Cardiopulmonary Resuscitation Education Research Articles

Knowledge on Basic Life Support and Automated External Defibrillator (AED) Among Medical Professionals

The health care professionals are an essential part of the life-saving system. Basic life support includes the crucial components such as Cardio-pulmonary resuscitation (CPR) and defibrillation with automated external defibrillator (AED) which helps to restore the heart’s rhythm and breathing. There have been many studies that have shown that health care professionals are lacking knowledge of BLS and AED use. The purpose of this study was to assess BLS and AED knowledge among medical staffs and students in a private college and hospital. Only theoretical knowledge was examined using a questionnaire with 20 multiple choice questions relating to BLS abilities and a sample size of 862 people over the course of four months. The mean score for the study participants was 13.91±3.98. The major findings of this study show there is a statistically significant difference in the mean score with the departments of the respondents. As a result, the majority of them lack proper CPR knowledge, which can be improved through proper CPR training and education.

Effects of immersive virtual reality cardiopulmonary resuscitation training on prospective kindergarten teachers' learning achievements, attitudes and self‐efficacy

Children's unexpected cardiac arrest warrants cardiopulmonary resuscitation (CPR) by kindergarten teachers. Yet, recent research revealed trained personnel reporting poor transfer of acquired skills during real‐world emergencies with conventional CPR training. Immersive virtual reality (IVR) training induces a greater sense of presence and agency than conventional CPR training and may be more effective in terms of increasing trainees' intention and initiative to perform CPR in real‐world emergencies. A quasi‐experiment was conducted to assess the effectiveness of the IVR‐based CPR training method in terms of enhancing the intention to perform CPR. The trial enrolled 50 participants, 25 of whom examined a child patient in an IVR virtual scenario, using an AED, and performed two rounds of two‐minute chest compressions. The remaining 25 participants were trained using a video with consistent content on a monitor. A generalised estimating equation analysis demonstrated that the IVR training method significantly increased prospective kindergarten teachers' self‐efficacy for performing CPR, positive attitudes towards CPR, and CPR knowledge. This advantage was also maintained after the five‐week follow‐up. Thus, CPR teaching via IVR looks to be an excellent way to enhance the intention to perform CPR and may be of great value in improving existing CPR training systems. Practitioner notesWhat is already known about this topic Many trainees who have received traditional cardiopulmonary resuscitation (CPR) training hesitate to perform the skills learned in a real‐world emergency. The critical determinant of whether an individual performs a behaviour is the individual's ‘intention’ to perform that behaviour. Individual's self‐efficacy to perform CPR, attitudes towards CPR, and perceived social norms are three determinants that influence intention to perform CPR. Immersive media such as virtual reality may elicit more attitudinal changes and a greater sense of learner self‐efficacy than current mainstream media. What this paper adds The study's results indicated that compared to conventional technology‐supported video training, immersive virtual reality (IVR) training significantly increased participants' self‐efficacy about performing CPR, positive attitudes towards CPR and CPR knowledge. CPR training through IVR may enhance trainees' intention to perform CPR in real‐world emergencies. Implications for practice and/or policy The effectiveness of combining IVR technology into existing CPR training methods such as mixed reality training, which blends virtual environments with realistic mannequins, should be further examined in the future. IVR may be a more effective medium for enhancing the intention to perform behaviour than conventional technology. Future research could further experiment with the use of IVR as a behavioural intervention technique in education

Prone Dispatch-Directed CPR in Out-of-Hospital Cardiac Arrest: Two Successful Cases

Historically, dispatch-directed cardiopulmonary resuscitation (CPR) protocols only allow chest compression instructions to be delivered for patients able to be placed in the traditional supine position. For patients who are unable to be positioned supine, the telecommunicator and caller have no option except to continue attempts to position supine, which may result in delayed or no chest compressions being delivered prior to emergency medical services arrival. Any delay or lack of bystander chest compressions may result in worsening clinical outcomes of out-of-hospital cardiac arrest (OHCA) victims. We present the first two cases, to the best of our knowledge, of successfully delivered, bystander-administered, prone CPR instructions by a trained telecommunicator for two OHCA victims unable to be positioned supine.

