Teaching basic life support (original) (raw)

Randomised controlled trials of staged teaching for basic life support. 2. Comparison of CPR performance and skill retention using either staged instruction or conventional training

Resuscitation, 2001

We have investigated a method of teaching community CPR in three stages instead of in a single session. These have been designated bronze, silver, and gold stages. The first involves only opening of the airway and chest compression with back blows for choking, the second adds ventilation in a ratio of compressions to breaths of 50:5, and the third is a conversion to conventional CPR. In a controlled randomised trial of 495 trainees we compared the performance in tests immediately after instruction of those who had received a conventional course and those who had had the simpler bronze level tuition. The tests were based on video recordings of simulated resuscitation scenarios and the readouts from recording manikins. Differences occurred as a direct consequence of ventilation being required in one group and not the other, some variation probably followed from unforeseen minor changes in the way that instruction was given, whilst others may have followed from the greater simplicity in the new method of training. A careful approach was followed by slightly more trainees in the conventional group whilst appreciably more in the bronze group remembered to shout for help (44% vs. 71%). A clear advantage was also seen for bronze level training in terms of those who opened the airway as taught (35% vs. 56%), for checking breathing (66% vs. 88%), and for mentioning the need to phone for an ambulance (21% vs. 32%). Little difference was observed in correct or acceptable hand position between the conventional group who were given detailed guidance and the bronze group who were instructed only to push on the centre of the chest. The biggest differences related to the number of compressions given. The mean delay to first compression was 63 s and 34 s, and the mean duration of pauses between compressions was 16 s and 9 s, respectively. Average performed rates were similar in the two groups, but more in the conventional group compressed too slowly whereas more in the bronze group compressed too rapidly. Observations were made for only three cycles of compression, but extrapolating these to the 8 min often considered a watershed for chances of survival for victims of cardiac arrest, an average of 308 compressions would be expected from those using conventional CPR compared with 675 for those using bronze level CPR. The implications of this difference are discussed. : S 0 3 0 0 -9 5 7 2 ( 0 0 ) 0 0 1 5 2 -0 D. Assar et al. / Resuscitation 45 (2000) 7-15 8

Hands-only cardiopulmonary resuscitation training for schoolchildren: A comparison study among different class groups

Turkish journal of emergency medicine, 2020

BACKGROUND AND AIM: Up to 70% of out-of-hospital cardiac arrests are witnessed by family members, friends, and other bystanders. These bystanders can play a vital role in delivering help, before professional help arrives. Mandatory nationwide training of schoolchildren has shown the highest impact in improving the bystander cardiopulmonary resuscitation (CPR) rate. In our study, we compared the competency of different classes of schoolchildren from middle school onward in learning hands-only CPR. MATERIALS AND METHODS: This study was conducted in four schools. Schoolchildren were divided into three groups as middle school (6 th to 8 th standard) (MS), secondary school (9 th and 10 th standard) (SC), and senior secondary school (11 th and 12 th standard) (SN). Training module consisted of slide presentation on "hands-only CPR" of 1 h, video demonstration of 30 min, and hands-on session of 2.5 h. Students were then individually assessed for the skills. RESULTS: A total of 810 children were enrolled and trained. Initial approach was performed correctly by 68% of MS, 79.3% of SC, and 82.4% of SN school children, whereas 49.4% of MS, 61.3% of SC, and 72.5% of SN correctly performed chest compression in terms of rate, depth, and duration. Median compression depth and maximum duration of CPR achieved were significantly different across class groups (P < 0.001) Compression depth and duration of chest compression were positively correlated with children's age, height, weight, and body mass index (P < 0.001). CONCLUSION: Theoretical training on hands-only CPR can be started at the middle school level, and practical training can be incorporated in school curricula from secondary school.

