Community attitudes towards performing cardiopulmonary resuscitation in Western Australia

Factors influencing civil servants' willingness to implement cardiopulmonary resuscitation in Chongqing, China: Based on the theory of planned behavior

Background

Timely bystander cardiopulmonary resuscitation is the key to improving the survival rate of out-of-hospital cardiac arrest. Civil servants are potential bystander CPR providers. This study aimed to explore civil servants' willingness to implement CPR in Chongqing, identify the influencing factors and mechanisms affecting civil servants' willingness to perform CPR, and then seek countermeasures to improve civil servants' willingness to implement CPR.

Methods

We introduced the theory of perceived risk into the theory of planned behavior, developed a 7-point Likert scale based on the extended theory of planned behavior, and conducted a questionnaire survey on civil servants in Chongqing, China. Descriptive statistical analysis and one-way ANOVA were employed to explore respondents' willingness and differences. Structural equation modeling was used to analyze the relationship between attitude, subjective norm, perceived behavioral control and perceived risk and respondents' willingness to implement CPR.

Results

A total of 1235 valid questionnaires were included for analysis. 50.1 % of respondents were willing to implement CPR. Male, over 40 years old, living with the elderly, having previous experience performing CPR on another person, and having higher CPR knowledge scores were associated with a more positive willingness to perform CPR. Attitude, subjective norm and perceived behavioral control had significant positive effects on willingness, and the standardized regression coefficients were 0.164, 0.326 and 0.313, respectively. The perceived risk has a significant negative effect on willingness, and the standardized regression coefficient was -0.109. The four latent variables accounted for 44.2 % of the variance in the willingness of civil servants to implement CPR.

Conclusions

The willingness of civil servants in Chongqing to implement CPR needs to be improved, and the countermeasures to enhance the subjective norm and perceived behavioral control of civil servants should be emphasized, such as developing a social support network for rescuing conduct, establishing regular training mechanisms and improving the practical applicability and popularization of the Chinese-style "Good Samaritan Law" etc., to improve the willingness of civil servants in Chongqing to implement CPR.

Pre-Arrival Care of the Out-of-Hospital Cardiac Arrest Victim

Lay rescuers play a pivotal role in the recognition and initial management of out-of-hospital cardiac arrest. The provision of timely pre-arrival care by lay responders, including cardiopulmonary resuscitation and the use of automated external defibrillator before emergency medical service arrival, is important link in the chain of survival and has been shown to improve outcomes from cardiac arrest. Although physicians are not directly involved in bystander response to cardiac arrest, they play a key role in emphasizing the importance of bystander interventions.

The psychological and behavioural factors associated with laypeople initiating CPR for out-of-hospital cardiac arrest: a systematic review

BACKGROUND

Prompt, effective CPR greatly increases the chances of survival in out-of-hospital c ardiac arrest. However, it is often not provided, even by people who have previously undertaken training. Psychological and behavioural factors are likely to be important in relation to CPR initiation by lay-people but have not yet been systematically identified.

METHODS

Aim: to identify the psychological and behavioural factors associated with CPR initiation amongst lay-people.

DESIGN

Systematic review Data sources: Cochrane Library, MEDLINE, EMBASE, CINAHL, PsycInfo and Google Scholar.

STUDY ELIGIBILITY CRITERIA

Primary studies reporting psychological or behavioural factors and data on CPR initiation involving lay-people published (inception to 31 Dec 2021).

STUDY APPRAISAL AND SYNTHESIS METHODS

Potential studies were screened independently by two reviewers. Study characteristics, psychological and behavioural factors associated with CPR initiation were extracted from included studies, categorised by study type and synthesised narratively.

RESULTS

One hundred and five studies (150,820 participants) comprising various designs, populations and of mostly weak quality were identified. The strongest and most ecologically valid studies identified factors associated with CPR initiation: the overwhelming emotion of the situation, perceptions of capability, uncertainty about when CPR is appropriate, feeling unprepared and fear of doing harm. Current evidence comprises mainly atheoretical cross-sectional surveys using unvalidated measures with relatively little formal testing of relationships between proposed variables and CPR initiation.

CONCLUSIONS

Preparing people to manage strong emotions and increasing their perceptions of capability are likely important foci for interventions aiming to increase CPR initiation. The literature in this area would benefit from more robust study designs.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO: CRD42018117438.

