1
|
Li S, Qin C, Zhang H, Maimaitiming M, Shi J, Feng Y, Huang K, Bi Y, Wang M, Zhou Q, Jin Y, Zheng ZJ. Survival After Out-of-Hospital Cardiac Arrest Before and After Legislation for Bystander CPR. JAMA Netw Open 2024; 7:e247909. [PMID: 38669021 PMCID: PMC11053379 DOI: 10.1001/jamanetworkopen.2024.7909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/23/2024] [Indexed: 04/29/2024] Open
Abstract
Importance The lack of evidence-based implementation strategies is a major contributor to increasing mortality due to out-of-hospital cardiac arrest (OHCA) in developing countries with limited resources. Objective To evaluate whether the implementation of legislation is associated with increased bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use and improved clinical outcomes for patients experiencing OHCA and to provide policy implications for low-income and middle-income settings. Design, Setting, and Participants This observational cohort study analyzed a prospective city registry of patients with bystander-witnessed OHCA between January 1, 2010, and December 31, 2022. The Emergency Medical Aid Act was implemented in Shenzhen, China, on October 1, 2018. An interrupted time-series analysis was used to assess changes in outcomes before and after the law. Data analysis was performed from May to October 2023. Exposure The Emergency Medical Aid Act stipulated the use of AEDs and CPR training for the public and provided clear legal guidance for OHCA rescuing. Main Outcomes and Measures The primary outcomes were rates of bystander-initiated CPR and use of AEDs. Secondary outcomes were rates of prehospital return of spontaneous circulation (ROSC), survival to arrival at the hospital, and survival at discharge. Results A total of 13 751 patients with OHCA (median [IQR] age, 59 [43-76] years; 10 011 men [72.83%]) were included, with 7858 OHCAs occurring during the prelegislation period (January 1, 2010, to September 30, 2018) and 5893 OHCAs occurring during the postlegislation period (October 1, 2018, to December 31, 2022). The rates of bystander-initiated CPR (320 patients [4.10%] vs 1103 patients [18.73%]) and AED use (214 patients [4.12%] vs 182 patients [5.29%]) increased significantly after legislation implementation vs rates before the legislation. Rates of prehospital ROSC (72 patients [0.92%] vs 425 patients [7.21%]), survival to arrival at the hospital (68 patients [0.87%] vs 321 patients [5.45%]), and survival at discharge (44 patients [0.56%] vs 165 patients [2.80%]) were significantly increased during the postlegislation period. Interrupted time-series models demonstrated a significant slope change in the rates of all outcomes. Conclusions and Relevance These findings suggest that implementation of the Emergency Medical Aid Act in China was associated with increased rates of CPR and public AED use and improved survival of patients with OHCA. The use of a systemwide approach to enact resuscitation initiatives and provide legal support may reduce the burden of OHCA in low-income and middle-income settings.
Collapse
Affiliation(s)
- Siwen Li
- Shenzhen Center for Prehospital Care, Futian District, Shenzhen, China
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Chongzhen Qin
- Shenzhen Center for Prehospital Care, Futian District, Shenzhen, China
| | - Hongjuan Zhang
- Shenzhen Center for Prehospital Care, Futian District, Shenzhen, China
| | - Mailikezhati Maimaitiming
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Junyi Shi
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - YiKai Feng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Kepei Huang
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yanxin Bi
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Minmin Wang
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Qiang Zhou
- Shenzhen Center for Prehospital Care, Futian District, Shenzhen, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| |
Collapse
|
2
|
Horriar L, Rott N, Böttiger BW. Improving survival after cardiac arrest in Europe: The synergetic effect of rescue chain strategies. Resusc Plus 2024; 17:100533. [PMID: 38205146 PMCID: PMC10776426 DOI: 10.1016/j.resplu.2023.100533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
Sudden cardiac arrest is a global problem and is considered the third leading cause of death in industrialized countries. Patient survival rates after out-of-hospital cardiac arrest (OHCA) vary significantly between countries and continents. In particular, the 2021 European Resuscitation Council (ERC) Resuscitation Guidelines place a special focus on the chain of survival of patients after OHCA. As a complex, interconnected approach, the focus is on: Raising awareness for cardiac arrest and lay resuscitation, school children's education in resuscitation "KIDS SAVE LIVES", first responder systems - technologies to engage the community, telephone-assisted resuscitation (telephone-CPR; T-CPR) by dispatchers, and cardiac arrest centers (CAC) for further treatment in specialized hospitals. The Systems Saving Lives approach is a comprehensive strategy that emphasizes the interconnectedness of all links in the chain of survival following an OHCA, with a particular focus on the relationship between the community and emergency medical services (EMS). This system-level approach emphasizes the importance of the connection between all those involved in the chain of survival. It has a high potential to improve overall survival after OHCA. Therefore, it is recommended that these strategies be promoted and expanded in all countries.
Collapse
Affiliation(s)
- Lina Horriar
- German Resuscitation Council, Prittwitzstraße 43, 89070 Ulm, Germany
| | - Nadine Rott
- German Resuscitation Council, Prittwitzstraße 43, 89070 Ulm, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine Kerpener Straße 62, 50937 Cologne, Germany
| | - Bernd W. Böttiger
- German Resuscitation Council, Prittwitzstraße 43, 89070 Ulm, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine Kerpener Straße 62, 50937 Cologne, Germany
| |
Collapse
|
3
|
Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
Collapse
|
4
|
Huebinger R, Spring M, McNally B, Humphries A, Persse D, Diggs D, Boerwinkle E, Bobrow B. Agency factors associated with first response systems that improve out-of-hospital cardiac arrest outcomes. Resuscitation 2023; 193:109954. [PMID: 37661014 DOI: 10.1016/j.resuscitation.2023.109954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/08/2023] [Accepted: 08/27/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Data are conflicting regarding the association between first responder (FR) intervention and improved outcomes after out-of-hospital cardiac arrest (OHCA). We evaluated characteristics of agencies that have positive associations between FR interventions and outcomes. METHODS We analyzed the 2016-2021 national Cardiac Arrest Registry to Enhance Survival (CARES). We defined the exposures as FR CPR and AED. The outcome was survival with favorable neurologic status. We used logistic regression models to evaluate the association between FR interventions with OHCA outcome for each agency, stratifying agencies into positive association (95% confidence interval above 1) and no/inverse association (95% confidence below or including 1). We compared characteristics between cohorts. RESULTS For the association between FR CPR and outcomes, 21 agencies caring for 42,856 OHCAs had a positive association; 371 agencies caring for 449,824 OHCAs had no association. For FR AED, 47 agencies caring for 103,120 OHCAs had a positive association; 262 agencies caring for 327,761 OHCAs had no association. Comparing agency characteristics for FR CPR, agencies with a positive association had more annual OHCAs (+300), lower FR CPR rate (-11.3%), and lower FR AED rate (-10.8%). Comparing FR AED, agencies with a positive association had more OHCAs per year (+150.5), lower FR CPR rate (-6.8%), lower FR AED rate (-13.3%), lower response time (-0.6 minutes), and more OHCAs from high-income neighborhoods (+3.7%). CONCLUSION FR AED more commonly had a positive association with outcomes than FR CPR. Agencies with better outcomes from FR interventions treated more OHCAs and had lower rates of FR intervention.
Collapse
Affiliation(s)
- Ryan Huebinger
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TX, United States; Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, United States.
| | - Mary Spring
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TX, United States; Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, United States.
| | - Brian McNally
- Department of Emergency Medicine, Emory University, Atlanta, GA, United States
| | - Amanda Humphries
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TX, United States; Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, United States.
| | - David Persse
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TX, United States; Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, United States; Houston Fire Department, United States.
| | - Dominique Diggs
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TX, United States; Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, United States.
| | - Eric Boerwinkle
- School of Public Health, UTHealth Houston, Houston, TX, United States.
| | - Bentley Bobrow
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TX, United States; Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, United States.
| |
Collapse
|
5
|
Huebinger R, Del Rios M, Abella BS, McNally B, Bakunas C, Witkov R, Panczyk M, Boerwinkle E, Bobrow B. Impact of Receiving Hospital on Out-of-Hospital Cardiac Arrest Outcome: Racial and Ethnic Disparities in Texas. J Am Heart Assoc 2023; 12:e031005. [PMID: 37929677 PMCID: PMC10727382 DOI: 10.1161/jaha.123.031005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/28/2023] [Indexed: 11/07/2023]
Abstract
Background Factors associated with out-of-hospital cardiac arrest (OHCA) outcome disparities remain poorly understood. We evaluated the role of receiving hospital on OHCA outcome disparities. Methods and Results We studied people with OHCA who survived to hospital admission from TX-CARES (Texas Cardiac Arrest Registry to Enhance Survival), 2014 to 2021. Using census data, we stratified OHCAs into majority (>50%) strata: non-Hispanic White race and ethnicity, non-Hispanic Black race and ethnicity, and Hispanic or Latino ethnicity. We stratified hospitals into performance quartiles based on the primary outcome, survival with good neurologic outcome. We evaluated the association between race and ethnicity and care at higher-performance hospitals. We compared 3 models evaluating the association between race and ethnicity and outcome: (1) ignoring hospital, (2) adjusting for hospital as a random intercept, and (3) adjusting for hospital performance quartile. We adjusted models for possible confounders. We included 10 434 OHCAs. Hospital performance quartile outcome rates ranged from 11.3% (fourth) to 37.1% (first). Compared with OHCAs in neighborhoods of majority White race, those in neighborhoods of majority Black race (odds ratio [OR], 0.1 [95% CI, 0.1-0.1]) and Hispanic or Latino ethnicity (OR, 0.2 [95% CI, 0.2-0.2]) were less likely to be cared for at higher-performing hospitals. Compared with White neighborhoods (30.1%) and ignoring hospital, outcomes were worse in Black neighborhoods (15.4%; adjusted OR [aOR], 0.5 [95% CI, 0.4-0.5]) and Hispanic or Latino neighborhoods (19.2%; aOR, 0.6 [95% CI, 0.5-0.7]). Adjusting for hospital as a random intercept, outcomes improved for Black neighborhoods (aOR, 0.9 [95% CI, 0.7-1.05]) and Hispanic or Latino neighborhoods (aOR, 0.9 [95% CI, 0.8-0.99]). Adjusting for hospital performance quartile, outcomes improved for Black neighborhoods (aOR, 0.8 [95% CI, 0.7-1.01]) and Hispanic or Latino neighborhoods (aOR, 0.9 [95% CI, 0.8-0.996]). Conclusions In Black and Hispanic or Latino communities, OHCAs were less likely to be cared for at higher-performing hospitals, and adjusting for receiving hospital improved OHCA outcome disparities.
Collapse
Affiliation(s)
- Ryan Huebinger
- Texas Emergency Medicine Research CenterMcGovern Medical SchoolHoustonTXUSA
- Department of Emergency MedicineMcGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)HoustonTXUSA
| | - Marina Del Rios
- Department of Emergency MedicineUniversity of IowaIowa CityIAUSA
| | - Benjamin S. Abella
- Department of Emergency Medicine and Center for Resuscitation ScienceUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Bryan McNally
- Department of Emergency MedicineEmory UniversityAtlantaGAUSA
| | - Carrie Bakunas
- Texas Emergency Medicine Research CenterMcGovern Medical SchoolHoustonTXUSA
- Department of Emergency MedicineMcGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)HoustonTXUSA
| | - Richard Witkov
- Texas Emergency Medicine Research CenterMcGovern Medical SchoolHoustonTXUSA
- Department of Emergency MedicineMcGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)HoustonTXUSA
| | - Micah Panczyk
- Texas Emergency Medicine Research CenterMcGovern Medical SchoolHoustonTXUSA
- Department of Emergency MedicineMcGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)HoustonTXUSA
| | | | - Bentley Bobrow
- Texas Emergency Medicine Research CenterMcGovern Medical SchoolHoustonTXUSA
- Department of Emergency MedicineMcGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)HoustonTXUSA
| |
Collapse
|
6
|
Marijon E, Narayanan K, Smith K, Barra S, Basso C, Blom MT, Crotti L, D'Avila A, Deo R, Dumas F, Dzudie A, Farrugia A, Greeley K, Hindricks G, Hua W, Ingles J, Iwami T, Junttila J, Koster RW, Le Polain De Waroux JB, Olasveengen TM, Ong MEH, Papadakis M, Sasson C, Shin SD, Tse HF, Tseng Z, Van Der Werf C, Folke F, Albert CM, Winkel BG. The Lancet Commission to reduce the global burden of sudden cardiac death: a call for multidisciplinary action. Lancet 2023; 402:883-936. [PMID: 37647926 DOI: 10.1016/s0140-6736(23)00875-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 04/13/2023] [Accepted: 04/25/2023] [Indexed: 09/01/2023]
Abstract
Despite major advancements in cardiovascular medicine, sudden cardiac death (SCD) continues to be an enormous medical and societal challenge, claiming millions of lives every year. Efforts to prevent SCD are hampered by imperfect risk prediction and inadequate solutions to specifically address arrhythmogenesis. Although resuscitation strategies have witnessed substantial evolution, there is a need to strengthen the organisation of community interventions and emergency medical systems across varied locations and health-care structures. With all the technological and medical advances of the 21st century, the fact that survival from sudden cardiac arrest (SCA) remains lower than 10% in most parts of the world is unacceptable. Recognising this urgent need, the Lancet Commission on SCD was constituted, bringing together 30 international experts in varied disciplines. Consistent progress in tackling SCD will require a completely revamped approach to SCD prevention, with wide-sweeping policy changes that will empower the development of both governmental and community-based programmes to maximise survival from SCA, and to comprehensively attend to survivors and decedents' families after the event. International collaborative efforts that maximally leverage and connect the expertise of various research organisations will need to be prioritised to properly address identified gaps. The Commission places substantial emphasis on the need to develop a multidisciplinary strategy that encompasses all aspects of SCD prevention and treatment. The Commission provides a critical assessment of the current scientific efforts in the field, and puts forth key recommendations to challenge, activate, and intensify efforts by both the scientific and global community with new directions, research, and innovation to reduce the burden of SCD worldwide.