Characteristics and motivational factors for joining a lay responder system dispatch to out-of-hospital cardiac arrests

BackgroundThere has been in increase in the use of systems for organizing lay responders for suspected out-of-hospital cardiac arrests (OHCAs) dispatch using smartphone-based technology. The purpose is to increase survival rates; however, such systems are dependent on people’s commitment to becoming a lay responder. Knowledge about the characteristics of such volunteers and their motivational factors is lacking. Therefore, we explored characteristics and quantified the underlying motivational factors for joining a smartphone-based cardiopulmonary resuscitation (CPR) lay responder system.MethodsIn this descriptive cross-sectional study, 800 consecutively recruited lay responders in a smartphone-based mobile positioning first-responder system (SMS-lifesavers) were surveyed. Data on characteristics and motivational factors were collected, the latter through a modified version of the validated survey “Volunteer Motivation Inventory” (VMI). The statements in the VMI, ranked on a Likert scale (1–5), corresponded to(a) intrinsic (an inner belief of doing good for others) or (b) extrinsic (earning some kind of reward from the act) motivational factors.ResultsA total of 461 participants were included in the final analysis. Among respondents, 59% were women, 48% between 25 and 39 years of age, 37% worked within health care, and 66% had undergone post-secondary school. The most common way (44%) to learn about the lay responder system was from a CPR instructor. A majority (77%) had undergone CPR training at their workplace. In terms of motivation, where higher scores reflect greater importance to the participant, intrinsic factors scored highest, represented by the category values (mean 3.97) followed by extrinsic categories reciprocity (mean 3.88) and self-esteem (mean 3.22).ConclusionThis study indicates that motivation to join a first responder system mainly depends on intrinsic factors, i.e. an inner belief of doing good, but there are also extrinsic factors, such as earning some kind of reward from the act, to consider. Focusing information campaigns on intrinsic factors may be the most important factor for successful recruitment. When implementing a smartphone-based lay responder system, CPR instructors, as a main information source to potential lay responders, as well as the workplace, are crucial for successful recruitment.

Medical education in Cardiopulmonary Resuscitation: Didactic transposition from traditional-presential to remote-interactive with simulation

Resumo: Introdução: A transposição didática do processo de ensino-aprendizagem presencial-tradicional para o remoto-interativo com simulação em reanimação cardiopulmonar foi uma estratégia implementada por docentes para promover a educação cognitiva, psicomotora e reflexiva sobre aspectos éticos de estudantes de Medicina primeiranistas em tempos de pandemia. Relato de experiência: Trata-se de um relato de experiência de abordagem descritiva e reflexiva, resultado colaborativo multiprofissional e multidisciplinar de oito docentes, visando atingir objetivos educacionais. Ocorreu em 2021, na Faculdade de Medicina de Jundiaí (FMJ), nas disciplinas de Fundamentos Assistenciais e Noções de Primeiros Socorros, e Bioética e Humanidades Médicas. As atividades foram planejadas para serem realizadas com os 120 estudantes matriculados, por meio da plataforma Google Sala de Aula, vinculada à conta institucional, de maneira síncrona e assíncrona. Combinaram-se diferentes estratégias de ensino, materiais, mídias e linguagens com materiais didáticos on-line hipermidiáticos e off-line multimidiáticos, compostos por diferentes tipos/formatos. Discussão: A transposição foi singular e desafiadora para docentes e discentes. Fundamentou-se o trabalho colaborativo interprofissional docente na integração das duas disciplinas e na materialização da educação nas dimensões teóricas e práticas simuladas. Acredita-se que a abordagem utilizada, combinando alguns meios tecnológicos, simuladores artesanais, possibilitou, no contexto das restrições impostas pela pandemia em curso, o ensino e a aprendizagem em suporte básico de vida, na temática reanimação cardiopulmonar. Os estudantes tiveram a oportunidade de desenvolver competências cognitivas, técnicas e comportamentais, e avaliar o seu progresso, realizando e recebendo feedbacks imediatos, bem como por meio de avaliação formativa sem atribuição de nota. Conclusão: A transposição didática do processo de ensino e aprendizagem mediada por tecnologias possibilitou que os estudantes se aproximassem do conteúdo teórico e participassem de simulações clínicas em seus lares com segurança. Porém, não há um estudo comparativo que mostre que o desenvolvimento foi semelhante ao presencial. Consequentemente, será necessário que a assessoria pedagógica avalie as possíveis lacunas de aprendizagem e como poderão ser superadas ao longo do curso.

