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Edinboro D, Brady W. Cardiopulmonary resuscitation training: A narrative review comparing traditional educational programs with alternative, reduced-resource methods of CPR instruction for lay providers. Am J Emerg Med 2022; 56:196-204. [DOI: 10.1016/j.ajem.2022.03.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/12/2022] [Accepted: 03/27/2022] [Indexed: 10/18/2022] Open
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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.
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Nebsbjerg MA, Rasmussen SE, Bomholt KB, Krogh LQ, Krogh K, Povlsen JA, Riddervold IS, Grøfte T, Kirkegaard H, Løfgren B. Skills among young and elderly laypersons during simulated dispatcher assisted CPR and after CPR training. Acta Anaesthesiol Scand 2018; 62:125-133. [PMID: 29143314 DOI: 10.1111/aas.13027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 09/06/2017] [Accepted: 10/13/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Dispatcher assisted cardiopulmonary resuscitation (DA-CPR) increase the rate of bystander CPR. The aim of the study was to compare the performance of DA-CPR and attainable skills following CPR training between young and elderly laypersons. METHODS Volunteer laypersons (young: 18-40 years; elderly: > 65 years) participated. Single rescuer CPR was performed in a simulated DA-CPR cardiac arrest scenario and after CPR training. Data were obtained from a manikin and from video recordings. The primary endpoint was chest compression depth. RESULTS Overall, 56 young (median age: 26, years since last CPR training: 6) and 58 elderly (median age: 72, years since last CPR training: 26.5) participated. Young laypersons performed deeper (mean (SD): 56 (14) mm vs. 39 (19) mm, P < 0.001) and faster (median (25th-75th percentile): 107 (97-112) per min vs. 84 (74-107) per min, P < 0.001) chest compressions compared to elderly. Young laypersons had shorter time to first compression (mean (SD): 71 (11) seconds vs. 104 (38) seconds, P < 0.001) and less hands-off time (median (25th-75th percentile): 0 (0-1) seconds vs. 5 (2-10) seconds, P < 0.001) than elderly. After CPR training chest compressions were performed with a depth (mean (SD): 64 (8) mm vs. 50 (14) mm, P < 0.001) and rate (mean (SD): 111 (11) per min vs. 93 (18) per min, P < 0.001) for young and elderly laypersons respectively. CONCLUSION Despite long CPR retention time for both groups, elderly laypersons had longer retention time, and performed inadequate DA-CPR compared to young laypersons. Following CPR training the attainable CPR level was of acceptable quality for both young and elderly laypersons.
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Affiliation(s)
- M. A. Nebsbjerg
- Research Center for Emergency Medicine; Aarhus University Hospital; Aarhus C Denmark
- Emergency Department; Aarhus University Hospital; Aarhus C Denmark
| | - S. E. Rasmussen
- Research Center for Emergency Medicine; Aarhus University Hospital; Aarhus C Denmark
- Department of Respiratory Diseases and Allergy; Aarhus University Hospital; Aarhus C Denmark
| | - K. B. Bomholt
- Research Center for Emergency Medicine; Aarhus University Hospital; Aarhus C Denmark
| | - L. Q. Krogh
- Research Center for Emergency Medicine; Aarhus University Hospital; Aarhus C Denmark
- Psychiatric Department; Regional Hospital of Herning; Herning Denmark
| | - K. Krogh
- Centre for Health Sciences Education; Aarhus University; Aarhus N Denmark
- Department of Anaesthesiology and Intensive Care; Aarhus University Hospital; Aarhus N Denmark
| | - J. A. Povlsen
- Institute of Clinical Medicine; Aarhus University; Aarhus N Denmark
- Department of Cardiology; Aarhus University Hospital; Aarhus N Denmark
| | - I. S. Riddervold
- Prehospital Emergency Medical Services; Central Denmark Region; Aarhus N Denmark
| | - T. Grøfte
- Prehospital Emergency Medical Services; Central Denmark Region; Aarhus N Denmark
- Department of Anaesthesiology and Intensive Care; Regional Hospital of Randers; Randers Denmark
| | - H. Kirkegaard
- Research Center for Emergency Medicine; Aarhus University Hospital; Aarhus C Denmark
- Prehospital Emergency Medical Services; Central Denmark Region; Aarhus N Denmark
| | - B. Løfgren
- Research Center for Emergency Medicine; Aarhus University Hospital; Aarhus C Denmark
- Institute of Clinical Medicine; Aarhus University; Aarhus N Denmark
- Department of Internal Medicine; Regional Hospital of Randers; Randers Denmark
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Ko RJM, Lim SH, Wu VX, Leong TY, Liaw SY. Easy-to-learn cardiopulmonary resuscitation training programme: a randomised controlled trial on laypeople's resuscitation performance. Singapore Med J 2017; 59:217-223. [PMID: 29167910 DOI: 10.11622/smedj.2017084] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Simplifying the learning of cardiopulmonary resuscitation (CPR) is advocated to improve skill acquisition and retention. A simplified CPR training programme focusing on continuous chest compression, with a simple landmark tracing technique, was introduced to laypeople. The study aimed to examine the effectiveness of the simplified CPR training in improving lay rescuers' CPR performance as compared to standard CPR. METHODS A total of 85 laypeople (aged 21-60 years) were recruited and randomly assigned to undertake either a two-hour simplified or standard CPR training session. They were tested two months after the training on a simulated cardiac arrest scenario. Participants' performance on the sequence of CPR steps was observed and evaluated using a validated CPR algorithm checklist. The quality of chest compression and ventilation was assessed from the recording manikins. RESULTS The simplified CPR group performed significantly better on the CPR algorithm when compared to the standard CPR group (p < 0.01). No significant difference was found between the groups in time taken to initiate CPR. However, a significantly higher number of compressions and proportion of adequate compressions was demonstrated by the simplified group than the standard group (p < 0.01). Hands-off time was significantly shorter in the simplified CPR group than in the standard CPR group (p < 0.001). CONCLUSION Simplifying the learning of CPR by focusing on continuous chest compressions, with simple hand placement for chest compression, could lead to better acquisition and retention of CPR algorithms, and better quality of chest compressions than standard CPR.
