Hands-only Cardiopulmonary Resuscitation Research Articles

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.
 
 

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<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.

Different Resting Methods in Improving Laypersons Hands-Only Cardiopulmonary Resuscitation Quality and Reducing Fatigue: A Randomized Crossover Study

ObjectiveTo determine the effects of different resting methods with various rest-start points or rest-compression ratios on improving cardiopulmonary resuscitation (CPR) quality and reducing fatigue during continuous chest compressions (CCC) in 10-min hands-only CPR scenario. MethodsThis prospective crossover study was conducted in 30 laypersons aged 18-65. Trained participants were randomized to follow different orders to perform following hands-only CPR methods: (1) CCC, 10-min CCC; (2) 4+6, 4-min CCC + 6-min of 10-s pause after 60-s compressions; (3) 2+8 (10/60), 2-min CCC + 8-min of 10-s pause after 60-s compressions; (4) 5/30, 2-min CCC + 8-min of 5-s pause after 30-s compressions; (5) 3/15, 2-min CCC + 8-min of 3-s pause after 15-s compressions. CPR quality (depth, rate, hands-off duration, chest compression fraction (CCF)) and participants’ fatigue indicators (heart rate, blood pressure, rating of perceived exertion (RPE)) were compared among methods of different rest-start points and different rest-compression ratios with CCC. ResultsTwenty-eight participants completed all methods. All resting methods reduced the trend of declining compression depth and the trend of increasing RPE while maintaining CCF of more than 86%. In methods with different rest-start points, the 2+8 method showed no difference in overall CPR quality or fatigue, but better CPR quality of every minute than 4+6 method. In methods with different rest-compression ratios, the 3/15 method showed the best CPR quality and the highest heart rate increment. ConclusionDuring prolonged hands-only CPR, appropriate transient rests were associated with higher CPR quality and lower subjectively perceived fatigue in laypersons.

Airborne infection risk during open-air cardiopulmonary resuscitation

AimCardiopulmonary resuscitation (CPR) is an emergency procedure where interpersonal distance cannot be maintained. There are and will always be outbreaks of infection from airborne diseases. Our objective was to assess...

Interim Guidance for Emergency Medical Services Management of Out-of-Hospital Cardiac Arrest During the COVID-19 Pandemic.

Interim Guidance for Emergency Medical Services Management of Out-of-Hospital Cardiac Arrest During the COVID-19 Pandemic.

Attitude and behavior toward bystander cardiopulmonary resuscitation during COVID-19 outbreak.

BackgroundOutbreaks of emerging infectious diseases, such as COVID-19, have negative impacts on bystander cardiopulmonary resuscitation (BCPR) for fear of transmission while breaking social distancing rules. The latest guidelines recommend hands-only cardiopulmonary resuscitation (CPR) and facemask use. However, public willingness in this setup remains unknown.MethodsA cross-sectional, unrestricted volunteer Internet survey was conducted to assess individuals’ attitudes and behaviors toward performing BCPR, pre-existing CPR training, occupational identity, age group, and gender. The raking method for weights and a regression analysis for the predictors of willingness were performed.ResultsAmong 1,347 eligible respondents, 822 (61%) had negative attitudes toward performing BCPR. Healthcare providers (HCPs) and those with pre-existing CPR training had fewer negative attitudes (p < 0.001); HCPs and those with pre-existing CPR training and unchanged attitude showed more positive behaviors toward BCPR (p < 0.001). Further, 9.7% of the respondents would absolutely refuse to perform BCPR. In contrast, 16.9% would perform BCPR directly despite the outbreak. Approximately 9.9% would perform it if they were instructed, 23.5%, if they wore facemasks, and 40.1%, if they were to perform hands-only CPR. Interestingly, among the 822 respondents with negative attitudes, over 85% still tended to perform BCPR in the abovementioned situations. The weighted analysis showed similar results. The adjusted predictors for lower negative attitudes toward BCPR were younger age, being a man, and being an HCP; those for more positive behaviors were younger age and being an HCP.ConclusionsOutbreaks of emerging infectious diseases, such as COVID-19, have negative impacts on attitudes and behaviors toward BCPR. Younger individuals, men, HCPs, and those with pre-existing CPR training tended to show fewer negative attitudes and behaviors. Meanwhile, most individuals with negative attitudes still expressed positive behaviors under safer measures such as facemask protection, hands-only CPR, and available dispatch instructions.