Understanding the Importance of the Lay Responder Experience in Out-of-Hospital Cardiac Arrest: A Scientific Statement From the American Heart Association

Bystander cardiopulmonary resuscitation (CPR) is critical to increasing survival from out-of-hospital cardiac arrest. However, the percentage of cases in which an individual receives bystander CPR is actually low, at only 35% to 40% globally. Preparing lay responders to recognize the signs of sudden cardiac arrest, call 9-1-1, and perform CPR in public and private locations is crucial to increasing survival from this public health problem. The objective of this scientific statement is to summarize the most recent published evidence about the lay responder experience of training, responding, and dealing with the residual impact of witnessing an out-of-hospital cardiac arrest. The scientific statement focuses on the experience-based literature of actual responders, which includes barriers to responding, experiences of doing CPR, use of an automated external defibrillator, the impact of dispatcher-assisted CPR, and the potential for postevent psychological sequelae. The large body of qualitative and observational studies identifies several gaps in crucial knowledge that, if targeted, could increase the likelihood that those who are trained in CPR will act. We suggest using the experience of actual responders to inform more contextualized training, including the implications of performing CPR on a family member, dispelling myths about harm, training and litigation, and recognition of the potential for psychologic sequelae after the event.

Greek BLS Certified Providers’ CPR Willingness and Skill Retention During the Pre-Vaccine Covid-19 Pandemic Period. A Survey of the Hellenic Society of Cardiology

Objective

Methods

Results

Conclusion

Global prevalence of cardiopulmonary resuscitation training among the general public: a scoping review

A scoping review was conducted to identify, map, and analyze international evidence from studies investigating the prevalence of community cardiopulmonary resuscitation (CPR) training. We searched major bibliographic databases and grey literature for original studies evaluating the prevalence of CPR training in the general population. Studies published from January 2000 to October 2020 were included without language or publication type restrictions. Seventy-three eligible papers reported a total of 61 population-based surveys conducted in 29 countries. More than three-fourths of the surveys were conducted in countries with high-income economies, and none in low-income countries. Over half of the surveys were at a subnational level. Globally, the proportion of laypeople trained in CPR varied greatly (median, 40%). For high-income countries, the median percentage was twice as high as that of upper middle-income countries (50% vs. 23%). The studies used heterogeneous survey methods and reporting patterns. Key methodological aspects were frequently not described. In summary, few studies have assessed CPR training prevalence among the general public. The rates of resuscitation training for the vast majority of countries remain unknown. High heterogeneity of studies precludes a reliable interpretation of the research. International Utstein-style consensus guidelines are needed to inform future research and reporting of public resuscitation training worldwide.

Attitudes to Cardiopulmonary Resuscitation and Defibrillator Use: A Survey of UK Adults in 2017

Background

Bystander cardiopulmonary resuscitation (CPR) and public access defibrillator (PAD) use can save the lives of people who experience out‐of‐hospital cardiac arrest. Little is known about the proportions of UK adults trained, their characteristics and willingness to act if witnessing an out‐of‐hospital cardiac arrest, or the public's knowledge regarding where the nearest PAD is located.

Methods and Results

An online survey was administered by YouGov to a nonprobabilistic purposive sample of UK adults, achieving 2084 participants, from a panel that was matched to be representative of the population. We used descriptive statistics and multivariate logistic regression modeling for analysis. Almost 52% were women, 61% were aged <55 years, and 19% had witnessed an out‐of‐hospital cardiac arrest. Proportions ever trained were 57% in chest‐compression‐only CPR, 59% in CPR, and 19.4% in PAD use. Most with training in any resuscitation technique had trained at work (54.7%). Compared with people not trained, those trained in PAD use said they were more likely to use one (odds ratio: 2.61), and those trained in CPR or chest‐compression‐only CPR were more likely to perform it (odds ratio: 5.39). Characteristics associated with being trained in any resuscitation technique included youth, female sex, higher social grade, and full‐time employment.

Conclusions

In the United Kingdom, training makes a difference in people's willingness to act in the event of a cardiac arrest. Although there is considerable opportunity to increase the proportion of the general population trained in CPR, consideration should be also given to encouraging training in PAD use and targeting training for those who are older or from lower social grades.

The Effectiveness of a New Dispatcher-Assisted Basic Life Support Training Program on Quality in Cardiopulmonary Resuscitation Performance During Training and Willingness to Perform Bystander Cardiopulmonary Resuscitation: A Cluster Randomized Controlled Study

INTRODUCTION

A new dispatcher-assisted basic life support training program, called "Home Education and Resuscitation Outcome Study (HEROS)" was developed with a goal to provide high-quality dispatcher-assisted cardiopulmonary resuscitation (CPR) training, with a focus on untrained home bystanders. This study aimed to determine whether the HEROS program is associated with improved quality in CPR performance during training and willingness to provide bystander CPR compared with other basic life support programs without dispatcher-assisted CPR (non-HEROS).

