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Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, Fernanda de Almeida M, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Daripa Kawakami M, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, John Madar R, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Gene Ong YK, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Resuscitation 2024; 195:109992. [PMID: 37937881 DOI: 10.1016/j.resuscitation.2023.109992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
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Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, de Almeida MF, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, Madar RJ, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Ong YKG, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation 2023; 148:e187-e280. [PMID: 37942682 PMCID: PMC10713008 DOI: 10.1161/cir.0000000000001179] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
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Breckwoldt J, Cheng A, Lauridsen KG, Lockey A, Yeung J, Greif R. Stepwise approach to skills teaching in resuscitation: A systematic review. Resusc Plus 2023; 16:100457. [PMID: 37674547 PMCID: PMC10477803 DOI: 10.1016/j.resplu.2023.100457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
Aim To compare the effectiveness of Peyton's four-step approach for teaching resuscitation skills with alternative approaches. Methods For this systematic review, we followed the PICOST format (population, intervention, comparison, outcome, study design, timeframe) using Peyton's four-step approach as the standard. We included all studies analyzing skills training related to resuscitation and First Aid in any educational setting. Eligible were randomized controlled trials (RCTs) and non-randomized studies (non-randomized controlled trials, interrupted time series, controlled before-and-after studies, cohort studies, published conference abstracts, and case series where n ≥ 5). We excluded unpublished results (e.g. trial protocols), commentaries, editorials, reviews. Medline, Embase, PsycINFO, ERIC, CINAHL, and Cochrane were searched from inception until November 10, 2020 (updated November 25, 2022) for publications in all languages as long as there was an English abstract. Titles and abstracts of the papers retrieved were screened, and eligible publications were analysed in full text. From the final set of papers, data were extracted into a spreadsheet, subsequently risk of bias assessment was performed (using RoB2 and ROBINS-I), and the certainty of evidence (using GRADE) for each paper was assessed. Screening of studies, data extraction, risk-of-bias assessment, and assessment of certainty of evidence were all performed by two independent researchers. This review was conducted in adherence with PRISMA standards and was registered with PROSPERO (CRD42023377398). Results Overall, the search identified 2,574 studies from which 17 were included in the final analysis (14 RCTs, and 3 non-RCTs). The studies involved a total of 2,906 participants from various populations (from lay persons to health care professionals) and analysed nine different resuscitation skills being taught (ranging from chest compressions to needle cricotomy). The alternative teaching approaches ranged from two-steps to five-steps with various modifications of single steps. High methodological and clinical heterogeneity precluded a meta-analysis from being conducted. The risk of bias assessment showed considerable variation between the studies ranging from 'low' to 'serious'. Across all studies, certainty of evidence was rated as very low due to imprecision and inconsistency. Overall, 14 out of 17 studies showed no difference in skill acquisition or retention when comparing Peyton's four steps to other stepwise approaches. Conclusions Very low certainty evidence suggest that Peyton's four-step approach was not more effective in resuscitation skills training compared to alternative approaches. Funding None.
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Affiliation(s)
- Jan Breckwoldt
- Institute of Anesthesiology, Zurich University Hospital, University of Zurich, Zurich, Switzerland
| | - Adam Cheng
- Departments of Pediatrics and Emergency Medicine, University of Calgary, Calgary, Canada
| | - Kasper G. Lauridsen
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Medicine, Randers Regional Hospital, Randers, Denmark
| | - Andrew Lockey
- Emergency Department, Calderdale & Huddersfield NHS Trust, Halifax, UK
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Joyce Yeung
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Robert Greif
- University of Bern, Bern, Switzerland
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
| | - Education Implementation Team Task Force of the International Liaison Committee on Resuscitation ILCOR1
- Institute of Anesthesiology, Zurich University Hospital, University of Zurich, Zurich, Switzerland
- Departments of Pediatrics and Emergency Medicine, University of Calgary, Calgary, Canada
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Medicine, Randers Regional Hospital, Randers, Denmark
- Emergency Department, Calderdale & Huddersfield NHS Trust, Halifax, UK
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- University of Bern, Bern, Switzerland
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
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Performing Simulated Basic Life Support without Seeing: Blind vs. Blindfolded People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010724. [PMID: 34682471 PMCID: PMC8536197 DOI: 10.3390/ijerph182010724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/24/2021] [Accepted: 10/04/2021] [Indexed: 01/08/2023]
Abstract
Previous pilot experience has shown the ability of visually impaired and blind people (BP) to learn basic life support (BLS), but no studies have compared their abilities with blindfolded people (BFP) after participating in the same instructor-led, real-time feedback training. Twenty-nine BP and 30 BFP participated in this quasi-experimental trial. Training consisted of a 1 h theoretical and practical training session with an additional 30 min afterwards, led by nurses with prior experience in BLS training of various collectives. Quantitative quality of chest compressions (CC), AED use and BLS sequence were evaluated by means of a simulation scenario. BP’s median time to start CC was less than 35 s. Global and specific components of CC quality were similar between groups, except for compression rate (BFP: 123.4 + 15.2 vs. BP: 110.8 + 15.3 CC/min; p = 0.002). Mean compression depth was below the recommended target in both groups, and optimal CC depth was achieved by 27.6% of blind and 23.3% of blindfolded people (p = 0.288). Time to discharge was significantly longer in BFP than BP (86.0 + 24.9 vs. 66.0 + 27.0 s; p = 0.004). Thus, after an adapted and short training program, blind people were revealed to have abilities comparable to those of blindfolded people in learning and performing the BLS sequence and CC.
