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Scapigliati A, Zace D, Matsuyama T, Pisapia L, Saviani M, Semeraro F, Ristagno G, Laurenti P, Bray JE, Greif R. Community Initiatives to Promote Basic Life Support Implementation-A Scoping Review. J Clin Med 2021; 10:jcm10245719. [PMID: 34945015 PMCID: PMC8703423 DOI: 10.3390/jcm10245719] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Early intervention of bystanders (the first links of the chain of survival) have been shown to improve survival and good neurological outcomes of patients suffering out-of-hospital cardiac arrest (OHCA). Many initiatives have been implemented to increase the engagement of communities in early basic life support (BLS) and cardiopulmonary resuscitation (CPR), especially of lay people with no duty to respond. A better knowledge of the most effective initiatives might help improve survival and health system organization. Aim of the scoping review: To assess the impact of specific interventions involving lay communities on bystander BLS rates and other consistent clinical outcomes, and to identify relevant knowledge gaps. METHODS This scoping review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR), and was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. We performed a literature search using the PubMed, EMBASE, and Cochrane databases until 1 February 2021. The screening process was conducted based on predefined inclusion/exclusion criteria, and for each included study, we performed data extraction focusing on the type of intervention implemented, and the impact of these interventions on the specific OHCAs outcomes. RESULTS Our search strategy identified 19 eligible studies, originating mainly from the USA (47.4%) and Denmark (21%). The type of intervention included in 57.9% of cases was a community CPR training program, in 36.8% bundled interventions, and in 5.3% mass-media campaigns. The most commonly reported outcome for OHCAs was bystander CPR rate (94.7%), followed by survival to hospital discharge (36.8%), proportion of people trained (31.6%), survival to hospital discharge with good neurological outcome (21%), and Return of Spontaneous Circulation (10.5%). Community training programs and bundled interventions improved bystander CPR in most of the included studies. CONCLUSION Based on the results of our scoping review, we identified the potential benefit of community initiatives, such as community training in BLS, even as part of bundled intervention, in order to improve bystander CPR rates and patient outcomes.
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Affiliation(s)
- Andrea Scapigliati
- Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (L.P.); (M.S.)
- Italian Resuscitation Council, 40128 Bologna, Italy; (D.Z.); (F.S.); (G.R.)
- Correspondence: ; Tel.: +39-630154507
| | - Drieda Zace
- Italian Resuscitation Council, 40128 Bologna, Italy; (D.Z.); (F.S.); (G.R.)
- Section of Hygiene, University Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, 00168 Rome, Italy;
| | - Tasuku Matsuyama
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan;
| | - Luca Pisapia
- Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (L.P.); (M.S.)
| | - Michela Saviani
- Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (L.P.); (M.S.)
| | - Federico Semeraro
- Italian Resuscitation Council, 40128 Bologna, Italy; (D.Z.); (F.S.); (G.R.)
- Department of Anaesthesia and Intensive Care and EMS, Maggiore Hospital Bologna, 40133 Bologna, Italy
| | - Giuseppe Ristagno
- Italian Resuscitation Council, 40128 Bologna, Italy; (D.Z.); (F.S.); (G.R.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Patrizia Laurenti
- Section of Hygiene, University Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, 00168 Rome, Italy;
| | - Janet E. Bray
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3400, Australia;
| | - Robert Greif
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
- School of Medicine, Sigmund Freud University Vienna, 1020 Vienna, Austria
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Abstract
The European Resuscitation Council (ERC) has produced these Systems Saving Lives guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include chain of survival, measuring performance of resuscitation, social media and smartphones apps for engaging community, European Restart a Heart Day, World Restart a Heart, KIDS SAVE LIVES campaign, lower-resource setting, European Resuscitation Academy and Global Resuscitation Alliance, early warning scores, rapid response systems, and medical emergency team, cardiac arrest centres and role of dispatcher.
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Greif R, Bhanji F, Bigham BL, Bray J, Breckwoldt J, Cheng A, Duff JP, Gilfoyle E, Hsieh MJ, Iwami T, Lauridsen KG, Lockey AS, Ma MHM, Monsieurs KG, Okamoto D, Pellegrino JL, Yeung J, Finn JC. Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2020; 142:S222-S283. [PMID: 33084395 DOI: 10.1161/cir.0000000000000896] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application.
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Greif R, Bhanji F, Bigham BL, Bray J, Breckwoldt J, Cheng A, Duff JP, Gilfoyle E, Hsieh MJ, Iwami T, Lauridsen KG, Lockey AS, Ma MHM, Monsieurs KG, Okamoto D, Pellegrino JL, Yeung J, Finn JC, Baldi E, Beck S, Beckers SK, Blewer AL, Boulton A, Cheng-Heng L, Yang CW, Coppola A, Dainty KN, Damjanovic D, Djärv T, Donoghue A, Georgiou M, Gunson I, Krob JL, Kuzovlev A, Ko YC, Leary M, Lin Y, Mancini ME, Matsuyama T, Navarro K, Nehme Z, Orkin AM, Pellis T, Pflanzl-Knizacek L, Pisapia L, Saviani M, Sawyer T, Scapigliati A, Schnaubelt S, Scholefield B, Semeraro F, Shammet S, Smyth MA, Ward A, Zace D. Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2020; 156:A188-A239. [PMID: 33098918 DOI: 10.1016/j.resuscitation.2020.09.014] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application.
