Cardiopulmonary Resuscitation Education Research Articles

CPR RACISM: A Guide for Health Care Providers to Safely Address Racism in a Health Care Setting

Racism is a form of violence that results in poorer health outcomes for First Nation, Métis, and Inuit (FNMI) Peoples and is a barrier toward achieving equitable healthcare. There is growing recognition that FNMI Peoples experience racism in health care and with the highly publicized deaths of Brian Sinclair and more recently the death of Joyce Echaquan in Canada, there has been an outcry to end racism in health care. With the growing numbers of nurses and nursing students learning about the impact of racism on health outcomes there is a need for a concrete, practical, and visual guide to assist with teaching an intervention for when racism is witnessed. As part of creating and supporting a speak-up culture to address unsafe care related to racism in health care, the writer offers the following guide - CPR RACISM. Health care providers are all familiar with cardiopulmonary resuscitation (CPR), capable of saving a life during cardiac arrest — when the heart stops beating or is unable to effectively circulate blood to the brain and other vital organs. CPR instructors advocate for everyone to be prepared for moments that matter by taking a CPR class to help save a life. Similarly, there needs to be a plan to save lives lost related to racism. The writer selected the name of this guide, CPR RACISM, as a way to underscore the urgency to address racism in health care as FNMI Peoples’ lives are at risk. Just as CPR is meant to be a set of actions to save lives when the heart stops beating, CPR RACISM is a guide to prepare healthcare providers to save lives when they witness racism in healthcare. The CPR RACISM guide was created in response to the common questions the writer has heard from nursing students and colleagues: Where do I begin? How can I address racism in healthcare? How do I teach my nursing students to effectively intervene when they witness racism? To address this gap in praxis, the writer suggests CPR RACISM as an additional resource to disrupt and dismantle racism in health care. Key Words: racism, health care, advocating, teaching, equity, Indigenous, First Nation, Métis, Inuit, Aboriginal, intervening.

Implementation of a Smart Teaching and Assessment System for High-Quality Cardiopulmonary Resuscitation.

The purpose of this study is to develop a smart training and assessment system called SmartCPR, for teaching and training cardiopulmonary resuscitation (CPR), based on human posture estimation techniques. In this system, trainees can automatically recognize and evaluate whether chest compressions during CPR meet the standard of high-quality CPR by simply using a device such as a smart phone. Through the system, trainees are able to obtain real-time feedback on the quality of compressions so that they can adjust the cycle, depth, frequency, and posture of compressions to meet the standard of high-quality CPR. In addition, the SmartCPR system is convenient for CPR trainers. Trainers can instantly and accurately assess whether the trainee's compressions meet the standard of high-quality CPR, which reduces the risk of manual assessment errors and also reduces the trainer's teaching pressures. Therefore, the SmartCPR system developed in this study can be an important tool for CPR teaching and training for physicians, which can provide training and guidance for high-quality CPR maneuvers and enable trainees to become more proficient in CPR and self-training.

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.

Out-of-Hospital Cardiac Arrest in the Eye of the Beholder and Emergency Medical Service.

Out-of-hospital cardiac arrest (OHCA) remains a global healthcare problem, with low survival and bystander cardiopulmonary resuscitation (CPR) rates. This study aimed to identify event-related factors in OHCA and their impact on return of spontaneous circulation (ROSC) achievement and maintenance until hospital admission. All data were collected from Utstein Resuscitation Registry Template for OHCA from The Institute of Emergency Medicine of Zagreb from January 2012 to August 2022. This cross-sectional research analyzed 2839 Utstein reports, including 2001 male, 836 female, and 8 subjects of unknown gender. The average age was 65.4 ± 16.2 years. The most frequent place of collapse was private residence, and 27% of collapses were unwitnessed. Dispatcher-provided CPR instructions were provided in 39.7% of cases until the arrival of the emergency service team, which showed a very strong effect on bystander-provided CPR, and were followed in 68.4% of cases, while non-instructed bystander CPR was provided in only 7.9% of cases. Bystander CPR is more likely to be provided in public places than in private residences, often with both compression and ventilation. Bystander CPR was also more likely to be provided to men. Cases with bystander CPR, and compressions with ventilation compared to compression only CPR, showed a significantly greater success in maintaining ROSC later in CPR, both with moderate effects. Bystander CPR has been shown to have a significant role in achieving and maintaining ROSC until hospital admission. However, our results showed a location-dependent nature of bystanders' willingness to perform CPR as well as sex disparities in patients receiving CPR. With deficient education in basic life support in Croatia, dispatchers need to insist on and instruct bystander CPR performance.

