Retention of CPR skills learned in a traditional AHA Heartsaver course versus 30-min video self-training: A controlled randomized study (original) (raw)
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Resuscitation, 2000
Cardiopulmonary resuscitation (CPR) training is not well targeted to family members of individuals at highest risk of cardiac arrest. Participants in traditional CPR classes (TRAD) average 31 years of age, while family members of cardiac patients average 55 years. Video self-instruction (VSI) can reach older individuals and others who do not participate in TRAD classes. VSI is a combination of a 34-min videotape and an inexpensive manikin intended for use in the home, where three-quarters of all out-of-hospital cardiac arrests occur. We exposed 202 subjects 40 years of age and older (mean age 59.4 years, S.D. =10.9) to either TRAD or VSI, and tested them individually immediately following training using validated methods including measurement by means of a Laerdal-Skillmeter ® manikin. According to American Heart Association (AHA) criteria, VSI subjects performed an average of 20.8% of all compressions and 25.1% of all ventilations correctly, compared with 3.4% of compressions and 1.7% of ventilations by TRAD subjects (PB 0.0001). VSI subjects performed an average of 10.1 of the total 14 CPR assessment and sequence skills correctly, compared with an average of 4.7 for TRAD (PB 0.0001). On a measure of overall performance, 62.7% of the VSI subjects were rated 'competent' or better (i.e. capable of performing CPR that 'would probably be effective'), compared to 6.1% of TRAD subjects (PB 0.0001). Only 17.8% of VSI subjects were rated as 'not competent' (i.e. unable to obtain a combination of any chest rise and any compression of the sternum) compared with 69.1% of TRAD subjects. VSI provides an effective, convenient, and inexpensive means of training persons over 40 years of age that achieves skill performance superior to TRAD.
Resuscitation, 2005
Background: The length of current 4-h classes in cardiopulmonary resuscitation (CPR) is a barrier to widespread dissemination of CPR training. The effectiveness of video-based self-instruction (VSI) has been demonstrated in several studies; however, the effectiveness of this method with older adults is not certain. Although older adults are most likely to witness out-of-hospital cardiac arrests, these potential rescuers are underrepresented in traditional classes. We evaluated a VSI program that comprised a 22-min video, an inflatable training manikin, and an audio prompting device with individuals 40-70 years old. The hypotheses were that VSI results in performance of basic CPR skills superior to that of untrained learners and similar to that of learners in Heartsaver classes. Methods: Two hundred and eighty-five adults between 40 and 70 years old who had had no CPR training within the past 5 years were assigned to an untrained control group, Heartsaver training, or one of three versions of VSI. Basic CPR skills were measured by instructor assessment and by a sensored manikin. Results: The percentage of subjects who assessed unresponsiveness, called the emergency telephone number 911, provided adequate ventilation, proper hand placement, and adequate compression depth was significantly better (P < 0.05) for the VSI groups than for untrained controls. VSI subjects tended to have better overall performance and better ventilation performance than did Heartsaver subjects. Conclusions: Older adults learned the fundamental skills of CPR with this training program in about half an hour. If properly distributed, this type of training could produce a significant increase in the number of lay responders who can perform CPR.
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
Continuous cardiopulmonary resuscitation training compared to single training by laypersons
Signa Vitae - A Journal In Intensive Care And Emergency Medicine
Background. Compression-Only Cardiopulmonary Resuscitation (COCPR) has been broadly studied during the last few years and specially introduced into lay rescuers' training. The aim of the study was to compare the quality of COCPR performed by laypersons (Group A) who attended a single cardiopulmonary resuscitation (CPR) training course, and those (Group B) who underwent regular CPR training every 6 months. Methods. Both groups completed the "Heartsaver CPR AED" course of the American Heart Association. After 30 minutes they were required to perform COCPR on a manikin with a skills reporter system. Results. Comparing the 76 once only trained laypersons to the 74 continuously trained lay rescuers, we found that average age (20 versus 40 years old), male gender (54% versus 93%), body mass index (BMI) (24.9 versus 27.3 kg/m 2) and regular physical exercise (55% versus 36%) proved significant predictors, p<0.01, p<0.01, p<0.01 and p=0.04 respectively. Regarding COCPR-quality, the percentage of efficient chest compressions (43% versus 58%), average depth of compression (45 versus 50 mm) and percentage of error-free compressions (36% versus 50%) indicated a significant statistical difference, with p=0.01, p=0.01 and p<0.01 respectively. However, the average frequency of compressions per minute (121 versus 124), the percentage of correct hand positioning during chest compressions (87% versus 90%) and the average duty cycle (47% versus 45%) did not display a significant difference. Conclusion. The continuous CPR training group obtained better results regarding quality of chest compressions when compared with single CPR training.