METHODS

This clustered randomized trial was conducted in 3 district health centers in Seoul. Intervention group was trained with the HEROS program and control group was trained with non-HEROS program. The primary outcome was overall CPR quality, measured as total CPR score. Secondary outcomes were other CPR quality parameters including average compression depth and rate, percentages of adequate depth, and acceptable release. Tertiary outcomes were posttraining survey results. Difference in difference analysis was performed to analyze the outcomes.

RESULTS

Among total 1929 trainees, 907 (47.0%) were trained with HEROS program. Compared with the non-HEROS group, the HEROS group showed higher-quality CPR performances and better maintenance of their CPR quality throughout the course (total scores of 84% vs. 80% for first session and 72% vs. 67% for last session; difference in difference of 12.2 vs. 13.2). Other individual CPR parameters also showed significantly higher quality in the HEROS group. The posttraining survey showed that both groups were highly willing to perform bystander CPR (91.4% in the HEROS vs. 92.3% in the non-HEROS) with only 3.4% of respondents in the HEROS group were not willing to volunteer compared with 6.2% in the non-HEROS group (P < 0.01).

CONCLUSIONS

The HEROS training program helped trainees perform high-quality CPR throughout the course and enhanced their willingness to provide bystander CPR.

Australia's awareness of cardiac arrest and rates of CPR training: results from the Heart Foundation's HeartWatch survey

OBJECTIVE

We aimed to provide the first national estimates of cardiopulmonary resuscitation (CPR) training and awareness of cardiac arrest.

DESIGN

A retrospective analysis of a national cross-sectional survey was undertaken. Data were collected online from adults in July 2017 as part of the Heart Foundation of Australia's HeartWatch survey. We used logistic regression to examine demographic factors associated with CPR training.

PARTICIPANTS

A national cohort was invited to participate in the survey using purposive, non-probability sampling methods with quotas for age, gender and area of residence, in order to reflect the wider Australian population. The final sample consisted of 1076 respondents.

MAIN OUTCOME MEASURE

To determine an estimation of the prevalence of cardiac arrest awareness and CPR training at a national level and the relationship of training to demographic factors.

RESULTS

The majority (76%) of respondents were born in Australia with 51% female and 66% aged between 35 and 64 years. Only 16% of respondents could identify the difference between a cardiac arrest and a heart attack. While 56% reported previous CPR training, only 22% were currently trained (within 1 year). CPR training was associated with younger age (35 to 54 years) (OR 1.45, 95% CI 1.06 to 2.0), being born in Australia (OR 1.59, 95% CI 1.17 to 2.17) and higher levels of education (university, OR 1.86, 95% CI 1.35 to 2.57). CPR training increased confidence in respondents ability to perform effective CPR and use a defibrillator. Lack of CPR training was the most common reason why respondents would not provide CPR to a stranger.

CONCLUSIONS

There is a need to improve the community's understanding of cardiac arrest, and to increase awareness and training in CPR. CPR training rates have not changed over the past decades-new initiatives are needed.

The influence of past experiences on future willingness to perform bystander cardiopulmonary resuscitation

Background

The influence of past familial experiences of receiving cardiopulmonary resuscitation (CPR) and medical help in various cardiac arrest and nonfatal cardiac events toward willingness to “pay it forward” by helping the next cardiac arrest victim was explored.

Methods

Using a validated questionnaire, 6248 participants were asked to rate their willingness to perform bystander chest compression with mouth-to-mouth ventilation and chest compression-only CPR. Their past familial experiences of receiving cardiopulmonary resuscitation (CPR) and medical help in various cardiac arrest and nonfatal cardiac events were also recorded.

Results

Kruskal-Wallis test with post hoc Dunn’s pairwise comparisons showed that the following were significantly more willing to perform CPR with mouth-to-mouth ventilation: familial experience of “nonfatal cardiac events” (mean rank = 447) vs “out-of-hospital cardiac arrest with no CPR” (mean rank = 177), U = 35442.5, z = −2.055, p = 0.04; “in-hospital cardiac arrest and successful CPR” (mean rank = 2955.79) vs “none of these experiences” (mean rank = 2468.38), U = 111903, z = −2.60, p = 0.01; and “in-hospital cardiac arrest with successful CPR” (mean rank = 133.45) vs “out-of-hospital arrest with no CPR” (mean rank = 112.36), U = 4135.5, z = −2.06, p = 0.04. For compression-only CPR, Kruskal-Wallis test with multiple runs of Mann-Whitney U tests showed that “nonfatal cardiac events” group was statistically higher than the group with “none of these experiences” (mean rank = 3061.43 vs 2859.91), U = 1194658, z = −2.588, p = 0.01. The groups of “in-hospital cardiac arrest with successful CPR” and “in-hospital cardiac arrest with transient return of spontaneous circulation” were the most willing groups to perform compression-only CPR.