Development and effects of advanced cardiac resuscitation nursing education program using web-based serious game: application of the IPO model

BackgroundThe significant rise in cardiac arrest cases within hospitals, coupled with a low survival rate, poses a critical health issue. And in most situations, nurses are the first responders. To develop nursing students’ competencies in advanced cardiopulmonary resuscitation, systematic and repetitive learner-centered self-directed education that can promote the integration of knowledge and practice is necessary.ObjectivesTo develop an advanced cardiopulmonary resuscitation training program using a web-based serious game for nursing students and verifying its efficacy.DesignThe program was developed based on the stages of analysis, design, development, implementation, and evaluation, and the Input Process Outcome Model of Serious Game Design formed the theoretical basis.Settings and participantsThe research design employed a before-and-after non-equivalent control group, and data collection took place among 2nd and 3rd year nursing students at K University in D City, Korea, from March 2, 2023, to March 24, 2023.MethodsThe program consisted of a 120-min video lecture, 30 min of a web-based serious game, 30-min of written self-reported debriefing, and individual feedback using a video conference system. The effectiveness of the program was measured for both groups using an 89-item structured questionnaire regarding knowledge, confidence in performance, problem-solving ability, and learning transfer expectations.ResultsThe program was effective in improving nursing students’ advanced cardiopulmonary knowledge, confidence in performance, problem-solving ability, and learning transfer expectation immediately after intervention.ConclusionsThis program underscores the necessity of a new direction in nursing education, emphasizing learner-centered approaches, rather than the traditional focus on the mere transmission of basic knowledge and skills, to cultivate nurses with advanced cardiopulmonary resuscitation capabilities.

Performance of the Medical Priority Dispatch System® in Identifying Patients Requiring Chest Compressions at Overdose Prevention Services: A Retrospective Cohort Study

Background and Aims The Medical Priority Dispatch System (MPDS)® is used to triage 9-1-1 calls according to acuity, with certain coding receiving telecommunicator cardiopulmonary resuscitation (T-CPR) for suspected out-of-hospital cardiac arrest (OHCA). However, this may be challenging for those with drug poisoning emergencies, who may resemble OHCA. We sought to examine the performance of the system to correctly identify cases requiring T-CPR, specifically at overdose prevention services (OPS). Methods This retrospective cohort study included patients attended by the provincial emergency medical system (EMS) (May 1, 2019–January 31, 2023). We calculated the diagnostic performance of MPDS® assessment of whether the case required T-CPR instructions against the gold standard of whether the patient was found pulseless on EMS clinician arrival. We compared performance among subgroups, specifically OPS vs other locations and drug poisoning-classified cases vs other case classifications. Results Comparing OPS to other locations, the sensitivity of MPDS® was similar (66.7% vs 62.4%, p = 0.4), with lower specificity (87.3% vs 98.1%, p < 0.01) and positive predictive value (0.3% vs 35.7%, p < 0.01) and higher negative predictive value (99.9% vs 99.4%, p < 0.01). The negative likelihood ratio of MPDS® was 0.381 at OPS locations, compared with 0.383 at other locations, while the positive likelihood ratio was 5.24, compared with 32.36. In patients with drug poisoning emergencies, compared with other 9-1-1 events, MPDS® had higher sensitivity (83.6% vs 60.6%, p < 0.01) but lower specificity (77.6% vs 98.9%, p < 0.01) and positive predictive value (10.5% vs 48.5%, p < 0.01), and similar negative predictive value (99.33% vs 99.35%, p = 0.03). The negative likelihood ratio of MPDS® was 0.212 in drug poisoning emergencies compared with 0.398 for all other presentations, and the positive likelihood ratio was 3.73 compared with 57.88. Discussion and Conclusions The ability of MPDS® to correctly identify patients needing telecommunicator cardiopulmonary resuscitation instructions differed between OPS settings and other locations, frequently recommending T-CPR for patients not suffering OHCA at an OPS. Different strategies developed in collaboration with people who use substances are required to better tailor dispatch instructions prior to EMS arrival to avoid delays in life-saving interventions.