Comparison of two instructional modalities for nursing student CPR skill acquisition

Resuscitation, 2010

Aims: The purpose of the study was to compare performance based measures of CPR skills (compressions, ventilations with bag-valve-mask (BVM), and single rescuer CPR) from two types of CPR courses: a computer-based course (HeartCode TM BLS) with voice advisory manikin (VAM) feedback and instructorled (IL) training with traditional manikins. Methods: 604 nursing students from 10 schools of nursing throughout the United States were randomized by school to course type. After successful course completion, students performed 3 min each of compressions; ventilations with BVM; and single rescuer CPR on a Laerdal Resusci Anne ® SkillReporter TM manikin. The primary outcome measures were: (1) compression rate, (2) percentage of compressions performed with adequate depth, (3) percentage of compressions performed with correct hand placement, (4) number of ventilations/min, and (5) percentage of ventilations with adequate volume. Results: There were no differences in compression rates between the two courses. However, students with HeartCode BLS with VAM training performed more compressions with adequate depth and correct hand placement and had more ventilations with adequate volume than students who had IL courses particularly when learning on hard molded manikins. During single rescuer CPR, students who had HeartCode BLS with VAM training had more compressions with adequate depth and ventilations with adequate volume than students with IL training. Conclusion: Students who trained using HeartCode BLS and practiced with VAMs performed more compressions with adequate depth and ventilations with adequate volume than students who had IL courses. Results of this study provide evidence to support use of HeartCode BLS with VAM for training nursing students in CPR.

Relationship between level of CPR training, self-reported skills, and actual manikin test performance — an observational study

International Journal o f Emergency Medicine, 2019

Background: Quality of bystander cardiopulmonary resuscitation (CPR) skills may influence out of hospital cardiac arrest (OHCA) outcomes. We analyzed how the level of CPR training related to indicators of good CPR quality and also the relationship between self-reported skills and actual CPR performance. Methods: Two hundred thirty-seven persons trained in standardized BLS curricula were divided into three groups according to the level of training: group I (40 h basic first aid training), group II , and g roup III (96 h advanced first aid, group III had also some limited additional life support training courses). We recorded the participants ’ real-life CPR experience and self-reported CPR skills, and then assesse d selected CPR quality indicators on a manikin. The data were analyzed with multivariate logistic regression. Differences between groups were analyzed with ANOVA/MANOVA. Results: Out of 237 participants, 125 had basic training (group I), 84 reported advanced training (group II), and 28 advanced training plus addi tional courses (group III ) . Group II and III had shorter start-up time, better compression depth and hand positioning, higher fraction of effective rescue ventilations, shorter hands-off time, and thus a higher chest compression fraction . Chest compression rate did not differ between groups. The participants in group I assessed their own skills and preparedness significantly lower than groups II and III both before and after the test. In addition, group III reported higher confidence in examining the critically ill patient and preparedness in doing CPR before the manikin test than both groups I and II. However, the observed differences between groups II and III in self-reported skills and preparedness were not statistically significant after the test. Conclusion: As expected, higher levels of BLS training correlated with better CPR quality. However, this study showed that ventilations and hands-on time were the components of CPR that were most affected by the level of training. Self- assessments of CPR ability correlated well to actual test p erformance and may have a role in probing CPR skills in students. The results may be important for BLS instructors and program developers

A comparison of the effectiveness of QCPR and conventional CPR training in final-year medical students at a South African university

