Basic Cardiopulmonary Resuscitation Skills Research Articles

Impact of a Training Intervention for Usein Emergency Situations on Knowledge and Skills Acquisition by Undergraduate Students

The aim of this study was to evaluate the impact of an intervention aimed at the enhancing of undergraduate students in emergency situations and to identify the factors related to the acquisition of participants’ knowledge and skills. This was an intervention study using a convenience sample of 424 students from different campuses of a public university in the interior of São Paulo State, Brazil. Theoretical learning was assessed using pre-test and post-test multiple-choice questions, and skills in basic life support were assessed via simulation using a mannequin, immediate feedback devices and a checklist. The mean knowledge score attained was 15.1 (SD±3.50) on the pre-test and20.9 (SD±3.20) on the post-test (p< 0.001). Regarding basic cardiopulmonary resuscitation skills, the mean scores before and after the training were 36.3(SD=±5.3) and178 (SD± 28.3) respectively (p< 0.001). Age was associated with an increase in knowledge and skills’ score when comparing before and after training scores (p=0.0000). The practical basic life support training intervention received an assessment of 75.4%from students of all areas. The training intervention contributed to improvement in both knowledge of care in emergency situations and basic life support skills. Age was the only factor that independently influenced the development of learning and psychomotor skills.

Retention of Skills with and without Debriefing Three-Months after Cardiopulmonary Resuscitation Training in Makkah, Saudi Arabia: A Randomized Controlled Trial

Background: Evidence of cardiopulmonary resuscitation (CPR) performance has driven interest in procedures, e.g., debriefing to improve CPR quality. Aim: To investigate retention of skills with and without debriefing 3-months after CPR training on high-fidelity manikins (HFM) among participants involved in the “Heart Safe City Initiative” event (HSCI) in Makkah, Saudi Arabia. Methodology: A randomized controlled design was used during October 2017-January 2018. Participants were divided into two groups: an intervention group to receive debriefing after CPR (debriefing group or “subjects”), and a non-intervention group (“controls”). Participants were tested repeatedly: before training (pre-training test), immediately after and 3-months after training (retention or late test); and scores for each test were recorded. Results: The study’s subjects and controls did not vary by age, sex, nationality, and profession’s criteria (p > 0.05, all analyses). The mean retention posttests scores significantly varied between subjects and controls [t>(df = 200) = 27.7, p p = 0.18). Further, the immediate posttest scores were significantly higher than the pretests’ within the study population as a whole group [mean difference 38.05% ± 27.59%, t>(df = 201) = 13.5, p t>(105) = 14.31, p t>(df = 95) = 13.50, p t>(df = 201) = 20.85, p t>(df = 105) = 21.46, p t>(df = 95) = 22.12, p t>(df = 200),4.76, p t(df = 97) = -2.95, p Conclusions: Debriefing using HFM training achieves the target of improving the public’s skills of CPR. Considering the urgent need to recruit every society member to be a heartsaver; debriefing after CPR training helps improve the quality and retention of basic CPR skills.

EXPERIENCE IN APPLYING EDUCATIONAL PROGRAM FOR PEDIATRICIANS ON EMERGENCY CARE FOR CHILDREN USING MOBILE SIMULATION EQUIPMENT

The article describes the experience of implementing the “Emergency pediatrics” educational program with the use of simulation training methods, mobile simulation equipment, and distance educational technologies. The program is aimed at improving the doctors’ professional competence in emergency medical care for children. This format of the training helps to train the largest number of doctors in accordance with the international standards for emergency medical care on-the-job. The educational program makes it possible to assess the level of initial and final knowledge, to monitor professional skills, to determine the degree of the doctor’s readiness for emergency medical care for children. Based on the results of the incoming test control and assessment of basic cardiopulmonary resuscitation skills, we can conclude that the pediatricians have insufficient theoretical and practical skills of emergency care. As a promising direction, we plan to create a Register for sudden cardiac arrest, the Register of survival after sudden cardiac arrest in children at hospital and outside the hospital, which improve the quality of emergency and urgent care for children.