Conclusion

Prior familial experiences of receiving CPR and medical help, particularly among those with successful outcomes in a hospital setting, seem to increase the willingness to perform bystander CPR.

Public perception towards bystander cardiopulmonary resuscitation

Objective

Bystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest (OHCA) improves survival and neurological outcomes. Nonetheless, many OHCA patients do not receive bystander CPR during a witnessed arrest. Our aim was to identify potential barriers to bystander CPR.

Methods

Participants at CPR training events conducted in the USA between February and May 2018 answered a 14-question survey prior to training. Respondents were asked about their overall comfort level performing CPR, and about potential concerns specific to performing CPR on a middle-aged female, a geriatric male, and male and female adolescent patients. Open-ended responses were analysed qualitatively by categorising responses into themes.

Results

Of the 677 participants, 582 (86.0%) completed the survey, with 509 (88.1%) between 18 and 29 years of age, 341 (58.6%) without prior CPR training and 556 (96.0%) without prior CPR experience. Across all four scenarios of patients in cardiac arrest, less than 65% of respondents reported that they would be ‘Extremely Likely’ (20.6%–29.1%) or ‘Moderately Likely’ (26.9%–34.8%) to initiate CPR. The leading concerns were ‘causing injury to patient’ for geriatric (n=193, 63.1%), female (n=51, 20.5%) and adolescent (n=148, 50.9%) patients. Lack of appropriate skills was the second leading concern when the victim was a geriatric (n=41, 13.4%) or adolescent (n=68, 23.4%) patient, whereas for female patients, 35 (14.1%) were concerned about exposing the patient or the patient’s breasts interfering with performance of CPR and 15 (6.0%) were concerned about being accused of sexual assault. Significant differences were observed in race, ethnicity and age regarding the likelihood of starting to perform CPR on female and adolescent patients.

Conclusions

Participants at CPR training events have multiple concerns and fears related to performing bystander CPR. Causing additional harm and lack of skills were among the leading reservations reported. These findings should be considered for improved CPR training and public education.

Characteristics Associated with First Aid and Cardiopulmonary Resuscitation Training and Use in Queensland, Australia

INTRODUCTION

First aid, particularly bystander cardiopulmonary resuscitation (CPR), is an important element in the chain of survival. However, little is known about what influences populations to undertake first aid/CPR training, update their training, and use of the training.

OBJECTIVES

The aim of this study was to explore the characteristics of people who have first aid/CPR training, those who have updated their training, and use of these skills.

METHODS

As part of the 2011 state-wide, computer-assisted telephone interviewing (CATI) survey of people over 18 years of age living in Queensland, Australia, stratified by gender and age group, three questions about first aid training, re-training, and skill uses were explored.

RESULTS

Of the 1,277 respondents, 73.2% reported having undertaken some first aid/CPR training and 39.5% of those respondents had used their first aid/CPR skills. The majority of respondents (56.7%) had not updated their first aid/CPR skills in the past three years, and an additional 2.5% had never updated their skills. People who did not progress beyond year 10 in school and those in lower income groups were less likely to have undertaken first aid/CPR training. Males and people in lower income groups were less likely to have recently updated their first aid/CPR training. People with chronic health problems were in a unique demographic sub-group; they were less likely to have undertaken first aid/CPR training but more likely to have administered first aid/CPR.

CONCLUSION

Training initiatives that target people on the basis of education level, income group, and the existence of chronic health problems might be one strategy for improving bystander CPR rates when cardiac arrest occurs in the home.Franklin RC, Watt K, Aitken P, Brown LH, Leggat PA. Characteristics associated with first aid and cardiopulmonary resuscitation training and use in Queensland, Australia. Prehosp Disaster Med. 2019;34(2):155-160.

Teaching basic life support with an automated external defibrillator using the two-stage or the four-stage teaching technique

INTRODUCTION

Laypersons often hesitate to perform basic life support (BLS) and use an automated external defibrillator (AED) because of self-perceived lack of knowledge and skills. Training may reduce the barrier to intervene. Reduced training time and costs may allow training of more laypersons. The aim of this study was to compare BLS/AED skills' acquisition and self-evaluated BLS/AED skills after instructor-led training with a two-stage versus a four-stage teaching technique.

METHODS

Laypersons were randomized to either two-stage or four-stage teaching technique courses. Immediately after training, the participants were tested in a simulated cardiac arrest scenario to assess their BLS/AED skills. Skills were assessed using the European Resuscitation Council BLS/AED assessment form. The primary endpoint was passing the test (17 of 17 skills adequately performed). A prespecified noninferiority margin of 20% was used.

