Prior Cardiopulmonary Resuscitation Training 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.

KNOWLEDGE OF CARDIO-PULMONARY RESUSCITATION AMONG FIRST-YEAR NURSING STUDENTS

: In the dynamic realm of healthcare, proficiency in cardiopulmonary resuscitation (CPR) stands as a cornerstone skill for nursing professionals. First-year nursing students represent the future frontline caregivers entrusted with the critical responsibility of preserving human life during emergencies. Methods: A descriptive cross-sectional study was conducted from January to April 2024 at the Superior University Department of Nursing in Lahore, to assess CPR knowledge among first-year nursing students. The study, involving 80 participants selected through convenient sampling, included students without prior CPR training. Data was collected using a demographic questionnaire and a CPR Knowledge Questionnaire, with scores ranging from 0 to 77. Analysis was performed using SPSS 25.Results: The results of the study provide a comprehensive overview of the participants' demographics and their knowledge about CPR. Most participants were under 30 years old (91.3%), with nearly equal numbers living in hostels (48.8%) and as day scholars (51.2%). A significant majority were single (95%). Knowledge about CPR varied, with 53.8% of participants having average knowledge and 46.3% having good knowledge. Responses revealed varying levels of understanding about CPR's purpose, procedures, and effectiveness, highlighting a need for improved education and training. Conclusion: The study shows that most nursing students are under 30 years old, with a near-equal distribution between hostel residents and day scholars, and a majority are single. Overall, 53.8% have average CPR knowledge, while 46.3% have good knowledge.

Incorporation of Drone Technology Into the Chain of Survival for OHCA: Estimation of Time Needed for Bystander Treatment of OHCA and CPR Performance.

Drone-delivered automated external defibrillators (AEDs) hold promises in the treatment of out-of-hospital cardiac arrest. Our objective was to estimate the time needed to perform resuscitation with a drone-delivered AED and to measure cardiopulmonary resuscitation (CPR) quality. Mock out-of-hospital cardiac arrest simulations that included a 9-1-1 call, CPR, and drone-delivered AED were conducted. Each simulation was timed and video-recorded. CPR performance metrics were recorded by a Laerdal Resusci Anne Quality Feedback System. Multivariable regression modeling examined factors associated with time from 9-1-1 call to AED shock and CPR quality metrics (compression rate, depth, recoil, and chest compression fraction). Comparisons were made among those with recent CPR training (≤2 years) versus no recent (>2 years) or prior CPR training. We recruited 51 research participants between September 2019 and March 2020. The median age was 34 (Q1-Q3, 23-54) years, 56.9% were female, and 41.2% had recent CPR training. The median time from 9-1-1 call to initiation of CPR was 1:19 (Q1-Q3, 1:06-1:26) minutes. A median time of 1:59 (Q1-Q3, 01:50-02:20) minutes was needed to retrieve a drone-delivered AED and deliver a shock. The median CPR compression rate was 115 (Q1-Q3, 109-124) beats per minute, the correct compression depth percentage was 92% (Q1-Q3, 25-98), and the chest compression fraction was 46.7% (Q1-Q3, 39.9%-50.6%). Recent CPR training was not associated with CPR quality or time from 9-1-1 call to AED shock. Younger age (per 10-year increase; β, 9.97 [95% CI, 4.63-15.31] s; P<0.001) and prior experience with AED (β, -30.0 [95% CI, -50.1 to -10.0] s; P=0.004) were associated with more rapid time from 9-1-1 call to AED shock. Prior AED use (β, 6.71 [95% CI, 1.62-11.79]; P=0.011) was associated with improved chest compression fraction percentage. Research participants were able to rapidly retrieve an AED from a drone while largely maintaining CPR quality according to American Heart Association guidelines. Chest compression fraction was lower than expected.

Knowledge, attitudes, practices, and self-efficacy of the Chinese public regarding cardiopulmonary resuscitation: an online cross-sectional survey.

