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Wingen S, Großfeld N, Adams NB, Streit A, Stock J, Böttiger BW, Wetsch WA. Do laypersons need App-linked real-time feedback devices for effective resuscitation? - Results of a prospective, randomised simulation trial. Resusc Plus 2024; 18:100631. [PMID: 38666255 PMCID: PMC11043874 DOI: 10.1016/j.resplu.2024.100631] [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: 11/15/2023] [Revised: 03/26/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Background App-linked real-time feedback-devices for cardiopulmonary resuscitation (CPR) aim to improve laypersons' resuscitation quality. Resuscitation guidelines recommend these technologies in training settings. This is the first study comparing resuscitation quality of all App-linked feedback-devices currently on market. Methods A prospective randomised simulation study was performed. After standardised instructions, participants performed 2-minutes compression-only CPR on a manikin without feedback (baseline). Afterwards, participants performed 4 × 2 min CPR with four different feedback devices in randomised order (CorPatch® Trainer, CPRBAND AIO Training, SimCPR®ProTrainer, Relay Response™) (intervention). CPR metrics (chest compression depth (CD), chest compression rate (CR), percentage of correct CD/CR (%), correct hand position, correct chest recoil, and technical preparation-time) were assessed. Devices data were compared to the baseline group using Wilcoxon testing with IBM SPSS (primary outcome). Differences between devices were analysed with ANOVA testing (secondary outcome). Normally distributed data were described as mean ± standard deviation (SD) and non-normally distributed data as Median [Interquartile range (IQR). CPR self-confidence was measured by means of questionnaire before and after feedback devices' use. Comparison was performed by students t-test. Results Forty participants were involved. SimCPR®ProTrainer was the only device, which resulted in guideline-compliant chest compressions (Mean ± SD:5.37 ± 0.76) with improved chest compression depth (p < 0.001), and percentage of correct chest compression depth (p < 0.001) compared to unassisted CPR (baseline). CorPatch® Trainer as the only device with audio-visual recoil instructions resulted in improved chest recoil (Mean ± SD:72.25 ± 24.89) compared to baseline (Mean ± SD:49.00 ± 42.20; p < 0.01), while the other three devices resulted in significantly lower chest recoil rates (CPRBAND AIO Training: 37.03 ± 39.90; p < 0.01, SimCPR®ProTrainer: Mean ± SD:39.88 ± 36.50; p = 0.03, Relay Response™: Mean ± SD:36.88 ± 37.73; p = 0.02). CPR quality when using the different feedback devices differ in chest compression depth (p = 0.02), chest compression rate (p < 0.001), percentage of correct chest compression depth/rate (p = 0.03/p = 0.04), and technical preparation-time (p < 0.001). Feedback-devices' use increased participant's CPR self-confidence (p < 0.001). Conclusion Although, CPR feedback devices show improved CPR performance in layperson in some metrics, none of the tested CPR feedback devices supported layperson in overall adequate CPR performance. More and better technical functionality is necessary, to fully utilise the potential of CPR feedback devices and to prevent a worsening of CPR performance when layperson use this technology.
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Affiliation(s)
- Sabine Wingen
- University of Cologne, Medical Faculty and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Kerpener Str. 62, 50937 Cologne, Germany
- German Resuscitation Council, Prittwitzstraße 43, 89070 Ulm, Germany
- FOM University of Applied Sciences, Agrippinawerft 4, 50678 Cologne, Germany
| | - Nele Großfeld
- University of Applied Science Stralsund, Faculty of Electrical Engineering and Computer Science, Zur Schwedenschanze 15, 18435 Stralsund, Germany
- L2R GmbH, Cliev 4, 51515 Kürten, Germany
| | - Niels-Benjamin Adams
- University of Cologne, Medical Faculty and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Kerpener Str. 62, 50937 Cologne, Germany
- University of Cologne, Medical Faculty, Albertus-Magnus-Platz, 50923 Cologne, Germany
| | - Antonia Streit
- University of Cologne, Medical Faculty, Albertus-Magnus-Platz, 50923 Cologne, Germany
| | - Jan Stock
- L2R GmbH, Cliev 4, 51515 Kürten, Germany
| | - Bernd W. Böttiger
- University of Cologne, Medical Faculty and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Kerpener Str. 62, 50937 Cologne, Germany
- German Resuscitation Council, Prittwitzstraße 43, 89070 Ulm, Germany
- University of Cologne, Medical Faculty, Albertus-Magnus-Platz, 50923 Cologne, Germany
| | - Wolfgang A. Wetsch
- University of Cologne, Medical Faculty and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Kerpener Str. 62, 50937 Cologne, Germany
- German Resuscitation Council, Prittwitzstraße 43, 89070 Ulm, Germany
- University of Cologne, Medical Faculty, Albertus-Magnus-Platz, 50923 Cologne, Germany
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Huang LW, Chan YW, Tsan YT, Zhang QX, Chan WC, Yang HH. Implementation of a Smart Teaching and Assessment System for High-Quality Cardiopulmonary Resuscitation. Diagnostics (Basel) 2024; 14:995. [PMID: 38786293 PMCID: PMC11120156 DOI: 10.3390/diagnostics14100995] [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: 03/28/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
The purpose of this study is to develop a smart training and assessment system called SmartCPR, for teaching and training cardiopulmonary resuscitation (CPR), based on human posture estimation techniques. In this system, trainees can automatically recognize and evaluate whether chest compressions during CPR meet the standard of high-quality CPR by simply using a device such as a smart phone. Through the system, trainees are able to obtain real-time feedback on the quality of compressions so that they can adjust the cycle, depth, frequency, and posture of compressions to meet the standard of high-quality CPR. In addition, the SmartCPR system is convenient for CPR trainers. Trainers can instantly and accurately assess whether the trainee's compressions meet the standard of high-quality CPR, which reduces the risk of manual assessment errors and also reduces the trainer's teaching pressures. Therefore, the SmartCPR system developed in this study can be an important tool for CPR teaching and training for physicians, which can provide training and guidance for high-quality CPR maneuvers and enable trainees to become more proficient in CPR and self-training.
