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Kłosiewicz T, Śmigasiewicz S, Cholerzyńska H, Zasada W, Czabański A, Puślecki M. Knowledge and attitudes towards performing resuscitation among seniors - a population-based study. Arch Public Health 2024; 82:67. [PMID: 38720394 PMCID: PMC11077712 DOI: 10.1186/s13690-024-01301-9] [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: 09/25/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Cardiac arrest constitutes a critical medical emergency necessitating swift intervention to reinstate normal heart rhythm and prevent harm to vital organs. The pivotal role of bystander cardiopulmonary resuscitation (CPR) in influencing survival rates is well recognized. With older adults being the most common group to witness such events, it's curcial to understand their attitudes and knowledge about performing CPR. Additionally, understanding if health status has an influence can help in tailoring education for specific seniors needs. METHODS A cross-sectional survey was sent to University of the Third Age (UTA) students. The survey comprised sections focusing on demographic data, CPR knowledge, automated external defibrillator (AED) knowledge, first aid training, and readiness to perform CPR and use AEDs. Participants' health conditions were also assessed through multiple-choice options. RESULTS We received 456 responses. Significant awareness of emergency numbers and cardiac arrest recognition was revealed. However, knowledge gaps persisted, particularly in compression rates. Most participants comprehended AED usage, yet training primarily relied on theoretical approaches. Health conditions notably affected CPR readiness, with associations between specific chronic diseases and willingness to perform CPR. CONCLUSIONS Addressing knowledge gaps and tailoring education for elderly needs are crucial for improving survival rates. Future research should explore barriers to bystander CPR during out-of-hospital cardiac arrests to further enhance survival prospects.
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Affiliation(s)
- Tomasz Kłosiewicz
- Department of Medical Rescue, Faculty of Health Sciences, Poznan University of Medical Sciences, 7 Rokietnicka Street, Poznań, 60-608, Poland.
| | - Sandra Śmigasiewicz
- Department of Medical Rescue, Faculty of Health Sciences, Poznan University of Medical Sciences, 7 Rokietnicka Street, Poznań, 60-608, Poland
| | - Hanna Cholerzyńska
- Faculty of Health Sciences, Poznan University of Medical Sciences, 7 Rokietnicka Street, Poznań, 60- 608, Poland
| | - Wiktoria Zasada
- Faculty of Health Sciences, Poznan University of Medical Sciences, 7 Rokietnicka Street, Poznań, 60- 608, Poland
| | - Adam Czabański
- Faculty of Administration and National Security, The Jacob of Paradies University, 52 Fryderyka Chopina Street, Gorzów Wielkopolski, 66-400, Poland
| | - Mateusz Puślecki
- Department of Medical Rescue, Faculty of Health Sciences, Poznan University of Medical Sciences, 7 Rokietnicka Street, Poznań, 60-608, Poland
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Wyckoff MH, Greif R, Morley PT, Ng KC, Olasveengen TM, Singletary EM, Soar J, Cheng A, Drennan IR, Liley HG, Scholefield BR, Smyth MA, Welsford M, Zideman DA, Acworth J, Aickin R, Andersen LW, Atkins D, Berry DC, Bhanji F, Bierens J, Borra V, Böttiger BW, Bradley RN, Bray JE, Breckwoldt J, Callaway CW, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Phil Chung S, Considine J, Costa-Nobre DT, Couper K, Couto TB, Dainty KN, Davis PG, de Almeida MF, de Caen AR, Deakin CD, Djärv T, Donnino MW, Douma MJ, Duff JP, Dunne CL, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Finn J, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman M, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin YJ, Lockey AS, Maconochie IK, Madar J, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Morgan P, Morrison LJ, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, O'Neill BJ, Gene Ong YK, Orkin AM, Paiva EF, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, 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, Skrifvars MB, Smith CM, Sugiura T, Tijssen JA, Trevisanuto D, Van de Voorde P, Wang TL, Weiner GM, Wyllie JP, Yang CW, Yeung J, Nolan JP, Berg KM. 2022 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. Pediatrics 2023; 151:189896. [PMID: 36325925 DOI: 10.1542/peds.2022-060463] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.
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Farquharson B, Dixon D, Williams B, Torrens C, Philpott M, Laidlaw H, McDermott S. The psychological and behavioural factors associated with laypeople initiating CPR for out-of-hospital cardiac arrest: a systematic review. BMC Cardiovasc Disord 2023; 23:19. [PMID: 36639764 PMCID: PMC9840280 DOI: 10.1186/s12872-022-02904-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/17/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Prompt, effective CPR greatly increases the chances of survival in out-of-hospital c ardiac arrest. However, it is often not provided, even by people who have previously undertaken training. Psychological and behavioural factors are likely to be important in relation to CPR initiation by lay-people but have not yet been systematically identified. METHODS Aim: to identify the psychological and behavioural factors associated with CPR initiation amongst lay-people. DESIGN Systematic review Data sources: Cochrane Library, MEDLINE, EMBASE, CINAHL, PsycInfo and Google Scholar. STUDY ELIGIBILITY CRITERIA Primary studies reporting psychological or behavioural factors and data on CPR initiation involving lay-people published (inception to 31 Dec 2021). STUDY APPRAISAL AND SYNTHESIS METHODS Potential studies were screened independently by two reviewers. Study characteristics, psychological and behavioural factors associated with CPR initiation were extracted from included studies, categorised by study type and synthesised narratively. RESULTS One hundred and five studies (150,820 participants) comprising various designs, populations and of mostly weak quality were identified. The strongest and most ecologically valid studies identified factors associated with CPR initiation: the overwhelming emotion of the situation, perceptions of capability, uncertainty about when CPR is appropriate, feeling unprepared and fear of doing harm. Current evidence comprises mainly atheoretical cross-sectional surveys using unvalidated measures with relatively little formal testing of relationships between proposed variables and CPR initiation. CONCLUSIONS Preparing people to manage strong emotions and increasing their perceptions of capability are likely important foci for interventions aiming to increase CPR initiation. The literature in this area would benefit from more robust study designs. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42018117438.
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Affiliation(s)
- Barbara Farquharson
- grid.11918.300000 0001 2248 4331NMAHP Research Unit, University of Stirling, Stirling, FK9 4LA UK
| | - Diane Dixon
- grid.7107.10000 0004 1936 7291University of Aberdeen, Aberdeen, UK
| | - Brian Williams
- grid.23378.3d0000 0001 2189 1357University of Highlands and Islands, Inverness, UK
| | - Claire Torrens
- grid.11918.300000 0001 2248 4331University of Stirling, Stirling, UK
| | - Melanie Philpott
- grid.11918.300000 0001 2248 4331University of Stirling, Stirling, UK
| | - Henriette Laidlaw
- grid.23378.3d0000 0001 2189 1357University of Highlands and Islands, Inverness, UK
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4
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Wyckoff MH, Greif R, Morley PT, Ng KC, Olasveengen TM, Singletary EM, Soar J, Cheng A, Drennan IR, Liley HG, Scholefield BR, Smyth MA, Welsford M, Zideman DA, Acworth J, Aickin R, Andersen LW, Atkins D, Berry DC, Bhanji F, Bierens J, Borra V, Böttiger BW, Bradley RN, Bray JE, Breckwoldt J, Callaway CW, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Couto TB, Dainty KN, Davis PG, de Almeida MF, de Caen AR, Deakin CD, Djärv T, Donnino MW, Douma MJ, Duff JP, Dunne CL, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Finn J, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman M, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin YJ, Lockey AS, Maconochie IK, Madar RJ, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Morgan P, Morrison LJ, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, O'Neill BJ, Ong YKG, Orkin AM, Paiva EF, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, 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, Skrifvars MB, Smith CM, Sugiura T, Tijssen JA, Trevisanuto D, Van de Voorde P, Wang TL, Weiner GM, Wyllie JP, Yang CW, Yeung J, Nolan JP, Berg KM, Cartledge S, Dawson JA, Elgohary MM, Ersdal HL, Finan E, Flaatten HI, Flores GE, Fuerch J, Garg R, Gately C, Goh M, Halamek LP, Handley AJ, Hatanaka T, Hoover A, Issa M, Johnson S, Kamlin CO, Ko YC, Kule A, Leone TA, MacKenzie E, Macneil F, Montgomery W, O’Dochartaigh D, Ohshimo S, Palazzo FS, Picard C, Quek BH, Raitt J, Ramaswamy VV, Scapigliati A, Shah BA, Stewart C, Strand ML, Szyld E, Thio M, Topjian AA, Udaeta E, Vaillancourt C, Wetsch WA, Wigginton J, Yamada NK, Yao S, Zace D, Zelop CM. 2022 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 2022; 146:e483-e557. [PMID: 36325905 DOI: 10.1161/cir.0000000000001095] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.
