Cardiopulmonary Resuscitation Education Research Articles

Training of neonatal cardiopulmonary resuscitation instructors.

The Consensus on Science and Treatment Recommendations 2010 supported simulation-based training for education in resuscitation. This approach has been introduced into neonatal cardiopulmonary resuscitation (NCPR) courses in Japan, but no method for teaching instructors has been established. We developed a course for training instructors of NCPR, with inclusion of an instruction practice program. The goal of the study was to evaluate the performance of instructors who completed the course. Based on problems in the conventional instructor training course (old course 1), we developed and implemented a new course. Persons who had completed an NCPR course took the new course after developing two resuscitation scenarios. The new course included lectures and instruction practice, in which participants provided instruction using these scenarios. Instruction by participants was evaluated, and knowledge, opinions and satisfaction were examined by questionnaire after the course. Activity of the participants as instructors for 6 months after certification was also evaluated. The performance of trained instructors was compared between the old and new courses. Of 143 participants in the new course, > 90% had confidence to teach NCPR, while only 50-60% of the 89 participants in the old course indicated that they could instruct on resuscitation procedures and practice (P < 0.001). All participants in the new course recognized the value of scenario practice and all were glad they had taken the course. For 6 months after certification, significantly more participants who had done the new course worked as instructors compared with those who had done the old course (60% vs 34%, P < 0.001). This is the first trial of a resuscitation training course using scenarios that participants developed themselves. A new course including instruction practice for training NCPR instructors was effective for improving instructor performance.

Dispatcher instruction of chest compression-only CPR increases actual provision of bystander CPR

BackgroundA preceding randomized controlled trial demonstrated that chest compression-only cardiopulmonary resuscitation (CPR) instruction by dispatcher was more effective to increase bystander CPR than conventional CPR instruction. However, the actual condition of implementation of each type of dispatcher instruction (chest compression-only CPR [CCCPR] or conventional CPR with rescue breathing) and provision of bystander CPR in real prehospital settings has not been sufficiently investigated. MethodsThis registry prospectively enrolled patients aged =>18 years suffering an out-of-hospital cardiac arrest (OHCA) of non-traumatic causes before emergency-medical-service (EMS) arrival, who were considered as target subjects of dispatcher instruction, resuscitated by EMS personnel, and transported to medical institutions in Osaka, Japan from January 2005 through December 2012. The primary outcome measure was provision of CPR by a bystander. Multiple logistic regression analysis was used to assess factors that were potentially associated with provision of bystander CPR. ResultsAmong 37,283 target subjects of dispatcher instruction, 5743 received CCCPR instruction and 13,926 received conventional CPR instruction. The proportion of CCCPR instruction increased from 5.7% in 2005 to 25.6% in 2012 (p for trend <0.001). The CCCPR instruction group received bystander CPR more frequently than conventional CPR instruction group (70.0% versus 62.1%, p<0.001). In the multivariable analysis, CCCPR dispatcher instruction was significantly associated with provision of bystander CPR compared with conventional CPR instruction (adjusted odds ratio 1.44, 95% CI 1.34–1.55). ConclusionsCCCPR dispatcher instruction among adult OHCA patients significantly increased the actual provision of bystander CPR.

