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Maár C, Zima E, Nagy B, Pál-Jakab Á, Szvath P, Kiss B, Fritúz G, Gál J, Merkely B, Kovács E. The investigation of the efficiency of basic life support education among high school students: Protocol, design and implementation of an interventional, prospective longitudinal, individually randomised, parallel 1:1 grouped trial. Resusc Plus 2024; 18:100585. [PMID: 38439933 PMCID: PMC10909624 DOI: 10.1016/j.resplu.2024.100585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
Background Basic life support (BLS) skills are crucial not only for healthcare workers but for all lay people as well. Timely recognition of out-of-hospital cardiac arrest (OHCA) and the initiation of BLS by bystanders before the arrival of healthcare personnel may improve survival. There are several methods of spreading BLS skills and improve BLS skill retention among lay people. One of these methods can be the education of adolescent school children. The introduction of mandatory BLS education in schools was very effective in some European countries to increase the rate of bystander BLS. Methods/design The current study aims to investigate the efficacy of a BLS training and BLS curriculum among high school children in Hungary. Moreover, the investigators would like to optimise factors influencing skill retention in this first responder group and aim to compare two types of teaching methods: feedback given by the instructor or software-based feedback on the efficacy of chest compressions during the course. This study will be an interventional, assessor blinded, individually randomised parallel group trial recruiting 360 students. BLS skill retention will be assessed at the end of the course, two months after the training and six months after training. Discussion The current study will increase our knowledge on the methods educating BLS among high school children. The results will help us to create an effective BLS curriculum at schools.Trial registration: ClinicalTrials.gov: NCT06016153. Prospectively registered on 08/2023.
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Affiliation(s)
- Csaba Maár
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest 1082, Hungary
- Department of Anesthesiology and Perioperative Care, Semmelweis University, Üllői út 78, 1082 Budapest, Hungary
- Hungarian Resuscitation Council, Bem rakpart 28, 1011 Budapest, Hungary
| | - Endre Zima
- Department of Anesthesiology and Perioperative Care, Semmelweis University, Üllői út 78, 1082 Budapest, Hungary
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
- Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary
| | - Bettina Nagy
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
| | - Ádám Pál-Jakab
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
| | - Petra Szvath
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest 1082, Hungary
| | - Boldizsár Kiss
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
| | - Gábor Fritúz
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest 1082, Hungary
- Hungarian Resuscitation Council, Bem rakpart 28, 1011 Budapest, Hungary
| | - János Gál
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest 1082, Hungary
| | - Béla Merkely
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
| | - Enikő Kovács
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78, Budapest 1082, Hungary
- Hungarian Resuscitation Council, Bem rakpart 28, 1011 Budapest, Hungary
- Heart and Vascular Centre, Semmelweis University, Gaál József út 9-11, 1122 Budapest, Hungary
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Scapigliati A, Etmektsoglou S, Kalyvas T, Böttiger BW, Kozaris I. LIFEFORCE: Learning initiative for elementary-school fun-oriented resuscitation coaching Europewide. A novel project for resuscitation pre-training of 6-10 years-old schoolchildren in Europe. Resuscitation 2024; 199:110229. [PMID: 38705562 DOI: 10.1016/j.resuscitation.2024.110229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Affiliation(s)
- Andrea Scapigliati
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Rome, Italy.
