scholarly journals The effect of step stool use and provider height on CPR quality during pediatric cardiac arrest: A simulation-based multicentre study

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 80-88 ◽  
Author(s):  
Adam Cheng ◽  
Yiqun Lin ◽  
Vinay Nadkarni ◽  
Brandi Wan ◽  
Jonathan Duff ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Visual Feedback ◽  
Just In Time ◽  
Average Height ◽  
Compression Depth ◽  
Simulation Based ◽  
Cpr Quality ◽  
Cpr Training ◽  
Gender Specific

AbstractObjectivesWe aimed to explore whether a) step stool use is associated with improved cardiopulmonary resuscitation (CPR) quality; b) provider adjusted height is associated with improved CPR quality; and if associations exist, c) determine whether just-in-time (JIT) CPR training and/or CPR visual feedback attenuates the effect of height and/or step stool use on CPR quality.MethodsWe analysed data from a trial of simulated cardiac arrests with three study arms: No intervention; CPR visual feedback; and JIT CPR training. Step stool use was voluntary. We explored the association between 1) step stool use and CPR quality, and 2) provider adjusted height and CPR quality. Adjusted height was defined as provider height + 23 cm (if step stool was used). Below-average height participants were ≤ gender-specific average height; the remainder were above average height. We assessed for interaction between study arm and both adjusted height and step stool use.ResultsOne hundred twenty-four subjects participated; 1,230 30-second epochs of CPR were analysed. Step stool use was associated with improved compression depth in below-average (female, p=0.007; male, p<0.001) and above-average (female, p=0.001; male, p<0.001) height providers. There is an association between adjusted height and compression depth (p<0.001). Visual feedback attenuated the effect of height (p=0.025) on compression depth; JIT training did not (p=0.918). Visual feedback and JIT training attenuated the effect of step stool use (p<0.001) on compression depth.ConclusionsStep stool use is associated with improved compression depth regardless of height. Increased provider height is associated with improved compression depth, with visual feedback attenuating the effects of height and step stool use.

Advantage and Limitation of Using a Visual Feedback Device during Cardiopulmonary Resuscitation Training

2020 ◽  
Vol 35 (1) ◽  
pp. 104-108
Author(s):  
Chan Woong Kim ◽  
Je Hyeok Oh
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Visual Feedback ◽  
Chest Compression ◽  
Educational Strategy ◽  
Compression Depth ◽  
Trade Off ◽  
Resuscitation Training ◽  
Before And After ◽  
Cpr Training

AbstractIntroduction:Recent cardiopulmonary resuscitation (CPR) guidelines recommend the use of CPR prompt/feedback devices during CPR training because it can improve the quality of CPR.Problem:Chest compression depth and full chest recoil show a trade-off relationship. Therefore, achievement of both targets (adequate chest compression depth and full chest recoil) simultaneously is a difficult task for CPR instructors. This study hypothesized that introducing a visual feedback device to the CPR training could improve the chest compression depth and ratio of full chest recoil simultaneously.Methods:The study investigated the effects of introducing a visual feedback device during CPR training by comparing the results of skill tests before and after introducing a visual feedback device. The results of skill tests from 2016 through 2018 were retrospectively reviewed. The strategy of emphasizing chest compression depth was implemented during the CPR training in 2017, and a visual feedback device was introduced in 2018. The interval between the CPR training and skill tests was seven days. Feedback was not provided during the skill tests.Results:In total, 159 students completed skill tests. Although the chest compression depth increased significantly from 50 mm (42–54) to 60 mm (59–61) after emphasizing chest compression depth (P < .001), the ratio of full chest recoil decreased simultaneously from 100% (100–100) to 81% (39–98; P < .001). The ratio of full chest recoil increased significantly from 81% (39–98) to 95% (77–100) after introducing a visual feedback device (P = .018). However, the students who did not achieve 80% of the ratio of full chest recoil remained significantly higher than in 2016 (1% in 2016, 49% in 2017, and 27% in 2018; P < .001).Conclusions:Although introducing a visual feedback device during CPR training resulted in increasing the ratio of full chest recoil while maintaining the adequacy of chest compression depth, 27% of the students still did not achieve 80% of the ratio of full chest recoil. Another educational strategy should be considered to increase the qualities of CPR more completely.

