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Bene Watts S, McDonagh E, Richardson W, Wilson N, Shi K. The rural CPR outreach project: Medical students teach bystander CPR to secondary school students. CANADIAN JOURNAL OF RURAL MEDICINE 2024; 29:103-108. [PMID: 39155632 DOI: 10.4103/cjrm.cjrm_45_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/17/2024] [Indexed: 08/20/2024]
Abstract
INTRODUCTION Prompt bystander cardiopulmonary resuscitation (CPR) can double the chance of cardiac arrest survival. Rural and remote communities experience longer emergency service wait times and have lower rates of bystander-CPR compared to their urban counterparts. Our study addresses this disparity. METHODS We designed a 1.5-h free hands-only CPR course tailored to secondary school students in rural and remote communities taught by medical students. We evaluated our course using pre-test and post-test surveys. RESULTS We taught over 300 secondary students in 5 days. Less than one-third of students had previously taken a CPR course. We found that brief CPR instruction taught by medical students was effective in both improving students' knowledge of CPR (t[528] = -26, P < 0.01) and perceived comfort in performing CPR (t[548] = -12, P < 0.01). CONCLUSION CPR courses taught by medical students are effective, low cost, and may help address regional health care disparities. Teaching CPR to rural/remote communities may have secondary benefits such as promoting health care careers to rural youth. We encourage other health professional programmes to consider engaging students in CPR outreach projects. INTRODUCTION Une réanimation cardio-pulmonaire rapide peut doubler les chances de survie en cas d'arrêt cardiaque. Les communautés rurales et éloignées connaissent des temps d'attente plus longs dans les services d'urgence et ont des taux plus faibles de RCP par rapport à leurs homologues urbains. Notre étude porte sur cette disparité. MTHODES Nous avons conçu un cours de RCP pratique et gratuit d'une heure et demie, adapté aux élèves du secondaire des communautés rurales et isolées et dispensé par des étudiants en médecine. Nous avons évalué notre cours à l'aide d'enquêtes pré-test et post-test. RSULTATS En 5 jours, nous avons enseigné à plus de 300 élèves du secondaire. Moins d'un tiers des élèves avaient déjà suivi un cours de RCP. Nous avons constaté qu'une brève formation à la RCP dispensée par des étudiants en médecine était efficace pour améliorer les connaissances des élèves en matière de RCP (t[528] = -26, P < 0,01) et la perception de leur aisance à pratiquer la RCP (t[548] = -12, P < 0,01). CONCLUSION Les cours de RCP dispensés par les étudiants en médecine sont efficaces, peu coûteux et peuvent contribuer à lutter contre les disparités régionales en matière de soins de santé. L'enseignement de la RCP aux communautés rurales/éloignées peut avoir des avantages secondaires tels que la promotion des carrières dans le domaine de la santé auprès des jeunes ruraux. Nous encourageons d'autres programmes professionnels de santé à envisager d'engager leurs étudiants dans des projets de sensibilisation à la RCP.
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Idrees S, Abdullah R, Anderson KK, Tijssen JA. Sociodemographic factors associated with paediatric out-of-hospital cardiac arrest: A systematic review. Resuscitation 2023; 192:109931. [PMID: 37562664 DOI: 10.1016/j.resuscitation.2023.109931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/08/2023] [Accepted: 08/02/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Paediatric out-of-hospital cardiac arrest (POHCA) is associated with poor survival and severe neurological sequelae. We conducted a systematic review on the impact of sociodemographic factors across different stages of POHCA. METHODS We searched MEDLINE, EMBASE, and Web of Science from database inception to October 2022. We included studies examining the association between sociodemographic factors (i.e., race, ethnicity, migrant status and socioeconomic status [SES]) and POHCA risk, bystander cardiopulmonary resuscitation (CPR) provision, bystander automated external defibrillator (AED) application, survival (at or 30-days post-discharge), and neurological outcome. We synthesized the data qualitatively. RESULTS We screened 11,097 citations and included 18 articles (arising from 15 studies). There were 4 articles reporting on POHCA risk, 5 on bystander CPR provision, 3 on bystander AED application, 13 on survival, and 6 on neurological outcome. In all studies on POHCA risk, significant differences were found across racial groups, with minority populations being disproportionately impacted. There were no articles reporting on the association between SES and POHCA risk. Bystander CPR provision was consistently associated with race and ethnicity, with disparities impacting Black and Hispanic children. The association between bystander CPR provision and SES was variable. There was little evidence of socioeconomic or racial disparities in studies on bystander AED application, survival, and neurological outcome, particularly across adjusted analyses. CONCLUSIONS Race and ethnicity are likely associated with POHCA risk and bystander CPR provision. These findings highlight the importance of prioritizing at-risk groups in POHCA prevention and intervention efforts. Further research is needed to understand underlying mechanisms.