| | | | | | - Bernd W Böttiger
- University of Cologne, Faculty of Medicine and University Hospital, Department of Anaesthesiology and Intensive Care Medicine, Cologne, Germany
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Doan T, Howell S, Ball S, Finn J, Cameron P, Bosley E, Dicker B, Faddy S, Nehme Z, Heriot N, Swain A, Thorrowgood M, Thomas A, Perillo S, McDermott M, Smith T, Smith K, Belcher J, Bray J. Identifying areas of Australia with high out-of-hospital cardiac arrest incidence and low bystander cardiopulmonary resuscitation rates: A retrospective, observational study. PLoS One 2024; 19:e0301176. [PMID: 38652707 PMCID: PMC11037527 DOI: 10.1371/journal.pone.0301176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 03/12/2024] [Indexed: 04/25/2024] Open
Abstract
AIM This study aims to explore regional variation and identify regions within Australia with high incidence of out-of-hospital cardiac arrest (OHCA) and low rates of bystander cardiopulmonary resuscitation (CPR). METHOD Adult OHCAs of presumed medical aetiology occurring across Australia between 2017 and 2019 were mapped onto local government areas (LGA) using the location of arrest coordinates. Bayesian spatial models were applied to provide "smoothed" estimates of OHCA incidence and bystander CPR rates (for bystander-witnessed OHCAs) for each LGA. For each state and territory, high-risk LGAs were defined as those with an incidence rate greater than the state or territory's 75th percentile and a bystander CPR rate less than the state or territory's 25th percentile. RESULTS A total of 62,579 OHCA cases attended by emergency medical services across 543 LGAs nationwide were included in the study. Nationally, the OHCA incidence rate across LGA ranged from 58.5 to 198.3 persons per 100,000, while bystander CPR rates ranged from 45% to 75%. We identified 60 high-risk LGAs, which were predominantly located in the state of New South Wales. Within each region, high-risk LGAs were typically located in regional and remote areas of the country, except for four metropolitan areas-two in Adelaide and two in Perth. CONCLUSIONS We have identified high-risk LGAs, characterised by high incidence and low bystander CPR rates, which are predominantly in regional and remote areas of Australia. Strategies for reducing OHCA and improving bystander response may be best targeted at these regions.
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Affiliation(s)
- Tan Doan
- Queensland Ambulance Service, Brisbane, Queensland, Australia
| | - Stuart Howell
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Stephen Ball
- Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Bentley, Western Australia, Australia
- St John Western Australia, Belmont, Western Australia, Australia
| | - Judith Finn
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Bentley, Western Australia, Australia
- St John Western Australia, Belmont, Western Australia, Australia
| | - Peter Cameron
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Emergency and Trauma Centre, The Alfred, Melbourne, Victoria, Australia
| | - Emma Bosley
- Queensland Ambulance Service, Brisbane, Queensland, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane City, Queensland, Australia
| | - Bridget Dicker
- Hato Hone St John New Zealand, Auckland, New Zealand
- Auckland University of Technology, Auckland, New Zealand
| | - Steven Faddy
- NSW Ambulance, Sydney, New South Wales, Australia
| | - Ziad Nehme
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Ambulance Victoria, Doncaster, Victoria, Australia
| | | | - Andy Swain
- Wellington Free Ambulance, Wellington, New Zealand
| | | | - Andrew Thomas
- St John Ambulance NT, Darwin, Northern Territory, Australia
| | - Samuel Perillo
- ACT Ambulance, Canberra, Australian Capital Territory, Australia
| | | | - Tony Smith
- Hato Hone St John New Zealand, Auckland, New Zealand
| | - Karen Smith
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Research and Innovation, Silverchain, Victoria, Australia
| | - Jason Belcher
- St John Western Australia, Belmont, Western Australia, Australia
| | - Janet Bray
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Bentley, Western Australia, Australia
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Gamberini L, Del Giudice D, Tartaglione M, Allegri D, Coniglio C, Pastori A, Gordini G, Semeraro F. Logistic and cognitive-emotional barriers experienced by first responders when alarmed to get dispatched to out-of-hospital cardiac arrest events: a region-wide survey. Intern Emerg Med 2024; 19:813-822. [PMID: 38123905 DOI: 10.1007/s11739-023-03487-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023]
Abstract