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Berg KM, Cheng A, Panchal AR, Topjian AA, Aziz K, Bhanji F, Bigham BL, Hirsch KG, Hoover AV, Kurz MC, Levy A, Lin Y, Magid DJ, Mahgoub M, Peberdy MA, Rodriguez AJ, Sasson C, Lavonas EJ. Part 7: Systems of Care: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S580-S604. [PMID: 33081524 DOI: 10.1161/cir.0000000000000899] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Survival after cardiac arrest requires an integrated system of people, training, equipment, and organizations working together to achieve a common goal. Part 7 of the 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care focuses on systems of care, with an emphasis on elements that are relevant to a broad range of resuscitation situations. Previous systems of care guidelines have identified a Chain of Survival, beginning with prevention and early identification of cardiac arrest and proceeding through resuscitation to post-cardiac arrest care. This concept is reinforced by the addition of recovery as an important stage in cardiac arrest survival. Debriefing and other quality improvement strategies were previously mentioned and are now emphasized. Specific to out-of-hospital cardiac arrest, this Part contains recommendations about community initiatives to promote cardiac arrest recognition, cardiopulmonary resuscitation, public access defibrillation, mobile phone technologies to summon first responders, and an enhanced role for emergency telecommunicators. Germane to in-hospital cardiac arrest are recommendations about the recognition and stabilization of hospital patients at risk for developing cardiac arrest. This Part also includes recommendations about clinical debriefing, transport to specialized cardiac arrest centers, organ donation, and performance measurement across the continuum of resuscitation situations.
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Utilizing Advanced Telecommunication Strategies to Enhance the Response of Emergency Medical Services Volunteers. Disaster Med Public Health Prep 2020; 15:86-91. [PMID: 32000881 DOI: 10.1017/dmp.2019.126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Emergency medical services (EMS) provides a critical role in the rapid treatment, stabilization, and transfer of patients in the prehospital setting. The national EMS provider for Israel has developed a robust and unique organization of volunteers with advanced telecommunication strategies to activate and direct them in order to improve these processes. The volunteers include local high school students, international college students, emergency medical technicians, on-call volunteers, motorcyclists, and Life Guardian first responders. The telecommunication strategies include pagers, push-to-talk over cellular, and sophisticated smartphone-based software applications. These are monitored and directed via a central command and control station. Such processes, both on an organizational as well as technical level, can be adapted to improve prehospital emergency care.
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Viewing an ultra-brief chest compression only video improves some measures of bystander CPR performance and responsiveness at a mass gathering event. Resuscitation 2017; 118:96-100. [DOI: 10.1016/j.resuscitation.2017.07.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/09/2017] [Accepted: 07/10/2017] [Indexed: 11/15/2022]
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Tsunoyama T, Nakahara S, Yoshida M, Kitamura M, Sakamoto T. Effectiveness of dispatcher training in increasing bystander chest compression for out-of-hospital cardiac arrest patients in Japan. Acute Med Surg 2017; 4:439-445. [PMID: 29123905 PMCID: PMC5649305 DOI: 10.1002/ams2.303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/04/2017] [Indexed: 11/06/2022] Open
Abstract
Aim The Japanese government has developed a standardized training program for emergency call dispatchers to improve their skills in providing oral guidance on chest compression to bystanders who have witnessed out‐of‐hospital cardiac arrests (OHCAs). This study evaluated the effects of such a training program for emergency call dispatchers in Japan. Methods The analysis included all consecutive non‐traumatic OHCA patients transported to hospital by eight emergency medical services, where the program was implemented as a pilot project. We compared the provision of oral guidance and the incidence of chest compression applications by bystanders in the 1‐month period before and after the program. Data collection was undertaken from October 2014 to March 2015. Results The 532 non‐traumatic OHCA cases were used for analysis: these included 249 cases before and 283 after the guidance intervention. Most patients were over 75 years old and were men. After the program, provision of oral guidance to callers slightly increased from 63% of cases to 69% (P = 0.13) and implementation of chest compression on patients by bystanders significantly increased from 40% to 52% (P = 0.01). Appropriate chest compression also increased from 34% to 47% (P = 0.01). In analysis stratified by the provision of oral guidance, increased chest compressions were observed only under oral guidance. Conclusions We found increased provision of oral guidance by dispatchers and increased appropriate chest compressions by bystanders after the training program for dispatchers had been rolled out. Long‐term observation and further data analysis, including patient outcomes, are needed.