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.

The Effects of Serious Games on Cardiopulmonary Resuscitation Training and Education: Systematic Review With Meta-Analysis of Randomized Controlled Trials.

Serious games have emerged as an innovative educational strategy with the potential to significantly enhance the quality and effectiveness of cardiopulmonary resuscitation (CPR) training. Despite their promise, there remains a degree of controversy when comparing the advantages of serious games with traditional CPR training methods. This study seeks to provide a comprehensive assessment of the impact of serious games on CPR training and education by systematically analyzing the results of previous research. This study aimed to assess the effect of serious games on CPR training and education by summarizing and pooling the results of previous studies. We conducted a thorough and systematic search across 9 prominent web-based databases, encompassing the period from the inception of these databases until April 1, 2023. The databases included in our search were PubMed, Cochrane Library, Wiley Online Library, EBSCO (PsycInfo), SpringerLink, Chinese Biology Medicine Disc, Vip Journal Integration Platform, Wanfang Database, and Chinese National Knowledge Infrastructure. The studies selected adhered to the following criteria: (1) being a randomized controlled trial comparing serious games and traditional methods for CPR training; (2) having participants aged 12 years or older in CPR; (3) having an experimental group using serious games and a control group using nongame methods for CPR instruction; and (4) having outcomes including theoretical and skill assessments, compression depth, and rate. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias. Data analysis was performed using RevMan (version 5.3; Cochrane Training), and mean differences (MDs) and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables. A total of 9 articles were included, involving 791 study participants, of whom 395 in the experimental group taught CPR training using serious games and 396 in the control group taught CPR training using traditional methods. The results of our meta-analysis indicate that the use of serious games in CPR training yields outcomes that are comparable in effectiveness to traditional training methods across several key areas. Specifically, serious games demonstrated equivalence to traditional formats in theory assessment (SMD -0.22, 95% CI - 0.96 to 0.51; P=.55), skill assessment (SMD -0.49, 95% CI -1.52 to 0.55; P=.36), compression depth (MD -3.17, 95% CI -0.18 to 6.53; P=.06), and compression rate (MD -0.20, 95% CI -7.29 to 6.89; P=.96). In summary, serious games offer a viable and effective CPR education approach, yielding results comparable to traditional formats. This modality is a valuable addition to CPR training methodologies. However, caution is warranted in interpreting these findings due to limited controlled trials, small sample sizes, and low-quality meta-analyzed evidence.

Hands-Only Cardiopulmonary Resuscitation Education for Elementary School Students in Korea: Tracking by School Grade, Physical Characteristics, and Physical Strength.

Objectives: This study aimed to assess variations in chest compression depth among Korean elementary school students based on grade, physical characteristics, and strength. Methods: The study involved 140 children in the third to sixth grades from elementary schools. Before providing cardiopulmonary resuscitation (CPR) education, we assessed height, weight, BMI, grip strength, and back strength. Subsequently, CPR education was administered, followed by individual measurements of compression depth. The factors related to compression depths was analyzed using t-test, ANOVA and multivariable regression. Results: The mean compression depth was consistently lower than the guideline standard across all grades, indicating grade-dependent differences (p = 0.000). Moreover, height, weight, BMI, grip strength and back strength increased, exhibited significant increases with grade (p = 0.000). In multivariable regression analysis, it was observed that as grade increased, chest compression depth increased by 0.701cm (p = 0.000). Conclusion: School grade significantly influenced achieving the proper chest compressions depth, no notable correlation found for physical factors. Thus, a strategy emphasizing the importance of sufficient chest compressions during CPR education, particularly targeting elementary school students, seems necessary to encourage greater effort.

