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Horning J, Griffith D, Slovis C, Brady W. Pre-Arrival Care of the Out-of-Hospital Cardiac Arrest Victim. Emerg Med Clin North Am 2023; 41:413-432. [PMID: 37391242 DOI: 10.1016/j.emc.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Lay rescuers play a pivotal role in the recognition and initial management of out-of-hospital cardiac arrest. The provision of timely pre-arrival care by lay responders, including cardiopulmonary resuscitation and the use of automated external defibrillator before emergency medical service arrival, is important link in the chain of survival and has been shown to improve outcomes from cardiac arrest. Although physicians are not directly involved in bystander response to cardiac arrest, they play a key role in emphasizing the importance of bystander interventions.
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Affiliation(s)
- Jillian Horning
- Department of Emergency Medicine, University of Virginia Health System, PO Box 800699, Charlottesville, VA 22908, USA
| | - Daniel Griffith
- Department of Emergency Medicine, University of Virginia Health System, PO Box 800699, Charlottesville, VA 22908, USA
| | - Corey Slovis
- Department of Emergency Medicine, University of Virginia Health System, PO Box 800699, Charlottesville, VA 22908, USA; Department of Emergency Medicine, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - William Brady
- Department of Emergency Medicine, University of Virginia Health System, PO Box 800699, Charlottesville, VA 22908, USA.
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2
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Kovoor JG, Bacchi S, Gupta AK, Elliott R, Page GJ, Kovoor P. Staying Alive: Promoting Bystander CPR and Defibrillation With Public Messaging. Heart Lung Circ 2023; 32:e42-e43. [PMID: 37344053 DOI: 10.1016/j.hlc.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/25/2023] [Indexed: 06/23/2023]
Affiliation(s)
- Joshua G Kovoor
- University of Adelaide, Adelaide, SA, Australia; Health and Information, Adelaide, SA, Australia; Heart of the Nation, Sydney, NSW, Australia. http://www.twitter.com/josh.kovoor
| | - Stephen Bacchi
- University of Adelaide, Adelaide, SA, Australia; Health and Information, Adelaide, SA, Australia
| | | | | | - Gregory J Page
- Heart of the Nation, Sydney, NSW, Australia. http://www.twitter.com/GregPage_Yellow
| | - Pramesh Kovoor
- Heart of the Nation, Sydney, NSW, Australia; University of Sydney, Westmead Hospital, Sydney, NSW, Australia.
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Goldberg SA, Battistini V, Cash RE, Kelleher M, Laporte C, Peters G, Goralnick E. A retrospective review of out of hospital cardiac arrest at Gillette Stadium: 10 years of experience at a large sports venue. Resusc Plus 2023; 14:100386. [PMID: 37056959 PMCID: PMC10085775 DOI: 10.1016/j.resplu.2023.100386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 04/09/2023] Open
Abstract
Introduction Rates of out-of-hospital cardiac arrest (OHCA) at major sporting events are as high as 0.7 per 100,000 attendees. However, factors contributing to OHCA at mass gatherings have not been well-described. We describe our experience with ten years of medical oversight and OHCA care at a professional football stadium. Methods We performed a retrospective review of OHCA events between August 2010 and January 2020 at a 65,878-seat football stadium, with a single transporting EMS agency and a single receiving hospital. We analyzed EMS incident reports and matched patients to hospital records for outcome data. Results A total of 7,767,345 people attended 115 football games during the study period. There were 21 OHCAs (0.27 per 100,000 attendees). Ninety-five percent of OHCAs were witnessed and 71.4% had an initial shockable rhythm, with bystander AED use in 47.6%. Median EMS response time was 2 minutes (IQR 1-6). For 7 patients defibrillated by EMS, time to defibrillation was 4 minutes (IQR 4-11). Return of spontaneous circulation (ROSC) occurred in 71%, with 47% having good 30-day neurologic survival. All patients with an initial rhythm of asystole died. Conclusion The ROSC rate at our stadium exceeded 70% with almost half surviving with good neurologic outcomes, substantially higher than that reported for the general public. We hope that our experience will provide valuable lessons to other similarly sized stadiums.
