Hands-only Cardiopulmonary Resuscitation Research Articles

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 12years 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...

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

Vaccination status and knowledge of CPR do not affect medical students' decision to perform BLS during the COVID-19 pandemic

Abstract Funding Acknowledgements Type of funding sources: None. Introduction To address the risks of transmission by COVID-19, various recommendations been released by medical societies, which include strongly advocating for the use of personal protective equipment. In addition, hands-only cardiopulmonary resuscitation (CPR) has also been promoted among cardiac arrest victims. Some studies which evaluated healthcare practitioners’ attitudes towards CPR during the pandemic showed negative attitudes in responding to those who have unknown COVID-19 status citing safety as the primary reason. At present, there is no study which evaluates the attitudes of medical students towards Basic Life Support (BLS) during the pandemic. Purpose The study aimed to determine the factors associated with willingness of medical students to perform basic life support in out-of-hospital cardiac arrest during the COVID-19 pandemic. Methods This is a cross-sectional study using online surveys. We performed face validation and pilot study on 39 medical students. The main survey was disseminated in Metro Manila schools wherein 349 medical students participated. Questions included demographic data, prior BLS training, and vaccination status, evaluated knowledge of CPR, and determined their attitudes on CPR during the pandemic. Results Results showed that 338 (97%) were willing to do CPR during the pandemic. Majority are fully vaccinated (99%) and are BLS-trained (75%). The median total knowledge score was 7 out of 10. Of all participants, 37 (11%) had a perfect score. Most (79%) had a passing mark. Majority (61%) claimed that a victim’s vaccination status does not play a role in deciding to perform CPR. Among the unwilling, 55% factored in a victim’s vaccination status. Most who agreed to perform CPR will do so if they are provided with adequate protection (55%). Simple and multiple logistic regression analyses showed that students who will do CPR on a patient who is not fully vaccinated or has unknown vaccination status have about 5 times higher odds of having the will to perform BLS during the pandemic. It also found that there is no correlation between knowledge, vaccination status, and prior training with choosing to perform BLS during the pandemic. This means that if a student is willing to do CPR on a victim wherein chances of contracting COVID-19 infection are higher, then their likelihood of performing BLS regardless of victim status, during the pandemic is five times more likely. Conclusion Most Filipino medical students are willing to perform BLS during the pandemic and in spite of risks of COVID-19 transmission. Their adequate knowledge, full vaccination status, or prior training did not influence their decision. In a pandemic situation, the students’ willingness to perform CPR among those with unknown COVID-19 status influences their decision to perform BLS in general.

PS-C13-10: A PROFILE OF OUT-OF-HOSPITAL CARDIAC ARREST IN AMANG RODRIGUEZ MEMORIAL MEDICAL CENTER: A PROSPECTIVE COHORT STUDY

Objective: For every minute of cardiac arrest without early intervention, chances of survival drop by 7 to 10%. It is crucial that CPR be initiated within 4 to 6 minutes to avoid brain death. Most out-of-hospital cardiac arrests (OHCA) occur in a residential setting where access to trained personnel and equipment are not readily available, resulting to poor victim outcomes. The objective of the study is to present the different patient, responder, and transport factors affecting out-of-hospital cardiac arrest among adult patients brought to Amang Rodriguez Memorial Medical Center. Design and method: This is a descriptive study done from August to November 2021 using a prospective cohort design. Participants of the study include adult patients aged 18 years and above brought to the emergency room who suffered from out-of-hospital cardiac arrest. Descriptive statistics was used to summarize the demographic and clinical characteristics of the patients. Results: 63 participants were included in the study. Majority were male patients at 73.02%. Hypertension was identified as the top co-morbidity. Medical causes of arrest were identified in 96.83% of the cases. 90.48% of cardiac arrests occurred at home. Only 26 patients (41.27%) received pre-hospital intervention prior to ER arrival in the form of hands-only CPR. 60.32% were brought via self-conduction, the remainder by ambulances, which had no available equipment necessary to provide proper resuscitation. Average travel time from dispatch to ER arrival is 20 minutes. Conclusion: Overall survival of OHCA in our local setting remain dismal, as return of spontaneous circulation was not achieved in any of the patients. The small number of patients having pre-hospital CPR indicates the need for emphasis on training and community education.