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Affiliation(s)
- Li-Wen Huang
- Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (L.-W.H.); (Y.-T.T.); (W.-C.C.)
| | - Yu-Wei Chan
- Department of Computer Science and Information Management, Providence University, Taichung 40301, Taiwan;
| | - Yu-Tse Tsan
- Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (L.-W.H.); (Y.-T.T.); (W.-C.C.)
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Qi-Xiang Zhang
- Department of Computer Science and Information Engineering, Providence University, Taichung 40301, Taiwan
| | - Wei-Chang Chan
- Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (L.-W.H.); (Y.-T.T.); (W.-C.C.)
| | - Han-Hsuan Yang
- Everlink Occupational Medicine Clinic, Taichung 40760, Taiwan;
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Tanaka S, Sagisaka R, Sone E, Tanaka H. Sport level and sex differences in sport-related concussion among Japanese collegiate athletes: Epidemiology, knowledge, reporting behaviors, and reported symptoms. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:229-238. [PMID: 37753424 PMCID: PMC10518792 DOI: 10.1016/j.smhs.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/23/2023] [Accepted: 07/05/2023] [Indexed: 09/28/2023] Open
Abstract
This study investigated the incidence of sport-related concussion (SRC) in sports, effect of athlete knowledge on reporting behavior differences between collegiate and non-collegiate athletes, and differences in SRC symptoms between sexes and level of participation. In this cross-sectional survey, 1 344 Japanese collegiate and non-collegiate athletes from a single institute were analyzed. Using a web-based survey, demographics, general SRC, knowledge of SRC, the most recent SRC reporting behaviors, and symptom presentation were examined. The prevalence of SRC during the academic year 2016-2017 was 2.68 (95% confidence interval [CI]: 1.88-3.69) across all sports. The prevalence of SRC was 33.3 (95% CI: 17.96-51.83) in rugby union and 8.33 (95% CI: 1.03-27.00) in women's soccer. The prevalence of SRC in males (3.47 [95% CI: 2.38-4.86] was 3.65 times higher than that in females (0.95 [95% CI: 0.26-2.41]). In total, the mean total score of knowledge was 5.30 (4.2) across 25 questions; dizziness was the most well-known symptom (867/1 344, 64.5%), followed by headache (59.3%). Being more emotional (44/1 345, 3.3%) was the least frequently known symptom. Level of participation did not affect scores (5.16 [3.96] vs. 5.52 [4.54]; p = 0.131). All 87 disclosing participants experienced drowsiness and irritability and felt more emotional. In terms of sex and participant level, no significant differences were found in any symptoms. This study found very low rates of concussion education in Japan. Dissemination of concussion education is essential in the future to recognize concussion earlier and prevent severe concussive injury.