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Affiliation(s)
- Scott A. Goldberg
- Brigham and Women’s Hospital, Boston, MA, USA
- Corresponding author at: Department of Emergency Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA.
| | | | | | | | - Christopher Laporte
- Brigham and Women’s Hospital, Boston, MA, USA
- Foxborough Fire Department, Foxborough, MA, USA
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Development of an intervention to facilitate dissemination of community-based training to respond to out-of-hospital cardiac arrest: FirstCPR. PLoS One 2022; 17:e0273028. [PMID: 36001615 PMCID: PMC9401178 DOI: 10.1371/journal.pone.0273028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/01/2022] [Indexed: 11/20/2022] Open
Abstract
Background and aim
Out-of-hospital cardiac arrest (OHCA) is a significant public health issue with low survival rates. Prompt bystander action can more than double survival odds. OHCA response training is primarily pursued due to work-related mandates, with few programs targeting communities with lower training levels. The aim of this research was to describe the development process of a targeted multicomponent intervention package designed to enhance confidence and training among laypeople in responding to an OHCA.
Methods
An iterative, three-phase program development process was employed using a mixed methods approach. The initial phase involved establishment of a multidisciplinary panel that informed decisions on key messages, program content, format, and delivery modes. These decisions were based on scientific evidence and guided by behavioural theories. The second phase comprised the development of the intervention package, identifying existing information and developing new material to fill identified gaps. The third phase involved refining and finalising the material via feedback from panel members, stakeholders, and community members.
Results
Through this approach, we collaboratively developed a comprehensive evidence-based education and training package consisting of a digital intervention supplemented with free access to in-person education and training. The package was designed to teach community members the specific steps in recognising and responding to a cardiac arrest, while addressing commonly known barriers and fears related to bystander response. The tailored program and delivery format addressed the needs of individuals of diverse ages, cultural backgrounds, and varied training needs and preferences.
Conclusion
The study highlights the importance of community engagement in intervention development and demonstrates the need of evidence-based and collaborative approaches in creating a comprehensive, localised, relatively low-cost intervention package to improve bystander response to OHCA.
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Park GJ, Song KJ, Shin SD, Hong KJ, Kim TH, Park YM, Kong J. Clinical effects of a new dispatcher-assisted basic life support training program in a metropolitan city. Medicine (Baltimore) 2022; 101:e29298. [PMID: 35839001 PMCID: PMC11132370 DOI: 10.1097/md.0000000000029298] [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
This study estimates the effect of a new dispatcher-assisted basic life support training program on the survival outcomes of out-of-hospital cardiac arrest (OHCA). Before-and-after intervention trials were conducted in Seoul. Patients who suffered OHCA in a private place from January 2014 to December 2017 were included. The intervention group was 3 districts; the other 22 districts were regarded as the control group. The primary outcome was survival up to hospital discharge. The difference-in-difference (DID) was calculated to evaluate changes in the survival outcomes of the 2 groups over the period. A total of 10,127 OHCA patients were included in the final analysis. OHCA patients in the intervention group were less likely to receive bystander cardiopulmonary resuscitation (57.8% vs 61.1%; P = .02) and showed lower survival outcomes (5.7% vs 6.4% for survival up to hospital discharge; P = .34 and 2.8% vs 3.7% for good neurological recovery; P = .11), but this was not statistically significant. Compared to 2014, good neurological recovery in 2017 was significantly improved in the intervention group (DID for good neurological recovery = 3.2%; 0.6-5.8). There were no statistically significant differences in return of spontaneous circulation and survival up to hospital discharge between the 2 groups (DID for survival to discharge was 1.8% [-1.7 to 5.3] and DID for return of spontaneous circulation was -2.5% [-9.8 to 4.8]). Improvement in neurological recovery was observed in the 3 districts after implementing the new dispatcher-assisted basic life support training program.