Influences of hands-only cardiopulmonary resuscitation on lumbar muscle tone, stiffness, and fatigue in emergency medical technicians

Influences of hands-only cardiopulmonary resuscitation on lumbar muscle tone, stiffness, and fatigue in emergency medical technicians

Effects of vibration-guided cardiopulmonary resuscitation with a smartwatch versus metronome guidance cardiopulmonary resuscitation during adult cardiac arrest: a randomized controlled simulation study

BackgroundSmartwatches could be used as a cardiopulmonary resuscitation (CPR) guidance system through its vibration function. This study was conducted to determine whether vibration guidance by a smartwatch application influences CPR performance compared to metronome guided CPR in a simulated noisy setting. MethodsThis study was randomised controlled trial. A total of 130 university students were enrolled. The experiment was conducted using a cardiac arrest model with hands-only CPR. Participants were randomly divided into two groups 1:1 ratio and performed 2-min metronome guidance or vibration guidance compression at the rate of 110/min. Basic life support quality data were compared in simulated noisy environments. ResultsThere were significant differences between the audio and vibration guidance groups in the mean compression rate (MCR). However, there were no significant differences in correct or mean compression depth, correct hand position, and correctly released compression. The vibration guidance group resulted in 109 MCR (Interquartile range [IQR] 108–110), whereas the metronome guidance group resulted in 115 MCR (IQR 112–117) (p < 0.001). ConclusionIn a simulated noisy environment, vibration guided CPR showed to be particularly advantageous in maintaining a desired MCR during hands-only CPR compared to metronome guided CPR.

Save a Life: Implementation and Evaluation of a Community-Focused CPR Education Program in Houston, Texas.

Over 350 000 people in the United States experience out-of-hospital cardiac arrest (OHCA) annually—and almost 90% die as a result. However, survival varies widely between counties, ranging from 3.4% to 22.0%—a disparity that the American Heart Association (AHA) largely attributes to variation in rates of bystander CPR. Studies show that regions with low rates of bystander CPR have low rates of CPR training, making CPR training initiatives a high-priority intervention to reduce OHCA mortality. In Houston, Texas, researchers have identified census tracts with higher OCHA incidence and lower rates of bystander CPR. We developed a free, annual Hands-Only CPR bilingual health education program central to these high-risk neighborhoods. In 5 years, this collaborative effort trained over 2700 individuals. In 2016, 2017, and 2018, we conducted a process evaluation to assess fidelity, dose delivered, and dose received. We also conducted an outcome evaluation using the Kirkpatrick Model for Training Evaluation to assess participants’ reactions and learning. Overall, the program yielded positive outcomes. Of the 261 respondents (from 314 attendees), 63% were first-time learners. The majority (87%) were satisfied with the event and 85% felt that information was presented clearly and concisely. Pre- and post-knowledge assessments showed a 51% increase in the proportion of respondents who could correctly identify the steps for Hands-Only CPR. This program exemplifies how collaborative education can impact a community’s health status. Leveraging each partner’s resources and linkages with the community can enhance the reach and sustainability of health education initiatives.

Effectiveness of chest compressions after a short training method: a pilot study with future lifeguards

Objective: To analyze the effectiveness of short training sessions on instructor-led and computer-based resuscitation maneuvers for future lifeguards. Methods: To measure effects of training methods on performance of a hands-only CPR test, each participant completed testing H (1) before training (T1); (2) immediately after completion of six short training sessions (T2); (3) 3 weeks after T2 (T3). The training involved performing 4 rounds of 30 seconds of chest compressions with 30 seconds of recovery between rounds. Participants were randomized to groups (G1 or G2) to receive feedback at the end of each round from an instructor or from a manikin with a feedback system, respectively. Results: Twenty-seven participants (26% female) were included. After training, performance of chest compressions in both training groups improved significantly in terms of overall quality (P &lt; 0.01) and of adequacy of compression depth (P &lt; 0.01). There were no significant differences in any of the three tests between G1 and G2. Conclusions: Short training sessions with instructor or automated feedback effectively improves quality of chest compressions and prolong skills retention in the short term.

Chest compressions quality during sudden cardiac arrest scenario performed in virtual reality: A crossover study in a training environment.

Potential attributes of virtual reality (VR) can be a breakthrough in the improvement of sudden cardiac arrest (SCA) training. However, interference with the virtual world is associated with the need of placing additional equipment on the trainee's body. The primary aim of the study was to evaluate if it does not affect the quality of chest compressions (CCs).91 voluntarily included in the study medical students participated twice in the scenario of SCA – Traditional Scenario (TS) and Virtual Reality Scenario (VRS). In both cases two minutes of resuscitation was performed.If VRS was the first scenario there were significant differences in CCs depth (VRS - Me = 47 mm [IQR 43 – 52] vs TS - Me = 48 mm [IQR 43 – 55]; P = .02) and chest relaxation (VRS - Me = 37% [IQR 5 – 91] vs TS - Me = 97% [IQR 87 – 100]; P < .001). 97.8% of respondents believe that training with the use of VR is more effective than a traditional method (P < .01). Most of the study group (91%, P < .01) denied any negative symptoms during the VR scenario.Virtual reality can be a safe and highly valued by medical students, method of hands-on CPR training. However additional VR equipment placed on the trainee's body may cause chest compressions harder to provide. If it is not preceded by traditional training, the use of VR may have an adverse impact on depth and full chest relaxation during the training. To make the best use of all the potential that virtual reality offers, future studies should focus on finding the most effective way to combine VR with traditional skill training in CPR courses curriculum.