Collapse
Affiliation(s)
- Eloi Marijon
- Division of Cardiology, European Georges Pompidou Hospital, AP-HP, Paris, France; Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France.
| | - Kumar Narayanan
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France; Medicover Hospitals, Hyderabad, India
| | - Karen Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Silverchain Group, Melbourne, VIC, Australia
| | - Sérgio Barra
- Department of Cardiology, Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal
| | - Cristina Basso
- Cardiovascular Pathology Unit-Azienda Ospedaliera and Department of Cardiac Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Marieke T Blom
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Lia Crotti
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; Istituto Auxologico Italiano, IRCCS, Center for Cardiac Arrhythmias of Genetic Origin, Cardiomyopathy Unit and Laboratory of Cardiovascular Genetics, Department of Cardiology, Milan, Italy
| | - Andre D'Avila
- Department of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Cardiology, Hospital SOS Cardio, Santa Catarina, Brazil
| | - Rajat Deo
- Department of Cardiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Florence Dumas
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France; Emergency Department, Cochin Hospital, Paris, France
| | - Anastase Dzudie
- Cardiology and Cardiac Arrhythmia Unit, Department of Internal Medicine, DoualaGeneral Hospital, Douala, Cameroon; Yaounde Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
| | - Audrey Farrugia
- Hôpitaux Universitaires de Strasbourg, France, Strasbourg, France
| | - Kaitlyn Greeley
- Division of Cardiology, European Georges Pompidou Hospital, AP-HP, Paris, France; Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France
| | | | - Wei Hua
- Cardiac Arrhythmia Center, FuWai Hospital, Beijing, China
| | - Jodie Ingles
- Centre for Population Genomics, Garvan Institute of Medical Research and UNSW Sydney, Sydney, NSW, Australia
| | - Taku Iwami
- Kyoto University Health Service, Kyoto, Japan
| | - Juhani Junttila
- MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Rudolph W Koster
- Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Theresa M Olasveengen
- Department of Anesthesia and Intensive Care Medicine, Oslo University Hospital and Institute of Clinical Medicine, Oslo, Norway
| | - Marcus E H Ong
- Singapore General Hospital, Duke-NUS Medical School, Singapore
| | - Michael Papadakis
- Cardiovascular Clinical Academic Group, St George's University of London, London, UK
| | | | - Sang Do Shin
- Department of Emergency Medicine at the Seoul National University College of Medicine, Seoul, South Korea
| | - Hung-Fat Tse
- University of Hong Kong, School of Clinical Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Zian Tseng
- Division of Cardiology, UCSF Health, University of California, San Francisco Medical Center, San Francisco, California
| | - Christian Van Der Werf
- University of Amsterdam, Heart Center, Amsterdam, Netherlands; Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Fredrik Folke
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christine M Albert
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Bo Gregers Winkel
- Department of Cardiology, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
7
|
Schnaubelt S, Krammel M. PULS - Austrian Cardiac Arrest Awareness Association: An overview of a multi-tiered and multi-facetted regional initiative to save lives. Resusc Plus 2023; 15:100453. [PMID: 37645620 PMCID: PMC10461014 DOI: 10.1016/j.resplu.2023.100453] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
Background Out-of-hospital cardiac arrest with subsequent cardiopulmonary resuscitation (CPR) still leads to dismal outcomes worldwide. The crucial gap between cardiac arrest and advanced life support can only be filled by bystander-CPR. However, knowledge and willingness of the public towards basic life support (BLS) remain low. Global and national initiatives for awareness building and CPR training have produced promising improvements, but an additional focus on regional initiatives might be necessary to truly implement change. Methods and results In order to support other like-minded groups, we present a "coming of age" narrative review of PULS - Austrian Cardiac Arrest Awareness Association, along with a future outlook and "lessons learned". Interviews with past and present employees, members, and functionaries were conducted by the authors. Additionally, the organization's archives were assessed. Conclusion Following current guidelines and the Utstein formula of survival, building a system to save lives is essential to achieve progress concerning cardiac arrest survival and outcomes. As kinds of "regional offices" of global resuscitation efforts, a network of individual local initiatives and organizations such as PULS can carry the respective messages, engage with local key figures of implementation, and keep up perpetual work for cardiac arrest awareness and BLS education.
Collapse
Affiliation(s)
- Sebastian Schnaubelt
- PULS – Austrian Cardiac Arrest Awareness Association, Vienna, Austria
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Mario Krammel
- PULS – Austrian Cardiac Arrest Awareness Association, Vienna, Austria
- Emergency Medical Service Vienna, Austria
| |
Collapse
|
8
|
Daud A, Nawi AM, Aizuddin AN, Yahya MF. Factors and Barriers on Cardiopulmonary Resuscitation and Automated External Defibrillator Willingness to Use among the Community: A 2016-2021 Systematic Review and Data Synthesis. Glob Heart 2023; 18:46. [PMID: 37649652 PMCID: PMC10464530 DOI: 10.5334/gh.1255] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 07/11/2023] [Indexed: 09/01/2023] Open
Abstract
Background Bystander cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED) can improve out-of-hospital cardiac arrest survival. However, bystander CPR and AED rates remained consistently low. The goal of this systematic review was to assess factors influencing community willingness to perform CPR and use an AED for out-of-hospital cardiac arrest survival (OHCA) victims, as well as its barriers. Methods The review processes (PROSPERO: CRD42021257851) were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) review protocol; formulation of review questions; systematic search strategy based on identification, screening, and eligibility using established databases including Scopus, Web of Science, and Medline Complete via EBSCOhost; quality appraisal; and data extraction and analysis. There is identification of full-text journal articles that were published between 2016 and 2021 and written in English. Results Of the final 13 articles, there are six identified factors associated with willingness to perform CPR and use an AED, including socio-demographics, training, attitudes, perceived norms, self-efficacy, and legal obligation. Younger age, men, higher level of education, employed, married, having trained in CPR and AED in the previous 5 years, having received CPR education on four or more occasions, having a positive attitude and perception toward CPR and AED, having confidence to perform CPR and to apply an AED, and legal liability protection under emergency medical service law were reasons why one would be more likely to indicate a willingness to perform CPR and use an AED. The most reported barriers were fear of litigation and injuring a victim. Conclusions There is a need to empower all the contributing factors and reduce the barrier by emphasizing the importance of CPR and AEDs. The role played by all stakeholders should be strengthened to ensure the success of intervention programs, and indirectly, that can reduce morbidity and mortality among the community from OHCA.
Collapse
Affiliation(s)
- Amsyar Daud
- Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur 56000, Malaysia
| | - Azmawati Mohammed Nawi
- Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur 56000, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mohammad Fadhly Yahya
- Emergency and Trauma Department, Malacca General Hospital, Jalan Mufti Haji Khalil, Malacca 75450, Malaysia
| |
Collapse
|
9
|
Oh YT, Ahn C. Characteristics and Treatment Outcomes of Out-of-Hospital Cardiac Arrests Occurring in Public Places: A National Population-Based Observational Study. J Pers Med 2023; 13:1191. [PMID: 37623442 PMCID: PMC10455591 DOI: 10.3390/jpm13081191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
Sudden cardiac arrest, particularly out-of-hospital cardiac arrest (OHCA), is a global public health concern. However, limited research exists on the epidemiology of OHCAs occurring in public places, trends and impact of bystander intervention, and influence of extraordinary circumstances. This study investigated the epidemiological factors, bystander characteristics, and outcomes of OHCAs that occurred in public places in South Korea from 2016 to 2021 and analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic. A retrospective analysis was conducted using an Out-of-Hospital Cardiac Arrest Surveillance database, including 33,206 cases of OHCA that occurred in public places. Cases with do-not-resuscitate orders or insufficient data were excluded. A steady increase in bystander-performed cardiopulmonary resuscitation over the years and a constant decrease in bystander automated external defibrillator (AED) use were observed. Survival-to-discharge rates for OHCAs remained relatively steady until a marginal decrease was observed during the pandemic (pandemic, 13.1%; pre-pandemic, 14.4%). Factors affecting survival included the presence of a shockable rhythm, witnessed arrest, cardiac arrest due to disease, use of bystander AED, and period relative to the COVID-19 pandemic. These findings emphasize the critical role of bystanders in outcomes of OHCAs and inform public health strategies on better management of OHCAs in public places.
Collapse
Affiliation(s)
- Young Taeck Oh
- Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea;
| | - Chiwon Ahn
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06974, Republic of Korea
| |
Collapse
|
10
|
Huebinger R, Panczyk M, Villa N, Al-Araji R, Schulz K, Humphries A, Gill J, Persse D, J Bobrow B. First Responder CPR and Survival Differences in Texas Minority and Lower Socioeconomic Status Neighborhoods. PREHOSP EMERG CARE 2023; 27:1076-1082. [PMID: 36880880 DOI: 10.1080/10903127.2023.2188331] [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: 12/13/2022] [Accepted: 03/02/2023] [Indexed: 03/08/2023]
Abstract
INTRODUCTION First responder (FR) cardiopulmonary resuscitation (CPR) is an important component of out-of-hospital cardiac arrest (OHCA) care. However, little is known about FR CPR disparities. METHODS We linked the 2014-2021 Texas Cardiac Arrest Registry to Enhance Survival (TX-CARES) database to census tract data. We included non-traumatic OHCAs that were not witnessed by 9-1-1 responders and did not receive bystander CPR. We defined census tracts as having >50% of a race/ethnicity: White, Black, or Hispanic/Latino. We also stratified patients into quartiles based on socioeconomic status (SES): household income, high school graduation, and unemployment. We also combined race/ethnicity and income to create a total of five mixed strata, comparing lower income and minority census tracts to high income White census tracts. We created mixed model logistic regression models, adjusting for confounders and modeling census tract as a random intercept. Using the models, we compared FR CPR rates for census race/ethnicity (Black and Hispanic/Latino compared to White), and SES quartiles (2nd, 3rd, and 4th quartiles compared to 1st quartiles). Secondarily, we evaluated the association between FR CPR and survival for all strata. RESULTS We included 21,966 OHCAs, and 57.4% had FR CPR. Evaluating the association between census tract characteristic and FR CPR, majority Black (aOR 0.30, 95% CI 0.22-0.41) had a lower bystander CPR rate when compared to majority White. The lowest income quartile had a lower rate of bystander CPR (aOR 0.80, 95% CI 0.65-0.98). The worst unemployment quartile was also associated with a lower rate of FR CPR (aOR 0.75, 95% CI 0.61-0.92). Combining race/ethnicity and income, middle income majority Black (30.0%; aOR 0.27, 95% CI 0.17-0.46) and low income >80% Black (31.8%; aOR 0.27, 95% CI 0.10-0.68) had lower rates of FR CPR in comparison to high income majority White. There were no associations between Hispanic or lower high school graduation and lower rates of FR CPR. We found no association between FR CPR and survival for all three strata. CONCLUSION While we identified disparities in FR CPR in low SES and majority Black census tracts, we identified no association between FR CPR and survival in Texas.
