Cardiopulmonary Resuscitation Course Research Articles

Koolangka Infant Life Saving: Culturally responsive infant CPR education for Aboriginal Australian parents

Objectives: Among Aboriginal children, the year between birth and 1 year of age has the highest mortality rate compared with any other age. Prompt administration of cardiopulmonary resuscitation (CPR) leads to better outcomes and a lower likelihood of ongoing sequalae. Current education on infant CPR is not provided to parents except in certain circumstances in a neonatal intensive care unit. Currently, there are no identified CPR education courses specifically available for Aboriginal or Torres Strait Islander people, meaning that current infant CPR education courses are not culturally responsive. Design: Partnering with an Aboriginal community from the Bindjareb region of the Western Australian Noongar nation, the researchers used a co-design approach and an Aboriginal Participatory Action Research (APAR) design to explore how to deliver culturally safe and responsive infant CPR community education. This resulted in the development of the Koolangka Infant Life Saving Education Framework (KILSEF), which can be used to guide future planning and delivery of culturally safe and responsive community level infant CPR education. Results: The study findings identified that members of the Aboriginal community were very interested in receiving infant CPR education, but the barriers identified from mainstream CPR course delivery need to be removed for the community to benefit from culturally responsive ways of learning. Culturally responsive community CPR education should be provided in culturally safe places and the focus of learning should be on the practical applications of CPR and less on the academic pre-reading and written requirements. Explanations should be provided in lay terms and patience is required to communicate ideas in ways that facilitate understanding, and the course may need to be delivered over several days to accommodate community participant availability. Conclusion: Addressing Aboriginal community concerns and barriers allowed for the implementation of culturally responsive infant resuscitation education which was highly valued by community members and led to increased community confidence and participation in CPR education.

Cardiopulmonary Resuscitation Education in United States Schools: Shortcomings and Future Directions.

Cardiopulmonary resuscitation (CPR) is a lifesaving procedure that is performed during a cardiac arrest. CPR consists of chest compressions, rescue breaths, and the usage of an automated external defibrillator (AED) based on availability. Performance of CPR can greatly increase the chances of survival by enabling the manual perfusion of vital organs in lieu of the heart's normal function. Despite extensive studies demonstrating the efficacy and necessity of CPR in an emergency, most of the public across the United States is ill-equipped and/or educated on how to perform it. While there may be other contributing factors, the lack of CPR education across schools in the United States almost certainly furthers the CPR illiteracy of the general population. Although states require some degree of CPR training, the level of education that students receive varies widely across communities and school districts, largely dictated by the available funding for training courses. Despite the lack of CPR education in the United States, studies conducted abroad have shown the efficacy of a CPR course in preparing students to respond in emergencies-lending hope to mending the current situation in the United States. In this article, we analyze legislation dictating CPR instruction and hypothesize ways in which states' Department of Education might be able to promote education and hands-on experience for students across all ages of schooling. Ultimately, we hope to highlight the importance and feasibility of preparing the next generation of citizens across the United States to respond when their name is called upon in an emergency.

Impact of a national initiative to provide civilian cardiopulmonary resuscitation training courses on the rates of bystander intervention by citizens and survival after out-of-hospital cardiac arrest

BackgroundThe impact of a national initiative to provide cardiopulmonary resuscitation (CPR) education to the public on the rates of citizen-initiated CPR and survival following out-of-hospital cardiac arrest (OHCA) remains uncertain. MethodsWe examined 358,025 cases of citizen-witnessed OHCA with presumed cardiac origin, recorded in the Japanese nationwide registry from 2005 to 2020. We assessed the relationship between the number of individuals certified in CPR courses, citizen interventions, and neurologically favorable survival at one month. ResultsThe cumulative number of certified citizens has linearly increased from 9,930,327 in 2005 to 34,938,322 in 2020 (incidence rate ratio for annual number = 1.03, p < 0.001), encompassing 32.3% of the Japanese population aged 15 and above. Similarly, the prevalence of citizen-initiated CPR has consistently increased from 40.6% in 2005 to 56.8% in 2020 (P for trend < 0.001). Greater citizen CPR engagement was significantly associated with better outcome in initial shockable rhythm patients [chest compression only: odds ratio (OR) 1.24; 95% confidence interval (CI) 1.02–1.51; P = 0.029; chest compression with rescue breathing: OR 1.33; 95% CI 1.08–1.62; P = 0.006; defibrillation with chest compression: OR 2.27; 95% CI 1.83–2.83; P < 0.001; defibrillation with chest compression and rescue breathing: OR 2.15; 95% CI 1.70–2.73; P < 0.001 vs. no citizen CPR]. ConclusionsThe incidence of citizen-initiated CPR across Japan has consistently and proportionately increased with the rising number of individuals certified in CPR courses. Greater citizen CPR involvement has been linked to neurologically favorable survival, particularly in cases with an initial shockable rhythm.