Wilderness First Responder: Are Skills Soon Forgotten?

Wilderness first responders are trained to provide competent medical care in wilderness settings or until evacuation for more advanced treatment can be obtained. In light of the isolated environments in which they are called upon to respond to illnesses and injuries, their ability to effectively apply their training is crucial. Despite the responsibility assigned to them, there is an absence of research assessing the skill and knowledge retention of wilderness first responders, creating a gap in understanding whether a deficit in their ability to perform exists between certifications. Without such research, it is important to review knowledge and skill retention in related responder groups. The literature over the past 4 decades documents the loss over time of skills and knowledge across an array of trained responders, both professional and laypeople. Although the findings reviewed suggest that WFRs will exhibit a similar pattern of increasing skill loss beginning shortly after certification and a slower, but concurrent, decrease in knowledge, research is needed to document or refute this assumption.

Abstract 236: Systematic CPR Training in Elementary Schools and Students' Attitudes Toward CPR and AED Use

Introduction: Despite the proven effectiveness of bystander cardiopulmonary resuscitation (CPR), actual bystander CPR remains infrequent. The Japanese Society for Emergency Medicine started an activity to encourage schools (elementary schools/junior high schools/high schools) and school teachers to conduct a CPR training course as a systematic approach to increase bystander CPR in Japan. Objective: The objective of this study is to compare students' attitude towards CPR before and after CPR training, and to evaluate their sense of achievement after the training among young children. Method: Designs: A questionnaire survey. Main outcome measure: The positive attitude towards CPR and automated external defibrillator (AED) use. Participants: 5th- to 6th-grade elementary school students. A questionnaire survey was carried out before and after the CPR training program in schools among 1017 children. Result: A questionnaire was completed and collected from 925 (90.9%) students both before and after the CPR training. Before the training, 46.6% and 30.1% answered yes and maybe yes, respectively, to the question: “Do you feel you could check the responses of someone collapsed in front of you? Or call for emergency assistance? ”. The proportion increased to 73.1% and 19.4%, respectively, after the CPR training (Figure). Among 340 (36.8%) children, the attitude towards CPR improved after the training. For the question: “Do you understand how to perform chest compressions?”, 63.6% and 34.6% of children answered yes and almost, respectively, after the training. 72.2% and 26.2% answered yes and almost, respectively, for the question on acquisition of AED use. Conclusion: Elementary school children can understand basic CPR skills and AED use, and CPR training can improve their attitude towards CPR and AED use. Systematic CPR training in schools including elementary schools should be more enhanced to spread CPR.

Retention, retention, retention: targeting the young in CPR skills training!

The usefulness of basic cardiopulmonary resuscitation (CPR) training in school systems has been questioned, considering that young students may not have the physical or cognitive skills required to perform complex tasks correctly. In the study conducted by Fleishhackl and coworkers, students as young as 9 years were able to successfully and effectively learn basic CPR skills, including automated external defibrillator deployment, correct recovery position, and emergency calling. As in adults, physical strength may limit the depth of chest compressions and ventilation volumes given by younger individuals with low body mass index; however, skill retention is good. Training all persons across an entire community in CPR may have a logarithmic improvement in survival rates for out-of-hospital cardiac arrest because bystanders, usually family members, are more likely to know CPR and can perform it immediately, when it is physiologically most effective. Training captured audiences of trainees, such as the entire work-force of the community or the local school system, are excellent mechanisms to help achieve that goal. In addition to better retention with new half hour training kits, a multiplier effect can be achieved through school children. In addition, early training not only sets the stage for subsequent training and better retention, but it also reinforces the concept of a social obligation to help others.