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Nguyen DT, Lauridsen KG, Krogh K, Løfgren B. Bystander performance using the 2010 vs 2015 ERC guidelines: A post-hoc analysis of two randomised simulation trials. Resusc Plus 2021; 6:100123. [PMID: 34223381 PMCID: PMC8244366 DOI: 10.1016/j.resplu.2021.100123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/26/2021] [Accepted: 04/04/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The European Resuscitation Council (ERC) basic life support (BLS) 2015 guidelines were simplified compared to the 2010 guidelines. We aimed to compare BLS/automated external defibrillator (AED) skill performance and skill retention following training with the 2010 or 2015 BLS/AED guidelines. METHODS Post-hoc analysis of two randomised simulation trials including videorecordings of laypersons skill-tested after ERC BLS/AED training using either the 2010 (n = 70) or 2015 (n = 70) BLS guidelines. Outcomes: (a) correct sequence of the BLS/AED algorithm, (b) correct sequence of the BLS/AED algorithm with all skills performed correctly, and (c) time to EMS call, first chest compression and shock delivery immediately after training and three months later. Groups were compared using multivariate logistic regression. RESULTS Mean age (±standard deviation) was 40 (±11) vs. 44 (±11) years and 70% vs. 50% were females for the 2010 and 2015 groups, respectively. Correct sequence of the BLS/AED algorithm for the 2010 vs. 2015 group was 84% vs. 91%, P = 0.08 immediately after training and 16% vs. 41%, adjusted odds ratio (aOR): 5.6 (95% CI: 2.3-14.0, P < 0.001) after three months. Correct sequence with all skills performed correctly was 56% vs. 47%, P = 0.31 immediately after training and 5% vs. 16%, aOR: 4.8 (95% CI: 1.2-19.2), P = 0.03 after three months. Time to EMS call was shorter in the 2015 group immediately after training (P = 0.008) but all other time points did not differ. CONCLUSION The simplified 2015 BLS guidelines was associated with better adherence to the sequence of the BLS/AED algorithm when compared to the 2010 BLS guidelines three months after training in a simulated cardiac arrest scenario, without significantly improving skill performance immediately after training.
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Affiliation(s)
- Dung Thuy Nguyen
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
- Clinical Research Unit, Randers Regional Hospital, Randers, Denmark
| | - Kasper Glerup Lauridsen
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
- Clinical Research Unit, Randers Regional Hospital, Randers, Denmark
- Department of Medicine, Randers Regional Hospital, Randers, Denmark
- Center for Simulation, Advanced Education, and Innovation, Children's Hospital of Philadelphia, USA
| | - Kristian Krogh
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Anaesthesiology and Intensive Care, Viborg Regional Hospital, Denmark
| | - Bo Løfgren
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Medicine, Randers Regional Hospital, Randers, Denmark
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
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Stærk M, Vammen L, Andersen CF, Krogh K, Løfgren B. Basic life support skills can be improved among certified basic life support instructors. Resusc Plus 2021; 6:100120. [PMID: 34223379 PMCID: PMC8244352 DOI: 10.1016/j.resplu.2021.100120] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/03/2021] [Accepted: 03/29/2021] [Indexed: 11/29/2022] Open
Abstract
Background A correct visual skill demonstration is important when learning cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator (AED). Basic life support (BLS) instructors are expected to master and demonstrate CPR/AED skills correctly. The aim of this study was to evaluate certified BLS instructors’ competencies in demonstrating CPR and the use of an AED. Methods Certified BLS instructors demonstrated CPR and the use of an AED on a resuscitation manikin. Skills were evaluated using data collected from the manikin and video recordings and compared to resuscitation guidelines. Further, instructors completed questionnaires on resuscitation guidelines and rating of their own CPR/AED skills. Results Overall, we analyzed data from 125 instructors. Of all chest compressions, only 22% were within guideline recommendations regarding depth. Instructors performed chest compressions with excessive depth (mean depth 64 mm (7.3)) and a mean rate of 115 min−1 (10.8). Only 25% of instructors placed the left AED electrode correctly (median distance 7.6 cm (5.0;10.5)), while the right AED electrode usually was placed correctly (median distance 2.9 cm (1.5;4.0), 85% placed correctly). Nearly half of the instructors failed to state correct answers regarding how to diagnose a cardiac arrest and where to place the AED electrodes. Despite their performance, instructors rated their BLS skills as good. Conclusion Certified BLS instructors’ have poor CPR/AED skills and several important knowledge gaps on CPR/AED guidelines in contrast to instructors’ self-reported skills. This highlights a need for improving BLS instructor education, including continuous faculty development to ensure optimal learning conditions for BLS course participants.