The effectiveness of cardiopulmonary resuscitation education for 5th and 6th grade students and how the children felt about it

The effectiveness of cardiopulmonary resuscitation education for 5th and 6th grade students and how the children felt about it

Influencing Factors on Knowledge Attitude and Performance of CPR of Faculty and Staff

Purpose: This Study aimed to investigate elementary school teacher’s knowledge, attitude regarding cardio pulmonary resuscitation(CPR) and Explore which factors affect their intention to performance CPR. Method: Data were collected from March 1 to November 30, 2019 from 164 elementary school teacher’s. The collected data were analyzed by SPSS/WIN 23.0 program for descriptive statistics, independent t-test, One way ANOVA, Pearson correlation coefficients, and logistic regression. Results: There were significant differences in knowledge and attitude and intention to performance CPR ac -cording to education satisfaction. There were positive correlation between attitude and intention to performance CPR. Factors influencing. These factors explained 15.0% of the variance in intention to perform the CPR. Conclusion: The results of this study suggest that In CPR education, it is important to develop and apply standardized programs such as education contents, education time, and education methods, and it is necessary to operate effective CPR education programs by conducting education that meets the educational needs of the subjects.

Impact of emergency management in a simulated home environment for caregivers of children who are tracheostomy dependent.

Children who are tracheostomy dependent require comprehensive caregiver preparation for safe hospital-to-home transition. Although a structured discharge education program successfully trained caregivers to provide routine daily tracheostomy care, emergency response training was limited, lacking realistic experiences. Initiation of simulated emergency training for caregivers indicated performance confusion related to tracheostomy cardiopulmonary resuscitation (CPR). This study evaluated the effectiveness of an evidence-based tracheostomy CPR education intervention via caregiver participation in a high-fidelity simulation of a home-based emergency scenario on the performance of essential behaviors, comfort, and satisfaction. The study utilized a prospective descriptive pre- and post interventional design; 44 caregivers of children who were tracheostomy dependent participated. All caregiver participants completed: video- and instructor-assisted specialized tracheostomy CPR class, high-fidelity simulation performance of a home-based emergency (respiratory failure with cardiac arrest), postsimulation video debriefing, performance assessment with an objective scoring rubric, and pre- and post simulation surveys on levels of comfort and satisfaction. On the performance of essential emergency management behaviors, 86.4% of caregivers performed all four behaviors, but only 36.4% performed these essential behaviors in order. Post simulation caregiver comfort with emergency management significantly increased from pre simulation (p = .001). All caregivers were satisfied with this training and would recommend simulation of home-based emergencies for all caregivers. Qualitative feedback from caregivers revealed themes of gratitude and the importance of hands-on practice with guided debriefing/feedback. Study power was 0.98. Objective evaluation of caregiver performance demonstrated specialized tracheostomy CPR education prepared caregivers to respond in a home emergency. Caregivers viewed simulation as an opportunity to gain hands-on experience and improve emergency responses. It may be beneficial for other similar programs to include specialized tracheostomy CPR and emergency scenario simulation in their discharge education protocols and subsequently compare this program to other similar programs to establish best practice guidelines.

Dispatcher instructions for bystander cardiopulmonary resuscitation and neurologically intact survival after bystander-witnessed out-of-hospital cardiac arrests: a nationwide, population-based observational study

BackgroundThe International Liaison Committee on Resuscitation recommends that dispatchers provide instructions to perform compression-only cardiopulmonary resuscitation (CPR) to callers responding to adults with out-of-hospital cardiac arrest (OHCA). This study aimed to determine the optimal dispatcher-assisted CPR (DA-CPR) instructions for OHCA.MethodsWe analysed the records of 24,947 adult patients (aged ≥ 18 years) who received bystander DA-CPR after bystander-witnessed OHCA. Data were obtained from a prospectively recorded Japanese nationwide Utstein-style database for a 2-year period (2016–2017). Patients were divided into compression-only DA-CPR (n = 22,778) and conventional DA-CPR (with a compression-to-ventilation ratio of 30:2, n = 2169) groups. The primary outcome measure was 1-month neurological intact survival, defined as a cerebral performance category score of 1–2 (CPC 1–2).ResultsThe 1-month CPC 1–2 rate was significantly higher in the conventional DA-CPR group than in the compression-only DA-CPR group (before propensity score (PS) matching, 7.5% [162/2169] versus 5.8% [1309/22778], p < 0.01; after PS matching, 7.5% (162/2169) versus 5.7% (123/2169), p < 0.05). Compared with compression-only DA-CPR, conventional DA-CPR was associated with increased odds of 1-month CPC 1–2 (before PS matching, adjusted odds ratio 1.39, 95% confidence interval [CI] 1.14–1.70, p < 0.01; after PS matching, adjusted odds ratio 1.34, 95% CI 1.00–1.79, p < 0.05).ConclusionWithin the limitations of this retrospective observational study, conventional DA-CPR with a compression-to-ventilation ratio of 30:2 was preferable to compression-only DA-CPR as an optimal DA-CPR instruction for coaching callers to perform bystander CPR for adult patients with bystander-witnessed OHCAs.

