Effectiveness of Bystander Cardiopulmonary Resuscitation and Survival Following Out-of-Hospital Cardiac Arrest

Gallagher, E. John; Lombardi, Gary; Gennis, Paul

doi:10.1001/jama.1995.03530240032036

Cited by 344 publications

(91 citation statements)

References 19 publications

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“…4 The ''Chain of Survival'' emphasizes calling 911, early CPR, and early defibrillation as the first three links of the chain 5,6 [see Figure 1]. Bystander CPR [7][8][9][10][11][12][13][14][15] and application of an AED 3,10,12,16 have been shown to increase survival in an OHCA from 7 to 22%, 3 increasing to as high as 38% when a shock is delivered by an AED. 3,12 The effect of CPR and defibrillation decreases significantly with each minute that passes without intervention.…”

Section: Ré Sumémentioning

confidence: 99%

Cardiopulmonary resuscitation and automatic external defibrillator training in schools: “Is anyone learning how to save a life?”

Hart

Flores-Medrano

Brooks

et al. 2013

CJEM

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Objectives: Bystander resuscitation efforts, such as cardiopulmonary resuscitation (CPR) and use of an automatic external defibrillator (AED), save lives in cardiac arrest cases. School training in CPR and AED use may increase the currently low community rates of bystander resuscitation. The study objective was to determine the rates of CPR and AED training in Toronto secondary schools and to identify barriers to training and training techniques. Methods: This prospective study consisted of telephone interviews conducted with key school staff knowledgeable about CPR and AED teaching. An encrypted Web-based tool with prespecified variables and built-in logic was employed to standardize data collection. Results: Of 268 schools contacted, 93% were available for interview and 83% consented to participate. Students and staff were trained in CPR in 51% and 80% of schools, respectively. Private schools had the lowest training rate (39%). Six percent of schools provided AED training to students and 47% provided AED training to staff. Forty-eight percent of schools had at least one AED installed, but 25% were unaware if their AED was registered with emergency services dispatch. Cost (17%), perceived need (11%), and school population size (10%) were common barriers to student training. Frequently employed training techniques were interactive (32%), didactic instruction (30%) and printed material (16%). Conclusions: CPR training rates for staff and students were moderate overall and lowest in private schools, whereas training rates in AED use were poor in all schools. Identified barriers to training include cost and student population size (perceived to be too small to be cost-effective or too large to be implemented). Future studies should assess the application of convenient and cost-effective teaching alternatives not presently in use. RÉ SUMÉObjectifs: Les manoeuvres de ré animation effectué es par les té moins, telles que la ré animation cardiorespiratoire (RCR) et l'utilisation du dé fibrillateur externe automatique (DEA), peuvent sauver la vie dans les cas d'arrê t cardiaque. Enseigner, dans les é coles, la RCR et l'utilisation du DEA peut augmenter les faibles taux de ré animation effectué e par les té moins, enregistré s au moment de l'é tude dans les collectivité s. L'é tude visait à dé terminer les taux de formation sur la RCR et l'utilisation du DEA dans les é coles secondaires à Toronto et à cerner les obstacles à la formation et aux techniques de formation. Mé thode: Il s'agit d'une é tude prospective, qui consistait en des entrevues té lé phoniques et qui a é té mené e parmi des membres importants du personnel, bien au fait de la formation sur la RCR et l'utilisation du DEA. Nous avons utilisé un outil Web, encodé , comportant des variables pré dé terminé es et doté d'une fonction logique inté gré e pour uniformiser la collecte de donné es. Ré sultats: Sur 268 é coles avec lesquelles nous avons communiqué , 93% ont fait é cho à la demande d'entrevue et 83% ont accepté d'y participer. Les é lè ves et ...

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Section: Ré Sumémentioning

confidence: 99%

Cardiopulmonary resuscitation and automatic external defibrillator training in schools: “Is anyone learning how to save a life?”

Hart

Flores-Medrano

Brooks

et al. 2013

CJEM

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“…A growing body of evidence highlights the association between quality of resuscitation manoeuvres and patients’ outcome. [1–6] Adequate rate, depth, recoil and hands position constitute what international guidelines [7,8] define high-quality chest compressions and when applied to cardiopulmonary resuscitation (CPR) they are associated with improved survival rates in the settings of both in-hospital and out-of-hospital cardiac arrest. Indeed, adequate rate and depth have been associated with better blood flow and oxygen delivery to the heart and brain and with an increased rate of return of spontaneous circulation (ROSC) and neurologically intact survival-to-hospital discharge.…”

