Evolution of Bystander Intention to Perform Resuscitation Since Last Training: Web-Based Survey

Effectiveness of first-aid education in road traffic crashes on non-healthcare professionals' knowledge, attitude, and skills: a systematic review

This review aimed to evaluate and synthesize information on the effects of first-aid education in road traffic crashes on knowledge, attitudes, and skills among non-healthcare professionals. A qualitative study was designed according to the Prepared Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards to evaluate three outcomes, knowledge, skills, and attitude. The search strategy was performed in five databases (Science Direct, Scopus, CINAHL Plus, PubMed, and Google Scholar) to retrieve primary studies published between January 2011 and December 2021. In addition, the full texts of randomized controlled trials conducted on adults were included. Among the 2,399 articles retrieved from the databases, 2,388 were discarded, and only five studies met the inclusion criteria and were used in the final analysis and synthesis. Three of the five studies suggested that knowledge and skills are crucial in differentiating outcome factors between intervention and control groups regarding the effectiveness of first aid education. However, two studies on attitude and behaviour toward first-aid found no discernible change between the intervention and the control group. Therefore, our review revealed that only a well-structured first aid education is crucial to leverage the knowledge and skills of non-healthcare professionals before first aid provision, not attitude or behaviours.

Impact of Two Resuscitation Sequences on Alveolar Ventilation during the First Minute of Simulated Pediatric Cardiac Arrest: Randomized Cross-Over Trial

The International Liaison Committee on Resuscitation regularly publishes a Consensus on Science with Treatment Recommendations, but guidelines can nevertheless differ when knowledge gaps persist. In case of pediatric cardiac arrest, the American Heart Association recommends following the adult resuscitation sequence, i.e., starting with chest compressions. Conversely, the European Resuscitation Council advocates the delivery of five initial rescue breaths before starting chest compressions. This was a superiority, randomized cross-over trial designed to determine the impact of these two resuscitation sequences on alveolar ventilation in a pediatric model of cardiac arrest. The primary outcome was alveolar ventilation during the first minute of resuscitation maneuvers according to the guidelines used. A total of 56 resuscitation sequences were recorded (four sequences per team of two participants). The ERC approach enabled higher alveolar ventilation volumes (370 mL [203−472] versus 276 mL [140−360], p < 0.001) at the cost of lower chest compression fractions (57% [54;64] vs. 66% [59;68], p < 0.001). Although statistically significant, the differences found in this simulation study may not be clinically relevant. Therefore, and because of the importance of overcoming barriers to resuscitation, advocating a pediatric-specific resuscitation algorithm may not be an appropriate strategy.

Basic Life Support Knowledge among Junior Medical and Dental Students, Communication Channels, and the COVID-19 Pandemic

Background and objective: The prognosis of cardiac arrest victims strongly depends on the prompt provision of Basic Life Support (BLS) maneuvers. Medical students should therefore be proficient in this area, but many lack essential BLS knowledge. The goal of this prospective, closed web-based study was to determine whether a short intervention designed to motivate first-year medical students to follow a blended BLS course could lead to a significant improvement in BLS knowledge in the following year. Materials and Methods: A fully automated web-based questionnaire was administered to second-year medical students one year after they had been given the opportunity of following a blended BLS course (e-learning and practice session). The primary outcome was the difference, on a 6-question score assessing essential BLS knowledge, between these students and those from the 2020 promotion since the latter had not been offered the optional BLS course. Results: The score was similar between the two study periods (3.3 ± 0.8 in 2022 vs. 3.0 ± 1.0 in 2020, p = 0.114), but no firm conclusion could be drawn since participation was much lower than expected (17.9% in 2022 vs. 43.7% in 2020, p < 0.001). Therefore, a second questionnaire was created and administered to understand the reasons underlying this low participation. Conclusions: There was a lack of improvement in BLS knowledge in second-year medical students after the introduction of an optional introductory BLS course in the first-year curriculum, but the limited participation rate precludes drawing definitive conclusions. Ineffective communication appears to be the cause of this low participation rate, but a lack of motivation in the aftermath of the COVID-19 pandemic cannot be ruled out. Corrective actions should be considered to enhance communication, restore motivation, and ultimately improve BLS knowledge among medical and dental students.

Translation, Cross-Cultural Adaptation, and Validation of the Malay-Version of the Factors Influencing Community Willingness to Perform Cardiopulmonary Resuscitation and Use an Automated External Defibrillator Questionnaire

Limited factors influence community willingness to perform cardiopulmonary resuscitation and use an automated external defibrillator, making it difficult to take preventive and control measures to improve the survival of patients with out-of-hospital cardiac arrest. In this study, we translated and evaluated the Malay-language version of the cardiopulmonary resuscitation and an automated external defibrillator questionnaire. The translation and evaluation involved three phases: development, translation and cultural adaptation, and validation. Content validity was assessed by five experts, and demonstrated a content validity index of 0.98 and a Fleiss kappa index of 0.159. Construct validity for the multi-item scale performed using factor analysis and involving 100 participants was 0.777. Factor analysis using the varimax rotation method demonstrated the appropriateness of the data in the exploratory factor analysis. Cronbach’s alpha was 0.849, suggesting high reliability. Test–retest reliability involving 45 participants calculated using the intraclass correlation coefficient had a value of 0.723. The findings demonstrate that the Malay-version FIXED questionnaire is a valid and reliable instrument and is ready to be used by health care workers and policymakers to evaluate the factors influencing the community’s willingness to perform cardiopulmonary resuscitation and use an automated external defibrillator.

