Challenges in Basic Life Support and Automated External Defibrillator Training of Deaf People

Abstract BackgroundBasic life support (BLS) with the use of an automated external defibrillator (AED) is a fundamental link to a successful chain of survival of patients with cardiac arrest. However, the BLS protocol is not tailored for deaf people who encounter many challenges during BLS training. MethodsAfter an ergonomic analysis and modifications of the BLS and AED protocol, a practical course was conducted. A pre-course BLS and AED knowledge was tested with a questionnaire. After the course, each participant practically solved a cardiac arrest scenario on a manikin and qualitative and quantitative data on BLS and AED performance were collected with a modified Cardiff test and the QCPR mobile application. Results of the knowledge test and performance were presented with frequencies and correlations between pre- and post-course BLS and AED knowledge and performance were analyzed and presented with Spearman’s rho. Results51 deaf volunteers from seven Slovenian societies for deaf people participated in the study. Results on the pre-course knowledge test were poor (3.5 points out of 10). BLS performance according to the modified Cardiff test post-course was also poor: 52.9 % of the participants used a safe approach, 58.8 % checked responsiveness and 51.0 % sent a text message to the rescue service. Only 43.1 % of them opened the airway and 49.0% checked initial breathing. 80.4% of the deaf rescuers performed chest compressions on the lower half of the sternum but only 52.9 % of them compressed with adequate depth. According to the QCPR application the best performance was achieved with the compression score of 61.1 % and flow fraction 74.9%.ConclusionsThis study shows that a more comprehensive and assidiuous approach is needed for effective BLS and AED training courses for deaf people.

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Challenges in basic life support and automated external deﬁbrillator training of deaf individuals

10.22514/sv.2021.019 ◽

2021 ◽

Keyword(s):

Basic Life Support ◽

Life Support ◽

Text Message ◽

Automated External Defibrillator ◽

Training Methods ◽

Knowledge Test ◽

Rescue Service ◽

Training Courses ◽

And Performance ◽

External Defibrillator

Objectives: Basic life support (BLS) with the use of an automated external defibrillator (AED) is linked to survival of patients with out-of-hospital cardiac arrest (OHCA). However, the BLS protocol is not tailored to specific needs of the deaf who encounter many challenges during BLS training. Methods: The BLS and AED protocol was modified according to the challenges faced by deaf people. Pre-course BLS and AED knowledge was tested using a questionnaire. After completion of a practical course, each participant was presented with an OHCA scenario using a manikin. Qualitative and quantitative data on BLS and AED performance were collected with a modified Cardiff test and the QCPR mobile application. Results of the knowledge test and performance scores are presented with values and frequencies. Correlations between pre- and post-course BLS and AED knowledge and performance were analyzed and presented with Spearman’s rho. Results: 51 deaf volunteers from seven Slovenian deaf associations participated in the study. The pre-course knowledge test scores were 3.5 points out of 10 and considered low. The rest of the results were also poor. BLS performance using the modified Cardiff test post-course was as follows: 52.9% of the participants used a safe approach, 58.8%checked responsiveness and 51.0% sent a text message to the rescue service. Only 43.1% opened the airway and 49.0% checked initial breathing. 80.4% of deaf rescuers performed chest compressions on the lower half of the sternum and 52.9% compressed with adequate depth. According to the QCPR application the best performance was achieved with a compression score of 61.1% and flow fraction 74.9%. Conclusions: This study shows that a comprehensive and assiduous approach is needed for effective BLS and AED training courses for deaf individuals.

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In-hospital first-responder automated external defibrillation: what critical care practitioners need to know

American Journal of Critical Care ◽

10.4037/ajcc1998.7.4.314 ◽

1998 ◽

Vol 7 (4) ◽

pp. 314-319 ◽

Cited By ~ 14

Author(s):

ME Mancini ◽

W Kaye

Keyword(s):

Cardiac Arrest ◽

Critical Care ◽

Basic Life Support ◽

Life Support ◽

Survival Rates ◽

First Responders ◽

Critical Care Nurses ◽

Automated External Defibrillator ◽

Coronary Care ◽

External Defibrillator

Despite the development and widespread implementation of Basic Life Support and Advanced Cardiac Life Support, the percentage of patients who survive in-hospital cardiac arrest has remained stable at approximately 15%. Although survival rates may approach 90% in coronary care units, survival rates plummet outside of these units. The lower survival rates for cardiac arrest that occur outside of the coronary care unit may relate to the time elapsed between the onset of ventricular fibrillation and first defibrillation. The advent of automated external defibrillators has made it possible to decrease the time elapsed before first defibrillation in non-critical care areas of the hospital. First responders need only recognize that the patient is unresponsive, apneic, and pulseless before attaching and activating the automated external defibrillator. Our research shows that, as part of Basic Life Support training, non-critical care nurses can learn to use the device and can retain the knowledge and skill over time. Establishing an in-hospital automated external defibrillator program requires commitment from administration, physicians, and nursing personnel. Critical care practitioners should be aware of this technology and the literature that supports its safety and effectiveness when used by non-critical care first responders. Critical care nurses are in a unique position to effect changes that will decrease the time between the onset of cardiac arrest and first defibrillation.