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Affiliation(s)
| | - Swee Han Lim
- Department of Emergency Medicine, Singapore General Hospital, Singapore
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Skill learning and retention. J Trauma Acute Care Surg 2017; 82:S103-S106. [DOI: 10.1097/ta.0000000000001429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhan L, Yang LJ, Huang Y, He Q, Liu GJ. Continuous chest compression versus interrupted chest compression for cardiopulmonary resuscitation of non-asphyxial out-of-hospital cardiac arrest. Cochrane Database Syst Rev 2017; 3:CD010134. [PMID: 28349529 PMCID: PMC6464160 DOI: 10.1002/14651858.cd010134.pub2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is a major cause of death worldwide. Cardiac arrest can be subdivided into asphyxial and non asphyxial etiologies. An asphyxia arrest is caused by lack of oxygen in the blood and occurs in drowning and choking victims and in other circumstances. A non asphyxial arrest is usually a loss of functioning cardiac electrical activity. Cardiopulmonary resuscitation (CPR) is a well-established treatment for cardiac arrest. Conventional CPR includes both chest compressions and 'rescue breathing' such as mouth-to-mouth breathing. Rescue breathing is delivered between chest compressions using a fixed ratio, such as two breaths to 30 compressions or can be delivered asynchronously without interrupting chest compression. Studies show that applying continuous chest compressions is critical for survival and interrupting them for rescue breathing might increase risk of death. Continuous chest compression CPR may be performed with or without rescue breathing. OBJECTIVES To assess the effects of continuous chest compression CPR (with or without rescue breathing) versus conventional CPR plus rescue breathing (interrupted chest compression with pauses for breaths) of non-asphyxial OHCA. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1 2017); MEDLINE (Ovid) (from 1985 to February 2017); Embase (1985 to February 2017); Web of Science (1985 to February 2017). We searched ongoing trials databases including controlledtrials.com and clinicaltrials.gov. We did not impose any language or publication restrictions. SELECTION CRITERIA We included randomized and quasi-randomized studies in adults and children suffering non-asphyxial OHCA due to any cause. Studies compared the effects of continuous chest compression CPR (with or without rescue breathing) with interrupted CPR plus rescue breathing provided by rescuers (bystanders or professional CPR providers). DATA COLLECTION AND ANALYSIS Two authors extracted the data and summarized the effects as risk ratios (RRs), adjusted risk differences (ARDs) or mean differences (MDs). We assessed the quality of evidence using GRADE. MAIN RESULTS We included three randomized controlled trials (RCTs) and one cluster-RCT (with a total of 26,742 participants analysed). We identified one ongoing study. While predominantly adult patients, one study included children. Untrained bystander-administered CPRThree studies assessed CPR provided by untrained bystanders in urban areas of the USA, Sweden and the UK. Bystanders administered CPR under telephone instruction from emergency services. There was an unclear risk of selection bias in two trials and low risk of detection, attrition, and reporting bias in all three trials. Survival outcomes were unlikely to be affected by the unblinded design of the studies.We found high-quality evidence that continuous chest compression CPR without rescue breathing improved participants' survival to hospital discharge compared with interrupted chest compression with pauses for rescue breathing (ratio 15:2) by 2.4% (14% versus 11.6%; RR 1.21, 95% confidence interval (CI) 1.01 to 1.46; 3 studies, 3031 participants).One trial reported survival to hospital admission, but the number of participants was too low to be certain about the effects of the different treatment strategies on survival to admission(RR 1.18, 95% CI 0.94 to 1.48; 1 study, 520 participants; moderate-quality evidence).There were no data available for survival at one year, quality of life, return of spontaneous circulation or adverse effects.There was insufficient evidence to determine the effect of the different strategies on neurological outcomes at hospital discharge (RR 1.25, 95% CI 0.94 to 1.66; 1 study, 1286 participants; moderate-quality evidence). The proportion of participants categorized as having good or moderate cerebral performance was 11% following treatment with interrupted chest compression plus rescue breathing compared with 10% to 18% for those treated with continuous chest compression CPR without rescue breathing. CPR administered by a trained professional In one trial that assessed OHCA CPR administered by emergency medical service professionals (EMS) 23,711 participants received either continuous chest compression CPR (100/minute) with asynchronous rescue breathing (10/minute) or interrupted chest compression with pauses for rescue breathing (ratio 30:2). The study was at low risk of bias overall.After OHCA, risk of survival to hospital discharge is probably slightly lower for continuous chest compression CPR with asynchronous rescue breathing compared with interrupted chest compression plus rescue breathing (9.0% versus 9.7%) with an adjusted risk difference (ARD) of -0.7%; 95% CI (-1.5% to 0.1%); moderate-quality evidence.There is high-quality evidence that survival