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Affiliation(s)
- Shota Tanaka
- Research Institute of Disaster Management and EMS, Kokushikan University, Japan
- Kokushikan Sports Promotion Center, Kokushikan University, Japan
| | - Ryo Sagisaka
- Research Institute of Disaster Management and EMS, Kokushikan University, Japan
- Department of Integrated Science and Engineering for Sustainable Societies, Chuo University, Japan
| | - Etsuko Sone
- Research Institute of Disaster Management and EMS, Kokushikan University, Japan
- Kokushikan Sports Promotion Center, Kokushikan University, Japan
| | - Hideharu Tanaka
- Research Institute of Disaster Management and EMS, Kokushikan University, Japan
- Kokushikan Sports Promotion Center, Kokushikan University, Japan
- Department of Sports Medicine, Kokushikan University, Japan
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Gillam L, Crawshaw B, Booker M, Allsop S. Prompt identification of struggling candidates in near peer-led basic life support training: piloting an online performance scoring system. BMC MEDICAL EDUCATION 2023; 23:303. [PMID: 37131183 PMCID: PMC10152634 DOI: 10.1186/s12909-023-04225-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 04/03/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Bristol Medical School has adopted a near peer-led teaching approach to deliver Basic Life Support training to first year undergraduate medical students. Challenges arose when trying to identify early in the course which candidates were struggling with their learning, in sessions delivered to large cohorts. We developed and piloted a novel, online performance scoring system to better track and highlight candidate progress. METHODS During this pilot, a 10-point scale was used to evaluate candidate performance at six time-points during their training. The scores were collated and entered on an anonymised secure spreadsheet, which was conditionally formatted to provide a visual representation of the score. A One-Way ANOVA was performed on the scores and trends analysed during each course to review candidate trajectory. Descriptive statistics were assessed. Values are presented as mean scores with standard deviation (x̄±SD). RESULTS A significant linear trend was demonstrated (P < 0.001) for the progression of candidates over the course. The average session score increased from 4.61 ± 1.78 at the start to 7.92 ± 1.22 at the end of the final session. A threshold of less than 1SD below the mean was used to identify struggling candidates at any of the six given timepoints. This threshold enabled efficient highlighting of struggling candidates in real time. CONCLUSIONS Although the system will be subject to further validation, our pilot has shown the use of a simple 10-point scoring system in combination with a visual representation of performance helps to identify struggling candidates earlier across large cohorts of students undertaking skills training such as Basic Life Support. This early identification enables effective and efficient remedial support.
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Affiliation(s)
| | | | | | - Sarah Allsop
- University of Bristol Medical School, Bristol, UK
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Effect of real-time feedback device compared to use or non-use of a checklist performance aid on post-training performance and retention of infant cardiopulmonary resuscitation: A randomized simulation-based trial. Australas Emerg Care 2023; 26:36-44. [PMID: 35915032 DOI: 10.1016/j.auec.2022.07.005] [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: 06/07/2022] [Revised: 07/02/2022] [Accepted: 07/18/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION This study aims to determine the best method for achieving optimal performance of pediatric cardiopulmonary resuscitation (CPR) during simulation-based training, whether with or without a performance aid. METHODS In this randomized controlled study, 46 participants performed simulated CPR in pairs on a Resusci Baby QCPR™ mannequin, repeated after four weeks. All participants performed the first simulation without performance aids. For the second simulation, they were randomly assigned to one of three groups with stratification based on status: throughout CPR, Group A (n = 16) was the control group and did not use a performance aid; Group B (n = 16) used the CPR checklist; Group C (n = 14) used real-time visualization of their CPR activity on a feedback device. Overall performance was assessed using the QCPR™. RESULTS All groups demonstrated improved performance on the second simulation (p < 0.01). Use of the feedback device resulted in better CPR performance than use of the CPR checklist (p = 0.02) or no performance aid (p = 0.04). Additionally, participants thought that the QCPR™ could effectively improve their technical competences. CONCLUSIONS Performance aid based on continuous feedback is helpful in the learning process. The use of the QCPR™, a real-time feedback device, improved the quality of resuscitation during infant CPR simulation-based training.
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Ghaderi MS, Malekzadeh J, Mazloum S, Pourghaznein T. Comparison of real-time feedback and debriefing by video recording on basic life support skill in nursing students. BMC MEDICAL EDUCATION 2023; 23:62. [PMID: 36698121 PMCID: PMC9878936 DOI: 10.1186/s12909-022-03951-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cardiopulmonary resuscitation skill have a direct impact on its success rate. Choosing the right method to acquire this skill can lead to effective performance. This investigation was conducted to compare the effect of Real-time feedback and debriefing by video recording on basic life support skill in nursing students. METHODS This quasi-experimental study was performed on 67 first year nursing students. First, a theoretical basic life support (BLS) training session was held for the all participants, at the end of session the pre-test was taken. Students were randomly assigned to two groups. A 4-hour practical BLS training session was conducted in the real - time feedback group as well as the debriefing by video recording group, and at the end of the training, a post-test was taken from each group. Each group received a post-test. Data were analyzed using SPSS 25 software. RESULTS Results showed a significant difference between mean (SD) of debriefing by video recording group in pre-test and post-test (p < 0.001) and in the real-time feedback group there was a significant difference between mean (SD) in pre-test and post-test (p < 0.001), respectively. In addition, there was no significant difference between the mean score of basic life support skill in real-time feedback and debriefing by video recording. CONCLUSIONS Both real-time feedback and debriefing by video recording were effective on basic life support skill.
