CPR Performance Research Articles

Optimal training frequency for acquisition and retention of high-quality CPR skills: A randomized trial

AimSpaced training programs employ short, frequent CPR training sessions to improve provider skills. The optimum training frequency for CPR skill acquisition and retention has not been determined. We aimed to determine the training interval associated with the highest quality CPR performance at one year. MethodsParticipants were randomized to 1-month, 3-month, 6-month, and 12-month CPR training intervals over the course of a 12-month study period. Practice sessions included repeated two-minute CPR practice sessions with visual feedback and verbal coaching until Excellent CPR was achieved, to a maximum of three attempts. Excellent CPR was defined as a two-minute CPR session with ≥90% of compressions with a depth of 50–60 millimeters, a rate of 100–120 per minute, and with complete chest recoil. CPR performance was assessed in all groups at 12 months. The primary outcome was the proportion of participants able to perform Excellent CPR in each group. ResultsA total of 167 participants were included in the analysis. Baseline assessment showed no difference in CPR performance (p = 0.38). Participants who were trained monthly had a significantly higher proportion of Excellent CPR performance (58%) than those in all other groups (26% in the 3-month group, p = 0.008; 21% in the 6-month group, p = 0.002; and 15% in the 12-month group, p < 0.001). ConclusionShort-duration, distributed CPR training on a manikin with real-time visual feedback is effective in improving CPR performance, with monthly training more effective than training every 3, 6, or 12 months.

Hands-only cardiopulmonary resuscitation: Rescuer fatigue and CPR performance in different protocols

Purpose of the study: The aim of the study is to verify whether the inclusion of breaks during a 10 min scenario hands-only CPR could increase chest compression quality and fatigue will be reduced.

In-hospital CPR – Is it good enough?

Background: Emergency department (ED) Service Assistants (SA) at a Danish University Hospital, are part of the cardiac arrest team and trained in performing CPR several times a year. Outside the ED CPR is delegated to SAs who only participate in the mandatory training once every three years. All SAs have to pass an e-learning resuscitation program once every year. Data from the past three years from AEDs located outside the ED indicate below standard performance of CPR, by SAs. Data from defibrillators at the ED do not exist for comparison.

Basic Life Support, Defibrillation and Quality CPR (QCPR) programme for medical students: Preliminary results

Integration of Quality CPR feedback (Q-FB) during Basic life support (BLS) training demonstrated to improve learning outcomes compared to instructor feedback only (I-FB). In collaboration with University of Bologna, we trained students of the first year of medical school with the aim of investigating the role of Q-FB and I-FB in BLS and AED teaching. Between March and June 2018, 60 students were enrolled (50% Female, BMI 21.6 ± 2.2). We used the Resusci Anne (RA) Skill Reporter with Q-CPR software (Laerdal, Norway) to give feedback (FB) and to record CPR performance. The programme had several steps: 1.Initial Q-CPR: students performed 2 minutes of BLS with pocket mask without any previous training or instruction, at first without and, immediately after, with Q-FB; 2.BLS course: after lesson and demonstration, students performed: CPR1 - 2 minutes of CPR with Q-FB and without I-FB; CPR2 - 2 minutes of CPR with both Q-CPR and I-FB; AED1 - 2 minutes of CPR and AED, lone rescuer with Q-FB; AED2 - 2 minutes of CPR and AED, two rescuers with Q-FB; 3.post-course Q-CPR: 2 minutes of BLS without and with Q-FB.