Impact of the number of citizens officially certified for government-organized civilian cardiopulmonary resuscitation courses on the prognosis for patients with out-of-hospital cardiac arrest in Japan

Abstract Background To improve the prognosis of patients with out-of-hospital cardiac arrest (OHCA), the rate of high-quality cardiopulmonary resuscitation (CPR) and immediate use of automated external defibrillators (AEDs) by citizens must be further increased. Japanese government launched certified CPR courses for citizens throughout Japan in 1994 and the number of citizens certified on the course is increasing. However, the impact of the number of citizens officially certified for the courses on the rate of CPR implementation by citizens and the outcomes in patients with OHCA is unclear. Methods From a prospective, nationwide, population-based registry of patients with OHCA in Japan, we identified 350,444 patients from 2005 through 2020 with bystander-witnessed OHCA with 72,069 ventricular-fibrillation (VF) and the other non-VF cardiac arrests. The association between the number of citizens certified for the CPR courses and the rate of CPR implementation by citizens throughout Japan was analyzed by Poisson distribution and Cochran–Armitage test for trend. The primary outcome was survival at 1 month. The secondary outcomes were favorable neurologic outcome at 1 month. The associations between the CPR attempted by citizens [categorized into three (chest-compression-only CPR, chest compression with rescue breathing, and use of AEDs with chest compression and rescue breathing)] and outcomes were determined by multivariable mixed logistic regression analyses. Results Cumulative number of citizens certified for the CPR courses increased from 717,808 in 2005 to 34,938,322 in 2020, which reached to 27.8% of total Japanese population. Annual course receivers were also linearly increased during the period (Incidence Rate Ratios 1.03, p&amp;lt;0.001). Similarly, the rate of patients receiving CPR by citizens increased linearly from 40.6% in 2005 to 56.8% in 2020 (P for trend&amp;lt;0.001). In the multivariable mixed logistic regression analyses, higher CPR activity by citizens were significantly associated with better 1-year survival in both VF and non-VF patients even after adjusted for covariates [VF = chest compression: odds ratio (OR) 1.17; 95% confidence interval (CI) 0.98–1.39; P =0.078; chest compression with rescue breathing: OR 1.22; 95% CI 1.02–1.49; P =0.030; use of AEDs with chest compression and rescue breathing: OR 1.54; 95% CI 1.54–1.92; P &amp;lt;0.001 vs no CPR, non-VF= chest compression: OR 1.19; 95% CI 0.76–1.87; P =0.45; chest compression with rescue breathing: OR 2.26; 95% CI 1.34–3.82; P =0.020 vs non-CPR]. Similar results were also found in neurological outcomes in 1 month. Conclusions The rate of CPR implementation by citizens throughout Japan has continuously and linearly increased in these 15 years in proportion to the increase in the number of citizens certified for the government-organized CPR courses. Higher CPR activity by citizens were significantly associated with better 1-year survival and favorable functional status in both VF and non-VF patients.

