The willingness of final year medical and dental students to perform bystander cardiopulmonary resuscitation in an Asian community

Knowledge and willingness of schoolteachers in Jordan to perform CPR: a cross-sectional study

OBJECTIVES

This study aimed to assess the cardiopulmonary resuscitation (CPR) knowledge and willingness of schoolteachers in Jordan.

DESIGN

This was a cross-sectional study conducted using an online questionnaire.

SETTING

For inclusion in this study, schoolteachers must be currently teaching at any level in schools across the country. Responses were collected from 1 April 2021 to 30 April 2021.

PARTICIPANTS

All schoolteachers actively working in public or private schools were included in our study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Continuous variables were summarised as means and SD, whereas categorical variables were reported as frequencies and percentages (%). A χ2 test for independence, independent sample t-tests and analysis of variance were used appropriately. A p-value less than 0.05 was used to determine statistical significance.

RESULTS

A total of 385 questionnaires were eligible for analyses. Only 14.5% of the participants received CPR training and overall correct knowledge answers were 18.8% of the total score. Those participants with previous CPR training had higher mean knowledge scores (2.34 vs 1.15, p<0.001). Trained participants were also more likely to provide hands-only CPR to various patient groups than untrained participants (p<0.05). Participants were more willing to provide standard CPR to family members than hands-only CPR (p<0.001), but more willing to provide hands-only CPR to friends (p<0.001), students (75.1% vs 58.2%, p<0.001), neighbour (p<0.001), stranger (p=0.001) and patient from the opposite gender (p<0.001).

CONCLUSIONS

Schoolteachers in Jordan possess limited knowledge of CPR. However, the study participants showed a positive attitude towards performing CPR. The study revealed that they were more inclined to provide hands-only CPR than standard CPR. Policymakers and public health officials can take advantage of these findings to incorporate CPR training programmes for schoolteachers, either as a part of their undergraduate studies or as continuing education programmes with an emphasis on hands-only CPR.

Comparing the effectiveness of a group-directed video instruction versus instructor-led traditional classroom instruction for learning cardiopulmonary resuscitation skills among first-year medical students: A prospective randomized controlled study

Introduction: Bystander cardiopulmonary resuscitation (CPR) training is inconsistent among students and the public. Existing CPR teaching courses are costly, time-consuming, and inconsistent. This study aimed to determine the association between overall CPR competency and two teaching modules, a group-directed video instruction module versus an instructor-led traditional classroom instruction module. Methods: This randomized prospective interventional study involved first year medical students of Universiti Sains Malaysia Health Campus from November 2018 until January 2019. Pass-fail scores representing the overall CPR, individual skill performance, and willingness to perform CPR for strangers and family members were collected. Factors associated with reluctance to perform CPR were assessed in a questionnaire. Results: A total of 99 participants were included, 50 in the group-directed video instruction as the intervention module and 49 in the traditional classroom instruction as the control module. There was no statistical significance between the pass and fail outcomes for both video module (p=0.436). Participants in both modules performed similarly in 8 out of 12 individual CPR skills. There was a significant difference in the distribution of skill scores between the pass and fail outcomes (p=<0.001). The intervention module is non-inferior compared to the control module, in relation to CPR willingness rates for strangers (p=0.999) and family members (p=0.117) after the training. Conclusions: The group-directed video self-instruction method is as effective as the instructor-led traditional classroom method to help participants to be competent and willing to perform CPR. It can be used as an independent or supplementary teaching tool for first-time learners and refreshers, especially in a group setting when teaching materials are limited.

The willingness to perform first aid among high school students and associated factors in Hue, Vietnam

Background

Adolescents who are willing to perform first aid can help prevent injuries and ultimately death among themselves and others involved in accidents or injuries. This study aims to estimate the prevalence of students’ willingness to perform first aid procedures and additionally examine associated factors among high school students in Hue, Vietnam.

Methods

A cross-sectional study utilizing multi-stage stratified random sampling was conducted between April to July 2020 by investigating 798 high school students in Hue, Vietnam. Participants were invited to complete a self-reported questionnaire pertaining to individual demographic characteristics, personal perception of self-efficacy, and willingness to perform first aid. To better interpret these findings, both multivariable linear and Poisson regression models were fitted to evaluate the association between individual student characteristics and the willingness to perform first aid.