To evaluate the current status of Chinese public's knowledge, attitudes, practices (KAP) and self-efficacy regarding cardiopulmonary resuscitation (CPR), and to analyze the factors that influence KAP and self-efficacy. An online cross-sectional survey was conducted from February to June 2022 in Mainland China via a self-designed self-filled questionnaire. Potential participants were recruited through WeChat by convenience sampling and snowball sampling methods. Descriptive and quantitative analyses were used for statistical analysis. The survey included 4,450 participants from 31 provinces, autonomous regions, or municipalities across Mainland China, aged 18 or above. The public's average understanding (clear and very clear) of the knowledge regarding CPR was 67.4% (3,000/4,450), with an average proportion of positive attitudes at 96.8% (4,308/4,450). In practice, the average proportion of good practices was 92.8% (4,130/4,450), while the percentage of good self-efficacy averaged at 58.9% (2,621/4,450), only 42.4% (1,885/4,450) of the participants had confidence in the correct use of automated external defibrillator (AED). Pearson correlation analysis showed a significantly positive correlation among knowledge, attitude, practice, and self-efficacy (p < 0.01). Multiple linear regression analysis revealed that several factors have a significant influence on the public's CPR KAP and self-efficacy, including ever having received CPR training (p < 0.001), hearing about AED (p < 0.001), performing CPR on others (p < 0.001), hearing about CPR (p < 0.001), occupation (p < 0.001), personal health status (p < 0.001), education level (p < 0.001), gender (p < 0.001), and encountering someone in need of CPR (p = 0.021). The Chinese public demonstrates good knowledge of CPR, positive attitude, and high willingness to perform CPR. However, there is still room for improvement in the mastery of some professional knowledge points related to CPR and AED. It should be noted that knowledge, attitude, practice, and self-efficacy are interrelated and influence each other. Factors such as prior CPR training, hearing about AED, having performed CPR before, hearing about CPR, occupation, personal health status, education level, gender, and having encountered someone in need of CPR have a significant impact on the public's KAP and self-efficacy.

Publicly available online course as a promising tool for teaching and promoting first aid skills in cardiac arrest

Relevance. The probability of resuscitation in cardiac arrest depends on incident eyewitnesses’ ability to timely and correctly provide first aid to the victim. However, such skills require appropriate training. With poor availability of face-to-face training in cardiopulmonary resuscitation (CPR), alternative training formats, including online e-learning, are gaining prominence to ensure widest dissemination of the life-saving competencies among general population.The objective is to study personal experience and attitudes among the individuals who completed the publicly available open online course on basic CPR (basic life support) skills in order to identify prospects and practical value of such online distance training aimed at CPR skills mainstreaming and better training availability.Methods. From July 2020 to August 2022, we conducted an anonymous survey among individuals who had completed the public open online course on basic life support training presented in Russian language. Our digital questionnaire included 16 questions designed to collect information on prior CPR training experience, training constraints, willingness to engage in volunteer teaching of CPR principles and respondent demographics. Data was analyzed using nonparametric statistics.Results and discussion. The analytical sample included 4342 respondents, mostly residents of Russia (81.1 %), including women (63.1 %), individuals aged under 40 y. (81.2 %), those without prior medical education (84.9 %), as well as schoolchildren and students (41.5 %). 44.2 % of respondents received no prior CPR training before the online course, mainly because they had been unaware of its practical value (39.4 % of respondents without CPR training experience) or had not known where to get trained (34.4 %). 76.3 % of respondents confirmed willingness to engage in volunteer teaching of CPR principles. Willingness to teach CPR to other individuals was related to prior experience of resuscitation training (the rate of respondents ready for CPR teaching was 77.5 % among those with prior resuscitation training and 74.9 % among those without such prior training, p = 0.043).Conclusion. Poor public awareness of CPR training importance and limited availability of training are the major constraints in acquiring life-saving knowledge and skills. As a publicly available tool for remote self-training, including within blended distant-classroom learning, the free online training course opens up great prospects for extensive mainstreaming of first aid skills, offering broad public coverage. The majority of online training graduates are willing to engage in volunteer CPR teaching, thus providing additional opportunities to increase availability of CPR training.

Effectiveness of a Short Refresher Course on the Retention of Cardiopulmonary Resuscitation-Related Psychomotor Skills (REF-CPR).