Collapse
Affiliation(s)
- Ryan Huebinger
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, Texas
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Micah Panczyk
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, Texas
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Normandy Villa
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, Texas
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Rabab Al-Araji
- Public Health, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Kevin Schulz
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, Texas
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
- Houston Fire Department, Emergency Medicine, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Amanda Humphries
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, Texas
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Joseph Gill
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, Texas
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - David Persse
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
- Houston Fire Department, Emergency Medicine, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Bentley J Bobrow
- Texas Emergency Medicine Research Center, McGovern Medical School, Houston, Texas
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| |
Collapse
|
11
|
Priscilla Ng T, Wai-Onn Eng S, Xin Rui Ting J, Bok C, Yang Hong Tay G, Yeon Joyce Kong S, Stassen W, Zhang L, Eng Hock Ong M, Blewer AL, Wei Yeo J, Fu Wah Ho A. Global prevalence of basic life support training: A systematic review and meta-analysis. Resuscitation 2023; 186:109771. [PMID: 36934835 DOI: 10.1016/j.resuscitation.2023.109771] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND AND AIMS Out-of-hospital cardiac arrest exerts a large disease burden, which may be mitigated by bystander cardiopulmonary resuscitation and automated external defibrillation. We aimed to estimate the global prevalence and distribution of bystander training among laypersons, which are poorly understood, and to identify their determinants. METHODS We searched electronic databases for cross-sectional studies reporting the prevalence of bystander training from representative population samples. Pooled prevalence was calculated using random-effects models. Key outcome was cardiopulmonary resuscitation training (training within two-years and those who were ever trained). We explored determinants of interest using subgroup analysis and meta-regression. RESULTS 28 studies were included, representing 53,397 laypersons. Among national studies, the prevalence of cardiopulmonary resuscitation training within two-years and among those who were ever trained, and automated external defibrillator training was 10.02% (95% CI 6.60-14.05) and 39.64% (95%CI 29.11-50.67), and 15.70% (95% CI 10.17-22.18) respectively. Subgroup analyses by continent revealed pooled prevalence estimates of 31.58% (95%CI 18.70-46.09), 52.62% (95%CI 38.40-66.63), 18.93 (95%CI 0.00-62.94), 64.97% (95%CI 64.00-65.93), and 50.56% (95%CI 47.57-53.54) in Asia, Europe, Middle East, North America, and Oceania respectively, with significant subgroup differences (p<0.01). A country's income and cardiopulmonary resuscitation training (ever trained) (p=0.033) were positively correlated. Similarly, this prevalence was higher among the employed (p<0.00001) and highly educated (p<0.00001). CONCLUSIONS Large regional variation exists in data availability and bystander training prevalence. Socioeconomic status correlated with prevalence of bystander training, and regional disparities were apparent between continents. Bystander training should be promoted, particularly in Asia, Middle East, and low-income regions. Data availability should be encouraged from under-represented regions.
Collapse
Affiliation(s)
- Trina Priscilla Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sean Wai-Onn Eng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joel Xin Rui Ting
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chermaine Bok
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Willem Stassen
- Division of Emergency Medicine, University of Cape Town, South Africa
| | - Lin Zhang
- Department of Epidemiology and Biostatistics, Shanghai Jiao Tong University School of Public Health, China
| | - Marcus Eng Hock Ong
- Department of Emergency Medicine, Singapore General Hospital, Singapore; Pre-hospital and Emergency Research Center, Duke-NUS Medical School, Singapore
| | - Audrey L Blewer
- Department of Family Medicine and Community Health, Duke University School of Medicine, USA; Department of Population Health Sciences, Duke University School of Medicine, USA; Pre-hospital and Emergency Research Center, Duke-NUS Medical School, Singapore
| | - Jun Wei Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Andrew Fu Wah Ho
- Department of Emergency Medicine, Singapore General Hospital, Singapore; Pre-hospital and Emergency Research Center, Duke-NUS Medical School, Singapore.
| | | |
Collapse
|
12
|
Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1122] [Impact Index Per Article: 1122.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
Collapse
|
13
|
Farquharson B, Dixon D, Williams B, Torrens C, Philpott M, Laidlaw H, McDermott S. The psychological and behavioural factors associated with laypeople initiating CPR for out-of-hospital cardiac arrest: a systematic review. BMC Cardiovasc Disord 2023; 23:19. [PMID: 36639764 PMCID: PMC9840280 DOI: 10.1186/s12872-022-02904-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/17/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Prompt, effective CPR greatly increases the chances of survival in out-of-hospital c ardiac arrest. However, it is often not provided, even by people who have previously undertaken training. Psychological and behavioural factors are likely to be important in relation to CPR initiation by lay-people but have not yet been systematically identified. METHODS Aim: to identify the psychological and behavioural factors associated with CPR initiation amongst lay-people. DESIGN Systematic review Data sources: Cochrane Library, MEDLINE, EMBASE, CINAHL, PsycInfo and Google Scholar. STUDY ELIGIBILITY CRITERIA Primary studies reporting psychological or behavioural factors and data on CPR initiation involving lay-people published (inception to 31 Dec 2021). STUDY APPRAISAL AND SYNTHESIS METHODS Potential studies were screened independently by two reviewers. Study characteristics, psychological and behavioural factors associated with CPR initiation were extracted from included studies, categorised by study type and synthesised narratively. RESULTS One hundred and five studies (150,820 participants) comprising various designs, populations and of mostly weak quality were identified. The strongest and most ecologically valid studies identified factors associated with CPR initiation: the overwhelming emotion of the situation, perceptions of capability, uncertainty about when CPR is appropriate, feeling unprepared and fear of doing harm. Current evidence comprises mainly atheoretical cross-sectional surveys using unvalidated measures with relatively little formal testing of relationships between proposed variables and CPR initiation. CONCLUSIONS Preparing people to manage strong emotions and increasing their perceptions of capability are likely important foci for interventions aiming to increase CPR initiation. The literature in this area would benefit from more robust study designs. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42018117438.
Collapse
Affiliation(s)
- Barbara Farquharson
- grid.11918.300000 0001 2248 4331NMAHP Research Unit, University of Stirling, Stirling, FK9 4LA UK
| | - Diane Dixon
- grid.7107.10000 0004 1936 7291University of Aberdeen, Aberdeen, UK
| | - Brian Williams
- grid.23378.3d0000 0001 2189 1357University of Highlands and Islands, Inverness, UK
| | - Claire Torrens
- grid.11918.300000 0001 2248 4331University of Stirling, Stirling, UK
| | - Melanie Philpott
- grid.11918.300000 0001 2248 4331University of Stirling, Stirling, UK
| | - Henriette Laidlaw
- grid.23378.3d0000 0001 2189 1357University of Highlands and Islands, Inverness, UK
| | | |
Collapse
|
14
|
Orlob S, Grundner S, Wittig J, Eichinger M, Pucher F, Eichlseder M, Lingitz R, Rief M, Palt N, Hartwig C, Zangl G, Haar M, Manninger M, Rohrer U, Scherr D, Zirlik A, Prause G, Zweiker D. Assessing the weak links - Necessity and impact of regional cardiac arrest awareness campaigns for laypersons. Resusc Plus 2023; 13:100352. [PMID: 36654724 PMCID: PMC9841163 DOI: 10.1016/j.resplu.2022.100352] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Introduction Public knowledge of out-of-hospital cardiac arrest (OHCA), and initiation of basic life support (BLS) is crucial to increase survival in OHCA. Methods The study analysed the knowledge and willingness to perform BLS of laypersons passing an AED at a public train station. Interviewees were recruited at two time points before and after a four year-long structured regional awareness campaign, which focused on call, compress, shock in a mid-size European city (270,000 inhabitants). Complete BLS was defined as multiple responses for call for help; initiation of chest compressions; and usage of an AED, without mentioning recovery position. Minimal BLS was defined as call for help and initiation of chest compressions. Results A total of 784 persons were interviewed, 257 at baseline and 527 post-campaign. Confronted with a fictional OHCA, at baseline 8.5% of the interviewees spontaneously mentioned actions for complete BLS and 17.9% post-campaign (p = 0.009). An even larger increase in knowledge was seen in minimal BLS (34.6% vs 60.6%, p < 0.001). Conclusion After a regional cardiac arrest awareness campaign, we found an increase in knowledge of BLS actions in the lay public. However, our investigation revealed severe gaps in BLS knowledge, possibly resulting in weak first links of the chain of survival.
Collapse
Affiliation(s)
- Simon Orlob
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Stephan Grundner
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria,Department of Diagnostic and Interventional Radiology, Ordensklinikum Linz Elisabethinen, Fadingerstraße 1, 4020 Linz, Austria
| | - Johannes Wittig
- Research Center for Emergency Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 161, 8200 Aarhus N, Denmark,Medical University of Graz; Auenbruggerplatz 12, 8036 Graz, Austria
| | - Michael Eichinger
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Felix Pucher
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Michael Eichlseder
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Raphaela Lingitz
- Department of Paediatrics, Hospital Wiener Neustadt, Corvinusring 3-5, 2700 Wiener Neustadt, Austria
| | - Martin Rief
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Niklas Palt
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria,Medical University of Graz; Auenbruggerplatz 12, 8036 Graz, Austria
| | - Charlotte Hartwig
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Gregor Zangl
- State Hospital Hochsteiermark, Location Bruck, Tragösser Strasse 1, 8600 Bruck an der Mur, Austria
| | - Markus Haar
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246 Hamburg, Germany
| | - Martin Manninger
- Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria,Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands
| | - Ursula Rohrer
- Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Daniel Scherr
- Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Andreas Zirlik
- Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Gerhard Prause
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - David Zweiker
- Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria,Third Medical Department for Cardiology and Intensive Care, Clinic Ottakring, Montleartstraße 37, Pavillon 29, 1160 Vienna, Austria,Corresponding author at: Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
| |
Collapse
|
15
|
Chang YT, Wu KC, Yang HW, Lin CY, Huang TF, Yu YC, Hu YJ. Effects of different cardiopulmonary resuscitation education interventions among university students: A randomized controlled trial. PLoS One 2023; 18:e0283099. [PMID: 36917584 PMCID: PMC10013893 DOI: 10.1371/journal.pone.0283099] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023] Open
Abstract
Cardiopulmonary resuscitation (CPR) education for the public may improve bystander intention to perform CPR on cardiac arrest patients. Studies have shown that different CPR education intervention methods can improve learning performance, with key indicators including attitude toward to CPR, intention to perform CPR, and degree of CPR knowledge and skills. The present study compared the traditional face-to-face method to hybrid and virtual reality (VR) methods to observe difference in learning performance and length of performance retention. This study adopted randomized controlled trial to compare CPR learning performance between traditional face-to-face, hybrid, and VR methods. Participants from each intervention group completed a pretest and 2 posttests. The measurement tools included an attitude and intention questionnaire, knowledge examination, and skill examination with a RESUSCI ANNE QCPR ® manikin. The performance among all participants in pretest showed no significant difference between the intervention groups, indicating no difference in their background attitude, knowledge, and skill level. Significant differences were observed in the average degree of intention to perform CPR between the hybrid and traditional groups in 1st and 2nd posttest. Compared to the pretest results, the posttests revealed significantly higher attitude toward CPR, intention to perform CPR, knowledge examination results, accuracy of overall chest compression, accuracy of CPR procedure, accuracy of AED usage, accuracy of chest compression rate, and accuracy of chest compression depth. The average time to reattending CPR learning and practice session was 11-12 weeks reported by participants. The hybrid and VR methods to CPR education resulted in the same level of improvement in learning performance as traditional face-to-face teaching. The suggested frequency for renewing CPR knowledge and skills is 12 weeks which may be considered in new strategies aimed at promoting CPR education and exposure to the public.
Collapse
Affiliation(s)
- Yu-Tung Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- * E-mail:
| | - Kun-Chia Wu
- Department of Medical VR, HTC Corporation, Taipei, Taiwan
| | | | - Chung-Yi Lin
- Department of Shipping and Transportation Management, National Taiwan Ocean University, Keelong, Taiwan
| | - Tzu-Fu Huang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Yi-Chi Yu
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Yih-Jin Hu
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| |
Collapse
|
16
|
Ferrell MC, Khojasteh J, Vassar M. Public awareness of cardiopulmonary resuscitation and cardiac arrest in association with Christian Eriksen. Public Health 2022; 212:42-45. [PMID: 36208501 DOI: 10.1016/j.puhe.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 07/26/2022] [Accepted: 08/19/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES During the Union of European Football Association EURO 2020 Football Championship, Danish football player Christian Eriksen experienced a cardiac arrest on the field of play. With prompt intervention and cardiopulmonary resuscitation (CPR), Erikson had a positive outcome and survived the arrest. Our goal is to determine the extent to which this event informed the general population about cardiac arrests and CPR. STUDY DESIGN This was a cross-sectional internet analysis. METHODS First, Google Trends was used to identify the search interest of topics "Cardiopulmonary resuscitation," "Myocardial infarction," and disease "Cardiac arrest" worldwide from May 29, 2021, to June 19, 2021. Second, we downloaded Twitter data via Sprout Social using the keywords "CPR" and "cardiac arrest," which are presented as the absolute number of tweets. An ARIMA model was used to forecast expected search volumes. RESULTS The following week, there was an increase of 91.72% (95% confidence interval [CI] 89.01-94.93) for "Cardiac arrest" above expected values, an 80.67% (95% CI 75.84-85.5) increase for "Cardiopulmonary resuscitation," and a 65.50% (95% CI 62.98-68.02) increase for "Myocardial infarction." Within Twitter, there was a peak increase in daily tweets using "CPR" by 184,706 (95% CI 181,933-187,479) beyond expected values and a peak increase in the daily tweets using "cardiac arrest" by 73,126 (95% CI 72,499-73,752). CONCLUSION Although all cardiac arrests are undesirable, public knowledge of the positive effects of CPR could contribute to a means of promoting and increasing the desire for CPR awareness as well as its application.