Optimizing CPR performance with CPR coaching for pediatric cardiac arrest: A randomized simulation-based clinical trial

AimTo determine if integrating a trained CPR Coach into resuscitation teams can improve CPR quality during simulated pediatric cardiopulmonary arrest (CPA). MethodsWe conducted a multicenter, prospective, randomized trial. An 18-minute simulated CPA scenario was run for resuscitation teams comprised of CPR-certified professionals from four International Network for Simulation-based Pediatric Innovation, Research & Education (INSPIRE) institutions. Forty teams (200 participants) were randomized to having a trained CPR Coach vs. no CPR Coach. CPR Coaches were responsible for providing real-time verbal feedback of CPR performance to compressors. All teams utilized CPR feedback technology. We report the proportion of overall excellent CPR, proportion of chest compressions (CC) with depth 50–60 mm, the proportion of CC with rate 100–120 per minute, CC fraction, and pre-, post-, and peri-shock pause duration. ResultsCPR coached teams compared with teams without a CPR Coach resulted in an absolute improvements in overall excellent CPR by 31.8% (95% CI, 17.7, 35.9; p < 0.001), mean CC depth compliance by 31.5% (15.7, 47.4; p < 0.001), mean CC depth by 4.6 mm (1.6, 7.5; p < 0.001), mean CC fraction by 5.4% (0.2, 10.6; p = 0.04), and mean pre-, post- and peri-shock pause duration by −2.7 s (−5.1, −0.4; p = 0.02), −1.0 s (−1.8, −0.2; p = 0.01); and −3.8 (−6.6, −1.0; p = 0.008), respectively. Changes in mean CC rate compliance and mean CC rate were not statistically significant. ConclusionsIn the presence of CPR feedback technology, the integration of a trained CPR coach into resuscitation teams enhances CPRquality metrics associated with improved survival outcomes from pediatric cardiac arrest.

Improving CPR quality with distributed practice and real-time feedback in pediatric healthcare providers – A randomized controlled trial

ObjectivesGuideline compliant CPR is associated with improved survival for patients with cardiac arrest. Conventional Basic Life Support (BLS) training results in suboptimal CPR competency and skill retention. We aimed to compare the effectiveness of distributed CPR training with real-time feedback to conventional BLS training for CPR skills in pediatric healthcare providers. MethodsHealthcare providers were randomized into receiving annual BLS training (control) or distributed training with real-time feedback (intervention). The intervention group was asked to practice CPR for 2 min on mannequins while receiving real-time CPR feedback, at least once per month. Control group participants were not asked to practice CPR during the study period. Excellent CPR was defined as 90% guideline-compliance for depth, rate and recoil of chest compressions. CPR performance of participants was assessed (on infant and adult-sized mannequins) every 3 months for a duration of 12 months. CPR performance was compared between the 2 groups. ResultsA total of 87 healthcare providers were included in the analyses (control n = 41, intervention n = 46). Baseline assessment showed no significant difference in CPR performance across the 2 groups. The intervention group has a significantly greater proportion of participants with excellent CPR compared with the control group on an adult sized mannequin (14.6% vs. 54.3%, p < 0.001) and infant-sized mannequin (19.5% vs. 71.7%, p < 0.001) at the end of the study. In the intervention group, all CPR metrics except infant depth were improved and retained over the course of the study. ConclusionDistributed CPR training with real-time feedback improves the compliance of AHA guidelines of quality of CPR.

P116: A randomized cross-over trial of conventional bimanual versus single elbow (Koch) chest compression quality in a height-restricted aeromedical helicopter