Surfers as aquatics rescuers in Portugal and Spain: Characteristics of rescues and resuscitation knowledge

The aim of this study was to analyze the rescues carried out by surfers from Portugal and Spain, their knowledge of rescue and resuscitation and their perception and risk behavior while surfing. An online survey was conducted in 2048 surfers from Portugal and Spain, with questions regarding the demographic characteristics, experience, perception and risk behavior of the surfers; rescues attended by the surfers and surfer's knowledge and experience in rescue and resuscitation. Concerning the number of rescues carried out by surfers, 78.5% of the participants had to carry out at least one rescue in their lifetime. A significant association was found between the years of surfing experience, the surfing level and the number of rescues carried out (p < 0.05). Thirty-five-point eight percent of the surfers never attended a cardiopulmonary resuscitation (CPR) course and 76.2% had no work experience as a lifeguard. Correspondingly, the vast majority of the surfers analyzed did not have the essential knowledge about rescue and resuscitation. This study provides evidence of the important role that surfers play in saving lives on Portuguese and Spanish beaches. The results suggest that the number of rescues conducted by surfers each year in Portugal and Spain is relevant to reducing the number of fatalities that occur along coasts.

The knowledge of infant CPR among parents visiting Maternity and Children Hospital (MCH) in Al –Ahsa, Saudi Arabia

Background: CPR (cardiopulmonary resuscitation) is a medical procedure that anyone can learn which can help to save a life in the event of a medical emergency. Resuscitation Council UK report that for every minute that a person in cardiac arrest does not receive CPR its survival chance drops by up to 10%. However, an inadequate public awareness and knowledge of infant and pediatric CPR have been documented. Therefore, parents and caregiver should be educated about infant CPR which can help in correctly implementing it and save the life of infant. This study was conducted on the mothers attending the MCH for the baby care is to assess their knowledge on infant CPR skill. Material and methods: This was a Cross sectional study conducted at Maternity and Children Hospital (MCH) in AL- Ahsa. All the parents visiting MCH with their children for the treatment were the study population. The website Raosoft was used to calculate the sample size (n=284). Convenient sampling technique was used to collect the sample. Pretested and predesigned self-reported questionnaire from the previous regional study was distributed to the selected sample participants. The data were entered and analyzed by using the SPSS; version 21. Descriptive statistics were presented using counts, proportions (%), mean ± standard deviation whenever appropriate. Descriptive statistics (e.g. number, percentage) and analytic statistics using Chi Square tests (χ2) to test for the association and/or the difference between two categorical variables were applied. A p-value equal to or less than 0.05 was considered statistically significant. Results: A total of 254 out of 284 subjects responded the questionnaires. The mean age of the participants was 38.65 years ± Std. Dev. 9.90 years .The majority of the participants (61.0%) were graduate Almost sixteen percent (15.7%) of the participants had family history of heart disease. Fifty percent of the participants had attended the CPR course. An overwhelming majority of the participants (87.0%) were willing to take a short course of infant CPR if it is available in MCH. The mean knowledge sore in infant CPR of the participants was 2.42 ± Std.Dev.1.33 (Range 00-6). More than forty one percent of the participants had poor knowledge regarding Infant CPR while 58.7% had good knowledge. As educational qualification increased the percent of good knowledge significantly also increased .The participants who did not have the family history of cardiac disease were having significantly good knowledge about infant(P=0.01).Those participants who had attended infant CPR course had significantly higher knowledge score than those who did not attend the infant CPR course (76.37% vs.40.94%, P=0.000) Those participants who were not willing to take a short course of infant CPR had significantly better knowledge score on infant CPR as compared to those participants who were willing to join the course on infant CPR (69.69% vs.57.01%,P=0.021). Conclusion: The present study has shown a better knowledge among the females regarding infant CPR as compared to other studies conducted in Saudi Arabia. The participants in this study were found very motivated to learn the skills of infant CPR. However there is a need to develop programmers for teaching the infant CPR to the mothers at all level of health care facility attending the MCH, Al Ahsa.

Paediatric manikins and school nurses as Basic Life Support coordinators: A useful strategy for schools?