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Affiliation(s)
- Mohammad Sajjad Ghaderi
- Department of Nursing, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Razavi Khorasan Province, Iran
- Clinical Research Development Unit, Sajjadieh Hospital, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Razavi Khorasan Province, Iran
| | - Javad Malekzadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyedreza Mazloum
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tayebe Pourghaznein
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Donizeti Silva M, Augusto Barbieri R, Figueiredo Foresti Y, Augusto Cursiol J, Antônio Viana F, Fernando dos Santos E, Pereira Rodrigues K, da Silva Rodrigues G, da Silva Garcia Nascimento J, Barcellos Dalri MC. Association of Training in Basic Life Support with the Evolution of Cardiopulmonary Resuscitation Performed by Firefighters. Emerg Med Int 2023; 2023:8150697. [PMID: 37188319 PMCID: PMC10181904 DOI: 10.1155/2023/8150697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/03/2023] [Accepted: 04/27/2023] [Indexed: 05/17/2023] Open
Abstract
Introduction This study aimed to compare the results of professional technical and anthropometric anamnesis data with the transmission of external chest compressions performed by military firefighters at different execution times. Objective The objective was to evaluate the performance and perceived effort of the sequence of external chest compressions performed in two minutes, as well as the evolution of the technique over time. Materials and Methods This was a descriptive, correlational study involving adult firefighters who were members of a specific firefighter group, comprising a population of 105 individuals with a voluntary sample of 44 participants. The study used a Bayesian statistical approach to provide probabilistic expressions. Results The participants had an average work experience of 17 years, an average age of 38.6 years, an average weight of 81.48 kilograms, an average height of 176 centimeters, and an average of 2.5 qualifications. The results indicated that the firefighters performed external chest compressions with excellent technique and a moderate level of perceived effort in a two-minute evaluation. The evaluation of the evolution of the technique over time showed that the participants were able to maintain high-quality compressions for an average of 6 minutes, with a maximum of 20 uninterrupted minutes. Conclusion The study underscores the critical role of professional firefighters in performing and maintaining high-quality external chest compressions, which has the potential to reduce morbidity and mortality in cases of cardiorespiratory arrest.
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Affiliation(s)
- Marcelo Donizeti Silva
- School of Nursing of Ribeirao Preto, University of Sao Paulo, Avenida Bandeirantes 3900, 14049-900 Ribeirao Preto, São Paulo, Brazil
| | - Ricardo Augusto Barbieri
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Avenida Bandeirantes 3900, 14049-900 Ribeirao Preto, São Paulo, Brazil
| | - Yan Figueiredo Foresti
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Avenida Bandeirantes 3900, 14049-900 Ribeirao Preto, São Paulo, Brazil
| | - Jônatas Augusto Cursiol
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Avenida Bandeirantes 3900, 14049-900 Ribeirao Preto, São Paulo, Brazil
| | | | | | - Karine Pereira Rodrigues
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | | | - Maria Celia Barcellos Dalri
- School of Nursing of Ribeirao Preto, University of Sao Paulo, Avenida Bandeirantes 3900, 14049-900 Ribeirao Preto, São Paulo, Brazil
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Boonmak S, Boonmak P. Effect of Contact-Restricted Basic Life Support Training During the Nation's Contact Restriction Policy on Learning Outcomes. Open Access Emerg Med 2023; 15:157-164. [PMID: 37193123 PMCID: PMC10182788 DOI: 10.2147/oaem.s411096] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 04/29/2023] [Indexed: 05/18/2023] Open
Abstract
Objective Basic life support (BLS) training aimed at building knowledge and skills in cardiopulmonary resuscitation. During training, there is the possibility of airborne COVID-19 transmission. The aim was to evaluate students' knowledge, skills, and course satisfaction following contact-restricted BLS training under the contact restriction policy. Methods From July 2020 to January 2021, a prospective, descriptive study was conducted among fifth-year dental students. Contact-restricted BLS training consisted of online learning, online pre-testing, non-contact training with automated real-time feedback manikins, and remote monitoring. The participants' skills, knowledge through online testing, and course satisfaction were all evaluated after training. At three months and six months after training, their knowledge was re-evaluated through online testing. Results Fifty-five participants were included in this study. Their mean (SD) knowledge scores after training, at three and six months, were 81.5 (10.8)%, 71.1 (16.4)%, and 65.8 (14.5)%, respectively. The percentage of participants, who passed the skills test on their first, second, and third attempts had been 83.6%, 94.5%, and 100%, respectively. The mean (SD) satisfaction score with the course was 4.87 (0.34) on a five-point Likert score. After training, no participants had COVID-19 infection. Conclusion Training in contact-restricted BLS had produced acceptable knowledge, skills, and satisfaction results. Knowledge tests, competence tests, and course satisfaction were comparable to conventional pre-pandemic trainings with similar participants. Due to the significant dangers of aerosol disease transmission, it became a viable training alternative. Trial Registration TCTR20210503001 (Thai Clinical Trials Registry).