Effects of Dispatcher-Assisted Public-Access Defibrillation Programs on the Outcomes of Out-of-Hospital Cardiac Arrest: A Before-and-After Study.

Public access defibrillation (PAD) programs have been implemented globally over the past decade. Although PAD can substantially increase the survival of cardiac arrest, PAD use remains low. This study aimed to evaluate whether drawing upon the successful experiences of dispatcher-assisted cardiopulmonary resuscitation programs would increase the use of PAD in dispatcher-assisted PAD programs. This study using a before-and-after design was conducted in Taoyuan City using a local out-of-hospital cardiac arrest registry system and data of dispatcher performance derived from audio recordings. The primary outcomes were the rate of bystander PAD use, sustained return of spontaneous circulation, survival to discharge, and favorable neurological outcomes. The secondary outcomes were the performance of dispatchers in terms of PAD instruction and dispatcher-assisted cardiopulmonary resuscitation administration, the time interval indicators of dispatcher-assisted cardiopulmonary resuscitation. A total of 1159 patients were included and divided into 2 groups: the before-run-in group (502 patients) and the after-run-in group (657 patients). No significant difference was observed between the 2 groups in terms of baseline characteristics. The rate of PAD use in the after-run-in group significantly increased from 5.0% to8.7% (P=0.015). The rate of favorable neurological outcomes increased from 4.4% to 5.9%, which was not a statistically significant difference. Compared with the before-run-in group, the rate of successful automated external defibrillator acquisition was 13.5% in the after-run-in group (P<0.001). Implementing a dispatcher-assisted PAD protocol in a municipality setting significantly increased bystander PAD use without affecting dispatcher performance in out-of-hospital cardiac arrest recognition, cardiopulmonary resuscitation instruction, or dispatcher-assisted cardiopulmonary resuscitation time indicators.

Effectiveness of a dispatcher-assisted CPR using an animated image: Simulation study

IntroductionConsidering the few studies evaluating bystander cardiopulmonary resuscitation (CPR) performance, we sought to analyze differences in bystander CPR performance with and without the use of our self-developed animated GIFs based on dispatcher-assisted CPR simulation. MethodsA total of 80 adults who had not received CPR training over the past two years participated in the study. Among them, 40 people were classified into the auditory group (receiving CPR instructions only over the phone), and the other 40 people were classified into the audiovisual group (receiving CPR instructions over the phone after receiving images on a smartphone). All participants were asked to perform adult and infant CPR for 2 min. CPR performance was recorded using two video cameras (front and side) and analyzed by two emergency physicians, whereas CPR quality was measured using Resusci Anne & Baby QCPR Mk II (Laerdal). ResultsIn the adult CPR study, the audiovisual group had higher performance scores for adequacy of “knee position,” “hand posture,” “elbow extension,” and “vertical compression,” as well as higher Standard Posture Completeness and Instruction Performance scores (p < 0.001). No significant difference in CPR quality was observed between the two groups. In the infant CPR study, audiovisual group had higher performance scores in adequacy of “compression site,” “finger posture,” and “vertical compression,” as well as higher Standard Posture Completeness and Instruction Performance scores (p < 0.001). Regarding CPR quality, the audiovisual group had higher scores for “adequate compression rate ratio” (p = 0.047). ConclusionAudiovisual guidance using animated GIFs more effectively improved CPR Standard Posture Completeness and Instruction Performance than did traditional auditory guidance.