to hospital admission is 1.3% lower with continuous chest compression CPR with asynchronous rescue breathing compared with interrupted chest compression plus rescue breathing (24.6% versus 25.9%; ARD -1.3% 95% CI (-2.4% to -0.2%)).Survival at one year and quality of life were not reported.Return of spontaneous circulation is likely to be slightly lower in people treated with continuous chest compression CPR plus asynchronous rescue breathing (24.2% versus 25.3%; -1.1% (95% CI -2.4 to 0.1)), high-quality evidence.There is high-quality evidence of little or no difference in neurological outcome at discharge between these two interventions (7.0% versus 7.7%; ARD -0.6% (95% CI -1.4 to 0.1).Rates of adverse events were 54.4% in those treated with continuous chest compressions plus asynchronous rescue breathing versus 55.4% in people treated with interrupted chest compression plus rescue breathing compared with the ARD being -1% (-2.3 to 0.4), moderate-quality evidence). AUTHORS' CONCLUSIONS Following OHCA, we have found that bystander-administered chest compression-only CPR, supported by telephone instruction, increases the proportion of people who survive to hospital discharge compared with conventional interrupted chest compression CPR plus rescue breathing. Some uncertainty remains about how well neurological function is preserved in this population and there is no information available regarding adverse effects.When CPR was performed by EMS providers, continuous chest compressions plus asynchronous rescue breathing did not result in higher rates for survival to hospital discharge compared to interrupted chest compression plus rescue breathing. The results indicate slightly lower rates of survival to admission or discharge, favourable neurological outcome and return of spontaneous circulation observed following continuous chest compression. Adverse effects are probably slightly lower with continuous chest compression.Increased availability of automated external defibrillators (AEDs), and AED use in CPR need to be examined, and also whether continuous chest compression CPR is appropriate for paediatric cardiac arrest.
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Affiliation(s)
- Lei Zhan
- The First People’s Hospital of Shuangliu CountyDepartment of NeurosurgeryChengduChina610041
| | - Li J Yang
- Affiliated Hospital of Chengdu UniversityEmergency DepartmentChengduSichuanChina610081
| | - Yu Huang
- The Third People's Hospital of ChengduDepartment of Intensive Care Medicine82 Qinglong streetChengduChina610031
- The Second Affiliated Hospital of Chengdu, Chongqing Medical UniversityDepartment of Intensive Care MedicineChengduSichuanChina
| | - Qing He
- The Third People's Hospital of ChengduDepartment of Intensive Care Medicine82 Qinglong streetChengduChina610031
- The Second Affiliated Hospital of Chengdu, Chongqing Medical UniversityDepartment of Intensive Care MedicineChengduSichuanChina
| | - Guan J Liu
- West China Hospital, Sichuan UniversityCochrane ChinaNo. 37, Guo Xue XiangChengduSichuanChina610041
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Min Ko RJ, Wu VX, Lim SH, San Tam WW, Liaw SY. Compression-only cardiopulmonary resuscitation in improving bystanders’ cardiopulmonary resuscitation performance: a literature review. Emerg Med J 2016; 33:882-888. [DOI: 10.1136/emermed-2015-204771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 11/12/2015] [Accepted: 12/28/2015] [Indexed: 11/03/2022]
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Understanding and improving low bystander CPR rates: a systematic review of the literature. CAN J EMERG MED 2015; 10:51-65. [DOI: 10.1017/s1481803500010010] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTObjectives:Cardiopulmonary resuscitation (CPR) is a crucial yet weak link in the chain of survival for out-of-hospital cardiac arrest. We sought to understand the determinants of bystander CPR and the factors associated with successful training.Methods:For this systematic review, we searched 11 electronic databases, 1 trial registry and 9 scientific websites. We performed hand searches and contacted 6 content experts. We reviewed without restriction all communications pertaining to who should learn CPR, what should be taught, when to repeat training, where to give CPR instructions and why people lack the motivation to learn and perform CPR. We used standardized forms to review papers for inclusion, quality and data extraction. We grouped publications by category and classified recommendations using a standardized classification system that was based on level of evidence.Results:We reviewed 2409 articles and selected 411 for complete evaluation. We included 252 of the 411 papers in this systematic review. Differences in their study design precluded a meta-analysis. We classified 22 recommendations; those with the highest scores were 1) 9-1-1 dispatch-assisted CPR instructions, 2) teaching CPR to family members of cardiac patients, 3) Braslow's self-training video, 4) maximizing time spent using manikins and 5) teaching the concepts of ambiguity and diffusion of responsibility. Recommendations not supported by evidence include mass training events, pulse taking prior to CPR by laymen and CPR using chest compressions alone.Conclusion:We evaluated and classified the potential impact of interventions that have been proposed to improve bystander CPR rates. Our results may help communities design interventions to improve their bystander CPR rates.