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Best B, Bissonnette E, Côté É, Henson A, Ohle R. The learning impact of a virtual CPR webinar for seniors. Resusc Plus 2022; 12:100307. [PMID: 36187431 PMCID: PMC9520270 DOI: 10.1016/j.resplu.2022.100307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 12/01/2022] Open
Abstract
Aim To assess the learning impact of a virtual interactive CPR webinar for seniors through mix-methods quantitative and qualitative survey analysis. Methods We surveyed 350 webinar attendees. The webinar trained participants in hands-only CPR technique and AED use. Survey questions included multiple-choice selection and open-ended responses. Qualitative inductive thematic analysis was conducted on open-ended question responses. Knowledge of CPR was measured on a 3-point scale (very little knowledge, some knowledge, a lot of knowledge). Proportions were compared pre and post seminar using a z-test. Results 231 respondents ≥ 65 years participated in the survey (response rate 66.0 %). There was a significant increase in self-reported knowledge of CPR pre and post webinar (very little knowledge 33.9 % to 1.8 % P < 0.00001, some knowledge 54.2 % to 12.1 % P < 0.0001, a lot of knowledge 11.9 % to 86.1 % P < 0.0001). We found 5 main themes on participant feedback: Positive affective comments, learning, constructive criticism, the desire to share information and comments on CPR ability. We identified 4 main themes related to further questions: Performing CPR in different circumstances, risks of CPR, information sharing, and prevention of death from myocardial infarction. Following the webinar, 89.9 % of respondents chose that they would be very likely to perform CPR on a friend, family member or colleague. Conclusion This study highlights the success of virtual CPR webinars for senior citizens in improving self-reported CPR knowledge. This has potential to address barriers to online education for seniors and increase bystander CPR rates.
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Affiliation(s)
- Brittany Best
- Northern Ontario School of Medicine University, Sudbury, Ontario, Canada
- Corresponding author.
| | | | - Émélie Côté
- Laurentian University, Sudbury, Ontario, Canada
| | | | - Robert Ohle
- The Department of Emergency Medicine, Health Science North Research Institute, Northern Ontario School of Medicine University, Sudbury, Ontario, Canada
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6
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Wyckoff MH, Greif R, Morley PT, Ng KC, Olasveengen TM, Singletary EM, Soar J, Cheng A, Drennan IR, Liley HG, Scholefield BR, Smyth MA, Welsford M, Zideman DA, Acworth J, Aickin R, Andersen LW, Atkins D, Berry DC, Bhanji F, Bierens J, Borra V, Böttiger BW, Bradley RN, Bray JE, Breckwoldt J, Callaway CW, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Phil Chung S, Considine J, Costa-Nobre DT, Couper K, Couto TB, Dainty KN, Davis PG, de Almeida MF, de Caen AR, Deakin CD, Djärv T, Donnino MW, Douma MJ, Duff JP, Dunne CL, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Finn J, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman M, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin YJ, Lockey AS, Maconochie IK, Madar RJ, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Morgan P, Morrison LJ, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, O'Neill BJ, Gene Ong YK, Orkin AM, Paiva EF, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, 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, Skrifvars MB, Smith CM, Sugiura T, Tijssen JA, Trevisanuto D, Van de Voorde P, Wang TL, Weiner GM, Wyllie JP, Yang CW, Yeung J, Nolan JP, Berg KM. 2022 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 2022; 181:208-288. [PMID: 36336195 DOI: 10.1016/j.resuscitation.2022.10.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimising pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.
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Gentile FR, Compagnoni S, Baldi E, Ghio S, Scelsi L, Greco A, Turco A, Oltrona Visconti L, Savastano S. Out-of-hospital cardiac arrest in patients with heart disease from family members' perspective: high perception of risk, low sense of adequacy and the importance of training. J Cardiovasc Med (Hagerstown) 2021; 22:790-791. [PMID: 33851938 DOI: 10.2459/jcm.0000000000001149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Cheng A, Magid DJ, Auerbach M, Bhanji F, Bigham BL, Blewer AL, Dainty KN, Diederich E, Lin Y, Leary M, Mahgoub M, Mancini ME, Navarro K, Donoghue A. Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S551-S579. [PMID: 33081527 DOI: 10.1161/cir.0000000000000903] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Oh GJ, Lee K, Kim K, Lee YH. Indicators Related to Cardiopulmonary Resuscitation According to Occupation Among Family Members of Coronary Heart Disease Patients. Chonnam Med J 2020; 56:196-202. [PMID: 33014759 PMCID: PMC7520363 DOI: 10.4068/cmj.2020.56.3.196] [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: 08/12/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 12/01/2022] Open
Abstract
This study aimed to evaluate differences in cardiopulmonary resuscitation (CPR)-related indicators among families of community-dwelling coronary heart disease (CHD) patients according to their occupation. A total of 6,867 family members living with CHD patients were selected for analysis from the 2016 Korea Community Health Survey. Respondents' occupations were classified into managers and professionals (MP), clerks (CL), service and sales workers (SSW), agricultural/forestry/fishery workers (AFFW), mechanical and manual laborers (MML), and homemakers and unemployed (HU). The adjusted odds ratio (aOR) for awareness of CPR in the MP (3.82), SSW (1.73), and MML (1.29) groups were higher than that in HU (reference), while the CL (1.42) and AFFW (1.04) groups showed no significant difference compared to HU. The aORs for experience with CPR education and manikin-assisted CPR training were higher among the MP (4.00 and 3.94), CL (2.61 and 2.26), SSW (2.02 and 1.91), and MML (1.99 and 1.69) groups than in HU, and only AFFW (1.22 and 1.18) showed no difference from HU. Finally, the aOR for self-efficacy in CPR performance was significantly higher among the MP (3.17), CL (1.64), SSW (1.87), and MML (1.44) groups than in HU. However, there was no significant difference between AFFW (1.22) and HU in self-efficacy in CPR performance. To improve the survival rate of CHD patients through successful CPR at the pre-hospital stage during cardiac arrest, it is important to increase the ability of family members of CHD patients to perform CPR, especially among those in AFFW and HU occupations.