scholarly journals Randomised controlled trial of simulation-based education for mechanical cardiopulmonary resuscitation training

2019 ◽  
Vol 36 (5) ◽  
pp. 266-272 ◽  
Author(s):  
Andrew R Coggins ◽  
Cameron Nottingham ◽  
Karen Byth ◽  
Kevin R Ho ◽  
Felicia A Aulia ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Statistical Tests ◽  
Controlled Trial ◽  
Intervention Group ◽  
Secondary Outcome ◽  
Control Group ◽  
Resuscitation Training ◽  
Simulation Based ◽  
Cpr Training

IntroductionMechanical cardiopulmonary resuscitation (M-CPR) is increasingly used in the management of cardiac arrest. There are no previously reported randomised studies investigating M-CPR training. This study of newly trained M-CPR providers hypothesised that a brief simulation-based intervention after 4 months would improve M-CPR performance at 6 months.MethodsThis study used a simulated ‘in situ’ cardiac arrest model. The M-CPR device used was a proprietary Lund University Cardiac Assist System 3 machine (Physio Control, Redmond, Washington, USA). Standardised baseline training was provided to all participants. Following training, baseline performance was assessed. The primary outcome measure was the time taken to initiate M-CPR and the secondary outcome was performance against a checklist of errors. Participants were then randomised to intervention group (simulation training) or control group (routine clinical use of M-CPR). After 6 months the outcome measures were reassessed. Comparative statistical tests used an intention-to-treat analysis.Results112 participants were enrolled. The intervention group (n=60) and control group (n=52) had similar demographic characteristics. At the 6-month assessment, median time to M-CPR initiation was 27.0 s (IQR 22.0–31.0) in the intervention group and 31.0 s (IQR 25.6–46.0) in the control group (p=0.003). The intervention group demonstrated fewer errors compared with controls at 6 months (p<0.001)ConclusionIn this randomised study of approaches to M-CPR training, providers receiving additional simulation-based training had higher retention levels of M-CPR skills. Therefore, when resuscitation skills are newly learnt, provision follow-up training should be an important consideration.

scholarly journals Effect of the Use of Metronome Feedback on the Quality of Pediatric Cardiopulmonary Resuscitation

2021 ◽  
Vol 18 (15) ◽  
pp. 8087
Author(s):  
Dongjun Yang ◽  
Wongyu Lee ◽  
Jehyeok Oh
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Healthcare Providers ◽  
Compression Rate ◽  
Audio Feedback ◽  
Simple Method ◽  
Compression Depth ◽  
Pediatric Resuscitation ◽  
Cpr Quality

Although the use of audio feedback with devices such as metronomes during cardiopulmonary resuscitation (CPR) is a simple method for improving CPR quality, its effect on the quality of pediatric CPR has not been adequately evaluated. In this study, 64 healthcare providers performed CPR (with one- and two-handed chest compression (OHCC and THCC, respectively)) on a pediatric resuscitation manikin (Resusci Junior QCPR), with and without audio feedback using a metronome (110 beats/min). CPR was performed on the floor, with a compression-to-ventilation ratio of 30:2. For both OHCC and THCC, the rate of achievement of an adequate compression rate during CPR was significantly higher when performed with metronome feedback than that without metronome feedback (CPR with vs. without feedback: 100.0% (99.0, 100.0) vs. 94.0% (69.0, 99.0), p < 0.001, for OHCC, and 100.0% (98.5, 100.0) vs. 91.0% (34.5, 98.5), p < 0.001, for THCC). However, the rate of achievement of adequate compression depth during the CPR performed was significantly higher without metronome feedback than that with metronome feedback (CPR with vs. without feedback: 95.0% (23.5, 99.5) vs. 98.5% (77.5, 100.0), p = 0.004, for OHCC, and 99.0% (95.5, 100.0) vs. 100.0% (99.0, 100.0), p = 0.003, for THCC). Although metronome feedback during pediatric CPR could increase the rate of achievement of adequate compression rates, it could cause decreased compression depth.