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Affiliation(s)
- Taichiro Tsunoyama
- Department of Emergency Medicine Teikyo University School of Medicine Tokyo Japan
| | - Shinji Nakahara
- Department of Emergency Medicine Teikyo University School of Medicine Tokyo Japan
| | - Masafumi Yoshida
- Department of Emergency Medicine Teikyo University School of Medicine Tokyo Japan
| | - Maki Kitamura
- Department of Emergency Medicine Teikyo University School of Medicine Tokyo Japan
| | - Tetsuya Sakamoto
- Department of Emergency Medicine Teikyo University School of Medicine Tokyo Japan
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Harjanto S, Na MXB, Hao Y, Ng YY, Doctor N, Goh ES, Leong BSH, Gan HN, Chia MYC, Tham LP, Cheah SO, Shahidah N, Ong MEH. A before-after interventional trial of dispatcher-assisted cardio-pulmonary resuscitation for out-of-hospital cardiac arrests in Singapore. Resuscitation 2016; 102:85-93. [PMID: 26944042 DOI: 10.1016/j.resuscitation.2016.02.014] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 02/10/2016] [Accepted: 02/17/2016] [Indexed: 11/17/2022]
Abstract
AIM To evaluate the effects of a comprehensive dispatcher-assisted CPR (DACPR) training program on bystander CPR (BCPR) rate and the outcomes of out-of-hospital cardiac arrest (OHCA) in Singapore. METHODS This is an initial program evaluation of a national DACPR intervention. A before-after analysis was conducted using OHCA cases retrieved from a local registry and DACPR information derived from audio recordings and ambulance notes. The primary outcomes were survival to admission, survival at 30 days post-arrest and good functional recovery. RESULTS Data was collected before the intervention (April 2010 to December 2011), during the run-in period (January 2012 to June 2012) and after the intervention (July 2012 to February 2013). A total of 2968 cases were included in the study with a mean age of 65.6. Overall survival rate was 3.9% (116) with good functional recovery in 2.2% (66) of the patients. BCPR rate increased from 22.4% to 42.1% (p<0.001) with odds ratio (OR) of 2.52 (95% confidence interval [CI]: 2.09-3.04) and ROSC increased significantly from 26.5% to 31.2% (p=0.02) with OR of 1.26 (95%CI: 1.04-1.53) after the intervention. Significantly higher survival at 30 days was observed for patients who received BCPR from a trained person as compared to no BCPR (p=0.001, OR=2.07 [95%CI: 1.41-3.02]) and DACPR (p=0.04, OR=0.30 [95%CI: 0.04-2.18]). CONCLUSION A significant increase in BCPR and ROSC was observed after the intervention. There was a trend to suggest improved survival outcomes with the intervention pending further results from the trial.
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Affiliation(s)
| | - May Xue Bi Na
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Hao
- Division of Research, Singapore General Hospital, Singapore, Singapore
| | - Yih Yng Ng
- Medical Department, Singapore Civil Defence Force, Singapore, Singapore
| | - Nausheen Doctor
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - E Shaun Goh
- Department of Acute and Emergency Care, Khoo Teck Puat Hospital, Singapore, Singapore
| | | | - Han Nee Gan
- Accident & Emergency, Changi General Hospital, Singapore, Singapore
| | | | - Lai Peng Tham
- Children's Emergency, KK Women's and Children's Hospital, Singapore, Singapore
| | - Si Oon Cheah
- Emergency Medicine Department, Alexandra Hospital, Singapore, Singapore
| | - Nur Shahidah
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Marcus Eng Hock Ong
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore; Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore.
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Agerskov M, Nielsen AM, Hansen CM, Hansen MB, Lippert FK, Wissenberg M, Folke F, Rasmussen LS. Public Access Defibrillation: Great benefit and potential but infrequently used. Resuscitation 2015; 96:53-8. [DOI: 10.1016/j.resuscitation.2015.07.021] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/18/2015] [Accepted: 07/22/2015] [Indexed: 11/30/2022]
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Birkenes TS, Myklebust H, Hardeland C, Kramer-Johansen J, Hock Ong ME, Shin SD, Panczyk M, Bobrow BJ. HOW to train for telephone-CPR. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2015. [DOI: 10.1016/j.tacc.2015.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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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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Ong MEH, Shin SD, Tanaka H, Ma MHM, Nishiuchi T, Lee EJ, Ko PCI, Edwin Doctor N, Khruekarnchana P, Naroo GY, Wong KD, Nakagawa T, Ryoo HW, Lin CH, Goh ES, Khunkhlai N, Alsakaf OA, Hisamuddin NABRN, Bobrow BJ, McNally B, Assam PN, Chan ESY. Rationale, Methodology, and Implementation of a Dispatcher-assisted Cardiopulmonary Resuscitation Trial in the Asia-Pacific (Pan-Asian Resuscitation Outcomes Study Phase 2). PREHOSP EMERG CARE 2014; 19:87-95. [PMID: 25152997 DOI: 10.3109/10903127.2014.942482] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Background. Survival outcomes from out-of-hospital cardiac arrest (OHCA) in Asia are poor (2-11%). Bystander cardiopulmonary resuscitation (CPR) rates are relatively low in Asia. Dispatcher-assisted CPR (DA-CPR) has recently emerged as a potentially cost-effective intervention to increase bystander CPR and survival from OHCA. The Pan-Asian Resuscitation Outcomes Study (PAROS), an Asia-Pacific cardiac arrest registry, was set up in 2009, with the aim of understanding OHCA as a disease in Asia and improving OHCA survival. The network has adopted DA-CPR as part of its strategy to improve OHCA survival. Objective. This article aims to describe the conceptualization, study design, potential benefits, and difficulties for implementation of DA-CPR trial in the Asia-Pacific. Methods. Two levels of intervention, basic and comprehensive, will be offered to PAROS participating sites. The basic level consists of implementation of a DA-CPR protocol and training program, while the comprehensive level consists of implementation of the basic level, with the addition of a dispatch quality measurement tool, quality improvement program, and community education program. Sites that are not able to implement the package will contribute control data. The primary outcome of the study is survival to hospital discharge or survival to 30 days post cardiac arrest. DA-CPR and bystander CPR are secondary outcomes. Conclusion. Implementation of DA-CPR requires concerted efforts by EMS leaders and supervisors, dispatchers, hospital stakeholders, policy makers, and the general public. The DA-CPR trial implemented by the PAROS sites, if successful, can serve as a model for other countries considering such an intervention in their EMS systems.
