Low dose- high frequency, case based psychomotor CPR training improves compression fraction for patients with in-hospital cardiac arrest

Background: Low-income and Latino neighborhoods are at high risk for having low provision of bystander CPR for victims of out-of-hospital cardiac arrest (OHCA). Novel community-based intervention is needed in these neighborhoods to increase awareness of CPR techniques and, ultimately, to decrease mortality from OHCA. Objective: To determine the feasibility of a train-the-trainer hands-only CPR program as a required assignment in a middle school. Methods: Design: Prospective survey-based interventional study. Setting: Public charter school in the Denver, CO metropolitan area. Population: Cohort of 118 subjects was recruited out of 134 eligible seventh grade students. Observations: Participants completed a 6-question test to assess baseline knowledge of CPR. Subjects then completed a group hands-only CPR training lasting 1 hour using the CPR Anytime kit, which included both an educational DVD and hands-on practical skills training with an inflatable mannequin. Participants were then asked to use these kits to train other community members over a 2-week period. At the end of the study, students were asked to complete the same 6-question survey to assess their retention of knowledge. Two-sample t-tests were conducted to assess for differences in hands-only CPR knowledge pre- and post-CPR training. Results: Demographics are given for the entire seventh grade class ( Table 1 ). Students were mostly white (71.6%), and 11 (8.2%) participated in the Free & Reduced Lunch program. Of 134 seventh graders attending the school, 118 (88%) completed a pre-intervention survey and 74 (55%) completed a post-intervention survey. Between the surveys, the mean number of questions answered correctly increased ( Table 2 ), as did performance on the question asking where to place AED pads on the chest (p < .001). Students performed poorest in both pre- and post-testing on identifying the appropriate situation for performing hands-only CPR. Conclusion: Implementation of a school-based train-the-trainee CPR education program is a feasible endeavor. Students demonstrated increased knowledge of CPR techniques two weeks after training compared to baseline. Future studies will need to be conducted to assess the people who are then trained by these students using the CPR Anytime Kits.

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Public Opinion on Community Basic Cardiopulmonary Resuscitation Training: a Survey of Inhabitants of the Crimean Peninsula

Russian Sklifosovsky Journal Emergency Medical Care ◽

10.23934/2223-9022-2018-7-4-311-318 ◽

2019 ◽

Vol 7 (4) ◽

pp. 311-318 ◽

Cited By ~ 1

Author(s):

A. A. Birkun ◽

Y. A. Kosova

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Fatal Outcome ◽

Motivation To Learn ◽

Potential Health ◽

Crimean Peninsula ◽

Resuscitation Training ◽

Cpr Training ◽

Hospital Cardiac Arrest ◽

The Crimean Peninsula

Background.The chances of fatal outcome in out-of-hospital cardiac arrest are exceeding 90%. However, the early initiation of bystander cardiopulmonary resuscitation (CPR) substantially improves the probability of survival. The study was aimed to determine the extent of community CPR training, level of CPR knowledge, willingness and motivation to learn CPR among the population of the Crimea.Materials and methods.The representative sample of adult residents of the Crimean Peninsula (n=384) has been surveyed by means of individual structured interview from November 2017 to January 2018. The results were analyzed with social statistics.Results.According to the survey, 53% of respondents were previously trained in CPR. The training was performed mainly (82%) at work, school, college/technical school or university, or when acquiring a driver's license. The majority of females, people over 60, unemployed and retired, widowed and those with monthly income lower than 20,000 roubles are not trained. Of previously trained, 44% respondents attended a single CPR course, 72% were trained more than one year ago, 47% of participants had no previous training in CPR, mostly never thinking about the need to go for training. Being dependent from previous CPR training, the knowledge of CPR is generally poor: the proportions of correct answering as of the proper location and rate of chest compressions were 46% and 4%, respectively. Among the respondents, 56% expressed their willingness to attend CPR training. The main motivating factors to attend CPR training were awareness of importance of CPR training, potential health problems in relatives/friends and free-of-charge training.Conclusion.The Crimean population is insufficiently and non-uniformly trained in CPR, has limited knowledge of CPR and low motivation to learn. In order to increase the commitment of the community to provide first aid in out-of-hospital cardiac arrest, mass CPR training programs should be implemented with active involvement of the least trained and motivated social strata.