Collapse
Affiliation(s)
- M C Ferrell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.
| | - J Khojasteh
- Research, Evaluation, Measurement and Statistics, Oklahoma State University-Tulsa, Tulsa, OK, USA
| | - M Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| |
Collapse
|
17
|
Tellier É, Lacaze M, Naud J, Sanchez O, Vally R, Bérard C, Revel P, Galinski M, Gil-Jardiné C. Comparison of two infant cardiopulmonary resuscitation techniques explained by phone in a non-health professionals' population: Two-thumbs encircling hand technique vs. two-fingers technique, a randomised crossover study in a simulation environment. Am J Emerg Med 2022; 61:163-168. [PMID: 36148735 DOI: 10.1016/j.ajem.2022.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/14/2022] [Accepted: 09/11/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Paediatric out-of-hospital cardiac arrest (OHCA) is the reason for an emergency call in approximately 8/100,000 person-years. Improvement of OHCA resuscitation needs a quality chain of survival and a rapid start of resuscitation. The aim of this study was to compare the efficacy of two resuscitation techniques provided on a mannequin, the two-fingers technique (TFT) and the two-thumbs encircling hand technique (TTHT), explained by a trained emergency call responder on the phone in a population of non-health professionals. METHODS We conducted a randomised crossover study in the simulation lab of a University Hospital. The participants included in the study were non-health professional volunteers of legal age. The participants were assigned (1:1 ratio) to two groups: group A: TFT then TTHT, group B: TTHT then TFT. Scenario and techniques were discovered during the evaluation. RESULTS Thirty-five volunteers were randomised before the sessions and 33 ultimately came to the simulation lab. We found a better median QCPR global score during TTHT sessions than during TFT sessions (74 vs. 59, P = 0.046). Linear mixed models showed that the TTHT method was the only variable associated with a better QCPR global score [model 1: β = 14.3; 95% confidence interval (CI), 2.4-26.2; model 2: β = 14.5; 95% CI, 2.5-26.6]. CONCLUSION Our study showed the superiority of TTHT for infant CPR performed by non-health professionals when an emergency call responder advised them over the phone. It seemed to be the best technique for a solo rescuer regardless of previous training.
Collapse
Affiliation(s)
- Éric Tellier
- University Hospital of Bordeaux, Pellegrin Hospital, Pole of Emergency, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France; INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France
| | - Mélanie Lacaze
- University Hospital of Bordeaux, Pellegrin Hospital, Pole of Emergency, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France; Pole Santé Arcachon, Emergency Department, Avenue Jean Hameau, 33164 La Teste de Buch Cedex, France
| | - Julien Naud
- University Hospital of Bordeaux, Pellegrin Hospital, Pole of Pediatry, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France; University Hospital of Bordeaux, Pediatric Transport Team, SMUR Bordeaux, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France
| | - Oriana Sanchez
- University Hospital of Bordeaux, Pellegrin Hospital, Pole of Emergency, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France
| | - Rishad Vally
- University Hospital of Bordeaux, Pellegrin Hospital, Pole of Emergency, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France
| | - Cécile Bérard
- University Hospital of Bordeaux, Pellegrin Hospital, Pole of Emergency, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France
| | - Philippe Revel
- University Hospital of Bordeaux, Pellegrin Hospital, Pole of Emergency, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France; INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France
| | - Michel Galinski
- University Hospital of Bordeaux, Pellegrin Hospital, Pole of Emergency, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France; INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France
| | - Cédric Gil-Jardiné
- University Hospital of Bordeaux, Pellegrin Hospital, Pole of Emergency, Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France; INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France.
| |
Collapse
|
18
|
Guerrero A, Blewer AL, Joiner AP, Leong BSH, Shahidah N, Pek PP, Ng YY, Arulanandam S, Østbye T, Gordee A, Kuchibhatla M, Ong MEH. Evaluation of telephone-assisted cardiopulmonary resuscitation recommendations for out-of-hospital cardiac arrest. Resuscitation 2022; 178:87-95. [PMID: 35870555 PMCID: PMC10013180 DOI: 10.1016/j.resuscitation.2022.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/11/2022] [Accepted: 07/15/2022] [Indexed: 10/17/2022]
Abstract
AIM OF THE STUDY While out-of-hospital cardiac arrest (OHCA) is associated with poor survival, early bystander CPR (B-CPR) and telephone CPR (T-CPR) improves survival from OHCA. American Heart Association (AHA) Scientific Statements outline recommendations for T-CPR. We assessed these recommendations and hypothesized that meeting performance standards is associated with increased likelihood of survival. Additional variables were analyzed to identify future performance measurements. METHODS We conducted a retrospective cohort study of non-traumatic, adult, OHCA using the Singapore Pan-Asian Resuscitation Outcomes Study. The primary outcome was likelihood of survival; secondary outcomes were pre-hospital Return of Spontaneous Circulation (ROSC) and B-CPR. RESULTS From 2012 to 2016, 2,574 arrests met inclusion criteria. Mean age was 68 ± 15; of 2,574, 1,125 (44%) received T-CPR with 5% (135/2574) survival. T-CPR cases that met the Lerner et al. performance metrics analyzed, demonstrated no statistically significant association with survival. Cases which met the Kurz et al. criteria, "Time for Dispatch to Recognize Need for CPR" and "Time to First Compression," had adjusted odds ratios of survival of 1.01 (95% CI:1.00, 1.02; p = <0.01) and 0.99 (95% CI:0.99, 0.99; p = <0.01), respectively. Identified barriers to CPR decreased the odds of T-CPR and B-CPR being performed. Patients with prehospital ROSC had higher odds of B-CPR being performed. EMS response time < 8 minutes was associated with increased survival among patients receiving T-CPR. CONCLUSION AHA scientific statements on T-CPR programs serve as ideal starting points for increasing the quality of T-CPR systems and patient outcomes. More work is needed to identify other system performance measures.
Collapse
Affiliation(s)
- Angel Guerrero
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Audrey L Blewer
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
| | - Anjni P Joiner
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Benjamin S H Leong
- Emergency Medicine Department, National University Hospital, Singapore, Singapore
| | - Nur Shahidah
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Pin Pin Pek
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore; Pre-hospital & Emergency Research Centre, Duke-NUS Medical School, Singapore
| | - Yih Yng Ng
- Emergency Department, Tan Tock Seng Hospital, Singapore
| | - Shalini Arulanandam
- Emergency Medical Services Department, Singapore Civil Defence Force, Singapore
| | - Truls Østbye
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Alexander Gordee
- BERD Methods Core, Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Maragatha Kuchibhatla
- BERD Methods Core, Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Marcus E H Ong
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore; Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| |
Collapse
|
19
|
Brooks SC, Clegg GR, Bray J, Deakin CD, Perkins GD, Ringh M, Smith CM, Link MS, Merchant RM, Pezo-Morales J, Parr M, Morrison LJ, Wang TL, Koster RW, Ong MEH. Optimizing Outcomes After Out-of-Hospital Cardiac Arrest With Innovative Approaches to Public-Access Defibrillation: A Scientific Statement From the International Liaison Committee on Resuscitation. Circulation 2022; 145:e776-e801. [PMID: 35164535 DOI: 10.1161/cir.0000000000001013] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Out-of-hospital cardiac arrest is a global public health issue experienced by ≈3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge. To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives: (1) identify known barriers to public-access defibrillator use and early defibrillation, (2) discuss established and novel strategies to address those barriers, and (3) identify high-priority knowledge gaps for future research to address. The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behavior change approaches, optimization of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors. We provide evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.
Collapse
|
20
|
Brooks SC, Clegg GR, Bray J, Deakin CD, Perkins GD, Ringh M, Smith CM, Link MS, Merchant RM, Pezo-Morales J, Parr M, Morrison LJ, Wang TL, Koster RW, Ong MEH. Optimizing outcomes after out-of-hospital cardiac arrest with innovative approaches to public-access defibrillation: A scientific statement from the International Liaison Committee on Resuscitation. Resuscitation 2022; 172:204-228. [PMID: 35181376 DOI: 10.1016/j.resuscitation.2021.11.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Out-of-hospital cardiac arrest is a global public health issue experienced by ≈3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge. To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives: (1) identify known barriers to public-access defibrillator use and early defibrillation, (2) discuss established and novel strategies to address those barriers, and (3) identify high-priority knowledge gaps for future research to address. The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behavior change approaches, optimization of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors. We provide evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.
Collapse
|
21
|
Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2336] [Impact Index Per Article: 1168.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
Collapse
|
22
|
Birkun A, Gautam A, Trunkwala F. Global prevalence of cardiopulmonary resuscitation training among the general public: a scoping review. Clin Exp Emerg Med 2022; 8:255-267. [PMID: 35000353 PMCID: PMC8743682 DOI: 10.15441/ceem.21.066] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022] Open
Abstract
A scoping review was conducted to identify, map, and analyze international evidence from studies investigating the prevalence of community cardiopulmonary resuscitation (CPR) training. We searched major bibliographic databases and grey literature for original studies evaluating the prevalence of CPR training in the general population. Studies published from January 2000 to October 2020 were included without language or publication type restrictions. Seventy-three eligible papers reported a total of 61 population-based surveys conducted in 29 countries. More than three-fourths of the surveys were conducted in countries with high-income economies, and none in low-income countries. Over half of the surveys were at a subnational level. Globally, the proportion of laypeople trained in CPR varied greatly (median, 40%). For high-income countries, the median percentage was twice as high as that of upper middle-income countries (50% vs. 23%). The studies used heterogeneous survey methods and reporting patterns. Key methodological aspects were frequently not described. In summary, few studies have assessed CPR training prevalence among the general public. The rates of resuscitation training for the vast majority of countries remain unknown. High heterogeneity of studies precludes a reliable interpretation of the research. International Utstein-style consensus guidelines are needed to inform future research and reporting of public resuscitation training worldwide.
Collapse
Affiliation(s)
- Alexei Birkun
- Department of General Surgery, Anesthesiology, Resuscitation and Emergency Medicine, Medical Academy named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal University, Simferopol, Russia
| | - Adhish Gautam
- Department of Emergency, Government Multispeciality Hospital Sector-16, Chandigarh, India
| | - Fatima Trunkwala
- Department of Cardiology, George Eliot Hospital NHS Trust, Nuneaton, United Kingdom
| |
Collapse
|
23
|
Ong MEH, Shin SD, Ko PCI, Lin X, Ma MHM, Ryoo HW, Wong KD, Supasaowapak J, Lin CH, Kuo CW, Rao R, Cai W, Gaerlan FJ, Khursheed M, Son DN, Sarah K, El Sayed M, Al Qahtani S, Tanaka H. International multi-center real world implementation trial to increase out-of-hospital cardiac arrest survival with a dispatcher-assisted cardio-pulmonary resuscitation package (Pan-Asian resuscitation outcomes study phase 2). Resuscitation 2021; 171:80-89. [PMID: 34974143 DOI: 10.1016/j.resuscitation.2021.12.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/18/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dispatcher-assisted CPR (DA-CPR) has the potential to deliver early bystander CPR (BCPR) and improve out-of-hospital cardiac arrest (OHCA) survival. This study in the Asia-Pacific evaluated the impact of a DA-CPR program on BCPR rates and survival. METHODS This was a three-arm, prospective, multi-national, population-based, community-level, implementation trial. Cases between January 2009 and June 2018 from the Pan-Asian Resuscitation Outcomes Study were included. Sites either implemented a comprehensive (with quality improvement tool) or a basic DA-CPR package, or served as controls. Primary outcome was survival-to-discharge/30th day post-arrest. Secondary outcomes were BCPR and favorable neurological outcome. A before-after comparison was made within each country; this before-after change was then compared across the three groups using logistic regression. RESULTS 170,687 cases were analyzed. Before-after comparison showed that survival to discharge was higher in the 'implementation' period in all three groups: comprehensive odds ratio (OR) 1.09, 95% confidence interval (CI; [1.0-1.19]); basic OR 1.14, 95% CI (1.08-1.2); and control OR 1.25, 95% CI (1.02-1.53). Comparing between groups, the comprehensive group had significantly higher change in BCPR (comprehensive vs control ratio of OR 1.86, 95% CI [1.66-2.09]; basic vs control ratio of OR 0.94, 95% CI [0.85-1.05]; and comprehensive vs basic ratio of OR 1.97, 95% CI [1.87-2.08]) and survival with favorable neurological outcome (comprehensive vs basic ratio of OR 1.2, 95% CI [1.04-1.39]). CONCLUSION We evaluated the impact of a DA-CPR program across heterogeneous EMS systems and demonstrated that a comprehensive DA-CPR program had the most impact on BCPR and favorable neurological outcome.