THE EFFECTIVENESS OF HANDS-ONLY OFFLINE APPLICATION

Cardiac arrest is an emergency that can occur inside or outside the hospital and has a high risk of death. However, the survival rate is higher if cardiopulmonary resuscitation (CPR) first aid is given immediately. The patient’s family can give first aid in the form of hands-only CPR if the cardiac arrest incident occurs at home. Nowadays, learning to use hands-only CPR offline application on a mobile phone is one way to increase knowledge and skills besides being easy to access, we can also take it with us wherever we go. This study aims to determine whether hands-only cardiac resuscitation offline applications can improve family skills. This study was quasi-experimental, using a control group with pre-test and post-test designs. The experimental group used independent learning through a hands-only CPR offline application, while the control group used a hands-only CPR simulation. The number of samples for each group was 17 people, with a total of 34 people for the two groups. Analysis was done using Wilcoxon and Mann-Whitney. P-value obtained was 0.000, so there is a significant difference in CPR skills before and after intervention in the offline application group and the simulation group. P-value obtained was 0.000, so there is a significant relationship between offline application and simulation in improving the skills of patients’ families in performing hands-only CPR. Learning through a CPR hand-only application improves the skills of the family of patients with heart disease to perform hands-only CPR. Meanwhile, learning with a simulation method has a higher rank in improving the skills of the family of patients with heart disease to perform hands-only CPR.&#x0D; &#x0D; &#x0D;

Abstract 135: Regional Variation Of Adult Awareness Of And Likelihood To Perform Hands-only Cardiopulmonary Resuscitation

Introduction: About 75% of out-of-hospital cardiac arrests (OCHA) happen in the home. Based on US data, only about 40% of people who experience an OCHA receive bystander CPR before EMS arrives. Global community awareness data of Hands-Only CPR (HOCPR) and willingness to perform are limited. Objective: Determine global awareness of and likeliness to perform HOCPR among adults and examine regional variation. Methods: An online native language survey was administered among nationally representative samples of adults ≥18 years of age in 50 countries across 6 global regions. The survey was administered June-July 2021 using the YouGov RealTime omnibus service. The survey included one question regarding awareness of the concept of HOCPR as involving calling the local emergency number, and then pushing hard and fast in the center of the chest, but not involving breathing into the person’s mouth. A second question gauged willingness to perform HOCPR in an emergency on a 5-point scale. Participants were also able to answer “Don’t Know/Not Sure” to both questions. Results were weighted by country, then combined by region. Results: Of 47,488 adults (49.15% female), 66.79% reported awareness of HOCPR. Regional awareness ranged from 58.75% to 79.07%. Of those who were aware of HOCPR, 77.72% were extremely, very likely, or somewhat likely to give HOCPR in an emergency (regional range, 74.09% to 88.01%). Globally, awareness increased likeliness by 44.54%. In every region, there were no awareness differences between men and women (p=0.90); however, men were more likely than women to give HOCPR (p=0.02). Conclusions: Most respondents were aware of HOCPR. Those who were aware were more likely to give HOCPR to a bystander in an emergency. Likeliness to give HOCPR varies by global region. Efforts are needed in all regions to increase awareness and remove barriers that prevent people from helping OHCA victims.

Abstract 307: Kids Save Hearts Project: Hands-only Cardiopulmonary Resuscitation Training For Schoolchildren

Introduction: As part of a global initiative, several countries already provide cardiopulmonary resuscitation (CPR) training to children in school environments. This training is not a part of the Brazilian school curriculum, but it is necessary since cardiorespiratory arrest events are frequently fatal. Objective: This study investigates the effectiveness of hands-only cardiopulmonary resuscitation among different age groups of schoolchildren. Methods: The institution's research ethics committee previously approved the study. Prior to training, both parents and participants signed a consent form. This study was conducted in three (public and private) schools using a quasi-experimental intervention with two age groups: 7 to 11 (group I) and 12 to 17 (group II). The 90-minute training module consisted of short practice videos while watching a song dedicated to "hands-only CPR." Students were then individually evaluated for their skills and knowledge using Skill Reporter Software Laerdal Medical during one minute of chest compressions on a manikin and a dedicated game. Results: The total of 102 schoolchildren (54 females and 48 males) (table1) were trained and evaluated for demographic variables (rate, depth, recoil) and chest compression quality according to international guidelines 2020. There were differences in the physical characteristics of participants (p&lt;0.05) and significant statistical difference related to depth in CPR (median 66 mm; p: 0,01) in group II. Conclusion: It was concluded that schoolchildren performing hands-only cardiopulmonary resuscitation were adequate, and those future efforts are required to implement and expand training in low-income regions of Brazil.