African Journal of Emergency Medicine, 2022

Introduction: High-quality cardiopulmonary resuscitation (CPR) saves lives. Training on basic first aid manikins allows students to practice manoeuvres and provides realistic resistance to chest compressions. Conventional CPR has no real-time feedback to observe the quality of CPR. Quality cardiopulmonary resuscitation (QCPR) is technology using wireless sensors embedded in the manikin to measure the effectiveness of core CPR components. This study compared the effectiveness of CPR training of final-year undergraduate medical students using electronic-feedback QCPR adult manikins and conventional adult manikins. The effectiveness of compressions was compared and return on investment was investigated. Methods: In an experimental study, 53 students were divided into two groups using simple random sampling. The QCPR group practised CPR on the QCPR manikins. The CPR group practised on conventional CPR manikins. Both groups were allowed to practice for approximately 10 minutes. After the training session, both groups were tested using the QCPR manikin. Only chest compression performance in adult-sized manikins were measured, recorded and compared. Results: The median flow fraction for the QCPR group was 78.0% (interquartile range (IQR) 63-89%) and for the CPR group 80.0% (IQR 74-85%). The median number of compressions for the QCPR group was 104 (IQR 101-109) and for the CPR group 107 (IQR 79-124). Both groups achieved a 100% compression rate with adequate depth. The maximum total effectiveness of both groups was 99%. No statistically significant difference was seen for the overall percentage of compression effectiveness between the groups. Conclusion: Participants achieved acceptable scores on most CPR compression metrics and complied with CPR guidelines in most cases. Efficacy of CPR training on conventional and QCPR manikins was comparable. CPR training in low resource settings can be just as effective on conventional manikins. Immediate feedback technology adds value to the training experience, allowing for individuals to adjust for deviations to set standards.

CPR Education in the Modern Age

Researchgate, 2019

Abstract CPR Education in the Modern Age Cardio-Pulmonary Resuscitation (CPR) is a life-saving procedure, when applied properly. Since its inception in 1967, the education of the public in the proper application of this vital technique has been hampered by a lack of qualitative tools to measure the compression, decompression and frequency of the procedure as it is applied. Today, new tools are available to provide this qualitative analysis to help average citizens receive the appropriate training in CPR and to convert data collected during the training to qualitative data. This data can be stored for later review and research or transmitted through the web for comparison and company evaluation of training accuracy and effectiveness. These new tools will move CPR education closer to the goal of the American Heart Association, as stated in the American Heart Association Consensus statement of 2013, to “…develop industry standards for interoperable raw data downloads and reporting electronic data collected during resuscitation for both quality improvement and research.”

A Randomized Trial of Cardiopulmonary Resuscitation Training for Medical Students

Simulation in healthcare : journal of the Society for Simulation in Healthcare, 2013

Introduction: Current European Resuscitation Guidelines 2010 recommend the use of prompt/feedback devices when training for cardiopulmonary resuscitation (CPR). We aimed to assess the quality of CPR training among second-year medical students with a voice advisory mannequin (VAM) compared to guidance provided by an instructor. Methods: Forty-three students received a theoretical reminder about CPR followed by a 2-minute pretest on CPR (compressions/ventilations cycle) with Resusci Anne SkillReporter (Laerdal Medical). They were then randomized into a control group (n = 22), trained by an instructor for 4 minutes per student, and an intervention group (n = 21) trained individually with VAM CPR mannequin for 4 minutes. After training, the students performed a 2-minute posttest, with the same method as the pretest. Results: Participants in the intervention group (VAM) performed more correct hand position (73% vs. 37%; P = 0.014) and tended to display better compression rate (124 min j1 vs. 135 min j1 ; P = 0.089). In a stratified analyses by sex we found that only among women trained with VAM was there a significant improvement in compression depth before and after training (36 mm vs. 46 mm, P = 0.018) and in the percentage of insufficient compressions before and after training (56% vs. 15%; P = 0.021). Conclusions: In comparison to the traditional training method involving an instructor, training medical students in CPR with VAM improves the quality of chest compressions in hand position and in compression rate applied to mannequins. Only among women was VAM shown to be superior in compression depth training. This technology reduces costs in 14% in our setup and might potentially release instructors' time for other activities.

Disseminating Cardiopulmonary Resuscitation Training by Distributing 9,200 Personal Manikins