Collapse
Affiliation(s)
- Marcus Eng Hock Ong
- Prehospital and Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore; Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore.
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Patrick Chow-In Ko
- Department of Emergency Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Xinyi Lin
- Singapore Clinical Research Institute, Singapore, Singapore; Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Matthew Huei-Ming Ma
- Department of Emergency Medicine, National Taiwan University Hospital Yunlin Branch, Douliou, Taiwan
| | - Hyun Wook Ryoo
- Department of Emergency Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | | | | | - Chih-Hao Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chan-Wei Kuo
- Department of Emergency Medicine, Chang-Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Ramana Rao
- GVK Emergency Management and Research Institute (GVK EMRI), Secunderabad, Telangana, India
| | - Wenwei Cai
- Department of Emergency Medicine, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China
| | | | - Munawar Khursheed
- Emergency Department, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Do Ngoc Son
- Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam
| | - Karim Sarah
- Department of Emergency Medicine, Hospital Sungai Buloh, Sungai Buloh, Selangor, Malaysia
| | - Mazen El Sayed
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Emergency Medical Services and Prehospital Care Program, American University of Beirut Medical Center, Beirut, Lebanon
| | - Saad Al Qahtani
- National Ambulance, Abu Dhabi, United Arab Emirates; Department of Health Science, Saudi Electronic University, Saudi Arabia
| | - Hideharu Tanaka
- Department of EMS System, Graduate School, Kokushikan University, Tokyo, Japan
| |
Collapse
|
24
|
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: 0] [Impact Index Per Article: 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.
Collapse
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
| |
Collapse
|
25
|
Chong KM, Chen JW, Lien WC, Yang MF, Wang HC, Liu SSH, Chen YP, Chi CY, Wu MCH, Wu CY, Liao ECW, Huang EPC, He HC, Yang HW, Huang CH, Ko PCI. Attitude and behavior toward bystander cardiopulmonary resuscitation during COVID-19 outbreak. PLoS One 2021; 16:e0252841. [PMID: 34161378 PMCID: PMC8221461 DOI: 10.1371/journal.pone.0252841] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/23/2021] [Indexed: 11/18/2022] Open
Abstract
Background Outbreaks of emerging infectious diseases, such as COVID-19, have negative impacts on bystander cardiopulmonary resuscitation (BCPR) for fear of transmission while breaking social distancing rules. The latest guidelines recommend hands-only cardiopulmonary resuscitation (CPR) and facemask use. However, public willingness in this setup remains unknown. Methods A cross-sectional, unrestricted volunteer Internet survey was conducted to assess individuals’ attitudes and behaviors toward performing BCPR, pre-existing CPR training, occupational identity, age group, and gender. The raking method for weights and a regression analysis for the predictors of willingness were performed. Results Among 1,347 eligible respondents, 822 (61%) had negative attitudes toward performing BCPR. Healthcare providers (HCPs) and those with pre-existing CPR training had fewer negative attitudes (p < 0.001); HCPs and those with pre-existing CPR training and unchanged attitude showed more positive behaviors toward BCPR (p < 0.001). Further, 9.7% of the respondents would absolutely refuse to perform BCPR. In contrast, 16.9% would perform BCPR directly despite the outbreak. Approximately 9.9% would perform it if they were instructed, 23.5%, if they wore facemasks, and 40.1%, if they were to perform hands-only CPR. Interestingly, among the 822 respondents with negative attitudes, over 85% still tended to perform BCPR in the abovementioned situations. The weighted analysis showed similar results. The adjusted predictors for lower negative attitudes toward BCPR were younger age, being a man, and being an HCP; those for more positive behaviors were younger age and being an HCP. Conclusions Outbreaks of emerging infectious diseases, such as COVID-19, have negative impacts on attitudes and behaviors toward BCPR. Younger individuals, men, HCPs, and those with pre-existing CPR training tended to show fewer negative attitudes and behaviors. Meanwhile, most individuals with negative attitudes still expressed positive behaviors under safer measures such as facemask protection, hands-only CPR, and available dispatch instructions.
Collapse
Affiliation(s)
- Kah-Meng Chong
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jiun-Wei Chen
- Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Wan-Ching Lien
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Mei-Fen Yang
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hui-Chih Wang
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sot Shih-Hung Liu
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Yen-Pin Chen
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chien-Yu Chi
- Department of Emergency Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
| | - Marvin Chih-Hsien Wu
- Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Cheng-Yi Wu
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Edward Che-Wei Liao
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Edward Pei-Chuan Huang
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Hsien-Chin He
- Department of Family Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsiang-Wen Yang
- Graduate Computer-Aided Engineering Group, Civil Engineering, National Taiwan University, Taipei, Taiwan
| | - Chien-Hua Huang
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Patrick Chow-In Ko
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
26
|
Lee MJ, Shin TY, Lee CH, Moon JD, Roh SG, Kim CW, Park HE, Woo SH, Lee SJ, Shin SL, Oh YT, Lim YS, Choe JY, Na SH, Hwang SO. 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 9. Education and system implementation for enhanced chain of survival. Clin Exp Emerg Med 2021; 8:S116-S124. [PMID: 34034453 PMCID: PMC8171173 DOI: 10.15441/ceem.21.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/28/2021] [Indexed: 02/07/2023] Open
Affiliation(s)
- Mi Jin Lee
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Tae-Yong Shin
- Department of Emergency Medicine, Asan Chungmu General Hospital, Asan, Korea
| | - Chang Hee Lee
- Department of Emergency Medical Technician, Namseoul University, Cheonan, Korea
| | - Jun Dong Moon
- Department of Emergency Medical Service, College of Health & Nursing, Kongju National University, Gongju, Korea
| | - Sang Gyun Roh
- Department of Emergency Medical Services, Sun Moon University, Asan, Korea
| | - Chan Woong Kim
- Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyo Eun Park
- Division of Cardiology, Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Seon Hee Woo
- Department of Emergency Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seung Joon Lee
- National Medical Emergency Center, National Medical Center, Seoul, Korea
| | - Seung Lyul Shin
- Department of Emergency Medicine, Inha University College of Medicine, Incheon, Korea
| | - Young Taeck Oh
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Su Lim
- Department of Emergency Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sang-Hoon Na
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Oh Hwang
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | | |
Collapse
|
27
|
Huebinger R, Jarvis J, Schulz K, Persse D, Chan HK, Miramontes D, Vithalani V, Troutman G, Greenberg R, Al-Araji R, Villa N, Panczyk M, Wang H, Bobrow B. Community Variations in Out-of-Hospital Cardiac Arrest Care and Outcomes in Texas. PREHOSP EMERG CARE 2021; 26:204-211. [PMID: 33779479 DOI: 10.1080/10903127.2021.1907007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Large and unacceptable variation exists in cardiac resuscitation care and outcomes across communities. Texas is the second most populous state in the US with wide variation in community and emergency response infrastructure. We utilized the Texas-CARES registry to perform the first Texas state analysis of out-of-hospital cardiac arrest (OHCA) in Texas, evaluating for variations in incidence, care, and outcomes.Methods: We analyzed the Texas-CARES registry, including all adult, non-traumatic OHCAs from 1/1/2014 through 12/31/2018. We analyzed the incidence and characteristics of OHCA care and outcome, overall and stratified by community. Utilizing mixed models accounting for clustering by community, we characterized variations in bystander CPR, bystander AED in public locations, and survival to hospital discharge across communities, adjusting for age, gender, race, location of arrest, and rate of witnessed arrest (bystander and 911 responder witnessed).Results: There were a total of 26,847 (5,369 per year) OHCAs from 13 communities; median 2,762 per community (IQR 444-2,767, min 136, max 9161). Texas care and outcome characteristics were: bystander CPR (43.3%), bystander AED use (9.1%), survival to discharge (9.1%), and survival with good neurological outcomes (4.0%). Bystander CPR rate ranged from 19.2% to 55.0%, and there were five communities above and five below the adjusted 95% confidence interval. Bystander AED use ranged from 0% to 19.5%, and there was one community below the adjusted 95% confidence interval. Survival to hospital discharge ranged from 6.7% to 14.0%, and there were three communities above and two below the adjusted 95% confidence interval.Conclusion: While overall OHCA care and outcomes were similar in Texas compared to national averages, bystander CPR, bystander AED use, and survival varied widely across communities in Texas. These variations signal opportunities to improve OHCA care and outcomes in Texas.
Collapse
Affiliation(s)
- Ryan Huebinger
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - Jeff Jarvis
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - Kevin Schulz
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - David Persse
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - Hei Kit Chan
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - David Miramontes
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - Veer Vithalani
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - Gerad Troutman
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - Robert Greenberg
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - Rabab Al-Araji
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - Normandy Villa
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - Micah Panczyk
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - Henry Wang
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| | - Bentley Bobrow
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas (RH, KS, DP, NV, MP, HW, BB); Baylor Scott & White Health/Texas A&M University College of Medicine, Temple, Texas (JJ, RG); Williamson County EMS, Georgetown, Texas (JJ); Houston Fire Department Emergency Medical Services, Houston, Texas (KS, DP); Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas (HKC); University of Texas Health Science Center at San Antonio, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas (DM); MedStar Mobile Healthcare, Fort Worth, Texas (VV); Department of Emergency Medicine, JPS Health Network, Fort Worth, Texas (VV); Division of Emergency Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas (GT); Emory University Rollins School of Public Health, Atlanta, Georgia (RA-A)
| |
Collapse
|
28
|
Lee JH, Lee DE, Ryoo HW, Moon S, Cho JW, Kim YJ, Kim JK, Kim JH, Lee KW, Jin SC, Seo JS. Public awareness and willingness to use automated external defibrillators in a metropolitan city. Clin Exp Emerg Med 2021; 8:1-8. [PMID: 33845516 PMCID: PMC8041576 DOI: 10.15441/ceem.20.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/29/2020] [Indexed: 12/02/2022] Open
Abstract
Objective Early defibrillation is crucial for the survival of patients with out-of-hospital cardiac arrest. This study aimed to examine the trends and associated factors regarding public awareness and willingness to use automated external defibrillators (AEDs) through citywide surveys. Methods Three-round surveys were conducted in February 2012 (n=1,000), December 2016 (n=1,141), and December 2018 (n=1,001) among citizens in Daegu, South Korea, who were aged ≥19 years. The subjects were selected through a three-stage quota sampling. Awareness and willingness to use an AED were assessed in the three groups. The primary outcome was willingness to use AEDs. Results Of 3,142 respondents, 3,069 were eligible for analysis. The proportion of respondents who knew how to use AEDs increased from 4.7% in 2012 to 20.8% in 2018. Of the respondents in 2012, 2016, and 2018, 39.7%, 50.0%, and 43.2%, respectively, were willing to use an AED. Factors associated with willingness to use AEDs were male sex (adjusted odds ratio [AOR], 1.39; 95% confidence interval [CI], 1.10–1.75), cardiopulmonary resuscitation training experience in the previous 2 years (AOR, 1.80; 95% CI, 1.43–2.28), recognition of the Good Samaritan law (AOR, 1.45; 95% CI, 1.13–1.86), and awareness of how to use an AED (AOR, 4.40; 95% CI, 3.26–5.93). Conclusion To increase willingness to use AEDs, education in AED use and the Good Samaritan law, along with re-education to maintain knowledge of AED use, should be considered.
