Cardiopulmonary Resuscitation Education Research Articles

간호대학생과 간호사 대상 심폐소생 교육 연구 동향 분석: 주제범위 문헌고찰

Objectives The purpose of this study was to analyze research on CPR education for nursing students and nurses in Korea to identify research trends and propose future directions. Methods The methodological framework was based on a previous work by Arksey and O’Malley. The studies re viewed were found through electronic databases, such as KCI, RISS, PubMed, and CINAHL. The scope of the data was from January 2013 to December 2023. Each study was analyzed, and extracted data were abstracted into the following domains: general characteristics, study design, program characteristics, and program contents, program outcome. Results The 25 studies were reviewed. Cardiopulmonary resuscitation (CPR) training subjects were 22 nursing students (88%), 2 nurses (8%), and 1 new nurse (4%). 12 papers (48%) of Basic Life Support(BLS) papers and 13 papers (52%) of Advanced Cardiovascular Life Support (ACLS) (including Korean CPR KALS) were classified. Among the 25 selected papers, 16(64%) were simulation-based education as a teaching method, of which 5(20%) were applied to low-fidelity simulator and 11(44%) were applied to high-fidelity simulator. There were 13 debrief ing papers, and the majority of CPR education was conducted at a ratio of more than 1: 5 between instructors and students. In addition, Kirkpatrick's educational program performance measurement model was used to examine the performance of CPR education. Among the total of 25 studies 80 outcome indicators, 6 reaction level out comes (7.5%), 52 learning level outcomes (65.0%), 22 behavior level outcomes (27.5%), and result level outcomes were not found. Conclusions Appropriate BLS, ACLS education is essential for nursing students and nurses to adapt to their work. However, there was a lack of research on education programs for new nurses. Results indicate that it is necessary to develop various education programs for new nurses. Future researchers should focus on nursing education pro grams to enhance the clinical competency and apply effective debriefing.

Training in Basic Cardiopulmonary Resuscitation for high school students of an educational institution in the city of Venado Tuerto

Introduction: Cardiorespiratory arrest (CRA) was a pathology of high incidence worldwide, characterized by its time dependence. Immediate intervention by Basic Life Support (BLS) by witnesses significantly increased the survival rate. However, these maneuvers were performed in few cases due to the lack of training in the general population. Institutions such as the American Heart Association (AHA) recommended including learning Cardiopulmonary Resuscitation (CPR) in schools to increase its application and improve survival outcomes.Development: The management of CPR included two main levels: BLS, which could be performed by untrained individuals using chest compressions and automated external defibrillation (AED), and advanced life support, reserved for trained personnel. Studies showed that every minute without attention reduced the probability of survival by 10%, highlighting the need for rapid and efficient responses. CPR training in adolescents was identified as a key strategy, given their rapid learning and ability to transmit the knowledge to their environment. In addition, the importance of including AEDs in public spaces to facilitate their use in emergencies was emphasized.Conclusions: Education in basic CPR proved to be fundamental in increasing survival rates in cases of CRA, reducing sequelae and improving prognosis. Training from an early age and the implementation of community strategies were essential tools to face this high mortality emergency

Abstract Su406: Acceptability and Effectiveness of a Novel, Video-Based CPR and AED Education Program in Canadian Schools

Background: Early cardiopulmonary resuscitation (CPR) and defibrillation are critical for favorable outcomes after sudden cardiac arrest (SCA). Scientific evidence supports CPR and Automated External Defibrillator (AED) training in school-age children. Few studies have used gamified, video-based training to teach students. This national project aimed to assess the acceptability and effectiveness of a brief, video-based educational program (CardiacCrash™), developed by the Heart and Stroke Foundation to teach students hands-only CPR and AED use within a classroom setting. Methods/Results: This study reports preliminary data from two Canadian provinces (Ontario, Alberta). The acceptability and effectiveness of training was measured using a pre/post survey evaluating students’ self-confidence in recognizing SCA, calling for help, and providing bystander CPR, including the use of an AED. CPR performance was measured by using Little Anne QCPR manikins that collected data on CPR effectiveness throughout the training session. Results are stratified by student cohort (elementary—grades 4-8, and secondary—grades 9-12). A total of 1273 students from 6 Ontario and 7 Alberta schools were trained between October 2023 to April 2024. The average age for elementary students (n=729; 47.3% male) was 11.2 ± 1.3 years, and 39.9% had previous CPR training. The average age for secondary students (n=544; 54.4% male) was 15.5 ± 1.1, and 42.6% had previous CPR training. Both groups thought the training was easy (86%), fun (81%), the correct duration (59%) and would recommend it to their friends (85%). All outcome variables improved post-training for both elementary and secondary students, including the self-confidence to recognize and assist in cases of SCA (p=0.008 for both cohorts), (Figure 1). Secondary students were significantly better at providing effective compressions vs. elementary for most CPR measures (Table 2). Conclusion: Preliminary data suggest that CardiacCrash™, a video-based educational program, is acceptable to school-age students and effective at teaching them to perform CPR and use an AED. While both elementary and secondary students achieved acceptable CPR performance, secondary students performed higher quality CPR.