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Hasani H, Bahrami M, Malekpour A, Dehghani M, Allahyary E, Amini M, Abdorahimi M, Khani S, Kalantari Meibodi M, Kojuri J. Evaluation of Teaching Methods in Mass CPCR Training in Different Groups of the Society, an Observational Study. Medicine (Baltimore) 2015; 94:e859. [PMID: 26020392 PMCID: PMC4616420 DOI: 10.1097/md.0000000000000859] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To determine the efficacy of different methods of cardiopulmonary resuscitation (CPCR) training in 3 different groups of the society. In a prospective and observational study of 2000 individuals in 3 different groups including G1, G2, and G3 4 different protocols of CPCR training were applied and their efficacy was compared between the groups. Also, 12 months after the study course, 460 participants from 3 groups were asked to take apart in a theoretical and practical examination to evaluate the long-term efficacy of the 4 protocols. Among 2000 individuals took a parted in the study, 950 (47.5%) were G1, 600 (30%) were G2, and 450 (22.5%) were G3. G1 in 4 groups were 2.37 and 2.65 times more successful in pretest theoretical and 2.61 and 18.20 times more successful in practical examinations compared with G2 and G3 and gained highest improvement in CPCR skills. Other groups also showed significantly improved CPCR skills. Comparison of different methods of CPCR learning showed that the workshop using interactive lecture as well as human model, educational film, and reference CPCR book has the highest efficacy in all groups. This protocol of CPCR training showed more efficacy in long-term postdelayed evaluation. On the contrary, medical students had better long-term outcomes from the course. Although G1 and G2 obtained better results in learning CPCR skills, in G3 also the theoretical and practical knowledge were improved significantly. This course increased confidence for doing CPCR in all groups of the study. Considering that the most of the bystanders at emergency states are general population, training this group of the society and increasing their confidence about performing CPCR can be so effective and lifesaving at emergency states. (Clinical trial. Gov registration: NCT02120573).
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Affiliation(s)
- Hamed Hasani
- From the Quality Improvement in Clinical Education Research Center, Shiraz University of Medical Sciences (HH, MB, AM, MA, MA, SK); Shiraz Quality Improvement in Clinical Education Research Center, Shiraz University of Medical Sciences, University of Medical Sciences (MB); Shiraz University of Medical Sciences (EA); Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran (MK); Education Development and Research Center, Cardiovascular research center, Shiraz University of Medical Sciences, Shiraz, Iran (JK)
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Potential association of bystander–patient relationship with bystander response and patient survival in daytime out-of-hospital cardiac arrest. Resuscitation 2015; 86:74-81. [DOI: 10.1016/j.resuscitation.2014.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/03/2014] [Accepted: 11/10/2014] [Indexed: 11/15/2022]
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Heidenreich JW, Sanders AB. Response to Neset et al. J Emerg Med 2013; 44:991-992. [PMID: 23473820 DOI: 10.1016/j.jemermed.2012.11.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 11/19/2012] [Indexed: 06/01/2023]
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Jenko M, Frangez M, Manohin A. Four-stage teaching technique and chest compression performance of medical students compared to conventional technique. Croat Med J 2012; 53:486-95. [PMID: 23100211 PMCID: PMC3490459 DOI: 10.3325/cmj.2012.53.486] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 10/01/2012] [Indexed: 11/30/2022] Open
Abstract
AIM To compare the 2-stage and 4-stage basic life support teaching technique. The second aim was to test if students' self-evaluated knowledge was in accordance with their actual knowledge. METHODS A total of 126 first-year students of the Faculty of Medicine in Ljubljana were involved in this parallel study conducted in the academic year 2009/2010. They were divided into ten groups. Five groups were taught the 2-stage model and five the 4-stage model. The students were tested in a scenario immediately after the course. Questionnaires were filled in before and after the course. We assessed the absolute values of the chest compression variables and the proportions of students whose performance was evaluated as correct according to our criteria. The results were analyzed with independent samples t test or Mann-Whitney-U test. Proportions were compared with χ(2) test. The correlation was calculated with the Pearson coefficient. RESULTS There was no difference between the 2-stage (2S) and the 4-stage approach (4S) in the compression rate (126±13 min-1 vs 124±16 min -1, P=0.180, independent samples t test), compression depth (43±7 mm vs 44±8 mm, P=0.368, independent samples t test), and the number of compressions with correct hand placement (79±32% vs 78±12, P=0.765, Mann-Whitney U-test). However, students from the 4-stage group had a significantly higher average number of compressions per minute (70±13 min -1 2S, 78±12 min-1 4S, P=0.02, independent samples t test). The percentage of students with all the variables correct was the same (13% 2S, 15% 4S, P=0.741, χ2 test). There was no correlation between the students' actual and self-evaluated knowledge (P=0.158, Pearson coefficient=0.127). CONCLUSIONS The 4-stage teaching technique does not significantly improve the quality of chest compressions. The students' self-evaluation of their performance after the course was too high.
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Affiliation(s)
- Matej Jenko
- Katedra za anesteziologijo in reanimatologijo, Zaloska 7/I, Ljubljana, Slovenia.