Collapse
Affiliation(s)
- Jae Hyuk Lee
- Department of Emergency Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Dong Eun Lee
- Department of Emergency Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyun Wook Ryoo
- Department of Emergency Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sungbae Moon
- Department of Emergency Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Wan Cho
- Department of Emergency Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Yun Jeong Kim
- Department of Emergency Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jung Ho Kim
- Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyung Woo Lee
- Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Sang-Chan Jin
- Department of Emergency Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jun Seok Seo
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Seoul, Korea
| |
Collapse
|
29
|
Huebinger R, Vithalani V, Osborn L, Decker C, Jarvis J, Dickson R, Escott M, White L, Al-Araji R, Nikonowicz P, Villa N, Panczyk M, Wang H, Bobrow B. Community disparities in out of hospital cardiac arrest care and outcomes in Texas. Resuscitation 2021; 163:101-107. [PMID: 33798624 DOI: 10.1016/j.resuscitation.2021.03.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/02/2021] [Accepted: 03/17/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Large racial and socioeconomic inequalities exist for out-of-hospital cardiac arrest (OHCA) care and outcomes. We sought to characterize racial, ethnic, and socioeconomic disparities in OHCA care and outcomes in Texas. METHODS We analyzed 2014-2018 Texas-Cardiac Arrest Registry to Enhance Survival (CARES) data. Using census tracts, we defined race/ethnicity neighborhoods based on majority race/ethnicity composition: non-Hispanic/Latino white, non-Hispanic/Latino black, and Hispanic/Latino. We also stratified neighborhoods into socioeconomic categories: above and below the median for household income, employment rate, and high school graduation. We defined outcomes as bystander CPR rates, public bystander AED use, and survival to hospital discharge. Using mixed models, we analyzed the associations between outcomes and neighborhood (1) racial/ethnic categories and (2) socioeconomic categories. RESULTS We included data on 18,488 OHCAs. Relative to white neighborhoods, black neighborhoods had lower rates of AED use (OR 0.3, CI 0.2-0.4), and Hispanic/Latino neighborhoods had lower rates of bystander CPR (OR 0.7, CI 0.6-0.8), AED use (OR 0.4, CI 0.3-0.6), and survival (OR 0.8, CI 0.7-0.8). Lower income was associated with a lower rates of bystander CPR (OR 0.8, CI 0.7-0.8), AED use (OR 0.5, CI 0.4-0.8), and survival (OR 0.9, CI 0.9-0.98). Lower high school graduation was associated with a lower rate of bystander CPR (OR 0.8, CI 0.7-0.9) and AED use (OR 0.6, CI 0.4-0.9). Higher unemployment was associated with lower rates of bystander CPR (OR 0.9, CI 0.8-0.94) and AED use (OR 0.7, CI 0.5-0.99). CONCLUSION Minority and poor neighborhoods in Texas experience large and unacceptable disparities in OHCA bystander response and outcomes.
Collapse
Affiliation(s)
- Ryan Huebinger
- McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Department of Emergency Medicine, Houston, TX, USA.
| | - Veer Vithalani
- Office of the Medical Director, MedStar Mobile Healthcare, Fort Worth, TX, USA; JPS Health Network, Department of Emergency Medicine, Fort Worth, TX, USA
| | - Lesley Osborn
- McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Department of Emergency Medicine, Houston, TX, USA
| | | | - Jeff Jarvis
- Scott & White Healthcare/Texas A&M University College of Medicine, Temple, TX, USA; Williamson County EMS, Georgetown, TX, USA
| | | | | | - Lynn White
- Global Medical Response, Greenwood Village, CO, USA
| | - Rabab Al-Araji
- Emory University, Rollins School of Public Health, Atlanta, GA, USA
| | - Peter Nikonowicz
- William Marsh Rice University, Department of Psychological Sciences, Houston, TX, USA
| | - Normandy Villa
- McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Department of Emergency Medicine, Houston, TX, USA
| | - Micah Panczyk
- McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Department of Emergency Medicine, Houston, TX, USA
| | - Henry Wang
- McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Department of Emergency Medicine, Houston, TX, USA
| | - Bentley Bobrow
- McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Department of Emergency Medicine, Houston, TX, USA
| |
Collapse
|
30
|
Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson KL, Lee CD, Lewis TT, Liu J, Loop MS, Lutsey PL, Ma J, Mackey J, Martin SS, Matchar DB, Mussolino ME, Navaneethan SD, Perak AM, Roth GA, Samad Z, Satou GM, Schroeder EB, Shah SH, Shay CM, Stokes A, VanWagner LB, Wang NY, Tsao CW. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation 2021; 143:e254-e743. [PMID: 33501848 DOI: 10.1161/cir.0000000000000950] [Citation(s) in RCA: 3003] [Impact Index Per Article: 1001.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
Collapse
|
31
|
Koca B, Bayram B, Pakdemirli A, Bektaş M. Psychological effects of Cpr training methods on high school students: a randomized trial. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-01198-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
32
|
Pei-Chuan Huang E, Chiang WC, Lu TC, Wang CH, Sun JT, Hsieh MJ, Wang HC, Yang CW, Lin CH, Lin JJ, Yang MC, Huei-Ming Ma M. Barriers to bystanders defibrillation: A national survey on public awareness and willingness of bystanders defibrillation ☆. J Formos Med Assoc 2020; 120:974-982. [PMID: 33218851 DOI: 10.1016/j.jfma.2020.10.020] [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: 12/16/2019] [Revised: 09/10/2020] [Accepted: 10/19/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND After years of setting up public automated external defibrillators (AEDs), the rate of bystander AED use remains low all over the world. This study aimed to assess the public awareness and willingness of bystanders to use AEDs and to investigate the awareness on the Good Samaritan Law (GSL) and the factors associated with the low rate of bystander AED use. METHODS Using stratified random sampling, national telephone interviews were conducted using an author-designed structured questionnaire. The results were weighted to match the census data in Taiwan. The factors associated with public awareness and willingness of bystanders to use AEDs were analysed by logistic regression. RESULTS Of the 1073 respondents, only 15.2% had the confidence to recognise public AEDs, and 5.3% of them had the confidence to use the AED. Concerns on immature technique and legal issues remain the most common barriers to AED use by bystanders. Moreover, only 30.8% thought that the public should use AEDs at the scene. Few respondents (9.6%) ever heard of the GSL in Taiwan, and less than 3% understood the meaning of GSL. Positive awareness on AEDs was associated with high willingness of bystanders to use AEDs. Respondents who were less likely to use AEDs as bystanders were healthcare personnel and women. CONCLUSION The importance of active awareness and the barriers to the use of AEDs among bystanders seemed to have been underestimated in the past years. The relatively low willingness to use AEDs among bystander healthcare providers and women needs further investigation.
Collapse
Affiliation(s)
- Edward Pei-Chuan Huang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu City, Taiwan
| | - Wen-Chu Chiang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan
| | - Tsung-Chien Lu
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Hung Wang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jen-Tang Sun
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ming-Ju Hsieh
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hui-Chih Wang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Wei Yang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Hao Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jr-Jiun Lin
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Chin Yang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Matthew Huei-Ming Ma
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan.
| |
Collapse
|
33
|
Riccò M, Berrone M, Vezzosi L, Gualerzi G, Canal C, De Paolis G, Schallenberg G. Factors influencing the willingness to perform bystander cardiopulmonary resuscitation on the workplace: a study from North-Eastern Italy. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020180. [PMID: 33525292 PMCID: PMC7927506 DOI: 10.23750/abm.v91i4.8593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 07/11/2019] [Indexed: 11/23/2022]
Abstract
Background: Early bystander cardiopulmonary resuscitation (CPR) improves the chances of successful resuscitation and survival. However, few data are available regarding the willingness to perform CPR among First Aid Attendants on the Workplace (FAAWs) in Italy. The present study was performed in order to identify current attitudes of Italian FAAWs towards CPR. Methods: Between February and June 2017, FAAWs from the Autonomous Province of Trento were asked about their willingness to perform CPR through a structured questionnaire assessing their knowledge about CPR, and the reasons for hesitancy. A cumulative knowledge score (KS) was eventually calculated. Results: A total of 123 FAAWs (male 57.7%, mean age 45.2 years ± 10.1) completed the questionnaire. About 1/3 of participants (32.5%) had previously performed First Aid procedures. Overall, 77.2% exhibited willingness to perform CPR, and such attitude was more frequently reported by subjects younger than 40 years (29.5% vs. 10.7% in older subjects; p=0.045), perceiving First Aid training as useful (98.9% vs. 84.7%, p=0.002), and exhibiting a better knowledge of CPR (KS≥75%: 47.4% vs. 15.3%). The reasons for the unwillingness were inadequate knowledge and doubt regarding whether they could perform the techniques effectively. Eventually, KS was identified as the main predictor for willingness to perform CPR (OR 4.450, 95%CI 1.442-14.350). Conclusions: Willingness to perform CPR was seemingly high, and knowledge of CPR techniques was its main predictor. These findings emphasize the importance for an accurate CPR training, as well as for the surveillance of the quality of qualification courses.(www.actabiomedica.it)
Collapse
Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
| | - Mirco Berrone
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
| | - Luigi Vezzosi
- Azienda Socio Sanitaria Territoriale di Cremona, Direzione Medica Ospedale di Cremona.
| | - Giovanni Gualerzi
- School of Medicine and Surgery, Department of Medicine and Surgery, University of Parma, Parma (PR).
| | - Chiara Canal
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
| | - Giuseppe De Paolis
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
| | - Gert Schallenberg
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
| |
Collapse
|
34
|
Cho JW, Jung H, Lee MJ, Lee SH, Lee SH, Mun YH, Chung HS, Kim YH, Kim GM, Park SY, Jeon JC, Kim C. Preparedness of personal protective equipment and implementation of new CPR strategies for patients with out-of-hospital cardiac arrest in the COVID-19 era. Resusc Plus 2020; 3:100015. [PMID: 34031648 PMCID: PMC7315986 DOI: 10.1016/j.resplu.2020.100015] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 12/13/2022] Open
Abstract
Background In February and March 2020, healthcare providers and citizens in Daegu, South Korea, experienced the onslaught of a large-scale community epidemic of COVID-19. This had a profound impact on patients who experienced out-of-hospital cardiac arrest (OHCA). Methods We conducted a retrospective observational study of 171 OHCA patients based on the multicenter WinCOVID registry. Demographic and clinical characteristics, overall survival, COVID-19 related data, as well as personal protective equipment (PPE) and resuscitation techniques used during the COVID-19 outbreak were evaluated and compared with outcomes from a 2018 historical cohort (n = 158). Results Among the interventions, high-level PPE was introduced and standard cardiopulmonary resuscitation was changed to chest compressions using mechanical devices. All OHCA patients were treated as confirmed or suspicious for COVID-19 regardless of symptoms. Furthermore, complete or partial closures of emergency centers and the number of medical personnel requiring self-isolation decreased in response to the introduction of isolated resuscitation units. However, the adjusted odds ratio and 95% confidence intervals for survival discharge and favorable neurologic outcome were 0.51 (0.25-0.97) and 0.45 (0.21-1.07) compared with those in the 2018 historical cohort. Conclusions Responses to the COVID-19 pandemic included changes to current PPE strategies and introduction of isolated resuscitation units; the latter intervention reduced the number of unexpected closures and quarantines of emergency resources early on during the COVID-19 outbreak. Given the possibility of future outbreaks, we need to have revised resuscitation strategies and the capacity to commandeer emergency resources for OHCA patients.
Collapse
Affiliation(s)
- Jae Wan Cho
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Haewon Jung
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Mi Jin Lee
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Sang Hun Lee
- Department of Emergency Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Suk Hee Lee
- Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - You Ho Mun
- Department of Emergency Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Han-Sol Chung
- Department of Emergency Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Yang Hun Kim
- Department of Emergency Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Gyun Moo Kim
- Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Sin-Youl Park
- Department of Emergency Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Jae Cheon Jeon
- Department of Emergency Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Changho Kim
- Department of Emergency Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | | |
Collapse
|
35
|
Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation 2020; 141:e139-e596. [PMID: 31992061 DOI: 10.1161/cir.0000000000000757] [Citation(s) in RCA: 4741] [Impact Index Per Article: 1185.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association's 2020 Impact Goals. RESULTS Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
Collapse
|
36
|
Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, O'Flaherty M, Pandey A, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Spartano NL, Stokes A, Tirschwell DL, Tsao CW, Turakhia MP, VanWagner LB, Wilkins JT, Wong SS, Virani SS. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation 2019; 139:e56-e528. [PMID: 30700139 DOI: 10.1161/cir.0000000000000659] [Citation(s) in RCA: 5236] [Impact Index Per Article: 1047.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
37
|
Evaluating barriers to community CPR education. Am J Emerg Med 2019; 38:603-609. [PMID: 31866250 DOI: 10.1016/j.ajem.2019.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/05/2019] [Accepted: 10/16/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The primary objective of this study is to better understand the preferences of the general public regarding cardiopulmonary resuscitation (CPR) education as it relates to both format and the time and place of delivery. METHODS Survey data were collected from a convenience sample at large public gatherings in Baltimore, Maryland, between May 23, 2015, and February 11, 2017. The survey was a 23-item single-page instrument administered at fairs and festivals. RESULTS A total of 516 surveys were available for analysis. Twenty-four percent of the total population reported being very confident in performing CPR (scoring 8 to 10 on a Likert scale). Thirty-two percent of respondents who had previously taken a CPR class reported being very confident in performing CPR. A stepwise decline in reported confidence in performing CPR was observed as the time from last CPR class increased. Among all respondents the most favored instruction style was an instructor-led class. Least favorable was a local learning station at an event. The most favored location for instruction were libraries, while community festivals were least favored. CONCLUSION Respondent preferences regarding the location and style of the training differed little between socioeconomic groups. Instructor-led instruction at local libraries was the most preferred option. CPR education offered at local learning stations during events and at community festivals were least favored among respondents. This study's findings can be used to more effectively structure CPR outreach and educational programs in an attempt to increase rates of bystander CPR.