Academic Emergency Medicine, 2014

Background-Because most cardiac arrests occur at home, widespread training is needed to increase the incidence of cardiopulmonary resuscitation (CPR) by lay persons. The aim of this study was to evaluate the effect of mass distribution of CPR instructional materials among schoolchildren. Methods and Results-We distributed 35 002 resuscitation manikins to pupils (12 to 14 years of age) at 806 primary schools. Using the enclosed 24-minute instructional DVD, they trained in CPR and subsequently used the kit to train family and friends (second tier). They completed a questionnaire on who had trained in CPR using the kit. Teachers also were asked to evaluate the project. The incidence of bystander CPR in out-of-hospital cardiac arrest in the months following the project was compared with the previous year. In total, 6947 questionnaires (19.8%) were returned. The 6947 kits had been used to train 17 140 from the second tier (mean, 2.5 persons per pupil; 95% confidence interval, 2.4 to 2.5). The teachers had used a mean of 64 minutes (95% confidence interval, 60 to 68) for preparation and a mean of 13 minutes (95% confidence interval, 11 to 15) to tidy up. Incidence of bystander CPR in the months after the project did not increase significantly compared with the previous year (25.0% versus 27.9%; Pϭ0.16). Conclusions-CPR training can be disseminated in a population by distributing personal resuscitation manikins among children in primary schools. The teachers felt able to easily facilitate CPR training. The incidence of bystander CPR did not increase significantly in the months following the project. (Circulation. 2007;116:1380-1385.)

Disseminating Cardiopulmonary Resuscitation Training by Distributing 35 000 Personal Manikins Among School Children

Circulation, 2007

Background-Because most cardiac arrests occur at home, widespread training is needed to increase the incidence of cardiopulmonary resuscitation (CPR) by lay persons. The aim of this study was to evaluate the effect of mass distribution of CPR instructional materials among schoolchildren. Methods and Results-We distributed 35 002 resuscitation manikins to pupils (12 to 14 years of age) at 806 primary schools. Using the enclosed 24-minute instructional DVD, they trained in CPR and subsequently used the kit to train family and friends (second tier). They completed a questionnaire on who had trained in CPR using the kit. Teachers also were asked to evaluate the project. The incidence of bystander CPR in out-of-hospital cardiac arrest in the months following the project was compared with the previous year. In total, 6947 questionnaires (19.8%) were returned. The 6947 kits had been used to train 17 140 from the second tier (mean, 2.5 persons per pupil; 95% confidence interval, 2.4 to 2.5). The teachers had used a mean of 64 minutes (95% confidence interval, 60 to 68) for preparation and a mean of 13 minutes (95% confidence interval, 11 to 15) to tidy up. Incidence of bystander CPR in the months after the project did not increase significantly compared with the previous year (25.0% versus 27.9%; Pϭ0.16). Conclusions-CPR training can be disseminated in a population by distributing personal resuscitation manikins among children in primary schools. The teachers felt able to easily facilitate CPR training. The incidence of bystander CPR did not increase significantly in the months following the project. (Circulation. 2007;116:1380-1385.)

A randomized controlled trial comparing traditional training in cardiopulmonary resuscitation (CPR) to self-directed CPR learning in first year medical students: The two-person CPR study

Resuscitation, 2011

The primary purpose of this study was to compare two, shorter, self-directed methods of cardiopulmonary resuscitation (CPR) education for healthcare professionals (HCP) to traditional training with a focus on the trainee's ability to perform two-person CPR.First-year medical students with either no prior CPR for HCP experience or prior training greater than 5 years were randomized to complete one of three courses: 1) HeartCode BLS System, 2) BLS Anytime, or 3) Traditional training. Only data from the adult CPR skills testing station was reviewed via video recording by certified CPR instructors and the Laerdal PC Skill Reporter software program (Laerdal Medical, Stavanger, Norway).There were 180 first-year medical students who met inclusion criteria: 68 were HeartCode BLS System, 53 BLS Anytime group, and 59 traditional group Regarding two-person CPR, 57 (84%) of Heartcode BLS students and 43 (81%) of BLS Anytime students were able to initiate the switch compared to 39 (66%) of traditional course students (p = 0.04). There were no significant differences in the quality of chest compressions or ventilations between the three groups. There was a trend for a much higher CPR skills testing pass rate for the traditional course students. However, failure to “clear to analyze or shock” while using the AED was the most common reason for failure in all groups.The self-directed learning groups not only had a high level of success in initiating the “switch” to two-person CPR, but were not significantly different from students who completed traditional training.