Out-of-hospital cardiac arrest (OHCA) is a major public health concern with low survival rates. First responders (FRs) and public access defibrillation (PAD) programs can significantly improve survival, although barriers to response activation persist. The Emilia Romagna region in Italy has introduced a new system, the DAE RespondER App, to improve the efficiency of FR dispatch in response to OHCA. The study aimed to evaluate the association between different logistic factors, FRs' perceptions, and their decision to accept or decline dispatch to an OHCA scene using the DAE RespondER App. A cross-sectional web survey was conducted, querying 14,518 registered FRs using the DAE RespondER app in Emilia Romagna. The survey explored logistic and cognitive-emotional perceptions towards barriers in responding to OHCAs. Statistical analysis was conducted, with responses adjusted using non-response weights. 4,644 responses were obtained (32.0% response rate). Among these, 1,824 (39.3%) had received at least one dispatch request in the past year. Multivariable logistic regression showed that being male, having previous experience with OHCA situations, and having an automated external defibrillator (AED) available at the moment of the call were associated with a higher probability of accepting the dispatch. Regarding FRs' perceptions, logistic obstacles were associated with mission rejection, while higher scores in cognitive-emotional obstacles were associated with acceptance. The study suggests that both logistical and cognitive-emotional factors are associated with FRs' decision to accept a dispatch. Addressing these barriers and further refining the DAE RespondER App can enhance the effectiveness of PAD programs, potentially improving survival rates for OHCA. The insights from this study can guide the development of interventions to improve FR participation and enhance overall OHCA response systems.
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Affiliation(s)
- Lorenzo Gamberini
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy
| | | | - Marco Tartaglione
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy.
| | - Davide Allegri
- Department of Clinical Governance and Quality, Bologna Local Healthcare Authority, Bologna, Italy
| | - Carlo Coniglio
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy
| | - Antonio Pastori
- Settore Assistenza Ospedaliera, Direzione Generale Cura Della Persona, Salute E Welfare, Assessorato Politiche Per La Salute, Regione Emilia, Bologna, Italy
| | - Giovanni Gordini
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy
| | - Federico Semeraro
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy
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Alcázar Artero PM, Greif R, Cerón Madrigal JJ, Escribano D, Pérez Rubio MT, Alcázar Artero ME, López Guardiola P, Mendoza López M, Melendreras Ruiz R, Pardo Ríos M. Teaching cardiopulmonary resuscitation using virtual reality: A randomized study. Australas Emerg Care 2024; 27:57-62. [PMID: 37666723 DOI: 10.1016/j.auec.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/17/2023] [Accepted: 08/14/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND The main functions of healthcare professionals include training and health education. In this sense, we must be able to incorporate new technologies and serious game to the teaching cardiopulmonary resuscitation. METHODS a multicenter, comparative and cross-sectional study was carried out to assess the learning of resuscitation of a group that was trained with the use of serious gaming with virtual reality, as compared to a control group trained with conventional classroom teaching. RESULTS the mean quality obtained in chest compressions for the virtual reality group was 86.1 % (SD 9.3), and 74.8 % (SD 9.5) for the control group [mean difference 11.3 % (95 % CI 6.6-16.0), p < 0.001]. Salivary Alpha-Amylase was 218.882 (SD 177.621) IU/L for the virtual reality group and 155.190 (SD 116.746) IU/L for the control group [mean difference 63.691 (95 % CI 122.998-4.385), p = 0.037]. CONCLUSION using virtual reality and serious games can improve the quality parameters of chest compressions as compared to traditional training.
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Affiliation(s)
- P M Alcázar Artero
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain; Health Emergencies Service 061 from the Region de Murcia, Spain
| | - R Greif
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; School of Medicine, Sigmund Freud Private University Vienna, Vienna, Austria
| | - J J Cerón Madrigal
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, University of Murcia, Spain
| | - D Escribano
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, University of Murcia, Spain
| | - M T Pérez Rubio
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain
| | - M E Alcázar Artero
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain
| | - P López Guardiola
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain
| | - M Mendoza López
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain
| | - R Melendreras Ruiz
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain
| | - M Pardo Ríos
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain; Health Emergencies Service 061 from the Region de Murcia, Spain.