Objective: To evaluate cardiopulmonary resuscitation (CPR) skills performance and retention in schoolchildren aged 8 to 12 years following instruction by their teachers and with the guidance of a school nurse using paediatric manikins. Design: Descriptive simulation trial. Method: A school nurse provided support to six schoolteachers as they taught a modified 40-minute CPR course. Pupils were shown an out-of-hospital cardiac-arrest recognition video followed by a CPR simulation using paediatric manikins. 117 schoolchildren aged 8 to 12 years received the training. Both the schoolchildren and teachers completed a survey before and afterwards. Children completed an out-of-hospital cardiac-arrest recognition test and a 1-minute CPR test 1 week later. Results: After training, schoolchildren increased their self-efficacy as rescuers (8 ± 2 vs 10 ± 2; p &lt; 0.001). Irrespective of age differences, 74% of schoolchildren performed the entire out-of-hospital cardiac-arrest recognition sequence correctly. Children aged 11 to 12 years and 10 to 11 years performed higher quality CPR (49% and 47%, respectively) compared to 8 to 9 year olds (14%, p = 0.008 and p = 0.014). Children aged 11 to 12 years outperformed younger children aged 8 to 9 years with respect to compression depth (48 ± 6 mm vs 43 ± 5 mm, p = 0.008) Conclusion: Schoolchildren’s teachers, who were guided by a nurse using paediatric manikins, taught children aged 10 to 12 years to perform high-quality CPR. We suggest integrating paediatric manikins as part of children’s CPR training as feedback from successful CPR performance increases motivation and confidence to act as a rescuer as well as improves skills retention.

Are dental professionals ready to deal with medical emergencies in their clinical office? A survey of university hospitals.

This research aimed to assess the availability and need of dental emergency kits in Saudi Arabia university hospitals. A cross-sectional study was conducted among 267 dentists, including undergraduate, dental interns, general dentists, and specialists in 6 university hospitals (private and government colleges). In addition, a closed-ended questionnaire was distributed through emails using the online platform. The data revealed that 49.4% of dentists faced medical emergencies. Out of them, 72.7% said that emergency kits were available in their clinics. Sugar sources and oxygen were most commonly available. On the other hand, 37.8% of dentists handled emergencies independently, 34.5% considered themselves competent with cardiopulmonary resuscitation (CPR), and 28.8% were confident of using emergency (ER) drugs. The most common medical emergencies were vasovagal syncope and hypoglycemia. The emergency kit in dental clinics is relatively available, and the incidence of medical emergencies is relatively minor. However, the competence and confidence of the dentists in tackling an emergency is low, including handling of emergency (ER), knowledge of CPR, and its performance. Therefore, CPR courses should be improved and promoted more widely for this purpose.

Knowledge and Practice of Cardiopulmonary Resuscitation (CPR) For Drowning Among Primary School Children

Introduction: Drowning is one of the cases that contribute to a high number of death cases as unintentional injury cases worldwide. The victims of this issue are higher among primary school children. Cardiopulmonary resuscitation (CPR) can be performed for drowning victims who showed an absence of breathing and pulse to regain their consciousness and their life. Furthermore, providing the knowledge and practice of CPR should not only be limited to adults but also the children including at the primary level. Objectives: This study aimed to identify knowledge and the practice of CPR for drowning victims before and after the intervention given. Methods: A pre-post interventional study design with a purposive sampling method was conducted at the primary school. The studied participants were primary school children who live near the coastal areas. Developed self-administered questionnaires and CPR educational videos were used in this study to identify the knowledge and practice of the studied participants. The data were analysed by using IBM SPSS statistics version 25.0. Results: The studied participant's ages were 10 and 11 years old. They were capable of comprehending the information delivered to them. Both knowledge and practice of CPR for drowning victims were increased after the educational video intervention was given to them. Conclusion: The findings showed that although they lacked knowledge and practice of CPR for drowning victims before the intervention, they were able to show improvements in their total score for both parts after the intervention. Educating the children as early as 10 years old regarding CPR for drowning victims was capable to be carried out in the local setting. Hence, the implementation of CPR courses in the curriculum of school children starting from the primary level may happen in the future.