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Affiliation(s)
- Gwan Jin Park
- Department of Emergency Medicine, Chungbuk National University Hospital
| | - Kyoung Jun Song
- Department of Emergency Medicine, Seoul National University Boramae Medical Center, Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute
| | - Ki Jeong Hong
- Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute
| | - Tae Han Kim
- Department of Emergency Medicine, Seoul National University Boramae Medical Center, Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Yu Mi Park
- Citizens' Health Bureau, Seoul Metropolitan Government
| | - Joyce Kong
- Laerdal Medical, Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute
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Dainty KN, Colquitt B, Bhanji F, Hunt EA, Jefkins T, Leary M, Ornato JP, Swor RA, Panchal A. Understanding the Importance of the Lay Responder Experience in Out-of-Hospital Cardiac Arrest: A Scientific Statement From the American Heart Association. Circulation 2022; 145:e852-e867. [PMID: 35306832 DOI: 10.1161/cir.0000000000001054] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bystander cardiopulmonary resuscitation (CPR) is critical to increasing survival from out-of-hospital cardiac arrest. However, the percentage of cases in which an individual receives bystander CPR is actually low, at only 35% to 40% globally. Preparing lay responders to recognize the signs of sudden cardiac arrest, call 9-1-1, and perform CPR in public and private locations is crucial to increasing survival from this public health problem. The objective of this scientific statement is to summarize the most recent published evidence about the lay responder experience of training, responding, and dealing with the residual impact of witnessing an out-of-hospital cardiac arrest. The scientific statement focuses on the experience-based literature of actual responders, which includes barriers to responding, experiences of doing CPR, use of an automated external defibrillator, the impact of dispatcher-assisted CPR, and the potential for postevent psychological sequelae. The large body of qualitative and observational studies identifies several gaps in crucial knowledge that, if targeted, could increase the likelihood that those who are trained in CPR will act. We suggest using the experience of actual responders to inform more contextualized training, including the implications of performing CPR on a family member, dispelling myths about harm, training and litigation, and recognition of the potential for psychologic sequelae after the event.
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Klacman A, Barnes D, Wang J. The Effects of a Novel Quarterly Cardiopulmonary Resuscitation Training Program on Hospital Basic Life Support Providers' Cardiopulmonary Resuscitation Skill Performance. J Nurses Prof Dev 2021; 37:131-137. [PMID: 33961358 DOI: 10.1097/nnd.0000000000000727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This is a retrospective descriptive study of a novel cardiopulmonary resuscitation (CPR) training program. Using quarterly, brief CPR training at a skills station, hospital basic life support providers who failed to meet CPR performance measures during the first quarter quickly improved on the skills necessary to meet CPR measures. Those meeting CPR measures during the first quarter maintained that performance over time. Staff nurse educators should consider incorporating innovative CPR education strategies that focus on spaced learning with immediate feedback.
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Hooker EA, Werft M. Using laypersons to train friends and family in Hands-Only CPR improves their willingness to perform bystander CPR. Am J Emerg Med 2021; 49:419-420. [PMID: 33642125 DOI: 10.1016/j.ajem.2021.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 10/22/2022] Open
Affiliation(s)
- Edmond A Hooker
- Xavier University, Cincinnati, OH, United States of America; University of Cincinnati, Cincinnati, OH, United States of America.