RESULTS

The two-stage teaching technique (n=72, pass rate 57%) was noninferior to the four-stage technique (n=70, pass rate 59%), with a difference in pass rates of -2%; 95% confidence interval: -18 to 15%. Neither were there significant differences between the two-stage and four-stage groups in the chest compression rate (114±12 vs. 115±14/min), chest compression depth (47±9 vs. 48±9 mm) and number of sufficient rescue breaths between compression cycles (1.7±0.5 vs. 1.6±0.7). In both groups, all participants believed that their training had improved their skills.

CONCLUSION

Teaching laypersons BLS/AED using the two-stage teaching technique was noninferior to the four-stage teaching technique, although the pass rate was -2% (95% confidence interval: -18 to 15%) lower with the two-stage teaching technique.

The effectiveness of modified basic life support module on knowledge, attitude, and performance of cardiopulmonary resuscitation among university students

Introduction:

Cardiopulmonary resuscitation is a primary method used in the treatment of sudden cardiac arrest. It is a crucial skill that a healthcare provider and a lay rescuer should acquire to improve the survival and the neurological outcome of out-of-hospital cardiac arrest. Several modules were used to teach cardiopulmonary resuscitation for the healthcare provider and lay rescuer, but no module been developed that could be utilised in both population. Thus, this study aims to investigate the effectiveness of modified cardiopulmonary resuscitation training to knowledge (K), attitude (A), and performance (P) between medical and non-medical university students.

Methods:

This research was a single experimental study involving a total number of 125 students: 58 for a medical group and 67 for a non-medical group. A modified basic life support module, based on American Heart Association guideline 2015 was delivered to both groups under the same study setting. Pre and post KA scores were assessed using Res-Q questionnaire. The performance was evaluated by resuscitation feedback machine. The KA scores were analysed using repeated measure analysis of variance, and performance was examined using Pearson chi-square.

Results:

The study showed 64.8% of the participants were able to perform high-quality chest compression. Despite significant differences of sociodemographic background, there was no significant difference on effective chest compression between two groups (p = 0.200). There were also significant improvements in KA scores in both groups after intervention (p < 0.001).

Conclusion:

The knowledge of cardiopulmonary resuscitation can be delivered to everyone as aspired by our stakeholder to have one qualified cardiopulmonary resuscitation provider in a family. This modified basic life support module is reliably applicable to both healthcare and lay rescuer cardiopulmonary resuscitation training. All rescuers will perform in a similar manner, and this will tremendously reduce the discrepancy in the cardiopulmonary resuscitation qualities. Ultimately, this will improve an out-of-hospital return of spontaneous circulation rate.

Laypeople roles at road traffic crash scenes: a systematic review

This study aimed to identify the roles of laypeople at road traffic injuries (RTIs). A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words of 'laypeople', 'layman', 'layperson', 'bystander', 'first responder', 'lay first responder', 'road traffic', 'road traffic injury', 'crash injury', 'crash scene', 'emergency', 'trauma care', and 'prehospital trauma care' were used in combination with the Boolean operators OR and AND. We did electronic search on Google Scholar, PubMed, ISI Web of Science, CINAHL, Science Direct, Scopus, ProQuest. Based on the reviewed studies, some factors such as cultural conditions, knowledge, relief agencies, and demographic factors affect the interventions of laypeople at the crash scene in functional areas. Regarding the permanent presence of people at the crash scene, the present study can provide an opportunity to reduce different side effects of RTIs imposed on the society.

The role of dispatch in resuscitation

The role of the dispatch centre has increasingly become a focus of attention in cardiac arrest resuscitation. The dispatch centre is part of the first link in the chain of survival because without the initiation of early access, the rest of the chain is irrelevant. The influence of dispatch can also extend to the initiation of bystander cardiopulmonary resuscitation, early defibrillation and the rapid dispatch of emergency ambulances. The new International Liaison Committee on Resuscitation, the American Heart Association and, especially, the European Resuscitation Council 2015 guidelines have been increasing their emphasis on dispatch as the key to improving out-of-hospital cardiac arrest survival.

Social attitude and willingness to attend cardiopulmonary resuscitation training and perform resuscitation in the Crimea

BACKGROUND

To promote potentially life-saving bystander cardiopulmonary resuscitation (CPR), the proportion of CPR-trained general public and their attitude toward CPR should be assessed, which is yet to be done in the former Soviet Union countries. As a case study, the survey is aimed to investigate the prevalence of CPR training, CPR knowledge, attitude and willingness to attend training and attempt CPR in the general population of the Crimea.

METHODS

A personal interview survey was done from November 2017 to January 2018 with quota sampling reflecting age, gender and territorial distribution of the Crimean population.