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Affiliation(s)
- Suhattaya Boonmak
- Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Polpun Boonmak
- Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Correspondence: Polpun Boonmak, Email
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Yu Y, Liu X, Wang L, Gao Y, Ding Y, Ao H. Evaluation of cardiopulmonary resuscitation quality during the pandemic of COVID-19. BMC Emerg Med 2022; 22:193. [PMID: 36471252 PMCID: PMC9724342 DOI: 10.1186/s12873-022-00754-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cardiopulmonary resuscitation (CPR) is an important technique of first aid. It is necessary to be popularized. Large-scale offline training has been affected after the outbreak of Coronavirus disease 2019 (COVID-19). Online training will be the future trend, but the quality of online assessment is unclear. This study aims to compare online and offline evaluations of CPR quality using digital simulator and specialist scoring methods. METHODS Forty-eight out of 108 contestants who participated in the second Chinese National CPR Skill Competition held in 2020 were included in this study. The competition comprised two stages. In the preliminary online competition, the contestants practiced on the digital simulator while the specialist teams scored live videos. The final competition was held offline, and consisted of live simulator scoring and specialist scoring. The grades of the simulator and specialists in different stages were compared. RESULTS There was no statistical significance for simulator grades between online and offline competition(37.7 ± 2.0 vs. 36.4 ± 3.4, p = 0.169). For specialists' grades, the video scores were lower than live scores (55.0 ± 1.4 vs. 57.2 ± 1.7, p < 0.001). CONCLUSION Simulator scoring provided better reliability than specialist scoring in the online evaluation of CPR quality. However, the simulator could only collect quantified data. Specialist scoring is necessary in conjunction with online tests to provide a comprehensive evaluation. A complete and standardized CPR quality evaluation system can be established by combining simulator and specialist contributions.
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Affiliation(s)
- Yang Yu
- grid.415105.40000 0004 9430 5605Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaojie Liu
- grid.412521.10000 0004 1769 1119Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lijuan Wang
- grid.415105.40000 0004 9430 5605Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuchen Gao
- grid.415105.40000 0004 9430 5605Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yao Ding
- grid.415105.40000 0004 9430 5605Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hushan Ao
- grid.415105.40000 0004 9430 5605Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Zheng J, Du L, Deng X, Zhang L, Wang J, Chen G. Efficacy of virtual reality techniques in cardiopulmonary resuscitation training: protocol for a meta-analysis of randomised controlled trials and trial sequential analysis. BMJ Open 2022; 12:e058827. [PMID: 35149577 PMCID: PMC8845316 DOI: 10.1136/bmjopen-2021-058827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Cardiopulmonary resuscitation (CPR) is the most critical procedure in the rescue of patients with sudden cardiac death (SCD). The success rate of CPR remains far below expectations, which made CPR education identified as the top priority for SCD. CPR training using the virtual reality (VR) technique is a feasible training method, with a wider population and lower cost, but its efficacy remains controversial. Thus, we will perform a protocol for a systematic review and meta-analysis to identify the efficacy of the VR technique on CPR quality. METHODS AND ANALYSIS We will search PubMed, Web of Science, Cochrane Library, Ovid Medline, Embase, China National Knowledge Infrastructure, Chinese BioMedical Literature, Wanfang and VIP databases from inception to November 2021, to identify randomised controlled trials and the first period in randomised cross-over trials assessing the efficacy of VR techniques versus non-VR techniques for adult participants accepting adult CPR training. No language restrictions will be considered. Data synthesis will be performed using RevMan V.5.4 and Stata/MP V.16.0. Outcome measures will be present as relative risk with 95% CIs for dichotomous data and mean difference with 95% CIs for continuous data. The primary outcome will be the CPR quality defined as chest compression rate and depth. Secondary outcomes will be the overall performance of CPR. Heterogeneity will be assessed by the χ2 test and I2 statistic. Data will be synthesised by either fixed-effects or random-effects models according to the I2 value. Trial sequential analysis and modified Jadad Scale will be used to control the risks of random errors and evaluate the evidence quality. Egger's regression test and funnel plots will be used to assess the publication bias. ETHICS AND DISSEMINATION Ethical approval was not required for this systematic review protocol. The findings will be disseminated through peer-reviewed publications. PROSPERO REGISTRATION NUMBER CRD42021281059.