Collapse
|
38
|
Baldi E, Contri E, Bailoni A, Rendic K, Turcan V, Donchev N, Nadareishvili I, Petrica AM, Yerolemidou I, Petrenko A, Franke J, Labbe G, Jashari R, Pérez Dalí A, Borg J, Hertenberger N, Böttiger BW. Final-year medical students' knowledge of cardiac arrest and CPR: We must do more! Int J Cardiol 2019; 296:76-80. [PMID: 31375334 DOI: 10.1016/j.ijcard.2019.07.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 06/27/2019] [Accepted: 07/04/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Students are an important part of the community response to an out-of-hospital cardiac arrest (OHCA). If even schoolchildren now know cardio-pulmonary resuscitation (CPR), even more the reason a young doctor should know how to treat an OHCA. The aim of our study was to assess medical students' knowledge of CPR and OHCA throughout Europe. METHODS An online survey was given to final-year students by the Medical Student Associations of different countries. RESULTS 1012 medical students from 99 different universities and 14 different countries completed the questionnaire. A total of 82.2% attended a BLS or BLS/AED course, provided by the University in only 69.7% of cases. In 84.3% it was a mandatory part of their degree. A total of 78.6% felt able to rescue a person in OHCA. Only 49.3% knew that 'unresponsiveness' and 'absence of normal breathing' are sufficient for lay people to identify an OHCA, and less than half of those interviewed knew the incidence of OHCA in Europe and the decrease in chance of survival if CPR is not performed. The correct compression:ventilation ratio was known by 90.2%, the correct compression depth by 69.7%, whilst only 57.8% knew the right compression rate. In total, 69.7% knew that an AED must be used immediately when available, and only 57.2% recognized the AED symbol. CONCLUSIONS Medical students' knowledge of cardiac arrest and CPR needs to be improved throughout Europe and we believe that BLS/AED training should be mandatory in all European Universities.
Collapse
Affiliation(s)
- Enrico Baldi
- Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy; Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Pavia nel Cuore, Pavia, Italy; Robbio nel Cuore, Robbio, Italy.
| | - Enrico Contri
- Pavia nel Cuore, Pavia, Italy; Robbio nel Cuore, Robbio, Italy; AREU Azienda Regionale Emergenza Urgenza-AAT Pavia c/o Fondazione IRCCS Policlinico San Matteo Hospital, Pavia, Italy
| | | | - Kristina Rendic
- Srpska Medical Students' International Committee-SaMSIC, Banja Luka, Bosnia and Herzegovina
| | - Valeria Turcan
- Asociaţia Studenţilor şi Rezidenţilor în Medicină-ASRM, Chișinău, Republic of Moldova
| | - Nikola Donchev
- Association of Medical Students in Bulgaria-AMSB, Sofia, Bulgaria
| | - Ilia Nadareishvili
- Georgian Medical Students Association-GMSA, Tbilisi, Georgia; David Tvildiani Medical University, Tbilisi, Georgia
| | - Ana-Maria Petrica
- Federaţia Asociaţiilor Studenţilor în Medicină din România-FASMR, Bucharest, Romania
| | | | | | | | - Gabrielle Labbe
- Association Nationale des Etudiants en Médecine de France-ANEMF, Montrouge, France
| | - Redon Jashari
- Kosova's Organization of Medical Students-KOMS, Pristina, Kosovo
| | - Alba Pérez Dalí
- Federación Española de Estudiantes de Medicina para la cooperación internacional-IFMSA Spain, Valladolid, Spain
| | - Jordy Borg
- Malta Medical Students' Association-MMSA, Msida, Malta
| | | | - Bernd W Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Köln, Germany; European Resuscitation Council, Niel, Belgium
| |
Collapse
|
39
|
Yoon W, Ro YS, Cho SI. A mediation analysis of the effect of practical training on the relationship between demographic factors, and bystanders' self-efficacy in CPR performance. PLoS One 2019; 14:e0215432. [PMID: 31034486 PMCID: PMC6488056 DOI: 10.1371/journal.pone.0215432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 04/02/2019] [Indexed: 11/18/2022] Open
Abstract
This study examined the mediation effect of practical training on the relationship of demographic characteristics with bystander self-efficacy in cardiopulmonary resuscitation (CPR) performance. We used nationwide, cross-sectional data from the Korea Community Health Survey and analyzed 25,082 Korean adults who participated in CPR training within the last 2 years. A mediation model was applied to explore the pathway from demographic characteristics via CPR practical training to self-efficacy in CPR performance. A multiple logistic regression analysis was performed to examine each path in the mediation model. Of the 25,082 respondents recently trained, 19,168 (76.8%) practiced on a manikin. In the unadjusted CPR practical training model, the demographic characteristics associated with high self-efficacy in CPR performance were male gender (odds ratio [OR] = 2.54); 50s age group (OR = 1.30); college or more (OR = 1.39) and high school education (OR = 1.32); white collar (OR = 1.24) and soldier (OR = 2.98) occupational statuses. The characteristics associated with low self-efficacy were 30s age group (OR = 0.69) and capital (OR = 0.79) and metropolitan (OR = 0.84) areas of residence (p < 0.05). In the adjusted CPR practical training model, the significance of the relationship between demographics and self-efficacy in CPR performance decreased in male gender, 30s age group, college or more and high school education, and soldier occupational status (i.e., partial mediation), and disappeared in metropolitan residents (i.e., complete mediation). The degree of the mediating effect of CPR practical training on self-efficacy differed for each demographic characteristic. Thus, individualized educational strategies considering recipient demographics are needed for effective practice-based CPR training and improving bystander CPR performance.
Collapse
Affiliation(s)
- Wonjeong Yoon
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Young Sun Ro
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Sung-il Cho
- Department of Public Health Science, Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
- * E-mail:
| |
Collapse
|
40
|
A 5-year change of knowledge and willingness by sampled respondents to perform bystander cardiopulmonary resuscitation in a metropolitan city. PLoS One 2019; 14:e0211804. [PMID: 30730932 PMCID: PMC6366762 DOI: 10.1371/journal.pone.0211804] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 01/20/2019] [Indexed: 11/30/2022] Open
Abstract
Background Nationwide and regional interventions can help improve bystander cardiopulmonary resuscitation (CPR) awareness, knowledge, and the willingness. Periodic community investigation will help monitor the effect. This study aimed to compare the experience of CPR education, CPR knowledge, and CPR willingness, during a 5-year interval. Methods This is a pre and post study. Two surveys were done in February 2012 and December 2016. National and regional intervention including legislation promoting public involvement, standardizing CPR education programs, training CPR instructors, and installing supporting organizations were done at the period. In both surveys, respondents were selected via quota sampling in Daegu Metropolitan City and answered the survey through face-to-face interview. Respondents’ general demographic characteristics, CPR educational experience, CPR knowledge and CPR willingness were questioned. Results Total of 2141 respondents (1000 in 2012, 1141 in 2016) were selected. The percentage of respondents who received CPR education itself and recent education were higher after intervention compared to before intervention (36.2% vs. 55.1%, 16.9% vs. 30.1%, respectively). Correct knowledge of performing CPR seems to be improved overall (1.6% vs. 11.7%, odd ratio 14.28, 95% confidence interval 5.68–35.94). However, less respondents were willing to perform CPR on strangers (54.5% vs 35.0%). Conclusion Nationwide and regional interventions to promote bystander CPR and CPR education were associated with increased CPR education experience and improved correct CPR knowledge in performing bystander CPR. Willingness to perform bystander CPR on family did not increase significantly and CPR willingness to strangers was decreased. Additional legal and technological measures should be implemented to promote bystander CPR.
Collapse
|
41
|
Fratta KA, Bouland AJ, Lawner BJ, Comer AC, Halliday MH, Levy MJ, Seaman KG. Barriers to bystander CPR: Evaluating socio-economic and cultural factors influencing students attending community CPR training. Am J Emerg Med 2019; 37:159-161. [DOI: 10.1016/j.ajem.2018.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 05/10/2018] [Accepted: 05/13/2018] [Indexed: 11/27/2022] Open
|
42
|
The incidence and outcomes of out-of-hospital cardiac arrest precipitated by drug overdose: A systematic review and meta-analysis. Resuscitation 2019; 134:10-18. [DOI: 10.1016/j.resuscitation.2018.12.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 11/13/2018] [Accepted: 12/18/2018] [Indexed: 11/22/2022]
|
43
|
Public knowledge, attitudes and willingness regarding bystander cardiopulmonary resuscitation: A nationwide survey in Taiwan. J Formos Med Assoc 2018; 118:572-581. [PMID: 30190091 DOI: 10.1016/j.jfma.2018.07.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/11/2018] [Accepted: 07/23/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND A low bystander cardiopulmonary resuscitation (CPR) rate is one of the factors associated with low cardiac arrest survival. This study aimed to assess knowledge, attitudes, and willingness towards performing CPR and the barriers for implementation of bystander-initiated CPR. METHODS Telephone interviews were conducted using an author-designed and validated structured questionnaire in Taiwan. After obtaining a stratified random sample from the census, the results were weighted to match population data. The factors affecting bystander-initiated CPR were analysed using logistic regression. RESULTS Of the 1073 respondents, half of them stated that they knew how to perform CPR correctly, although 86.7% indicated a willingness to perform CPR on strangers. The barriers to CPR performance reported by the respondents included fear of legal consequences (44%) and concern about harming patients (36.5%). Most participants expressed a willingness to attend only an hour-long CPR course. Respondents who were less likely to indicate a willingness to perform CPR were female, healthcare providers, those who had no cohabiting family members older than 65 years, those who had a history of a stroke, and those who expressed a negative attitude toward CPR. CONCLUSION The expressed willingness to perform bystander CPR was high if the respondents possessed the required skills. Attempts should be made to recruit potential bystanders for CPR courses or education, targeting those respondent subgroups less likely to express willingness to perform CPR. The reason for lower bystander CPR willingness among healthcare providers deserves further investigation.
Collapse
|
44
|
Weidenauer D, Hamp T, Schriefl C, Holaubek C, Gattinger M, Krammel M, Winnisch M, Weidenauer A, Mundigler G, Lang I, Schreiber W, Sterz F, Herkner H, Domanovits H. The impact of cardiopulmonary resuscitation (CPR) manikin chest stiffness on motivation and CPR performance measures in children undergoing CPR training-A prospective, randomized, single-blind, controlled trial. PLoS One 2018; 13:e0202430. [PMID: 30114240 PMCID: PMC6095555 DOI: 10.1371/journal.pone.0202430] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 08/02/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cardio-pulmonary-resuscitation (CPR) training starting at the age of 12 years is recommended internationally. Training younger children is not recommended because young children lack the physical ability to perform adequate CPR and discouragement to perform CPR later is apprehended. The aim of this study was to answer the following questions: Are younger children discouraged after CPR training? Is discouragement caused by their lack in physical ability to perform adequate chest compressions on a standard manikin and would the use of manikins with a reduced resistance affect their motivation or performance? METHODS We investigated the motivation and CPR performance of children aged 8-13 years after CPR training on manikins of different chest stiffness in a prospective, randomized, single-blind, controlled trial. 322 children underwent randomization and received 30 minutes CPR training in small groups at school. We used two optically identical resuscitation manikins with different compression resistances of 45kg and 30kg. Motivation was assessed with a self-administered questionnaire. Performance was measured with the Resusci®Anne SkillReporter™. FINDINGS Motivation after the training was generally high and there was no difference between the two groups in any of the questionnaire items on motivation: Children had fun (98 vs. 99%; P = 0.32), were interested in the training (99 vs. 98%; P = 0.65), and were glad to train resuscitation again in the future (89 vs. 91%; P = 0.89). CPR performance was generally poor (median compression score (8, IQR 1-45 and 29, IQR 11-54; P<0.001) and the mean compression depth was lower in the 45kg-resistance than in the 30kg-resistance group (33±10mm vs. 41±9; P<0.001). CONCLUSIONS Compression resistances of manikins, though influencing CPR performance, did not discourage 8 to 13 year old children after CPR training. The findings refute the view that young children are discouraged when receiving CPR training even though they are physically not able to perform adequate CPR.
