Hands-only Cardiopulmonary Resuscitation Research Articles

Abstract Su401: Confidence in performing CPR after training with traditional and female-breasted manikins

Introduction: Studies have documented that females experiencing an OHCA are significantly less likely to receive cardiopulmonary resuscitation (CPR) than males in public locations. Reasons for this disparity include bystanders fear of being perceived as sexualizing or assaulting females during CPR, concerns about physically injuring females, or low confidence in rendering CPR on females. This pilot study aimed to assess the confidence of CPR trainees who were trained on both traditional and female-breasted manikins. Methods: Participants were enrolled at a community bystander CPR training for teachers at an urban public school in 2024. Participants who consented to participate in the study were asked to complete surveys. All participants received a didactic on hands-only CPR, followed by two sets of hands-on practice, first with a traditional manikin, and then with a female-breasted manikin or vice versa. Results: Of the 112 participants enrolled in the study, 88.4% were women, and 14% were >50 years of age. The sample was almost all White participants, with high education status (88.4% with a Master’s or college education). The majority (86.6%) had prior CPR training, but most of them reported receiving training more than a year ago. After the two sets of practice (one with traditional manikin, and one with female manikin), 84.7% felt confident to perform CPR on both males and females, while 9.9% felt more confident to perform CPR on female and 5.4% on male. Men and women (84.6% and 84.7%, respectively) felt equally confident in performing CPR on both males and females. Although 28.4% felt either ‘slightly uncomfortable’ or ‘very uncomfortable’ with use of the female manikin, after practicing on a female manikin, 81.6% felt more comfortable with doing CPR on women (11.1% still felt uncomfortable and 7.3% were neutral). When asked which manikin made them feel more confident in performing CPR, 70.9% reported both, while 7.2% said neither, 10% said female manikin and 11.8% selected traditional manikin. 70% of women and 75% of men selected both manikins. Conclusion: Training with both types of anatomically accurate manikins is important in improving confidence of community lay responders in performing CPR and reducing community level gender disparities. Future analysis will evaluate change in confidence with each manikin type and assess confidence and knowledge retention 6 months after the training.

Abstract 4144566: Building CPR/AED Confidence through Community Volunteer Prevention Screening Sessions: The Impact of the Eric Paredes Save A Life Foundation

Introduction: Sudden cardiac arrest (SCA) remains a leading cause of death among young individuals, often occurring without prior symptoms. Public confidence in recognizing SCA warning signs, understanding risk factors, and using cardiopulmonary resuscitation (CPR) and Automated External Defibrillators (AEDs) is generally low. The Eric Paredes Save A Life Foundation addresses this gap by offering free cardiac screenings and educational sessions. This abstract evaluates the foundation's impact on participants' confidence in these critical areas. Goals: The primary objectives were to enhance participants' confidence in identifying SCA warning signs and risk factors, performing CPR, using AEDs during cardiac emergencies, and communicating youth heart health concerns to healthcare providers. Methods: Volunteer-led prevention screening sessions were conducted, incorporating educational components on SCA warning signs, risk factors, and hands-only CPR and AED training. Post-session surveys were administered to 1,123 participants to assess their confidence levels in these areas. Results: The screening sessions significantly increased participants' confidence. Specifically, 96% of participants reported heightened confidence in recognizing SCA warning signs and understanding risk factors. Additionally, 94% felt more assured in discussing youth heart health with providers. Confidence in performing CPR during a cardiac emergency rose to 92%, while confidence in using an AED reached 89%. These results demonstrate the effectiveness of the sessions in empowering individuals with essential life-saving skills. Conclusions: The Eric Paredes Save A Life Foundation's prevention screening sessions are highly effective in improving participants' confidence in recognizing SCA warning signs, understanding risk factors, and using CPR and AEDs. The substantial increase in confidence levels underscores the importance of community-based education and training programs in reducing SCA-related fatalities among youth. These findings support the need for ongoing and expanded initiatives to further enhance public health outcomes and preparedness for cardiac emergencies.