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NESET A, BIRKENES TS, FURUNES T, MYKLEBUST HE, MYKLETUN RJ, ODEGAARD S, OLASVEENGEN TM, KRAMER-JOHANSEN J. A randomized trial on elderly laypersons' CPR performance in a realistic cardiac arrest simulation. Acta Anaesthesiol Scand 2012; 56:124-31. [PMID: 22092097 DOI: 10.1111/j.1399-6576.2011.02566.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2011] [Indexed: 01/08/2023]
Abstract
BACKGROUND Bystander cardiopulmonary resuscitation (CPR) is important for survival after cardiac arrest. We hypothesized that elderly laypersons would perform CPR poorer in a realistic cardiac arrest simulation, compared to a traditional test. METHODS Sixty-four lay rescuers aged 50-75 were randomized to realistic or traditional test, both with ten minutes of telephone assisted CPR. Realistic simulation started suddenly without warning, leaving the test subject alone in a confined and noisy apartment. Traditional test was conducted in a spacious and calm classroom with a researcher present. CPR performance was recorded with a manikin with human like chest properties. Heart rate and self-reported exhaustion were registered. RESULTS CPR quality was not different in the two groups: compression depth, 43 mm ± 7 versus 43 ± 4, P = 0.72; compressions rate, 97 min(-1) ± 11 versus 93 ± 15, P = 0.26; ventilation rate, 2.4 min(-1) ± 1.7 versus 2.8 ± 1.1, P = 0.35; and hands-off time 273 s ± 50 versus 270 ± 66, P = 0.82; in realistic (n = 31) and traditional (n = 33) groups, respectively. No fatigue was evident in the repeated measures analysis of variance. Work load was not different between the groups; attained percentage of age predicted maximum heart rate, 73% ± 9 and 76 ± 11, P = 0.37, reported exhaustion 43 ± 21 (scale: 0 to 100) and 37 ± 19, P = 0.24. CONCLUSIONS Elderly lay people are capable of performing chest compressions with acceptable quality for ten minutes in a realistic cardiac arrest simulation. Ventilation quality and hands-off time were not adequate in either group.
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Affiliation(s)
| | | | - T. FURUNES
- Faculty of Social Sciences; University of Stavanger; Stavanger; Norway
| | | | - R. J. MYKLETUN
- Faculty of Social Sciences; University of Stavanger; Stavanger; Norway
| | - S. ODEGAARD
- Institute for Experimental Medical Research; Oslo University Hospital HF; Oslo; Norway
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Blewer AL, Leary M, Decker CS, Andersen JC, Fredericks AC, Bobrow BJ, Abella BS. Cardiopulmonary resuscitation training of family members before hospital discharge using video self-instruction: a feasibility trial. J Hosp Med 2011; 6:428-32. [PMID: 21916007 PMCID: PMC4091628 DOI: 10.1002/jhm.847] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 06/14/2010] [Accepted: 08/14/2010] [Indexed: 12/30/2022]
Abstract
BACKGROUND Bystander cardiopulmonary resuscitation (CPR) is a crucial therapy for sudden cardiac arrest (SCA), yet rates of bystander CPR are low. This is especially the case for SCA occurring in the home setting, as family members of at-risk patients are often not CPR trained. OBJECTIVE To evaluate the feasibility of a novel hospital-based CPR education program targeted to family members of patients at increased risk for SCA. DESIGN Prospective, multicenter, cohort study. SETTING Inpatient wards at 3 hospitals. SUBJECTS Family members of inpatients admitted with cardiac-related diagnoses. MEASUREMENTS AND RESULTS Family members were offered CPR training via a proctored video-self instruction (VSI) program. After training, CPR skills and participant perspectives regarding their training experience were assessed. Surveys were conducted one month postdischarge to measure the rate of "secondary training" of other individuals by enrolled family members. At the 3 study sites, 756 subjects were offered CPR instruction; 280 agreed to training and 136 underwent instruction using the VSI program. Of these, 78 of 136 (57%) had no previous CPR training. After training, chest compression performance was generally adequate (mean compression rate 90 ± 26/minute, mean depth 37 ± 12 mm). At 1 month, 57 of 122 (47%) of subjects performed secondary training for friends or family members, with a calculated mean of 2.1 persons trained per kit distributed. CONCLUSIONS The hospital setting offers a unique "point of capture" to provide CPR instruction to an important, undertrained population in contact with at-risk individuals.
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Affiliation(s)
- Audrey L. Blewer
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Marion Leary
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Christopher S. Decker
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - James C. Andersen
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Amanda C. Fredericks
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Bentley J. Bobrow
- Emergency Medicine Department, Maricopa Medical Center, Phoenix, Arizona
| | - Benjamin S. Abella
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania
- Address for correspondence and reprint requests: Benjamin S. Abella, MD, MPhil, 3400 Spruce Street, Ground Ravdin, Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA 19104; Telephone: 215-279-3452; Fax: 215-662-3953;
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Koster RW, Sayre MR, Botha M, Cave DM, Cudnik MT, Handley AJ, Hatanaka T, Hazinski MF, Jacobs I, Monsieurs K, Morley PT, Nolan JP, Travers AH. Part 5: Adult basic life support: 2010 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Resuscitation 2011; 81 Suppl 1:e48-70. [PMID: 20956035 DOI: 10.1016/j.resuscitation.2010.08.005] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Rudolph W Koster
- Department of Cardiology, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands.