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Affiliation(s)
- Samina Idrees
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Ream Abdullah
- School of Interdisciplinary Science, Faculty of Science, McMaster University, Hamilton, ON, Canada
| | - Kelly K Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Janice A Tijssen
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
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Blanchard PG, Graham JM, Gauvin V, Lanoue MP, Péloquin F, Bertrand I, Ulrich Singbo MN, Poirier P, Émond M, Mercier E. Reducing Barriers to Optimal Automated External Defibrillator Use: An Elementary School Intervention Study. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2022; 1:30-36. [PMID: 37969560 PMCID: PMC10642092 DOI: 10.1016/j.cjcpc.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2023]
Abstract
Background Timely use of an automated external defibrillator (AED) improves outcomes in sudden cardiopulmonary arrest (SCA). Our project aims were to: 1) identify the barriers to optimal AED use in the Québec City area elementary schools; 2) create targeted educational material regarding AEDs; and 3) measure the impact of the teaching module. Methods Using a quality improvement in health-care framework, a survey exploring the barriers to AED use was sent to 139 elementary schools. We then developed a video teaching module on using AEDs to address these barriers. A convenience sample of 92 elementary school professionals participated in a mock scenario. Metrics related to AED use were assessed at baseline and after completing the post-teaching module. The primary outcome was the time to first shock and secondary outcomes consisted of evaluating the completion of each step required for safe and effective AED use. Results The barrier analysis survey received a response rate of 52.5%. Most schools reported having an AED (95%), but 48.6% indicated that no formal training was offered. After the teaching module, the appropriate use of the AED in an SCA simulation improved from 53% to 92% (P < 0.001). The average time elapsed before first shock was 66 (95% confidence interval [CI], 63-70) seconds at baseline compared with 47 (95% CI, 45-49) seconds post-teaching module (P < 0.001). Conclusions Lack of training, the main barrier to optimal use of AEDs in elementary schools, can be addressed through a brief video teaching module, thus improving the ability to deliver timely and effective defibrillation.
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Affiliation(s)
- Pierre-Gilles Blanchard
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
- Centre de recherche du CHU de Québec–Université Laval, Québec City, Québec, Canada
- VITAM---entre de recherche en santé durable de l’Université Laval, Québec City, Québec, Canada
| | - Johann M.I. Graham
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
- Centre de Recherche du CISSS de Lanaudière, Québec, Canada
| | - Vincent Gauvin
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
| | - Marie-Pier Lanoue
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
| | - Fannie Péloquin
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
| | - Isabelle Bertrand
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
| | | | - Paul Poirier
- Faculté de pharmacie, Université Laval, Québec, Canada
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Québec, Canada
| | - Marcel Émond
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
- Centre de recherche du CHU de Québec–Université Laval, Québec City, Québec, Canada
- VITAM---entre de recherche en santé durable de l’Université Laval, Québec City, Québec, Canada
| | - Eric Mercier
- Département de médecine familiale et médecine d’urgence, Faculté de médecine, Université Laval, Québec City, Québec, Canada
- Centre de recherche du CHU de Québec–Université Laval, Québec City, Québec, Canada
- VITAM---entre de recherche en santé durable de l’Université Laval, Québec City, Québec, Canada