Abstract 10861: Determining the Importance of Gender, Race, and Body Shape for Cardiopulmonary Resuscitation Education Using Manikins

Introduction: Cardiopulmonary resuscitation (CPR) education plays a critical role in reducing cardiovascular deaths. Thus, it is crucial that trainees engage in practice simulations that accurately replicate a cardiovascular emergency. Recent work has shown that certain demographic groups such as Black Americans and women are less likely to receive efficient CPR, and technique may vary on individuals who have an increased body mass index or who are pregnant. Poor representation of these groups in the manikins used for CPR simulation may play a substantial role in these inequities. Hypothesis: There is a deficiency in the diversity of race, gender, and body habitus of manikins used for CPR training in North and South America. Methods: Institutions, businesses, and non-governmental organizations which administer CPR certification in North and South America were identified for survey distribution through a collaboration with the Inter-American Society of Cardiology. A survey was administered using the online platform Qualtrics (Provo, USA) consisting of 18 questions about manikin supply, usage, and diversity. Results and Conclusions: A total of 52 survey responses were received from North America (n=20; 854 total manikins) and South America (n=32; 1,169 total manikins). Of the total manikins (n=2,023), 318 (16%) were non-white, 114 (6%) were female, 20 (1%) represented a non-lean body habitus, and 18 (1%) were pregnant. The importance of diverse manikin representation in simulation training is underscored by literature detailing deficiencies in CPR initiation and associated outcomes in individuals who are not lean white males. Yet, the majority of manikins used in North and South America still disproportionally represent this population. It is pertinent that manikins used for CPR training reflect all populations at risk for major adverse cardiovascular events.

Abstract 13248: The Impact of Instructions for Covering the Mouth and the Nose on Dispatch-Assisted Cardiopulmonary Resuscitation

Introduction: Under the SARS-CoV-2 pandemic, rescuers are recommended to cover their mouth and nose with a facemask or a cloth as well as victim’s mouth and nose when performing cardiopulmonary resuscitation (CPR). However, its impact on dispatch-assisted CPR (DACPR) has not been investigated well. Hypothesis: DACPR including the instruction for covering the rescuer’s and the victim’s mouth and nose can significantly delay the start of the first chest compression. Methods: We retrospectively analyzed DACPR records of the Nara Wide Area Fire Department, covering population of 853,000/3361km 2 , in Japan. We investigated the key time intervals of 505 DACPR records between May 2020 and March 2021. We also compared the results to that of the same period in 2019 (535 records). Results: Dispatchers failed to provide mask instruction in 322 cases (63.8%). The median time interval from the emergency call and the start of CPR instruction was longer in 2020 (197 seconds vs 190 seconds, p=0.641). The time to the first chest compression was also delayed in 2020 (264 seconds vs 246 seconds, p=0.015). Among the cases that dispatchers successfully provided mask instruction (183 cases, 36.2%), median time intervals to the start of instruction and the first chest compression were relatively faster than cases without mask instruction (177 seconds vs 211 seconds and 254 seconds vs 269.5 seconds, respectively). Conclusions: Dispatchers failed to provide mask instruction in the majority of CA cases. However, our study results indicate that the impact of mask instruction on DACPR can be minor in terms of immediate CPR provision.

Have Students Used Techniques to Stop the Bleed?