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Affiliation(s)
- Mathilde Stærk
- Department of Internal Medicine, Randers Regional Hospital, Randers, Denmark.,Education and Research, Randers Regional Hospital, Randers, Denmark.,Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lauge Vammen
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - Camilla Fuchs Andersen
- Department of Internal Medicine, Randers Regional Hospital, Randers, Denmark.,Education and Research, Randers Regional Hospital, Randers, Denmark.,Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Cardiology, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Kristian Krogh
- Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Bo Løfgren
- Department of Internal Medicine, Randers Regional Hospital, Randers, Denmark.,Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Comparison of Long-Term Effects between Chest Compression-Only CPR Training and Conventional CPR Training on CPR Skills among Police Officers. Healthcare (Basel) 2021; 9:healthcare9010034. [PMID: 33401707 PMCID: PMC7824449 DOI: 10.3390/healthcare9010034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/24/2020] [Accepted: 12/29/2020] [Indexed: 12/22/2022] Open
Abstract
Despite of the changes of out-of-hospital cardiac arrest (OHCA) survival rise when bystander CPR is provided, this was only conducted in about 23% of OHCA patients in Korea in 2018. Police officers acting as first responders have a high chance of witnessing situations requiring CPR. We investigated long-term effects on CPR quality between chest compression-only CPR training and conventional CPR training in police officers to find an efficient CPR training method in a prospective, randomized, controlled trial. Police officers underwent randomization and received different CPR training. With the Brayden Pro application, we compared the accuracy of CPR skills immediately after training and the one after 3 months. Right after training, the conventional CPR group presented the accuracy of the CPR skills (compression rate: 74.6%, compression depth: 66.0%, recoil: 78.0%, compression position: 96.1%) and chest compression-only CPR group presented the accuracy of the CPR skills (compression rate: 74.5%, compression depth: 71.6%, recoil: 79.2%, compression position: 99.0%). Overall, both groups showed the good quality of CPR skills and had no meaningful difference right after the training. However, three months after training, overall accuracy of CPR skills decreased, a significant difference between two groups was observed for compression position (conventional CPR: 80.0%, chest compression only CPR: 95.0%). In multiple linear regression analysis, three months after CPR training, chest compression-only CPR training made CPR skills accuracy 28.5% higher. In conclusion, police officers showed good-quality CPR right after CPR training in both groups. But three months later, chest compression-only CPR training group had better retention of CPR skills. Therefore, chest compression-only CPR training is better to be a standard training method for police officers as first responders.
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8
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Lockey A, Conaghan P, Bland A, Astin F. Educational theory and its application to advanced life support courses: a narrative review. Resusc Plus 2020; 5:100053. [PMID: 34223327 PMCID: PMC8244342 DOI: 10.1016/j.resplu.2020.100053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/27/2020] [Accepted: 11/11/2020] [Indexed: 11/30/2022] Open
Abstract
The knowledge, skills and attitudes taught on Advanced Life Support (ALS) courses are an important learning requirement for healthcare professionals who are involved with the care of acutely unwell patients. It is essential that the course design and delivery is appropriately planned to ensure that it optimises the learning opportunities for all learners. This paper offers a narrative review of how the application of educational theory has positively influenced the evolution of ALS courses since their inception in the late twentieth century. By embracing and understanding the relevant educational theories, the ALS course design has transformed from a predominantly lecture-based and behaviourist approach, to a more participative and social constructivist approach to learning. In addition, the advent of smarter technology and the challenges posed by the COVID-19 pandemic have facilitated a more connectivist approach to learning. It can therefore be demonstrated that the ALS course is influenced by a combination of theoretical approaches and provides a diverse framework of teaching and learning strategies that cater for many individual learning styles. Any further evolution and development of the course should be based upon contemporary educational theory to ensure that it remains fit for purpose.