Implementing a Comprehensive CPR Education in New York State Public High Schools: Ideas, Drawbacks, & Future Directions.

Cardiopulmonary resuscitation (CPR) is a lifesaving skill that can be employed when people experience cardiac arrest. While the benefits of CPR on survival are well known, much of the American population remains uneducated on how to perform it. There are many reasons for this, ranging from the cost of CPR courses to fear of making mistakes in emergency situations. There have been a variety of efforts across the United States that attempted to boost CPR education, one of which is education in schools. While not a federal law, many states now require some degree of CPR education to be provided to high school students. New York joined this coalition of states in September of 2014. Signed into law by then Governor Cuomo, Act 804-C helped pave the way for CPR education across many pupils in the state. While undoubtedly a step in the right direction, many elements of 804-C promote a disjointed, unequal, and sometimes insufficient CPR education across different schools and counties in the state. In this review, we will highlight some shortcomings of 804-C. We will also highlight ways in which New York State can improve upon their CPR education efforts while also acknowledging logistical and financial obstacles that our proposals might incur.

Empowering Medical Students by Facilitating Cardiopulmonary Resuscitation Training for Their Peer

Cardiopulmonary Resuscitation (CPR) training is an essential component of medical education, equipping students with life-saving skills to respond effectively in emergencies. Following a CPR training program, this study investigates the impact of medical students’ knowledge and confidence levels as they facilitate hands-on CPR sessions for their peers. Through a review of literature and empirical analysis, this research elucidates the benefits of peer-assisted learning in CPR education. Results indicate a significant improvement in both knowledge and confidence levels among facilitators following the CPR training program. Overall, the findings highlight the invaluable role of medical student facilitators in enhancing CPR training outcomes and fostering a culture of peer support and empowerment within the medical community. This study underscores the significance of integrating peer-assisted learning strategies into CPR education programs, providing medical students with opportunities for both personal and professional growth. By leveraging the expertise and enthusiasm of medical student facilitators, educators can enhance the effectiveness and sustainability of CPR training initiatives, ultimately contributing to improved patient outcomes and community resilience in emergencies.

Does Real-time Feedback Guide Devices Improve the Quality of Chest Compressions in the Bystander (Naves) Provider?

Cardiopulmonary resuscitation (CPR) is an important lifesaving technique that must taught to everyone. As most cardiac arrests occur outside of the hospital, training the general population in the recognition of cardiac arrest and performing high-quality CPR is vital. Thus, this study aimed to compare the chest compression quality data (rate, depth, and fraction) with and without the use of feedback devices during CPR. A crossover observational study was carried out at a tertiary hospital in September 2021. Five hundred and seventeen 1st-year university students were recruited, and the response rate was 90% (465). A feedback device was used to collect data. The data were numerically coded and statistical software (SPSS 21) was used to perform descriptive and inferential statistical analysis, including a paired t-test. The mean compression rate with feedback was statistically significantly lower after performing one cycle of CPR (mean difference: -5.610; 95% confidence interval [CI]= -7.987--3.233; P < 0.001), the difference between mean compression depth with and without feedback was not statistically significant (mean difference: = -0.006; 95% CI = -0.190-0.177; P = 0.944), and the mean compression target (%) with feedback was statistically significantly higher (mean difference: -15.951; 95% CI = -17.894--14.009; P < 0.001). We found that the use of feedback devices during layperson-simulated CPR scenarios significantly improved the quality of chest compression in terms of depth and rate and resulted in more guidelines adherence. Moreover, national programs for CPR education should be implemented.