Introduction: Aeromedical helicopters and fixed wing aircraft are used across Canada to transfer patients to definitive care. Given height limitation in aeromedical transport, CPR performance can be affected. An adapted manual compression technique has been proposed by H. Koch (pron. Cook) that uses the elbow to compress the sternum rather than the conventional hand. This preliminary study evaluated the quality of Koch compressions versus conventional bimanual compressions. Methods: Paramedics (5), registered nurses (3) and a physician (1) were recruited. Each participant performed a 2 minute cycle of each technique, were randomized to determine which technique was performed first, and rested 5 minutes between compression cycles. A Resusci Anne SkillReporter manikin atop a stretcher in a BK117 helicopter was used. The compressors performed without feedback or prompting. Outcomes include compression rate, depth, recoil, and fatigue. Results: The mean conventional compression rate was (bpm) 118 +/− 13 versus 111 +/− 10 in the Koch scenario (p=0.02) (target 100 to 120). Mean conventional compression depth (mm) was 44 +/− 9 versus 49 +/− 7 in the Koch scenario (p=0.01) (target 50 to 60). The mean percentage of compressions with complete release in the conventional scenario was 86 +/− 20 versus 84 +/− 22 in the Koch scenario (p=0.9) (target 100%). Using a Modified Borg Scale of 1 to 10, mean provider fatigue after conventional CPR was 7 (+/− 1.6) versus 3 (+/− 1.2) using Koch technique (p&lt;0.001). On average, Koch technique improved the percentage of compressions at target rate by 26%, the percentage at correct depth by 9%, overall compression quality score by 13% and were more less fatiguing. Conclusion: Using an elbow in a height-restricted environment improved compression depth and reduced provider fatigue. From our limited data, Koch compressions appear to improve compression quality. Further study and external validation are required.

Wilderness First Responder: Are Skills Soon Forgotten?

Wilderness first responders are trained to provide competent medical care in wilderness settings or until evacuation for more advanced treatment can be obtained. In light of the isolated environments in which they are called upon to respond to illnesses and injuries, their ability to effectively apply their training is crucial. Despite the responsibility assigned to them, there is an absence of research assessing the skill and knowledge retention of wilderness first responders, creating a gap in understanding whether a deficit in their ability to perform exists between certifications. Without such research, it is important to review knowledge and skill retention in related responder groups. The literature over the past 4 decades documents the loss over time of skills and knowledge across an array of trained responders, both professional and laypeople. Although the findings reviewed suggest that WFRs will exhibit a similar pattern of increasing skill loss beginning shortly after certification and a slower, but concurrent, decrease in knowledge, research is needed to document or refute this assumption.

Analysis of metronidazole removal and micro-toxicity in photolytic systems: Effects of persulfate dosage, anions and reactor operation-mode

The efficiency of persulfate (PS) alone, UV-C activated TiO2 (UV/TiO2), UV-C activated PS (UV/PS) and UV/PS with TiO2 (UV/PS/TiO2) in the oxidative removal of metronidazole (MNZ) was studied. In addition, applicability of UV/PS process in batch and continuous photo-reactors (BPR and CPR) was investigated. The performance of BPR and CPR was assessed in terms of energy consumed and electrical energy per order (EEO), which indicated that both UV/PS and UV/PS/TiO2 systems were energy efficient. On the other hand, MNZ removal kinetics has revealed a higher MNZ removal rate of 0.232 min−1 in UV/PS/TiO2 system and showed a pseudo-first-order kinetics (r2 > 0.96). Furthermore, the effect of influent anion concentration (i.e. Cl−, SO42−, NO3− and their combinations) on UV/PS system was examined. The sequence of MNZ removal (from highest to lowest) in the presence of anions was (SO42− + Cl− + NO3−) > (SO42− + NO3−) > SO42− > (SO42− + Cl−) > Cl− > NO3−. An oxidative degradation pathway of MNZ in UV/TiO2 system was proposed. The toxicity of treated samples was evaluated using micro-toxicity assay against V. fischeri. The percentage inhibition of effluent samples to V. fischeri was within 15%, which denotes the suitability of CPR for real-time application.

A study on the variables influencing performance of cardiopulmonary resuscitation of Pre-Service early childhood teachers