Results

The prevalence of having willingness to perform first aid (defined as ≥4 points out of 5 to all three questions) was 49.9% (95%CI:28.6–71.2%). The major reported barriers in performing first aid were fear of making mistakes and hurting victims (34.4%, 95%CI:31.9–37.0%), no prior first aid training (29.8%, 95%CI:25.9–33.9%), and forgetting first aid steps (23.0%, 95%CI:15.8–32.2%). By employing the multivariable linear regression model, it was identified that students with high (β = 0.614, 95%CI:0.009–1.219) or very high (β = 1.64, 95%CI:0.857–2.422) levels of self-efficacy appeared to be more willing to perform first aid. Similarly, in the Poisson regression models, compared to neutral students, students who reported high (PR = 1.214, 95%CI:1.048–1.407) or very high (PR = 1.871, 95%CI:1.049–3.337) levels of self-efficacy were more willing to perform first aid.

Conclusions

The level of willingness to perform first aid among high school students in this study population was found to be moderate. Therefore, integrating activities to promote self-efficacy in first aid training could be considered a progressive step towards improving a student’s willingness to provide such life-saving procedures.

Validity and Reliability of a Cardiopulmonary Resuscitation Attitudes Questionnaire Among Allied Health Profession Students

Aim

To investigate the structural validity and internal consistency of a cardiopulmonary resuscitation attitudes questionnaire among Allied Health Professions (AHP) university students.

Methods

Structural validity of a 17-item questionnaire was tested using principal component analysis. A group of AHP university students completed the questionnaire. Internal consistency of the questionnaire was measured by Cronbach’s α.

Results

A total of 856 AHP students completed the questionnaire (mean age= 20.8 (±1.1) years, 74.0% were females). The analysis reduced a 17-item questionnaire to an 11-item questionnaire. The final questionnaire had three distinct factors; (1) attitudes towards mouth-to-mouth ventilation (MMV), (2) attitudes towards chest compressions (CC), and (3) the importance of cardiopulmonary resuscitation (CPR). It had factor loadings ranging from 0.629 to 0.878 and could explain 66% of the variance in the attitude. The questionnaire had acceptable internal consistency (Cronbach α=0.83; 95% CI=81.5) and was feasible with no floor or ceiling effect.

Conclusion

The 11-item CPR attitude questionnaire had acceptable structural validity and internal consistency and good parsimony and unidimensionality. The questionnaire can be used to measure the university students’ attitude and assess the effectiveness of CPR training activities. Future studies are required to measure the responsiveness and applicability to other cohorts.

The influence of past experiences on future willingness to perform bystander cardiopulmonary resuscitation

Background

The influence of past familial experiences of receiving cardiopulmonary resuscitation (CPR) and medical help in various cardiac arrest and nonfatal cardiac events toward willingness to “pay it forward” by helping the next cardiac arrest victim was explored.

Methods

Using a validated questionnaire, 6248 participants were asked to rate their willingness to perform bystander chest compression with mouth-to-mouth ventilation and chest compression-only CPR. Their past familial experiences of receiving cardiopulmonary resuscitation (CPR) and medical help in various cardiac arrest and nonfatal cardiac events were also recorded.

Results

Kruskal-Wallis test with post hoc Dunn’s pairwise comparisons showed that the following were significantly more willing to perform CPR with mouth-to-mouth ventilation: familial experience of “nonfatal cardiac events” (mean rank = 447) vs “out-of-hospital cardiac arrest with no CPR” (mean rank = 177), U = 35442.5, z = −2.055, p = 0.04; “in-hospital cardiac arrest and successful CPR” (mean rank = 2955.79) vs “none of these experiences” (mean rank = 2468.38), U = 111903, z = −2.60, p = 0.01; and “in-hospital cardiac arrest with successful CPR” (mean rank = 133.45) vs “out-of-hospital arrest with no CPR” (mean rank = 112.36), U = 4135.5, z = −2.06, p = 0.04. For compression-only CPR, Kruskal-Wallis test with multiple runs of Mann-Whitney U tests showed that “nonfatal cardiac events” group was statistically higher than the group with “none of these experiences” (mean rank = 3061.43 vs 2859.91), U = 1194658, z = −2.588, p = 0.01. The groups of “in-hospital cardiac arrest with successful CPR” and “in-hospital cardiac arrest with transient return of spontaneous circulation” were the most willing groups to perform compression-only CPR.