Cardiopulmonary resuscitation (CPR) skills deteriorate within 6-12 months of formal basic life support (BLS) training. The impact of refresher BLS training timing and format on the retention of CPR-related psychomotor skills is still under investigation. This study aimed to assess the effectiveness of BLS refresher training on the retention of CPR psychomotor skills. This prospective randomized clinical trial was conducted between February 2018 to August 2020 at the Sultan Qaboos University Hospital, Muscat, Oman. Healthcare workers with prior CPR training were enrolled. Baseline CPR-related knowledge and skills were assessed; subsequently, all participants received CPR training until they achieved 100% performance. At six months, a preassessment test was conducted, after which the intervention group received refresher training while the control group did not. At 12 months, both groups underwent assessment. Little Anne® QCPR manikins (Laerdal Corp., Stavanger, Norway) were used to assess CPR performance at each stage. A total of 38 personnel participated in the trial, comprising 19 in each arm. Overall, there were equal numbers of males and females; 21 participants (55.3%) were nurses, 15 (39.5%) were physicians, and two (5.3%) were paramedics. All participants demonstrated good baseline CPR knowledge. Within the intervention and control groups, CPR performance was 72.7% and 75.8% (p = 0.638) at baseline, 87.2% and 88.5% (p = 0.682) at six months, and 93.8% and 79.4% (p = 0.010) at 12 months, perspectively. Refresher CPR training six months after initial training was found to promote skills retention at 12 months.

Immediate psychological impact on citizen responders dispatched through a mobile application to out-of-hospital cardiac arrests

BackgroundActivating citizen responders may increase survival after out-of-hospital cardiac arrest (OHCA) but could induce significant psychological impact on the citizen responders. We examined psychological impact among citizen responders within the first days following resuscitation attempt. Methods and ResultsA mobile phone application to activate citizen responders to perform cardiopulmonary resuscitation (CPR) was implemented in the Capital Region of Denmark. All dispatched citizen responders (September 2017 to May 2019) received a survey 90 minutes after an alarm, including self-rating of perceived psychological impact on a scale of 1–4.Of 5,395 included citizen responders, most (88.6%) completed the survey within 24 hours.The majority reported no psychological impact (68.6%), whereas 24.7%, 5.5% and 1.2% reported low, moderate, or severe impact, respectively. Severe impact was more commonly reported in the following groups: No CPR training (3.8% vs 1.2%, p = 0.02), age < 30 years (2.0% vs 0.9%, p < 0.001), female sex (1.8% vs 0.7%, p < 0.001), provided CPR (2.7% vs 1.0%, p < 0.001), and arrived prior to the emergency medical services (EMS) (2.8% vs 0.7%, p < 0.001) compared to no to moderate impact.Chi square test, Mann-Whitney U test, Fischer’s exact test and a logistic regression model were used to assess differences in psychological impact across groups. ConclusionVery few citizen responders reported severe psychological impact. Lack of prior CPR training, younger age, female sex, performing CPR and arrival prior to the EMS were associated with greater psychological impact. Though very few citizen responders reported severe impact, the possibility of professional debriefing should be considered in citizen responder programs.

Abstract 250: Effect of Coaching on Dispatch-assisted Cardiopulmonary Resuscitation: A Randomized Simulation Study

Introduction: Immediate bystander cardiopulmonary resuscitation (CPR) is essential for the good outcome of sudden cardiac arrest victims. Current guidelines recommend dispatch-assisted CPR (DACPR). Its quality, however, varies from case to case. The aim of this study was todetermine the effectiveness of dispatch coaching on the quality of CPR by lay rescuers. Methods: We conducted a DACPR simulation study. Participants with no prior CPR training within 1 year were assigned randomly to one of two DACPR simulations (No Coaching Group: callers were told to perform CPR and the dispatcher sometimes confirmed if the caller was performing CPR or Coaching Group: the dispatcher coached, encouraged, and counted out loud with a metronome). The study participants performed CPR for 2 minutes under the study dispatcher. All performances were recorded by video camera and Resusci Anne® QCPR (Laerdal, Norway). Results: Forty-nine participants aged 20s to 50s were recruited, and 48 completed the simulation (Coaching Group, 27, 9 males and No Coaching Group, 21, 16 males). The average rate of chest compressions was 102.5/min in Coaching Group and 109.3/min in No Coaching group (p=0.270). The average compression depth was slightly deeper in Coaching group (43.0mm vs 41.5mm, p=0.695). When compared the average depth of the first 10 compressions to the total average in each group, the depth significantly improved in Coaching group while that decreased in No Coaching Groups (38.4mm to 43.0mm; p=0.020, 42.3mm to 41.5mm; p=0.431, respectively). The chest compression fraction was also high in Coaching Group (99.4% vs 93.0%, p=0.005). Conclusions: Participants in Coaching Group performed better CPR compared to No Coaching Group in terms of high flow fraction. Although the average compression depth was below the guideline recommendation in both groups, it significantly improved in Coaching group. This study indicates that dispatch coaching can optimize the performance of bystander CPR.