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.

Enhancing cardiopulmonary resuscitation training for the community with foam pillows: A promising approach

This study evaluates the efficacy of foam pillows as instructional aides to achieve accurate compression depth and chest recoil during CPR training. A descriptive study design was employed. The study involved 30 respondents with no experience with CPR. We enrolled 30 respondents aged 17 to 25 through open recruitment via WhatsApp and Instagram. Foam pillows (45 cm x 60 cm) with compression markers served as instructional tools. The study utilized Laerdal's Little Anne QCPR CPR mannequins and the QCPR application on an iPad Air 2 . After 1 minute of hands-only CPR on a foam pillow, all respondents continue to perform in Little Anne QCPR mannequin. The findings of this study show that the correct compression depth was performed by 28 respondents (93%) and the correct chest recoil by 30 respondents (100%). Foam pillows promise to enhance community-based CPR training by promoting precision in compression depth and chest recoil.

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.

#CPR challenge: Impact of a social media campaign on cardiopulmonary resuscitation awareness and skills among young adults − A quasi experimental study

The aim of our study was to explore the effect of nomination-based social-media campaign and CPR-skill-booth on change in knowledge as well as hands-only CPR skills among young adults. A quasi-experimental study was conducted in two non-healthcare-stream colleges, one intervention and other control arm. After baseline evaluation of CPR knowledge in both colleges, a 4-week nomination-based social media campaign '#CPR challenge' was rolled out in the intervention arm which included a CPR-skill-booth that was setup for one hour every day to train interested participants in CPR. The participants were encouraged to share the same on their social media handles and data of self-reported metrics were collected. A post-intervention assessment was conducted in both arms, to assess knowledge and its translation to hands-only-CPR skills using qCPR mannequin and qCPR app® for objective assessment. A total of 690 assessments were done; Intervention arm (pre-intervention-214, post intervention -155) and control arm (pre-intervention -157, post-intervention -134). The baseline knowledge scores were comparable in both groups. Knowledge score doubled in the intervention arm, (p<0.001) from a median value of 29% (IQR:14 - 43) in the pre-intervention-cohort to 57% (IQR:29 - 71) in the post-intervention-cohort. Median CPR-skill-score was higher in the intervention arm 67.5(IQR:39-92) in comparison to control arm 21 (IQR:1-53) (p<0.001). In terms of social media engagement, 50% of participants had watched the videos and 40.6% attended the CPR-skill-booth. Strategies such as a nomination-based social media campaign can improve the awareness, knowledge and also skills regarding hand-only CPR.

Effects of peer-education training on cardiopulmonary resuscitation knowledge and skill retention of secondary school students: a feasibility study

ObjectivesThe need for cardiopulmonary resuscitation (CPR) training dissemination in the community could be resolved by mass school training programmes. However, the availability of instructors remains an unsolved problem. Our purpose...

Assessing the quality of chest compressions with a DIY low-cost manikin (LoCoMan) versus a standard manikin: a quasi-experimental study in primary education