Conclusion

Prior familial experiences of receiving CPR and medical help, particularly among those with successful outcomes in a hospital setting, seem to increase the willingness to perform bystander CPR.

Awareness of basic life support among Saudi dental students and interns

Objective:

Fatal medical emergencies may occur at any time in the dental clinic. The present study assessed the level of awareness and attitudes toward basic life support (BLS) among Saudi dental students and interns.

Materials and Methods:

A self-administered questionnaire comprising 23 closed-ended questions was used in this survey. The first part of the questionnaire assessed the demographical profile of the students such as age, gender, and educational level. The second part investigated their knowledge and awareness about BLS. Data from 203 respondents were analyzed using Statistical Package for the Social Studies version 22.0.

Results:

The response rate was 81.2%. Overall, the respondents showed a low level of knowledge with significant differences between males and females (<0.001). Surprisingly, final-year dental students showed relatively better knowledge than interns though the differences were not statistically significant.

Conclusion:

The present study demonstrates poor knowledge among dental students regarding BLS and showed the urgent need for continuous refreshing courses for this critical topic.

High-fidelity simulation in training dental students for medical life-threatening emergency

INTRODUCTION

Any dental surgeon may be faced with a critical life-threatening emergency situation. In our university, all students in dentistry receive a standard course on emergency first aid. The aim of this prospective, comparative, single-centre study was to determine whether additional training on a high-fidelity patient simulator would improve student performance.

METHODS

After approval by an Ethical Committee and written informed consent, the students of the Simulation group (n=42) had full-scale high-fidelity training on a patient simulator SimMan 3G^™ (3 hours by six students). They participated in pairs in two scenarios (airway obstruction, seizures, allergies, vasovagal syncope, asthma, chest pain). The first scenario was simple, and the second was a progression to cardiac arrest. Three months later, the Simulation group and the Control group (n=42) participated in a test session with two scenarios. The primary end point was the score at the test session (with a standardised scoring grill, direct observation and audio-video recording). Data were median and 25%-75% percentiles.

RESULTS

High-fidelity training strongly improved the score on the test obtained by the students of the Simulation group (146 [134-154]) which was much higher (P<.0001) than in the Control group (77 [67-85]). Technical as well as non-technical skills components of the scores were improved. In addition, performances of the Simulation group were increased between the training and the test. Simulation session was very positively assessed by the students.

CONCLUSIONS

The results support the systematic introduction of training to critical life-threatening emergency situations on high-fidelity patient simulators the dentistry curriculum. The impact on clinical practice in the dental office remains to be assessed.

Impact of basic life-support training on the attitudes of health-care workers toward cardiopulmonary resuscitation and defibrillation

BACKGROUND

Cardiopulmonary resuscitation (CPR) increases the probability of survival of a person with cardiac arrest. Repeating training helps staff retain knowledge in CPR and in use of automated external defibrillators (AEDs). Retention of knowledge and skills during and after training in CPR is difficult and requires systematic training with appropriate methodology. The aim of this study was to determine the effect of basic life-support (BLS) training on the attitudes of health-care providers toward initiating CPR and on use of AEDs, and to investigate the factors that influence these attitudes.

METHODS

A quasi-experimental study was conducted in two groups: health-care providers who had just attended a BLS-AED course (post-BLS group, n = 321), and those who had not (pre-BLS group, n = 421). All participants had previously received BLS training. Both groups were given a validated questionnaire to evaluate the status of life-support education and certification, attitudes toward use of CPR and AED and concerns regarding use of CPR and AED. Multiple linear regression analyses were applied to identify significant predictors of the attitude and concern scores.

RESULTS

Overall positive attitudes were seen in 53.4% of pre-BLS respondents and 64.8% of post-BLS respondents (χ² = 9.66, p = 0.002). Positive attitude was significantly predicted by the recent completion of BLS training (β = 5.15, p < 0.001), the number of previous BLS training courses (β = 2.10, p = 0.008) and previous exposure to cardiac-arrest cases (β = 3.44, p = 0.018), as well as by low concern scores, (β = -0.09, p < 0.001). Physicians had significantly lower concern scores than nurses (β = -10.45, p = 0.001). Concern scores decreased as the duration of work experience increased (t = 2.19, p = 0.029).