Kids Save Lives Malaysia Handbook for Primary School Children: Development and Usability Study

Out-of-hospital cardiac arrest (OHCA) is an important global public health issue that leads to death if not recognised and managed early. Integrating Cardiopulmonary Resuscitation (CPR) as part of the educational school programs will increase trained resuscitators within the community. Unfortunately, CPR courses are only available voluntarily, and not part of the Malaysian national curriculum. We report the development of the KIDS SAVE LIVES MALAYSIA (KSLM) handbook for primary school students in Malaysia. An in-depth review of the latest literature, adapting and adopting relevant guidelines for the handbook was conducted. Next, experts ranging from certified American Heart Association (AHA) instructors, language, and primary school teachers were appointed for content validity. Lastly, the drafted handbook was further tested to determine the usability of selected year 4 - 6 students. All items had an I-CVI and S-CVI of 1.00. Four students passed the knowledge test whilst 18 of the students passed the technical skills test. On average, year four (age 10) students’ knowledge and technical skills scores were the highest. As for attitude, year five (age 11) exhibit the highest score. A MANOVA analysis yielded significant effect of the students’ age on the technical skills, F (2,35) = 10.29, p &lt; .001, partial η2 = .370 and attitude, F (2,35) = 13.87, p &lt; .001, partial η2 = .442. The outcomes of this preliminary study make the KSLM handbook worthy of future application towards primary school students across Malaysia.

Basic life support and automated external defibrillators in secondary schools

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Sudden cardiac arrest is the leading cause of premature death. Effective cardiopulmonary resuscitation (CPR) and early defibrillation substantially improve survival rates. This has also been replicated in schools, with excellent outcome data in schools who advocated CPR certification together with the availability of onsite automated external defibrillator (AED). Most entities now encourage AED installation in schools. Objectives As a follow up to the BEAT-IT cardiac screening program performed across all secondary schools in 2017/2018, the main aim of this study was to evaluate the availability of AEDs in schools across the Maltese archipelago. Information on staff CPR certification was also evaluated. Methodology One school administrator in all secondary schools across Malta and Gozo (n=54) were asked to complete an online questionnaire. All data was kept anonymous. Data was tabulated. Categorical variables were presented as percentages. Statistical analysis was performed with SPSS v23. Results Most schools (n=40, 74.1%) complied, the majority from the northern harbour region (n=15, 37.5%). Student gender in most schools was mixed (n=23, 57.5%). Two schools (5%) reported a cardiac arrest in one of their pupils over the previous 10 years, one happening during school hours. A minority (n=3, 7.5%) strongly disagreed that preventing sudden cardiac death (SCD) in schools is important. Only 1 (2.5%) had never heard of an AED. Some schools (n=3, 7.5%) did not have an AED on school premises. The majority had one AED (n=1, 75.0%). Most schools service their AED regularly (n=34, 94.4%). The majority had an AED only on one floor (n=35, 97.2%). Most AEDs were installed in easily accessible areas (n=35, 97.2%), yet the location was not subjected to a risk assessment prior to installation in a significant proportion (n=17, 47.2%). Defibrillators in a third of schools (n=11, 30.6%) were not close to sporting facilities, an area traditionally recognized as a high risk location. Most schools do not organise onsite CPR certification courses (n=21, 52.5%). Some staff are certified in CPR (n=35, 87.5%), a fifth having more than 5 certified individuals (n=8, 20.0%). The majority have also undergone recertification (n=28, 70.0%). Most were strongly in favour of a systematic cardiac screening program in schools (n=28, 70.0%). Conclusion A significant proportion of schools have experienced a cardiac arrest in one of its pupils (5.0%), implying this is an important health concern. Yet some still disagree that SCD prevention in schools is important (7.5%). Despite the majority having an AED on site, a substantial proportion did not have a risk assessment prior to installation (47.2%). Only a small proportion of staff members are certified in CPR. Most schools do not organise on-site CPR courses (52.5%). More education and awareness about cardiac arrest in students and CPR certification is necessary.