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Georgiou M, Lockey AS. ERC initiatives to reduce the burden of cardiac arrest: The European Cardiac Arrest Awareness Day. Best Pract Res Clin Anaesthesiol 2013; 27:307-15. [DOI: 10.1016/j.bpa.2013.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 07/23/2013] [Indexed: 10/26/2022]
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Vaillancourt C, Kasaboski A, Charette M, Islam R, Osmond M, Wells GA, Stiell IG, Brehaut JC, Grimshaw JM. Barriers and facilitators to CPR training and performing CPR in an older population most likely to witness cardiac arrest: a national survey. Resuscitation 2013; 84:1747-52. [PMID: 23989115 DOI: 10.1016/j.resuscitation.2013.08.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/11/2013] [Accepted: 08/08/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bystander CPR rates are lowest at home, where 85% of out-of-hospital cardiac arrests occur. We sought to identify barriers and facilitators to CPR training and performing CPR among older individuals most likely to witness cardiac arrest. METHODS We selected independent-living Canadians aged ≥55 using random-digit-dial telephone calls. Respondents were randomly assigned to answer 1 of 2 surveys eliciting barriers and facilitators potentially influencing either CPR training or performance. We developed survey instruments using the Theory of Planned Behavior, measuring salient attitudes, social influences, and control beliefs. RESULTS Demographics for the 412 respondents (76.4% national response rate): Mean age 66, 58.7% female, 54.9% married, 58.0% CPR trained (half >10 years ago). Mean intentions to take CPR training in the next 6 months or to perform CPR on a victim were relatively high (3.6 and 4.1 out of 5). Attitudinal beliefs were most predictive of respondents' intentions to receive training or perform CPR (Adjusted OR; 95%CI were 1.81; 1.41-2.32 and 1.63; 1.26-2.04 respectively). Respondents who believed CPR could save a life, were employed, and had seen CPR advertised had the highest intention to receive CPR training. Those who believed CPR should be initiated before EMS arrival, were proactive in a group, and felt confident in their CPR skills had the highest intention to perform CPR. INTERPRETATION Attitudinal beliefs were most predictive of respondents' intention to complete CPR training or perform CPR on a real victim. Behavioral change techniques targeting these specific beliefs are most likely to make an impact.
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Affiliation(s)
- Christian Vaillancourt
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada; Department of Epidemiology and Community Medicine, University of Ottawa, ON, Canada.
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Nielsen AM, Isbye DL, Lippert FK, Rasmussen LS. Can mass education and a television campaign change the attitudes towards cardiopulmonary resuscitation in a rural community? Scand J Trauma Resusc Emerg Med 2013; 21:39. [PMID: 23675991 PMCID: PMC3666962 DOI: 10.1186/1757-7241-21-39] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 05/09/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Survival after out-of-hospital cardiac arrest (OHCA) is improved when bystanders provide Basic Life Support (BLS). However, bystander BLS does not occur frequently. The aim of this study was to assess the effects on attitudes regarding different aspects of resuscitation of a one-year targeted media campaign and widespread education in a rural Danish community. Specifically, we investigated if the proportion willing to provide BLS and deploy an automated external defibrillator (AED) increased. METHODS BLS and AED courses were offered and the local television station had broadcasts about resuscitation in this study community. A telephone enquiry assessed the attitudes towards different aspects of resuscitation among randomly selected citizens before (2008) and after the project (2009). RESULTS For responses from 2008 (n = 824) to 2009 (n = 815), there was a significant increase in the proportions who had participated in a BLS course within the past 5 years, from 34% to 49% (p = 0.0001), the number willing to use an AED on a stranger (p < 0.0001), confident at providing chest compressions (p = 0.03), and confident at providing mouth-to-mouth ventilations (MMV) (p = 0.048). There was no significant change in the proportions willing to provide chest compressions (p = 0.15), MMV (p = 0.23) or confident at recognizing a cardiac arrest (p = 0.09). The most frequently reported reason for not being willing to provide chest compressions, MMV and use an AED was insecurity about how to perform the task. CONCLUSION A targeted media campaign and widespread education can significantly increase the willingness to use an AED, and the confidence in providing chest compressions and MMV. The willingness to provide chest compressions and MMV may be less influenced by a targeted campaign.