Postpartum Unit Modifies Delivery of Care to Enhance Readiness

Poster Presentation Purpose for the Program New mothers and their families have multiple learning needs, starting in the prenatal period and progressing through labor into the postpartum phase. Nurses are accountable for facilitating the necessary learning by identifying and addressing the specific needs of the family unit. Before discharge it is the responsibility of the nurse and health care team to ensure that the patient and family receive consistent and reliable information. Recognizing an opportunity to improve patient perception of readiness for discharge, our mother/infant unit decided to revise our care delivery model. Proposed Change Modifications to practice included development of a blue discharge folder to be originated upon admission and serve as a living document to record education and follow the woman throughout her stay. This folder served as a reference for the interprofessional team as well as a continuous resource for home. Additionally by incorporating a designated discharge nurse, providing an in‐patient daily Baby Care Class, developing and utilizing a Postpartum Resource Reference Guide , and incorporating specific medication use/side effect information cards, efforts were established to reinforce patient education throughout the hospital stay. Additional resources were implemented for women after discharge, including 24‐hour help‐lines, follow‐up phone calls, home health visits, breastfeeding support groups, and infant cardiopulmonary resuscitation (CPR) education. Implementation, Outcomes, and Evaluation For a 12‐month period we have tracked patient responses to the following specific Press Ganey Patient Satisfaction Survey questions. These data were used to measure the effectiveness of the modifications implemented. Specific questions and corresponding results included Staff described possible side effects of their medicine (preintervention 55, postintervention 73.7); Nurses and physicians explained things in a way patients could understand (preintervention 84.2 postintervention 91.50); Patients received information in writing about symptoms or health problems to look out for after leaving the hospital (preintervention 87.3, postintervention 98.3); and Extent to which you felt ready for discharge (preintervention 85.9, postintervention 92.7). The patient response has been overwhelmingly positive to these changes as evidenced by patient comments. Implications for Nursing Practice By providing consistent and individualized education to all patients, our unit was able to provide thorough and accurate discharge education and to increase patient readiness for discharge.

심폐소생술 교육 후 재교육이 간호대학생의 지식, 수행능력 및 자기효능감 지속에 미치는 효과

Purpose: This study was undertaken to examine the effects regarding reeducation of cardiopulmonary resuscitation on persistence of nursing students` knowledge, performance, and self-efficacy. Methods: The research design for this study was a repeated experimental design featuring 35 female nursing students. Participants were educated using the standardized cardiopulmonary resuscitation protocol from the American Heart Association. Three months after the initial education, participants received reeducation about cardiopulmonary resuscitation. Knowledge and self-efficacy were measured before the initial education. Knowledge, performance, and self-efficacy were measured immediately after the initial education, 3 months later, and 6 months later. Collected data were analyzed using PASW Statistics 18.0. Results: Knowledge and self-efficacy significantly increased immediately after the initial education; knowledge, performance, and self-efficacy significantly decreased 3 months afterwards. No further decrease occurred until 3 months after reeducation. Conclusion: These results suggest that the duration between initial education and reeducation was insufficient, although the effects of cardiopulmonary resuscitation education were maintained 3 months after reeducation.

Metodología didáctica para la enseñanza de reanimación cardiopulmonar en edad infantil

In a study published in the British Medical Journal 2007, a critique was presented on the teaching of cardiopulmonary resuscitation (CRP) in children, being based on the lack of sufficient force to perform a few manoeuvres of effective chest compressions and with suitable depth. Placing the minimum age for the education between 13-14 years, due to having the cognitive and physical aptitude to act as witnesses of life-threatening emergencies. This study concluded that although the best ages to perform effective CRP was from 13 years, and that the teaching of younger children provides knowledge and the perspective to be better skilled in the future.Although, with this work, it is intended to present the didactic lines of the education of the CRP in pre-schoolchildren, adapting the contents to their stage of physical and mental development of evolutionary physical and mental development, account is taken of the need to involve the children's teachers in this project.

Cardiopulmonary resuscitation, chest compression only and teamwork from the perspective of medical doctors, surgeons and anesthesiologists.

Background:New resuscitation guidelines that were proposed by the European Resuscitation Council in 2010 have introduced a new method of cardiopulmonary resuscitation (CPR) by chest compressions only for untrained individuals.Objectives:We conducted this study to evaluate differences in attitudes towards CPR among medical doctors, surgeons and anesthesiologists in Osijek University Hospital. A call for help, chest-compression-only resuscitation, mouth-to-mouth ventilation and team-work were recognized as critical points that may influence the outcome. Unfamiliarity with these methods may be indicative of a lack of education in resuscitation and may result in poor outcomes for victims.Patients and Methods:An anonymous survey was conducted on 190 medical professionals: 93 medical doctors, 70 surgeons, and 27 anesthesiologists during year 2012 (mean age 41.9 years). The questions were related to previous education in resuscitation, current resuscitation practices and attitudes towards cardiopulmonary resuscitation. Data were analyzed using ANOVA and Fisher exact test. A P value of < 0.05 was considered statistically significant.Results:The only difference between groups was regarding the male and female ratio, with more male surgeons (45, 55, and 11, P < 0.001). All doctors considered CPR as important, but only anesthesiologists knew how often guidelines in CPR change. Approximately 45% of medical doctors, 48% of surgeons and 77% of anesthesiologists reported that they have renewed their knowledge in CPR within the last five years, whereas 34%, 25% and 22% had never renewed their knowledge in the CPR (P = 0.01 between surgeons anesthesiologists). Furthermore, chest-compression-only was recognized as a valuable CPR technique by 25.8% of medical doctors, 14.3% of surgeons and 59.3% of anesthesiologists (P < 0.001). Anesthesiologists estimated a high risk of infection transmission (62%) and were more likely to refuse mouth-to-mouth ventilation when compared to surgeons (25% vs.10%, P = 0.01). Anesthesiologists are most often called for help by their colleagues, only rarely surgeons call their departmental colleagues and nurses to help in CPR.Conclusions:An insufficient formal education in CPR was registered for all groups, reflecting the lack of familiarity with new CPR methods. A team education, involving doctors and nurses may improve familiarity with CPR and patient outcomes.