Serious game, lectures or simulation-based mastery learning course which is the best method for training students about cardiac arrest management?

2019 ◽  
Author(s):  
Giuliana Scarpati ◽  
Paolo Remondelli ◽  
Ornella Piazza
Keyword(s):  
Cardiac Arrest ◽  
Medical Students ◽  
Primary Outcome ◽  
Serious Game ◽  
Training Time ◽  
Simulation Based ◽  
Before And After ◽  
Second Year ◽  
Cpr Training ◽  
Passing Score

"Background and aim: This study aimed to compare a serious game and lectures for the pretraining of medical students before learning about simulation-based management of cardiac arrest. Methods: Participants were 150 volunteer second-year medical students between April and June 2018 randomly assigned to CPR training using either lectures (n = 75) or a serious game (n = 75). Each participant was evaluated on a scenario of cardiac arrest before and after exposure to the learning methods. The primary outcome measures were the median total training time needed for the student to reach the minimum passing score. This same outcome was also assessed three months later. Results: The median training time necessary for students to reach the minimum passing score was similar between the two groups (p=0,45). Achieving an appropriate degree of chest compression was the most difficult requirement to fulfill for students in both groups. Singing the refrain of the song ""staying alive"" significantly increased the number of compressions with the correct rate. Three months later, the median training time decreased significantly in both groups. However, students have remained interested in the serious game for a longer time showing a preference for using this method. Conclusions: The serious game was not superior to lectures to pretraining medical students in the management of a cardiac arrest."

scholarly journals Current Status of Knowledge about Cardiopulmonary Resuscitation among the University Students in the Northern Region of Saudi Arabia

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Abdulmajeed Owaid Alsharari ◽  
Abdulrahaman Alduraywish ◽  
Ekremah Ali Al-Zarea ◽  
Naif Ibrahim Salmon ◽  
Md Sayed Ali Sheikh
Keyword(s):  
Saudi Arabia ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
University Students ◽  
Northern Region ◽  
Current Status ◽  
Major Public Health Problem ◽  
Knowledge And Attitude ◽  
The University ◽  
Cpr Training

Background. Sudden cardiac arrest is a major public health problem in the world. Immediate initiation of high-quality cardiopulmonary resuscitation (CPR) significantly increased patient survival rate. Therefore, it is very important to train young people and increase public awareness of CPR for the long-term benefit of the community. Objective. We aimed at estimating the level of knowledge and attitude towards cardiopulmonary resuscitation (CPR) among the university students in the northern region of Saudi Arabia. Methodology. A cross-sectional, prospective study was conducted among the students of four northern region universities of Saudi Arabia (Jouf, Hail, Northern Borders, and Tabuk) between March and November 2017. A self-administered questionnaire was prepared in both Arabic and English languages and distributed to all the participants. All the data were collected and analyzed by using SPSS version 21. Results. A total of 947 students from four universities completed the questionnaire: Jouf (57%), Hail (15%), Northern Borders (13%), and Tabuk (15%). Although 72% of students have previous knowledge about CPR, 49% of them lack knowledge about a medical emergency. Moreover, 59% failed to answer regarding CPR where only 41% wrote the ABC steps in the correct sequence. However, 67% of the participants had very poor knowledge, 89% of participants desired to receive additional CPR training course, and 49% of the students thought that CPR training should be a mandatory graduation requirement for all universities. There were no significant differences between male and female students. Students from medicine-related colleges have significantly (p<0.001) more knowledge and scored better compared with non-medicine-related colleges. Tabuk University scored better compared to the others, but the overall knowledge and attitude scored were low. Conclusions. Overall knowledge about CPR among the university students was not satisfactory; however, attitude towards CRP training was very positive. Our results suggested that there is a need for improvement of CPR education among Saudi university students, which will help to reduce the cardiac arrest mortality rate among the community.