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Affiliation(s)
- Anne Møller Nielsen
- Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Vaillancourt C, Charette M, Kasaboski A, Brehaut JC, Osmond M, Wells GA, Stiell IG, Grimshaw J. Barriers and facilitators to CPR knowledge transfer in an older population most likely to witness cardiac arrest: a theory-informed interview approach. Emerg Med J 2013; 31:700-5. [PMID: 23636603 DOI: 10.1136/emermed-2012-202192] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND We sought to identify perceived barriers and facilitators to cardiopulmonary resuscitation (CPR) training and performing CPR among people above the age of 55 years. METHODS We conducted semistructured qualitative interviews with a purposive sample of independent-living individuals aged 55 years and older from urban and rural settings. We developed an interview guide based on the constructs of the Theory of Planned Behaviour, which elicits salient attitudes, social influences and control beliefs potentially influencing CPR training and performance. Interviews were recorded, transcribed verbatim and analysed until achieving data saturation. Two independent reviewers performed inductive analyses to identify emerging themes, and ranked them by way of consensus. RESULTS Demographics for the 24 interviewees: mean age 71.4 years, women 58.3%, urban location 75.0%, single dwelling 58.3%, CPR training 79.2% and prior CPR on real victim 8.3%. Facilitators of CPR training included: (1) classes in a convenient location; (2) more advertisements; and (3) having a spouse. Barriers to taking CPR training included: (1) perception of physical limitations; (2) time commitment; and (3) cost. Facilitators of providing CPR included: (1) 9-1-1 CPR instructions; (2) reminders/pocket cards; and (3) frequent but brief updates. Barriers to providing CPR included: (1) physical limitations; (2) lack of confidence; and (3) ambivalence of duty to act in a large group. CONCLUSIONS We identified key facilitators and barriers for CPR training and performance in a purposive sample of individuals aged 55 years and older.
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Affiliation(s)
- Christian Vaillancourt
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Manya Charette
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Ann Kasaboski
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Jamie C Brehaut
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Martin Osmond
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - George A Wells
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian G Stiell
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeremy Grimshaw
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Møller Nielsen A, Lou Isbye D, Knudsen Lippert F, Rasmussen LS. Engaging a whole community in resuscitation. Resuscitation 2012; 83:1067-71. [PMID: 22561466 DOI: 10.1016/j.resuscitation.2012.04.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 03/08/2012] [Accepted: 04/22/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Survival after out-of-hospital cardiac arrest (OHCA) is influenced by each link in the chain of survival. On the Danish island of Bornholm (population 42,000, area 588 km2) none survived an OHCA in 2001-2003. Therefore, we designed a multifaceted community-based approach aiming at strengthening each link in the chain of survival. The purpose of this study was to evaluate the effect of implementation of the intervention on bystander basic life support (BLS) rates and survival to hospital discharge after OHCA. METHODS Laypersons completed 24-min DVD-based-self-instruction BLS courses in schools and workplaces or 4-h BLS/automated external defibrillator (AED) courses. The local television station had broadcasts about resuscitation. The ambulance personnel were trained and the staff at the island hospital completed BLS courses or more advanced courses. RESULTS During 2 years 9226 people (22% of the population) completed the short course and 2453 (6% of the population) completed the 4-h course. The number of AEDs increased from 3 to 147. The bystander BLS rate for OHCAs with a presumed cardiac aetiology (N=96, incidence 114/100,000 person-years) was 47% [95% CI 30-50] and for witnessed OHCAs (N=35) it increased significantly from 22% (2004) to 74% [95% CI 58-86]. The AEDs were deployed in 9 cases. Survival to discharge for all-rhythms OHCA was 5.4% [95% CI 2-12], and for witnessed ventricular fibrillation (N=17) 18% [95% CI 5-42]. CONCLUSION Strengthening all links in the chain of survival was associated with significant increases in bystander BLS rates and survival after OHCA on a rural island.