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Affiliation(s)
- Jianqiao Zheng
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Du
- Department of Anesthesiology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xiaoqian Deng
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lu Zhang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jia Wang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guo Chen
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Chun MJ, Zhang Y, Toraih EA, McGrew PR. Iatrogenic Injuries in Manual and Mechanical Cardiopulmonary Resuscitation. Am Surg 2021:31348211047507. [PMID: 34645331 DOI: 10.1177/00031348211047507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Mechanical chest compression has been shown to be equivalent to manual chest compression in providing survival benefits to patients experiencing cardiac arrest. There has been a growing need for a contemporary review of iatrogenic injuries caused by mechanical in comparison with manual chest compression. Our study aims to analyze the studies that document significant life-threatening iatrogenic injuries caused by mechanical and manual chest compression. METHODS A systematic review of PubMed and Embase was performed according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. All studies published after January 1st, 2000 were reviewed using inclusion/exclusion criteria and completed by May 2020. A total of 7202 patients enrolled in 15 studies were included in our meta-analysis. RESULTS Significant life-threatening iatrogenic injuries had higher odds of occurring when mechanical chest compression was used compared to manual chest compression, especially for hemothorax and liver lacerations. Mechanical chest compression involves consistently deeper compression depths compared to manual chest compression, potentially resulting in more injuries. In the mechanical chest compression cohort, chest wall fractures had the highest incidence rate (55.7%), followed by sternal fracture (28.3%), lung injuries (3.7%), liver (1.0%), and diaphragm (.2%) lacerations. CONCLUSIONS Mechanical chest compression was associated with more iatrogenic injuries as compared to manual chest compression. Further research is needed to define the appropriate application of mechanical in comparison with manual chest compression in different scenarios. Levels of provider training, different mechanical chest compression device types, patient demographics, and compression duration/depth may all play roles in influencing outcomes.
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Affiliation(s)
- Magnus J Chun
- Department of Surgery, 12255Tulane University School of Medicine, New Orleans, LA, USA
| | - Yichi Zhang
- Department of Surgery, 12255Tulane University School of Medicine, New Orleans, LA, USA
| | - Eman A Toraih
- Department of Surgery, 12255Tulane University School of Medicine, New Orleans, LA, USA
| | - Patrick R McGrew
- Department of Surgery, 12255Tulane University School of Medicine, New Orleans, LA, USA
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Misztal-Okońska P, Goniewicz K, Goniewicz M, Ranse J, Hertelendy AJ, Gray L, Carlström E, Løwe Sørensen J, Khorram-Manesh A. Importance of Immediate Electronic-Based Feedback to Enhance Feedback for First-Time CPR Trainees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083885. [PMID: 33917203 PMCID: PMC8067975 DOI: 10.3390/ijerph18083885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/22/2021] [Accepted: 04/06/2021] [Indexed: 11/23/2022]
Abstract
Sudden cardiac arrest is one of the leading causes of death globally. The recommended clinical management in out-of-hospital cardiac arrest cases is the immediate initiation of high-quality cardiopulmonary resuscitation (CPR). Training mannequins should be combined with technology that provides students with detailed immediate feedback on the quality of CPR performance. This study aimed to verify the impacts of the type of feedback (basic or detailed) the responders receive from the device while learning CPR and how it influences the quality of their performance and the motivation to improve their skills. The study was conducted at the Medical University of Lublin among 694 multi-professional health students during first aid classes on basic life support (BLS). The students first practiced on an adult mannequin with a basic control panel; afterward, the same mannequin was connected to a laptop, ensuring a detailed record of the performed activities through a projector. Next, the participants expressed their subjective opinion on how the feedback provided during the classes, basic vs. detailed, motivated them to improve the quality of their CPR performance. Additionally, during the classes, the instructor conducted an extended observation of students’ work and behavior. In the students’ opinion, the CPR training with detailed feedback devices provided motivation for learning and improving CPR proficiency than that with a basic control panel. Furthermore, the comments given from devices seemed to be more acceptable to the students, who did not see any bias in the device’s evaluation compared to that of the instructor. Detailed device feedback motivates student health practitioners to learn and improve the overall quality of CPR. The use of mannequins that provide detailed feedback during BLS courses can improve survival in out-of-hospital cardiac arrest.