RESULTS

Out of 384 persons surveyed, 53% were trained in CPR. Of trained, 24% passed training within the last year, 44% attended a single course. Among the non-trained, 51% never thought about the need to attend training. Knowledge of CPR is generally poor. About 52% wish to learn CPR, 79% and 91% are willing to attempt CPR on a stranger or a loved one, respectively. Lack of knowledge is the strongest barrier to attempt CPR. People aged ≥60, those with educational level lower than high school, widowed and retired are mostly untrained and unwilling to learn CPR. Females and unemployed are mostly untrained, but willing to be educated.

CONCLUSION

There is a need for increasing CPR training and retraining, and improving awareness and motivation to learn CPR in the Crimean population, targeting the least trained groups. The results could be used as a reference point for future studies in the former USSR countries, utilising the same methodology.

Impact of basic life-support training on the attitudes of health-care workers toward cardiopulmonary resuscitation and defibrillation

BACKGROUND

Cardiopulmonary resuscitation (CPR) increases the probability of survival of a person with cardiac arrest. Repeating training helps staff retain knowledge in CPR and in use of automated external defibrillators (AEDs). Retention of knowledge and skills during and after training in CPR is difficult and requires systematic training with appropriate methodology. The aim of this study was to determine the effect of basic life-support (BLS) training on the attitudes of health-care providers toward initiating CPR and on use of AEDs, and to investigate the factors that influence these attitudes.

METHODS

A quasi-experimental study was conducted in two groups: health-care providers who had just attended a BLS-AED course (post-BLS group, n = 321), and those who had not (pre-BLS group, n = 421). All participants had previously received BLS training. Both groups were given a validated questionnaire to evaluate the status of life-support education and certification, attitudes toward use of CPR and AED and concerns regarding use of CPR and AED. Multiple linear regression analyses were applied to identify significant predictors of the attitude and concern scores.

RESULTS

Overall positive attitudes were seen in 53.4% of pre-BLS respondents and 64.8% of post-BLS respondents (χ² = 9.66, p = 0.002). Positive attitude was significantly predicted by the recent completion of BLS training (β = 5.15, p < 0.001), the number of previous BLS training courses (β = 2.10, p = 0.008) and previous exposure to cardiac-arrest cases (β = 3.44, p = 0.018), as well as by low concern scores, (β = -0.09, p < 0.001). Physicians had significantly lower concern scores than nurses (β = -10.45, p = 0.001). Concern scores decreased as the duration of work experience increased (t = 2.19, p = 0.029).

CONCLUSIONS

Repeated educational programs can improve attitudes toward CPR performance and the use of AEDs. Training that addressed the concerns of health-care workers could further improve these attitudes.

Improvement in Trainees' Attitude and Resuscitation Quality With Repeated Cardiopulmonary Resuscitation Training: Cross-Sectional Simulation Study

INTRODUCTION

This study investigated the effect of increasing numbers of training sessions in cardiopulmonary resuscitation (CPR) on trainees' attitude and CPR quality.

METHODS

Cardiopulmonary resuscitation training for hospital employees was held every year from 2006 to 2010. Participants were recruited among the trainees in 2010. The trainees' attitudes toward CPR were surveyed by questionnaire, and the quality of their CPR was measured using 5-cycle 30:2 CPR on a manikin. Participants were categorized according to the number of consecutive CPR training sessions as T1 (only 2010), T2 (2009 and 2010), T3 (from 2008 to 2010) and T4-5 (from 2006 or 2007 to 2010). The trainee attitude and CPR quality were compared among the 4 groups.

RESULTS

Of 923 CPR trainees, 267 were enrolled in the study. There was significant increase in willingness to start CPR and confidence in chest compression and mouth-to-mouth ventilation (MTMV) with increasing number of CPR training sessions attended (especially for ≥ 3 sessions). There was a significant increase in mean compression depth and decrease in percentage of chest compressions with depth of less than 38 mm in the T3 and T4-5 compared with the T1 and T2. No-flow time decreased significantly, and the percentage of MTMV with visible chest rise increased, as the number of training sessions increased.

CONCLUSIONS

Repeated CPR training improved trainees' attitude and CPR quality. Because the number of training sessions increased (≥3), the willingness to start CPR and the confidence in skills increased significantly, and chest compression depth, no-flow time, and MTMV improved.