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Affiliation(s)
- Anne Møller Nielsen
- Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
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Bray JE, Deasy C, Walsh J, Bacon A, Currell A, Smith K. Changing EMS dispatcher CPR instructions to 400 compressions before mouth-to-mouth improved bystander CPR rates. Resuscitation 2011; 82:1393-8. [DOI: 10.1016/j.resuscitation.2011.06.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 05/05/2011] [Accepted: 06/13/2011] [Indexed: 11/17/2022]
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Bjørshol CA, Lindner TW, Søreide E, Moen L, Sunde K. Hospital employees improve basic life support skills and confidence with a personal resuscitation manikin and a 24-min video instruction. Resuscitation 2009; 80:898-902. [PMID: 19573973 DOI: 10.1016/j.resuscitation.2009.06.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Revised: 05/28/2009] [Accepted: 06/05/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The use of a personal resuscitation manikin with video instruction is reportedly as effective as traditional instructor-led courses in teaching lay people basic life support (BLS). We applied this method to an entire hospital staff to determine its effect on their practical and self-judged BLS skills. METHODS All 5382 employees at Stavanger University Hospital were asked to learn or refresh their BLS skills with the personal resuscitation manikin and video instruction. Prior to and nine months after training, all employees were asked to rate their BLS skills on a scale from one to five. Additionally, randomly chosen study subjects were tested for BLS skills pre-training and six months post-training during 2min of resuscitation on a manikin. RESULTS In total, 5118 employees took part in the BLS training program. The number of correct chest compressions increased significantly from 60 (5-102) to 119 (75-150) in the pre- vs. post-training periods, respectively, P<0.01, but the number of correct MTM ventilations did not change. Self-reported BLS skills increased from 3.1 (+/-1.0) pre-training to 3.8 (+/-0.8) post-training, P=0.031. CONCLUSION After distributing a personal resuscitation manikin with video instruction to an entire hospital staff, the median number of correctly performed chest compressions doubled and self-confidence in BLS skills improved significantly. This is a simple and less time-consuming method than instructor-led courses in preparing hospital employees in the basic handling of cardiac arrest.
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Affiliation(s)
- Conrad Arnfinn Bjørshol
- Department of Anaesthesia and Intensive Care Medicine, Stavanger University Hospital, Stavanger, Norway.
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Impact of a self-instruction CPR kit on 7th graders’ and adults’ skills and CPR performance. Resuscitation 2008; 79:103-8. [DOI: 10.1016/j.resuscitation.2008.04.030] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Revised: 04/10/2008] [Accepted: 04/27/2008] [Indexed: 11/18/2022]
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Isbye DL, Rasmussen LS, Ringsted C, Lippert FK. Disseminating cardiopulmonary resuscitation training by distributing 35,000 personal manikins among school children. Circulation 2007; 116:1380-5. [PMID: 17724257 DOI: 10.1161/circulationaha.107.710616] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Because most cardiac arrests occur at home, widespread training is needed to increase the incidence of cardiopulmonary resuscitation (CPR) by lay persons. The aim of this study was to evaluate the effect of mass distribution of CPR instructional materials among schoolchildren. METHODS AND RESULTS We distributed 35,002 resuscitation manikins to pupils (12 to 14 years of age) at 806 primary schools. Using the enclosed 24-minute instructional DVD, they trained in CPR and subsequently used the kit to train family and friends (second tier). They completed a questionnaire on who had trained in CPR using the kit. Teachers also were asked to evaluate the project. The incidence of bystander CPR in out-of-hospital cardiac arrest in the months following the project was compared with the previous year. In total, 6947 questionnaires (19.8%) were returned. The 6947 kits had been used to train 17,140 from the second tier (mean, 2.5 persons per pupil; 95% confidence interval, 2.4 to 2.5). The teachers had used a mean of 64 minutes (95% confidence interval, 60 to 68) for preparation and a mean of 13 minutes (95% confidence interval, 11 to 15) to tidy up. Incidence of bystander CPR in the months after the project did not increase significantly compared with the previous year (25.0% versus 27.9%; P=0.16). CONCLUSIONS CPR training can be disseminated in a population by distributing personal resuscitation manikins among children in primary schools. The teachers felt able to easily facilitate CPR training. The incidence of bystander CPR did not increase significantly in the months following the project.