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Horriar L, Rott N, Böttiger BW. Improving survival after cardiac arrest in Europe: The synergetic effect of rescue chain strategies. Resusc Plus 2024; 17:100533. [PMID: 38205146 PMCID: PMC10776426 DOI: 10.1016/j.resplu.2023.100533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
Sudden cardiac arrest is a global problem and is considered the third leading cause of death in industrialized countries. Patient survival rates after out-of-hospital cardiac arrest (OHCA) vary significantly between countries and continents. In particular, the 2021 European Resuscitation Council (ERC) Resuscitation Guidelines place a special focus on the chain of survival of patients after OHCA. As a complex, interconnected approach, the focus is on: Raising awareness for cardiac arrest and lay resuscitation, school children's education in resuscitation "KIDS SAVE LIVES", first responder systems - technologies to engage the community, telephone-assisted resuscitation (telephone-CPR; T-CPR) by dispatchers, and cardiac arrest centers (CAC) for further treatment in specialized hospitals. The Systems Saving Lives approach is a comprehensive strategy that emphasizes the interconnectedness of all links in the chain of survival following an OHCA, with a particular focus on the relationship between the community and emergency medical services (EMS). This system-level approach emphasizes the importance of the connection between all those involved in the chain of survival. It has a high potential to improve overall survival after OHCA. Therefore, it is recommended that these strategies be promoted and expanded in all countries.
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Affiliation(s)
- Lina Horriar
- German Resuscitation Council, Prittwitzstraße 43, 89070 Ulm, Germany
| | - Nadine Rott
- German Resuscitation Council, Prittwitzstraße 43, 89070 Ulm, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine Kerpener Straße 62, 50937 Cologne, Germany
| | - Bernd W. Böttiger
- German Resuscitation Council, Prittwitzstraße 43, 89070 Ulm, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine Kerpener Straße 62, 50937 Cologne, Germany
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Veigl C, Orlob S, Kloimstein T, Schnaubelt B, Krammel M, Draxl M, Feurhuber L, Wittig J, Schlieber J, Schnaubelt S. [Layperson basic life support education in Austria: An overview]. Wien Klin Wochenschr 2024:10.1007/s00508-024-02331-7. [PMID: 38300333 DOI: 10.1007/s00508-024-02331-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
Early interventions of laypersons can improve the survival and neurological outcome in patients with out-of-hospital cardiac arrest. There are several organizations in Austria which train lay people in basic life support and raise awareness for sudden cardiac death. To obtain an overview of the various initiatives, a questionnaire was sent to 26 organizations, and 15 of the organizations (58%) replied. The geographical distribution of the organizations between rural and urban areas was illustrated in a map. Most of them are situated in a university city, resulting in accessibility disparities for individuals in urban and rural settings. Layperson resuscitation education in Austria is largely dependent on the individual commitments of volunteers. The time spent practicing chest compressions in resuscitation courses ranges from 25% to 90% of the total course time. Furthermore, reasons for a lack of scientific endeavours could be identified, and solutions are suggested. Through better networking between organizations and initiatives, more laypersons could be trained in the future, which would lead to improved survival chances for persons suffering from out-of-hospital cardiac arrest in Austria. Appropriate support by political bodies and public authorities is and will remain a key element.