Readiness and Challenges in Cardiopulmonary Resuscitation Teaching: A Preliminary Perspective Amongst Malaysian Secondary School Principles

Introduction: Malaysia has not legalized CPR teaching in the national curriculum, leaving it to school principals to implement the teaching of CPR who may have limited knowledge. This study aims to investigate Malaysian secondary school principals’ level of readiness, defined as knowledge, attitude, willingness to teach CPR, and barriers to implementation. Methods: Malaysian secondary school principals were invited to complete a survey that consisted of five parts: (1) demographics, (2) CPR knowledge, (3) attitude towards CPR, (4) willingness to teach CPR, and (5) barriers to implementing CPR teaching. Results: A total of 54 secondary school principals responded to the survey. Three (5.6%) principals passed the CPR test. More than 80% agreed CPR course is important for students, mandatory to be taken before graduation and best taught by certified teachers. Principals are willing to qualify themselves and teachers with CPR certification and to provide funding to support and hire an outsider to teach CPR courses. Funding, teachers’ readiness for skills and knowledge proficiency, and curriculum burden are perceived as potential barriers to successful CPR teaching. One-way MANOVA analysis showed that gender (p = .257), age (p = .108), qualifications (p = .321), teaching experience (p = .194), and administrative experience (p = .193) did not have a significant effect on the combined dependent variables. Conclusion: Malaysian secondary school principals are aware of the importance of CPR and were willing to acquire the knowledge, skills, funds, equipment, and support in ensuring its implementation in the national curriculum.

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.

Effect of prebriefing in cardiopulmonary resuscitation education for laypeople on educational effectiveness and satisfaction

Bystander cardiopulmonary resuscitation (CPR) is important for improving survival rates and neurological outcomes in out-of-hospital cardiac arrest. However, laypeople often have psychological barriers to performing CPR, even if they have received training. Prebriefing provides psychological stability to the participants, enabling them to concentrate more comfortably during simulation. However, previous studies have mainly focused on simulation-based education for medical professionals, and no study has focused on prebriefing for laypeople. Therefore, we developed a structured prebriefing for laypeople and applied it to their CPR education to investigate its effect on educational effectiveness and satisfaction. This group randomization study was conducted from 09 November 2022 to 09 December 2022. Individuals aged ≥18 years who participated in CPR training as non-medical personnel were included. A 60-min CPR education focusing on hands-on skills was conducted. The Prebriefing Experience Scale for laypersons (PESL) was developed and surveyed using a 5-point Likert scale by modifying the Prebriefing Experience Scale for medical personnel based on existing research. During the study, a total of 382 people applied for education in 29 classes. Owing to logistical constraints resulting in randomization failure within the cohort of 10 classes, 82 participants were affected and subsequently excluded. In addition, 12 participants were excluded because of incomplete responses in the PESL survey. Ultimately, the experimental cohort consisted of 139 participants distributed across 10 classes, and the control group comprised 149 participants within the 9 classes. No difference in age and sex was found between the two groups. No statistically significant differences were observed between the two groups across all categories of the PESL assessment. In this study, when structured prebriefing was conducted on the general public, no statistically significant differences were found in PESL compared with conventional prebriefing. However, more improved research is needed.

Evaluation of the willingness to perform cardiopulmonary resuscitation (CPR) with automated external defibrillator (AED) among Hong Kong Chinese using the theory of planned behaviour framework: an online cross-sectional survey

IntroductionBystander cardiopulmonary resuscitation (CPR) and defibrillation by an automated external defibrillator (AED) in out-of-hospital cardiac arrest (OHCA) events were low in Hong Kong (HK). This study evaluated the willingness and...

Effectiveness of Teaching and Demonstration in Improvement of Knowledge and Skill on CPR among School-going Adolescents: A Quasi-experimental Study