Extending the access to cardiopulmonary resuscitation (CPR) training to a wider public is an important step in increasing survivability of out-of-hospital cardiac arrest. However, often price and maintenance of CPR manikins are barriers that prevent training at schools. This study aims to evaluate the learning of hands-only (HO) CPR by practicing with a low-cost manikin (LoCoMan) with visual qualitative feedback and to compare the results with the skills acquired by practice on a conventional manikin. A quasi-experimental study with 193 schoolchildren (10 to 12 years old) who were allocated to two groups: the LoCoMan group was taught via an integrative approach (science combined with physical education (PE)) and practiced on a handmade manikin, and a control group practiced in a traditional setting with a commercial manikin (Resusci Junior, Laerdal, Norway). All participants practiced for 1 hands-on skill session before performing a post-test on an instrumented CPR manikin. The outcomes including HO-CPR performance variables were compared between groups. The LoCoMan and control groups both achieved acceptable percentage of HO-CPR quality (57% and 71%, p = 0.004). Among 6th-graders, there were no significant differences in HO-CPR quality between LoCoMan 68% and control 71%, p = 0.66. The control group achieved better chest compression depth while the LoCoMan group showed more compressions with adequate chest recoil. Conclusion: Schoolchildren are able to build and use a low-cost manikin with visual feedback. The integrative learning approach used in this study may be a feasible alternative methodology for training and learning HO-CPR in schools when commercial manikins are not available.What is Known:• Access to CPR training should be universal and independent of age, location, financial means, or access to qualified instructors.• Scientific societies promote the implementation of CPR in schools, so that teachers and schoolchildren can play a multiplier role in their environment, but the gap in CPR learning is related to cultural, economic factors or access to resources and materials.What is New:• LoCoMan may be a useful device for teaching and learning CPR in schoolchildren from the age of 10 and upwards.• LOCOMAN shows that it is feasible and possible to build a low-cost manikin (about €5 in the European Region) and to integrate it into an integrative educational project, and outlines how this could be done. this approach can be an incentive for teachers to attempt teaching CPR, but also for education outside the formal environment.

Pilot Training Program on Hands-Only CPR and Choking First Aid for Frontline Police Responders in Rural Nepal.

Basic life support (BLS) is an emergency skill that includes performing appropriate cardiopulmonary resuscitation (CPR). Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality worldwide and is rising in Nepal. After an OHCA event, a bystander starting CPR quickly has been shown to increase the survival rate. While the Nepali police are generally the first responders to emergencies in rural parts, they are not trained in BLS. This program assesses a pilot training of hands-only CPR and choking first aid to the Nepal Police and Nepal Army participants in rural Nepal. A community-based nonprofit organization, HAPSA-Nepal, coordinated with local government to pilot this program. The program included pre- and post-tests, lectures, videos, and small group hands-on exercises; facilitators included faculty emergency physicians, residents, and medical officers. Structured pre- andp post-test questionnaires, confidence surveys, and skills checklists were conducted. Descriptive analysis examined the respondent's characteristics, and paired t-test was used to compare pretest and post-test scores. A total of 126 participants received the training in this pilot phase. Prior to this training, 98.4% of the participants had not received any CPR training, and 100% of the participants had not received training on first aid for choking. The average pretest score was 4.4 with 95% CI ± 1.75, and the average post-test score was 8.06 with 95% CI ± 1.73 (out of a total of 11). All participants passed the skills assessment. Locally adapted BLS training programs that included hands-only CPR and choking first aid showed a significant knowledge gain and skills competence among the frontline participants.

Early intranasal medication administration in out-of-hospital cardiac arrest: Two randomized simulation trials.

Intranasal medications have been proposed as adjuncts to out-of-hospital cardiac arrest (OHCA) care. We sought to quantify the effects of intranasal medication administration (INMA) in OHCA workflows. We conducted separate randomized OHCA simulation trials with lay rescuers (LRs) and first responders (FRs). Participants were randomized to groups performing hands-only cardiopulmonary resuscitation (CPR)/automated external defibrillator with or without INMA during the second analysis phase. Time to compression following the second shock (CPR2) was the primary outcome and compression quality (chest compression rate (CCR) and fraction (CCF)) was the secondary outcome. We fit linear regression models adjusted for CPR training in the LR group and service years in the FR group. Among LRs, INMA was associated with a significant increase in CPR2 (mean diff. 44.1s, 95% CI: 14.9, 73.3), which persisted after adjustment (p=0.005). We observed a significant decrease in CCR (INMA 95.1 compressions per min (cpm) vs control 104.2cpm, mean diff. -9.1cpm, 95% CI -16.6, -1.6) and CCF (INMA 62.4%vs control 69.8%, mean diff. -7.5%, 95% CI -12.0, -2.9). Among FRs, we found no significant CPR2 delays (mean diff. -2.1s, 95% CI -15.9, 11.7), which persisted after adjustment (p=0.704), or difference in quality (CCR INMA 115.5cpm vs control 120.8cpm, mean diff. -5.3cpm, 95% CI -12.6, 2.0; CCF INMA 79.6%vs control 81.2% mean diff. -1.6%, 95% CI -7.4, 4.3%). INMA in LR resuscitation was associated with diminished resuscitation performance. INMA by FR did not impede key times or quality.