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Affiliation(s)
- Gyung-Jae Oh
- Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
| | - Kyungsuk Lee
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea
| | - Kyungsu Kim
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
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Xu Y, Li J, Wu Y, Yue P, Wu F, Xu Y. An audio-visual review model enhanced one-year retention of cardiopulmonary resuscitation skills and knowledge: A randomized controlled trial. Int J Nurs Stud 2019; 102:103451. [PMID: 31734218 DOI: 10.1016/j.ijnurstu.2019.103451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 10/08/2019] [Accepted: 10/12/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND As the majority of out-of-hospital cardiac arrest occur at patients' homes, implementing high-quality cardiopulmonary resuscitation by family members is critical in improving patient outcomes. However, the survival rate remains low due to low bystander cardiopulmonary resuscitation rate and rapid skill deterioration in individuals who complete the training. OBJECTIVES To evaluate the effectiveness of audio-visual review model and audio-visual-practice review model on cardiopulmonary resuscitation skill retention 12 months after training. DESIGN A randomized, double-blind, placebo controlled, and three-arm parallel study. PARTICIPANTS A total of 641 family members of patients at high risk of out-of-hospital cardiac arrest enrolled in the study and 448 participants completed the follow-up. METHODS Family members from Beijing, China were recruited. All families underwent initial cardiopulmonary resuscitation training. Their cardiopulmonary resuscitation skill and knowledge were assessed immediately after training. Trainees who were rated "adequate skill and knowledge" were assigned randomly into one of three groups. The control group was given a cardiopulmonary resuscitation instruction booklet and a placebo-DVD without any reminders. Both audio-visual and audio-visual-practice groups were reinforced by a telephone reminder every 3 months. The audio-visual-practice group was also asked to simultaneously practice the skills while watching the instructional-DVD. The trainees' cardiopulmonary resuscitation skills and knowledge were re-assessed 12 months after training. RESULTS The retention rates of cardiopulmonary resuscitation skills in both audio-visual-practice (N = 177) and audio-visual (N = 157) groups were higher than that in control group (N = 114) 12 months after training (all P-values < 0.001). The cardiopulmonary resuscitation skill retention rate in audio-visual-practice group was higher than that in audio-visual group (49.7% vs 36.9%, P = 0.019), but no difference was found in intention-to-treat analysis (32.1% vs 27.1%, P = 0.230). Both audio-visual-practice and audio-visual groups had higher correct rates on all skill elements than that in control group (all P-values < 0.05). The cardiopulmonary resuscitation knowledge scores in both audio-visual-practice and audio-visual groups were higher than that in control group (all P-values < 0.001). However, no significant difference was found between audio-visual-practice and audio-visual groups (P = 0.243). CONCLUSIONS Both audio-visual-practice and audio-visual review models demonstrated better long-term retention of cardiopulmonary resuscitation skills for families of people at higher risk of out-of-hospital cardiac arrest. (Registration number: chiCTR-TRC-12002149).
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Affiliation(s)
- Yimin Xu
- School of Nursing, Capital Medical University, 10 You-an-men Wai Xi-tou-tiao, Fengtai District Beijing, 100069, China
| | - Jia Li
- School of Nursing, Capital Medical University, 10 You-an-men Wai Xi-tou-tiao, Fengtai District Beijing, 100069, China
| | - Ying Wu
- School of Nursing, Capital Medical University, 10 You-an-men Wai Xi-tou-tiao, Fengtai District Beijing, 100069, China.
| | - Peng Yue
- School of Nursing, Capital Medical University, 10 You-an-men Wai Xi-tou-tiao, Fengtai District Beijing, 100069, China
| | - Fangqin Wu
- School of Nursing, Capital Medical University, 10 You-an-men Wai Xi-tou-tiao, Fengtai District Beijing, 100069, China
| | - Yahong Xu
- School of Nursing, Capital Medical University, 10 You-an-men Wai Xi-tou-tiao, Fengtai District Beijing, 100069, China
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Cariou G, Pelaccia T. Are they trained? Prevalence, motivations and barriers to CPR training among cohabitants of patients with a coronary disease. Intern Emerg Med 2017; 12:845-852. [PMID: 27350627 DOI: 10.1007/s11739-016-1493-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 06/18/2016] [Indexed: 10/21/2022]
Abstract
Out-of-hospital cardiac arrest occurs most often at home and often in the presence of family members of the patient who witness the event. Cardiopulmonary resuscitation (CPR) training of the next of kin of at-risk patients is thus potentially beneficial. The aim of our study was to document the prevalence of appropriate training among cardiac patients' cohabitants, as well as the motivations or obstacles to seeking training. 153 cohabitants of 127 patients who were hospitalized 1 year prior for confirmed coronary disease in a cardiology department (Paris, France) were interviewed using a structured questionnaire between October 2013 and March 2014. 38 % of interrogated cohabitants had received CPR training, and in two-thirds of the cases, their training was undertaken prior to the onset of the patient's heart disease. The training received was often a single instruction session. Half took place more than 5 years prior to the interview. For two-thirds of interrogated families, the reasons they sought training were related to professional or military duties. Training undertaken solely due to cohabitation with a patient affected by coronary disease represented only 3.5 % of the trained respondents. A lack of information regarding existing training programs and a lack of concrete propositions were given as the main barriers to seeking training. The families of patients who are at-risk for cardiac arrests that were interrogated in our study are inadequately trained in CPR. The creation of dedicated training programs at cardiac rehabilitation services for patients' next of kin or the use of alternative methods such as self-instruction kits could potentially remedy this situation.
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Affiliation(s)
- Guillaume Cariou
- Mobile Palliative Care Team, Cochin University Hospital, Paris Hospitals Public Assistance, 27 rue du Faubourg-Saint-Jacques, 75014, Paris, France
| | - Thierry Pelaccia
- Centre for Training and Research in Health Sciences Education (CFR-PS), Faculty of Medicine, University of Strasbourg, 4 rue Kirschleger, 67085, Strasbourg, France.
- Prehospital Emergency Care Service (SAMU 67), Strasbourg University Hospital, PO Box 426, 67200, Strasbourg, France.
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A systematic review of basic life support training targeted to family members of high-risk cardiac patients. Resuscitation 2016; 105:70-8. [DOI: 10.1016/j.resuscitation.2016.04.028] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 03/01/2016] [Accepted: 04/27/2016] [Indexed: 01/08/2023]
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Bhanji F, Donoghue AJ, Wolff MS, Flores GE, Halamek LP, Berman JM, Sinz EH, Cheng A. Part 14: Education: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2016; 132:S561-73. [PMID: 26473002 DOI: 10.1161/cir.0000000000000268] [Citation(s) in RCA: 202] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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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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Tanaka Y, Nishi T, Takase K, Yoshita Y, Wato Y, Taniguchi J, Hamada Y, Inaba H. Survey of a Protocol to Increase Appropriate Implementation of Dispatcher-Assisted Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest. Circulation 2014; 129:1751-60. [DOI: 10.1161/circulationaha.113.004409] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) attempts to improve the management of out-of-hospital cardiac arrest by laypersons who are unable to recognize cardiac arrest and are unfamiliar with CPR. Therefore, we investigated the sensitivity and specificity of our new DA-CPR protocol for achieving implementation of bystander CPR in out-of-hospital cardiac arrest victims not already receiving bystander CPR.
Methods and Results—
Since 2007, we have applied a new DA-CPR protocol that uses supplementary key words. Fire departments prospectively collected baseline data on DA-CPR from January 2009 to December 2011. DA-CPR was attempted in 2747 patients; of these, 417 (15.2%) did not experience cardiac arrest. The sensitivity and specificity of the 2007 protocol versus estimated values of the previous standard protocol were 72.9% versus 50.3% and 99.6% versus 99.8%, respectively. We identified key words that may be useful for detecting out-of-hospital cardiac arrest. Multiple logistic regression analysis revealed that the occurrence of cardiac arrest after an emergency call (odds ratio, 16.85) and placing an emergency call away from the scene of the arrest (odds ratio, 11.04) were potentially associated with failure to provide DA-CPR. Furthermore, at-home cardiac arrest (odds ratio, 1.61) and family members as bystanders (odds ratio, 1.55) were associated with bystander noncompliance with DA-CPR. No complications were reported in the 417 patients who received DA-CPR but did not have cardiac arrest.
Conclusions—
Our 2007 protocol is safe and highly specific and may be more sensitive than the standard protocol. Understanding the factors associated with failure of bystanders to provide DA-CPR and implementing public education are necessary to increase the benefit of DA-CPR.