How effectively can young people perform dispatcher-instructed cardiopulmonary resuscitation without training?

AimsSurvival from out-of-hospital cardiac arrest is increased by bystander cardiopulmonary resuscitation (CPR). Bystander performance can be improved when CPR instructions are delivered by a calltaker at the Emergency Communications Centre. Little is known about a young person's ability to understand these instructions and perform CPR correctly. We assessed the ability of a group of untrained young people to effectively apply these directions to an adult resuscitation manikin. Methods87 youngsters aged 7–15 years with no previous training in CPR were separately equipped with a mobile phone and an adult assessment manikin. They phoned the emergency number (111) and were automatically diverted to a senior emergency medical dispatcher (EMD). The EMD delivered resuscitation instructions which complied fully with Medical Priority Dispatch System (version 12.1). Performance was monitored using a Laerdal Computerised Skill Reporting System. ResultsAverage compression depth increased with age from 10.3mm to 30mm for 8 and 15 year olds respectively. 100 compressions per minute was achieved in youngsters aged 10 years and older but the rate fatigued over time and improved after interruption for two ventilations. Those aged 11 years and older consistently compressed the chest from 31mm to 50mm. Only one participant could successfully ventilate the manikin by mouth-to-mouth. ConclusionThis study demonstrates that untrained youngsters should perform compression-only CPR. From 11 years of age, they can effectively perform dispatcher-directed CPR by compressing the chest at an appropriate rate and depth. However, their technique benefits from formal training.

동영상 심폐소생술 교육이 간호사의 심폐소생술 수행능력에 미치는 효과

Purpose: The aim of this study was to identify the effect of video programs of cardiopulmonary cerebral resuscitation (CPCR) education of cardiopulmonary cerebral resuscitation of nurses. Methods: The subjects of the study were 64 nurses working in a university hospital. Nurse’s CPCR performance have been measured four times (pre-test, post-test at immediately, 3 months and 6 months after intervention). Data were collected from February to August 2013. Results: There were significant differences in knowledge, attitude, self-efficacy, and performance between groups by measure time. And there were significant interactions in knowledge, self-efficacy, and performance between groups, within groups, except for the attitude. The video programs of CPCR interventions appear to be effective in the improvement of knowledge, self-efficacy, and performance, as compared to the control group. Conclusion: The video programs of CPCR education was an effective intervention to improve and retain the level of knowledge, attitude, self-efficacy and performance. And the video program of CPCR education have an advantage of self-learning effect for nurses with shift work. Therefore video programs of CPCR education will be utilized for continuing nurse’s education.

Current Approaches to Cardiopulmonary Resuscitation

Real progress has been made in improving long-term outcome after out-of-hospital cardiac arrest in the past 10 years. Many communities have doubled their survival-to-hospital-discharge rate during this period. Common features of such successful programs include the following: (1) 911 dispatcher-assisted cardiopulmonary resuscitation (CPR) instruction, (2) bystander chest compression–only CPR program, (3) public access defibrillation, including targeted automated external defibrillator programs, (4) renewed emphasis on minimally interrupted chest compressions by emergency medical services responders, and (5) aggressive postresuscitation care, including targeted temperature management and early coronary angiography and intervention. An important lesson from these successful community efforts is that multiple, simultaneous changes to the local cardiac arrest response system are necessary to improve survival. The next exciting step in this quest appears to be the treatment of refractory cardiac arrest with the combination of mechanical CPR, intra-arrest hypothermia, extracorporeal CPR with mechanical circulatory support devices, and early coronary intervention.