Comparison between a low-cost model (CPR Pillow) and a mannequin in training hands only cardiopulmonary resuscitation (CPR): A randomised trial

IntroductionCPR is an important lifesaving skill that can improve outcomes of patients in cardiac arrest. Mass training of hands-only CPR is one of the ways to spread information and teach this skill. Need for expensive CPR mannequins are a limiting factor in conducting such mass training programmes. This study assessed the effectiveness of a low-cost CPR pillow model in training hands-only CPR. MethodologyTwo hundred and six undergraduate students underwent a two-hour CPR training session. They were randomly divided into two groups – mannequin group and CPR pillow group and practiced hands-only CPR on a standard mannequin and a low-cost CPR pillow model, respectively. Knowledge, attitude, and skill acquisition were objectively assessed and compared between the two groups. ResultsThere was no statistical difference in hand positioning, chest compression rate and fraction, depth and overall CPR score between the two groups trained via mannequin and CPR Pillow (P > 0.05). The CPR pillow group had better percentage of chest recoil as compared to the mannequin group (86% vs 73%; P < 0.001). ConclusionThe use of low-cost homemade CPR devices such as our CPR pillow model is an acceptable alternative to mannequin for training hands-only CPR to lay rescuers.

Teaching Cardiopulmonary Resuscitation to Later Elementary School Students

Bystander cardiopulmonary resuscitation (CPR) rates remain low in the United States. Training children is a proposed method to increase this rate, but data on the compression efficacy of US elementary school-aged children are scarce. We hypothesized that fourth and fifth graders could learn how to respond to cardiac arrests and provide effective chest compressions. We conducted a nonrandomized before-and-after study with fourth- and fifth-grade elementary students. Two 2-hour CPR educational sessions were held. Two weeks later, skills were assessed using a de novo checklist, and manikin-analyzed compression effectiveness (dichotomized at 50% efficacy) was analyzed using Chi-squared tests. We used paired t tests to evaluate knowledge change on identical pre- and post-tests. Secondary analysis evaluated associations between compression effectiveness and grade, age, sex, and body mass index (BMI) using Chi-squared tests. Three hundred fifty-six students completed the study. The mean change in test scores measuring CPR knowledge increased from 8.2 to 9.3 (1.1, 95% confidence interval [CI] 0.9 to 1.2). Self-reported adequate CPR knowledge increased from 44% to 97% (odds ratio [OR] 44.17, 95% CI 12.62 to 154.62). Seventy-two percent of students completed >7/11 predefined resuscitation steps, and 76% delivered ≥50% effective compressions. Grade was significantly associated with achieving ≥50% effective compression (OR 2.02, 95% CI, 1.19 to 3.43). Age, BMI, and sex were not significantly associated with greater compression efficacy. Most students were able to learn hands-only CPR, apply their knowledge during a simulated cardiac arrest scenario, and deliver effective chest compressions. Students' confidence and willingness to perform CPR increased after the intervention.

Methodological analysis of a community-based training initiative using the EPIS framework: an ongoing initiative to empower 10 million bystanders in CPR and bleeding control

BackgroundOut-of-hospital cardiac arrest (OHCA) and life-threatening bleeding from trauma are leading causes of preventable mortality globally. Early intervention from bystanders can play a pivotal role in increasing the survival rate...

Importance of basic life support training in rural India.