Community involvement in out of hospital cardiac arrest: A cross-sectional study assessing cardiopulmonary resuscitation awareness and barriers among the Lebanese youth

Out of hospital cardiac arrest (OHCA) is a leading cause of death worldwide. Developing countries including Lebanon report low survival rates and poor neurologic outcomes in affected victims. Community involvement through early recognition and bystander cardiopulmonary resuscitation (CPR) can improve OHCA survival.This study assesses knowledge and attitude of university students in Lebanon and identifies potential barriers and facilitators to learning and performing CPR.A cross-sectional survey was administered to university students. The questionnaire included questions regarding the following data elements: demographics, knowledge, and awareness about sudden cardiac arrest, CPR, automated external defibrillator (AED) use, prior CPR and AED training, ability to perform CPR or use AED, barriers to performing/learning CPR/AED, and preferred location for attending CPR/AED courses. Descriptive analysis followed by multivariate analysis was carried out to identify predictors and barriers to learning and performing CPR.A total of 948 students completed the survey. Participants' mean age was 20.1 (±2.1) years with 53.1% women. Less than half of participants (42.9%) were able to identify all the presenting signs of cardiac arrest. Only 33.7% of participants felt able to perform CPR when witnessing a cardiac arrest. Fewer participants (20.3%) reported receiving previous CPR training. Several perceived barriers to learning and performing CPR were also reported. Significant predictors of willingness to perform CPR when faced with a cardiac arrest were: earning higher income, previous CPR training and feeling confident in one's ability to apply an AED, or perform CPR. Lacking enough expertise in performing CPR was a significant barrier to willingness to perform CPR.University students in Lebanon are familiar with the symptoms of cardiac arrest, however, they are not well trained in CPR and lack confidence to perform it. The attitude towards the importance of bystander CPR and the need to learn CPR is very positive. Interventions should focus on public awareness campaigns regarding the importance of initiating bystander CPR while activating emergency medical services (EMS) and on making CPR training more available.

Factors influencing Chinese university students' willingness to performing bystander cardiopulmonary resuscitation

BACKGROUND AND AIM

Low rates of bystander-initiated CPR are a major obstacle to improved survival rates, and the aim of this study is to elucidate the factors associated with university students' attitudes toward performing bystander CPR.

METHODS

Questionnaires were distributed to 18 universities across three metropolises in China. One question asking for respondents' attitudes toward performing bystander CPR was set as the dependent variable, and the logistic regression models were used to extract independent factors for respondents' attitudes toward performing bystander CPR.

RESULTS

2934 questionnaires were completed, with a response rate of 81.5%. Results suggested that predictors of willingness to perform bystander CPR were: previous experience of performing bystander CPR, higher self-perceived ability to perform bystander CPR properly after instruction, medicine and law discipline, male gender, not being the single child of their parents, higher participation in university societies, being used to taking decisive action immediately, less self-perceived life stress and higher self-perceived knowledge level of CPR.

CONCLUSIONS

Persons having previous experience of performing bystander CPR and those who thought they would have the ability to perform bystander CPR properly are predominantly associated with willingness to perform bystander CPR. Psychological and cultural factors need further study.

Are Canadians more willing to provide chest-compression-only cardiopulmonary resuscitation (CPR)?-a nation-wide public survey

BACKGROUND

Bystander cardiopulmonary resuscitation (CPR) improves the likelihood of survival from out-of-hospital cardiac arrest (OHCA), yet it is performed in only 30% of cases. The 2010 guidelines promote chest-compression-only bystander CPR-a change intended to increase willingness to provide CPR.

OBJECTIVES

1) To determine whether the Canadian general public is more willing to perform chest-compression-only CPR compared to traditional CPR; 2) to characterize public knowledge of OHCA; and 3) to identify barriers and facilitators to bystander CPR.

METHODS

A 32-item survey assessing resuscitation knowledge, and willingness to provide CPR were disseminated in five Canadian regions. Descriptive statistics were used to characterize response distribution. Logistic regression analysis was applied to assess shifts in intention to provide CPR.

RESULTS

A total of 428 completed surveys were analysed. When presented with a scenario of being a bystander in an OHCA, a greater proportion of respondents were willing to provide chest-compression-only CPR compared to traditional CPR for all victims (61.5% v. 39.7%, p<0.001), when the victim was a stranger (55.1% v. 38.8%, p<0.001), or when the victim was an unkempt individual (47.9% v. 28.5%, p<0.001). When asked to describe an OHCA, 41.4% said the heart stopped beating, and 20.8% said it was a heart attack. Identified barriers and facilitators included fear of litigation and lack of skill confidence.

CONCLUSIONS

This study identified gaps in knowledge, which may impair the ability of bystanders to act in OHCA. Most respondents expressed greater willingness to provide chest-compression-only CPR, but this was mediated by victim characteristics, skill confidence, and recognition of a cardiac arrest.