CPR Knowledge and Attitudes among High School Students Aged 15-16 in Hong Kong

Background Sudden cardiac arrest is a serious public health problem in Hong Kong, with up to 85% of victims not surviving to hospital admission. International research findings show that teaching cardiopulmonary resuscitation (CPR) to lay bystanders can significantly improve out-of-hospital survival rates. A particular target group for CPR training and education is high school students. Since the commonest site of sudden cardiac deaths in Hong Kong occur at home, school-age adolescents are likely to be the only available bystanders in many emergent situations. Design Questionnaire survey. Methods This study investigated CPR knowledge and attitudes of 383 students aged 15-16 years across 18 schools in Hong Kong to understand barriers and facilitators for CPR delivery. A questionnaire pilot tested and validated by a panel of health professionals was distributed to students, using a convenience sampling methodology. Results Most students (87%) had not received CPR training, with common reasons for not attending being lack of time, lack of interest and not sure where to attend a course. Results of Mann Whitney U tests indicated that students who had received training scored significantly (p&lt;0.05) higher on factual knowledge and also attitudes toward CPR training than those without training. There were no gender differences. Most students reported that they would attempt to perform CPR in a cardiac arrest situation, even if they had not received training, because they believed that CPR could increase the survival rate and it was morally the right thing to do. Conclusions Teaching CPR to Hong Kong school students is an effective way to develop the next generation of emergency first responders. (Hong Kong j.emerg.med. 2015;22:3-13)

응급처치 및 심폐소생술 교육이 소외계층 청소년의 자아효능감과 사회공헌도에 미치는 효과

Purpose: This study aimed to evaluate the educational experience, re-demand, pre-post self-efficacy, subjective social contribution of disadvantaged youth after first-aid and cardiopulmonary resuscitation (CPR) education. Methods: The subjects in this study were 967 disadvantaged youth from the general population. Data analyzed were frequency, percentage, and results of the <TEX>$x^2=test$</TEX>, t = test, one-way analysis of variance, and Pearson correlation by using the SPSS 18.0 statistical program. Results: Of the subjects, 51.7% had educational experiences, mostly less than 1 year. First-aid and CPR education improved self-efficacy. In particular, a higher the self-efficacy resulted in a higher subjective social contribution. Conclusion: This study showed that first aid and CPR education positively affected the self-efficacy, and awareness of social contribution in disadvantaged youth. Therefore, appropriate first aid and CPR education program for disadvantaged youth is beneficial.

Out-of-hospital cardiac arrest: incidence, process of care, and outcomes in an urban city, Korea.

ObjectiveWe aimed to determine the incidence, processes of care, and outcomes in out-of-hospital cardiac arrests (OHCA) in Ansan, South Korea.MethodsFrom the Ansan Fire Department’s (1-1-9 emergency call number) Emergency Medical Services (EMS) database, we obtained a list of adult cardiac arrest cases occurring between January 2008 and December 2011. We excluded cases with obvious non-cardiac causes, such as trauma, drowning, hanging, and asphyxia. We matched the EMS data with in-hospital care and outcome data. We analyzed basic demographic variables (age and gender), the time and place of incidence, witnesses, bystander cardiopulmonary resuscitation (CPR), major time variables, CPR instructions during transport, initial cardiac rhythm at the scene, and automated defibrillator use.ResultsThe overall incidence of OHCA in Ansan was 33.1/100,000 persons per year. Out of 778 adult OHCAs in our study population, bystander CPR was provided in 103 cases (13.2%). Of the 517 OHCAs whose initial rhythms were confirmed, 85 (16.4%) showed shockable rhythms, but only 23 (27.1%) received defibrillation at the scene or during transportation. Of the 106 patients whose spontaneous circulation returned at the hospital, only 6 (5.7%) received mild therapeutic hypothermia. During the study period, 31 patients (4%) survived to discharge from hospitals, and 6 of these discharged patients (19.4%) showed favorable neurologic outcomes.ConclusionWhile the survival rate from OHCA in Ansan is very low, this study provides basic information needed to create improvements. Our analysis suggests that multiple variables contribute to the low OHCA survival rate. Several of these variables are modifiable; addressing them is a clear first step toward strengthening the chain of survival from OCHA in Ansan.