Basic life support (BLS) provided right away can lower fatality rates. Cardiac arrest typically results in death within minutes if it is untreated. Therefore, it is of interest to assess how BLS training affected villagers. The pre-experimental one-group pre-test post-test design was chosen for the investigation. A non-probability volunteer sampling technique was adopted to collect a sample of 220 village residents who met the inclusion requirements. The participants received training in basic life support that is achieved by using a real-life role model, hands-on CPR instruction. Checklist served as a standardized method for assessing the BLS training program. The pre-test and post-test's means were 23.05 and 56.51, respectively, and their respective standard deviations were 11.89 and 8.27. The 'z test' calculation result is 12.36) The results showed that BLS training was more successful for villagers and that they required regular BLS training programs to maintain their BLS skill level.

66 Hands-Only CPR and Stop the Bleed Training for Bank of America Chicago Marathon Volunteers

66 Hands-Only CPR and Stop the Bleed Training for Bank of America Chicago Marathon Volunteers

Association between bystander intervention and emergency medical services and the return of spontaneous circulation in out-of-hospital cardiac arrests occurring at a train station in the Tokyo metropolitan area: A retrospective cohort study

AimThe purpose of this study was to stratify patients who achieved return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) with bystander procedures pre-emergency medical service (EMS) arrival and those who achieved ROSC with procedures post-EMS arrival, compare outcomes at 1-month, and identify factors associated with pre-EMS-arrival-ROSC. MethodsA retrospective cohort analysis of OHCAs occurring at stations in the Tokyo metropolitan area between 2014 and 2018 was conducted. Subjects were stratified by ROSC phase (categorized as pre- and post-EMS arrival and non-ROSC). Survival at 1-month post-OHCA and the percentage of favourable neurological function in each ROSC phase were analysed. In addition, factors associated with Pre-EMS-arrival-ROSC were identified using multivariable logistic regression analysis. The time of occurrence of OHCA was classified into four-time categories as follows. Rush hour on morning [7:00–9:00], Rush hour on evening [17:00–21:00], Daytime [9:00–17:00], and Night or Early morning [21:00–7:00]. ResultsAmong the 63,089 OHCA in the dataset, 702 were analysed. At 1-month after OHCA occurrence, Pre-EMS-arrival ROSC had higher survival rates than post-EMS-arrival ROSC (86.8% vs. 54.1%) and CPC1-2 rates (73.6% vs. 38.5%). Pre-EMS-arrival ROSC was associated (adjusted odds ratio [95% confidence interval]) with non-older-adult patients (1.59 [1.05–2.43]), witnessed OHCA (1.82 [1.03–3.31]), evening rush-hour (17:00–21:00; 2.08 [1.05–4.11]), conventional CPR (33.42 [7.82–868.44]), hands-only CPR (17.06 [4.30–436.48]), bystander defibrillation performed once (3.31 [1.59–6.99]). ConclusionsIn an OHCA at a station in Tokyo, ROSC achieved with bystander treatment alone had a better outcome at 1-month compared to ROSC with EMS intervention

A comparative analysis of aerosol exposure and prevention strategies in bystander, pre-hospital, and inpatient cardiopulmonary resuscitation using simulation manikins