CONCLUSIONS

Repeated educational programs can improve attitudes toward CPR performance and the use of AEDs. Training that addressed the concerns of health-care workers could further improve these attitudes.

Knowledge, attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City, India

BACKGROUND

This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support (BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India.

METHODS

The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory (STAI) Questionnaire. Chi-square test was performed on SPSS 21.0 (IBM Statistics, 2012) to determine statistically significant differences (P<0.05) between assessed knowledge and anxiety.

RESULTS

Out of 183 interns, 39.89% had below average knowledge. A total of 123 (67.21%) reported unavailability of professional training. The majority (180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above high-stress level. Comparison of assessed knowledge and stress was found to be insignificant (P=0.983).

CONCLUSION

There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.

Factors influencing Chinese university students' willingness to performing bystander cardiopulmonary resuscitation

BACKGROUND AND AIM

Low rates of bystander-initiated CPR are a major obstacle to improved survival rates, and the aim of this study is to elucidate the factors associated with university students' attitudes toward performing bystander CPR.

METHODS

Questionnaires were distributed to 18 universities across three metropolises in China. One question asking for respondents' attitudes toward performing bystander CPR was set as the dependent variable, and the logistic regression models were used to extract independent factors for respondents' attitudes toward performing bystander CPR.

RESULTS

2934 questionnaires were completed, with a response rate of 81.5%. Results suggested that predictors of willingness to perform bystander CPR were: previous experience of performing bystander CPR, higher self-perceived ability to perform bystander CPR properly after instruction, medicine and law discipline, male gender, not being the single child of their parents, higher participation in university societies, being used to taking decisive action immediately, less self-perceived life stress and higher self-perceived knowledge level of CPR.

CONCLUSIONS

Persons having previous experience of performing bystander CPR and those who thought they would have the ability to perform bystander CPR properly are predominantly associated with willingness to perform bystander CPR. Psychological and cultural factors need further study.

Are Canadians more willing to provide chest-compression-only cardiopulmonary resuscitation (CPR)?-a nation-wide public survey

BACKGROUND

Bystander cardiopulmonary resuscitation (CPR) improves the likelihood of survival from out-of-hospital cardiac arrest (OHCA), yet it is performed in only 30% of cases. The 2010 guidelines promote chest-compression-only bystander CPR-a change intended to increase willingness to provide CPR.

OBJECTIVES

1) To determine whether the Canadian general public is more willing to perform chest-compression-only CPR compared to traditional CPR; 2) to characterize public knowledge of OHCA; and 3) to identify barriers and facilitators to bystander CPR.

METHODS

A 32-item survey assessing resuscitation knowledge, and willingness to provide CPR were disseminated in five Canadian regions. Descriptive statistics were used to characterize response distribution. Logistic regression analysis was applied to assess shifts in intention to provide CPR.

RESULTS

A total of 428 completed surveys were analysed. When presented with a scenario of being a bystander in an OHCA, a greater proportion of respondents were willing to provide chest-compression-only CPR compared to traditional CPR for all victims (61.5% v. 39.7%, p<0.001), when the victim was a stranger (55.1% v. 38.8%, p<0.001), or when the victim was an unkempt individual (47.9% v. 28.5%, p<0.001). When asked to describe an OHCA, 41.4% said the heart stopped beating, and 20.8% said it was a heart attack. Identified barriers and facilitators included fear of litigation and lack of skill confidence.

CONCLUSIONS

This study identified gaps in knowledge, which may impair the ability of bystanders to act in OHCA. Most respondents expressed greater willingness to provide chest-compression-only CPR, but this was mediated by victim characteristics, skill confidence, and recognition of a cardiac arrest.

Willingness to administer mouth-to-mouth ventilation in a first response program in rural Bangladesh

Background

Timely mouth-to-mouth ventilation is critical to resuscitate drowning victims. While drowning is frequent, there are no lay persons trained in cardio-pulmonary resuscitation (CPR) in rural Bangladesh. As part of a feasibility study to create a first response system in a conservative Islamic village environment, a pilot was undertaken to examine willingness to provide mouth-to-mouth ventilation for drowning resuscitation.