Cardiovascular deaths in children: General overview from the National Center for the Review and Prevention of Child Deaths

Cardiovascular conditions rank sixth in causes of death in 1- to 19-year-olds. Our study is the first analysis of the cardiovascular death data set from the National Center for the Review and Prevention of Child Deaths, which provides the only systematic collection of cardiovascular deaths in children. We developed an analytical data set from the National Center for the Review and Prevention of Child Deaths database for cardiovascular deaths in children 0 to 21 years old, reviewing 1,098 cases from 2005 to 2009 in 16 states who agreed to participate. Cardiovascular cases were aged 4.8 ± 6.6 years; 55.3%, ≤1 year; 24.6%, ≥10 years; male, 58%; white, 70.5%; black, 22.3%; Hispanic, 19.5%. Prior conditions were present in 48.5%: congenital heart disease, 23%; cardiomyopathies, 4.6%; arrhythmia, 1.7%; and congestive heart failure, 1.6%. Deaths occurred most frequently in urban settings, 49.2%; and in the hospital, 40.4%; home, 26.1%; or at school/work/sports, 4.8%. Emergency medical services were not evenly distributed with differences by age, race, ethnicity, and area. Autopsies (40.4%) occurred more often in those >10 years old (odds ratio [OR] 2.9), blacks (OR 1.6), or in those who died at school/work/sports (OR 3.9). The most common cardiovascular causes of death included congenital heart disease, 40.8%; arrhythmias, 27.1%; cardiomyopathy, 11.8%; myocarditis, 4.6%; congestive heart failure, 3.6%; and coronary artery anomalies, 2.2%. Our study identified differences in causes and frequencies of cardiovascular deaths by age, race, and ethnicity. Prevention of death may be impacted by knowledge of prior conditions, emergency plans, automated external defibrillator programs, bystander cardiopulmonary resuscitation education, and by a registry for all cardiovascular deaths in children.

Quality of cardiopulmonary resuscitation of in-hospital cardiac arrest and its relation to clinical outcome: An Egyptian University Hospital Experience

Abstract Introduction High quality cardiopulmonary resuscitation (CPR) performed according to international guidelines has a vital impact on survival of cardiac arrest. Objective To investigate different variables affecting return of spontaneous circulation (ROSC) and survival to discharge (STD) after in-hospital cardiac arrest (IHCA) and evaluate adherence to CPR guidelines using a modified Utstein-style template. Methods A prospective observational study of 126 IHCA out of 5479 admissions to cardiology units of 3 Cairo University hospitals. Results CPR was not attempted in 7 futile cases. ROSC was achieved in 50.4%, while STD was achieved in only 7.6% of 119 attempted resuscitations. CPR was started by a physician in 114 cases (95.8%) and by the on duty nurse in only 5 cases. The initial rhythm was shockable rhythm (SR) in 19 cases; 13 (68.4%) of whom achieved ROSC and 6 (31.6%) STD and non SR (pulseless electric activity/asystole) in 100 cases; 47 (47%) of whom achieved ROSC and 3 (3%) STD. Chest compressions were observed appropriate ⩾100/min, ⩾2 inches deep and interrupted P = 0.01) and STD ( P = 0.008 and 0.02 respectively). A cut-off value for CPR duration of 22.5 min had a sensitivity of 86.7% and a specificity of 81.4% in predicting ROSC by receiver-operator characteristics analysis. Conclusion The poor STD despite a relatively good ROSC calls for improvement of CPR education and training for hospital personnel and better post CA care.