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Affiliation(s)
- Christoph Veigl
- Universitätsklinik für Notfallmedizin, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
- PULS - Verein zur Bekämpfung des plötzlichen Herztodes, Wien, Österreich
- Österreichischer Rat für Wiederbelebung (ARC), Graz, Österreich
| | - Simon Orlob
- Österreichischer Rat für Wiederbelebung (ARC), Graz, Österreich
- Universitätsklinik für Anästhesiologie und Intensivmedizin, Medizinische Universität Graz, Graz, Österreich
- Drück Mich! Arbeitsgemeinschaft für Notfallmedizin, Graz, Österreich
| | - Thomas Kloimstein
- Österreichischer Rat für Wiederbelebung (ARC), Graz, Österreich
- Ordensklinikum Linz Elisabethinen, Linz, Österreich
- SINUS - Interdisziplinäre Notfallinitiative Linz, Linz, Österreich
| | - Benedikt Schnaubelt
- PULS - Verein zur Bekämpfung des plötzlichen Herztodes, Wien, Österreich
- Zurück ins Leben, Horn, Österreich
| | - Mario Krammel
- PULS - Verein zur Bekämpfung des plötzlichen Herztodes, Wien, Österreich
- Berufsrettung Wien (MA 70), Wien, Österreich
| | - Markus Draxl
- Medizinische Universität Innsbruck, Innsbruck, Österreich
- IGNI - Interessengemeinschaft Notfallmedizin Innsbruck, Innsbruck, Österreich
| | - Lukas Feurhuber
- Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Krems an der Donau, Österreich
- emerKREMSy - studentischer Verband für Notfallmedizin Krems, Krems an der Donau, Österreich
| | - Johannes Wittig
- Österreichischer Rat für Wiederbelebung (ARC), Graz, Österreich
- Drück Mich! Arbeitsgemeinschaft für Notfallmedizin, Graz, Österreich
- Research Center for Emergency Medicine, Universityhospital Aarhus, Aarhus, Dänemark
- Randers Regional Hospital, Randers, Dänemark
| | - Joachim Schlieber
- Österreichischer Rat für Wiederbelebung (ARC), Graz, Österreich
- Abteilung für Anästhesiologie und Intensivmedizin, Unfallkrankenhaus Salzburg, Salzburg, Österreich
| | - Sebastian Schnaubelt
- Universitätsklinik für Notfallmedizin, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
- PULS - Verein zur Bekämpfung des plötzlichen Herztodes, Wien, Österreich.
- Österreichischer Rat für Wiederbelebung (ARC), Graz, Österreich.
- Zurück ins Leben, Horn, Österreich.
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Semeraro F, Imbriaco G, Del Giudice D, Antognoli M, Celin D, Cuttitta M, Lo Guasto V, Giulini G, Gnudi T, Monesi A, Nava E, Tucci R, Carenzio A, Lo Jacono S, Gordini G, Gamberini L. Empowering the next Generation: An innovative "Kids Save Lives" blended learning programme for schoolchildren training. Resuscitation 2024; 194:110088. [PMID: 38101506 DOI: 10.1016/j.resuscitation.2023.110088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/07/2023] [Accepted: 12/10/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Guidelines recommend teaching resuscitation from school age; however, little is known about the best methods to provide it. We devised a blended learning program for primary and secondary students (Kids Save Lives - KSL) consisting of brief lectures, practical training with mannequins, and virtual reality. We aimed to evaluate its impact on students' attitudes towards intervening during cardiac arrest and their knowledge about basic life support. METHODS This observational, prospective, before-and-after study assessed attitudes and basic life support knowledge in primary and secondary school children exposed to the KSL program. 20 events were conducted in the metropolitan area of Bologna, Italy. A multiple-choice test (before and after the course) explored attitude, knowledge and perceptions of realism, engagement, and agreement with the virtual reality method. RESULTS A total of 1,179 students (response rate 81.4%) were included in the final analysis, with 12.89% from primary schools, 5.94% from middle schools, and 81.17% from high schools. Students' willingness to intervene during a cardiac arrest rose from 56.9% to 93.1% (p < 0.001) post-course. The course's realism, engagement, and future prospects received positive feedback, with median scores notably higher in primary schools compared to secondary schools. CONCLUSION The blended learning method improved students' understanding of basic life support techniques and their attitude to act during cardiac arrest situations. The positive reception of the virtual reality component underscores technology's potential to bolster engagement and should be further explored for basic life support teaching in schoolchildren.