| | - Meghan Werft
- Xavier University, Cincinnati, OH, United States of America
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Cheng A, Magid DJ, Auerbach M, Bhanji F, Bigham BL, Blewer AL, Dainty KN, Diederich E, Lin Y, Leary M, Mahgoub M, Mancini ME, Navarro K, Donoghue A. Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S551-S579. [PMID: 33081527 DOI: 10.1161/cir.0000000000000903] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Mcintyre D, Thiagalingam A, Chow C. While you're waiting, a waiting room-based, cardiovascular disease-focused educational program: protocol for a randomised controlled trial. BMJ Open 2020; 10:e036780. [PMID: 33082181 PMCID: PMC7577035 DOI: 10.1136/bmjopen-2020-036780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Patients with cardiovascular disease (CVD) frequently attend outpatient clinics and spend a significant amount of time in waiting rooms. Currently, this time is poorly used. This study aims to investigate whether providing CVD and cardiopulmonary resuscitation (CPR) education to waiting patients in a cardiology clinic of a large referral hospital improves motivation to change health behaviours, CPR knowledge, behaviours and clinic satisfaction post clinic, and whether there is any impact on reported CVD lifestyle behaviours or relevant CPR outcomes at 30 days. METHODS AND ANALYSIS Randomised controlled trial with parallel design to be conducted among 330 patients in the waiting room of a chest pain clinic in a tertiary referral hospital. Intervention (n=220) participants will receive a tablet-delivered series of educational videos catered to self-reported topics of interest (physical activity, blood pressure, diet, medications, smoking and general health) and level of health knowledge. Control (n=110) participants will receive usual care. In a substudy, intervention participants will be randomised 1:1 to receive an extra video on CPR or no extra video. The primary outcome will be the proportion of intervention and control participants who report high motivation to improve physical activity, diet and blood pressure monitoring at end of clinic. The primary outcome of the CPR study will be confidence to perform CPR post clinic. Secondary analysis will examine impact on clinic satisfaction, lifestyle behaviours, CPR knowledge and willingness to perform CPR post clinic and at 30-day follow-up. ETHICS AND DISSEMINATION Ethics approval has been received from the Western Sydney Local Health District Human Research Ethics Committee. All patients will provide informed consent via a tablet-based eConsent framework. Study results will be disseminated via the usual channels including peer-reviewed publications and presentations at national and international conferences. TRIAL REGISTRATION NUMBER ANZCTR12618001725257.
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Affiliation(s)
- Daniel Mcintyre
- Westmead Applied Research Centre, University of Sydney, Westmead, New South Wales, Australia
| | - Aravinda Thiagalingam
- Westmead Applied Research Centre, University of Sydney, Westmead, New South Wales, Australia
- Cardiology Department, Westmead Hospital, Westmead, New South Wales, Australia
| | - Clara Chow
- Westmead Applied Research Centre, University of Sydney, Westmead, New South Wales, Australia
- Cardiology Department, Westmead Hospital, Westmead, New South Wales, Australia
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Pujalte-Jesús MJ, Leal-Costa C, Ruzafa-Martínez M, Ramos-Morcillo AJ, Díaz Agea JL. Relief Alternatives during Resuscitation: Instructions to Teach Bystanders. A Randomized Control Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155495. [PMID: 32751430 PMCID: PMC7432336 DOI: 10.3390/ijerph17155495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 06/11/2023]
Abstract
To analyze the quality of resuscitation (CPR) performed by individuals without training after receiving a set of instructions (structured and unstructured/intuitive) from an expert in a simulated context, the specific objective was to design a simple and structured CPR learning method on-site. An experimental study was designed, consisting of two random groups with a post-intervention measurement in which the experimental group (EG) received standardized instructions, and the control group (CG) received intuitive or non-standardized instructions, in a public area simulated scenario. Statistically significant differences were found (p < 0.0001) between the EG and the CG for variables: time needed to give orders, pauses between chest compressions and ventilations, depth, overall score, chest compression score, and chest recoil. The average depth of the EG was 51.1 mm (SD 7.94) and 42.2 mm (SD 12.04) for the CG. The chest recoil median was 86.32% (IQR 62.36, 98.87) for the EG, and 58.3% (IQR 27.46, 84.33) in the CG. The use of a sequence of simple, short and specific orders, together with observation-based learning makes possible the execution of chest compression maneuvers that are very similar to those performed by rescuers, and allows the teaching of the basic notions of ventilation. The structured order method was shown to be an on-site learning opportunity when faced with the need to maintain high-quality CPR in the presence of an expert resuscitator until the arrival of emergency services.