Standardized telephone-assisted instructions on resuscitation by laypersons. Feasibility study using video-assisted quality analysis

Telephone-assisted instructions for cardiopulmonary resuscitation (T-CPR) are highly recommended by the current European Resuscitation Council (ERC) guidelines for resuscitation 2010. The aim of this study was to analyze the adherence of laypersons to T-CPR instructions given by dispatchers in a mock scenario. The dispatchers adapted international T-CPR instructions to local requirements. An emergency "collapse in the office" with subsequent T-CPR was simulated for 10 volunteer, untrained administrative staff, as the only single emergency witness and 4 emergency medical service (EMS) dispatchers. Each volunteer was sent to a "colleague" who simulated a sudden cardiovascular event and collapsed unconscious during the description of symptoms. The local lay responder made an emergency call by landline telephone and was connected to the dispatcher. In the course of the simulation the "victim" was replaced by a CPR manikin. Every participant, i.e. 10 out of 10, assessed the victim, recognized the situation and telephoned for help. On the orders of the dispatchers 9 out of the 10 activated the loudspeaker of the telephone but 4 still continued to use the handset. The instructions for positioning were followed by all 10. Correct positioning of the victim required a median of 33[Symbol: see text]s with an interquartile range (IQR) of 30-39[Symbol: see text]s. Breathing control including instructions lasted a median of 54[Symbol: see text]s (IQR 49-60[Symbol: see text]s). Breathing was assessed by 8 out of 10 but only 2 out of 8 achieved a duration of 10[Symbol: see text]s as recommended by the ERC guidelines for resuscitation 2010. After a median of 202[Symbol: see text]s (IQR 196-241[Symbol: see text]s) chest compressions were started by 9 out of 10 and were performed for a median of 63[Symbol: see text]s (IQR 60-69[Symbol: see text]s). A correct technique was used by 7 but with a low rate of 80 compressions/min (IQR 72-86/min). The instructions for ventilation were understood by 9 out of 10. Mouth-to-mouth resuscitation was performed by 7 participants and technically correct by 5 of them. The ventilation cycle of the 7 active participants lasted for a mean of 25[Symbol: see text]s (IQR 24-30[Symbol: see text]s). The mean total duration of the timeframe analyzed was 340[Symbol: see text]s (IQR 334-368[Symbol: see text]s). The results demonstrate that the local T-CPR concept for untrained laypersons is feasible in a mock scenario. No substantial errors were observed for the majority of the untrained responders but the simulation also showed that not every emergency witness implemented the instructions according to the dispatcher's expectations. The T-CPR procedure was also more time-consuming than expected; therefore, every standardized T-CPR concept should be tested for local practicability. In accordance with current studies, the results suggest that the focus should be on compression-only CPR instructions in urban settings. Dispatcher education in T-CPR should incorporate videotaped mock-up scenarios with untrained local laypersons.

A Novel Use of a Metronome in Dispatcher-assisted Cardiopulmonary Resuscitation

Early, high-quality cardiopulmonary resuscitation (CPR) is the key to increasing the likelihood of successful resuscitation in cardiac arrest. The use of dispatch-assisted (DA) CPR can increase the likelihood of bystander CPR. We describe a case in which a metronome was introduced to guide DA-CPR. The wife of a 52-year-old male activated 9-1-1 after her husband suffered a cardiac arrest. During her 9-1-1 call she received CPR instructions and heard a metronome over the phone while following the instructions. Return of spontaneous circulation of the patient occurred during paramedic on scene care. The patient was transported to hospital and discharged 6 days later with no neurological deficit. This case supports the use of a metronome by emergency medical dispatchers during the provision of DA-CPR to improve bystander CPR.

Schoolchildren as BLS instructors for relatives and friends: Impact on attitude towards bystander CPR

IntroductionWe investigated the impact of Cardio-Pulmonary Resuscitation (CPR) instruction by children on the attitude of people to perform bystander CPR. MethodsIn 2012, children from primary and secondary school (age span 11–13 years) received a free individual CPR training package containing an inexpensive manikin and a training video. After a CPR training session by their class teacher, they were invited to teach their relatives and friends. After the training, the trainees of the children were invited to participate in a web survey, containing a test and questions about prior CPR training and about their attitude towards bystander CPR (BCPR) before and after the training. We measured the impact on the attitude to perform BCPR and the theoretical knowledge transfer by the children. ResultsA total of 4012 training packages were distributed to 72 schools of which 55 class teachers subscribed their students (n=822) for the training programme for relatives and friends. After a validation procedure, 874 trainees of 290 children were included in the study. In comparison to trainees of secondary schoolchildren, trainees of primary schoolchildren scored better for the test as well as for a positive change of attitude towards future BCPR (P<0.001). For every child-instructor 1.7 people changed their attitude towards BCPR positively. ConclusionsInstructing schoolchildren to teach their relatives and friends in Basic Life Support (BLS) led to a more positive attitude towards BCPR. The results were more positive with trainees from primary schoolchildren than with trainees from secondary schoolchildren.