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Affiliation(s)
- Patrycja Misztal-Okońska
- Department of Emergency Medicine, Medical University of Lublin, 20-059 Lublin, Poland;
- Correspondence:
| | - Krzysztof Goniewicz
- Department of Aviation Security, Military University of Aviation, 08-521 Dęblin, Poland;
| | - Mariusz Goniewicz
- Department of Emergency Medicine, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Jamie Ranse
- School of Nursing and Midwifery, Griffith University, Gold Coast, QLD 4215, Australia;
- Department of Emergency Medicine, Gold Coast Health, Gold Coast, QLD 4215, Australia
| | - Attila J. Hertelendy
- Fellowship in Disaster Medicine, Department of Emergency Medicine, Beth Israel Deaconess Medical Centre, Boston, MA 02215, USA;
- Department of Emergency Medicine, Harvard Medical School, Boston, MA 02215, USA
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL 33119, USA
| | - Lesley Gray
- Department of Primary Health Care and General Practice, University of Otago, Wellington 6242, New Zealand;
- Joint Centre for Disaster Research, Massey University, Wellington 6021, New Zealand
| | - Eric Carlström
- Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden;
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- USN School of Business, University of South-Eastern Norway, 3616 Kongsberg, Norway;
| | - Jarle Løwe Sørensen
- USN School of Business, University of South-Eastern Norway, 3616 Kongsberg, Norway;
| | - Amir Khorram-Manesh
- Institute of Clinical Sciences, Department of Surgery, Sahlgrenska Academy, Gothenburg University, 413 45 Gothenburg, Sweden;
- Department of Development and Research, Armed Forces Center for Defense Medicine, 426 76 Gothenburg, Västra Frölunda, Sweden
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Efficacy and cost-feasibility of the Timely Chest Compression Training (T-CCT): a contextualized cardiopulmonary resuscitation training for personal support workers participating during in-hospital cardiac arrests. CAN J EMERG MED 2021; 23:180-184. [PMID: 33709352 DOI: 10.1007/s43678-020-00038-y] [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: 05/20/2020] [Accepted: 10/20/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The Timely Chest Compression Training (T-CCT) was created to promote more frequent training in chest compressions for personal support workers. This study aims to assess the efficacy of the T-CCT on the chest compression performance and to examine costs related to this intervention. METHODS A prospective single group, before-after study was conducted at a university-affiliated hospital. The T-CCT is adapted for support workers and lasts 20 min during working hours. Guided by peer trainers, live feedback devices and mannikins, the T-CCT targets chest compression training. Using an algorithm, chest compression performance scores were gathered before and after the intervention. RESULTS Of 875 employed support workers, 573 were trained in 5 days. Prior to the intervention, the median performance score was 72%. Participants significantly improved after the intervention (p < 0.001) and the median of the differences was 32% (95% CI 28.5-36.0). Support workers in critical care units and those with an active basic life support (BLS) certification performed better at baseline and were less inclined to have large changes in performance scores after the intervention. When compared to basic life support training, the T-CCT is over three times less expensive. CONCLUSIONS The T-CCT was an effective and low-cost initiative that allowed to train a large group of support workers in a short amount of time. Since they are actively involved in resuscitation efforts in Quebec (Canada), it may promote the delivery of high-quality compressions during in-hospital cardiac arrests. Our inquiry can incite and guide other organizations in the implementation of similar interventions.
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Jaskiewicz F, Kowalewski D, Starosta K, Cierniak M, Timler D. Chest compressions quality during sudden cardiac arrest scenario performed in virtual reality: A crossover study in a training environment. Medicine (Baltimore) 2020; 99:e23374. [PMID: 33235109 PMCID: PMC7710239 DOI: 10.1097/md.0000000000023374] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Potential attributes of virtual reality (VR) can be a breakthrough in the improvement of sudden cardiac arrest (SCA) training. However, interference with the virtual world is associated with the need of placing additional equipment on the trainee's body. The primary aim of the study was to evaluate if it does not affect the quality of chest compressions (CCs).91 voluntarily included in the study medical students participated twice in the scenario of SCA - Traditional Scenario (TS) and Virtual Reality Scenario (VRS). In both cases two minutes of resuscitation was performed.If VRS was the first scenario there were significant differences in CCs depth (VRS - Me = 47 mm [IQR 43 - 52] vs TS - Me = 48 mm [IQR 43 - 55]; P = .02) and chest relaxation (VRS - Me = 37% [IQR 5 - 91] vs TS - Me = 97% [IQR 87 - 100]; P < .001). 97.8% of respondents believe that training with the use of VR is more effective than a traditional method (P < .01). Most of the study group (91%, P < .01) denied any negative symptoms during the VR scenario.Virtual reality can be a safe and highly valued by medical students, method of hands-on CPR training. However additional VR equipment placed on the trainee's body may cause chest compressions harder to provide. If it is not preceded by traditional training, the use of VR may have an adverse impact on depth and full chest relaxation during the training. To make the best use of all the potential that virtual reality offers, future studies should focus on finding the most effective way to combine VR with traditional skill training in CPR courses curriculum.