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Abstract 446: Availability and Quality of Cardiopulmonary Resuscitation Films Featuring a Female Victim on the Internet: A Cross-Sectional Study

Circulation ◽

10.1161/circ.140.suppl_2.446 ◽

2019 ◽

Vol 140 (Suppl_2) ◽

Author(s):

Carlos Lynes ◽

Lorrel Brown

Keyword(s):

Cardiac Arrest ◽

Gender Disparity ◽

Hand Position ◽

Female Victim ◽

High Quality ◽

Cross Sectional ◽

Key Aspects ◽

Cpr Training ◽

Hospital Cardiac Arrest ◽

The U.S

Introduction: Bystander cardiopulmonary (CPR) improves survival following out-of-hospital cardiac arrest (OHCA). However, women are less likely than men to receive CPR in public locations. Female-specific issues such as fear of touching breasts have been identified as barriers to performing CPR on women. The purpose of this study was to quantify and evaluate online CPR instructional films featuring a female victim. Methods: Using the search query “how to do CPR” via Google and YouTube, 374 and 500 films (38 and 25 result pages), respectively, were reviewed in May 2019. Exclusion criteria included: non-English, non-instructional, pediatric or animal victim, duplicates, parity, or in-hospital cardiac arrest. We identified 11 films featuring a female victim. These films were scored on 6 key aspects of CPR education: scene safety, check responsiveness, activate Emergency Medical Services, proper hand position, accurate rate, and appropriate depth of compressions. Results: Of the 874 reviewed films, 11 featured a female victim. Just 5 films were high-quality (correctly addressing 5 or 6 key aspects of CPR training, Figure 1). Furthermore, 2 of the 5 high-quality instructional films taught rescue breathing, which is no longer a recommended component of bystander CPR in the U.S. The remaining 3 films were all created outside the U.S. (Australia, New Zealand, England). None of the films explicitly addressed barriers to performing CPR on a female, including fear of touching breasts or concerns about causing harm. Conclusion: Out of the billions of films available online, we identified only 3 high-quality instructional films teaching modern, hands-only CPR featuring a female victim, none of which addressed specific female-related CPR issues. This gender disparity can be addressed with high-quality CPR training films that feature a female victim and explicitly address previously-identified barriers to performing CPR on a female.

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Differential effects on out-of-hospital cardiac arrest of dihydropyridines: real-world data from population-based cohorts across two European countries

European Heart Journal - Cardiovascular Pharmacotherapy ◽

10.1093/ehjcvp/pvz038 ◽

2019 ◽

Vol 6 (6) ◽

pp. 347-355 ◽

Cited By ~ 1

Author(s):

Talip E Eroglu ◽

Grimur H Mohr ◽

Marieke T Blom ◽

Arie O Verkerk ◽

Patrick C Souverein ◽

...

Keyword(s):