Paediatric out-of-hospital resuscitation in an area with scattered population (Galicia-Spain)

BackgroundCardiorespiratory arrest (CRA) is a rare event in childhood. Our objective was to determine the characteristics of paediatric CRA and the immediate results of cardiopulmonary resuscitation (CPR) in Galicia, a community with a very scattered population.MethodsAll children (aged from newborn to 16 years old) who suffered an out-of-hospital CRA in Galicia and were assisted by the Public Foundation Medical Emergencies of Galicia-061 staff, from June 2002 to February 2005, were included in the study. Data were prospectively recorded following the Utstein's style guidelines.ResultsThirty-one cases were analyzed (3.4 CRA annual cases per 100.000 paediatric population). The arrest was respiratory in 16.1% and cardiac in 83.9% of cases. CRA occurred at home in 58.1% of instances. Time CRA to initiation of CPR was shorter than 10 minutes in 32.2% and longer than 20 minutes in 29.0% of cases. 22.6% of children received bystander CPR. The first recorded rhythm was asystole in 67.7% of cases. Bag-mask ventilation was used in 67.7% and in 83.8% oro-tracheal intubation was done. A peripheral venous access was achieved in 67.7% and intraosseous access was used in 16.1% of patients. 93.5% of children were treated with adrenaline. After initial CPR, sustained restoration of spontaneous circulation was achieved in 38.7% of cases. Six children (19.4%) survived until hospital discharge. Four of 5 children with respiratory arrest survived, whereas only 2 of 26 children with cardiac arrest survived until hospital discharge.ConclusionDespite the handicap of a highly disseminated population, paediatric CRA characteristics and CPR results in Galicia are comparable to references from other communities. Programs to increase bystander CPR, equip laypeople with basic CPR skills and to update life support knowledge of health staff are needed to improve outcomes.

Effectiveness of a 30-min CPR self-instruction program for lay responders: a controlled randomized study

Background: The length of current 4-h classes in cardiopulmonary resuscitation (CPR) is a barrier to widespread dissemination of CPR training. The effectiveness of video-based self-instruction (VSI) has been demonstrated in several studies; however, the effectiveness of this method with older adults is not certain. Although older adults are most likely to witness out-of-hospital cardiac arrests, these potential rescuers are underrepresented in traditional classes. We evaluated a VSI program that comprised a 22-min video, an inflatable training manikin, and an audio prompting device with individuals 40–70 years old. The hypotheses were that VSI results in performance of basic CPR skills superior to that of untrained learners and similar to that of learners in Heartsaver classes. Methods: Two hundred and eighty-five adults between 40 and 70 years old who had had no CPR training within the past 5 years were assigned to an untrained control group, Heartsaver training, or one of three versions of VSI. Basic CPR skills were measured by instructor assessment and by a sensored manikin. Results: The percentage of subjects who assessed unresponsiveness, called the emergency telephone number 911, provided adequate ventilation, proper hand placement, and adequate compression depth was significantly better ( P < 0.05) for the VSI groups than for untrained controls. VSI subjects tended to have better overall performance and better ventilation performance than did Heartsaver subjects. Conclusions: Older adults learned the fundamental skills of CPR with this training program in about half an hour. If properly distributed, this type of training could produce a significant increase in the number of lay responders who can perform CPR.

Basic cardiopulmonary resuscitation program for high school students (PROCES): How many concepts and skills remain one year later?