European Restart a Heart Day.

October 16th is European Restart a Heart Day (http://www.restartaheart.eu). This initiative, spearheaded by the European Resuscitation Council (ERC), is aimed at increasing survival rates from out-of-hospital cardiorespiratory arrest (OHCA). It was instigated in 2013 following a successful campaign by the ERC to pass a written declaration in the European Parliament, which called upon member states to improve awareness and provide cardiopulmonary resuscitation (CPR) education to the public as well as healthcare professionals. The 2010 ERC Guidelines had already endorsed the recommendation that all citizens should be taught CPR.1 Every year, approximately 350 000 Europeans suffer OHCA.2 In the UK alone, the figure is estimated to be 60 000.3 Average survival rates are, at best, 12% overall with higher rates (23%) seen in the subgroup of those who are fortunate to arrest in a ‘shockable’ rhythm (ventricular fibrillation or tachycardia).4 Factors that have been proven to improve survival include rapid access to defibrillation and swift onset of CPR in the meantime. For every minute that passes without CPR, survival decreases by 10%. With bystander CPR, this rate drops to 2–3% per minute thus buying extra time for a defibrillator to arrive and be used successfully.1 As Deakin and Gray5 have shown however, the presence of a nearby automated external defibrillator (AED) does not guarantee its use. We therefore need to increase awareness in the use of public access AEDs as well as train our population to perform CPR when needed. The theme of last year's Restart a Heart Day was ‘Children Save Lives’. Events were held throughout Europe to increase awareness of the problem. In the UK, the Resuscitation Council (UK) distributed a free copy of the award winning Lifesaver programme (http://www.life-saver.org.uk) to every …

The critical need for further research and development of abdominal compressions cardiopulmonary resuscitation

A recent editorial on the science of basic life support (BLS) education acknowledges that, despite nearly 4 decades of public instruction in cardiopulmonary resuscitation (CPR) classes, most people who complete CPR training still do not perform effective basic CPR even immediately after training [1]. But still supports the theory that survival rates for unexpected cardiac arrest depend not only on the quality of the education given to potential caregivers but also on the validity of treatment guidelines and a well-functioning chain of survival [2]. The author emphasizes that these factors hinge on BLS training to the highest level of performance. However, a recent study concluded that even with use of real-time feedback, emergency rescuers fail to sustain chest compression quality according to current guidelines [3]. Therefore, because professional rescuers, and for that matter lay bystanders, cannot even be prompted to perform effective CPR, they certainly likely cannot be trained to perform effective CPR. Although a well-functioning chain of survival can influence survival, it can be argued that increasing the number of efficiently educated CPR providers who do not have adequate height and upper-body weight cannot. In addition to those who have a cardiac arrest with smaller hearts and thoraces, male bystanders, may be another factor that is predictive of patient survival [4,5]. The typical male rescuer is generally stronger and more physically able to perform effective CPR than the typical female rescuer. However, the hidden reason why only very few rescuers can perform effective CPR despite receiving high-quality BLS training and/or while using feedback technology is likely because the typical rescuer lacks a combination of adequate height and upper-body weight. To perform effective rate (100-120/min) and depth (≥50 mm) CPR with complete sternal recoil, rescuers need to perform highimpulse CPR. High-impulse CPR with its high-velocity short duration compression phase and longer duration decompression phase (or duty cycle adequatelyb50%) not only produces superior hemodynamics but also apparently produces substantial compression-induced ventilation [6,7]. A longer decompression phase maximizes sternal recoil, thereby increasing venous return, coronary and cerebral perfusion, and inspiratory volume. When chest compressions are performed with gasping suppressed and with enough force to achieve a compression depth of only 38 mm at a 100/min rate and a 50% duty cycle, there is no compressioninduced minute alveolar ventilation [8]. Performing CPR at a rate of

A randomized control trial to compare retention rate of two cardiopulmonary resuscitation instruction methods in the novice

A randomized control trial to compare retention rate of two cardiopulmonary resuscitation instruction methods in the novice