Methods

A questionnaire was administered to 721 participants at the beginning of a village-based CPR training course. Trainees were asked regarding willingness to administer mouth-to-mouth ventilation on a variety of hypothetical victims. Responses were tabulated according to the age, sex and relationship of the trainee to the postulated victim.

Results

Willingness to deliver mouth-to-mouth ventilation was influenced by sex of a potential recipient and relationship to the trainee. Adolescent participants were significantly more willing to perform mouth-to-mouth ventilation on someone of the same sex. Willingness increased for both sexes when the postulated victim was an immediate family member. Willingness was lower with extended family members and lowest with strangers. Adult trainees were more likely to perform mouth-to-mouth ventilation than adolescent trainees in any scenario.

Conclusion

Adults express more willingness to resuscitate a broader range of drowning victims than adolescents. However in rural Bangladesh, adolescents are more likely to be in close proximity to a drowning in progress. Further efforts are needed to increase willingness of adolescents to provide resuscitation to drowning victims. However, despite potential cultural limitations, trained responders appear to be willing to give mouth-to-mouth ventilation to various recipients. Final determination will require evidence on response outcomes which is being collected.

An exploration of attitudes toward bystander cardiopulmonary resuscitation in university students in Tianjin, China: A survey

BACKGROUND

Despite the importance of early effective bystander cardiopulmonary resuscitation (CPR) to improve survival rates from out-of-hospital cardiac arrest, the attitudes toward performing, learning and disseminating CPR in university students of China are still unclear.

METHODS AND AIMS

To assess the attitudes regarding performing, learning and disseminating bystander CPR in university students of China.

RESULTS

The results indicated that except for the scenario where the victim was their own family member or close friend, all other scenarios showed a relatively dismally lower rate of positive response. Besides, it showed a greater willingness to perform chest compression only CPR (CC) than chest compression with mouth-to-mouth ventilation (CCMV) (P < 0.05). Females were more willing to perform CC across seven of the hypothetic scenarios than males. University students of medical-related specialties (45.3%) than university students of non-medical specialties (29.9%) were more willing to perform bystander CPR (P < 0.05). The top four reasons for being unwilling to perform bystander CPR were lack of confidence (32.9%), fear of legal disputes (17.2%), fear of disease transmission (16.0%) and feeling embarrassed (14.0%). 92.6% of respondents wanted to learn CPR and 80.3% of respondents were willing to disseminate CPR.

CONCLUSIONS

CPR technique, victim's status, respondent's specialty and respondent's gender affected the attitudes of respondents toward performing bystander CPR. The top four reasons for being unwilling to perform bystander CPR were lack of confidence, fear of legal disputes, fear of disease transmission and feeling embarrassed. However, the key reason for being unwilling to perform bystander CPR differed in different specialties and particularly 'feeling embarrassment' might be a cultural phenomenon. The attitudes toward learning and disseminating CPR were positive and affected by respondent's gender and specialty.

A multicenter controlled trial on knowledge and attitude about cardiopulmonary resuscitation among secondary school children in Malaysia

BACKGROUND

We performed a multicenter controlled trial to assess the knowledge and attitude (KA) about cardiopulmonary resuscitation (CPR) among secondary school children in a district in Malaysia.

METHODS

This was a prospective intervention study. The primary endpoint of the study was to determine the level of KA about resuscitation after CPR training. The six schools and classes from selected schools were chosen by randomization among the form three and four classes using sealed envelopes. A fully validated questionnaire consisting of three sections (sociodemographic, knowledge and attitude) was given to the pupils before and 2 weeks after the intervention. The intervention group was given a lecture, video show, pamphlet and 1-h practical session on CPR training. The control group received a placebo in order to overcome the learning effect. The maximum scores for the knowledge and attitude sections were 72 and 28, respectively. Repeated measures ANOVA analysis was used for specific objectives to determine the changes in knowledge and attitude level pre- and post-intervention for both study groups. P-values less than 0.05 were taken as significant at 95% confidence intervals.