Psychological effects of Cpr training methods on high school students: a randomized trial

Limited research exists on the effect of adolescents’ affections on the success of cardiopulmonary resuscitation (CPR) training and the adolescents’ decision-making skills and practices during an occurrence of cardiac arrest. We aimed to evaluate the effect of CPR training on the knowledge, behaviour and affections of students aged 16–17 years. A pretest-posttest randomised controlled trial was carried out with 115 tenth-grade students from western Turkey. The one group received basic life support (BLS) training, while the other group were given hands-only CPR (HOCPR) training. The study data were collected using a socio-demographic data form, the Positive and Negative Affect Scale (PANAS) and a CPR questionnaire. The median change in positive affect in the BLS group was −2.964; the median in the HOCPR group was −1.206. No significant difference was found between the groups. In the BLS group, the median change in negative affect was −3.649, and the median was 2.568 in the HOCPR group. The change in knowledge scores was higher in the HOCPR group. There was no difference between training methods in affections changes. Both methods reduced students’ anxiety about CPR and provided a positive change in their thoughts about intervening in an occurrence.

Abstract 354: Teaching Effective Cardiopulmonary Resuscitation to 4 Th and 5 Th Grade Elementary Students

Background: Cardiac arrests are a leading cause of mortality in the US. Many states have CPR training requirements for high school graduation. There is a paucity of research on CPR education and assessment in elementary students. We hypothesized that 4 th and 5 th graders could attain the knowledge of, and be physically equipped to provide, hands-only CPR. Methods: Forth and fifth grade students from one school district were taught basic resuscitation physiology and hands-only CPR using videos and inflatable CPR manikins. Knowledge gain was assessed by a 13-question pre-test and a 2-week follow-up post-test, at which time students also performed 1 minute of hands-only CPR on an adult high-fidelity manikin. CPR skills were assessed by an 11-step checklist. Manikin software analyzed the compression effectiveness. A secondary analysis evaluated for association between compression effectiveness and age, gender, and BMI. Results: Three hundred fifty-five students completed the high-fidelity portion of the study. On average, students answered 1.1 more questions correctly on the post-test than the pre-test (P&lt;0.0001). The proportion of students self-reporting adequate CPR knowledge increased from 45% (155/345) to 98% (339/345) (p&lt;0.0001) pre-test to post-test. The proportion of students willing to perform CPR increased from 92% (320/349) to 96% (335/349) (p=0.0018). At least 8/11 resuscitation steps were completed by 72% (256/355) (95% CI, 68-77%) of students. The most frequently missed step was “get the attention of an adult,” which was only demonstrated by 5.9% (21/355) of students. Seventy-six percent (271/355) (95% CI, 72-81%) were able to deliver at least half of their compressions effectively. Age, BMI, and gender were not significantly associated with compression effectiveness. Conclusions: The education intervention resulted in a significant increase in the number of questions answered correctly from the pre-test to the post-test. Most students were able to learn hands-only CPR, apply the knowledge in a simulated cardiac arrest, and deliver effective chest compressions. Following the intervention, the students felt more prepared and were more willing to do CPR. It would be reasonable for older elementary students to be taught hands-only CPR.

Abstract 351: Current Barriers for College Students to Perform Cardiopulmonary Resuscitation on Strangers and Family Members

Background: As opioid associated cardiac arrests increase on US college campuses, there is a need for students to learn and perform CPR. These arrests are respiratory in origin and require provision of compressions with rescue breathing (conventional CPR) over hands-only CPR. Unfortunately, only some college students will provide rescue breaths as mouth to mouth contact is a leading barrier to initiate CPR. The objective of this study was to evaluate the barriers of college students to performing conventional CPR on strangers and family members. Methods: Undergraduate students at The Ohio State University were recruited from Jan 2018 to Dec 2019 to participate in a survey. Respondents’ demographic data were collected, and they were asked about their attitudes concerning performing conventional CPR on strangers and family. This was followed by identifying their potential barriers to performing conventional CPR. Inclusion criteria were age &gt; 17 and missing &lt; 10% of survey data. Barriers were compared between respondents who were unlikely to perform CPR (unlikely) and those likely to perform CPR (likely). Descriptive statistics were calculated. Results: A total of 883 surveys were included in the analysis (response rate 74%). Of these respondents, 495 (56%) were likely to perform CPR on a stranger and 743 (84%) were likely to perform CPR on a family member. When performing CPR on a stranger, the barriers of fear of an incorrect method (unlikely: 81% vs likely: 61%, P&lt;0.001) and mouth to mouth contact (unlikely: 31% vs likely: 24%, p=0.03) were different between groups while facing legal risk and causing harm to the victim were not. In contrast, when performing CPR on a family member, there were no differences between groups except for the fear of applying an incorrect method, which persisted as a larger barrier for those unlikely to perform CPR (unlikely: 72% vs likely: 62%, p&lt;0.05). Conclusion: There are many barriers that influence college students’ intention to perform CPR. Surprisingly, the most significant barrier reported by both groups was fear of performing CPR incorrectly, while the fear of mouth-to-mouth contact was not as prevalent. Further evaluation is necessary in the post-COVID-19 era to understand the impact of increased fear of infectious diseases.