The Stop the Bleed course was initiated in response to the Hartford Consensus and over 1 million people have been taught basic bleeding control techniques. Our study sought to determine the extent to which this training has been utilized. Surveys were sent by email to students that had taken the Stop the Bleed course through our institution in 2017 or 2018. Data were collected utilizing the REDCap system and statistical calculations were performed. 2505 surveys were sent with 445 (18%) responses. The mean age of respondents was 48 years of age, 343 (77%) were female, and 230 (52%) were in the medical field. There were 17 respondents (3.8%) that stated they had utilized the techniques taught in the course; 16 out of 17 put pressure on a wound, 7 packed a wound, and 6 used a tourniquet. Patients had been injured by a variety of mechanisms including gunshot wound, stabbing, accidental laceration, and motor vehicle collision. Patients had good outcomes with 3 out of 17 surviving to emergency medical services arrival without known final outcome and the remaining 14 were known to do well. The Stop the Bleed course is important to enable bystanders to provide hemorrhage control. Our study shows that the techniques have been utilized with 17 treated patients having a good outcome and while a utilization rate of 3.8% may appear low, it is similar to the utilization rate of cardiopulmonary resuscitation instruction of 2%.

Dispatcher-assisted conventional cardiopulmonary resuscitation and outcomes for paediatric out-of-hospital cardiac arrests

AimAs asphyxial cardiac arrest is more common than cardiac arrest from a primary cardiac event in paediatric cardiac arrest, effective ventilation is important during paediatric cardiopulmonary resuscitation (CPR). We aimed to determine optimal dispatcher-assisted CPR instructions for bystanders after paediatric out-of-hospital cardiac arrest (OHCA). MethodsWe analysed the records of 8172 children who received bystander dispatcher-assisted CPR. Data were obtained from an All-Japan Utstein-style registry from 2005 to 2017. Patients were divided into conventional CPR and compression-only CPR groups. The primary study endpoint was 1-month neurologically intact survival, defined as a Cerebral Performance Category score of 1 or 2 (CPC 1–2). ResultsThe 1-month CPC 1–2 rate was significantly higher in the dispatcher-assisted conventional CPR group than in the dispatcher-assisted compression-only CPR group (before propensity score matching, 5.7% [175/3077] vs. 3.1% [160/5095], p < 0.0001, adjusted odds ratio 2.48, 95% confidence interval 1.19–3.22; after propensity score matching, 6.0% [156/2618] vs. 2.6% [69/2618], p < 0.0001, adjusted odds ratio 2.42, 95% confidence interval 1.76–3.32). In most subgroup analyses after matching, dispatcher-assisted conventional CPR had a higher CPC 1–2 rate than dispatcher-assisted compression-only CPR; however, CPC 1–2 rates were similar between the two groups for patients with an initial shockable rhythm, those with total prehospital CPR time ≥ 20 min, those receiving public access defibrillation, advanced airway management, or adrenaline administration. ConclusionWithin the limitations of this retrospective observational study, dispatcher-assisted conventional CPR was preferable to dispatcher-assisted compression-only CPR as optimal CPR instructions for coaching callers to perform bystander CPR.

293 Barriers in Telephone CPR Instruction by 911 Dispatchers for Out-of-Hospital Cardiac Arrest Before and During the COVID-19 Pandemic

Telephone cardiopulmonary resuscitation (T-CPR) instruction is crucial by 911 telecommunicators (Tcom) prior to emergency medical services (EMS) arrival for identified out-of-hospital cardiac arrest (OOHCA). Timely identification of OOHCA and successful T-CPR instructions are important for improved survival and neurological outcome. This study aims to describe barriers in providing T-CPR instruction to reporting parties (RP) in an urban 911 Dispatch center prior to the COVID-19 pandemic compared to during the COVID-19 pandemic.

KIDS SAVE LIVES: a narrative review of associated scientific production.

In sudden out-of-hospital cardiac arrest, bystander cardiopulmonary resuscitation (CPR) is one of the most important elements of the chain of survival. Since 2015, international health societies and associations have recognized KIDS SAVE LIVES (KSL) as an essential initiative on CPR principles dissemination among schoolchildren. Children can be potential multipliers of the CPR competencies by teaching families, relatives, and friends. This review aimed to determine the main CPR issues raised in the KSL-associated publications. We found 12 Editorials, 9 Letters, 2 Special Reports, 4 Reviews, 2 Guidelines, 9 Original Articles and 17 Conference Presentations on KSL history, the schoolchildren CPR education, and KSL program implementation in several countries. In nine original studies, the main issues were instructors' and learners' CPR knowledge, skills, and retention, gender and physical aspects affecting CPR performance, types of KSL programs and new technologies to teach CPR. The KSL-associated literature is limited to support KSL benefits. However, the KSL could potentially contribute to improve out-of-hospital CPR performed by lay people at earlier age in different countries. Children are an important target group to diffuse CPR principles ('CHECK-CALL-COMPRESS'), as they are curious, motivated and enjoy teaching others.