This article is a companion to a systematic review, entitled, Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: a systematic review (Riggs et al., 2019). The data tables described in this article summarise the impact that specific training interventions, number of times trained, and retention testing intervals have on laypeople's CPR psychomotor skills, as reported by peer-reviewed journal articles. The psychomotor skills included are: compression rate, compression depth, duration of interruptions to compressions, chest recoil, hand placement, proportion of adequate or 'correct' compressions, ventilation volume, compression-to-ventilation ratio, duty cycle and overall skills.
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.
Does basic life support training simplification foster retention of life saving maneuvers?
Signa Vitae - A Journal In Intensive Care And Emergency Medicine
Objectives. Simplification of Basic Life Support was proposed with the introduction of Chest-Compression only Cardio-Pulmonary Resuscitation (CC-CPR) as an alternative to Standard CPR (S-CPR). This study aimed to compare retention of knowledge, in the general public, of both CPR techniques (CC-CPR vs. S-CPR). Design, setting and participants. Multicentric prospective comparative cohort study. A training program was conducted among 906 individuals who were assigned to CC-CPR or to S-CPR group. They were evaluated before training (T0), after training (T1) and six months later (T2) on 17 CPR assessment criteria, they were evaluated twice at each time period and one global CPR performance score. Results. Initial knowledge was low. At T1, all CPR performance criteria improved significantly. Results were similar in both groups except for the rate of trainees calling for help and the time to turn on the automated SIGNA VITAE 2016; 11(1): level was lower than at T1. Finally, CPR performance score was lower in both groups at T2 compared to T1 but statistically higher than at T0. CPR performance score was higher in the CC-CPR group than in the S-CPR group at T2 (p=0.041). Conclusions. Performance score was significantly higher in the CC-CPR group. CC-CPR training seems to result in better retention and a faster reaction in the setting of an out of hospital cardiac arrest. Moreover, the retention of knowledge among a trained population fades partially with time. Regular CPR training should therefore be proposed to avoid the loss of benefit with time.
“Rolling Refreshers”: A novel approach to maintain CPR psychomotor skill competence
Resuscitation, 2009
Objectives: High quality CPR skill retention is poor. We hypothesized that "just-in-time" and "just-in-place" training programs would be effective and well-accepted to maintain CPR skills among PICU staff. Methods: "Rolling Refreshers", a portable manikin/defibrillator system with chest compression sensor providing automated corrective feedback to optimize CPR skills, were conducted daily in the PICU with multidisciplinary healthcare providers. Providers practiced CPR until skill success was attained, prospectively defined as <3 corrective prompts within 30 s targeting chest compression (CC) rate 90-120/min, CC depth >38 mm during continuous CPR. Providers completing ≥2 refreshers/month (Frequent Refreshers [FR]) were compared to providers completing <2 refreshers/month (Infrequent Refreshers [IR]) for time to achieve CPR skill success. Univariate analysis performed using non-parametric methods. Following actual cardiac arrests, CPR providers were surveyed for subjective feedback on training approach efficacy (5-point Likert scale; 1 = poor to 5 = excellent). Results: Over 15 weeks, 420 PICU staff were "refreshed": 340 nurses, 34 physicians, 46 respiratory therapists. A consecutive sample of 20 PICU staff was assessed before subsequent refresher sessions (FREQ n = 10, INFREQ n = 10). Time to achieve CPR skill success was significantly less in FREQ (median 21 s, IQR: 15.75-30 s) than in INFREQ (median 67 s, IQR: 41.5-84 s; p < 0.001). Following actual resuscitations, CPR providers (n = 9) rated "Rolling Refresher" training as effective (mean = 4.2; Likert scale 1-5; standard deviation 0.67). Conclusions: A novel "Rolling Refresher" CPR skill training approach using "just-in-time" and "just-inplace" simulation is effective and well received by PICU staff. More frequent refreshers resulted in significantly shorter times to achieve proficient CPR skills.
International Journal of Nursing Education Scholarship, 2012
This study evaluated the effects of brief monthly refresher training on CPR skill retention, confidence, and satisfaction with CPR skill level of 606 nursing students from ten different US schools. Students were randomized to course type, HeartCode TM Basic Life Support (BLS) or an instructor-led (IL) course, and then randomized to a practice group, six minutes of monthly practice or no further practice. End-of-study survey results were compiled and reported as percentages. Short answer data were grouped by category for reporting. Fewer HeartCode TM BLS students were satisfied with their CPR training compared to the IL students. Students who practiced CPR monthly were more confident than students who did not practice. Monthly practice improved CPR confidence, but initial course type did not. Students were most satisfied when they participated in the IL courses and frequent practice of CPR skills.