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Affiliation(s)
| | | | - Andrew Bland
- University of Huddersfield, Centre for Applied Research in Health, UK
| | - Felicity Astin
- Calderdale & Huddersfield NHS Trust, Halifax, UK.,University of Huddersfield, Centre for Applied Research in Health, UK
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9
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González-Salvado V, Rodríguez-Ruiz E, Abelairas-Gómez C, Ruano-Raviña A, Peña-Gil C, González-Juanatey JR, Rodríguez-Núñez A. Formación de población adulta lega en soporte vital básico. Una revisión sistemática. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2018.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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10
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Basic Life-Support Learning in Undergraduate Students of Sports Sciences: Efficacy of 150 Minutes of Training and Retention after Eight Months. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234771. [PMID: 31795163 PMCID: PMC6926514 DOI: 10.3390/ijerph16234771] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/20/2019] [Accepted: 11/25/2019] [Indexed: 02/03/2023]
Abstract
Several professional groups, which are not health professionals, are more likely to witness situations requiring basic life support (BLS) due to the nature of their job. The aim of this study was to assess BLS learning after 150 min of training in undergraduate students of sports science and their retention after eight months. Participants trained on BLS (150-min session: 30 theory, 120 practice). After training (T1) and after 8 months (T2), we evaluated their performance of the BLS sequence and two minutes of cardiopulmonary resuscitation (CPR). At T1, the 23 participants presented a mean score of 72.5 ± 21.0% in the quality of the CPRs (compressions: 78.6 ± 25.9%, ventilation: 69.9 ± 30.1%). More than 90% of the participants acted correctly in each step of the BLS sequence. At T2, although the overall quality of the CPR performed did not decrease, significant decreases were observed for: correct hand position (T1: 98.2 ± 8.8, T2: 77.2 ± 39.7%), compression depth (T1: 51.4 ± 7.9, T2: 56.0 ± 5.7 mm), and compression rate. They worsened opening the airway and checking for breathing. In conclusions, participants learned BLS and good-quality CPR after the 150-min training session. At eight months they had good retention of the BLS sequence and CPR skills. Training on airway management and the position of the hands during CPR should be reinforced.
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Three-Month Retention of Basic Life Support with an Automated External Defibrillator Using a Two-Stage versus Four-Stage Teaching Technique. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1394972. [PMID: 31392207 PMCID: PMC6662483 DOI: 10.1155/2019/1394972] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 06/09/2019] [Indexed: 11/26/2022]
Abstract
Introduction Resuscitation training increases bystander's ability to perform basic life support (BLS) with an automated external defibrillator (AED) immediately after training. However, several studies indicate that resuscitation skills decay rapidly. Methods This study evaluates retention of BLS/AED skills three months after an initial study comparing acquisition of BLS/AED skills among laypersons immediately after training with a two-stage versus four-stage teaching technique. Results There was no difference in retention of BLS/AED skills (pass rate 10.8% versus 10.9%, respectively, p=1) three months after training. Total average number of skills adequately performed (of 17) was 13.3 versus 13.7 among laypersons trained with a two-stage and a four-stage technique, respectively. No difference was found in quality of chest compressions and rescue breaths between the two groups. Conclusion Three months after training, this study found no difference in retention of BLS/AED skills among laypersons taught using a two-stage compared to a four-stage teaching technique.
