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

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Matthias Goldstein ◽  
Benjamin Goldstein ◽  
Joel Novograd ◽  
Kailah Carden ◽  
Michelle Kirwan

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.

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046694
Author(s):  
Jiani Mao ◽  
Feng Chen ◽  
Dianguo Xing ◽  
Huixian Zhou ◽  
Ling Jia ◽  
...  

ObjectiveTo evaluate knowledge of cardiopulmonary resuscitation (CPR) among Chinese college students and their attitude towards participating in CPR training and willingness to perform bystander CPR.DesignA cross-sectional study.ParticipantsA total of 1128 college students were selected through a multistage stratified random sampling method from 12 universities in Chongqing, China.Primary and secondary outcomesPrimary outcomes included CPR knowledge and willingness to participate in training and perform bystander CPR; secondary outcomes included CPR training experience and obstacles to training and performing CPR.ResultsThe average score on CPR knowledge was 2.078 (±1.342). Only 45.5% of the respondents were willing to participate in CPR training. Women, respondents who were postgraduate or above, with liberal arts as major and with high CPR knowledge level were more willing to participate in CPR training. A total of 47.2% of the respondents were willing to provide simple assistance, such as checking the consciousness and breathing of the patient and dialling 120 (medical emergency call). Only 34.1% indicated their willingness to perform bystander CPR on strangers. Perceived behavioural control, behavioural attitudes and subjective norms are positive predictors of willingness to provide bystander CPR.ConclusionsCPR knowledge and training rate were low among Chongqing college students. Willingness to participate in training and perform bystander CPR was also low. Improving legislation, strengthening training programmes, incorporating CPR training into the school curriculum and reshaping the social and public culture of offering timely help to those in need are recommended strategies to improve bystander CPR performance.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Hidetada Fukushima ◽  
Keisuke Takano ◽  
Hideki Asai

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.


CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 80-88 ◽  
Author(s):  
Adam Cheng ◽  
Yiqun Lin ◽  
Vinay Nadkarni ◽  
Brandi Wan ◽  
Jonathan Duff ◽  
...  

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.


2019 ◽  
Vol 11 (4) ◽  
pp. 314-317
Author(s):  
Mohammadreza Bastami ◽  
Parand Soliemanifard ◽  
Roholla Hemmati ◽  
Golnaz Forough Ameri ◽  
Mahboobeh Rasouli ◽  
...  

Introduction: There is no agreement on how the hands are positioned in cardiopulmonary resuscitation (CPR). In this study, the effects of two methods of positioning the hands during basic and advanced cardiovascular life support on the chest compression depth are compared.<br /> Methods: In this observational simulation, the samples included 62 nursing students and emergency medicine students trained in CPR. Each student performed two interventions in both basic and advanced situations on manikins and two positions of dominant hand on non-dominant hand, and vice versa, within four weeks. At each compression, the chest compression depth was numerically expressed in centimeter. Each student was assessed individually and without feedback.<br /> Results: The highest mean chest compression depth was related to Basic Cardiovascular Life Support (BCLS) and the position of the dominant hand on non-dominant hand (5.50 ± 0.6) and (P = 0.04). There was no statistically significant difference in the basic and advanced regression variables in men and women except in the case of Advanced Cardiovascular Life Support (ACLS) with dominant hand on non-dominant hand (P = 0.018). There was no significant difference in mean chest compression during basic and advanced cardiovascular life support in left- and right-handed individuals (P = 0.09). <br /> Conclusion: When the dominant hand is on the non-dominant hand, more pressure with greater depth is applied.


BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026140 ◽  
Author(s):  
Shota Tanaka ◽  
Kyoko Tsukigase ◽  
Takahiro Hara ◽  
Ryo Sagisaka ◽  
Helge Myklebust ◽  
...  