Comparison of a virtual reality compression-only Cardiopulmonary Resuscitation (CPR) course to the traditional course with content validation of the VR course – A randomized control pilot study

IntroductionTechnology has been a major contributor to recent changes in education, where simulation plays a huge role by providing a unique safe environment, especially with the recent incorporation of immersive virtual reality (VR) training. Cardiopulmonary Resuscitation (CPR) is said to double, even triple survival from cardiac arrest, and hence it is crucial to ensure optimal acquisition and retention of these skills. In this study, we aim to compare a VR CPR teaching program to current teaching methods with content validation of the VR course. MethodsA randomized single-blinded simulation-based pilot study where 26 participants underwent baseline assessment of their CPR skills using a validated checklist and Laerdal QCPR®. Participants were randomly allocated and underwent their respective courses. This was followed by a final assessment and a questionnaire for content validation, knowledge and confidence. The data was analysed using STATA 16.2 to determine the standardized mean difference using paired and unpaired t-test. ResultsSubjective assessment using the checklist showed statistically significant improvement in the overall scores of both groups (traditional group mean improved from 6.92 to 9.61 p-value 0.0005, VR group from 6.61 to 8.53 p-value 0.0016). However, no statistically significant difference was noted between the final scores in both the subjective and objective assessments. As for the questionnaire, knowledge and confidence seemed to improve equally. Finally, the content validation showed statistically significant improvement in ease of use (mean score 3 to 4.23 p-value of 0.0144), while for content, positivity of experience, usefulness and appropriateness participants showed similar satisfaction before and after use. ConclusionThis pilot study suggests that VR teaching could deliver CPR skills in an attractive manner, with no inferiority in acquisition of these skills compared to traditional methods. To corroborate these findings, we suggest a follow-up study with a larger sample size after adding ventilation and Automated External Defibrillator (AED) skills to the VR course with re-examination after 3–6 months to test retention of the skills.

Why Do Not Physicians Attend Hospital Cardiopulmonary Resuscitation Training?

IntroductionCardiopulmonary resuscitation (CPR) training is mandatory in most hospitals. Despite this, some hospital staff do not attend CPR training on a regular basis, but the barriers to training attendance are sparsely investigated. This study aimed to investigate CPR course attendance, barriers to participation, and possible initiatives to increase CPR course attendance.MethodsPhysicians from one university hospital and one regional hospital in the Central Denmark Region were included. Questionnaires were handed out at daily staff meetings at departments of internal medicine and surgery.ResultsIn total, 233 physicians responded (response rate: 92%, male: 54%). Overall, 32% of physicians had not attended CPR training at the hospital. Mean (±standard deviation) time since the last CPR course participation was 17 (±3) months. Frequent barriers to attending courses included not knowing when courses are conducted (70%) and where to sign up for training (45%). The majority (60%) of physicians responded that the reason why they prioritize course participation is to be professionally updated. In contrast, 16% stated that they had sufficient CPR skills and therefore CPR training was unnecessary. Physicians stated that the following factors would improve CPR training participation: an annual day protected (no clinical work) for course attendance (72%), use of short booster sessions (49%), shorter courses combined with e-learning (51%) and shorter courses held over 2 days (46%).ConclusionOne-third of physicians did not attend hospital CPR training at two Danish hospitals. Several barriers to course participation exist, of which course registration seems to be a crucial factor. Alternative CPR training methods may help improve training participation.

Characteristics of surfers as bystander rescuers in Europe.

Coastal locations contribute significantly to global drowning, with surfers frequently conducting rescues. This study explored the characteristics of surfers as bystander rescuers in Europe. A cross-sectional online survey collected demographics (age, sex, geographical location), surfing experience, ability, lifesaving and cardiopulmonary resuscitation (CPR) training, information seeking behaviors and previous performance of a rescue. Analyses comprised descriptive frequencies, binomial logistic regression with adjusted odds ratio (AOR) (95% confidence interval [CI]) and chi-squares (p < .05). Europe-dwelling respondents totaled 1705 (76% male; 43% 25-34 years). Thirty-nine percent (39.2%; n = 668) had previously performed a rescue. Likelihood of having conducted a rescue significantly increased with 6 or more years of surfing experience (6-10 years [AOR = 1.96; 95%CI: 1.20-3.22]; 11-15 years [AOR = 3.26; 95%CI: 1.56-6.79]; 16 years or more [AOR = 4.27; 95%CI: 2.00-9.11]) when compared to surfers with <1 year experience. Expert/professional ability surfers were 10.89 times (95%CI: 4.72-25.15) more likely to have conducted a rescue than novice/beginners. Respondents who had received both a certified lifeguard and CPR course were significantly more likely to have conducted a rescue (AOR = 3.34; 95%CI: 2.43-4.60). Surfers who had previously conducted rescues commonly had more years of experience, higher self-rated surf ability and greater likelihood of having received certified training. However, not all surfers who have performed rescues had received training. Findings suggest surfers should receive rescue and CPR training before they start surfing at locations without trained supervision and refresh training regularly. Surfers are amenable to injury prevention information, especially online and via apps.