Abstract 231: Single Bystander CPR Performance During Drone AED Delivery for Simulated Out of Hospital Cardiac Arrest

Background: Drones have great potential to speed the delivery of AEDs in the critical first few minutes of OHCA. However, it is unclear whether bystanders can balance high-quality cardiopulmonary resuscitation (CPR) with AED deployment. The 2015 AHA CPR guidelines recommend a chest compression (cc) rate of 100-120/minute, cc depth of 50-60mm, and cc fraction of &gt;60%. Method: We performed mock cardiac arrest simulations using bystander volunteers, including simulated 911 call, telephone-assisted dispatcher CPR instructions, bystander CPR, drone-delivered AED, and AED application. CPR performance was recorded by a Laerdal Resusci Anne Quality Feedback System and compared between two groups of participants: recent CPR training (&lt;2 years) versus remote (&gt;2 years) or no CPR training. Prior data had shown CPR skill degradation after 2 years. Chi-squared tests compared demographics; T-tests compared age and CPR performance data. Results: Between 9/2019-3/2020, 5 simulations were conducted with 51 participants. The mean age was 39.7 years, 56.9% were female, and 78.4% had a college or graduate degree. Racial/ethnic makeup consisted of 64.7% White, 15.7% African-American, 15.7% Asian, and 11.8% Hispanic. 41.2% had recent CPR training (n=21); 58.8% had remote CPR training (n=19) or no CPR training (n=11). There were no differences in demographics by CPR training groups. Participants with recent CPR training had shorter time from CPR initiation to AED shock delivery (3:45 vs. 4:14 [min:sec], p=0.01) and a trend toward higher percent of time with cc depth (77.4% vs 50.4%, p=0.11) and higher cc fraction (46.8% vs 42.9 %, p=0.12). There were no differences for percent of time with cc rate or CPR recoil. Conclusion: Overall, CPR quality was low regardless of prior CPR training status. Those recently trained had shorter resuscitation time and appeared to have better CPR performance. Realization of a drone AED networks may require novel CPR programs focused on high-quality CPR.

Public perception towards bystander cardiopulmonary resuscitation

ObjectiveBystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest (OHCA) improves survival and neurological outcomes. Nonetheless, many OHCA patients do not receive bystander CPR during a witnessed arrest. Our aim was...

Abstract 194: Public Perception Towards Out-of-Hospital Cardiac Arrest Victims: Potential Reasons Influencing the Decision to Perform Bystander Cardiopulmonary Resuscitation

Background: Bystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest (OHCA) improves survival and neurological outcomes. Unfortunately many OHCA victims do not receive bystander CPR during a witnessed arrest. It is known that gender disparities play a role with lower rates of bystander CPR in women suffering OHCA in public places. Our aim was to identify potential factors influencing the decision to perform bystander CPR. Methods: Participants at CPR training events were surveyed prior to training. Using different scenarios, subjects were asked about their comfort level performing CPR on female, geriatric, and pediatric victims. Anonymous responses were collected and transformed into categorical variables by a psychometrist. Results: Of the 677 participants, 585 (86.4%) responded the survey, with 87.5% between 18-29 years of age, 58.8% without prior CPR training and 93.3% without prior CPR experience. Reasons to hesitate starting bystander CPR in women included concern about exposing the victim (12.9%), being accused of sexual assault (6.1%), and possible pregnancy (6.5%). In participants with prior CPR training, 61.1% reported concerns about performing CPR on women, with 18.9% having concerns about performing chest compressions in relation to breast location. In participants without prior CPR training, 73.2% reported having concerns about performing CPR on women. Causing injury and exposing the patient were top concerns to perform CPR in women amongst participants who were uncomfortable (30.5% and 17.5% respectively) and comfortable (14.5% and 9.8% respectively) performing CPR in public. Causing injury was the top concern in performing CPR on geriatric (45.4%) and pediatric patients (41.7%), followed by fragility (18.1% and 10.2% respectively). Lack of skills to perform CPR on children was reported in 22% of CPR-trained participants. Conclusion: Public perception of OHCA victims influences willingness to perform bystander CPR. Factors such as age, gender, fear of injury, pregnancy status and sexual assault concerns can negatively impact this life saving intervention. Awareness of the importance of bystander CPR on any cardiac arrest victim must be improved.