Virtual reality training in cardiopulmonary resuscitation in schools

The UK average survival rate from out of hospital cardiac arrest (OHCA) is 8.6%, which is significantly lower than in comparable countries where survival rates can exceed 20%. A cardiac arrest victim is two to four times more likely to survive OHCA with bystander cardiopulmonary resuscitation (CPR). Mandatory teaching of CPR in schools is an effective way, endorsed by the World Health Organization, to train the entire population and improve the bystander CPR rate. Despite this, as with other UK home nations, there is significant variation in provision of CPR training within schools in Wales. Virtual reality (VR) technology offers an accessible, immersive way to teach CPR skills to schoolchildren. Computer scientists at the University of Chester and the Welsh Ambulance Services NHS Trust developed Virtual Cardio Pulmonary Resuscitation (VCPR), which can be used to teach children CPR skills. There were three stages: identifying requirements and specifications; development of a prototype; and management—development of software, further funding and exploring opportunities for commercialisation.

Development of a Performance Assessment Scale for Simulated Dispatcher-Assisted Cardiopulmonary Resuscitation (Telephone-CPR): A Multi-Center Randomized Simulation-Based Clinical Trial.

Dispatchers should be trained to interrogate bystanders with strict protocols to elicit information focused on recognizing cardiac arrest and should provide telephone cardiopulmonary resuscitation (CPR) instructions in all cases of suspected cardiac arrest. While an objective assessment of training outcomes is needed, there is no performance assessment scale for simulated dispatcher-assisted CPR. The aim of the study was to create a valid and reliable performance assessment scale for simulated dispatcher-assisted CPR. In this prospective, randomized, controlled, multi-centric simulation-based trial (registration number TCTR20210130002), the scale was developed according to the European Resuscitation Council (ERC) and American Heart Association (AHA) Guidelines 2015 and revised by experts. The performance of 48 dispatchers' telephone-CPR and of 48 bystanders carrying out CPR on a manikin was assessed by two independent evaluators using the scale and using a SkillReporter (PC) software to provide CPR objective performance. Continuous variables were described as mean (SD) and categorical variables as numbers and percentage (%). Comparative analysis between two groups used a Student t-test or a non-parametric test of Mann-Whitney. The internal structure of the scale was evaluated, including internal consistency using α Cronbach coefficient, and reproducibility using intraclass correlation coefficient (ICC) and linear correlation coefficient (R2) calculation. The scale included three different parts: two sections for dispatchers' (32 items) and bystanders' CPR performance (15 items) assessment, and a third part recording times. There was excellent internal consistency (α Cronbach coefficient = 0.77) and reproducibility (ICC = 0.93; R² = 0.86). For dispatchers' performance assessment, α Cronbach coefficient = 0.76; ICC = 0.91; R2 = 0.84. For bystanders' performance assessment, α Cronbach coefficient = 0.75; ICC = 0.93; R2 = 0.87. Reproducibility was excellent for nine items, good for 19 items, and moderate for 19 items. No item had poor reproducibility. There was no significant difference between dispatch doctors' and medical dispatch assistants' performances (33.0 [SD = 4.7] versus 32.3 [SD = 3.2] out of 52, respectively; P = .70) or between trained and untrained bystanders to follow the instructions (14.3 [SD = 2.0] versus 13.9 [SD = 1.8], respectively; P = .64). Objective performance (%) was significantly higher for trained bystanders than for untrained bystanders (67.4 [SD = 14.5] versus 50.6 [SD = 19.3], respectively; P = .03). The scale was valid and reliable to assess performance for simulated dispatcher-assisted CPR. To the authors' knowledge, no other valid performance tool currently exists. It could be used in simulated telephone-CPR training programs to improve performance.