Impact of a Serious Game (Escape COVID-19) on the Intention to Change COVID-19 Control Practices Among Employees of Long-term Care Facilities: Web-Based Randomized Controlled Trial

BACKGROUND

Most residents of long-term care facilities (LTCFs) are at high risk of complications and death following SARS-CoV-2 infection. In these facilities, viral transmission can be facilitated by shortages of human and material resources, which can lead to suboptimal application of infection prevention and control (IPC) procedures. To improve the dissemination of COVID-19 IPC guidelines, we developed a serious game called "Escape COVID-19" using Nicholson's RECIPE for meaningful gamification, as engaging serious games have the potential to induce behavioral change.

OBJECTIVE

As the probability of executing an action is strongly linked to the intention of performing it, the objective of this study was to determine whether LTCF employees were willing to change their IPC practices after playing "Escape COVID-19."

METHODS

This was a web-based, triple-blind, randomized controlled trial, which took place between November 5 and December 4, 2020. The health authorities of Geneva, Switzerland, asked the managers of all LTCFs under their jurisdiction to forward information regarding the study to all their employees, regardless of professional status. Participants were unaware that they would be randomly allocated to one of two different study paths upon registration. In the control group, participants filled in a first questionnaire designed to gather demographic data and assess baseline knowledge before accessing regular online IPC guidelines. They then answered a second questionnaire, which assessed their willingness to change their IPC practices and identified the reasons underlying their decision. They were then granted access to the serious game. Conversely, the serious game group played "Escape COVID-19" after answering the first questionnaire but before answering the second one. This group accessed the control material after answering the second set of questions. There was no time limit. The primary outcome was the proportion of LTCF employees willing to change their IPC practices. Secondary outcomes included the factors underlying participants' decisions, the domains these changes would affect, changes in the use of protective equipment items, and attrition at each stage of the study.

RESULTS

A total of 295 answer sets were analyzed. Willingness to change behavior was higher in the serious game group (82% [119/145] versus 56% [84/150]; P<.001), with an odds ratio of 3.86 (95% CI 2.18-6.81; P<.001) after adjusting for professional category and baseline knowledge, using a mixed effects logistic regression model with LTCF as a random effect. For more than two-thirds (142/203) of the participants, the feeling of playing an important role against the epidemic was the most important factor explaining their willingness to change behavior. Most of the participants unwilling to change their behavior answered that they were already applying all the guidelines.

CONCLUSIONS

The serious game "Escape COVID-19" was more successful than standard IPC material in convincing LTCF employees to adopt COVID-19-safe IPC behavior.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/25595.

Differences in Basic Life Support Knowledge Between Junior Medical Students and Lay People: Web-Based Questionnaire Study

BACKGROUND

Early cardiopulmonary resuscitation and prompt defibrillation markedly increase the survival rate in the event of out-of-hospital cardiac arrest (OHCA). As future health care professionals, medical students should be trained to efficiently manage an unexpectedly encountered OHCA.

OBJECTIVE

Our aim was to assess basic life support (BLS) knowledge in junior medical students at the University of Geneva Faculty of Medicine (UGFM) and to compare it with that of the general population.

METHODS

Junior UGFM students and lay people who had registered for BLS classes given by a Red Cross-affiliated center were sent invitation links to complete a web-based questionnaire. The primary outcome was the between-group difference in a 10-question score regarding cardiopulmonary resuscitation knowledge. Secondary outcomes were the differences in the rate of correct answers for each individual question, the level of self-assessed confidence in the ability to perform resuscitation, and a 6-question score, "essential BLS knowledge," which only contains key elements of the chain of survival. Continuous variables were first analyzed using the Student t test, then by multivariable linear regression. Fisher exact test was used for between-groups comparison of binary variables.

RESULTS

The mean score was higher in medical students than in lay people for both the 10-question score (mean 5.8, SD 1.7 vs mean 4.2, SD 1.7; P<.001) and 6-question score (mean 3.0, SD 1.1 vs mean 2.0, SD 1.0; P<.001). Participants who were younger or already trained scored consistently better. Although the phone number of the emergency medical dispatch center was well known in both groups (medical students, 75/80, 94% vs lay people, 51/62, 82%; P=.06), most participants were unable to identify the criteria used to recognize OHCA, and almost none were able to correctly reorganize the BLS sequence. Medical students felt more confident than lay people in their ability to perform resuscitation (mean 4.7, SD 2.2 vs mean 3.1, SD 2.1; P<.001). Female gender and older age were associated with lower confidence, while participants who had already attended a BLS course prior to taking the questionnaire felt more confident.

CONCLUSIONS

Although junior medical students were more knowledgeable than lay people regarding BLS procedures, the proportion of correct answers was low in both groups, and changes in BLS education policy should be considered.