Collapse
Affiliation(s)
- David Weidenauer
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Thomas Hamp
- Department of General Anesthesia and Intensive Care, Prehospital Emergency Medicine Research Group, Medical University of Vienna, Vienna, Austria
- * E-mail:
| | - Christoph Schriefl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Caroline Holaubek
- Department of Cardiothoracic and Vascular Anesthesia, Medical University of Vienna, Vienna, Austria
| | | | - Mario Krammel
- Municipal Ambulance Service of Vienna, Vienna, Austria
| | - Markus Winnisch
- Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Ana Weidenauer
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Gerald Mundigler
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Irene Lang
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Schreiber
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Fritz Sterz
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Hans Domanovits
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
45
|
Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation 2018; 137:e67-e492. [PMID: 29386200 DOI: 10.1161/cir.0000000000000558] [Citation(s) in RCA: 4466] [Impact Index Per Article: 744.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
46
|
Alismail A, Massey E, Song C, Daher N, Terry MH, López D, Tan L, Lo T. Emotional Impact of Cardiopulmonary Resuscitation Training on High School Students. Front Public Health 2018; 5:362. [PMID: 29435441 PMCID: PMC5796893 DOI: 10.3389/fpubh.2017.00362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/20/2017] [Indexed: 11/24/2022] Open
Abstract
Background The American Heart Association (AHA) has implemented several programs to educate the public about cardiopulmonary resuscitation (CPR). A common issue in bystander CPR is the fear of hurting the victim. As a result, the victim may not receive CPR in time. The purpose of this study was to measure the emotional impact of CPR training on high school students using two approved AHA courses. Methods A total of 60 students participated in this study. These students had a mean age of 15.4 ± 1.2 years old and were selected from a high school in Southern California. Subjects were divided into two groups, Basic Life Support (BLS) (n1 = 31) and Hands-Only™ CPR (n2 = 29). Emotional impacts were assessed by having each subject answer a questionnaire based on given scenarios before and after their training session. Results There was a significant difference in both groups when comparing positive-emotion scores before and after the training (BLS: 30.3 ± 6.0 vs. 34.5 ± 6.7, p < 0.001; Hands-Only 27.9 ± 5.0 vs. 32.1 ± 6.5, p < 0.001). In addition, both groups showed significant reductions in negative-emotion scores (BLS: 29.2 ± 6.7 vs. 23.7 ± 6.5, p < 0.001 and Hands-Only: 26.8 ± 6.1vs. 24.8 ± 7.7, p = 0.05). Conclusion Our results indicate that the AHA programs have positive effects on students’ emotional response. We recommend that future studies include an in-depth study design that probes the complexity of students’ emotions after completing an AHA session.
Collapse
Affiliation(s)
- Abdullah Alismail
- Cardiopulmonary Sciences, Loma Linda University, Loma Linda, CA, United States
| | - Evelyn Massey
- Cardiopulmonary Sciences, Loma Linda University, Loma Linda, CA, United States
| | - Cassaundra Song
- Chaminade University of Honolulu, Honolulu, HI, United States
| | - Noha Daher
- Allied Health Studies, Loma Linda University, Loma Linda, CA, United States
| | - Michael H Terry
- Cardiopulmonary Sciences, Loma Linda University, Loma Linda, CA, United States.,Respiratory Care, Loma Linda University Medical Center (LLUMC), Loma Linda, CA, United States
| | - David López
- Cardiopulmonary Sciences, Loma Linda University, Loma Linda, CA, United States
| | - Laren Tan
- Cardiopulmonary Sciences, Loma Linda University, Loma Linda, CA, United States.,Loma Linda University Medical Center (LLUMC), Loma Linda, CA, United States
| | - Takkin Lo
- Castle Medical Center, Kailua, HI, United States
| |
Collapse
|
47
|
Birkun A, Kosova Y. Social attitude and willingness to attend cardiopulmonary resuscitation training and perform resuscitation in the Crimea. World J Emerg Med 2018; 9:237-248. [PMID: 30181790 PMCID: PMC6117537 DOI: 10.5847/wjem.j.1920-8642.2018.04.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 07/16/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To promote potentially life-saving bystander cardiopulmonary resuscitation (CPR), the proportion of CPR-trained general public and their attitude toward CPR should be assessed, which is yet to be done in the former Soviet Union countries. As a case study, the survey is aimed to investigate the prevalence of CPR training, CPR knowledge, attitude and willingness to attend training and attempt CPR in the general population of the Crimea. METHODS A personal interview survey was done from November 2017 to January 2018 with quota sampling reflecting age, gender and territorial distribution of the Crimean population. RESULTS Out of 384 persons surveyed, 53% were trained in CPR. Of trained, 24% passed training within the last year, 44% attended a single course. Among the non-trained, 51% never thought about the need to attend training. Knowledge of CPR is generally poor. About 52% wish to learn CPR, 79% and 91% are willing to attempt CPR on a stranger or a loved one, respectively. Lack of knowledge is the strongest barrier to attempt CPR. People aged ≥60, those with educational level lower than high school, widowed and retired are mostly untrained and unwilling to learn CPR. Females and unemployed are mostly untrained, but willing to be educated. CONCLUSION There is a need for increasing CPR training and retraining, and improving awareness and motivation to learn CPR in the Crimean population, targeting the least trained groups. The results could be used as a reference point for future studies in the former USSR countries, utilising the same methodology.
Collapse
Affiliation(s)
- Alexei Birkun
- Department of Anaesthesiology, Resuscitation and Emergency Medicine, Medical Academy named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal University; 295051, Lenin Blvd, 5/7, Simferopol, Russian Federation
| | - Yekaterina Kosova
- Department of Applied Mathematics, Taurida Academy of V. I. Vernadsky Crimean Federal University; 295007, Prospect Vernadskogo, 4, Simferopol, Russian Federation
| |
Collapse
|
48
|
Smith CM, Lim Choi Keung SN, Khan MO, Arvanitis TN, Fothergill R, Hartley-Sharpe C, Wilson MH, Perkins GD. Barriers and facilitators to public access defibrillation in out-of-hospital cardiac arrest: a systematic review. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2017; 3:264-273. [PMID: 29044399 DOI: 10.1093/ehjqcco/qcx023] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 07/12/2017] [Indexed: 11/14/2022]
Abstract
Public access defibrillation initiatives make automated external defibrillators available to the public. This facilitates earlier defibrillation of out-of-hospital cardiac arrest victims and could save many lives. It is currently only used for a minority of cases. The aim of this systematic review was to identify barriers and facilitators to public access defibrillation. A comprehensive literature review was undertaken defining formal search terms for a systematic review of the literature in March 2017. Studies were included if they considered reasons affecting the likelihood of public access defibrillation and presented original data. An electronic search strategy was devised searching MEDLINE and EMBASE, supplemented by bibliography and related-article searches. Given the low-quality and observational nature of the majority of articles, a narrative review was performed. Sixty-four articles were identified in the initial literature search. An additional four unique articles were identified from the electronic search strategies. The following themes were identified related to public access defibrillation: knowledge and awareness; willingness to use; acquisition and maintenance; availability and accessibility; training issues; registration and regulation; medicolegal issues; emergency medical services dispatch-assisted use of automated external defibrillators; automated external defibrillator-locator systems; demographic factors; other behavioural factors. In conclusion, several barriers and facilitators to public access defibrillation deployment were identified. However, the evidence is of very low quality and there is not enough information to inform changes in practice. This is an area in urgent need of further high-quality research if public access defibrillation is to be increased and more lives saved. PROSPERO registration number CRD42016035543.
Collapse
Affiliation(s)
- Christopher M Smith
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham B9 5SS, UK
| | | | - Mohammed O Khan
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry CV4 7AL, UK
| | | | - Rachael Fothergill
- London Ambulance Service NHS Trust, 18-20 Pocock Street, London SE1 0BW, UK
| | | | - Mark H Wilson
- Imperial College, Neurotrauma Centre, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Gavin D Perkins
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham B9 5SS, UK
| |
Collapse
|
49
|
Son JW, Ryoo HW, Moon S, Kim JY, Ahn JY, Park JB, Seo KS, Kim JK, Kim YJ. Association between public cardiopulmonary resuscitation education and the willingness to perform bystander cardiopulmonary resuscitation: a metropolitan citywide survey. Clin Exp Emerg Med 2017; 4:80-87. [PMID: 28717777 PMCID: PMC5511954 DOI: 10.15441/ceem.16.160] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 03/17/2017] [Accepted: 04/02/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Bystander cardiopulmonary resuscitation (CPR) is an important factor associated with improved survival rates and neurologic prognoses in cases of out-of-hospital cardiac arrest. We assessed how factors related to CPR education including timing of education, period from the most recent education session, and content, affected CPR willingness. METHODS In February 2012, trained interviewers conducted an interview survey of 1,000 Daegu citizens through an organized questionnaire. The subjects were aged ≥19 years and were selected by quota sampling. Their social and demographic characteristics, as well as CPR and factors related to CPR education, were investigated. Chi-square tests and multivariate logistic regression analyses were used to evaluate how education-related factors affected the willingness to perform CPR. RESULTS Of total 1,000 cases, 48.0% were male. The multivariate analyses revealed several factors significantly associated with CPR willingness: didactic plus practice group (adjusted odds ratio [AOR], 3.38; 95% confidence interval [CI], 2.3 to 5.0), group with more than four CPR education session (AOR, 7.68; 95% CI, 3.21 to 18.35), interval of less than 6 months from the last CPR education (AOR, 4.47; 95% CI 1.29 to 15.52), and education with automated external defibrillator (AOR, 5.98; 95% CI 2.30 to 15.53). CONCLUSION The following were associated with increased willingness to perform CPR: practice sessions and automated electrical defibrillator training in public CPR education, more frequent CPR training, and shorter time period from the most recent CPR education sessions.
Collapse
Affiliation(s)
- Jeong Woo Son
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyun Wook Ryoo
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sungbae Moon
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jong-Yeon Kim
- Department of Preventive Medicine, Catholic University of Daegu College of Medicine, Daegu, Korea
| | - Jae Yun Ahn
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jeong Bae Park
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Kang Suk Seo
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Yun Jeong Kim
- Department of Emergency Medicine, Daegu Fatima Hospital, Daegu, Korea
| |
Collapse
|
50
|
Kim YJ, Cho Y, Cho GC, Ji HK, Han SY, Lee JH. Retention of cardiopulmonary resuscitation skills after hands-only training versus conventional training in novices: a randomized controlled trial. Clin Exp Emerg Med 2017; 4:88-93. [PMID: 28717778 PMCID: PMC5511957 DOI: 10.15441/ceem.16.175] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 02/17/2017] [Accepted: 02/28/2017] [Indexed: 11/30/2022] Open
Abstract
Objective Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study is to compare the retention rate of CPR skills in laypersons after hands-only or conventional CPR training. Methods Participants were randomly assigned to 1 of 2 CPR training methods: 80 minutes of hands-only CPR training or 180 minutes of conventional CPR training. Each participant’s CPR skills were evaluated at the end of training and 3 months thereafter using the Resusci Anne manikin with a skill-reporting software. Results In total, 252 participants completed training; there were 125 in the hands-only CPR group and 127 in the conventional CPR group. After 3 months, 118 participants were randomly selected to complete a post-training test. The hands-only CPR group showed a significant decrease in average compression rate (P=0.015), average compression depth (P=0.031), and proportion of adequate compression depth (P=0.011). In contrast, there was no difference in the skills of the conventional CPR group after 3 months. Conclusion Conventional CPR training appears to be more effective for the retention of chest compression skills than hands-only CPR training; however, the retention of artificial ventilation skills after conventional CPR training is poor.
Collapse
Affiliation(s)
- Young Joon Kim
- Department of Emergency Medicine, Kang Dong Sacred Heart Hospital, Hallym University School of medicine, Seoul, Korea
| | - Youngsuk Cho
- Department of Emergency Medicine, Kang Dong Sacred Heart Hospital, Hallym University School of medicine, Seoul, Korea
| | - Gyu Chong Cho
- Department of Emergency Medicine, Kang Dong Sacred Heart Hospital, Hallym University School of medicine, Seoul, Korea
| | - Hyun Kyung Ji
- Department of Emergency Medical Technology, Baekseok University, Cheonan, Korea
| | - Song Yi Han
- Department of Emergency Medical Technology, Baekseok University, Cheonan, Korea
| | - Jin Hyuck Lee
- Department of Emergency Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| |
Collapse
|