Keeping Bystanders Active: Resuscitating Resuscitation Skills

Abstract

Introduction: Sufficient CPR skills in the general population are essential to make them active bystanders and contribute to an effective chain of survival in cardiac arrest emergencies. However, having a large proportion of the population regularly retrained is practically infeasible. Objective: The aim of this study was to assess and retrain cardiopulmonary resuscitation (CPR) skills of individuals who received (limited) CPR training several months to years prior. Method: Ninety-nine German adults in a possession of a driver's license were asked to perform CPR on a Laerdal Resusci Anne ® QCPR manikin (Laerdal, Stavanger, Norway). After initial assessment, participants watched an instructional video and completed short, isolated compression, and ventilation practice with live feedback. CPR competency was assessed again after retraining and after a retention interval of 45 min. Results: Our results indicate that only 2% of participants managed to reach the performance criteria set by the European Resuscitation Council Guidelines, with most failing to reach even the lowest levels of performance. This corroborates earlier observations that CPR skills have deteriorated almost completely after a long retention interval, calling into question “one-and-done” certification of this basic life-saving. However, we also demonstrated that performance strikingly increased after watching a 6-min instructional video and a short opportunity for isolated practice. This increase in performance was stable over 45 min with 96% of participants meeting performance levels specified in the Guidelines. Closer inspection of the isolated compression practice data suggests that performance was very high at the start of the practice already, indicating that short refresher videos might suffice to change bystanders that would not have initiated CPR due to lack of knowledge into active first responders. Conclusion: We suggest that short refresher trainings could be an effective and affordable means of improving basic lifesaving skills to increase the effective contribution of bystanders during emergencies.

Knowledge and opinions of nursing undergraduate students about basic life support measures

“…The same research showed that the quality performance of the CPR procedure increased incredibly after watching a six-minute video with instructions and performing the practical part. With this procedure, as many as 96% of respondents met the level of performance specified in the Guidelines [7]. In this study, 85% of the students who previously attended health-oriented secondary school took part, and they, apart from taking the driving test, also encountered the BLS procedure and CPR procedures through secondary education.…”

“…The survey showed that a large percentage of respondents (92%) have a driver's license, confirming that all respondents (100%) were familiar with BLS. However, given that it is known that the skills and knowledge of BLS and CPR that are acquired during certain trainings are reduced and forgotten over time, it has been proven that one training of the mentioned programs is not enough for long-term competence [7]. The same has been proven with medical professionals, where it has been established that the quality of performance of the exact procedures usually deteriorates in the first year after certification [8].…”

“…istraživanje pokazalo je da se kvalitetna provedba KPR-a nevjerojatno povećala nakon gledanja šestominutnog videozapisa s uputama i provođenjem praktičnog dijela. Tim postupkom čak 96 % ispitanika zadovoljilo je razinu učinka navedenu u Smjernicama [7]. U ovoj je studiji sudjelovalo 85 % studenata koji su prethodno pohađali srednju školu zdravstvenog usmjerenja te su se oni, osim prilikom polaganja vozačkog ispita, i tijekom srednjoškolskog obrazovanja susreli s BLS postupkom i postupkom KPR-a.…”

“…Anketa je pokazala da ispitanici u velikom postotku (92 %) posjeduju vozačku dozvolu što potvrđuje i dobiveni rezultat da su svi ispitanici (100 %) upoznati s pojmom BLS. No, s obzirom na to da je poznato da se vještine i znanja BLS-a i KPR-a koja se steknu tijekom određenih treninga s vremenom smanjuju i zaboravljaju, dokazano je da jedan trening navedenih programa nije dovoljan za dugoročnu kompetenciju [7]. Isto je potvrđeno i kod medicinskih stručnjaka gdje je utvrđeno da se kvaliteta izvedbe samih postupaka obično pogoršava u prvoj godini nakon certifikacije [8].…”