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Affiliation(s)
- Federico Semeraro
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Guglielmo Imbriaco
- Centrale Operativa 118 Emilia Est, Prehospital Emergency Dispatch Center, Helicopter Emergency Medical Service, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy.
| | - Donatella Del Giudice
- Centrale Operativa 118 Emilia Est, Prehospital Emergency Dispatch Center, Helicopter Emergency Medical Service, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Marco Antognoli
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Daniele Celin
- Centrale Operativa 118 Emilia Est, Prehospital Emergency Dispatch Center, Helicopter Emergency Medical Service, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Micaela Cuttitta
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Vincenzo Lo Guasto
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Gabriele Giulini
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Tania Gnudi
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Alessandro Monesi
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Elisa Nava
- Centrale Operativa 118 Emilia Est, Prehospital Emergency Dispatch Center, Helicopter Emergency Medical Service, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Riccardo Tucci
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Alessandra Carenzio
- Università Cattolica del Sacro Cuore, Milan, Italy; C.R.E.M.I.T: Centro di Ricerca Sull'educazione ai Media, All'innovazione e Alla Tecnologia, Milan, Italy
| | - Sara Lo Jacono
- Università Degli Studi di Verona, Verona, Italy; C.R.E.M.I.T: Centro di Ricerca Sull'educazione ai Media, All'innovazione e Alla Tecnologia, Milan, Italy
| | - Giovanni Gordini
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
| | - Lorenzo Gamberini
- Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
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Fuchs A, Bockemuehl D, Jegerlehner S, Both CP, Cools E, Riva T, Albrecht R, Greif R, Mueller M, Pietsch U. Favourable neurological outcome following paediatric out-of-hospital cardiac arrest: a retrospective observational study. Scand J Trauma Resusc Emerg Med 2023; 31:106. [PMID: 38129894 PMCID: PMC10734091 DOI: 10.1186/s13049-023-01165-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) in children is rare and can potentially result in severe neurological impairment. Our study aimed to identify characteristics of and factors associated with favourable neurological outcome following the resuscitation of children by the Swiss helicopter emergency medical service. MATERIALS AND METHODS This retrospective observational study screened the Swiss Air-Ambulance electronic database from 01-01-2011 to 31-12-2021. We included all primary missions for patients ≤ 16 years with OHCA. The primary outcome was favourable neurological outcome after 30 days (cerebral performance categories (CPC) 1 and 2). Multivariable linear regression identified potential factors associated with favourable outcome (odd ratio - OR). RESULTS Having screened 110,331 missions, we identified 296 children with OHCA, which we included in the analysis. Patients were 5.0 [1.0; 12.0] years old and 61.5% (n = 182) male. More than two-thirds had a non-traumatic OHCA (67.2%, n = 199), while 32.8% (n = 97) had a traumatic OHCA. Thirty days after the event, 24.0% (n = 71) of patients were alive, 18.9% (n = 56) with a favourable neurological outcome (CPC 1 n = 46, CPC 2 n = 10). Bystander cardiopulmonary resuscitation (OR 10.34; 95%CI 2.29-51.42; p = 0.002) and non-traumatic aetiology (OR 11.07 2.38-51.42; p = 0.002) were the factors most strongly associated with favourable outcome. Factors associated with an unfavourable neurological outcome were initial asystole (OR 0.12; 95%CI 0.04-0.39; p < 0.001), administration of adrenaline (OR 0.14; 95%CI 0.05-0.39; p < 0.001) and ongoing chest compression at HEMS arrival (OR 0.17; 95%CI 0.04-0.65; p = 0.010). CONCLUSION In this study, 18.9% of paediatric OHCA patients survived with a favourable neurologic outcome 30 days after treatment by the Swiss helicopter emergency medical service. Immediate bystander cardiopulmonary resuscitation and non-traumatic OHCA aetiology were the factors most strongly associated with a favourable neurological outcome. These results underline the importance of effective bystander and first-responder rescue as the foundation for subsequent professional treatment of children in cardiac arrest.