PROCES was supported in part by Nestle Espana SA. Study objectives: Programa de Reanimacio cardiopulmonar Orientat a Centres d'Ensenyanca Secundaria (PROCES) is specifically aimed at teaching basic cardiopulmonary resuscitation (CPR) to teenagers within their high school period, which is mandatory in our education system. Therefore, nearly all the future adult population will be expected to perform basic CPR as needed. The aim was to analyze whether a group of high school students who had completed this program 1 year ago still retained basic CPR concepts and skills. Methods: From 400 students who had completed PROCES the year before, 40 were randomly picked. Such students were asked to take the same 20-question test they just passed twice (preprogram and postprogram) 1 year ago. The test was divided into 2 parts: first part, 10 questions related to basic CPR concepts; second part, 10 questions about basic CPR skills. Scores from this test were compared with those obtained from previous postprogram and preprogram tests. We considered that students still kept basic CPR skills if they correctly answered at least 8 questions of the second part of the test. Results are presented in percentages and mean (SD). For comparisons, the Student's t test was used. Results: When marks obtained from 1 year later were compared with those from the postprogram test, a downward trend was noted in test scores (more than 20 points: 13.6 [3.7] to 13.1 [3.5]; P =.54), concept part score (more than 10 points: 5.7 [1.8] to 5.6 [2.2], P =.82), and skill part score (over 10 points: 7.8 [2.3] to 7.3 [1.9], P =.29); however, none of them achieved statistical significance. Besides, all these scores were significantly higher than those reached from the preprogram test: 8.3 (1.9) points for the test, 4 (1.3) for the concept part, and 4.3 (1.2) for the skill part ( P P =.11) but remained significantly higher than the percentage obtained at the beginning of the program (0%, P =.001). Conclusion: Students who learned basic CPR through PROCES show a downward trend in acquired concepts and skills, although the sample size does not allow us to reach conclusions about statistical significance. Such a decrease agrees with the results from other groups to whom basic CPR is taught and suggests that a reminder course should regularly be performed.

Basic cardiopulmonary resuscitation program for high school students (PROCES): Results from the pilot program

PROCES was supported in part by Nestle Espana SA. Study objectives: Programa de Reanimacio cardiopulmonar Orientat a Centres d'Ensenyanca Secundaria (PROCES) is aimed at teaching basic cardiopulmonary resuscitation (CPR) to teenagers in high school. The aim was to analyze results obtained from the pilot program. Methods: PROCES was split in 7 sessions. Specific concepts, methods, and attitudes pointed out in each session had to be reached by students. The first 4 sessions and the seventh session were prepared to be taught by teachers of high school. Health providers were in charge of teaching the fifth and sixth sessions, which included how to perform basic CPR. To assess the degree of students' learning, they took a 20-question test before (PRE-PROCES) and after (POST-PROCES) the program. The test was divided into 2 parts: 10 questions related to basic CPR concepts and 10 questions about basic CPR skills. Finally, students were requested to rate the program from 0 to 10. These data, along with epidemiologic characteristics from the first 250 students, were collected and analyzed. Results are presented in percentages and mean (SD). Results: Students were 14 years old (36%), 15 years old (40%), 16 years old (22%), and 17 years or older (2%). Fifty-five percent were male students, 18% would like to study a health-related course at the university, 39% did not pass at least 1 subject within the past school year, and 13% had previously taken a first aid or similar course. For the PRE-PROCES test, the mean score (>20 points) was 8.6 (2.8): 4.2 (1.5) in concepts and 4.4 (1.5) in skills. After PROCES, scores improved up to 14.2 (3), with 6.1 (1.9) in concepts and 8.2 (1.6) in skills ( P Conclusion: PROCES is a useful tool for teaching and improving teenagers' knowledge and skills in basic CPR. The level of skills reached by students was good, although the teaching of theoretical concepts should be improved. In general, PROCES was welcomed by students.

Evaluation of Medical Students in the Training of Paediatric Life Support – a Spanish Perspective

Summary Objective To determine the usefulness of a training programme in paediatric basic cardiopulmonary resuscitation for 5th and 6th year medical students. Methods For the past eight years, the Faculty of Medicine of the Complutense University in Madrid has been offering formal training in paediatric cardiopulmonary resuscitation (CPR) to its students. We have analysed the results of 8 basic paediatric cardiopulmonary courses with 527 students, comparing scores in written tests consisting of 10 or 20 multiple-choice questions, administered before and at the end of the courses, while also undertaking a practical test on basic cardiopulmonary resuscitation skills in infants and children. The course was evaluated by the students by means of an anonymous written questionnaire. Results The mean initial score (out of a maximum of 10) was 6.03 ± 1.58 (maximum 10, range 2-10), whereas in the final test it was 9.59 ± 0.68 (range 5–10) (p &lt; 0.001). The majority of these students acquired theoretical knowledge (97.2%) and adequate practical skills (93%) in paediatric basic cardiopulmonary resuscitation. They were generally satisfied with the lectures, practical training and ability of the teaching staff. Conclusion The paediatric basic life support course is a useful method for theoretical and practical training. Paediatric cardiopulmonary resuscitation should be included in the medical training curriculum.