Objectives‘Quality Cardiopulmonary Resuscitation (QCPR) Classroom’ was recently introduced to provide higher-quality Cardiopulmonary Resuscitation (CPR) training. This study aimed to examine whether novel QCPR Classroom training can lead to higher chest-compression quality than standard CPR training.DesignA cluster randomised controlled trial was conducted to compare standard CPR training (control) and QCPR Classroom (intervention).SettingLayperson CPR training in Japan.ParticipantsSix hundred forty-two people aged over 15 years were recruited from among CPR trainees.InterventionsCPR performance data were registered without feedback on instrumented Little Anne prototypes for 1 min pretraining and post-training. A large classroom was used in which QCPR Classroom participants could see their CPR performance on a big screen at the front; the control group only received instructor’s subjective feedback.Primary and secondary outcome measuresThe primary outcomes were compression depth (mm), rate (compressions per minute (cpm)), percentage of adequate depth (%) and recoil (%). Survey scores were a secondary outcome. The survey included participants’ confidence regarding CPR parameters and ease of understanding instructor feedback.ResultsIn total, 259 and 238 people in the control and QCPR Classroom groups, respectively, were eligible for analysis. After training, the mean compression depth and rate were 56.1±9.8 mm and 119.2±7.3 cpm in the control group and 59.5±7.9 mm and 116.8±5.5 cpm in the QCPR Classroom group. The QCPR Classroom group showed significantly more adequate depth than the control group (p=0.001). There were 39.0% (95% CI 33.8 to 44.2; p<0.0001) and 20.0% improvements (95% CI 15.4 to 24.7; P<0.0001) in the QCPR Classroom and control groups, respectively. The difference in adequate recoil between pretraining and post-training was 2.7% (95% CI −1.7 to 7.1; pre 64.2±36.5% vs post 66.9%±34.6%; p=0.23) and 22.6% in the control and QCPR Classroom groups (95% CI 17.8 to 27.3; pre 64.8±37.5% vs post 87.4%±22.9%; p<0.0001), respectively.ConclusionsQCPR Classroom helped students achieve high-quality CPR training, especially for proper compression depth and full recoil. For good educational achievement, a novel QCPR Classroom with a metronome sound is recommended.


Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 34
Author(s):  
Byung-Jun Cho ◽  
Seon-Rye Kim

Despite of the changes of out-of-hospital cardiac arrest (OHCA) survival rise when bystander CPR is provided, this was only conducted in about 23% of OHCA patients in Korea in 2018. Police officers acting as first responders have a high chance of witnessing situations requiring CPR. We investigated long-term effects on CPR quality between chest compression-only CPR training and conventional CPR training in police officers to find an efficient CPR training method in a prospective, randomized, controlled trial. Police officers underwent randomization and received different CPR training. With the Brayden Pro application, we compared the accuracy of CPR skills immediately after training and the one after 3 months. Right after training, the conventional CPR group presented the accuracy of the CPR skills (compression rate: 74.6%, compression depth: 66.0%, recoil: 78.0%, compression position: 96.1%) and chest compression-only CPR group presented the accuracy of the CPR skills (compression rate: 74.5%, compression depth: 71.6%, recoil: 79.2%, compression position: 99.0%). Overall, both groups showed the good quality of CPR skills and had no meaningful difference right after the training. However, three months after training, overall accuracy of CPR skills decreased, a significant difference between two groups was observed for compression position (conventional CPR: 80.0%, chest compression only CPR: 95.0%). In multiple linear regression analysis, three months after CPR training, chest compression-only CPR training made CPR skills accuracy 28.5% higher. In conclusion, police officers showed good-quality CPR right after CPR training in both groups. But three months later, chest compression-only CPR training group had better retention of CPR skills. Therefore, chest compression-only CPR training is better to be a standard training method for police officers as first responders.


2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Zahra Farsi ◽  
Mahdieh Yazdani ◽  
Samantha Butler ◽  
Maryam Nezamzadeh ◽  
Jila Mirlashari

Background. The proper implementation of cardiopulmonary resuscitation (CPR) is crucial in saving patients. Purpose. This study was aimed at evaluating the difference in educating nursing students on CPR when using the traditional simulation training with a mannequin versus a more novel serious game training on the smartphone platform. Methods. This randomized control trial was conducted in 2018-2019. Through purposive sampling, 56 nursing students were selected and randomly assigned to three groups: a simulation-based CPR training, CPR training using a serious game on the smartphone platform, and a control group that received no CPR training. Each student was evaluated pre- and posttraining on CPR knowledge and skill. Results. Both the simulation and serious game training groups increased CPR abilities two weeks after training. The control group did not show improvement in skill or knowledge of CPR. The simulation and serious game intervention groups demonstrated better scores on the knowledge questionnaire and on the CPR skill demonstration in comparison to the control group. However, the simulation group and the serious game group showed no significant difference in knowledge ( 9.55 ± 2.81 vs. 7.77 ± 2.46 ; p = 0.065 ) or CPR skill demonstration ( 27.17 ± 2.81 vs. 25.72 ± 3.98 ; p = 0.988 ). The overall scores for CPR knowledge did not meet minimum expectations (70% score) in either the simulation (47.75%) or serious game (38.85%) group. However, both groups demonstrated adequate CPR skill on demonstration (simulation 87.64% and serious game 83.06%). Conclusions. Both the simulation and serious game training groups were found to increase CPR skill. CPR training would likely benefit from a multimodal approach to education.


2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Joris Nas ◽  
Jos Thannhauser ◽  
Robert‐Jan M. van Geuns ◽  
Niels van Royen ◽  
Judith L. Bonnes ◽  
...  