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Affiliation(s)
- Alexander Fuchs
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse, Bern, 3010, +41 31 664 14 65, Switzerland.
- Unit for Research in Anaesthesia, Department of Paediatric Anaesthesia, IRCCS, Istituto Giannina Gaslini, Genova, Italy.
- Swiss Air-Ambulance (Rega), Zurich, Switzerland.
| | - Deliah Bockemuehl
- Department of perioperative Intensive Care Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Sabrina Jegerlehner
- Department of Emergency Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Christian P Both
- Department of Anaesthesiology, Children's Hospital Zurich, Zurich, Switzerland
| | - Evelien Cools
- Swiss Air-Ambulance (Rega), Zurich, Switzerland
- Unit for Anaesthesiological Investigations, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Thomas Riva
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse, Bern, 3010, +41 31 664 14 65, Switzerland
| | - Roland Albrecht
- Swiss Air-Ambulance (Rega), Zurich, Switzerland
- Department of perioperative Intensive Care Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Robert Greif
- University of Bern, Bern, Switzerland
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
- European Resuscitation Council (ERC) Research NET, Niel, Belgium
| | - Martin Mueller
- Department of Emergency Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Urs Pietsch
- Swiss Air-Ambulance (Rega), Zurich, Switzerland
- Department of perioperative Intensive Care Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Emergency Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
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10
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Li P, Milkovic A, Morley P, Ng L. Outcomes of medical students training schoolchildren of ages 13-18 in cardiopulmonary resuscitation: A systematic review. Resusc Plus 2023; 16:100463. [PMID: 37779883 PMCID: PMC10540049 DOI: 10.1016/j.resplu.2023.100463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
Background Training schoolchildren in cardiopulmonary resuscitation (CPR) can increase the number of qualified people in the community, which in turn can improve survival rates of out-of-hospital cardiac arrests (OHCA). Medical students could be a valuable resource for providing the training. This systematic review aims to determine the outcomes of medical students providing CPR training to schoolchildren, aged 13-18 (who are thought to have the strength for effective chest compression), specifically CPR skills for both and non-technical skills such as communication and leadership for medical students. Methods A literature search of academic databases was conducted on 5 July 2023 using the following keywords: cardiopulmonary resuscitation, basic life support, medical students and high/middle/secondary school students. For the purpose of this review, "schoolchildren" refer to those aged 13-18. Studies were included where the primary focus was medical students teaching CPR to schoolchildren. The studies were critically appraised using the Medical Education Research Study Quality Instrument (MERSQI) tool and outcomes categorised by Kirkpatrick's Levels. Results Eleven studies were included, six randomised controlled trials and five cohort studies, with 1670 schoolchildren and 355 medical students as participants. Eight studies examined outcomes targeting schoolchildren, two examined outcomes for medical students and one examined both. Four of the eleven studies used validated outcome measures. Only outcomes at Kirkpatrick Level 1 and 2 were found, and all outcomes for both schoolchildren and medical students were positive. Schoolchildren showed improvements in theoretical and practical elements of CPR post-training, while medical students demonstrated improved professional practice skills such as leadership and mentorship as well as improvements in their own CPR skills post-teaching. Conclusions Schoolchildren can effectively acquire CPR skills through being trained by medical students, who themselves also benefit from improved CPR and professional practice skills after teaching. Further studies with robust methodology such as multi-site randomised controlled trials, the use of consistent and validated outcome measures, and the measurement of outcomes at higher Kirkpatrick levels to determine the impact on bystander CPR rates and community OHCA survival rates, are needed.