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The Effectiveness of a New Dispatcher-Assisted Basic Life Support Training Program on Quality in Cardiopulmonary Resuscitation Performance During Training and Willingness to Perform Bystander Cardiopulmonary Resuscitation: A Cluster Randomized Controlled Study. Simul Healthc 2020; 15:318-325. [PMID: 32604135 DOI: 10.1097/sih.0000000000000435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION A new dispatcher-assisted basic life support training program, called "Home Education and Resuscitation Outcome Study (HEROS)" was developed with a goal to provide high-quality dispatcher-assisted cardiopulmonary resuscitation (CPR) training, with a focus on untrained home bystanders. This study aimed to determine whether the HEROS program is associated with improved quality in CPR performance during training and willingness to provide bystander CPR compared with other basic life support programs without dispatcher-assisted CPR (non-HEROS). METHODS This clustered randomized trial was conducted in 3 district health centers in Seoul. Intervention group was trained with the HEROS program and control group was trained with non-HEROS program. The primary outcome was overall CPR quality, measured as total CPR score. Secondary outcomes were other CPR quality parameters including average compression depth and rate, percentages of adequate depth, and acceptable release. Tertiary outcomes were posttraining survey results. Difference in difference analysis was performed to analyze the outcomes. RESULTS Among total 1929 trainees, 907 (47.0%) were trained with HEROS program. Compared with the non-HEROS group, the HEROS group showed higher-quality CPR performances and better maintenance of their CPR quality throughout the course (total scores of 84% vs. 80% for first session and 72% vs. 67% for last session; difference in difference of 12.2 vs. 13.2). Other individual CPR parameters also showed significantly higher quality in the HEROS group. The posttraining survey showed that both groups were highly willing to perform bystander CPR (91.4% in the HEROS vs. 92.3% in the non-HEROS) with only 3.4% of respondents in the HEROS group were not willing to volunteer compared with 6.2% in the non-HEROS group (P < 0.01). CONCLUSIONS The HEROS training program helped trainees perform high-quality CPR throughout the course and enhanced their willingness to provide bystander CPR.
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Landgraf P, Spies C, Lawatscheck R, Luz M, Wernecke KD, Schröder T. Does Telemedical Support of First Responders Improve Guideline Adherence in an Offshore Emergency Scenario? A Simulator-Based Prospective Study. BMJ Open 2019; 9:e027563. [PMID: 31462465 PMCID: PMC6720317 DOI: 10.1136/bmjopen-2018-027563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 05/24/2019] [Accepted: 07/17/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate, in a simulator-based prospective study, whether telemedical support improves quality of emergency first response (performance) by medical non-professionals to being non-inferior to medical professionals. SETTING In a simulated offshore wind power plant, duos (teams) of offshore engineers and teams of paramedics conducted the primary survey of a simulated patient. PARTICIPANTS 38 offshore engineers and 34 paramedics were recruited by the general email invitation. INTERVENTION Teams (randomised by lot) were supported by transmission technology and a remote emergency physician in Berlin. OUTCOME MEASURES From video recordings, performance (17 item checklist) and required time (up to 15 min) were quantified by expert rating for analysis. Differences were analysed using two-sided exact Mann-Whitney U tests for independent measures, non-inferiority was analysed using Schuirmann one-sided test. The significance level of 5 % was Holm-Bonferroni adjusted in each family of pairwise comparisons. RESULTS Nine teams of engineers with, nine without, nine teams of paramedics with and eight without support completed the task. Two experts quantified endpoints, insights into rater dependence were gained. Supported engineers outperformed unsupported engineers (p<0.01), insufficient evidence was found for paramedics (p=0.11). Without support, paramedics outperformed engineers (p<0.01). Supported engineers' performance was non-inferior (at one item margin) to that by unsupported paramedics (p=0.03). Supported groups were slower than unsupported groups (p<0.01). CONCLUSIONS First response to medical emergencies in offshore wind farms with substantially delayed professional care may be improved by telemedical support. Future work should test our result during additional scenarios and explore interdisciplinary and ecosystem aspects of this support. TRIAL REGISTRATION NUMBER DRKS00014372.