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Affiliation(s)
- Yoshio Tanaka
- From the Department of Emergency Medical Science, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan (Y.T., T.N., K.T., H.I.); Department of Surgery, Tsuruga Municipal Hospital, Tsuruga, Fukui, Japan (Y.T.); Department of Anesthesia, Komatsu Municipal Hospital, Komatsu, Ishikawa, Japan (Y.Y.); Department of Emergency Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan (Y.W.); Emergency Medical Center, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Taiki Nishi
- From the Department of Emergency Medical Science, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan (Y.T., T.N., K.T., H.I.); Department of Surgery, Tsuruga Municipal Hospital, Tsuruga, Fukui, Japan (Y.T.); Department of Anesthesia, Komatsu Municipal Hospital, Komatsu, Ishikawa, Japan (Y.Y.); Department of Emergency Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan (Y.W.); Emergency Medical Center, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Keiko Takase
- From the Department of Emergency Medical Science, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan (Y.T., T.N., K.T., H.I.); Department of Surgery, Tsuruga Municipal Hospital, Tsuruga, Fukui, Japan (Y.T.); Department of Anesthesia, Komatsu Municipal Hospital, Komatsu, Ishikawa, Japan (Y.Y.); Department of Emergency Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan (Y.W.); Emergency Medical Center, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Yutaka Yoshita
- From the Department of Emergency Medical Science, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan (Y.T., T.N., K.T., H.I.); Department of Surgery, Tsuruga Municipal Hospital, Tsuruga, Fukui, Japan (Y.T.); Department of Anesthesia, Komatsu Municipal Hospital, Komatsu, Ishikawa, Japan (Y.Y.); Department of Emergency Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan (Y.W.); Emergency Medical Center, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Yukihiro Wato
- From the Department of Emergency Medical Science, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan (Y.T., T.N., K.T., H.I.); Department of Surgery, Tsuruga Municipal Hospital, Tsuruga, Fukui, Japan (Y.T.); Department of Anesthesia, Komatsu Municipal Hospital, Komatsu, Ishikawa, Japan (Y.Y.); Department of Emergency Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan (Y.W.); Emergency Medical Center, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Junro Taniguchi
- From the Department of Emergency Medical Science, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan (Y.T., T.N., K.T., H.I.); Department of Surgery, Tsuruga Municipal Hospital, Tsuruga, Fukui, Japan (Y.T.); Department of Anesthesia, Komatsu Municipal Hospital, Komatsu, Ishikawa, Japan (Y.Y.); Department of Emergency Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan (Y.W.); Emergency Medical Center, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Yoshitaka Hamada
- From the Department of Emergency Medical Science, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan (Y.T., T.N., K.T., H.I.); Department of Surgery, Tsuruga Municipal Hospital, Tsuruga, Fukui, Japan (Y.T.); Department of Anesthesia, Komatsu Municipal Hospital, Komatsu, Ishikawa, Japan (Y.Y.); Department of Emergency Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan (Y.W.); Emergency Medical Center, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Hideo Inaba
- From the Department of Emergency Medical Science, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan (Y.T., T.N., K.T., H.I.); Department of Surgery, Tsuruga Municipal Hospital, Tsuruga, Fukui, Japan (Y.T.); Department of Anesthesia, Komatsu Municipal Hospital, Komatsu, Ishikawa, Japan (Y.Y.); Department of Emergency Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan (Y.W.); Emergency Medical Center, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
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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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Wagner KD, Davidson PJ, Iverson E, Washburn R, Burke E, Kral AH, McNeeley M, Jackson Bloom J, Lankenau SE. "I felt like a superhero": the experience of responding to drug overdose among individuals trained in overdose prevention. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2013; 25:157-65. [PMID: 23932166 DOI: 10.1016/j.drugpo.2013.07.003] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 07/01/2013] [Accepted: 07/07/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Overdose prevention programs (OPPs) train people who inject drugs and other community members to prevent, recognise and respond to opioid overdose. However, little is known about the experience of taking up the role of an "overdose responder" for the participants. METHODS We present findings from qualitative interviews with 30 participants from two OPPs in Los Angeles, CA, USA from 2010 to 2011 who had responded to at least one overdose since being trained in overdose prevention and response. RESULTS Being trained by an OPP and responding to overdoses had both positive and negative effects for trained "responders". Positive effects include an increased sense of control and confidence, feelings of heroism and pride, and a recognition and appreciation of one's expertise. Negative effects include a sense of burden, regret, fear, and anger, which sometimes led to cutting social ties, but might also be mitigated by the increased empowerment associated with the positive effects. CONCLUSION Findings suggest that becoming an overdose responder can involve taking up a new social role that has positive effects, but also confers some stress that may require additional support. OPPs should provide flexible opportunities for social support to individuals making the transition to this new and critical social role. Equipping individuals with the skills, technology, and support they need to respond to drug overdose has the potential to confer both individual and community-wide benefits.
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Affiliation(s)
- Karla D Wagner
- Division of Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0507, San Diego, CA 92093-0507, USA.
| | - Peter J Davidson
- Division of Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0507, San Diego, CA 92093-0507, USA
| | - Ellen Iverson
- Division of Adolescent Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS 2, Los Angeles, CA 90027, USA
| | - Rachel Washburn
- Department of Sociology, Loyola Marymount University, One LMU Drive, Suite 4314, Los Angeles, CA 90045-2659, USA
| | - Emily Burke
- Department of Community Health and Prevention, Drexel University School of Public Health, 1505 Race Street, Bellet Building, Philadelphia, PA 19102-1192, USA
| | - Alex H Kral
- Urban Health Program, RTI International, San Francisco Regional Office, 114 Sansome Street, Suite 500, San Francisco, CA 94104, USA
| | - Miles McNeeley
- Community, Health Outcomes and Intervention Research Program, The Saban Research Institute, Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS 30, Los Angeles, CA 90027, USA
| | - Jennifer Jackson Bloom
- Division of Adolescent Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS 2, Los Angeles, CA 90027, USA
| | - Stephen E Lankenau
- Department of Community Health and Prevention, Drexel University School of Public Health, 1505 Race Street, Bellet Building, Philadelphia, PA 19102-1192, USA
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Knight LJ, Wintch S, Nichols A, Arnolde V, Schroeder AR. Saving a Life After Discharge: CPR Training for Parents of High-Risk Children. J Healthc Qual 2013; 35:9-16; quiz17. [DOI: 10.1111/j.1945-1474.2012.00221.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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The impact on anxiety and perceived control of a short one-on-one nursing intervention designed to decrease treatment seeking delay in people with coronary heart disease. Eur J Cardiovasc Nurs 2012; 11:160-7. [PMID: 21126918 DOI: 10.1016/j.ejcnurse.2010.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Patient delay in seeking treatment for acute coronary syndrome symptoms remains a problem. Thus, it is vital to test interventions to improve this behavior, but at the same time it is essential that interventions not increase anxiety. PURPOSE To determine the impact on anxiety and perceived control of an individual face-to-face education and counseling intervention designed to decrease patient delay in seeking treatment for acute coronary syndrome symptoms. METHODS This was a multicenter randomized controlled trial of the intervention in which anxiety data were collected at baseline, 3-months and 12-months. A total of 3522 patients with confirmed coronary artery disease were enrolled; data from 2597 patients with anxiety data at all time points are included. The intervention was a 45 min education and counseling session, in which the social, cognitive and emotional responses to acute coronary syndrome symptoms were discussed as were barriers to early treatment seeking. Repeated measures analysis of covariance was used to compare anxiety and perceived control levels across time between the groups controlling for age, gender, ethnicity, education level, and comorbidities. RESULTS There were significant differences in anxiety by group (p = 0.03). Anxiety level was stable in patients in the control group, but decreased across time in the intervention group. Perceived control increased across time in the intervention group and remained unchanged in the control group (p = 0.01). CONCLUSION Interventions in which cardiac patients directly confront the possibility of an acute cardiac event do not cause anxiety if they provide patients with appropriate strategies for managing symptoms.
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Mancini ME, Soar J, Bhanji F, Billi JE, Dennett J, Finn J, Ma MHM, Perkins GD, Rodgers DL, Hazinski MF, Jacobs I, Morley PT. Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2010; 122:S539-81. [PMID: 20956260 DOI: 10.1161/circulationaha.110.971143] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Soar J, Mancini ME, Bhanji F, Billi JE, Dennett J, Finn J, Ma MHM, Perkins GD, Rodgers DL, Hazinski MF, Jacobs I, Morley PT. Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2010; 81 Suppl 1:e288-330. [PMID: 20956038 PMCID: PMC7184565 DOI: 10.1016/j.resuscitation.2010.08.030] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol,United Kingdom.