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Sayre MR, Koster RW, Botha M, Cave DM, Cudnik MT, Handley AJ, Hatanaka T, Hazinski MF, Jacobs I, Monsieurs K, Morley PT, Nolan JP, Travers AH. Part 5: Adult basic life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2010; 122:S298-324. [PMID: 20956253 DOI: 10.1161/circulationaha.110.970996] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Neset A, Birkenes TS, Myklebust H, Mykletun RJ, Odegaard S, Kramer-Johansen J. A randomized trial of the capability of elderly lay persons to perform chest compression only CPR versus standard 30:2 CPR. Resuscitation 2010; 81:887-92. [PMID: 20418006 DOI: 10.1016/j.resuscitation.2010.03.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2009] [Revised: 03/05/2010] [Accepted: 03/22/2010] [Indexed: 02/06/2023]
Abstract
AIM OF THE STUDY Early cardiopulmonary resuscitation (CPR) improves survival after cardiac arrest, but there is a discrepancy between the age group normally attending CPR-classes and the age group most likely to witness a cardiac arrest. We wanted to study if elderly lay persons could perform 10min of CPR on a realistic manikin with continuous chest compressions (CCC) and conventional CPR (30:2). METHODS Volunteers were tested 5-7 months after CPR-classes. They were randomized to CCC or 30:2, and to receive feedback (FB) or not. Quality of CPR, age adjusted maximum heart rate (HRmax), and subjective exhaustion ratings were measured and evaluated in a blinded fashion. Temporal development and group differences were evaluated with ANOVA procedures. RESULTS All 64 volunteers were able to perform CPR for 10min and rated their efforts as mild to moderate in concordance with a mean HRmax of 78%. Quality of CPR was similar in all groups, except for chest compression rate that was slightly higher and had less variability in the FB group. Overall chest compression depth was 41+/-4.5mm. Analysis of temporal development of chest compression depth revealed a small initial decline before leveling off. As expected, CCC group had less pauses and higher total number of chests compressions. CONCLUSION Lay people in the age group 50-76 were able to perform CPR with acceptable quality for 10min and we found only very slight temporal quality deterioration. This makes training programs for the elderly meaningful to improve survival after cardiac arrest.
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Affiliation(s)
- Andres Neset
- Institute for Experimental Medical Research, Oslo University Hospital Ulleval, Kirkeveien 166, Oslo, Norway.
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Can effective basic life support be taught to untrained individuals during a cardiac arrest? Eur J Emerg Med 2008; 15:224-5. [DOI: 10.1097/mej.0b013e3282f08d5f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Christenson J, Nafziger S, Compton S, Vijayaraghavan K, Slater B, Ledingham R, Powell J, McBurnie MA. The effect of time on CPR and automated external defibrillator skills in the Public Access Defibrillation Trial. Resuscitation 2007; 74:52-62. [PMID: 17303309 PMCID: PMC2718839 DOI: 10.1016/j.resuscitation.2006.11.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2006] [Revised: 11/03/2006] [Accepted: 11/03/2006] [Indexed: 01/23/2023]
Abstract
BACKGROUND The time to skill deterioration between primary training/retraining and further retraining in cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED) for lay-persons is unclear. The Public Access Defibrillation (PAD) trial was a multi-center randomized controlled trial evaluating survival after CPR-only versus CPR+AED delivered by onsite non-medical volunteer responders in out-of-hospital cardiac arrest. AIMS This sub-study evaluated the relationship of time between primary training/retraining and further retraining on volunteer performance during pretest AED and CPR skill evaluation. METHODS Volunteers at 1260 facilities in 24 North American regions underwent training/retraining according to facility randomization, which included an initial session and a refresher session at approximately 6 months. Before the next retraining, a CPR and AED skill test was completed for 2729 volunteers. Primary outcome for the study was assessment of global competence of CPR or AED performance (adequate versus not adequate) using chi(2)-test for trends by time interval (3, 6, 9, and 12 months). Confirmatory (GEE) logistic regression analysis, adjusted for site and potential confounders was done. RESULTS The proportion of volunteers judged to be competent did not diminish by interval (3, 6, 9, and 12 months) for either CPR or AED skills. After adjusting for site and potential confounders, longer intervals to further retraining was associated with a slightly lower likelihood of performing adequate CPR but not with AED scores. CONCLUSIONS After primary training/retraining, the CPR skills of targeted lay responders deteriorate nominally but 80% remain competent up to 1 year. AED skills do not deteriorate significantly and 90% of volunteers remain competent up to 1 year.
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Affiliation(s)
- Jim Christenson
- Department of Emergency Medicine, St. Paul's Hospital, University of British Columbia, 1081 Burrard St., Vancouver, BC, Canada V6Z 1Y6.