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Affiliation(s)
- Philipp Landgraf
- Department of Anesthesiology and Intensive Care Medicine Campus Charité Mitte and Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia Spies
- Department of Anesthesiology and Intensive Care Medicine Campus Charité Mitte and Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Robert Lawatscheck
- Department of Anesthesiology and Intensive Care Medicine Campus Charité Mitte and Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Global Medical Affairs, Therapy Area Cardiovascular, Bayer Pharma AG, Berlin, Germany
| | - Maria Luz
- Faculty of Computer Science, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | | | - Torsten Schröder
- Department of Anesthesiology and Intensive Care Medicine Campus Charité Mitte and Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Cardiopulmonary resuscitation (CPR) psychomotor skills of laypeople, as affected by training interventions, number of times trained and retention testing intervals: A dataset derived from a systematic review. Data Brief 2019; 25:104236. [PMID: 31497626 PMCID: PMC6718818 DOI: 10.1016/j.dib.2019.104236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/17/2019] [Accepted: 07/01/2019] [Indexed: 11/30/2022] Open
Abstract
This article is a companion to a systematic review, entitled, Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: a systematic review (Riggs et al., 2019). The data tables described in this article summarise the impact that specific training interventions, number of times trained, and retention testing intervals have on laypeople's CPR psychomotor skills, as reported by peer-reviewed journal articles. The psychomotor skills included are: compression rate, compression depth, duration of interruptions to compressions, chest recoil, hand placement, proportion of adequate or ’correct’ compressions, ventilation volume, compression-to-ventilation ratio, duty cycle and overall skills. The data tables described in this article are available as a supplementary file to this article.
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Panchal A, Keim S, Ewy G, Kern K, Hughes KE, Beskind D. Development of a Medical Student Cardiopulmonary Resuscitation Elective to Promote Education and Community Outreach. Cureus 2019; 11:e4507. [PMID: 31249769 PMCID: PMC6584367 DOI: 10.7759/cureus.4507] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 04/19/2019] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION One of the barriers to improving cardiac arrest survival is the low rate of cardiopulmonary resuscitation (CPR) provision. Identifying this as a public health issue, many medical students often assist in training the community in CPR. However, these experiences are often short and are not associated with structured resuscitation education, limiting the student's and the community's learning. In this assessment, we identified a need and developed a curriculum, including defined goals and objectives, for an undergraduate medical education (UME) elective in CPR. METHODS At an academic university environment with a strong UME program, we developed a longitudinal UME elective in CPR. The curriculum is a four-year longitudinal experience, which satisfies two weeks of their fourth year of medical school. The curriculum includes structured training over the four-year period in the fundamentals of resuscitation science (through didactics, journal club, and hands-on skills training), in addition to structured community CPR teaching. The elective concludes with a final hands-on summative appraisal. Data concerning medical student program enrollment, CPR training events conducted, venues of events, and the number of individuals trained were collected over a five-year period. RESULTS The CPR elective was developed with clear goals and objectives based on identified needs. Over the five-year period, 186 medical students completed the CPR longitudinal elective, accounting for 8.4% of the total medical student population. Students completed curriculum requirements and satisfied both didactic and hands-on training with all students passing the final summative appraisal. Over the five-year period, students trained 8,694 people in bystander CPR. The summative evaluation had a 100% pass rate. CONCLUSION Implementation of a longitudinal CPR elective improved resuscitation science education for medical students and fostered increased community CPR training. This describes one local effort to improve resuscitation science education and training for medical students. Further work will need to be done to evaluate the impact of UME resuscitation curricula on medical student career choice and resuscitation outcomes.