Improving Cardiopulmonary Resuscitation skills for layperson in cases of heart attack: a scoping review

The proficiency of trained individuals in effectively administering Cardiopulmonary Resuscitation (CPR) is paramount in mitigating the impact of out-of-hospital cardiac arrest incidents. Inadequate CPR skills among laypersons can result in missed opportunities to save lives. Therefore, it is imperative to prioritize unified efforts to enhance CPR competencies within the general populace. This scoping review aims to consolidate literature discussing the enhancement of laypeople's CPR skills using various methodologies.This scoping review employed the PRISMA methodology and encompassed an extensive search across four critical databases (Science Direct, Proquest, Pubmed, and Google Scholar) for literature published between 2013 and 2023. The search utilized the keywords "CPR Teaching," "Skill," and "Layperson." Out of 487 collected articles, 20 were deemed relevant. The findings of all relevant articles consistently indicated an improvement in laypeople's CPR skills following training.Incorporating concise CPR instructional videos and smartphone applications has shown potential for enhancing CPR knowledge and improving emergency responsiveness. Nonetheless, integrating these modern technological approaches with traditional simulation methods has demonstrated greater efficacy in CPR training, resulting in enhanced compression quality and depth.In conclusion, Integrating traditional and technology-based learning methodologies improves the capability of individuals without specialized medical training to administer CPR effectively.

Are high school cardiopulmonary resuscitation education mandates working? Insights from a high school survey on CPR knowledge, attitudes, and readiness

BackgroundThe use of cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs) significantly improve the chances of survival after out-of-hospital cardiac arrest. Subsequently, state laws mandate training in CPR and AED use for high school graduation. However, training and its impact vary and must be better understood. ObjectiveWe assessed the current CPR training mandates and their impact. MethodsWe performed a nationwide, cross-sectional, survey-based observational study of high schoolers in 9th to 12th grades in all 50 states from 2020 to 2022 (NCT04493970), assessing basic demographics, attitudes, knowledge and skills, and willingness to learn CPR and AED. ResultsWe had an 8% response rate, resulting in 2395 high school students surveyed. The mean age of respondents was 16.8 ± 0.7 years, with 52.5% female students. Of these, 86% underwent some form of training, and 25.1% had CPR training in the last year. Only 58.7% knew how to use an AED. Notably, 26.9% had previously witnessed CPR, and almost all (94%) realized the importance of learning CPR. Most respondents also believed recurrent and longitudinal would be beneficial. ConclusionSurprisingly, only a small cohort of students undergo CPR training even when it is mandatory. The quality of this training appears to be inadequate to impart appropriate confidence and knowledge levels. This suggests a need for a significant overhaul of CPR training mandates across the United States.

Life-Saving-Experiments; Primary School CPR Skills Instruction Improves Teaching in Basic Science Knowledge Support

Basic Life Support (BLS) improves survival in patients after cardiac arrest. Consequently, several worldwide efforts have been made to train all school children in cardiopulmonary resuscitation (CPR) skills. Until now, no methodology has been applied to the school science curriculum that facilitates the teaching of CPR at school.

Enhancing Bystander Intervention: Insights from the Utstein Analysis of Out-of-Hospital Cardiac Arrests in Slovenia.

Background and Objectives: Out-of-hospital cardiac arrest (OHCA) and survival is a pressing matter all around the world. Despite years of research and great strides and advancements, survival remains alarmingly low. The aim of this study was to measure the survival and characteristics of patients having an OHCA in Slovenia, with an in-depth look at how the bystanders affect the return of spontaneous circulation (ROSC) and survival of OHCA. Materials and Methods: In this observational cross-sectional prospective study, we enrolled patients between 1 September 2022 and 30 November 2022, with a follow-up period of 1 month. All OHCAs attended by the emergency medical services were included. Data were collected and analyzed according to the Utstein 2015 reporting template. Independent predictors of ROSC and 30-day survival or survival were explored using ridge regression. Results: ROSC was achieved in 41% of cases where resuscitation was attempted. The overall 30-day survival rate where resuscitation was attempted was 14%. In 13% of all cases where resuscitation was attempted, patients had a favorable neurological outcome. Using our prediction model, we found that defibrillation under 20 min and ventricular fibrillation as an initial rhythm improves survival, whilst no defibrillation and bystander full cardiopulmonary resuscitation negatively predicted survival. Conclusions: Slovenia has OHCA 30-day survival comparable to the rest of the European Union. The favorable neurological outcome is high. Our data show that bystanders do not significantly improve survival. This represents an untapped potential of general public education in cardiopulmonary resuscitation and automatic external defibrillator use. Following good practices from abroad and improving layperson CPR knowledge could further improve OHCA survival.