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Section 8: Disease Management, Advance Directives, and End-of-Life Care in Heart Failure Education and Counseling. J Card Fail 2010. [DOI: 10.1016/j.cardfail.2010.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Mark DB, Anstrom KJ, McNulty SE, Flaker GC, Tonkin AM, Smith WM, Toff WD, Dorian P, Clapp-Channing NE, Anderson J, Johnson G, Schron EB, Poole JE, Lee KL, Bardy GH. Quality of life effects of automatic external defibrillators in the home: results from the Home Automatic External Defibrillator Trial (HAT). Am Heart J 2010; 159:627-634.e7. [PMID: 20362722 DOI: 10.1016/j.ahj.2010.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Accepted: 01/23/2010] [Indexed: 01/22/2023]
Abstract
BACKGROUND Public access automatic external defibrillators (AEDs) can save lives, but most deaths from out-of-hospital sudden cardiac arrest occur at home. The Home Automatic External Defibrillator Trial (HAT) found no survival advantage for adding a home AED to cardiopulmonary resuscitation (CPR) training for 7,001 patients with a prior anterior wall myocardial infarction. Quality of life (QOL) outcomes for both the patient and spouse/companion were secondary end points. METHODS A subset of 1,007 study patients and their spouse/companions was randomly selected for ascertainment of QOL by structured interview at baseline and 12 and 24 months after enrollment. The primary QOL measures were the Medical Outcomes Study 36-Item Short-Form psychological well-being (reflecting anxiety and depression) and vitality (reflecting energy and fatigue) subscales. RESULTS For patients and spouse/companions, the psychological well-being and vitality scales did not differ significantly between those randomly assigned an AED plus CPR training and controls who received CPR training only. None of the other QOL measures collected showed a clinically and statistically significant difference between treatment groups. Patients in the AED group were more likely to report being extremely or quite a bit reassured by their treatment assignment. Spouse/companions in the AED group reported being less often nervous about the possibility of using AED/CPR treatment than those in the CPR group. CONCLUSIONS Adding access to a home AED to CPR training did not affect QOL either for patients with a prior anterior myocardial infarction or their spouse/companion but did provide more reassurance to the patients without increasing anxiety for spouse/companions.
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Motivating People to Learn Cardiopulmonary Resuscitation and Use of Automated External Defibrillators. J Cardiovasc Nurs 2010; 25:69-74. [DOI: 10.1097/jcn.0b013e3181ba2957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vaillancourt C, Charette ML, Stiell IG, Wells GA. An evaluation of 9-1-1 calls to assess the effectiveness of dispatch-assisted cardiopulmonary resuscitation (CPR) instructions: design and methodology. BMC Emerg Med 2008; 8:12. [PMID: 18986546 PMCID: PMC2585572 DOI: 10.1186/1471-227x-8-12] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Accepted: 11/05/2008] [Indexed: 11/10/2022] Open
Abstract
Background Cardiac arrest is the leading cause of mortality in Canada, and the overall survival rate for out-of-hospital cardiac arrest rarely exceeds 5%. Bystander cardiopulmonary resuscitation (CPR) has been shown to increase survival for cardiac arrest victims. However, bystander CPR rates remain low in Canada, rarely exceeding 15%, despite various attempts to improve them. Dispatch-assisted CPR instructions have the potential to improve rates of bystander CPR and many Canadian urban communities now offer instructions to callers reporting a victim in cardiac arrest. Dispatch-assisted CPR instructions are recommended by the International Guidelines on Emergency Cardiovascular Care, but their ability to improve cardiac arrest survival remains unclear. Methods/Design The overall goal of this study is to better understand the factors leading to successful dispatch-assisted CPR instructions and to ultimately save the lives of more cardiac arrest patients. The study will utilize a before-after, prospective cohort design to specifically: 1) Determine the ability of 9-1-1 dispatchers to correctly diagnose cardiac arrest; 2) Quantify the frequency and impact of perceived agonal breathing on cardiac arrest diagnosis; 3) Measure the frequency with which dispatch-assisted CPR instructions can be successfully completed; and 4) Measure the impact of dispatch-assisted CPR instructions on bystander CPR and survival rates. The study will be conducted in 19 urban communities in Ontario, Canada. All 9-1-1 calls occurring in the study communities reporting out-of-hospital cardiac arrest in victims 16 years of age or older for which resuscitation was attempted will be eligible. Information will be obtained from 9-1-1 call recordings, paramedic patient care reports, base hospital records, fire medical records and hospital medical records. Victim, caller and system characteristics will be measured in the study communities before the introduction of dispatch-assisted CPR instructions (before group), during the introduction (run-in phase), and following the introduction (after group). Discussion The study will obtain information essential to the development of clinical trials that will test a variety of educational approaches and delivery methods for telephone cardiopulmonary resuscitation instructions. This will be the first study in the world to clearly quantify the impact of dispatch-assisted CPR instructions on survival to hospital discharge for out-of-hospital cardiac arrest victims. Trial Registration ClinicalTrials.gov NCT00664443
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Vaillancourt C, Grimshaw J, Brehaut JC, Osmond M, Charette ML, Wells GA, Stiell IG. A survey of attitudes and factors associated with successful cardiopulmonary resuscitation (CPR) knowledge transfer in an older population most likely to witness cardiac arrest: design and methodology. BMC Emerg Med 2008; 8:13. [PMID: 18986547 PMCID: PMC2585573 DOI: 10.1186/1471-227x-8-13] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Accepted: 11/05/2008] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Overall survival rates for out-of-hospital cardiac arrest rarely exceed 5%. While bystander cardiopulmonary resuscitation (CPR) can increase survival for cardiac arrest victims by up to four times, bystander CPR rates remain low in Canada (15%). Most cardiac arrest victims are men in their sixties, they usually collapse in their own home (85%) and the event is witnessed 50% of the time. These statistics would appear to support a strategy of targeted CPR training for an older population that is most likely to witness a cardiac arrest event. However, interest in CPR training appears to decrease with advancing age. Behaviour surrounding CPR training and performance has never been studied using well validated behavioural theories. METHODS/DESIGN The overall goal of this study is to conduct a survey to better understand the behavioural factors influencing CPR training and performance in men and women 55 years of age and older. The study will proceed in three phases. In phase one, semi-structured qualitative interviews will be conducted and recorded to identify common categories and themes regarding seeking CPR training and providing CPR to a cardiac arrest victim. The themes identified in the first phase will be used in phase two to develop, pilot-test, and refine a survey instrument based upon the Theory of Planned Behaviour. In the third phase of the project, the final survey will be administered to a sample of the study population over the telephone. Analyses will include measures of sampling bias, reliability of the measures, construct validity, as well as multiple regression analyses to identify constructs and beliefs most salient to seniors' decisions about whether to attend CPR classes or perform CPR on a cardiac arrest victim. DISCUSSION The results of this survey will provide valuable insight into factors influencing the interest in CPR training and performance among a targeted group of individuals most susceptible to witnessing a victim in cardiac arrest. The findings can then be applied to the design of trials of various interventions designed to promote attendance at CPR classes and improve CPR performance. TRIAL REGISTRATION ClinicalTrials.gov NCT00665288.