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Affiliation(s)
- Ashish Panchal
- Emergency Medicine, Ohio State University, Columbus, USA
| | - Samuel Keim
- Emergency Medicine, Banner University Medical Center, Tucson, USA
| | - Gordon Ewy
- Cardiology, Banner University Medical Center, Tucson, USA
| | - Karl Kern
- Cardiology, Banner University Medical Center, Tucson, USA
| | - Kate E Hughes
- Emergency Medicine, University of Arizona, Tucson, USA
| | - Daniel Beskind
- Emergency Medicine, Banner University Medical Center, Tucson, USA
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Riggs M, Franklin R, Saylany L. Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: A systematic review. Resuscitation 2019; 138:259-272. [PMID: 30928504 DOI: 10.1016/j.resuscitation.2019.03.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 03/05/2019] [Accepted: 03/17/2019] [Indexed: 11/30/2022]
Abstract
AIM To determine whether training history (including number of times and duration since last training), knowledge, self-efficacy or willingness are associated with cardiopulmonary resuscitation (CPR) psychomotor skills. METHODS Eight databases were systematically searched from January 2005 to February 2018 for articles that involved adult layperson participants and explored an association between training history, knowledge, self-efficacy or willingness and CPR psychomotor skills or survival outcomes after real CPR attempts. RESULTS Thirty-four articles with a total of 35,421 participants were included. CPR training was found to improve psychomotor skills, compared to no training, and any previous training was associated with better skills, compared to no previous training, however only the use of a popular song promoted meaningful retention of a specifically targeted skill, compared to standard training methods. Skills deteriorated within 3 months, then plateaued from 3 to 6 months. Self-efficacy was weakly associated with skill level, however knowledge was not associated with skill level. No studies assessed the association between willingness and psychomotor skills. CONCLUSION All laypeople should attend an instructor-led CPR training session with real-time or delayed feedback to improve CPR skills. Training sessions should utilise combinations of validated skill-specific training strategies, preferably including popular songs and feedback to help ensure skills retention. Refresher training, which focusses on skills and self-confidence rather than knowledge, should be undertaken every 3-6 months, although this timeframe needs further validation. All future studies assessing CPR psychomotor skills should adhere to a standardised reporting outcome list (proposed in this paper) to ensure consistency and comparability of results.
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Ward SR, Scott BC, Rubin DM, Pantanowitz A. Development of a novel cardiopulmonary resuscitation measurement tool using real-time feedback from wearable wireless instrumentation. Resuscitation 2019; 137:183-189. [PMID: 30797861 DOI: 10.1016/j.resuscitation.2019.02.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 01/31/2019] [Accepted: 02/11/2019] [Indexed: 10/27/2022]
Abstract
AIM The design and implementation of a wearable training device to improve cardiopulmonary resuscitation (CPR) is presented. METHODS The MYO contains both Electromyography (EMG) and Inertial Measurement Unit (IMU) sensors which are used to detect effective CPR, and the four common incorrect hand and arm positions viz. relaxed fingers; hands too low on the sternum; patient too close; or patient too far. The device determines the rate and depth of compressions calculated using a Fourier transform and dual-quaternions respectively. In addition, common positional mistakes are determined using classification algorithms (six machine learning algorithms are considered and tested). Feedback via Graphical User Interface (GUI) and audio is integrated. RESULTS The system is tested by performing CPR on a mannequin and comparing real-time results to theoretical values. Tests show that although the classification algorithm performed well in testing (98%), in real time, it had low accuracy for certain categories (60%), which are attributable to the MYO calibration, sampling rate and misclassification of similar hand positions. Combining these similar incorrect positions into more general categories significantly improves accuracy, and produces the same improved outcome of improved CPR. The rate and depth measures have a general accuracy of 97%. CONCLUSION The system allows for portable, real-time feedback for use in training and in the field, and shows promise toward classifying and improving the administration of CPR.
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Affiliation(s)
- Sarah R Ward
- Biomedical Engineering Research Group, School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, Private Bag 3, 2050 Johannesburg, South Africa
| | - Bronwyn C Scott
- Biomedical Engineering Research Group, School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, Private Bag 3, 2050 Johannesburg, South Africa
| | - David M Rubin
- Biomedical Engineering Research Group, School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, Private Bag 3, 2050 Johannesburg, South Africa
| | - Adam Pantanowitz
- Biomedical Engineering Research Group, School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, Private Bag 3, 2050 Johannesburg, South Africa.
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YouTube videos teaching Arabic speaking population how to perform cardiopulmonary resuscitation: The gap between the need and quality! Resuscitation 2018; 131:e13-e14. [DOI: 10.1016/j.resuscitation.2018.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 08/07/2018] [Indexed: 11/19/2022]
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Nolan J, Ornato J, Parr M, Perkins G, Soar J. Resuscitation highlights in 2017. Resuscitation 2018; 124:A1-A8. [DOI: 10.1016/j.resuscitation.2018.01.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 01/15/2018] [Indexed: 12/11/2022]
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