Abstract 226: Comparison of a Low and High Resource Model to Effectively Train College Students in Compression Only Cardiopulmonary Resuscitation

Introduction: High quality chest compressions, as measured by depth and rate per minute, are an integral component of cardiopulmonary resuscitation (CPR). CPR compression skills are often taught on a high resource training device such as manikin torso. Use of these manikin torso devices may be limited by availability and cost, reducing the number of individuals trained in CPR. We hypothesize that a bed pillow, a low resource device, is as effective as a manikin torso, a high resource device, in training college students to perform compression only CPR. Methods: College students with no prior CPR training were randomized to one of two training rooms, one with a bed pillow (n=119) and one with a manikin torso (n=123). Each participant watched a two- minute training video, which included a demonstration using the respective device and a practice-while-watching technique chest compression skills practice. Each room had a certified CPR instructor to assist and answer any technical questions. Another CPR instructor, blinded to the training randomizations, observed each participant for one minute on a recording manikin that evaluated the depth and rate of compressions. Results: Manikin-trained students had a significantly higher mean rate of compressions per minute compared to the pillow-trained students (122.9 vs. 118.0; p= 0.028). The manikin group exceeded the recommended rate range (100-120 compressions per minute). There was no significant difference between compression depth in the two groups; manikin-trained students had an average compression depth of 38.27 mm while pillow-trained students had an average compression depth of 38.50 mm (p=0.89). Mean compression depth for both groups were below the guidelines (50-61 mm).There was no significant difference (p=0.81) between the overall CPR competency of the pillow-trained compared to the manikin-trained students as measured by rate and depth of compressions. Conclusions: These findings demonstrate that a low resource pillow is comparable to a high resource manikin as a CPR training device. The use of a low resource training device can remove the barriers of cost and availability in training college students in CPR. This training method will allow for an increase in the number of people trained to save lives.

The Effects of Knowledge, Attitude, and Self-efficacy of CPR on Willingness to Perform CPR in Family Members of Patients with Heart Disease

Purpose: The purpose of this study was to investigate the effects of knowledge, attitude, and self-efficacy of cardiopulmonary resuscitation (CPR) and the willingness of family members to perform the CPR to their loved one with heart disease. Methods: 226 participants whose family member is hospitalized with heart disease were recruited from two hospitals in Daegu city. Data were collected by using questionnaires which included demographic characteristics, factors including knowledge, attitude, and self-efficacy and the willingness to perform CPR. Results: Participants reported on their level of knowledge, attitude, and self-efficacy of CPR at the following levels: 9.16±2.66, 35.55±5.56, and 63.83±19.37 respectively. Only 53% of the participants reported prior CPR training, and 67.7% indicated that they would be willing to perform CPR to their family member with heart disease. Of the participants without prior CPR training, 34% reported that they did not recognize the importance of CPR training. Participants reported attitude (p=.002) and self-efficacy (p=.040) predicted willingness to perform CPR. Age (p<.001), gender (p=.004), educational level (p<.001), occupation (p<.001), prior CPR training (p<.001) were related to willingness to perform CPR. Conclusion: This study findings suggest that it is necessary to develop educational programs for public to improve competent CPR performance.

Community involvement in out of hospital cardiac arrest: A cross-sectional study assessing cardiopulmonary resuscitation awareness and barriers among the Lebanese youth.

Out of hospital cardiac arrest (OHCA) is a leading cause of death worldwide. Developing countries including Lebanon report low survival rates and poor neurologic outcomes in affected victims. Community involvement through early recognition and bystander cardiopulmonary resuscitation (CPR) can improve OHCA survival.This study assesses knowledge and attitude of university students in Lebanon and identifies potential barriers and facilitators to learning and performing CPR.A cross-sectional survey was administered to university students. The questionnaire included questions regarding the following data elements: demographics, knowledge, and awareness about sudden cardiac arrest, CPR, automated external defibrillator (AED) use, prior CPR and AED training, ability to perform CPR or use AED, barriers to performing/learning CPR/AED, and preferred location for attending CPR/AED courses. Descriptive analysis followed by multivariate analysis was carried out to identify predictors and barriers to learning and performing CPR.A total of 948 students completed the survey. Participants’ mean age was 20.1 (±2.1) years with 53.1% women. Less than half of participants (42.9%) were able to identify all the presenting signs of cardiac arrest. Only 33.7% of participants felt able to perform CPR when witnessing a cardiac arrest. Fewer participants (20.3%) reported receiving previous CPR training. Several perceived barriers to learning and performing CPR were also reported. Significant predictors of willingness to perform CPR when faced with a cardiac arrest were: earning higher income, previous CPR training and feeling confident in one's ability to apply an AED, or perform CPR. Lacking enough expertise in performing CPR was a significant barrier to willingness to perform CPR.University students in Lebanon are familiar with the symptoms of cardiac arrest, however, they are not well trained in CPR and lack confidence to perform it. The attitude towards the importance of bystander CPR and the need to learn CPR is very positive. Interventions should focus on public awareness campaigns regarding the importance of initiating bystander CPR while activating emergency medical services (EMS) and on making CPR training more available.