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Affiliation(s)
- Dan L Isbye
- Department of Anesthesia, Section 4231, Center of Head and Orthopedics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
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Grmec S, Krizmaric M, Mally S, Kozelj A, Spindler M, Lesnik B. Utstein style analysis of out-of-hospital cardiac arrest—Bystander CPR and end expired carbon dioxide. Resuscitation 2007; 72:404-14. [PMID: 17161518 DOI: 10.1016/j.resuscitation.2006.07.012] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2005] [Revised: 07/17/2006] [Accepted: 07/17/2006] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The aim of this prospective cohort study was to describe the outcome for patients with out-of-hospital cardiac arrest in Maribor (Slovenia) over a 4 year period using a modified Utstein style, and to investigate elementary knowledge of basic life support among potential bystanders in our community. PATIENTS AND METHODS Through the prehospital and the hospital database system we followed up a consecutive group of patients with out-of-hospital cardiac arrest (OHCA) between January 2001 and December 2004. We investigated the effects of various factors on outcome in OHCA, especially partial end-tidal CO2 pressure (petCO2), efficacy of bystander CPR and their elementary knowledge of basic life support (BLS). We also examined motivation among potential bystanders and possible implementation for BLS education in our community. RESULTS OHCA was confirmed in 592 patients. Advanced cardiac life support was initiated in 389 patients, of which 277 were of cardiac aetiology. In 287 patients the event was bystanders witnessed and lay-bystander basic life support was performed only in 83 (23%). After treating OHCA by a physician-based prehospital medical team ROSC was obtained in 61%, the ROSC on admission was 50% and the overall survival to discharge was 21%. Initial petCO2 (OR: 22.04; 95%CI: 11.41-42.55), ventricular fibrillation or pulseless ventricular tachycardia as initial rhythm (OR: 2.13; 95%CI: 1.17-4.22), bystander CPR (OR: 2.55; 95%CI: 1.13-5.73), female sex (OR: 3.08; 95%CI: 1.49-6.38) and arrival time (OR: 1.29; 95%CI: 1.11-1.82) were associated with improved ROSC when using multivariate analysis. Using the same method we found that bystander CPR (OR: 5.05; 95%CI: 2.24-11.39), witnessed arrest (OR: 9.98; 95%CI: 2.89-34.44), final petCO2 (OR: 2.37; 95%CI: 1.67-3.37), initial petCO2 (OR: 1.61; 95%CI: 1.28-2.64) and arrival time (OR: 1.39; 95%CI: 1.33-1.60) were associated with improved survival. A questionnaire to potential bystanders has revealed disappointing knowledge about BLS fundamentals. On the other side, there is a welcomed willingness of potential bystanders to take BLS training and to follow dispatchers instructions by telephone on how to perform CPR. CONCLUSION After OHCA in a physician-based prehospital setting in our region, the overall survival to discharge was 21%. The potential bystander in our community is generally poorly educated in performing CPR, but willing to gain knowledge and skills in BLS and to follow dispatchers instructions. Arrival time, witnessed arrest, bystander CPR, initial petCO2 and final petCO2 were significantly positively related with ROSC on admission and with survival. Prehospital data from this and previous studies provide strong support for a petCO2 of 1.33 kPa to be a resuscitation threshold in the field. In our opinion the initial value of petCO2 should be included in every Utstein style analysis.
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Affiliation(s)
- Stefek Grmec
- Centre for Emergency Medicine Maribor, Ulica talcev 9, 2000 Maribor, Slovenia.
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Fleischhackl R, Foitik G, Czech G, Roessler B, Mittlboeck M, Domanovits H, Hoerauf K. Reaching the public via a multi media campaign as a first step to nationwide public access defibrillation. Resuscitation 2006; 69:269-75. [PMID: 16631300 DOI: 10.1016/j.resuscitation.2005.07.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Revised: 07/18/2005] [Accepted: 07/27/2005] [Indexed: 10/24/2022]
Abstract
Public access defibrillation (PAD) is a promising strategy to fight sudden cardiac death. The Austrian Red Cross provided automated external defibrillators (AEDs) and basic life support (BLS) training as an "all inclusive package" combined with on site consultation and maintenance with annual retraining as a part of a nationwide PAD programme. A multi media campaign was started to promote the package and to increase awareness about sudden cardiac death. Data about the campaign, its recognition by the public in Austria and the number of packages were recorded. Sixty-eight percent of the Austrian public above the age of 15 years were able to recall the multi media campaign. Comparing the periods before and after the campaign, the number of website hits climbed significantly from 2,931 hits/month (1,866-6,168) to 4,812 hits/month (3,432-13,434) (p=0.0276). The number of AED services implemented before the campaign increased significantly (p=0.0026) in the time after the campaign. Therefore, we conclude that a multi media campaign is useful to stimulate public discussion and it encourages companies to buy "all inclusive packages" containing AEDs, BLS training, on site consultation and maintenance. These measures represent a possible first step in introducing PAD but it seems that they have to be continued on a constant basis.
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Young KD, Gausche-Hill M, McClung CD, Lewis RJ. A prospective, population-based study of the epidemiology and outcome of out-of-hospital pediatric cardiopulmonary arrest. Pediatrics 2004; 114:157-64. [PMID: 15231922 DOI: 10.1542/peds.114.1.157] [Citation(s) in RCA: 259] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study reports the epidemiologic features, survival rates, and neurologic outcomes of the largest population-based series of pediatric out-of-hospital cardiopulmonary arrest patients with prospectively collected data. METHODS Secondary analysis of data from a prospective, interventional trial of out-of-hospital pediatric airway management conducted from 1994 to 1997 (Gausche M, Lewis RJ, Stratton SJ, et al. JAMA. 2000;283:783-790). Consecutive out-of-hospital patients from 2 large urban counties in California <12 years old or 40 kg in bodyweight who were determined by paramedics to be pulseless and apneic were included. Main outcome measures included survival to hospital discharge, patient demographics, arrest etiology, arrest rhythm, event intervals, and neurologic outcomes. RESULTS In 599 patients, 601 events were studied (54% were <1 year old, 58% were male). Return of spontaneous circulation was achieved in 29%; 25% were admitted to the hospital, and 8.6% (51) survived to hospital discharge. The most prevalent etiologies were sudden infant death syndrome and trauma; these resulted in relatively higher mortality. Respiratory etiologies and submersions followed; these resulted in relatively lower mortality. Twenty-six percent of the arrests were witnessed by citizens, and an additional 8% were witnessed by rescue personnel. Witnessed arrests had a higher survival rate (16%). Thirty-one percent of patients received bystander cardiopulmonary resuscitation, which was not demonstrated to result in improved survival rates. Arrest rhythms were asystole (67%), pulseless electrical activity (24%), and ventricular fibrillation (9%); children with the latter 2 rhythms had better survival rates. One third of the survivors (16 of 51) had good neurologic outcome, none of whom received >3 doses of epinephrine or were resuscitated for >31 minutes in the emergency department. CONCLUSIONS The 8.6% survival rate after out-of-hospital pediatric cardiopulmonary arrest is poor. Administration of >3 doses of epinephrine or prolonged resuscitation is futile.