Section: Introductionmentioning

confidence: 99%

Use of a Real-Time Training Software (Laerdal QCPR®) Compared to Instructor-Based Feedback for High-Quality Chest Compressions Acquisition in Secondary School Students: A Randomized Trial

et al. 2017

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High-quality chest compressions are pivotal to improve survival from cardiac arrest. Basic life support training of school students is an international priority. The aim of this trial was to assess the effectiveness of a real-time training software (Laerdal QCPR®) compared to a standard instructor-based feedback for chest compressions acquisition in secondary school students. After an interactive frontal lesson about basic life support and high quality chest compressions, 144 students were randomized to two types of chest compressions training: 1) using Laerdal QCPR® (QCPR group– 72 students) for real-time feedback during chest compressions with the guide of an instructor who considered software data for students’ correction 2) based on standard instructor-based feedback (SF group– 72 students). Both groups had a minimum of a 2-minute chest compressions training session. Students were required to reach a minimum technical skill level before the evaluation. We evaluated all students at 7 days from the training with a 2-minute chest compressions session. The primary outcome was the compression score, which is an overall measure of chest compressions quality calculated by the software expressed as percentage. 125 students were present at the evaluation session (60 from QCPR group and 65 from SF group). Students in QCPR group had a significantly higher compression score (median 90%, IQR 81.9–96.0) compared to SF group (median 67%, IQR 27.7–87.5), p = 0.0003. Students in QCPR group performed significantly higher percentage of fully released chest compressions (71% [IQR 24.5–99.0] vs 24% [IQR 2.5–88.2]; p = 0.005) and better chest compression rate (117.5/min [IQR 106–123.5] vs 125/min [115–135.2]; p = 0.001). In secondary school students, a training for chest compressions based on a real-time feedback software (Laerdal QCPR®) guided by an instructor is superior to instructor-based feedback training in terms of chest compression technical skill acquisition.Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12616000383460

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“…However, both out-of-hospital and in-hospital providers often fail to provide high quality CPR 3–5. Poor quality CPR has been shown to have similar outcomes to patients receiving no CPR, whereas increased survival is associated with high quality CPR, particularly the quality of chest compressions (CCs) 5,6. Therefore, recent recommendations have focused on CCs as the focus of compression optimization, which is reflected in the 2010 AHA Guidelines for CPR and ECC 7, as well as the ERC Guidelines for Resuscitation 2010 8 and 2010 CoSTR Guidelines 9…”

Section: Introductionmentioning

confidence: 99%

Effect of Prior Cardiopulmonary Resuscitation Knowledge on Compression Performance by Hospital Providers

Burkhardt¹,

Glick²,

Terndrup³

2014

WestJEM

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IntroductionThe purpose of this study was to determine cardiopulmonary resuscitation (CPR) knowledge of hospital providers and whether knowledge affects performance of effective compressions during a simulated cardiac arrest.MethodsThis cross-sectional study evaluated the CPR knowledge and performance of medical students and ED personnel with current CPR certification. We collected data regarding compression rate, hand placement, depth, and recoil via a questionnaire to determine knowledge, and then we assessed performance using 60 seconds of compressions on a simulation mannequin.ResultsData from 200 enrollments were analyzed by evaluators blinded to subject knowledge. Regarding knowledge, 94% of participants correctly identified parameters for rate, 58% for hand placement, 74% for depth, and 94% for recoil. Participants identifying an effective rate of ≥100 performed compressions at a significantly higher rate than participants identifying <100 (μ=117 vs. 94, p<0.001). Participants identifying correct hand placement performed significantly more compressions adherent to guidelines than those identifying incorrect placement (μ=86% vs. 72%, p<0.01). No significant differences were found in depth or recoil performance based on knowledge of guidelines.ConclusionKnowledge of guidelines was variable; however, CPR knowledge significantly impacted certain aspects of performance, namely rate and hand placement, whereas depth and recoil were not affected. Depth of compressions was poor regardless of prior knowledge, and knowledge did not correlate with recoil performance. Overall performance was suboptimal and additional training may be needed to ensure consistent, effective performance and therefore better outcomes after cardiopulmonary arrest.

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Effectiveness of Bystander Cardiopulmonary Resuscitation and Survival Following Out-of-Hospital Cardiac Arrest

Cited by 344 publications

References 19 publications

Cardiopulmonary resuscitation and automatic external defibrillator training in schools: “Is anyone learning how to save a life?”

Cardiopulmonary resuscitation and automatic external defibrillator training in schools: “Is anyone learning how to save a life?”

Use of a Real-Time Training Software (Laerdal QCPR®) Compared to Instructor-Based Feedback for High-Quality Chest Compressions Acquisition in Secondary School Students: A Randomized Trial

Effect of Prior Cardiopulmonary Resuscitation Knowledge on Compression Performance by Hospital Providers

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