The purpose of this study was to investigate the variables that positively affect the ability of preterm newborns to perform CPR as a basic study to improve the performance of preterm pre-service early childhood teachers’ performance on CPR. A cross-sectional study carried out among 349 pre-service early childhood teachers attending university in Korea. Data were obtained using multiple-choice questionnaire during Nov, 2017. The data were analyzed using the SPSS 20.0 program perform t-test, ANOVA and Pearson correlation and regression. The pre-service early childhood teachers’ knowledge about CPR was significantly different according to the experience of CPR. The pre-service early childhood teachers’ attitudes toward CPR did not show any significant difference according to the number and frequency of CPR training. The pre-service early childhood teachers’ ability to perform CPR was significantly different according to age and CPR experience. We showed a significant positive correlation between knowledge or attitude and ability to perform CPR. Pre-service early childhood teachers’ attitude toward CPR was positively influenced on CPR performance and negative factor was CPR education. In order to improve the knowledge, attitude and ability to perform CPR of pre-service early childhood teachers, it is necessary to develop a customized program that reflects the latest protocols using appropriate teaching media for infants and young children. In addition, it is important to emphasize the role of early childhood teachers and the importance of CPR in encouraging the will and attitude to actively perform CPR in emergency situations when they become early childhood teachers.

THE IMPACT OF RESPIRATORY MUSCLE FATIGUE ON THE QUALITY AND EFFICIENCY OF RESCUE ACTION

INTRODUCTION The lifeguard is the person in charge of safety in water environments. After a rescue, it is possible that he has to execute a CPR. The European Resuscitation Council (ERC) as well as theAmerican Heart Association are currently encouraging a quality CPR performance. The lifeguard may be obliged to carry out a CPR during a long period of time as the response of the Emergency Medical Service takes 5–8 min on average and it can even reach 20 min. The normal respiratory muscle effort at maximal swimming intensity requires a significant fraction of cardiac output and causes leg blood flow to fall. The main objective of this paper was to determine respiratory muscle fatigue (RMF) level in swimming with different intensity on quality and efficiency rescu action in the water. MATERIAL AND METHODS The study involved eleven lifeguards male (9) and female (2); age: (24.25±1.5); body height( 176,27±7,88) and body mass (75.81±11,01)form University School of Physical Education, Cracow. Two tests were conducted: the first test involved the execution of 5 min of CPR (rested), and the second one in performing water rescue and subsequent CPR (exhausted) for 5 minutes. The quality of the CPR at rest and at fatigue condition was compared. The recording instrument was the Ambu Defib Trainer W (Wireless).The time and precision of the simulated water rescue was also registered. Two spirometry tests were performed the first test was set before swimming and the second after (exhausted). Maximal respiratory pressures (PImax, PEmax) were evaluated before and directly after swimming in different intensity.The quality of the respiratory muscle fatigue at rest and at fatigue condition was compared. The recording instrument was portable MicroLoop spirometer. RESULTS After e simulated water rescue significantly increase parameters such as: ventilation minute volume rested (3,06±22,10) exhausted (4,23 ±22,10. P &lt; .001); ventilation rate rested (3.60±34.80) exhausted (4,80 ±34.80. P &lt; .001); and stomach inflation rested (2,0±20,47) exhausted (5.80 ±20.47. P &lt; .001). The greatest variation in the results of the respiratory muscle fatigue both before and after swimming with different intensity was observed only in two parameters: maximal ventilation index (MVV) and peak exhaust flow (PEF). CONCLUSIONS The accumulated fatigue during a simulated water rescue performed by lifeguards reduces the quality of compression depth and pause between compressions. The following respiratory parameters were found to have the strongest effect on the swimming: during maximum exercise intensity and FEV 1 (-0.77) rested and FEV 1 (-0.57) exhausted and FVC (-0.79) rested and FVC (-0.70) exhausted.

Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Using a French-Language Compression-Ventilation Pediatric Protocol.