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Richman PB, Bobrow BJ, Clark L, Noelck N, Sanders AB. Ability of citizens in a senior living community to perform lifesaving cardiac skills and appropriately utilize AEDs. J Emerg Med 2007; 33:395-9. [PMID: 17976750 DOI: 10.1016/j.jemermed.2007.02.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2006] [Revised: 02/02/2007] [Accepted: 02/03/2007] [Indexed: 11/17/2022]
Abstract
The objective of this study was to assess the ability of citizens in a senior living community (SLC) to perform adequate cardiopulmonary resuscitation (CPR) and appropriately utilize an automated external defibrillator (AED) in a simulated cardiac arrest scenario (SCAS). This study was a prospective, observational study; a convenience sample of SLC residents aged > 54 years was enrolled. Subjects were presented with a SCAS (adult mannequin, bystander available to assist, AED visible). Subjects' skills were rated in standardized fashion. For statistical analysis, 95% confidence intervals (CIs) were calculated as appropriate. There were 51 subjects; 69% were female; mean age was 64 years; 86% were without disabilities. Pre-retirement professions included: medical (13.7%), office/sales (41.2%), and engineer/science (15.7%). Subjects had previous American Heart Association first-responder training (CPR and AED use) as follows: none (22%), within 0 to 6 months (47%), 7-12 months (4%), > 12 months (27%). During the SCAS, subjects performed inconsistently on the various links in the chain of survival. Although most subjects (94%; 95% CI 84-99%) checked for unresponsiveness, only 62.8% (95% CI 48-76%) also specified "call 911 and bring me the AED." Most subjects (88%; 95% CI 76-96%) started chest compressions, however, only a minority provided high quality chest compressions (29%; 95% CI 17-44%). With respect to AED skill performance, we noted the following: 94% (95% CI 84-99%) of subjects removed the patient's clothing, 90% (95% CI 79-97%) turned the device on, 94% delivered a shock as directed, and 82% continued CPR if "no shock indicated" by AED (95% CI 69-92%). Performance was less satisfactory for the following: only 39.2% (95% CI 26-54%) continued chest compressions after AED arrival, 60.8% (95% CI 46-74%) of subjects correctly attached electrodes, and 6% (95% CI 1-16%) verbalized "clear" in advance of shock. Although many members of our sample SLC had prior training, they frequently failed to adequately perform some key steps in the SCAS. Recent efforts to place AEDs in SLCs should be augmented by a plan to adequately train residents and other available individuals (e.g., staff) in CPR/AED use.
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Affiliation(s)
- Peter B Richman
- Department of Emergency Medicine, Mayo Clinic Hospital, Phoenix, Arizona 85054, USA
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Mäkinen M, Niemi-Murola L, Mäkelä M, Castren M. Methods of assessing cardiopulmonary resuscitation skills: a systematic review. Eur J Emerg Med 2007; 14:108-14. [PMID: 17496690 DOI: 10.1097/mej.0b013e328013dc02] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Valid and reliable instruments are needed for assessment and comparison of training outcomes after various methods of cardiopulmonary resuscitation training. Trials were retrieved by searching MEDLINE (1990-February 2005) and using the reference lists of original communications and reviews. Studies were considered relevant if they included an intervention, a study population of life support providers randomized and divided into groups and an evaluation or assessment of the performance. The studies were analyzed and scored to assess their validity. Twenty-five studies fulfilled the criteria. Nineteen of them assessed cardiopulmonary resuscitation skills, four cardiopulmonary resuscitation and defibrillation and two assessed defibrillation only. The mean number of participants was 107 (range 36-495). A wide variety of assessment methods were used in the studies with methodological shortcomings. Most studies in this review compared participants with each other, not against a standard or a defined passing level. Qualified studies with well defined study populations, standardized study settings and explicit, comparable outcomes would be needed to assess the quality of cardiopulmonary resuscitation and defibrillation performance.
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Affiliation(s)
- Marja Mäkinen
- Uusimaa Emergency Medical Service, Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, FIN-00029 HUS, Helsinki, Finland
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Affiliation(s)
- Jerry Potts
- ECC Programs, American Heart Association, Dallas, TX 75231, USA.
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Swor R, Khan I, Domeier R, Honeycutt L, Chu K, Compton S. CPR training and CPR performance: do CPR-trained bystanders perform CPR? Acad Emerg Med 2006; 13:596-601. [PMID: 16614455 DOI: 10.1197/j.aem.2005.12.021] [Citation(s) in RCA: 164] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To determine factors associated with cardiopulmonary resuscitation (CPR) provision by CPR-trained bystanders and to determine factors associated with CPR performance by trained bystanders. METHODS The authors performed a prospective, observational study (January 1997 to May 2003) of individuals who called 911 (bystanders) at the time of an out-of-hospital cardiac arrest. A structured telephone interview of adult cardiac-arrest bystanders was performed beginning two weeks after the incident. Elements gathered during interviews included bystander and patient demographics, identifying whether the bystander was CPR trained, when and by whom the CPR was performed, and describing the circumstances of the event. If CPR was not performed, we asked the bystanders why CPR was not performed. Logistic regression was used to calculate odds ratios and 95% confidence intervals (95% CI) for factors associated with CPR performance. RESULTS Of 868 cardiac arrests, 684 (78.1%) bystander interviews were completed. Of all bystanders interviewed, 69.6% were family members of the victims, 36.8% of the bystanders had more than a high-school education, and 54.1% had been taught CPR at some time. In 21.2% of patients, the bystander immediately started CPR, and in 33.6% of cases, someone started CPR before the arrival of emergency medical services (EMS). Important overall predictors of CPR performance were the following: witnessed arrest (OR = 2.3; 95% CI = 1.4 to 3.8); bystander was CPR trained (OR = 6.6; 95% CI = 3.5 to 12.5); bystander had more than a high-school education (OR = 2.0; 95% CI = 1.2 to 3.1), or arrest occurred in a public location (OR = 3.1; 95% CI = 1.7 to 5.8). These variables were significant predictors of CPR performance among CPR-trained bystanders, as was CPR training within five years (OR = 4.5; 95% CI = 2.8 to 7.3). Common reasons that the CPR-trained bystanders cited for not performing CPR were the following: 37.5% stated that they panicked, 9.1% perceived that they would not be able to do CPR correctly, and 1.1% thought that they would hurt the patient. Surprisingly, only 1.1% objected to performing mouth-to-mouth resuscitation. CONCLUSIONS A minority of CPR-trained bystanders performed CPR. CPR provision was more common in CPR-trained bystanders with more than a high-school education and when CPR training had been within five years. Previously espoused reasons for not doing CPR (mouth-to-mouth, infectious-disease risk) were not the reasons that bystanders cited for not doing CPR. Further work is needed to maximize CPR provision after CPR training.