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12
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Veloso SG, Pereira GS, Vasconcelos NN, Senger MH, de Faria RMD. Learning by teaching basic life support: a non-randomized controlled trial with medical students. BMC MEDICAL EDUCATION 2019; 19:67. [PMID: 30823878 PMCID: PMC6397499 DOI: 10.1186/s12909-019-1500-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 02/20/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Cardiopulmonary resuscitation is usually taught in universities through theoretical lectures and simulations on mannequins with low retention of knowledge and skills. New teaching methodologies have been used to improve the learning, placing the student at the center of the process. Likewise, the outside community knows next to nothing about cardiopulmonary resuscitation. Patients who have an out-of-hospital cardiac arrest will die if the effective maneuvers are not promptly done. Learning by teaching could be a way to answer both requirements. It was therefore decided to evaluate whether the medical students' cardiopulmonary resuscitation performance would improve when they teach other people, and if those people could learn with them effectively. METHODS A non-randomized controlled trial was designed to assess whether teaching Basic Life Support would increase students' learning. Socially engaged, seeking to disseminate knowledge, 92 medical students were trained in Basic Life Support and who subsequently trained 240 community health professionals. The students performed theoretical and practical pre- and post-tests whereas the health professionals performed theoretical pre- and post-tests and one practical test. In order to assess the impact of teaching on students' learning, they were divided into two groups: a case group, with 53 students, reassessed after teaching health professionals, and a control group, with 39 students, reassessed before teaching. RESULTS The practical students' performance of the case group went from 13.3 ± 2.1 to 15.3 ± 1.2 (maximum = 17, p < 0.001) and theoretical from 10.1 ± 3.0 to 16.4 ± 1.7 (maximum = 20, p < 0.001) while the performance of the control group went from 14.4 ± 1.6 to 14.4 ± 1.4 (p = 0.877) and from 11.2 ± 2.6 to 15.0 ± 2.3 (p < 0.001), respectively. The theoretical performance of the health professionals changed from 7.9 ± 3.6 to 13.3 ± 3.2 (p < 0.001) and the practical performance was 11.7 ± 3.2. CONCLUSIONS The students who passed through the teaching activity had a theoretical and practical performance superior to that of the control group. The community was able to learn from the students. The study demonstrated that the didactic activity can be an effective methodology of learning, besides allowing the dissemination of knowledge. The University, going beyond its academic boundaries, performs its social responsibility.
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Affiliation(s)
- Sérgio Geraldo Veloso
- Departamento de Medicina, Curso de Medicina, Universidade Federal de São João del Rei, Praça Dom Helvécio, 74 - Dom Bosco, São João del Rei, MG 36301-160 Brazil
| | - Gabriel Santos Pereira
- Departamento de Medicina, Curso de Medicina, Universidade Federal de São João del Rei, Praça Dom Helvécio, 74 - Dom Bosco, São João del Rei, MG 36301-160 Brazil
| | - Nathália Nascimento Vasconcelos
- Departamento de Medicina, Curso de Medicina, Universidade Federal de São João del Rei, Praça Dom Helvécio, 74 - Dom Bosco, São João del Rei, MG 36301-160 Brazil
| | - Maria Helena Senger
- Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo, Sorocaba, SP Brazil
| | - Rosa Malena Delbone de Faria
- Departamento de Propedêutica Complementar, Faculdade de Medicina – Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil
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González-Salvado V, Rodríguez-Ruiz E, Abelairas-Gómez C, Ruano-Raviña A, Peña-Gil C, González-Juanatey JR, Rodríguez-Núñez A. Training adult laypeople in basic life support. A systematic review. ACTA ACUST UNITED AC 2019; 73:53-68. [PMID: 30808611 DOI: 10.1016/j.rec.2018.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 11/07/2018] [Indexed: 02/03/2023]
Abstract
INTRODUCTION AND OBJECTIVES Bystander assistance is decisive to enhance the outcomes of out-of-hospital cardiac arrest. Despite an increasing number of basic life support (BLS) training methods, the most effective formula remains undefined. To identify a gold standard, we performed a systematic review describing reported BLS training methods for laypeople and analyzed their effectiveness. METHODS We reviewed the MEDLINE database from January 2006 to July 2018 using predefined inclusion and exclusion criteria, considering all studies training adult laypeople in BLS and performing practical skill assessment. Two reviewers independently extracted data and evaluated the quality of the studies using the MERSQI (Medical Education Research Study Quality Instrument) scale. RESULTS Of the 1263 studies identified, 27 were included. Most of them were nonrandomized controlled trials and the mean quality score was 13 out of 18, with substantial agreement between reviewers. The wide heterogeneity of contents, methods and assessment tools precluded pooling of data. Nevertheless, there was an apparent advantage of instructor-led methods, with feedback-supported hands-on practice, and retraining seemed to enhance retention. Training also improved attitudinal aspects. CONCLUSIONS While there were insufficiently consistent data to establish a gold standard, instructor-led formulas, hands-on training with feedback devices and frequent retraining seemed to yield better results. Further research on adult BLS training may need to seek standardized quality criteria and validated evaluation instruments to ensure consistency.
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Affiliation(s)
- Violeta González-Salvado
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
| | - Emilio Rodríguez-Ruiz
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Servicio de Medicina Intensiva, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Cristian Abelairas-Gómez
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Facultad de Ciencias de la Educación, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Alberto Ruano-Raviña
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Carlos Peña-Gil
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
| | - José Ramón González-Juanatey
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
| | - Antonio Rodríguez-Núñez
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Unidad de Cuidados Intensivos Pediátricos, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Escuela de Enfermería, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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