scholarly journals Open Online Course on Basic Cardiopulmonary Resuscitation: Investigation of an Audience and the Effects of Distant Training

2020 ◽  
Vol 16 (2) ◽  
pp. 52-63 ◽  
Author(s):  
A. A. Birkun ◽  
V. R. Dantanarayana
Keyword(s):  
Medical Education ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
First Aid ◽  
Online Course ◽  
Massive Open Online ◽  
Massive Open Online Course ◽  
Level Of Knowledge ◽  
Cpr Training ◽  
Previous Training

Aim. To study the demand for the massive open online course on basic cardiopulmonary resuscitation (CPR), and to evaluate effects of the training based on the socio-demographic profile of the audience.Material and methods. The data obtained from a survey conducted on participants of the online course «First Aid in Cardiac Arrest (Basic Resuscitation)» during a one-year period (07.2018–07.2019) were analyzed, including demographic data, initial and final levels of knowledge on CPR, and willingness to resuscitate a stranger. The 5-point Lickert scale was used for self-assessment of knowledge and willingness to attempt CPR.Results. The analysis includes data collected from 11,924 people, out of which 3,445 (29%) have completed the training. Eighty percent of participants live in the Russian Federation. The mean age of trainees, who completed the course, was 25.7 years, 45% of them were males, 42% had learnt CPR previously, 12% had medical education. As a result of the training, a significant increase (P<0.001) in the willingness to attempt CPR (from 3.26 to 4.16 points) and an increase in self-perceived CPR knowledge (from 2.24 to 3.98 points) were registered. The percentage of trainees who expressed a high level of willingness to perform CPR (4–5 points) increased from 44% to 81% (P<0.001). The course was more likely to be completed by those trainees who had previous training in CPR (p<0.001), who initially demonstrated higher willingness to provide CPR (P=0.003) or a higher level of knowledge in CPR (P<0.001). Trainees who had previous CPR training showed a much higher level of knowledge, higher self-confidence and a higher level of readiness to provide CPR (P<0.001). Approximately 14% of trainees with medical education reported having no previous training in CPR.Conclusions. The massive open online course promotes knowledge of CPR and serves as an important tool for increasing the willingness of lay people to provide first aid in case of cardiac arrest. Previous CPR training is a motivating factor to continue education in resuscitation.

scholarly journals Metronome Use Positively Affect Cardiopulmonary Resuscitation Parameters: Prospective Observational Multicenter Manikin Study

2020 ◽  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Minute Ventilation ◽  
Heart Association ◽  
High Volume ◽  
Compression Rate ◽  
Compression Depth ◽  
Manikin Study ◽  
Volume Ventilation ◽  
Cpr Quality