Out-of-hospital cardiac arrest (OHCA) in pediatrics is a devastating event associated with poor survival rates. Although telephone dispatcher-assisted cardiopulmonary resuscitation (CPR; T-CPR) instructions improve the frequency and quality of bystander CPR for OHCA in adults, this support remains undeveloped in children. Our objective was to assess the effectiveness of a pediatric T-CPR protocol in untrained and trained bystanders. Secondarily, we sought to determine the feasibility and the effectiveness of ventilation in such a protocol. Eligible adults with no CPR experience were recruited in a movie theater in Liege, as well as bachelor nursing students in Liege. All volunteers were randomly assigned either to T-CPR or to no-T-CPR using randomization. The volunteers were exposed to a pediatric manikin model cardiac arrest. On the basis of Cardiff evaluation test, data were collected to evaluate CPR performance. A total of 115 volunteers were assigned to 4 groups: untrained nonguided group (n = 27), untrained guided group (n = 32), trained nonguided group (n = 26), and trained guided group (n = 30). We found an improvement in CPR performance in the guided groups. Most volunteers (81.2%) in untrained guided group and 83.3% in the trained guided group were able to give 2 ventilations after each compressions cycle. In a pediatric manikin model of OHCA, T-CPR instructions including mouth-to-mouth ventilations and chest compressions produced a significant increase in resuscitation performance not only among previously untrained but also among trained volunteers.

The school Lifesavers study—A randomised controlled trial comparing the impact of Lifesaver only, face-to-face training only, and Lifesaver with face-to-face training on CPR knowledge, skills and attitudes in UK school children

BackgroundLifesaver (www.life-saver.org.uk) is an immersive, interactive game that can be used for basic life support training. Users ‘resuscitate’ a victim of cardiac arrest in a filmed scenario and move their device up and down to simulate cardiac compressions. MethodsRandomised controlled trial of 3 UK schools (81 students) comparing Lifesaver, face-to-face (F2F) training, and a combination of both. Primary outcomes: mean chest compression rate and depth. Secondary outcomes: flow fraction, CPR performance, and attitude survey. Outcomes measured immediately, 3 and 6 months. ResultsPrimary outcomes: Mean chest compression depth was suboptimal in all groups due to body size. F2F performed better than Lifesaver initially (−11.676; 95% CI −18.34 to −5.01; p=0.0001) but no difference at 3 months (p=0.493) and 6 months (p=0.809). No difference in mean compression rates for Lifesaver vs F2F (−11.89; 95% CI −30.39 to −6.61; p=0.280) and combined vs Lifesaver (0.25; 95% CI −17.4 to −17.9; p=0.999). Secondary outcomes: all groups had flow fraction >60% after training. Combined group performed better for skills assessment than Lifesaver (4.02; 95% CI 2.81–5.22; p=0.001) and F2F (1.76; 95 CI 0.51–3; p=0.003); and the same at 6 months (1.92; 95% CI 0.19–3.64; p=0.026 and 1.96; 95% CI 0.17–3.75; p=0.029). ConclusionsUse of Lifesaver by school children, compared to F2F training alone, can lead to comparable learning outcomes for several key elements of successful CPR. Its use can be considered where resources or time do not permit formal F2F training sessions. The true benefits of Lifesaver can be realised if paired with F2F training.

Impact of basic life-support training on the attitudes of health-care workers toward cardiopulmonary resuscitation and defibrillation

BackgroundCardiopulmonary resuscitation (CPR) increases the probability of survival of a person with cardiac arrest. Repeating training helps staff retain knowledge in CPR and in use of automated external defibrillators (AEDs). Retention of knowledge and skills during and after training in CPR is difficult and requires systematic training with appropriate methodology. The aim of this study was to determine the effect of basic life-support (BLS) training on the attitudes of health-care providers toward initiating CPR and on use of AEDs, and to investigate the factors that influence these attitudes.MethodsA quasi-experimental study was conducted in two groups: health-care providers who had just attended a BLS–AED course (post-BLS group, n = 321), and those who had not (pre-BLS group, n = 421). All participants had previously received BLS training. Both groups were given a validated questionnaire to evaluate the status of life-support education and certification, attitudes toward use of CPR and AED and concerns regarding use of CPR and AED. Multiple linear regression analyses were applied to identify significant predictors of the attitude and concern scores.ResultsOverall positive attitudes were seen in 53.4% of pre-BLS respondents and 64.8% of post-BLS respondents (χ2 = 9.66, p = 0.002). Positive attitude was significantly predicted by the recent completion of BLS training (β = 5.15, p < 0.001), the number of previous BLS training courses (β = 2.10, p = 0.008) and previous exposure to cardiac-arrest cases (β = 3.44, p = 0.018), as well as by low concern scores, (β = −0.09, p < 0.001). Physicians had significantly lower concern scores than nurses (β = −10.45, p = 0.001). Concern scores decreased as the duration of work experience increased (t = 2.19, p = 0.029).ConclusionsRepeated educational programs can improve attitudes toward CPR performance and the use of AEDs. Training that addressed the concerns of health-care workers could further improve these attitudes.