Neighborhood-level out-of-hospital cardiac arrest risk and the impact of local CPR interventions

IntroductionIt is unclear how best to identify “high-risk” areas for out-of-hospital cardiac arrest (OHCA) and if neighborhood-level interventions improve bystander cardiopulmonary resuscitation (BCPR). Our objectives were to 1) identify and compare community characteristics between high and low-risk neighborhoods; and 2) examine change in BCPR after a targeted hands-only CPR intervention. MethodsThis was a cross-sectional analysis of OHCA events in Franklin County, Ohio between 1/1/2010–12/31/2017. Adult (≥18 years) OHCAs in a non-healthcare setting with emergency medical services resuscitation attempted were included. High-risk neighborhoods based on OHCA incidence and BCPR rates were identified using global Empirical Bayes, Local Moran’s I, and spatial scan statistic. We compared characteristics of high and low-risk neighborhoods and examined change in BCPR. ResultsFrom the 3,841 included OHCAs, the mean adjusted OHCA incidence per census tract was 0.81 per 1,000, BCPR rate was 37.2%, and survival to hospital discharge was 11.5%. Of the 35 census tracts identified as high-risk, ten persisted from previous work. OHCA incidence was higher in high-risk neighborhoods (1.30 per 1,000 vs. 0.73, p < 0.001) and BCPR rates were lower (30.2% vs. 38.5%, p < 0.001). There were significant differences in characteristics between high and low-risk neighborhoods (e.g., Black population: 45.3% vs. 25.7%, p < 0.001). The neighborhoods targeted for the community education intervention had similar pre- and post-intervention BCPR rates. ConclusionsDemographic and socioeconomic characteristics differed between high- and low-risk neighborhoods. BCPR rates were lower in high-risk neighborhoods despite a targeted BCPR intervention. Educational interventions may be necessary, but not sufficient, to improve OHCA outcomes.

Out of hospital cardiac arrest: experience of a bystander CPR training program in Karachi, Pakistan

BackgroundNearly 90% of out-of-hospital cardiac arrest (OHCA) patients are witnessed, yet only 2.3% received bystander cardiopulmonary resuscitation (CPR) in Pakistan. This study aimed to determine retention of knowledge and skills of Hands-Only CPR among community participants in early recognition of OHCA and initiation of CPR in Karachi, Pakistan.MethodsPre and post-tests were conducted among CPR training participants from diverse non-health-related backgrounds from July 2018 to October 2019. Participants were tested for knowledge and skills of CPR before training (pre-test), immediately after training (post-test), and 6 months after training (re-test). All the participants received CPR training through video and scenario-based demonstration using manikins. Post-training CPR skills of the participants were assessed using a pre-defined performance checklist. The facilitator read out numerous case scenarios to the participants, such as drowning, poisoning, and road traffic injuries, etc., and then asked them to perform the critical steps of CPR identified in the scenario on manikins. The primary outcome was the mean difference in the knowledge score and skills of the participants related to the recognition of OHCA and initiation of CPR.ResultsThe pre and post-tests were completed by 652 participants, whereas the retention test after 6 months was completed by 322 participants. The mean knowledge score related to the recognition of OHCA, and initiation of CPR improved significantly (p < 0.001) from pre-test [47.8/100, Standard Deviation (SD) ±13.4] to post-test (70.2/100, SD ±12.1). Mean CPR knowledge after 6 months (retention) reduced slightly from (70.2/100, ±12.1) to (66.5/100, ±10.8). CPR skill retention for various components (check for scene safety, check for response, check for breathing and correct placement of the heel of hands) deteriorated significantly (p < 0.001) from 77.9% in the post-test to 72.8% in re-test. Participants performed slightly better on achieving an adequate rate of chest compressions from 73.1% in post-test to 76.7% in re-test (p 0.27).ConclusionCommunity members with non-health backgrounds can learn and retain CPR skills, allowing them to be effective bystander CPR providers in OHCA situations. We recommend mass population training in Pakistan for CPR to increase survival from OHCA.

Teaching Hands-Only CPR (HOCPR) skills to 8th-grade students in urban Bengaluru: Development of a comprehensive Hands-Only CPR programme for high school students.

Background and Aims:Out-of-hospital cardiac arrest is one of the leading causes of death in India. Only 1.3% of these arrests receive bystander cardiopulmonary resuscitation (CPR). Bystander CPR increases a victim's chances of survival; training school children in Hands-Only CPR (HOCPR) is a proven method of increasing bystander CPR rates. Heart Rescue India is an international project working to improve care for cardiovascular diseases, and as a part of it, a ten module Cardiovascular disease (CVD) educational programme, including HOCPR training, was conducted in ten schools in 2017–18. The objective of our study was to assess the effectiveness of HOCPR training for 8th-grade high school students.Methods:Four hundred fourteen of the 530 enroled students from ten schools of Bengaluru participated in the study. The participants attended a one-hour didactic session about the recognition of cardiac arrest and HOCPR in three simple steps. Subsequently, students received hands-on training for HOCPR. The sessions included pre- and post-assessment of knowledge and skills. The results were statistically analysed using paired t-test and the McNemar test.Results:The mean overall pre-assessment score for knowledge was 62.07 ± 28.38%, and the post-assessment score was 72.42 ± 26.58% (P < 0.001). In addition, there was a statistically significant improvement in the post-training scores for HOCPR in all three parameters, namely compressions per minute, depth and chest recoil.Conclusion:The study demonstrated a simple yet effective HOCPR programme for high school children.