RESULTS

The mean (SD) total knowledge scores for the intervention (n = 216) and control (n = 252) groups were 62.43 (13.68) and 62.29 (12.11), respectively (maximum score 72) (p > 0.05). On the other hand, the mean (SD) total attitude scores for the intervention and the control groups were 19.33 (4.51) and 17.85 (4.52), respectively (maximum score 28) (p < 0.001). There were significant differences in mean knowledge and attitude scores between the intervention and control groups with regard to time (pre- and post-intervention). The mean difference in knowledge and attitude scores between both study groups was 8.31 (p < 0.001) and 2.39 (p < 0.001), respectively.

CONCLUSIONS

The level of knowledge and attitudes of secondary school children was shown to be acceptable prior to the intervention. Furthermore, a brief CPR training program improved their level of knowledge and attitudes significantly as compared to those who had never been trained.

Current knowledge of and willingness to perform Hands-Only CPR in laypersons

INTRODUCTION

Recent simplified guidelines recommend Hands-Only CPR for laypersons and efforts to educate the public of these changes have been made. We determined current knowledge of and willingness to perform Hands-Only CPR.

METHODS

Design-prospective anonymous survey. Setting-academic suburban emergency department. Subjects-adult patients and visitors in a suburban ED. Survey instrument-33 item closed question format based on prior studies that included baseline demographics and knowledge and experience of CPR. Main outcome-knowledge of and willingness to perform Hands-Only CPR. Data analysis-descriptive statistics. Univariate and multivariate analyses were performed to determine the association between predictor variables and knowledge of and willingness to perform Hands-Only CPR.

RESULTS

We surveyed 532 subjects; mean age was 44±16; 53.2% were female, 75.6% were white. 45.5% were college graduates, and 44.4% had an annual income of greater than $50,000. 41.9% had received prior CPR training; only 10.3% had performed CPR. Of all subjects 124 (23.3%) had knowledge of Hands-Only CPR, yet 414 (77.8%) would be willing to perform Hands-Only CPR on a stranger. Age (P=0.003) and income (P=0.014) predicted knowledge of Hands-Only CPR. A history of a cardiac related event in the family (P=0.003) and previous CPR training (P=0.01) were associated with likelihood to perform Hands-Only CPR.

CONCLUSIONS

Less than one fifth of surveyed laypersons knew of Hands-Only CPR yet three quarters would be willing to perform Hands-Only CPR even on a stranger. Efforts to increase layperson education are required to enhance CPR performance.

Practical skills training influences knowledge and attitude of dental students towards emergency medical care

BACKGROUND

Medical emergencies in dental practice are generally perceived as being rare. Nonetheless, recent studies have shown that incidents occur on a regular basis. Therefore, patients have the right to expect necessary skills to manage life-threatening situations from every dentist.

OBJECTIVE

To observe students' attitude and self-assessment towards emergency medical care (EMC) and its practical appliance.

MATERIAL AND METHODS

Students of dentistry took part in small group sessions for adult and paediatric basic life support. Participants filled out pre-post questionnaires regarding knowledge and attitude towards EMC (6, respectively, 10-point Likert scale). Additionally, feedback was asked for the quality of course and tutors.

RESULTS

Forty dental students in their last 2 years of study registered for the EMC courses. The majority had never attended any first-aid course; the mean age was 25% and 75% were women. A comparison between pre- and post-evaluation showed that the participation in practical training easily enhances the students' awareness of EMC importance as well as self-confidence in managing emergencies. After the course, 71% shared the opinion that retraining should be obligatory for all medical personnel. At the same time, students' self-assessment of confidence for specific tasks got significant upgrades in every aspect.

CONCLUSION

The evaluation data clearly show the participants' needs to deal with topics of EMC within the curriculum of dentistry. The proposed course is able to change participants' attitudes towards EMC and its importance for their daily practice. The considerable enhancement of self-confidence in performing EMC-techniques might also lead to more willingness to manage emergency situations.

Effect of a reminder video using a mobile phone on the retention of CPR and AED skills in lay responders

BACKGROUND

Skills related to cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use by lay responders decay rapidly after training, and efforts are required to maintain competence among trainees. We examined whether repeated viewing of a reminder video on a mobile phone would be an effective means of maintaining CPR and AED skills in lay responders.

