Challenges in basic life support and automated external defibrillator training of deaf individuals

Abstract

Objectives: Basic life support (BLS) with the use of an automated external defibrillator (AED) is linked to survival of patients with out-of-hospital cardiac arrest (OHCA). However, the BLS protocol is not tailored to specific needs of the deaf who encounter many challenges during BLS training. Methods: The BLS and AED protocol was modified according to the challenges faced by deaf people. Pre-course BLS and AED knowledge was tested using a questionnaire. After completion of a practical course, each participant was presented with an OHCA scenario using a manikin. Qualitative and quantitative data on BLS and AED performance were collected with a modified Cardiff test and the QCPR mobile application. Results of the knowledge test and performance scores are presented with values and frequencies. Correlations between pre- and post-course BLS and AED knowledge and performance were analyzed and presented with Spearman’s rho. Results: 51 deaf volunteers from seven Slovenian deaf associations participated in the study. The pre-course knowledge test scores were 3.5 points out of 10 and considered low. The rest of the results were also poor. BLS performance using the modified Cardiff test post-course was as follows: 52.9% of the participants used a safe approach, 58.8%checked responsiveness and 51.0% sent a text message to the rescue service. Only 43.1% opened the airway and 49.0% checked initial breathing. 80.4% of deaf rescuers performed chest compressions on the lower half of the sternum and 52.9% compressed with adequate depth. According to the QCPR application the best performance was achieved with a compression score of 61.1% and flow fraction 74.9%. Conclusions: This study shows that a comprehensive and assiduous approach is needed for effective BLS and AED training courses for deaf individuals.