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Affiliation(s)
- Robert Swor
- Department of Emergency Medicine, Royal Oak William Beaumont Hospital, Royal Oak, MI, USA.
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Noordergraaf GJ, Drinkwaard BWPM, van Berkom PFJ, van Hemert HP, Venema A, Scheffer GJ, Noordergraaf A. The quality of chest compressions by trained personnel: The effect of feedback, via the CPREzy, in a randomized controlled trial using a manikin model. Resuscitation 2006; 69:241-52. [PMID: 16457935 DOI: 10.1016/j.resuscitation.2005.08.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2005] [Revised: 07/27/2005] [Accepted: 08/03/2005] [Indexed: 11/20/2022]
Abstract
Even after training, the ability to perform effective cardiac compressions has been found to be poor and to decrease rapidly. We assessed this ability with and without a non-invasive feedback device, the CPREzy, during a 270s CPR session in an unannounced, single-blinded manikin study using 224 hospital employees and staff chosen at random and using a non-cross over design. The two groups self-assessed their knowledge and skills as adequate. However, the control group (N=111) had significantly more difficulty in delivering chest compressions deeper than 4 cm (25 versus 1 candidate in the CPREzy group), P=0.0001. The control group compressed ineffectively in 36% (+/-41%) of all compressions as opposed to 6+/-13% in the CPREzy group (N=112, P=0.0001). If compressions were effective initially, the time until >50% of compressions were less than 4 cm deep was 75+/-81s in the control group versus 194+/-87 s in the CPREzy group (P=0.0001 [-180 to -57.5]). After a few seconds of training in its use, our candidates used the CPREzy effectively. Against the background knowledge that estimation of compression depth by the rescuer or other team members is difficult, and that performing effective compressions is the cornerstone of any resuscitation attempt, our data suggests that a feedback device such as the CPREzy should be used consistently during resuscitation.
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Affiliation(s)
- Gerrit J Noordergraaf
- Department of Anaesthesiology, St. Elisabeth Hospital, Tilburg, Hilvarenbeekseweg 60, 5022 GC Tilburg, The Netherlands.
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Riegel B, Birnbaum A, Aufderheide TP, Thode HC, Henry MC, Van Ottingham L, Swor R. Predictors of cardiopulmonary resuscitation and automated external defibrillator skill retention. Am Heart J 2005; 150:927-32. [PMID: 16290965 DOI: 10.1016/j.ahj.2005.01.042] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2004] [Accepted: 01/26/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Few data exist regarding the retention of cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) skills over time in relationship to characteristics of lay volunteer responders, training, or risk of exposure to victims. The purpose of this study was to describe the characteristics associated with adequate CPR and AED skill retention. METHODS AND RESULTS Skill retention was tested 3 to 18 months (mean 6.9 +/- 3.5 months) after initial training. Instructors judged adequacy of performance of essential CPR or AED skills and provided an overall assessment (adequate/inadequate), which was used as the outcome. Data on 7261 laypersons trained in CPR (4358 also received AED training) in 24 sites across the United States and Canada were available from the Public Access Defibrillation (PAD) Trial. Characteristics of the volunteers, classes, and facilities were evaluated as predictors of performance adequacy. Adjusting for site, intervention assignment (CPR-only or CPR + AED), and time since initial training, volunteer characteristics associated with adequate CPR performance were age (OR 0.78 per 10-year increment), male sex (OR 1.44), minority (OR 0.62), married (OR 1.35), prior emergency experience (OR 1.66), prior CPR class (OR 1.68), prior advanced training (OR 1.59), and extracurricular CPR training (OR 1.91) (all P < .05). Characteristics associated with AED performance included age (OR 0.69), college education (OR 1.34), and native language other than English (OR 0.51) (all P < .05). CONCLUSIONS Certain subgroups of lay volunteers may need targeted outreach programs in CPR and AED use, classes with longer training time, more practice, or more intense retraining to maintain their CPR and/or AED skills.
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Affiliation(s)
- Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA 19104-6096, USA.
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Swor R, Fahoome G, Compton S. Potential Impact of a Targeted Cardiopulmonary Resuscitation Program for Older Adults on Survival from Private-residence Cardiac Arrest. Acad Emerg Med 2005. [DOI: 10.1111/j.1553-2712.2005.tb01469.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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