Viewing an ultra-brief chest compression only video improves some measures of bystander CPR performance and responsiveness at a mass gathering event

BackgroundCPR training at mass gathering events is an important part of health initiatives to improve cardiac arrest survival. However, it is unclear whether training lay bystanders using an ultra-brief video at a mass gathering event improves CPR quality and responsiveness. ObjectiveTo determine if showing a chest-compression only (CCO) Ultra-Brief Video (UBV) at a mass gathering event is effective in teaching lay bystanders CCO-CPR. MethodsProspective control trial in adults (age >18) who attended either a women’s University of Arizona or a men’s Phoenix Suns basketball game. Participants were evaluated using a standardized cardiac arrest scenario with Laerdal Skillreporter™ mannequins. CPR responsiveness (calling 911, time to calling 911, starting compressions within two minutes) and quality (compression rate, depth, hands-off time) were assessed for participants and data collected at Baseline and Post-intervention. Different participants were tested before and after the exposure of the UBV. Data were analyzed via the intention to treat principle using logistic regression for binary outcomes and median regression for continuous outcomes, controlling for clustering by venue. ResultsA total of 96 people were consented (Baseline=45; Post intervention=51). CPR responsiveness post intervention improved with faster time to calling 911 (s) and time to starting compressions (sec). Likewise, CPR quality improved with deeper compressions and improved hands-off time. ConclusionsShowing a UBV at a mass gathering sporting event is associated with improved CPR responsiveness and performance for lay bystanders. This data provides further support for the use of mass media interventions.

Benefits of Visual Feedback on Cardiopulmonary Resuscitation Training: A Non‐Randomised Manikin Study with Bystanders

IntroductionCardiopulmonary resuscitation (CPR) is vital for the survival of people who has suffered a cardiac arrest. In order to achieve a good quality CPR performance, rescuer needs a good training which could be gotten with the use of feedback devices. The aim of this study was to compare the use of visual feedback device in CPR training to learning without feedback.MethodsNinety‐nine subjects without basic life support knowledge participating in the study were divided into three groups. All of them carried out two tests: 2 minutes of CPR with compressions and ventilations. First two groups received trainings on CPR between the tests (experimental groups): one group with instructor‐led training and the other one with visual feedback device. The third group did not receive any training between the tests (control group).ResultsIn the first test no differences among the three groups were found. The experimental groups improved their scores in the last test. The number of correct chest compressions by hand position and depth, and the number of correct rescue breaths was increased. The experimental group with visual feedback CPR training achieved better scores of quality CPR in the second test than the instructor‐led training group.ConclusionsThe visual feedback and instruction‐led training have positive effects on the quality CPR. The use of visual feedback during learning has greater benefits than instruction‐led training in the three variables analysed.

Lay Bystanders' Perspectives on What Facilitates Cardiopulmonary Resuscitation and Use of Automated External Defibrillators in Real Cardiac Arrests.