Objective: Clinical studies have shown that eliminating performer errors is important to ensure high quality cardiopulmonary resuscitation (CPR). Literature on the effects of metronome use on the quality of CPR is scarce. This study aimed to investigate the effect of metronome use on the quality of cardiopulmonary resuscitation. Methods: Thirty volunteer emergency physicians who were divided into 15 groups participated in this prospective, observational, multi-center, manikin study. Firstly, each participant performed conventional CPR on a manikin, and then performed metronome-guided CPR after a short break. Parameters affecting CPR quality were evaluated based on the recommendations of the 2015 American Heart Association CPR and Emergency Cardiovascular Care Guideline. In addition, the fatigue levels of participants were evaluated using the Borg Fatigue Index. Results: Metronome-guided CPR significantly improved the chest compression rate (median (Interquartile Range-IQR); 128 (22) compressions/min vs. 110 (2) compressions/min; 95%CI, p < 0.001), deep compression rate (median (IQR); 95.25 (80) compressions/min vs. 72.63 (105) compressions/min; 95%CI, p < 0.001), compression depth (median (IQR); 62.50 (11) mm vs. 60.25 (14) mm; 95%CI, p = 0.016), ventilation number (median (IQR); 11.25 (6) ventilations/min vs. 9.50 (1) ventilations/min; 95%CI, p = 0.001), high-volume ventilation count (median (IQR); 10.13 (6) ventilations/min vs. 9.50 (1) ventilations/min; 95%CI, p = 0.026), minute ventilation volume (median (IQR); 11.75 (10) L/min vs. 8.03 (3) L/min; 95%CI, p < 0.05), and fatigue levels (median (IQR); 3 (2) vs. 2 (2); in 95%CI, p < 0.05). Conclusions: Our study showed that metronome is a useful device for reaching effective CPR. Metronome guidance may change the CPR parameters positively. This study is in accordance with previous studies which have investigated the effect of metronome-guided CPR on survival.

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

2019 ◽  
Vol 7 (4) ◽  
pp. 311-318 ◽  
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.

Abstract 12052: A Comprehensive Simulation-Based Training for E-CPR Improves the Neurological Outcome of Patients With Refractory Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Takaaki Toyofuku ◽  
Takashi Unoki ◽  
Junya Matsuura ◽  
Yutaka Konami ◽  
Hiroto Suzuyama ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Training Program ◽  
Neurological Outcome ◽  
Hazard Analysis ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Coronary Syndrome ◽  
Simulation Based ◽  
Favorable Neurological Outcome ◽  
Cpr Training ◽  
Refractory Cardiac Arrest

Background: Extracorporeal cardiopulmonary resuscitation (E-CPR) has been utilized as a rescue strategy for patients with refractory cardiac arrest (CA). To improve the outcome of E-CPR, we developed a comprehensive simulation-based E-CPR training program. In the present study we assessed whether the E-CPR training improved the mortality and the neurological outcome. Methods: We have implemented the comprehensive E-CPR simulation training program twice a year to the medical team, which consists of emergency physicians, cardiologists, nurses, clinical engineers, and radiographers using a mock vascular model for E-CPR (ECMO cannulation). We assessed collapse to ECMO time, cumulative 30-day survival and good neurological outcome at hospital discharge defined as the cerebral performance categories (CPC) of 1 or 2. Results: Fifty-three consecutive patients received E-CPR for OHCA from January 2012 to December 2020 in which 31 patients were prior to (until September 2017) and 22 were after (from October 2017) the initiation of the E-CPR training. No differences were found in age, rates of witnessed and bystander-CPR, shockable rhythms, or acute coronary syndrome (ACS). Intra-aortic balloon pump was used in 87% patients prior to and 27% patients after the training (p<0.001), and a microaxial Impella pump was used in 55% after the training. Collapse to ECMO time was significantly shorter after the training (p<0.001). Cumulative 30-day survival and the rate of favorable neurological outcome were significantly higher after the training (p<0.05). Multivariate cox proportional hazard analysis revealed that age (hazard ratio [HR], 1.38 (10 years increase), 95% confidence interval [CI], 1.12-1.73, p=0.002), Collapse to ECMO time (HR, 1.14, 95%CI, 1.04-1.23, p=0.006), and additional Impella use (HR, 0.23, 95% CI, 0.08-0.69, p=0.0009) were significantly associated with the 30-day survival. Conclusions: The E-CPR training significantly improved the collapse to ECMO time. The faster deployment of ECMO improves the neurological outcome and 30-day survival in patients with refractory CA. Additional use of Impella may improve the survival.

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