Background Dissemination of cardiopulmonary resuscitation (CPR) skills is essential for cardiac arrest survival. Virtual reality (VR)‐training methods are low cost and easily available, but to meet depth requirements adaptations are required, as confirmed in a recent randomized study on currently prevailing CPR quality criteria. Recently, the promising clinical performance of new CPR quality criteria was demonstrated, based on the optimal combination of compression depth and rate. We now study compliance with these newly proposed CPR quality criteria. Methods and Results Post hoc analysis of a randomized trial compared standardized 20‐minute face‐to‐face CPR training with VR training using the Lifesaver VR smartphone application. During a posttraining test, compression depth and rate were measured using CPR mannequins. We assessed compliance with the newly proposed CPR criteria, that is, compression rate within ±20% of 107/minute and depth within ±20% of 47 mm. We studied 352 participants, age 26 (22–31) years, 56% female, and 15% with CPR training ≤2 years. Among VR‐trained participants, there was a statistically significant difference between the proportions complying with newly proposed versus the currently prevailing quality criteria (52% versus 23%, P <0.001). The difference in proportions complying with rate requirements was statistically significant (96% for the new versus 50% for current criteria, P <0.001), whereas there was no significant difference with regard to the depth requirements (55% versus 51%, P =0.45). Conclusions Lifesaver VR training, although previously found to be inferior to face‐to‐face training, may lead to CPR quality compliant with recently proposed, new quality criteria. If the prognostic importance of these new criteria is confirmed in additional studies, Lifesaver VR in its current form would be an easily available vector to disseminate CPR skills.


2021 ◽  
Author(s):  
Chang Woo Im ◽  
Dong Keon Lee ◽  
You Hwan Jo ◽  
Todd Chang ◽  
Joo Lee Song ◽  
...  

Abstract BackgroundConventional cardiopulmonary resuscitation (CPR) training for the general public involves the use of a manikin and a training video, which has limitations of lack of realism and immersion. To overcome these limitations, virtual reality and extended reality technologies are being used in the field of medical education. The aim of this study is to explore the efficacy and safety of the extended reality (XR)-based basic life support (BLS) training.MethodsThis study is a prospective, multinational, multicentre, randomized controlled study. Four institutions in 4 countries will participate in the study. A total of 154 participants will be randomly assigned to either the XR group or the conventional group stratified by institution and sex (1:1 ratio). Each participant who is allocated to either group will be sent to a separate room to receive training with an XR BLS module or conventional CPR training video. All participants will perform a test on a CPR manikin after the training. The primary outcome will be mean compression depth. The secondary outcome will be overall BLS performances, including compression rate, correct hand position, compression and full release and hands-off time. DiscussionUsing VR to establish a virtual educational environment can give trainees a sense of realism. In the XR environment, which combines the virtual world with the real world, trainees can more effectively learn various skills. This trial will provide evidence of the usefulness of XR in CPR education.Trial registrationClinicalTrials.gov NCT04736888. Registered on 29 January 2021


Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Matthias Goldstein ◽  
Benjamin Goldstein ◽  
Joel Novograd ◽  
Inayzha Wallace ◽  
Leah Goldstein ◽  
...  

Introduction: CPR training and regular skills practice is often limited by the availability of a high resource device such as a manikin torso. We investigated the knowledge gains and attitude changes in student participants of group hands-only CPR training (20-50 participants) using a low resource device, a bed pillow, to practice skills. Methods: Hands-only CPR trainings, utilizing a bed pillow for skills practice, were conducted for groups of college students. Using a one-group pre-test post-test design, participants (n=360) completed a questionnaire which included demographic information, prior history of CPR training, and multiple-choice questions to evaluate knowledge. Five-point Likert scale questions were used to assess attitudes specific to willingness to perform CPR, confidence in ability to perform CPR and likeliness to practice skills in the next year. The survey was completed prior to training. The participants then watched a demonstration followed by interactive skills practice on a pillow. A specially designed printed pillow case was used to show hand position landmarks and review information. The post training survey was then completed and each participant was provided a printed pillow case for future skills practice and review. Results: 129 participants (36%) had no prior CPR training, there were more females 273 (76%) than males, and the average age of participants was 20 years old. Correct knowledge regarding depth of compressions increased by 47% (47 to 94) while speed of compression knowledge increased by 52% (40 to 92). In a paired analysis, there were significant differences (p<.0001) in all attitude measures from pre-to-post training. Willingness to perform CPR increased 31% (gain=0.94, pre test=3.01), confidence to perform CPR, 45% (gain=1.18, pre test=2.64) and likeliness to practice skills in the next year, 20% (gain=0.59, pre test=2.97). Conclusions: Participation in group hands-only CPR training using a low resource device for skills practice resulted in significant knowledge gains and improved attitudes in the areas of willingness to perform CPR, confidence to perform CPR and skills practice likeliness. This training method can provide an accessible and cost-effective means for providing group CPR training.


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