Background: Cardiopulmonary resuscitation (CPR) is one of the most evolving areas of saving actions that improve the survival rates following cardiac arrest and educating high school students can play a dynamic role in case of emergencies in society. Education of school students in CPR is a strategic goal for the improvement of bystander CPR in rural society. If adolescents were trained to perform CPR during school physical education hours, this may be a cost-effective approach to CPR training. This study is conducted to assess the effectiveness of health education in the improvement of knowledge of CPR among school-going adolescents. Aim: To assess the effect of a training program on students’ knowledge of CPR. Objective: (A) To determine the background knowledge of high school students about cardiac arrest and basic life support in adult victims of cardiac arrest. (B) To determine the association between knowledge of cardiopulmonary resuscitation and skills with selected demographic variables. Materials and methods: This is a quasi-experimental study conducted among adolescents aged 13–15 years attending schools in rural areas of South India. The study was conducted between Jan 2022 and Jan 2023. 680 students were included in this study. The universal sampling method was used to enumerate the participants to reduce the impact of the dropout rate. The data was collected using a pre-tested semi-structured questionnaire by interview method. Basic teaching of CPR for the participants included 2 hours of oral teaching using lecture method, question and answer discussion method as well as 2 hours of practical session using demonstration, practice on a manikin, provision of feedback and correction of errors. Results: A total of 680 participants were grouped into three categories according to their knowledge scores: (A) fair, (B) Moderate, and (C) Good scores obtained in pre-training observation and post-training observation. Initially, there were 666 (97.9%) in the fair category, most of them improved after training as seen in the post-training observation results, with 97 (14.3%) persons in the fair (A) category. There was not a single student in the good category of the score before intervention, which increased to 665 (45.6%) in the good category of knowledge. The mean score of pre-training is 2.55, and the post-training score is significantly increased to 9.5. Conclusion: An improvement is observed in knowledge of CPR post-training with planned teaching and demonstration. Hence, this method can be considered a logical solution for improving knowledge about CPR in cases of emergency life-saving skills in a particular group of society.

비보건계열 대학생 대상 시뮬레이션 기반 심폐소생술 교육 프로그램의 효과

Objectives The purpose of this study is to develop simulation-based cardiopulmonary resuscitation education and apply it to non-health related college students to understand its effect.&#x0D; Methods This study was conducted on 54 non-health college students (27 in the experimental group and 27 in the control group). The control group received the general cardiopulmonary resuscitation (CPR) education, and the experimental group received the shortened version of the CPR education provided to the control group and the simulation-based CPR education developed in this study.&#x0D; Results Simulation-based CPR education was developed and applied in five stages: analysis, design, development, implement, and evaluation. The experimental group's cardiopulmonary resuscitation performance was 41.22±3.91 points, and the control group's cardiopulmonary resuscitation performance was 28.15±4.05 points, indicating a significant difference in cardiopulmonary resuscitation performance (Z=-6.32, p=&lt;.001). There were no significant differences in knowledge of CPR (Z=-0.04, p=.972), confidence in performing CPR (Z=1.00, p=.922), education satisfaction (Z=-0.28, p=.782), and immersion (Z=-0.08, p=.935).&#x0D; Conclusions Simulation-based CPR education programs was found to be effective in improving CPR performance. Therefore, the simulation-based CPR program can be used as an effective educational method for non-health college students, and it is necessary to consider ways that can be applied not only to college students but also to the general public.

The effect of simulation-based advanced cardiac life support training on nursing students’ self-efficacy, attitudes, and anxiety in Palestine: a quasi-experimental study

BackgroundCardiac Arrest (CA) is one of the leading causes of death, either inside or outside hospitals. Recently, the use of creative teaching strategies, such as simulation, has gained popularity in Cardio Pulmonary Resuscitation (CPR) instruction. This study aimed to assess the effect of High-Fidelity Simulation (HFS) training on nursing students’ self-efficacy, attitude, and anxiety in the context of Advanced Cardiac Life Support (ACLS).MethodologyThe study design is quasi-experimental employing a pre-test and post-test approach during April and May 2023. A convenient sample of 60 undergraduate nursing students in a 4-year class from a nursing college at the Arab American University/ Palestine (AAUP) participated in this study. The data were analyzed using a paired sample t-test in SPSS program version 26. Three data collection tools were used pre- and post-intervention; the Resuscitation Self-Efficacy Scale (RSES), The Attitudinal instrument, and the State Anxiety Inventory (SAI).ResultsThe total number of nursing students was 60, out of them (56.7%) were female, while the mean age was (22.2) years. Improvements were seen in all four domains of self-efficacy following HFS training: recognition, debriefing, recording, responding and rescuing, and reporting. (t (59) = 26.80, p < 0.001, confidence interval [29.32, 34.05]). After receiving HFS training on ACLS, the post-intervention for the same group attitude scores significantly increased from 32.83 (SD = 15.35) to 54.58 (SD = 8.540) for emotion, from 6.72 (SD = 2.44) to 10.40 (SD = 1.40) for behavior, and from 7.03 (SD = 2.03) to 10.33 (SD = 1.42) for cognitive. The anxiety level decreased post-simulation from 3.53 (SD = 0.3) to 2.14 (SD = 0.65), which was found to be statistically significant (t(59) = 16.68, p < 0.001, 95% CI [1.22 to 1.55]). Female students (M = 73.18), students who observed a real resuscitation (M = 71.16), and who were satisfied with their nursing major (M = 72.17) had significantly higher self-efficacy scores post-simulation.ConclusionThe HFS can be recommended as an effective training strategy among nursing students. The ACLS training-based HFS was effective in improving the students’ self-efficacy and attitudes and decreasing their anxiety.