Basic life support training in schools

Older children and adolescents are able to learn and perform cardiopulmonary resuscitation maneuvers in a satisfactory manner. Schools are places where training in basic life support can be carried out. This narrative review was carried out to assess the effectiveness of training in basic life support in schools, analyzing different learning methodology, age groups, and gaining confidence in performing cardiopulmonary resuscitation in a real situation. The search was conducted in the MEDLINE database. Articles published from 01/01/2014 to 12/31/2019, with children under 18 years of age, published in English, Portuguese and Spanish, were selected. Three hundred and nine articles were found, of which 15 met the inclusion criteria in the study. There was great heterogeneity in the methodologies evaluated, making it difficult to compare some studies. Cardiopulmonary resuscitation taught to school children has resulted in the retention of skills and knowledge. There was a direct relationship between age group and quality of cardiopulmonary resuscitation. Learning cardiopulmonary resuscitation can also change the stigma and fear associated with procedures. We conclude that the teaching of cardiopulmonary resuscitation by different methodologies is effective in the learning of children and adolescents and improves their confidence in doing it. Although older than 12 years of age have a greater ability for depth of compression, other points of basic life support can be developed in younger children.

BLS courses for refugees are feasible and induce commitment towards lay rescuer resuscitation.

BackgroundHigh‐quality Basic Life Support (BLS), the first step in the Utstein formula for survival, needs effective education for all kinds of population groups. The feasibility of BLS courses for refugees is not well investigated yet.MethodsWe conducted BLS courses including automated external defibrillator (AED) training for refugees in Austria from 2016 to 2019. Pre‐course and after course attitudes and knowledge towards cardiopulmonary resuscitation (CPR) were assessed via questionnaires in the individuals’ native languages, validated by native speaker interpreters.ResultsWe included 147 participants (66% male; 22 [17‐34] years; 28% <18 years) from 19 countries (74% from the Middle East). While the availability of BLS courses in the participants’ home countries was low (37%), we noted increased awareness towards CPR and AED use after our courses. Willingness to perform CPR increased from 25% to 99%. A positive impact on the participants’ perception of integration into their new environment was noted after CPR training. Higher level of education, male gender, age <18 years and past traumatizing experiences positively affected willingness or performance of CPR.ConclusionBLS education for refugees is feasible and increases their willingness to perform CPR in emergency situations, with the potential to improve survival after cardiac arrest. Individuals with either past traumatizing experiences, higher education or those <18 years might be eligible for advanced life support education. Interestingly, these BLS courses bear the potential to foster resilience and integration. Therefore, CPR education for refuge should be generally offered and further evaluated.

Description of call handling in emergency medical dispatch centres in Scandinavia: recognition of out-of-hospital cardiac arrests and dispatcher-assisted CPR

BackgroundThe European resuscitation council have highlighted emergency medical dispatch centres as an important key player for early recognition of Out-of-Hospital Cardiac Arrest (OHCA) and in providing dispatcher assisted cardiopulmonary resuscitation (CPR) before arrival of emergency medical services. Early recognition is associated with increased bystander CPR and improved survival rates. The aim of this study is to describe OHCA call handling in emergency medical dispatch centres in Copenhagen (Denmark), Stockholm (Sweden) and Oslo (Norway) with focus on sensitivity of recognition of OHCA, provision of dispatcher-assisted CPR and time intervals when CPR is initiated during the emergency call (NO-CPRprior), and to describe OHCA call handling when CPR is initiated prior to the emergency call (CPRprior).MethodsBaseline data of consecutive OHCA eligible for inclusion starting January 1st 2016 were collected from respective cardiac arrest registries. A template based on the Cardiac Arrest Registry to Enhance Survival definition catalogue was used to extract data from respective cardiac arrest registries and from corresponding audio files from emergency medical dispatch centres. Cases were divided in two groups: NO-CPRprior and CPRprior and data collection continued until 200 cases were collected in the NO-CPRprior-group.ResultsNO-CPRprior OHCA was recognised in 71% of the calls in Copenhagen, 83% in Stockholm, and 96% in Oslo. Abnormal breathing was addressed in 34, 7 and 98% of cases and CPR instructions were started in 50, 60, and 80%, respectively. Median time (mm:ss) to first chest compression was 02:35 (Copenhagen), 03:50 (Stockholm) and 02:58 (Oslo). Assessment of CPR quality was performed in 80, 74, and 74% of the cases. CPRprior comprised 71 cases in Copenhagen, 9 in Stockholm, and 38 in Oslo. Dispatchers still started CPR instructions in 41, 22, and 40% of the calls, respectively and provided quality assessment in 71, 100, and 80% in these respective instances.ConclusionsWe observed variations in OHCA recognition in 71–96% and dispatcher assisted-CPR were provided in 50–80% in NO-CPRprior calls. In cases where CPR was initiated prior to emergency calls, dispatchers were less likely to start CPR instructions but provided quality assessments during instructions.