Abstract 80: Lay Bystanders Taught With the 2010 CPR Guidelines Perform Deeper Chest Compressions Than Those Taught With the 2005 Guidelines When Tested Longitudinally, A Multicenter Hospital-Based Study

Abstract

Background: Survival from cardiac arrest is sensitive to the quality of delivered CPR, including factors such as chest compression depth. In 2010, the American Heart Association (AHA) updated its recommended guidelines to promote deeper chest compressions (> 50-51 mm) and faster rate (>100 per min). It is unknown whether training lay bystanders in hands-only CPR using the 2010 CPR guidelines actually results in deeper compression depth and faster rate when tested longitudinally. Objectives: We hypothesized that laypersons taught CPR using the 2010 AHA guidelines will retain psychomotor memory and perform deeper chest compressions at a faster rate than those taught with the 2005 guidelines when tested six months after training. Methods: In an ongoing multicenter trial of CPR educational strategies, family members of hospitalized cardiac patients were trained in hands-only CPR using an established video self instructional tool. An initial cohort was taught using the 2005 AHA guidelines, and a separate cohort was taught in a comparable environment and methodology using the 2010 guideline training materials. Subject’s skills and impressions of the training were assessed after initial enrollment. CPR skills were quantified on a CPR-recording manikin and analyzed using statistical software. Results: Subject data were collected prospectively from 5/2009 to 4/2013; 312 subjects completed the assessment. Among the subjects, 202 received 2005 guideline training and 110 underwent 2010 training. Mean age were 52±14 years, 240/312 (77%) were spouses/immediate family of the hospitalized patients and 245/312 (79%) were never CPR trained or had not received training in over 10 years. The mean chest compression rate in the 2005 group was 87±25 per min, and in the 2010 group was 87±20 per min (p=ns), while the mean chest compression depth was 34±12 mm in the 2005 group and 44±12 mm in the 2010 cohort (p<0.001). Conclusions: Implementation of the 2010 CPR guidelines resulted in a statistically significant increase in lay bystander’s performance of chest compression depth long after initial training. However, mean chest compression rate remained low despite the new guidelines. These findings have important implications for future development of CPR training materials.