BackgroundMany patients who suffer an out‐of‐hospital cardiac arrest will fail to receive bystander intervention (cardiopulmonary resuscitation [CPR] or defibrillation) despite widespread CPR training and the dissemination of automated external defibrillators (AEDs). We sought to investigate what factors encourage lay bystanders to initiate CPR and AED use in a cohort of bystanders previously trained in CPR techniques who were present at an out‐of‐hospital cardiac arrest.Methods and ResultsOne‐hundred and twenty‐eight semistructured qualitative interviews with CPR‐trained lay bystanders to consecutive out‐of‐hospital cardiac arrest, where an AED was present were conducted (from January 2012 to April 2015, in Denmark). Purposive maximum variation sampling was used to establish the breadth of the bystander perspective. Twenty‐six of the 128 interviews were chosen for further in‐depth analyses, until data saturation. We used cross‐sectional indexing (using software), and inductive in‐depth thematic analyses, to identify those factors that facilitated CPR and AED use. In addition to prior hands‐on CPR training, the following were described as facilitators: prior knowledge that intervention is crucial in improving survival, cannot cause substantial harm, and that the AED will provide guidance through CPR; prior hands‐on training in AED use; during CPR performance, teamwork (ie, support), using the AED voice prompt and a ventilation mask, as well as demonstrating leadership and feeling a moral obligation to act.ConclusionsSeveral factors other than previous hands‐on CPR training facilitate lay bystander instigation of CPR and AED use. The recognition and modification of these factors may increase lay bystander CPR rates and patient survival following an out‐of‐hospital cardiac arrest.

The Effect of Verbal Encouragement in CPR Performance on the Accuracy of CPR Techniques

Objectives: To investigate the helpful techniques for Cardio Pulmonary Resuscitation by performing a comparative analysis of CPR between an encouragement and a non-encouragement group based on the AHA education program. Methods/ Statistical Analysis: This research was carried out by selecting 42 university students as a test group who had acquired a 2011 Health Care-Provider certificate issued by the AHA while attending Chungbuk University in C city. Informed consent was received from all participants in accordance with legal procedures. An average and standard deviation for each variable was calculated using the SPSS 12.0 version statistical program, and the gap between the averages values of each technique was verified using a Paired Samples Test. Findings: The encouragement language used in this study seems to have a tone of assertive sentences because it was directly quoted from the sentences in AHA education video, and it may have restricted a participant from performing techniques with more tension. Therefore, if the encouragement instructions are written using imperative sentences or suggesting sentences, it can be expected to increase concentration on the accuracy of CPR. Applications: This study provides proof that the verbal encouragement improves the accuracy and the speed of CPR; it is hence suggested to apply in the classroom for more efficient education.

Dispatcher assisted CPR: Is it still important to continue teaching lay bystander CPR?

PurposeThe aim of this study was to compare on manikin chest compressions only CPR performance carried out by untrained volunteers following Dispatcher assisted Cardiopulmonary Resuscitation (DACPR), and then by the same trained volunteers immediately after chest compressions only CPR course and 4months after the CPR course. Method38 university student volunteers with no previous experience in CPR took part in three on manikin chest compressions only CPR skill evaluations: first in a DACPR, then after chest compressions only CPR course (ACPRC) and lastly, four months after a CPR course (4MACPRC). Only 22 completed the whole process. ResultsIn DACPR 7.89% of participants carried out cardiac compressions outside the thorax. The mean average time from collapse to first compression was reduced in 4MACPRC (40.77 s), as compared to DACPR (144.54s); p<0.001).The following parameters were significantly better in 4MACPRC than in DACPR: Average compression depth (44.72 vs 25.22; p<0.001), average compression rate (106.1 vs 87.90; p<0.001), total number of compressions in 3min (317 vs 245; p<0.001), percentage of correct compressions (53.00% vs 4.72 %; p<0.001) and percentage of correct hand positioning (95.40 vs 91.09; p<0.001). ConclusionsEven though chest compressions only DACPR allows lay bystanders to be able to carry out cardiac compressions in 92.1% of cases, these were delivered later and were less efficient than chest compressions only CPR given by trained bystanders after a CPR course and four months after the course.

Bystander CPR performance and AED retrieval during out-of-hospital cardiac arrest

Bystander CPR performance and AED retrieval during out-of-hospital cardiac arrest