Effectiveness of the Family and Friends CPR course in learning cardiopulmonary resuscitation in relatives of patients with high cardiovascular risk or who have suffered a cardiovascular event

Introduction: Early, high-quality cardiopulmonary resuscitation (CPR) increases survival rates in cardiac arrest. Although most cases occur at home and are witnessed, CPR is performed in few of these cases. For this reason, teaching CPR is especially important in relatives of patients with high cardiovascular risk. Therefore, the aim of this study was to demonstrate the effectiveness of the Family and Friends CPR course in the theoretical and practical learning of cardiopulmonary resuscitation in relatives of patients with high cardiovascular risk or who have suffered a cardiovascular event. Materials and methods: We carried out an analytical, quasi-experimental, prospective, before-and-after study. We selected 20 participants during outpatient consultation at the Cardiology Department of the Cayetano Heredia Hospital in Lima, Peru. A theoretical knowledge questionnaire and an adult CPR checklist were used to assess the level of theoretical and practical knowledge, respectively. The theoretical knowledge was measured at three points in time (before, immediately after and one month after the intervention) and the practical skills at two points in time (immediately after and a month after the intervention). Results: The level of theoretical knowledge was low (8.64 ± 2.47) before the intervention, achieving a good level of knowledge immediately after (17.33 ± 2.02) and one month later (16.5 ± 1.91). Furthermore, the medians of the level of practical knowledge were 15 immediately after and one month later, showing that they maintained a good level of practical knowledge. Conclusions: The Family and Friends CPR course was effective in the theoretical and practical learning of CPR in the studied population, and was sustained one month after the intervention.

To ventilate or not to ventilate during bystander CPR — A EuReCa TWO analysis

BackgroundSurvival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). MethodIn this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. ResultsA total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17–1.83). ConclusionIn this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both.

The effective group size for teaching cardiopulmonary resuscitation skills – A randomized controlled simulation trial

Aim of the studyThe ideal group size for effective teaching of cardiopulmonary resuscitation is currently under debate. The upper limit is reached when instructors are unable to correct participants’ errors during skills practice. This simulation study aimed to define this limit during cardiopulmonary resuscitation teaching. MethodsMedical students acting as simulated Basic Life Support course participants were instructed to make three different pre-defined Basic Life Support quality errors (e.g., chest compression too fast) in 7 min. Basic Life Support instructors were randomized to groups of 3–10 participants. Instructors were asked to observe the Basic Life Support skills and to correct performance errors. Primary outcome was the maximum group size at which the percentage of correctly identified participants’ errors drops below 80%. ResultsSixty-four instructors participated, eight for each group size. Their average age was 41 ± 9 years and 33% were female, with a median [25th percentile; 75th percentile] teaching experience of 6 [2;11] years. Instructors had taught 3 [1;5] cardiopulmonary resuscitation courses in the year before the study. A logistic binominal regression model showed that the predicted mean percentage of correctly identified participants’ errors dropped below 80% for group sizes larger than six. ConclusionThis randomized controlled simulation trial reveals decreased ability of instructors to detect Basic Life Support performance errors with increased group size. The maximum group size enabling Basic Life Support instructors to correct more than 80% of errors is six. We therefore recommend a maximum instructor-to-participant ratio of 1:6 for cardiopulmonary resuscitation courses.