METHODS

In a single-blind case-control study, 75 male students received training in CPR and AED use. They were allocated either to the control or to the video-reminded group, who received a memory card containing a video clip about CPR and AED use for their mobile phone, which they were repeatedly encouraged to watch by SMS text message. CPR and AED skills were assessed in scenario format by examiners immediately and 3 months after initial training.

RESULTS

Three months after initial training, the video-reminded group showed more accurate airway opening (P<0.001), breathing check (P<0.001), first rescue breathing (P=0.004), hand positioning (P=0.004), AED electrode positioning (P<0.001), pre-shock safety check (P<0.001), defibrillation within 90s (P=0.010), and resuming CPR after defibrillation (P<0.001) than controls. They also showed significantly higher self-assessed CPR confidence scores and increased willingness to perform bystander CPR in cardiac arrest than the controls at 3 months (P<0.001, P=0.024, respectively).

CONCLUSION

Repeated viewing of a reminder video clip on a mobile phone increases retention of CPR and AED skills in lay responders.

CPR knowledge and attitude to performing bystander CPR among secondary school students in Norway

BACKGROUND

Early bystander cardiopulmonary resuscitation (CPR) is essential for survival from out-of-hospital cardiac arrest (OHCA). Young people are potentially important bystander CPR providers, as basic life support (BLS) training can be distributed widely as part of the school curriculum.

METHODS

Questionnaires were distributed to nine secondary schools in North Norway, and 376 respondents (age 16-19 years) were included. The completed questionnaires were statistically analysed to assess CPR knowledge and attitude to performing bystander CPR.

RESULTS

Theoretical knowledge of handling an apparently unresponsive adult person was high, and 90% knew the national medical emergency telephone number (113). The majority (83%) was willing to perform bystander CPR in a given situation with cardiac arrest. However, when presented with realistic hypothetical cardiac arrest scenarios, the option to provide full BLS was less frequently chosen, to e.g. a family member (74%), a child (67%) or an intravenous drug user (18%). Students with BLS training in school and self-reported confidence in their own BLS skills reported stronger willingness to perform BLS. 8% had personally witnessed a cardiac arrest, and among these 16% had performed full BLS. Most students (86%) supported mandatory BLS training in school, and three out of four wanted to receive additional training.

CONCLUSION

Young Norwegians are motivated to perform bystander CPR, but barriers are still seen when more detailed cardiac arrest scenarios are presented. By providing students with good quality BLS training in school, the upcoming generation in Norway may strengthen the first part of the chain of survival in OHCA.

The effect of basic life support education on laypersons' willingness in performing bystander hands only cardiopulmonary resuscitation

BACKGROUND

Recently, hands only CPR (cardiopulmonary resuscitation) has been proposed as an alternative to standard CPR for bystanders. The present study was performed to identify the effect of basic life support (BLS) training on laypersons' willingness in performing standard CPR and hands only CPR.

METHODS

The participants for this study were non-medical personnel who applied for BLS training program that took place in 7 university hospitals in and around Korea for 6 months. Before and after BLS training, all the participants were given questionnaires for bystander CPR, and 890 respondents were included in the final analyses.

RESULTS

Self-assessed confidence score for bystander CPR, using a visual analogue scale from 0 to 100, increased from 51.5+/-30.0 before BLS training to 87.0+/-13.7 after the training with statistical significance (p 0.001). Before the training, 19% of respondents reported willingness to perform standard CPR on a stranger, and 30.1% to perform hands only CPR. After the training, this increased to 56.7% of respondents reporting willingness to perform standard CPR, and 71.9%, hands only CPR, on strangers. Before and after BLS training, the odds ratio of willingness to perform hands only CPR versus standard CPR were 1.8 (95% CI 1.5-2.3) and 2.0 (95% CI 1.7-2.6) for a stranger, respectively. Most of the respondents, who reported they would decline to perform standard CPR, stated that fear of liability and fear of disease transmission were deciding factors after the BLS training.

CONCLUSIONS

The BLS training increases laypersons' confidence and willingness to perform bystander CPR on a stranger. However, laypersons are more willing to perform hands only CPR rather than to perform standard CPR on a stranger regardless of the BLS training.