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Affiliation(s)
- Kelly D Young
- Department of Pediatrics, David Geffen University of California Los Angeles School of Medicine, Los Angeles, California, USA.
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Swor R, Compton S. E STIMATINGC OST-E FFECTIVENESS OFM ASSC ARDIOPULMONARYR ESUSCITATIONT RAININGS TRATEGIES TOI MPROVES URVIVAL FROMC ARDIACA RREST INP RIVATEL OCATIONS. PREHOSP EMERG CARE 2004. [DOI: 10.1080/312704000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Swor R, Compton S, Farr L, Kokko S, Vining F, Pascual R, Jackson RE. Perceived Self-Efficacy in Performing and Willingness to Learn Cardiopulmonary Resuscitation in an Elderly Population in a Suburban Community. Am J Crit Care 2003. [DOI: 10.4037/ajcc2003.12.1.65] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
• Background Older persons are the group most likely to respond to cardiac arrests in private residences.
• Objective To characterize the knowledge about, attitudes toward, and perceived self-efficacy of older persons in learning and providing cardiopulmonary resuscitation.
• Methods A total of 2743 surveys were mailed to adults 55 years and older who resided in a single Michigan suburb. Data were collected on demographics, medical history, training in and willingness to provide cardiopulmonary resuscitation, and concerns about providing this intervention.
• Results The 631 persons (24.6%) who responded were elderly (mean age, 73.5 years) and had a mean of 1.7 occupants per household. More than one third lived alone. Of all respondents, 275 (43.6%) had received training in cardiopulmonary resuscitation, 370 (58.6%) indicated a willingness to learn cardiopulmonary resuscitation, and 412 (65.3%) thought that they had the ability to perform this intervention. Respondents 80 years or younger were significantly more likely than respondents more than 80 years old to be willing to learn cardiopulmonary resuscitation (65.7% vs 19.0%, P < .001) and perceived themselves as able to perform it (73.0% vs 34.0%, P < .001). The absence of mouth-to-mouth ventilation as part of training had minimal impact on the willingness of either age group to receive training (61.2% vs 58.6%, P = .19). Perceived ability to learn and perform cardiopulmonary resuscitation did not vary with the medical history of the respondent or the respondent’s spouse.
• Conclusion Adults 56 to 80 years old perceive themselves as able to perform cardiopulmonary resuscitation and are interested in receiving training.
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Affiliation(s)
- Robert Swor
- The Department of Emergency Medicine (RS, SC, RP, REJ) and the Department of Nursing Development and Educational Resources (LF, SK, FV), William Beaumont Hospital, Royal Oak, Mich
| | - Scott Compton
- The Department of Emergency Medicine (RS, SC, RP, REJ) and the Department of Nursing Development and Educational Resources (LF, SK, FV), William Beaumont Hospital, Royal Oak, Mich
| | - Lynn Farr
- The Department of Emergency Medicine (RS, SC, RP, REJ) and the Department of Nursing Development and Educational Resources (LF, SK, FV), William Beaumont Hospital, Royal Oak, Mich
| | - Sue Kokko
- The Department of Emergency Medicine (RS, SC, RP, REJ) and the Department of Nursing Development and Educational Resources (LF, SK, FV), William Beaumont Hospital, Royal Oak, Mich
| | - Fern Vining
- The Department of Emergency Medicine (RS, SC, RP, REJ) and the Department of Nursing Development and Educational Resources (LF, SK, FV), William Beaumont Hospital, Royal Oak, Mich
| | - Rebecca Pascual
- The Department of Emergency Medicine (RS, SC, RP, REJ) and the Department of Nursing Development and Educational Resources (LF, SK, FV), William Beaumont Hospital, Royal Oak, Mich
| | - Raymond E. Jackson
- The Department of Emergency Medicine (RS, SC, RP, REJ) and the Department of Nursing Development and Educational Resources (LF, SK, FV), William Beaumont Hospital, Royal Oak, Mich
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Part 1: introduction to the International Guidelines 2000 for CPR and ECC. A consensus on science. European Resuscitation Council. Resuscitation 2000; 46:3-15. [PMID: 10978786 DOI: 10.1016/s0300-9572(00)00269-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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