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Basic life support equipped with automated external defibrillator may not be categorized the same as traditional basic life support in meta-analysis

Resuscitation ◽

10.1016/j.resuscitation.2011.06.041 ◽

2011 ◽

Vol 82 (12) ◽

pp. e7

Author(s):

Patrick Chow-In Ko ◽

Ming-Tai Cheng ◽

Edward Pei-Chuan Huang ◽

Wen-Chu Chiang ◽

Matthew Heui-Ming Ma

Keyword(s):

Basic Life Support ◽

Life Support ◽

Meta Analysis ◽

Automated External Defibrillator ◽

External Defibrillator

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Abstract 147: Rapid Responder Operating Times for Out-of-hospital Cardiac Arrest Using Three Automated External Defibrillator Models

Circulation ◽

10.1161/circ.142.suppl_4.147 ◽

2020 ◽

Vol 142 (Suppl_4) ◽

Author(s):

Mengqi Gao ◽

Chenguang Liu ◽

Dawn Jorgenson

Keyword(s):

Cardiac Arrest ◽

Life Support ◽

Operating Time ◽

Sudden Cardiac Arrest ◽

The United States ◽

Automated External Defibrillator ◽

Simulation Studies ◽

Time Intervals ◽

Shock Delivery ◽

External Defibrillator

Background: Early defibrillation with an automated external defibrillator (AED) is crucial for improving the survival rate in out-of-hospital resuscitation from sudden cardiac arrest (SCA). Chance of survival decreases by 7% to 10% for every minute that defibrillation is delayed. While simulation studies have been used to assess AED usability factors, our objective was to report the actual operating time for three Philips AED models used in SCA responses. Methods: A convenience dataset recorded by Philips AEDs (HS1, FRx, or FR3) was obtained from Europe and the United States from 2007 - 2018. The HS1 is intended for minimally trained or untrained individuals, the FRx is for Basic Life Support (BLS), and the FR3 is for both BLS and Advanced Life Support (ALS) responders. A retrospective analysis was conducted to report the operating time intervals for cases where a shock was delivered after initial rhythm analysis. The study analyzed 90 HS1, 46 FRx and 32 FR3 cases. Results: Compared with HS1, both FRx (p < 0.001) and FR3 (p = 0.001) responders spent less time in placing pads on the patient after powering on the AED (Figure 1) as expected. Similarly, time intervals from the start of shock advised prompt to first shock delivery for FRx (p = 0.02) and FR3 (p < 0.01) are shorter than for HS1. Time from AED power-on to first shock was within 90 seconds in 74.4% (67 of 90) HS1 cases, 97.8% (45 of 46) FRx cases, and 100% (32 of 32) FR3 cases. On average, the FR3 and FRx responders were able to deliver the first shock within 48 seconds. Conclusions: The analysis shows that responders were able to quickly apply the AEDs and respond to the shock advisory prompt for all three AED models despite different training levels. This real-world performance is better than most reported simulation studies, however, this analysis cannot convey variety of activities that account for the differences in timing (e.g. pads applied before power-on, or compressions began before applying pads, etc.).

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Basic Life Support (BLS) and Automated External Defibrillator (AED) Course for Personnel in Kobe University Hospital

Prehospital and Disaster Medicine ◽

10.1017/s1049023x0001431x ◽

2005 ◽

Vol 20 (S1) ◽

pp. 101-101

Author(s):

T. Kawashima ◽

N. Ishii ◽

H. Nakao ◽

Y. Maeda ◽

M. Terukina ◽

...

Keyword(s):

Basic Life Support ◽

Life Support ◽

University Hospital ◽

Automated External Defibrillator ◽

External Defibrillator

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Development, validation and assessment of the test on knowledge about basic life support and use of automated external defibrillator among schoolchildren

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-019-0683-6 ◽

2019 ◽

Vol 27 (1) ◽

Cited By ~ 1

Author(s):

Vesna Borovnik Lesjak ◽

Andrej Šorgo ◽

Matej Strnad

Keyword(s):

Basic Life Support ◽

Life Support ◽

Statistical Significance ◽

Automated External Defibrillator ◽

Multiple Choice Questions ◽

Chi Square ◽

Before And After ◽

Baseline Knowledge ◽

Potential Improvement ◽

External Defibrillator

Abstract Background Educating lay public can significantly strengthen the Chain of Survival after out of hospital cardiac arrest. Schoolchildren are an accessible population for learning basic life support (BLS) and use of an automated external defibrillator (AED) and can be regarded as multipliers of knowledge that can reach the whole population. This study aimed to develop and validate a test for examining levels of knowledge about BLS and AED among schoolchildren that can be used to uniformly present reliable data. Methods A knowledge test about BLS and AED consisting of 10 multiple-choice questions was developed and implemented before and after a 2-h BLS and AED course consisting of an interactive lecture and a practical workshop for 783 students in seventh and ninth grades of elementary schools in Maribor, Slovenia. Each question was analyzed and presented with descriptive statistics and educometric parameters (difficulty and discriminating indices). All variables were checked for normality with the Kolmogorov-Smirnov test and analyzed using non-parametric tests. Statistical significance of the differences in knowledge before and after intervention were calculated with chi-square statistics and effect sizes r are reported. Differences between genders, grades and previous attendance to BLS courses were compared using Mann – Whitney U test. The effect size was calculated from the Z score and reported as r value. Results After educometric analysis, questions were adjusted to meet the requirements of satisfactory functioning difficulty and discriminating indices (values between 0,40 and 0,60, and above 0,20, respectively). Only one question had to be eliminated due to inadequate difficulty and discriminating index (0,99 and 0,02, respectively). Measurement invariance across gender (p < 0,001), school grade (p < 0,001), and attendance to previous courses (p = 0,303) was assured. Conclusions A test for accurate and reliable measurement of knowledge of BLS and AED among schoolchildren was developed and validated. According to the findings it can now reliably be used to assess baseline knowledge and potential improvement in knowledge after a course on BLS and AED. Standardized data gathered with a validated tool can now be presented at legislative levels to promote BLS and AED courses implementation in school curricula.

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