Cardiac Arrest ◽

General Population ◽

Calcium Channels ◽

Cardiac Electrophysiology ◽

Low Dose ◽

Population Based ◽

High Dose ◽

Real World Data ◽

Registration System ◽

Hospital Cardiac Arrest

Abstract Aims Various drugs increase the risk of out-of-hospital cardiac arrest (OHCA) in the general population by impacting cardiac ion channels, thereby causing ventricular tachycardia/fibrillation (VT/VF). Dihydropyridines block L-type calcium channels, but their association with OHCA risk is unknown. We aimed to study whether nifedipine and/or amlodipine, often-used dihydropyridines, are associated with increased OHCA risk, and how these drugs impact on cardiac electrophysiology. Methods and results We conducted a case–control study with VT/VF-documented OHCA cases with presumed cardiac cause from ongoing population-based OHCA registries in the Netherlands and Denmark, and age/sex/index date-matched non-OHCA controls (Netherlands: PHARMO Database Network, Denmark: Danish Civil Registration System). We included 2503 OHCA cases, 10 543 non-OHCA controls in Netherlands, and 8101 OHCA cases, 40 505 non-OHCA controls in Denmark. To examine drug effects on cardiac electrophysiology, we performed single-cell patch-clamp studies in human-induced pluripotent stem cell-derived cardiomyocytes. Use of high-dose nifedipine (≥60 mg/day), but not low-dose nifedipine (<60 mg/day) or amlodipine (any-dose), was associated with higher OHCA risk than non-use of dihydropyridines [Netherlands: adjusted odds ratios (ORadj) 1.45 (95% confidence interval 1.02–2.07), Denmark: 1.96 (1.18–3.25)] or use of amlodipine [Netherlands: 2.31 (1.54–3.47), Denmark: 2.20 (1.32–3.67)]. Out-of-hospital cardiac arrest risk of (high-dose) nifedipine use was not further increased in patients using nitrates, or with a history of ischaemic heart disease. Nifedipine and amlodipine blocked L-type calcium channels at similar concentrations, but, at clinically used concentrations, nifedipine caused more L-type calcium current block, resulting in more action potential shortening. Conclusion High-dose nifedipine, but not low-dose nifedipine or any-dose amlodipine, is associated with increased OHCA risk in the general population. Careful titration of nifedipine dose should be considered.

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Abstract 294: Different Effect of Bystander CPR According to Dispatcher-Assistance on Neurologic Outcome in Out-Of-Hospital Cardiac Arrest

Circulation ◽

10.1161/circ.140.suppl_2.294 ◽

2019 ◽

Vol 140 (Suppl_2) ◽

Author(s):

Jieun Pak ◽

Tae Han Kim ◽

Min Woo Kim ◽

Jong Hwan Kim ◽

Ki Jeong Hong ◽

...

Keyword(s):

Cardiac Arrest ◽

Final Analysis ◽

Neurologic Outcome ◽

Multivariable Logistic Regression Model ◽

Emergency Medical Dispatch ◽

Ambulance Transport ◽

Bystander Cpr ◽

Cpr Training ◽

Hospital Cardiac Arrest

Introduction: Bystander CPR is an important prognostic factor for outcome in out-of-hospital cardiac arrest (OHCA). Dispatcher-assisted(DA) CPR program have shown to successfully increase rate of bystander CPR in communities. However DA-CPR is usually targeted for bystanders with no or lower level of CPR training compared to bystanders who are able to perform CPR without dispatcher assistance. We evaluated the effect of bystander CPR separately according to presence of dispatcher assistance on neurologic outcome. Methods: Retrospective analysis was performed using nationwide OHCA database from 2014 to 2017. Adult EMS treated OHCA with presumed cardiac origin were enrolled. EMS witnessed arrest and arrest occurred during ambulance transport were excluded. Bystander CPR was classified into 2 groups according to presence of DA-CPR instruction from emergency medical dispatch center. Rate of favorable neurologic outcome (CPC 1 or 2) was compared according to type of bystander CPR. Multivariable logistic regression model was used to estimate effect of bystander CPR type on outcomes. Results: Total of 72,314 eligible OHCA were enrolled for final analysis. Proportion of patients with favorable neurologic outcome was highest in bystander CPR without dispatcher assistance. (8.6% for bystander CPR without DA, 5.0% for bystander CPR with DA and 2.9% for no bystander CPR, p<0.01). Bystander CPR with DA was associated with higher chance of good neurological recovery than no bystander CPR, effect on neurologic outcome was significantly different than bystander CPR without DA(adjusted OR with 95% CI (bystander CPR with DA as reference): 0.61[0.55-0.67] for no-bystander CPR , 1.24[1.14–1.36] for bystander CPR without DA) Conclusion: Bystander CPR with DA showed positive effect on neurologic outcome compared to no-bystander CPR. However bystander CPR with DA was less effective than bystander CPR performed without dispatcher assistance. To improve quality of bystander CPR with dispatcher assistance, strategy to monitor and give feedback bystander CPR during dispatcher assistance should be developed and implemented in dispatch center.