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Affiliation(s)
- Christian Vaillancourt
- Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- Department of Emergency Medicine, University of Ottawa, Ottawa, Canada
| | - Jeremy Grimshaw
- Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Jamie C Brehaut
- Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | - Martin Osmond
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
| | - Manya L Charette
- Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa, Canada
| | - George A Wells
- Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | - Ian G Stiell
- Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- Department of Emergency Medicine, University of Ottawa, Ottawa, Canada
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Bardy GH, Lee KL, Mark DB, Poole JE, Toff WD, Tonkin AM, Smith W, Dorian P, Yallop JJ, Packer DL, White RD, Longstreth W, Anderson J, Johnson G, Bischoff E, Munkers CD, Brown A, McNulty S, Ray LD, Clapp-Channing NE, Rosenberg Y, Salive M, Schron EB. Rationale and design of the Home Automatic External Defibrillator Trial (HAT). Am Heart J 2008; 155:445-54. [PMID: 18294476 DOI: 10.1016/j.ahj.2007.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Accepted: 12/03/2007] [Indexed: 10/22/2022]
Abstract
Most cardiac arrests occur in the home, where emergency medical services (EMS) systems are challenged to provide timely care. Because a large proportion of sudden cardiac arrests (SCAs) are due to ventricular tachycardia or ventricular fibrillation, home use of an automated external defibrillator (AED) might offer an opportunity to decrease mortality in those at risk. Predicting who will have a cardiac arrest in the general population is difficult. Individuals at high risk are usually easily identified and may become candidates for implantable cardioverter defibrillators. It is within the population at lower risk where home AEDs may be most useful. The purpose of the Home Automatic External Defibrillator Trial (HAT) is to test whether providing home access to an AED can improve survival in patients at modest risk of SCA, such as those surviving an anterior myocardial infarction but in whom implantable cardioverter defibrillator therapy is not deemed necessary. Between January 23, 2003, and October 20, 2005, 7001 patients were enrolled, with completion of follow-up scheduled for September 30, 2007. Randomization was conducted in a 1:1 fashion between control therapy, comprising the standard lay response to SCA (calling the EMS and performing cardiopulmonary resuscitation), and the use of an AED first, followed by calling the EMS and performing cardiopulmonary resuscitation. The primary end point is all-cause mortality. Secondary outcomes include survival from SCA (witnessed and unwitnessed, in home and out of home), incremental cost-effectiveness, and quality of life measures for both the patient and the spouse/companion. The results of the trial should be available in mid 2008.
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Affiliation(s)
- Kathleen Dracup
- The School of Nursing, University of California, San Francisco, San Francisco, Calif (kd) and the Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, NY (cwb-b)
| | - Christopher W. Bryan-Brown
- The School of Nursing, University of California, San Francisco, San Francisco, Calif (kd) and the Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, NY (cwb-b)
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Groeneveld PW, Owens DK. Cost-effectiveness of training unselected laypersons in cardiopulmonary resuscitation and defibrillation. Am J Med 2005; 118:58-67. [PMID: 15639211 DOI: 10.1016/j.amjmed.2004.08.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2004] [Revised: 08/09/2004] [Indexed: 11/22/2022]
Abstract
PURPOSE The cost-effectiveness of cardiopulmonary resuscitation (CPR) and defibrillation training for laypersons unselected for risk of encountering cases of cardiac arrest is not known. We compared the costs and health benefits of alternative resuscitation training strategies for adults without professional first-responder duties who are at average risk of encountering cases of out-of-hospital cardiac arrest. METHODS We constructed a cost-effectiveness analytic model. Data on cardiac arrest epidemiology and the effectiveness of CPR/defibrillation training were obtained from the medical literature. Instructional costs were determined from a survey of training programs. Downstream cardiac arrest survivor quality-adjusted life expectancy and long-term health care costs were derived from prior studies. We compared three strategies for training unselected laypersons: CPR/defibrillation training alone, training combined with home defibrillator purchase, and no training. The main outcome measures were total instructional costs for trainees combined with health care costs for additional cardiac arrest survivors, and quality-adjusted survival for additional patients resuscitated by trainees. RESULTS CPR/defibrillation training yielded 2.7 quality-adjusted hours of life at a cost of 62 US dollars per trainee (202,400 US dollars per quality-adjusted life-year [QALY] gained). Training laypersons in CPR/defibrillation with subsequent defibrillator purchase cost 2,489,700 US dollars per QALY. In contrast, CPR/defibrillation training cost less than 75,000 US dollars per QALY if trainees lived with persons older than 75 years or with persons who had cardiac disease, or if total training costs were less than 10 US dollars. CONCLUSION Training unselected laypersons in CPR/defibrillation is costly compared with other public health initiatives. Conversely, training laypersons selected by occupation, low training costs, or having high-risk household companions is substantially more efficient.
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Schneider L, Sterz F, Haugk M, Eisenburger P, Scheinecker W, Kliegel A, Laggner AN. CPR courses and semi-automatic defibrillators — life saving in cardiac arrest? Resuscitation 2004; 63:295-303. [PMID: 15582765 DOI: 10.1016/j.resuscitation.2004.06.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2003] [Revised: 06/05/2004] [Accepted: 06/05/2004] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The aim was to assess the knowledge of life-supporting first-aid in both cardiac arrest survivors and relatives, and their willingness to have a semi-automatic external defibrillator in their homes and use it in an emergency. MATERIAL AND METHODS Cardiac arrest survivors, their families, friends, neighbours and co-workers were interviewed by medical students using prepared questionnaires. Their knowledge and self-assessment of life-supporting first-aid, their willingness to have a semi-automatic defibrillator in their homes and their willingness to use it in an emergency before and after a course in cardiopulmonary resuscitation (CPR) with a semi-automatic external defibrillator was evaluated. Courses were taught by medical students who had received special training in basic and advanced life support. RESULTS Both patients and relatives, after a course of 2-3 h, were no longer afraid of making mistakes by providing life-supporting first-aid. The automated external defibrillator (AED) was generally accepted and considered easy to handle. CONCLUSION We consider equipping high-risk patients and their families with AEDs as a viable method of increasing their survival in case of a recurring cardiac arrest. This, of course, should be corroborated by further studies.
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Affiliation(s)
- Liane Schneider
- Department of Emergency Medicine, Medical University of Vienna, Vienna 1090, Austria
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Abstract
Cardiovascular nurses contribute significantly to health outcomes and frequently assume responsibility for the clinical and organizational processes to ensure positive outcomes for patients and families. In ventricular dysrhythmia populations, nurses have provided evidence for practices that influence outcomes and have studied patient outcomes related to mortality, morbidity, quality of life, psychological and physical functioning, symptoms, and family responses. Additionally, nurses have contributed to understanding organizational outcomes, such as costs and resource use related to patients with dysrhythmias. Most ventricular dysrhythmia outcome studies are descriptive. More intervention research is needed to develop a cohesive and comprehensive body of evidence upon which to base dysrhythmia nursing care to improve patient outcomes.
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Affiliation(s)
- Sandra B Dunbar
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA.
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Thierbach AR, Pelinka LE, Reuter S, Mauritz W. Comparison of bystander trauma care for moderate versus severe injury. Resuscitation 2004; 60:271-7. [PMID: 15050758 DOI: 10.1016/j.resuscitation.2003.11.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2003] [Revised: 10/23/2003] [Accepted: 11/19/2003] [Indexed: 11/23/2022]
Abstract
At the scene of an accident, the most severely injured patients need trauma care urgently. Bystanders are often present before the emergency medical service arrives and may be able to limit trauma-related damage by providing trauma care at the scene. The aim of this prospective study conducted in Mainz, Germany, and Vienna, Austria, was to compare the frequency and quality of bystander trauma care in moderately versus severely injured patients. Five specific measures (making the scene readily visible for oncoming traffic, extrication and positioning of the trauma patient, control of haemorrhage, and hypothermia protection) were assessed in a questionnaire and evaluated statistically. Bystanders were present at the scene in 58.7% of all accidents. Making the scene readily visible for oncoming traffic, patient extrication and patient positioning were initiated significantly more often than haemorrhage control and hypothermia protection. Extrication, patient positioning and hypothermia protection were initiated significantly more often in moderately (NACA I-II) compared to severely (NACA III-VII) injured patients. In severely injured patients, bystanders attempted measures less frequently and the measures performed were more often incorrect compared to those in moderately injured patients. Our findings show that severely injured patients received less and less appropriate bystander trauma care than moderately injured patients. In an effort to correct this serious problem and to improve trauma care on-scene, we advocate offering lay persons more extensive training in bystander trauma care.