Prompt-enhanced hierarchical transformer elevating cardiopulmonary resuscitation instruction via temporal action segmentation

The vast majority of people who suffer unexpected cardiac arrest are performed cardiopulmonary resuscitation (CPR) by passersby in a desperate attempt to restore life, but endeavors turn out to be fruitless on account of disqualification. Fortunately, many pieces of research manifest that disciplined training will help to elevate the success rate of resuscitation, which constantly desires a seamless combination of novel techniques to yield further advancement. To this end, we collect a specialized CPR video dataset in which trainees make efforts to behave resuscitation on mannequins independently in adherence to approved guidelines, promoting an auxiliary toolbox to assist supervision and rectification of intermediate potential issues via modern deep learning methodologies. Our research empirically views this problem as a temporal action segmentation (TAS) task in computer vision, which aims to segment an untrimmed video at a frame-wise level. Here, we propose a Prompt-enhanced hierarchical Transformer (PhiTrans) that integrates three indispensable modules, including a textual prompt-based Video Features Extractor (VFE), a transformer-based Action Segmentation Executor (ASE), and a regression-based Prediction Refinement Calibrator (PRC). The backbone preferentially derives from applications in three approved public datasets (GTEA, 50Salads, and Breakfast) collected for TAS tasks, which experimentally facilitates the model excavation on the CPR dataset. In general, we probe into a feasible pipeline that elevates the CPR instruction qualification via action segmentation equipped with novel deep learning techniques. Associated experiments on the CPR dataset advocate our resolution with surpassing 91.0% on Accuracy, Edit score, and F1 score.

Improve Survival of Out of Hospital Cardiac Arrest with Video-directed Chest Compressions

Background: Cardiovascular disease has been the leading cause of mortality worldwide for the past century, but advancements in health intervention have led to a decline of over 20%. However, the Out of Hospital Cardiac Arrest (OHCA) mortality rate remains unacceptably high, exceeding 90% over the past few decades. The primary reasons are the lack of cardiopulmonary resuscitation (CPR) knowledge and delayed medical response [1]. In 2018, the American Heart Association (AHA) introduced audio-directed CPR by 911 operators. However, the effectiveness of this approach in guiding laypeople to perform CPR is far from optimal [2]. Methods: Laypeople were randomly divided into audio and video groups, with each group receiving instructions through their respective medium on how to perform CPR on manikins. Simulated OHCA scenarios were created, involving on-site testing with subjects having no prior CPR experience, and a remote call site providing CPR instructions either through audio or video. Both on-site and online activities were recorded and analyzed. The accuracy of hand positions, the time of CPR initiation, the speed and effectiveness (depth) of chest compressions were tracked and compared between the audio and video guided groups based on AHA requirements. Results: Across 61 trials, CPR initiation occurred in 22 ± 11 seconds in the audio group and 22 ± 6 seconds in the video group. Hand location accuracy was 77% in audio participants and 97% in video participants (p&lt;0.05). The average speed of CPR was 0.55 ± 0.23 seconds with audio guidance and 0.45 ± 0.27 seconds with video guidance. The effectiveness of compressions was 33% ± 39% in the audio group and significantly improved to 79% ± 26% in the video group (p&lt;0.0001). Conclusion: The implementation of a new video-guided CPR system can significantly enhance CPR effectiveness when compared to the audio-assisted approach.