Barriers and Facilitators to Community CPR Education in San José, Costa Rica

Bystander cardiopulmonary resuscitation (CPR) improves survival after prehospital cardiac arrest. While community CPR training programs have been implemented across the US, little is known about their acceptability in non-US Latino populations. The purpose of this study was to identify barriers to enrolling in CPR training classes and performing CPR in San José, Costa Rica. After consulting 10 San José residents, a survey was created, pilot-tested, and distributed to a convenience sample of community members in public gathering places in San José. Questions included demographics, CPR knowledge and beliefs, prior CPR training, having a family member with heart disease, and prior witnessing of a cardiac arrest. Questions also addressed barriers to enrolling in CPR classes (cost/competing priorities). The analysis focused on two main outcomes: likelihood of registering for a CPR class and willingness to perform CPR on an adult stranger. Odds ratios and 95% CIs were calculated to test for associations between patient characteristics and these outcomes. Among 371 participants, most were male (60%) and <40 years old (77%); 31% had a college degree. Many had family members with heart disease (36%), had witnessed a cardiac arrest (18%), were trained in CPR (36%), and knew the correct CPR steps (70%). Overall, 55% (95% CI, 50-60%) indicated they would "likely" enroll in a CPR class; 74% (95% CI, 70-78%) would perform CPR on an adult stranger. Cardiopulmonary resuscitation class enrollment was associated with prior CPR training (OR: 2.6; 95% CI, 1.6-4.3) and a prior witnessed cardiac arrest (OR: 2.0; 95% CI, 1.1-3.5). Willingness to perform CPR on a stranger was associated with a prior witnessed cardiac arrest (OR: 2.5; 95% CI, 1.2-5.4) and higher education (OR: 1.9; 95% CI, 1.1-3.2). Believing that CPR does not work was associated with a higher likelihood of not attending a CPR class (OR: 2.4; 95% CI, 1.7-7.9). Fear of performing mouth-mouth, believing CPR is against God's will, and fear of legal risk were associated with a likelihood of not attending a CPR class and not performing CPR on a stranger (range of ORs: 2.4-3.9). Most San José residents are willing to take CPR classes and perform CPR on a stranger. To implement a community CPR program, barriers must be considered, including misgivings about CPR efficacy and legal risk. Hands-only CPR programs may alleviate hesitancy to perform mouth-to-mouth. Schmid KM , Mould-Millman NK , Hammes A , Kroehl M , Quiros García R , Umaña McDermott M , Lowenstein SR . Barriers and facilitators to community CPR education in San José, Costa Rica. Prehosp Disaster Med. 2016;31(5):509-515.

Abstract 12035: Effect of 10-minute Dispatch-Assisted Cardiopulmonary Resuscitation Training in Addition to a Standard Course: A Simulation Study

Introduction: Immediate bystander cardiopulmonary resuscitation (CPR) is essential for the good outcome of sudden cardiac arrest victims. Current guidelines recommend dispatch-assisted CPR (DA-CPR), which can double the frequency of bystander CPR. Laypersons, however, are not familiar with how dispatchers provide CPR instructions. DA-CPR training may be effective at spreading DA-CPR, but this needs to be validated. The aim of this study was to determine the effectiveness of brief DA-CPR training in addition to a standard CPR training course. Methods: We conducted a DA-CPR simulation study. Participants with no prior CPR training within 1 year were assigned randomly to one of two 90-min CPR training courses (DA-CPR Group: a standard CPR course with 10-min DA-CPR training or Standard Group: a standard CPR course with a simple introduction to how dispatchers deal with emergency calls). In the DA-CPR Group, the participants practiced the role of a dispatcher and an emergency caller. At 6 months after training, the subjects performed CPR for 2 min under instruction from off-duty dispatchers. Results: Of the 66 participants, 59 (DA-CPR Group, 30; Standard Group, 29) completed the simulation at 6 months after training. The median time intervals between call receipt and cardiac arrest recognition or instruction for chest compressions by dispatchers were similar between both groups. However, the subjects in the DA-CPR Group provided the first compression more quickly (median time interval between call receipt and the first dispatch-assisted compression: 108 vs. 129 s, respectively, p &lt; 0.05 Mann-Whitney U test). The quality of chest compressions was, however, similar between both groups. Conclusions: All participants could perform DA-CPR at 6 months after training, but those in the DA-CPR Group started chest compressions more quickly. DA-CPR training might be effective for the immediate development of better cooperation between a layperson and a dispatcher.