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Affiliation(s)
- A R Thierbach
- Clinic of Anaesthesiology, Johannes Gutenberg University, Langenbeckstrasse 1, Mainz 55131, Germany.
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Chen MA, Eisenberg MS, Meischke H. Impact of in-home defibrillators on postmyocardial infarction patients and their significant others: an interview study. Heart Lung 2002; 31:173-85. [PMID: 12011808 DOI: 10.1067/mhl.2002.124344] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the impact of automated external defibrillator (AED) placement in the homes of postmyocardial infarction (MI) patients and their significant others. DESIGN This qualitative study used a semistructured interview to examine a nonrandomized convenience sample recruited from a larger study of home AEDs. SETTING AND PARTICIPANTS Patients (and their significant others) were recruited from an ongoing study of AED use in the home. Seventeen interviews with 15 patients (14 men, 1 woman) and 16 significant others (1 man, 15 women) aged 39 to 80 years were performed in patients' homes. METHODS Verbatim transcripts of audiotaped interviews were reviewed, and responses were categorized. Other data were obtained from hospital chart abstraction. RESULTS The majority of subjects noted only positive effects of the presence of home AEDs (eg, giving them feelings of security and control). There was no evidence that AED presence in the home caused excessive anxiety or stress either in patients or their significant others, nor were they perceived to cause relationship stress. On average, patients and their significant others estimated a 38% and 43% (respectively) risk of cardiac arrest and a 92% and 87% likelihood of a successful resuscitation with the use of the AED. Subjects' perceived risk of cardiac arrest were subjectively related to their estimate of current health status, size of infarction, and symptoms during their MI. Subjects also related their estimates of risk to their likelihood of traveling with their AED and whether they would consider purchasing one. Significant others had high confidence in their ability to properly use the AED. CONCLUSIONS AEDs were valued highly by subjects and enhanced their perceived control over their heart disease. This was especially true for subjects who believed that their risk of cardiac arrest was high. The possible effects of providing education regarding expert estimates of the likelihood of cardiac arrest and of a successful resuscitation at the time of AED placement are discussed.
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Affiliation(s)
- Michael A Chen
- Department of Internal Medicine, Division of Health Services, University of Washington Hospitals, 9008 30th Avenue NE, Seattle, WA 98115, USA
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Bång A, Ortgren PO, Herlitz J, Währborg P. Dispatcher-assisted telephone CPR: a qualitative study exploring how dispatchers perceive their experiences. Resuscitation 2002; 53:135-51. [PMID: 12009217 DOI: 10.1016/s0300-9572(01)00508-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To investigate how emergency medical dispatchers (EMDs) perceive their experience of identifying suspected cardiac arrests (CA), and offer and provide instructions in cardiopulmonary resuscitation via telephone (t-CPR). DESIGN A qualitative method using the phenomenographic design where 10 EMDs were approached for semi-structured interviews. MAIN OUTCOME MEASURES Perception in identifying CA, perception in offering t-CPR and perception in providing t-CPR. RESULTS In this analysis, 12 categories and 31 subcategories emerged. The categories for perception in identifying CA were; to trust the witness's account, to be open-minded and to be organised. The categories for perception in offering t-CPR were: to feel prepared to connect with the witness on a mental level by being organised, flexible and supportive, to obtain a basis for assessments and to be observant for diverse obstacles in a situation. Finally, the categories for perception in providing t-CPR were: to feel engaged, to be supportive of the witness, to feel secure by recognising response-feedback from the witness, to observe external conditions with regard to the locality and technical complications, to be composed and adjust to the needs of the situation, to feel competent or to feel despair. CONCLUSIONS By listening in an open-minded way, a vast amount of information can be collected. Using criteria-based dispatch (CBD) and their own resources, the possibilities and difficulties of the situation are analysed. The EMDs believe that they are being an empathic support, relieving the witness of the burden of responsibility, and connecting with them mentally to enable them to act at the scene. There are EMDs who feel competent and experienced in managing these cases, and other EMDs who feel insecure and despair. The choice between providing t-CPR and answering incoming calls is prioritised differently among EMDs. There is also a broad subjective assessment among EMDs of offering t-CPR, especially to persons over 70 years old whom they consider incapable of performing CPR. The competence of the EMDs in t-CPR is dependent on re-training and a feedback on patient outcome. Witnesses who are negative towards acting constitute a common problem. There are witnesses with physical impediments or psychologically not susceptible to suggestions. The EMD is also dependent on the knowledge and trustworthiness of the witness. Convincing answers from witnesses prompt a more secure feeling in the EMDs, just as lack of knowledge in the witness has a negative effect on the efforts.
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Affiliation(s)
- Angela Bång
- Department of Cardiology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
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Platz E, Scheatzle MD, Pepe PE, Dearwater SR. Attitudes towards CPR training and performance in family members of patients with heart disease. Resuscitation 2000; 47:273-80. [PMID: 11114457 DOI: 10.1016/s0300-9572(00)00245-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Considering that heart patients may be at higher risk for cardiac arrest, this study was conducted to evaluate the preparedness and willingness of cardiac patient family members to perform cardiopulmonary resuscitation (CPR). A cross-sectional survey of 100 family members of cardiac patients was conducted at a tertiary care emergency department over a 1.5-month period. Response rate was 95%. While 49% reported prior CPR training, only 7% trained within the past year. The majority received training (59%) because of a school or job requirement with only 8% trained because of 'concern for a family member.' The most frequent reasons for not being trained were 'never thought about it' or 'not interested' (57%). However, 49% of the untrained group did report an interest in future training. While 2% of respondents recalled a healthcare professional suggesting such training, 58% stated they would be influenced positively by such a recommendation. The most frequently reported barriers to performing CPR included fear of harming the patient or a lack of knowledge and skill to help. Despite a presumed higher risk for sudden cardiac death, most family members of cardiac patients do not maintain skills in basic CPR. Healthcare professionals may have the ability to significantly alter this concerning statistic through education and routine recommendations to patients' families.
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Affiliation(s)
- E Platz
- Philipps-Universität Marburg, Fachbereich Humanmedizin, Baldingerstrasse, 35043 Marburg, Germany
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Kliegel A, Scheinecker W, Sterz F, Eisenburger P, Holzer M, Laggner AN. The attitudes of cardiac arrest survivors and their family members towards CPR courses. Resuscitation 2000; 47:147-54. [PMID: 11008152 DOI: 10.1016/s0300-9572(00)00214-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES to evaluate self-assessment of first aid knowledge, readiness to make use of it in case of a medical emergency and judgement of a 1-day CPR course by cardiac arrest survivors, their family members and friends as compared to the general public. BACKGROUND the recurrence rate of a cardiac arrest after successful resuscitation is high and most of out-of-hospital cardiac arrests occur at the patient's home. METHODS medical students trained in basic and advanced life support provided 101 members of the target group and 94 of a sex and age matched control group with a 1-day course in CPR. RESULTS after the course, half of the participants in both groups considered their knowledge of first aid to be very good or good. The readiness to perform first aid in a medical emergency increased significantly. Of the target group 96% of the participants as compared with the control group where 91% felt confident to recognise a cardiac arrest; 79 versus 68% considered themselves capable to perform CPR if needed. The course was judged as very good in 71 versus 69% and as good in 25 versus 27% with no differences between groups. CONCLUSION one-day CPR courses are well accepted by cardiac arrest survivors, their family members and friends and help to reduce fears of reacting in medical emergencies. They seem to be more motivated to gain and use first aid knowledge than others.