A quasi-experimental research to investigate the retention of basic cardiopulmonary resuscitation skills and knowledge by qualified nurses following a course in professional development.

The research was undertaken with the intention of testing six null hypotheses regarding the retention of basic cardiopulmonary resuscitation (CPR) skills and knowledge of registered nurses. The hypotheses were formulated from the broad aims of the research, which were to investigate conclusions reached by other researchers highlighting the speed with which retention of CPR skills and knowledge deteriorates, and to investigate the need for regular updating in CPR. The research was quasi-experimental in nature. The 19 nurses participating in the research were qualified staff undertaking the English National Board (ENB) 923 course in Professional Development, which included a refresher on basic CPR skills and included some discussion regarding advanced techniques. The latest guidelines issued by the Resuscitation Council (1993) were used, which also aided in the design and use of the two research tools, namely an eight-point skills-testing observation tool and a 26-point knowledge-testing questionnaire. While a 3-hour update in CPR skills revealed an initial improvement, the decrease in retention of skills 10 weeks later was significant (P = 0.0000). The update in CPR knowledge also revealed an initial improvement but the decrease in retention of knowledge 10 weeks later was significant (P = 0.0000). The findings of the research reflect similar results to previous research undertaken and discussed in the literature review, suggesting that retention of skills and knowledge quickly deteriorates if not used or updated regularly. Therefore this research supports the importance of CPR refresher courses on a regular basis.

O107 Basic cardiopulmonary resuscitation skills: A comparison of ambulance staff and medical students in Germany

O107 Basic cardiopulmonary resuscitation skills: A comparison of ambulance staff and medical students in Germany

Basic cardiopulmonary resuscitation skills in non consultant hospital doctors — the Irish experience

Basic cardiopulmonary resuscitation skills in non consultant hospital doctors — the Irish experience

Cardiopulmonary resuscitation: A mandatory training program for nursing staff

At Flinders Medical Centre, a 600 bed teaching hospital in Adelaide, South Australia, there are between eighty and one hundred cardiac arrests in the general wards areas each year. From the time an arrest occurs until the arrest team arrives, the patient's life will depend on the speed with which Cardiopulmonary Resuscitation (CPR) is initiated and the effectiveness of the CPR performed by ward staff. The outcome of cardiac arrest patients who receive promptly administered CPR is extensively documented in literature on the subject. When an arrest occurs in the ward at Flinders, staff activate an emergency call to the "cardiac arrest team", which consists of three medical staff members and one nursing staff member. The nurse, from the Intensive Care Unit, is responsible for coordinating the actions of the nursing staff during the arrest. Following the arrest an audit sheet is completed with details of the patient, the arrest, treatment, and any other pertinent information. Until 1985 it was not unusual at Flinders for arrest audit sheets to have comments such as: "CPR not performed by ward staff" or "CPR not being performed correctly by ward staff" or, even worse, "Ward staff disappeared when the arrest team arrived". In many hospitals throughout Australia this was, and may still be, a familiar problem. The nursing department at Flinders believed that if a program could be established in which nurses were given the opportunity to learn and practise CPR, they could gain the skills necessary to perform basic CPR in the ward until the arrest team arrived. In 1985 a coordinator of such a program was appointed, and it became mandatory at Flinders for all nursing staff to learn and be accredited annually in basic CPR skills. This article describes how the CPR Program started, its progress, and its results.