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Shende TC, Battaglia MR, Nuno T, Beskind D. Efficacy of a five-minute compression-only cardiopulmonary resuscitation class compared to thirty-minute instruction among college students. Resusc Plus 2020; 3:100012. [PMID: 34223296 PMCID: PMC8244424 DOI: 10.1016/j.resplu.2020.100012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 11/24/2022] Open
Abstract
Objective To determine if 5-minute compression-only cardiopulmonary resuscitation (CCO-CPR) instruction is as effective as 30-minute instruction in improving participant knowledge and comfort with performing CCO-CPR as well as teaching CPR quality and responsiveness to an Out of Hospital Cardiac Arrest (OHCA). Methods A prospective randomized controlled trial of university undergraduates was performed. Participants were randomized to either a 5-minute (experimental) or 30-minute (control) CCO-CPR instruction class. Pre- and post-testing was performed with a written and simulation test. Measurements collected assessed rate and depth of compressions, time to call 911, and time to start chest compressions. Prior to instruction, subjects’ baseline measurements of CPR performance were evaluated during a standardized sudden death scenario using a Laerdal SkillreporterTM mannequin. The written test and scenario were repeated after either the five or 30 minute CCO-CPR instruction using the same outcome measures. Statistical tests of association for categorical variables were assessed using the chi-square test and the independent samples t-test was utilized for continuous variables. All tests were two-sided and the level of significance was set at α = 0.05. Results Among the 59 participants, 28 received 5 minutes of instruction and 31 received 30 minutes. Fifteen (25.4%) individuals reported prior CPR training. Post intervention, all measurements reached statistically significant improvements in each group but there was no difference between the two groups improvement in depth of compressions (experimental group: 41.8 mm, 95% CI 36.6–43.4 vs control group: 46.5 mm, 95% CI 40.9–48.3, p = 0.06), compressions per minute (114.3 cpm, 95% CI 105.5–122.0 vs 121.1 cpm, 95% CI 115.1–131.4, p = 0.10), time to starting chest compressions (13.5 vs 12.4 sec, p = 0.45), or time to calling 911 (8.34 vs 7.65 sec, p = 0.58). Further, there was a statistically significant improvement in participants that said they would probably or definitely perform CCO-CPR in real life after both interventions but no difference between the groups (100% of the experimental group and 93.5% of the control group p < 0.49). Conclusion Five-minute instruction is not inferior to 30-minute instruction at teaching undergraduate students how to perform quality bystander CCO-CPR.
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Affiliation(s)
- Tanwe C. Shende
- University of Arizona College of Medicine, 1501 N. Campbell Ave., Tucson, AZ, USA
- Corresponding author. 1501 N. Campbell Ave, Tucson, AZ, 85724, USA.
| | - Morgan R. Battaglia
- University of Arizona College of Medicine, 1501 N. Campbell Ave., Tucson, AZ, USA
| | - Tomas Nuno
- University of Arizona, Department of Emergency Medicine, 1625 N. Campbell Ave., Tucson, AZ, USA
| | - Dan Beskind
- University of Arizona, Department of Emergency Medicine, 1625 N. Campbell Ave., Tucson, AZ, USA
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Nayak VR, Babu A, Unnikrishnan R, Babu AS, Krishna HM. Influence of Physical Activity of the Rescuer on Chest Compression Duration and its Effects on Hemodynamics and Fatigue Levels of the Rescuer: A Simulation-based Study. Indian J Crit Care Med 2020; 24:409-413. [PMID: 32863632 PMCID: PMC7435083 DOI: 10.5005/jp-journals-10071-23457] [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] [Indexed: 11/23/2022] Open
Abstract
Background Cardiopulmonary resuscitation (CPR) is a lifesaving skill performed during the cardiac arrest. Various factors of rescuer affect CPR quality, and rescuers physical fitness is one among the important factors needs to be explored for improved CPR quality. This study aimed to assess the physical activity (PA) levels of the health care providers (HCPs) who were trained in basic life support (BLS) and its relationship on chest compression duration, hemodynamic parameters, and fatigue levels of the rescuers. Materials and methods A single-center, cross-sectional study was conducted on 48 HCPs who were trained in BLS within one year. Eligible participants were contacted by email, and the responders’ level of PA was determined using the global physical activity questionnaire (GPAQ). The participants were recruited for chest compression-only cardiac arrest scenarios. Each subject performed continuous chest compression on the manikin until they perceived maximum fatigue. Heart rate (HR), blood pressure (BP), oxygen saturation (SpO2), and fatigue level were assessed at baseline, immediately after and following two minutes of cessation of chest compressions. The total duration of chest compression was also documented. Results Most participants (24, 50%) reported high levels of PA while 22 (45.83%) and 2 (4.17%) reported moderate and low intensity of PA, respectively. The mean age of the 35 participants was 26.08 ± 4.60 years. The mean duration of chest compressions was 193.25 seconds with higher times reported for those with high PA when compared to those with moderate PA (p = 0.017). Similar findings were also observed for fatigue. Conclusion Rescuers who reported high PA had lower levels of fatigue and could perform longer duration of chest compressions. How to cite this article Nayak VR, Babu A, Unnikrishnan R, Babu AS, Krishna HM. Influence of Physical Activity of the Rescuer on Chest Compression Duration and its Effects on Hemodynamics and Fatigue Levels of the Rescuer: a Simulation-based Study. Indian J Crit Care Med 2020;24(6):409–413.
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Affiliation(s)
- Varun R Nayak
- Department of Respiratory Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Akhila Babu
- Department of Respiratory Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ramesh Unnikrishnan
- Department of Respiratory Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Abraham Samuel Babu
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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