Pedagogical Implementation of Directive Feedback Manikins on Cardiopulmonary Resuscitation (CPR) Competencies: Expert Versus Peer Coaching.

Directive feedback manikins in resuscitation training evolved faster than the pedagogical evidence. Educators and learning systems must seek clarification on the efficacy of this technology to have evidence-based practices. This project explores directive feedback device use in cardiopulmonary resuscitation (CPR) education for laypersons. A prospective nonrandomized-controlled design assessed two pedagogical approaches of directive feedback manikins in adult CPR lessons.The 230 participants were distributed between three groups: a control group without directive feedback manikins (no lights, NL), an expert coaching (EC) group with directive feedback and educator interpretation, and a peer coaching (PC) group with directive feedback, peer interpretation, and expert quality assurance. From the 25 courses observed, average compression depth (mm) did not differ between groups (p = .498),average compression rate (compressions: minute) significantly differed between groups (p = .004), and correct hand placement did not differ between groups (p = .249). A chi-square test showed no significant association between groups and CPR skill feedback, or between groups and "recommending the course to a friend or family member." The PC group was more likely to agree that they could "coach someone to do CPR skills" than the NL or EC. This study expands the knowledge base of directive feedback manikins in a pedagogical setting to improve CPR competencies. Training organizations may consider any of these practices effective,choosing those that align with desired outcomes. CPR educators need orientation to feedback devices as well as professional development on educational options for their use. Considerations for further research include technology costs, access, and cultural aspects of implementing these tools.

Analysis of the Application Value of Virtual Reality Combined with Flipped Classroom Teaching Mode in Cardiopulmonary Resuscitation Teaching

Objective: To analyze the value of using virtual reality combined with the flipped classroom teaching model in teaching cardiopulmonary resuscitation (CPR). Methods: Two classes of our nursing program were randomly selected for the study from September 2022 to September 2023, Class A (52 students, conventional teaching method) and Class B (52 students, virtual reality combined with flipped classroom teaching mode). The assessment scores and independent learning ability scores of the students in the two classes were compared. Results: CPR theory and operation scores, passing rate, and independent learning ability scores of Class B were higher than those of Class A (P &lt; 0.05). Conclusion: the use of virtual reality combined with the flipped classroom teaching mode in CPR teaching is conducive to the improvement of students’ assessment scores and independent learning ability.

Enhancing ACLS training effects through video-assisted boosting methods: A comparative analysis of self-simulation and model simulation videos

AimsTo assess the impact of learner-participation and instructor-led simulation videos on nurses’ CPR skills, focusing on iterative learning to boost proficiency in ACLS. BackgroundAdvanced cardiac life support (ACLS) training is crucial for nurses, especially to improve cardiopulmonary resuscitation (CPR) proficiency, for which an effective training strategy is needed. DesignA quasi-experimental, pretest–posttest design was implemented to assess the impact of self-simulation and model simulation videos on sustaining CPR education. MethodsThe research was carried out at a university hospital in Korea from August 2021 to July 2022. A total of 110 nurses were allocated into three groups based on the building of their workplace in the hospital. Each group watched training videos at 4-month intervals after the simulation training. The self-video group viewed simulations featuring their participation, while the model video group watched instructor-led simulations. A comparison group participated in the simulations without subsequent video boosting. ResultsBoth the self-video and model video groups exhibited significantly superior ACLS performance compatred with the comparison group at both four months (H = 70.33, p <.001) and eight months (H = 81.52, p <.001) following the intervention, with large effect sizes (self-video vs. comparison: d = 4.73 at four months, d = 12.54 at eight months; model video vs. comparison: d = 4.53 at four months, d = 11.01 at eight months). ACLS knowledge scores also significantly increased over time in both intervention groups (self-video: χ² = 22.09, p <.001; model video: χ² = 24.13, p <.001), but not in the comparison group (χ² = 3.75, p =.153). There were no significant differences among the groups in terms of CPR self-efficacy or stress at either time point. ConclusionSupplementary training using simulation videos is an effective method for maintaining and enhancing nurses’ ACLS competency, offering a sustainable approach to repetitive CPR training. This study underscores the value of incorporating recorded simulation videos in clinical training, offering insights into efficient methods for continuous learning and CPR proficiency among nursing professionals.

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.