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Low-Dose, High-Frequency CPR Training Improves Skill Retention of In-Hospital Pediatric Providers

PEDIATRICS ◽

10.1542/peds.2010-2105d ◽

2011 ◽

Vol 128 (1) ◽

pp. peds.2010-2105d-peds.2010-2105d

Keyword(s):

High Frequency ◽

Low Dose ◽

Skill Retention ◽

Hospital Pediatric ◽

Cpr Training ◽

Pediatric Providers

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Abstract 251: Characterizing Bystanders and Their Actions in Response to Out of Hospital Cardiac Arrest

Circulation ◽

10.1161/circ.142.suppl_4.251 ◽

2020 ◽

Vol 142 (Suppl_4) ◽

Author(s):

Kristopher Torossian ◽

Mina Altwail ◽

Ryan Paternoster ◽

Eddie Ford ◽

Robert A Swor

Keyword(s):

Cardiac Arrest ◽

Prospective Observational Study ◽

Patient Survival ◽

Educational Programs ◽

Paper Survey ◽

Private Homes ◽

Cpr Training ◽

Physical Reasons ◽

Panic Assessment ◽

Hospital Cardiac Arrest

Background: Bystander actions upon witnessing a cardiac arrest are crucial to improving patient survival. Bystander perceptions and actions when witnessing a cardiac arrest are complex and not well understood. Our study has three primary aims: 1) To characterize CA bystanders demographics, 2) To understand the events from patient collapse until EMS arrival, with a focus on telecommunicator or dispatcher-assisted CPR (T-CPR), and 3) Bystander knowledge/ training in CPR and their actions at the time of CA. Methods: This is a prospective observational study conducted on bystanders of out of hospital cardiac arrests (OHCA) serviced by EMS agencies in southeast Michigan. OHCA patients were identified from 3/2018- 12/2019, and bystanders of these events surveyed. Surveys were mailed to non-medical addresses with an introductory letter and paper survey. A phone interview was conducted to describe bystander demographics, events from collapse to EMS arrival, and their actions including CPR performance. We inquired regarding telecommunicator CPR instructions (T-CPR), and if CPR was not performed what were the barriers. Results: During our study period, 126 surveys were mailed, and of these 47 bystander surveys were completed. The majority of events occurred in private homes (37/47,78.7%). Few patients (10, 21.2%) survived to discharge. The bystander and patient age were (mean, range)were 62.9 (30-91 ) and 69.3 (30-100) respectively. The majority were female 27/47(57.4%), most 43/47 (91.4%) knew the patient and were family (34/47,72.3%). Bystanders knew the patient a median(range) of 32 (0-68) years. A majority of bystanders (31/47,66.0%) had CPR training and 19 performed CPR. Of the 14/47 (27.8%) that received T-CPR instructions, 9 performed CPR. CPR trained bystanders that did not perform CPR(8/31), identified panic, assessment barriers and physical reasons for not performing CPR. Conclusion: In this preliminary work, we identify that bystanders to OHCA are most often family, of similar age to the patient and knew the patient for decades. CPR educational programs should prepare trainees to know that they may well respond to loved ones. Further researcher characterizing bystanders and their actions are needed to improve cardiac arrest outcomes.

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PENGARUH MEDIA PEMBELAJARAN DENGAN VAF TERHADAP PENGETAHUAN ANAK USIA SEKOLAH TENTANG RJP DI SDN KAMPUNGDALEM 3 DAN 4 KOTA KEDIRI

Dunia Keperawatan ◽

10.20527/dk.v5i2.4117 ◽

2017 ◽

Vol 5 (2) ◽

pp. 129

Author(s):

Yunita Wahyu Wulansari, ◽

Yuyun Yueniwati Prabowowati Wadjib, ◽

Tony Suharsono

Keyword(s):