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"Motorcycle Ambulance" Policy to Promote Health and Sustainable Development in Large Cities. Prehosp Disaster Med 2021; 37:78-83. [PMID: 34913423 DOI: 10.1017/s1049023x21001345] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Motorcycles can be considered a new form of smart vehicle when taking into account their small and modern structure and due to the fact that nowadays, they are used in the new role of ambulance to rapidly reach emergency patients in large cities with traffic congestion. However, there is no study regarding the measuring of access time for motorcycle ambulances (motorlances) in large cities of Thailand. STUDY OBJECTIVE This study aims to compare access times to patients between motorlances and conventional ambulances, including analysis of the use of automated external defibrillators (AEDs) installed on motorlances to contribute to the sustainable development of public health policies. METHODS A cross-sectional study was conducted on all motorlance operations in Emergency Medical Services (EMS) at Srinagarind Hospital, Thailand from January 2019 through December 2020. Data were recorded using a national standard operation record form for Thailand. RESULTS Two hundred seventy-one motorlance operations were examined over a two-year period. A total of 52.4% (N = 142) of the patients were male. The average times from dispatch to vehicle (motorlance and traditional ambulance) being en route (activation time) for motorlance and ambulance in afternoon shift were 0.59 minutes and 1.45 minutes, respectively (P = .004). The average motorlance response time in the afternoon shift was 6.12 minutes, and ambulance response time was 9.10 minutes at the same shift. Almost all of the motorlance operations (97.8%) were found to have no access to AED equipment installed in public areas. The average time from dispatch to AED arrival on scene (AED access time) was 5.02 minutes. CONCLUSION The response time of motorlances was shorter than a conventional ambulance, and the use of AEDs on a motorlance can increase the chances of survival for patients with cardiac arrest outside the hospital in public places where AEDs are not available.
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Grubic N, Hill B, Phelan D, Baggish A, Dorian P, Johri AM. Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review. Br J Sports Med 2021; 56:410-416. [PMID: 34853034 DOI: 10.1136/bjsports-2021-104623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the provision of bystander interventions and rates of survival after exercise-related sudden cardiac arrest (SCA). DESIGN Systematic review. DATA SOURCES MEDLINE, EMBASE, PubMed, CINAHL, SPORTDiscus, Cochrane Library and grey literature sources were searched from inception to November/December 2020. STUDY ELIGIBILITY CRITERIA Observational studies assessing a population of exercise-related SCA (out-of-hospital cardiac arrests that occurred during exercise or within 1 hour of cessation of activity), where bystander cardiopulmonary resuscitation (CPR) and/or automated external defibrillator (AED) use were reported, and survival outcomes were ascertained. METHODS Among all included studies, the median (IQR) proportions of bystander CPR and bystander AED use, as well as median (IQR) rate of survival to hospital discharge, were calculated. RESULTS A total of 29 studies were included in this review, with a median study duration of 78.7 months and a median sample size of 91. Most exercise-related SCA patients were male (median: 92%, IQR: 86%-96%), middle-aged (median: 51, IQR: 39-56 years), and presented with a shockable arrest rhythm (median: 78%, IQR: 62%-86%). Bystander CPR was initiated in a median of 71% (IQR: 59%-87%) of arrests, whereas bystander AED use occurred in a median of 31% (IQR: 19%-42%) of arrests. Among the 19 studies that reported survival to hospital discharge, the median rate of survival was 32% (IQR: 24%-49%). Studies which evaluated the relationship between bystander interventions and survival outcomes reported that both bystander CPR and AED use were associated with survival after exercise-related SCA. CONCLUSION Exercise-related SCA occurs predominantly in males and presents with a shockable ventricular arrhythmia in most cases, emphasising the importance of rapid access to defibrillation. Further efforts are needed to promote early recognition and a rapid bystander response to exercise-related SCA.
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Affiliation(s)
- Nicholas Grubic
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada .,Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Braeden Hill
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Dermot Phelan
- Sports Cardiology Center, Atrium Health Sanger Heart and Vascular Institute, Charlotte, North Carolina, USA
| | - Aaron Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Paul Dorian
- Department of Medicine, Division of Cardiology, University of Toronto, Toronto, Ontario, Canada
| | - Amer M Johri
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
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