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Affiliation(s)
- A Kliegel
- Universitätsklinik für Notfallmedizin, Allgemeines Krankenhaus der Stadt Wien, Währinger Gürtel 18-20/6/D, 1090, Wien, Austria
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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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Doering LV, Moser DK, Dracup K. Correlates of anxiety, hostility, depression, and psychosocial adjustment in parents of NICU infants. Neonatal Netw 2000; 19:15-23. [PMID: 11949109 DOI: 10.1891/0730-0832.19.5.15] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The birth of a premature or critically ill infant can result in debilitating parental responses. This study identifies correlates of parental anxiety, hostility, depression, and psychosocial adjustment so that nurses can identify parents likely to need special attention or intervention. DESIGN An explanatory, correlational design was used. SAMPLE The study involved 469 parents (mothers = 299, 65 percent; mean age 29.1 +/- 6.8 years) of infants hospitalized in five Level III NICUs. MAIN OUTCOME VARIABLE The main outcomes were those variables which correlated with the independent variables and included: parent status (mother or father), ethnicity, employment status, and education. RESULTS Parents experienced high levels of anxiety, hostility, and depression. Poorer family functioning, lower levels of social support, and lower perceived control were associated with higher levels of anxiety, hostility, and depression and with poorer adjustment. Parental status (mother or father), ethnicity, employment status, and education were significantly related to parental responses.
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Affiliation(s)
- L V Doering
- UCLA School of Nursing, PO Box 956918, Los Angeles, CA 90095-6918, USA.
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Axelsson A, Thorén A, Holmberg S, Herlitz J. Attitudes of trained Swedish lay rescuers toward CPR performance in an emergency. A survey of 1012 recently trained CPR rescuers. Resuscitation 2000; 44:27-36. [PMID: 10699697 DOI: 10.1016/s0300-9572(99)00160-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
59 years old. Only 1% had attended the course because of their own or a relative's cardiac disease. Ninety-four per cent believed there was a minor to major risk of serious disease transmission while performing CPR. When predicting their willingness to perform CPR in six scenarios, 17% would not start CPR on a young drug addict, 7% would not perform CPR on an unkempt man, while 97% were sure about starting CPR on a relative and 91% on a known person. In four of six scenarios, respondents from rural areas were significantly more positive than respondents from metropolitan areas about starting CPR. In conclusion, readiness to perform CPR on a known person is high among trained CPR rescuers, while hesitation about performing CPR on a stranger is evident. Respondents from rural areas are more frequently positive about starting CPR than those from metropolitan areas.
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Affiliation(s)
- A Axelsson
- Division of Cardiology, Sahlgrenska University Hospital, Röda Srâket 4, SE-413 45, Göteborg, Sweden.
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Westmacott J, Evans J, Turner S, Todd S, Bethell H, Baker N. Heartlearn: Effects of a training session for relatives of myocardial infarction patients. ACTA ACUST UNITED AC 1999. [DOI: 10.1016/s1362-3265(99)80045-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM, Grunwald MA, Levy D, Lytle BW, O'Rourke RA, Schafer WP, Williams SV, Ritchie JL, Cheitlin MD, Eagle KA, Gardner TJ, Garson A, Russell RO, Ryan TJ, Smith SC. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina). J Am Coll Cardiol 1999; 33:2092-197. [PMID: 10362225 DOI: 10.1016/s0735-1097(99)00150-3] [Citation(s) in RCA: 367] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Lie K, Richardson M. Attitudes of health professionals towards cardiopulmonary resuscitation training for family members of cardiac patients. ACTA ACUST UNITED AC 1999. [DOI: 10.1016/s1362-3265(99)80021-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Richardson ME, Lie KG. Cardiopulmonary resuscitation training for family members of patients on cardiac rehabilitation programmes in Scotland. Resuscitation 1999; 40:11-9. [PMID: 10321843 DOI: 10.1016/s0300-9572(98)00147-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Existing cardiopulmonary resuscitation (CPR) training programmes have failed to reach those most likely to witness a cardiac arrest, such as families of cardiac patients. In 1993, the Scottish Health Service Advisory Committee suggested that CPR training could be offered as part of cardiac rehabilitation programmes. A survey was carried out to identify the current extent and nature of such training and factors influencing its provision. Questionnaires were mailed to all the 45 Scottish cardiac rehabilitation programmes on the British Heart Foundation's register. A 93% response rate was achieved. Only 37% of programmes provided information to families about attending a CPR course and 37% actually provided CPR training The numbers trained by these programmes were very small. Hospital programmes were significantly more likely than community programmes to provide CPR training (chi2 = 6.65, P < 0.01) as were those which included an exercise component (chi2 = 7.63, P < 0.01). Reasons for not providing training ranged from lack of resources and lack of staff training, to not having considered it. CPR training is provided as part of cardiac rehabilitation programmes to a limited extent. Ways of recruiting and increasing the number of family members of cardiac patients who are trained in CPR need to be found.
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Dracup K, Moser DK, Taylor SE, Guzy PM. The psychological consequences of cardiopulmonary resuscitation training for family members of patients at risk for sudden death. Am J Public Health 1997; 87:1434-9. [PMID: 9314793 PMCID: PMC1380966 DOI: 10.2105/ajph.87.9.1434] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The purpose of this study was to determine psychological consequences of teaching cardiopulmonary resuscitation (CPR) to family members of patients at risk for sudden death. METHODS Patient-family pairs (n = 337) were randomized into one of four groups: control, CPR only, CPR with cardiac risk factor education, and CPR with a social support intervention. Only family members received CPR training. Data on emotional state and psychosocial adjustment to illness were collected at baseline, 2 weeks, and 3 and 6 months following CPR training. RESULTS There were no significant differences in the emotional states of family members across the four groups. However, significant differences in psychosocial adjustment and emotional states occurred in patients across treatment groups following CPR training. Patients whose family members learned CPR with the social support intervention reported better psychosocial adjustment and less anxiety and hostility than patients in the other groups. Control patients reported better psychosocial adjustment and less emotional distress than patients in the CPR-only and CPR-education groups. CONCLUSIONS These findings support tailoring family CPR training so that instruction does not result in negative psychological states in patients. The findings also illustrate the efficacy of a simple intervention that combines CPR training with social support.
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Affiliation(s)
- K Dracup
- School of Nursing, University of California, Los Angeles 90095, USA
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Braslow A, Brennan RT, Newman MM, Bircher NG, Batcheller AM, Kaye W. CPR training without an instructor: development and evaluation of a video self-instructional system for effective performance of cardiopulmonary resuscitation. Resuscitation 1997; 34:207-20. [PMID: 9178381 DOI: 10.1016/s0300-9572(97)01096-4] [Citation(s) in RCA: 168] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Traditional classroom-based instruction of cardiopulmonary resuscitation (CPR) has failed to achieve desired rates of bystander CPR. Video self-instruction (VSI) is a more accessible alternative to traditional classroom instruction (TRAD), and it achieves better CPR skill performance. VSI employs a 34-min training tape and an inexpensive manikin. VSI combines simplified and reordered content focusing on the delivery of one-rescuer CPR with the 'practice-as-you-watch' approach of an exercise video. Performance of CPR skills immediately following VSI was compared to performance immediately following TRAD using an instrumented manikin, a valid and reliable skill checklist, and an overall competency rating. Compared with TRAD subjects, VSI subjects performed more compressions correctly (P < 0.001), more ventilations correctly (P < 0.001), and more assessment and sequence skills correctly (P < 0.001). TRAD subjects delivered twice as many compressions that were too shallow, and underinflated the lungs twice as often. VSI subjects were rated 'competent' or better 80.0% of the time, compared with TRAD subjects, who achieved this rating only 45.1% of the time (P < 0.001). TRAD subjects were rated to be 'not competent' in performing CPR nearly 10 times more often than VSI subjects (P < 0.001). Subjects 40 years of age and older performed better after VSI than after TRAD. Superior skill performance among subjects exposed to VSI persisted 60 days following training. VSI has the potential to reach individuals unlikely to participate in TRAD classes because of its greater convenience, lower cost, and training in about 0.50 h compared with 3-4 h for TRAD classes.
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Affiliation(s)
- A Braslow
- Braslow and Associates, Alexandria, VA 22304, USA
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