Inicio / Archivos / Vol. 37 Núm. 2 (2021): Revista Médica del Uruguay / Artículos originales Primera experiencia en Uruguay en enseñanza curricular de resucitación cardíaca avanzada en el Ciclo Internado Rotatorio en el período 2017-2018, Facultad de Medicina, Universidad de la República. Comunicación y evaluación

In 2017 the School of Medicine of the University of the Republic included advanced cardiopulmonary resuscitation as a mandatory curricular activity during the rotating internship. The decision is justified by morbility and mortality rates of heart disease, in particular cardiopulmonary arrests and sudden death. Resuscitation courses enable the acquisition of technical and non- technical skills to respond to a prevalent condition and to compensate the absence of this specific training in the training of medical doctors.The study aimed to communicate and evaluate the first experience during the 2017-2018 rotating internship.A transversal study was conducted to analyse the number of participants and the percentage of successful candidates. Likewise, a survey was designed to assess self-perception of skills prior to the course and skills acquired during the course, as well as a course satisfaction.Results revealed the high acceptance rate of this first instance of the course and its positive assessment. Similarly, interns evidenced improvement in their self-perception of identified skills. As to a weaknesses found, the questionnaire used had not been validated and not all Interns completed the assessment, both aspects that will be improved in future assessments.To conclude, we managed to inform about the experience, advanced cardiopulmonary resuscitation courses are an advantage in itself, and it has been a significant advance in the professional training of future medical doctors.

Learning Effectiveness Assessment between Primary School Students and Adults in Basic Life Support Education.

Background Out-of-hospital cardiac arrest (OHCA) remains a big issue of critical care. It is well known that bystander cardiopulmonary resuscitation (CPR) with an automated external defibrillator (AED) used did improve the survival rate. Therefore, CPR education including basic life support (BLS) and AED has been advocated for years. It showed significant improvement of knowledge and willingness to perform CPR through adolescents after the course. However, little is known regarding the ability and learning effectiveness of school students who attend such courses. Therefore, this study aimed to evaluate the CPR effectiveness of both adolescents (12 years old) and adults who undergo the same course of BLS and AED. Methods This is a retrospective study. Sixth-grade elementary school students in Northern Taiwan were selected to compare with the adult group. Both took 90 minutes of the BLS and AED course by the doctor with BLS instructor qualification. The primary outcomes were CPR quality and passing or failing the skill examination parameters. The secondary outcome was the posttraining written test and questionnaire of CPR willingness. Results In the written test, there was a statistical difference in the pretest score except AED knowledge, but no difference was revealed in the posttest score. No statistical difference in CPR quality was noted. In the skill examination, only checking breathing status had statistical difference (elementary group (71%) vs. adult group (86%) (p=0.003)). Conclusion We revealed that sixth-grade elementary students' performance in CPR and AED was similar to that of adults after completing the current 90-minute course. Therefore, we strongly advocate offering CPR and AED courses to 12-year-old children, and these courses should emphasize checking the victim's breathing status.

Knowledge and attitudes to cardiopulmonary resuscitation (CPR)– a cross-sectional population survey in Sweden

Aim of the studyRates of bystander CPR are increasing, yet mortality after out-of-hospital cardiac arrest (OHCA) remains high. The aim of this survey was to explore public knowledge and attitudes to CPR. Our hypotheses were that recent CPR training (< 5 years) would be associated with a high-quality response in a case vignette of OHCA with agonal breathing, and associated with an interest to become a smartphone app responder in suspected OHCA. MethodsData were collected through a web survey. Respondents (≥18 years) in Skåne County, Sweden were members of a panel created by a market research company. Data were weighted with respect to gender, age, municipalities and level of education to increase generalisability to the general population. ResultsA total of 1060 eligible answers were analysed. Seventy-six percent of non-healthcare professionals (n = 912) had participated in a CPR course at some time in life, 58 percent during the previous five years. The recommended CPR algorithm was known by 57 percent, whereas knowledge of the location of the nearest automated external defibrillator (AED) in a home environment was poor. Recent CPR training (< 5 years) did not favour high-quality response in a case vignette of OHCA with agonal breathing, but was one predictor of wanting to become a smartphone app responder. ConclusionThis study highlights possible areas of improvement in CPR training, which might improve OHCA identification and facilitate knowledge retention. The potential to recruit smartphone app responders seems promising in certain groups.