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Affiliation(s)
- Peitong Li
- Melbourne Medical School, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Anita Milkovic
- Melbourne Medical School, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Peter Morley
- Melbourne Medical School, The University of Melbourne, Parkville, Victoria 3010, Australia
- Department of Intensive Care, Royal Melbourne Hospital, 300 Grattan Street, Victoria 3050, Australia
| | - Louisa Ng
- Melbourne Medical School, The University of Melbourne, Parkville, Victoria 3010, Australia
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11
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Mellett-Smith A, Couper K. Establishing an out-of-hospital cardiac arrest registry in China: a key first step to improving outcomes. Lancet Public Health 2023; 8:e908-e909. [PMID: 37722402 DOI: 10.1016/s2468-2667(23)00208-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 09/05/2023] [Indexed: 09/20/2023]
Affiliation(s)
- Adam Mellett-Smith
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; Clinical Audit and Research Unit, London Ambulance Service NHS Trust, London, UK
| | - Keith Couper
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
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12
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Yeung CY, So KY, Cheung HHT, Hou PY, Ko HF, Lee A. Comparison of instructor-led compression-only cardiopulmonary resuscitation and automated external defibrillator training for secondary school students: A multicenter noninferiority randomized trial. Resusc Plus 2023; 16:100487. [PMID: 37886710 PMCID: PMC10598683 DOI: 10.1016/j.resplu.2023.100487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/22/2023] [Accepted: 09/30/2023] [Indexed: 10/28/2023] Open
Abstract
Background Many barriers exist to the wider and sustainable implementation of basic life support (BLS) training in secondary schools. Whether trained teacher instructors are not worse than healthcare instructors by 20% (noninferiority margin) of simulated BLS skills for secondary school students is unclear. Methods We conducted a two-armed, parallel, noninferiority, blinded, randomized controlled trial at four secondary schools in Hong Kong after teachers had undergone BLS training. Students were randomized to either the trained teacher or healthcare instructor group for the 2-hour compression-only cardiopulmonary resuscitation and automated external defibrillator (CO-CPRAED) course. The assessors for the students' BLS skill performance six months after the CO-CPRAED course were blinded. Results Of the 33 trained teachers, 13 (39.4%) volunteered to be instructors for the CO-CPRAED course. Three hundred and eleven students (median age: 15 years, 67% males) were randomized to either the teacher (n = 161) or healthcare (n = 150) instructor group. The BLS skill performance passing rate (%) at six months was high in both instructor groups (teacher: 88% versus healthcare: 91%; mean difference: -3%, 95% CI: -11% to 5%; P = 0.22). The students' knowledge levels remained high (>90%) and were similar between instructor groups at six months (P = 0.91). The teachers' willingness to teach BLS to students was mildly positive. However, the students were extremely positive towards learning and performing BLS. Conclusions A brief 2-hour CO-CPRAED intervention by trained teachers was noninferior to healthcare instructors and it was associated with students' very positive attitudes towards CPR, and retention of knowledge and BLS skills.
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Affiliation(s)
- Chi Yeung Yeung
- Accident and Emergency Department, Queen Elizabeth Hospital, Kowloon, Hong Kong Special Administrative Region
| | - Kit Ying So
- Accident and Emergency Department, Queen Elizabeth Hospital, Kowloon, Hong Kong Special Administrative Region
| | - Helen Hoi Ting Cheung
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region
| | - Pik Yi Hou
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region
| | - Hiu Fai Ko
- Accident and Emergency Department, Queen Elizabeth Hospital, Kowloon, Hong Kong Special Administrative Region
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region
| | - Anna Lee
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region
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13
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Birkun AA. Using Artificial Intelligence to Develop Educational Content for Teaching Children on Cardiopulmonary Resuscitation. Prehosp Disaster Med 2023; 38:685-686. [PMID: 37667611 DOI: 10.1017/s1049023x23006258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Affiliation(s)
- Alexei A Birkun
- Department of General Surgery, Anesthesiology, Resuscitation and Emergency Medicine, Medical Academy named after S.I. Georgievsky of V.I. Vernadsky Crimean Federal University, Simferopol, Russian Federation
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