Traditional versus blended CPR training program: A randomized controlled non-inferiority study

Cheng-Yu Chien,Chen-Bin Chen,Kuang-Hung Hsu,Peng-Huei Liu,Cheng-Yu Lin,Hsiao-Jung Tseng,Li-Heng Tsai,Chien-Hsiung Huang,Shu-Yuan Peng,Chung-Hsien Chaou,Chip-Jin Ng,Yi-Ming Weng,Jih-Chang Chen,Tsung-Hsuan Cheng,Wei-Che Chien,Shang-Li Tsai,Chi-Chun Lin,Chen-June Seak,Shao-Yu Fang

doi:10.1038/s41598-020-67193-1

Abstract

Cardiopulmonary resuscitation (CPR) training and its quality are critical in improving the survival rate of cardiac arrest. This randomized controlled study investigated the efficacy of a newly developed CPR training program for the public in a Taiwanese setting. A total of 832 adults were randomized to either a traditional or blended (18-minute e-learning plus 30-minute hands-on) compression-only CPR training program. The primary outcome was compression depth. Secondary outcomes included CPR knowledge test, practical test, quality of CPR performance, and skill retention. The mean compression depth was 5.21 cm and 5.24 cm in the blended and traditional groups, respectively. The mean difference in compression depth between groups was −0.04 (95% confidence interval −0.13 to infinity), demonstrating that the blended CPR training program was non-inferior to the traditional CPR training program in compression depth after initial training. Secondary outcome results were comparable between groups. Although the mean compression depth and rate were guideline-compliant, only half of the compressions were delivered with adequate depth and rate in both groups. CPR knowledge and skill retained similarly in both groups at 6 and 12 months after training. The blended CPR training program was non-inferior to the traditional CPR training program. However, there is still room for improvement in optimizing initial skill performance as well as skill retention. Clinical Trial Registration: NCT03586752; www.clinicaltrial.gov

Highlights

The survival rate of out-of-hospital cardiac arrest (OHCA) is low
Wang et al.[5] reported that, among the documented OHCA cases with automated external defibrillators (AEDs) used, 35% were known to be operated by the employees at the designated AED locations, and long-term care facilities had the highest utilization rate of AED
By adopting a non-inferiority study design, we hypothesized that the new cardiopulmonary resuscitation (CPR)-AED training format would be comparable to that of the traditional program in terms of CPR quality as well as CPR knowledge and other skills performance but would be more time-saving and cost-effective

Summary

Introduction

The survival rate of out-of-hospital cardiac arrest (OHCA) is low. In the United States, it has remained between 7% and 9% for the past decades[1]. Training with a focus on cardiopulmonary resuscitation (CPR) quality and AED should be implemented and provided, at the AED locations of high cardiac arrest frequency. The CPR-AED training course is instructor-led and classroom-based For both the trainer and course-taker, time, cost, logistics, and discomfort over being in a classroom setting are often barriers to the traditional training program[11]. We aimed to develop an alternative training format, which was time-saving and convenient, while maintaining high quality, for the Taiwanese population. By adopting a non-inferiority study design, we hypothesized that the new CPR-AED training format would be comparable to that of the traditional program in terms of CPR quality (e.g. compression depth) as well as CPR knowledge and other skills performance but would be more time-saving and cost-effective

Objectives

Methods

Results

Conclusion