Experimental Study ◽

Cardiac Arrest ◽

Significant Influence ◽

Control Group ◽

Training Module ◽

Control Group Design ◽

Group Design ◽

Bystander Cpr ◽

Cpr Training ◽

Hospital Cardiac Arrest

ABSTRAKJumlah bystander RJP sebagai penolong pertama korban out of hospital cardiac arrest (OHCA) yang masih rendah menjadi sorotan di berbagai negara. Upaya yang dapat dilakukan yaitu dengan memberikan pelatihan RJP di komunitas. Penelitian ini bertujuan untuk menganalisis pengaruh media pembelajaran dengan VAF (Video Animasi Fabel) terhadap pengetahuan tentang RJP. Penelitian ini menggunakan metode true eksperimental dengan rancangan randomized subject, pretest-posttest control group design pada 120 responden yang dibagi menjadi dua kelompok penelitian, yaitu kelompok eksperimen dengan media VAF dan kelompok kontrol dengan media modul yang diambil dengan tiga kali pengukuran. Lokasi penelitian di SDN Kampungdalem 3 dan 4 Kota Kediri. Hasil analisis menunjukkan pada kedua kelompok penelitian memberikan pengaruh yang signifikan terhadap pengetahuan (p = 0,000). Perbedaan yang signifikan (p < 0,05) antara kelompok VAF dan modul yaitu pada setelah dan satu minggu setelah pelatihan RJP. Hal ini menunjukkan bahwa pelatihan RJP dengan menggunakan media VAF lebih efektif daripada modul terhadap pengetahuan tentang RJP pada anak usia SD.Kata Kunci: modul, pelatihan RJP, video animasiABSTRACTThe number of bystander CPR as the first helper of out of hospital cardiac arrest (OHCA) is still low in various countries. The effort that can be done is by providing CPR training in the community. This study aims to analyze the influence of learning media with fabel animation video (VAF) to knowledge about CPR. This true experimental study with randomized subject, pretest-posttest control group design have been done on 120 respondents divided into 2 groups that is VAF and module with three times measurement in SDN Kampungdalem 3 and 4 Kota Kediri. The result of this study indicate that in both groups has a significant influence on knowledge (p = 0,000). Significant differences between VAF and module are on after and one week after CPR training. This suggest that CPR training using VAF provides more effective than module on CPR knowledge in children.Keywords: animation video, CPR training, module

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Emergency staffers could guide local health-care providers constructing a team of mass CPR instructors: a survey report of knowledge and attitudes from Shenzhen City, China.

10.21203/rs.3.rs-15697/v1 ◽

2020 ◽

Author(s):

Jinle Lin ◽

Conghua wang ◽

Yi Luo ◽

Wenwu Zhang ◽

Qingli Dou ◽

...

Keyword(s):

Health Care ◽

Cardiac Arrest ◽

Health Care Providers ◽

Local Health ◽

Care Providers ◽

Knowledge And Attitudes ◽

Local Health Care ◽

Emergency Group ◽

Cpr Training ◽

Hospital Cardiac Arrest

Abstract Background Few investigations concern about why the local health-care providers participate in mass Cardiopulmonary Resuscitation (CPR) training in developing countries. This study aimed to survey knowledge and attitudes of local health-care providers who candidate to be mass CPR instructors in China. Method This was a retrospective survey study. Data were obtained from candidates being mass CPR instructors (n=496) between March 2018 and December 2018. Whether they belonged to the emergency group or non-emergency group was based on their service department. The outcome was passed in the final examination. Binary logistic regression was performed to analysis. Result Passed rate in emergency group is higher than non-emergency groups (90.7%, 175/194 vs. 83.8%, 253/302, P =0.042).Consisting with higher frequency on receiving CPR training, emergency staffers were richer in dealing emergency situation such as out-of-hospital cardiac arrest (58.2%), In-of-hospital cardiac arrest (95.4%), use of an automatic external defibrillator (AED) (96.4%), traumatic hemorrhage (83.5%), suffocation(74.2%), syncope (53.1%) and epilepsy (79.4%). In despite, younger group ( OR : 0.957, 95% CI [0.925-0.990]), previous training of AED ( OR : 2.698, 95% CI [1.441-5.050]) and pecuniary motivation (OR : 3.176, 95% CI [1.231-8.191]) independently affects being mass CPR instructors among health-care provider. Conclusion Because of better knowledge and skill, emergency staffers have ability to lead local health-care providers to build a team of mass CPR instructors. Our findings can be used to conduct public emergency education for health policy design in China.

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