Perception of CPR quality: Influence of CPR feedback, Just-in-Time CPR training and provider role

AimMany healthcare providers rely on visual perception to guide cardiopulmonary resuscitation (CPR), but little is known about the accuracy of provider perceptions of CPR quality. We aimed to describe the difference between perceived versus measured CPR quality, and to determine the impact of provider role, real-time visual CPR feedback and Just-in-Time (JIT) CPR training on provider perceptions. MethodsWe conducted secondary analyses of data collected from a prospective, multicenter, randomized trial of 324 healthcare providers who participated in a simulated cardiac arrest scenario between July 2012 and April 2014. Participants were randomized to one of four permutations of: JIT CPR training and real-time visual CPR feedback. We calculated the difference between perceived and measured quality of CPR and reported the proportion of subjects accurately estimating the quality of CPR within each study arm. ResultsParticipants overestimated achieving adequate chest compression depth (mean difference range: 16.1–60.6%) and rate (range: 0.2–51%), and underestimated chest compression fraction (0.2–2.9%) across all arms. Compared to no intervention, the use of real-time feedback and JIT CPR training (alone or in combination) improved perception of depth (p<0.001). Accurate estimation of CPR quality was poor for chest compression depth (0–13%), rate (5–46%) and chest compression fraction (60–63%). Perception of depth is more accurate in CPR providers versus team leaders (27.8% vs. 7.4%; p=0.043) when using real-time feedback. ConclusionHealthcare providers’ visual perception of CPR quality is poor. Perceptions of CPR depth are improved by using real-time visual feedback and with prior JIT CPR training.

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

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

Evaluation of a new semiautomated external defibrillator technology: a live cases video recording study

AimTo determine the effect of a new automated external defibrillator (AED) system connected by General Packet Radio Service (GPRS) to an external call centre in assisting novices in a sudden...

Training Mothers in Infant Cardiopulmonary Resuscitation With an Instructional DVD and Manikin

Classes in infant cardiopulmonary resuscitation (CPR) can be time consuming and costly. To determine whether mothers in an obstetric unit could learn infant CPR by using a 22-minute instructional kit and to assess the value and confidence they gained by learning CPR. Quasi-experimental study with enrollment between January and December 2008. Obstetric unit in Lehigh Valley Hospital, a suburban teaching hospital in Allentown, Pennsylvania. Mothers at least 18 years old who had given birth within the previous 24 hours. The experimental group included mothers without prior CPR training who watched a 22-minute instructional DVD and practiced on a manikin. The control group included mothers with prior conventional CPR training. In both groups, knowledge and proficiency were assessed with written and practical examinations developed by certified CPR instructors. Participant surveys were conducted at 3 times: immediately before dissemination of course materials, within 24 hours after the mother agreed to participate in the study, and 6 months after initial evaluation. A total of 126 mothers were enrolled in the study: 79 in the experimental group, 25 in the control group, and 22 who withdrew from the study. Written and practical examinations were used to determine proficiency, and composite scores were generated, with a maximum composite score of 12. The composite scores were statistically significantly higher in the experimental group than in the control group, with median scores of 10 and 7, respectively (P<.001). Twenty-two mothers (21%) had been previously offered CPR training. In the experimental group, 76 mothers (96%) felt more confident as caregivers after learning CPR. Before training in both groups, 84 mothers (81%) stated that learning CPR was extremely important, compared with 100 mothers (96%) after training (P=.001). Use of an instructional kit is an effective method of teaching CPR to new mothers. Mothers reported that learning CPR is extremely important and that it increases their confidence as caregivers.