomized study. SETTING Three academic medical center inpatient wards. SUBJECTS Adult family members or friends (≥ 18 yrs old) of inpatients admitted with cardiac-related diagnoses. INTERVENTIONS In a multicenter randomized trial, family members of hospitalized patients were trained via the educational method of video self-instruction. Subjects were randomized to continuous chest compression cardiopulmonary resuscitation or standard cardiopulmonary resuscitation educational modes. MEASUREMENTS Cardiopulmonary resuscitation performance data were collected using a cardiopulmonary resuscitation skill-reporting manikin. Trainee perspectives and secondary training rates were assessed through mixed qualitative and quantitative survey instruments. MAIN RESULTS Chest compression performance was similar in both groups. The trainees in the continuous chest compression cardiopulmonary resuscitation group were significantly more likely to express a desire to share their training kit with others (152 of 207 [73%] vs. 133 of 199 [67%], p = .03). Subjects were contacted 1 month after initial enrollment to assess actual sharing, or "secondary training." Kits were shared with 2.0 ± 3.4 additional family members in the continuous chest compression cardiopulmonary resuscitation group vs. 1.2 ± 2.2 in the standard cardiopulmonary resuscitation group (p = .03). As a secondary result, trainees in the continuous chest compression cardiopulmonary resuscitation group were more likely to rate themselves "very comfortable" with the idea of using cardiopulmonary resuscitation skills in actual events than the standard cardiopulmonary resuscitation trainees (71 of 207 [34%] vs. 57 of 199 [28%], p = .08). CONCLUSIONS Continuous chest compression cardiopulmonary resuscitation education resulted in a statistically significant increase in secondary training. This work suggests that implementation of video self-instruction training programs using continuous chest compression cardiopulmonary resuscitation may confer broader dissemination of life-saving skills and may promote rescuer comfort with newly acquired cardiopulmonary resuscitation knowledge. CLINICAL TRIAL REGISTRATION URL: http://clinicaltrials.gov. Unique identifier: NCT01260441.
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Atkins DL, Berger S. Improving outcomes from out-of-hospital cardiac arrest in young children and adolescents. Pediatr Cardiol 2012; 33:474-83. [PMID: 21842254 DOI: 10.1007/s00246-011-0084-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 07/28/2011] [Indexed: 12/01/2022]
Abstract
Out-of-hospital cardiac arrest (OHCA) is an unusual but devastating occurrence in a young person. Years of life-lost are substantial and long-term health care costs of survivors can be high. However, there have been noteworthy improvements in cardiopulmonary resuscitation (CPR) standards, out-of hospital care, and postcardiac arrest therapies that have resulted in a several-fold improvement in resuscitation outcomes. Recent interest and research in resuscitation of children has the promise of generating improvements in the outcomes of these patients. Integrated and coordinated care in the out-of-hospital and hospital settings are required. This article will review the epidemiology of OHCA, the 2010 CPR guidelines, and developments in public access defibrillation for children.
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Affiliation(s)
- Dianne L Atkins
- Carver College of Medicine, University of Iowa Children's Hospital, Iowa City, IA 52242, USA.
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