To evaluate aerosol exposure risk and prevention strategies during bystander, pre-hospital, and inpatient cardiopulmonary resuscitation (CPR). This study compared hands-only CPR, CPR with a surgical or N95 mask, and CPR with a non-rebreather mask at 15 L/min. 30:2 compression–ventilation ratio CPR was tested with face-mask ventilation (FMV), FMV with a high efficiency particulate air (HEPA) filter; supraglottic airway (SGA), SGA with a surgical mask, SGA with a HEPA filter, or SGA with both. Continuous CPR was tested with an endotracheal tube (ET), ET with a surgical mask, a HEPA filter, or both. Aerosol concentration at the head, trunk, and feet of the mannequin were measured to evaluate exposure to CPR personnel. Hands-only CPR with a surgical or N95 face mask coverings and ET tube ventilation CPR with filters showed the lowest aerosol exposure among all study groups, including CPR with NRM oxygenation, FMV, and SGA ventilation. NRM had a mask effect and reduced aerosol exposure at the head, trunk, and feet of the mannequin. FMV with filters during 30:2 CPR reduced aerosol exposure at the head and trunk, but increased at the feet of the mannequin. A tightly-sealed SGA when used with a HEPA filter, reduced aerosol exposure by 21.00–63.14% compared with a loose-fitting one. Hands-only CPR with a proper fit surgical or N95 face mask coverings is as safe as ET tube ventilation CPR with filters, compared with CPR with NRM, FMV, and SGA. FMV or tight-sealed SGA ventilation with filters prolonged the duration to achieve estimated infective dose of SARS-CoV-2 2.4–2.5 times longer than hands-on CPR only. However, a loose-fitting SGA is not protective at all to chest compressor or health workers standing at the foot side of the victim, so should be used with caution even when using with HEPA filters.

Knowledge and willingness of schoolteachers in Jordan to perform CPR: a cross-sectional study

ObjectivesThis study aimed to assess the cardiopulmonary resuscitation (CPR) knowledge and willingness of schoolteachers in Jordan.DesignThis was a cross-sectional study conducted using an online questionnaire.SettingFor inclusion in this study, schoolteachers...

Sosialisasi Hands Only CPR (HOCPR) Pada Pengunjung Car Free day (CFD) Samota, Sumbawa, Nusa Tenggara Barat

The incidence of out-of-hospital cardiac arrest increased (OHCA) significantly. The survival rates of OHCA would be decreased 7-10% every minutes. Therefore, the patients with OHCA must be performed cardiopulmonary resuscitation (CPR) immediately. However, CPR is commonly not performed due to lack of knowledge, skills and fair of being transmitted of diseases. Hands Only CPR (HOCPR) is designed for lay rescuer through two simple steps, firstly call the nearest health center, secondly performed compression to the middle of chest. This socialization aimed to improve knowledge and willingness of lay rescuer to perform HOCPR. This socialization has been done in CFD Samota Sumbawa on 18th June 2023. More than 100 flayers have been distributed followed by discussion regarding the importance of CPR. The result of the outreach showed that visitor of CFD Samota were very enthusiastic and they were able and willing to perform HOCPR. Therefore, health care centers, such as hospitals, university and organizations related to emergency sector need to actively provide outreach and demonstrations related to HOCPR.

Development of Cardiopulmonary Resuscitation Pillows for Increasing Number of Bystanders CPR In Lubuklinggau City

Introduction: Cardiac arrest is a situation that can lead to death if CPR is not immediately assisted. The chances of survival increase if the victims are directly helped by people nearby or CPR bystanders rather than waiting for the medical team to arrive. Training CPR bystanders requires large resources, including expensive CPR mannequins as a simulation medium. Creativity is needed to create cheap CPR simulation media with good feasibility. Objective: The study aimed to construct and test the effect of the CPR Pillow to improve the CPR skill in Lubuklinggau, South Sumatra, Indonesia. Method: Research and Development (R&amp;D) with experimental tests, pre-test, and post-tests were applied in this study. Forty people were given two meetings within two weeks. Skill was measured by how the subject performed hand's-only CPR using the CPR Operational Procedure checklist. Result: The result of this study is the creation of a low-cost CPR pillow design that meets the eligibility as a low-fidelity simulation medium for CPR skills. The data analysis using the paired t-test showed a significant effect of CPR training using CPR Pillows on the trainees' hand's-only CPR skills (t=-37,749) with a value of p=0.000. Recommendation: This CPR pillow can be used as a hand's-only CPR simulation medium. CPR simulation using this CPR pillow is a low-fidelity simulation. There is a positive influence related to CPR training using this CPR pillow on the hands-only CPR skills of the trainees