Evaluation of Public Awareness, Knowledge and Attitudes about Cardiopulmonary Resuscitation: Report of İzmir

OBJECTIVE

Early initiation of cardiopulmonary resuscitation (CPR) by witnesses increases survival after cardiac arrest. In Turkey, our country, it is rare that basic life support (BLS) is initiated by a layperson. In our study, we aimed to use a survey to research awareness, level of knowledge and attitudes of the public to CPR and BLS.

METHODS

A 21-question survey was administered to individuals aged ≥18 years on a busy street in a city of a western region of Turkey. Topics such as knowledge about cardiac arrest findings, previous experience of CPR, knowledge of BLS and concerns related to CPR were questioned.

RESULTS

The fully completed forms of 533 people were evaluated. There were 40.7% who stated that they had received training in CPR. For signs of cardiac arrest, 40.7% answered loss of consciousness, 49.3% answered cessation of breathing and 60.7% answered cessation of circulation. It was found that 35.5% could perform only chest compressions, 27.6% could perform mouth-to-mouth ventilation and 28.7% able to perform both. While 52.0% knew the location for performing chest compressions, 34.3% knew the correct depth and 15.6% knew the correct compression-ventilation rate. Bystander CPR was performed by 3.6%.

CONCLUSION

In conclusion, 40.7% of people living in a highly educated region in the western part of Turkey had received CPR training and 3.6% performed bystander CPR. A majority of participants stated that they were willing to correct and develop their knowledge and skills related to CPR. Effective public CPR training programmes may increase the knowledge and awareness of CPR in the adult population.

An exploration of attitudes toward bystander cardiopulmonary resuscitation in university students in Tianjin, China: A survey

BACKGROUND

Despite the importance of early effective bystander cardiopulmonary resuscitation (CPR) to improve survival rates from out-of-hospital cardiac arrest, the attitudes toward performing, learning and disseminating CPR in university students of China are still unclear.

METHODS AND AIMS

To assess the attitudes regarding performing, learning and disseminating bystander CPR in university students of China.

RESULTS

The results indicated that except for the scenario where the victim was their own family member or close friend, all other scenarios showed a relatively dismally lower rate of positive response. Besides, it showed a greater willingness to perform chest compression only CPR (CC) than chest compression with mouth-to-mouth ventilation (CCMV) (P < 0.05). Females were more willing to perform CC across seven of the hypothetic scenarios than males. University students of medical-related specialties (45.3%) than university students of non-medical specialties (29.9%) were more willing to perform bystander CPR (P < 0.05). The top four reasons for being unwilling to perform bystander CPR were lack of confidence (32.9%), fear of legal disputes (17.2%), fear of disease transmission (16.0%) and feeling embarrassed (14.0%). 92.6% of respondents wanted to learn CPR and 80.3% of respondents were willing to disseminate CPR.

CONCLUSIONS

CPR technique, victim's status, respondent's specialty and respondent's gender affected the attitudes of respondents toward performing bystander CPR. The top four reasons for being unwilling to perform bystander CPR were lack of confidence, fear of legal disputes, fear of disease transmission and feeling embarrassed. However, the key reason for being unwilling to perform bystander CPR differed in different specialties and particularly 'feeling embarrassment' might be a cultural phenomenon. The attitudes toward learning and disseminating CPR were positive and affected by respondent's gender and specialty.

Understanding and improving low bystander CPR rates: a systematic review of the literature

Objectives:

Cardiopulmonary resuscitation (CPR) is a crucial yet weak link in the chain of survival for out-of-hospital cardiac arrest. We sought to understand the determinants of bystander CPR and the factors associated with successful training.

Methods:

For this systematic review, we searched 11 electronic databases, 1 trial registry and 9 scientific websites. We performed hand searches and contacted 6 content experts. We reviewed without restriction all communications pertaining to who should learn CPR, what should be taught, when to repeat training, where to give CPR instructions and why people lack the motivation to learn and perform CPR. We used standardized forms to review papers for inclusion, quality and data extraction. We grouped publications by category and classified recommendations using a standardized classification system that was based on level of evidence.

Results:

We reviewed 2409 articles and selected 411 for complete evaluation. We included 252 of the 411 papers in this systematic review. Differences in their study design precluded a meta-analysis. We classified 22 recommendations; those with the highest scores were 1) 9-1-1 dispatch-assisted CPR instructions, 2) teaching CPR to family members of cardiac patients, 3) Braslow's self-training video, 4) maximizing time spent using manikins and 5) teaching the concepts of ambiguity and diffusion of responsibility. Recommendations not supported by evidence include mass training events, pulse taking prior to CPR by laymen and CPR using chest compressions alone.

Conclusion:

We evaluated and classified the potential impact of interventions that have been proposed to improve bystander CPR rates. Our results may help communities design interventions to improve their bystander CPR rates.

Basic life support knowledge and skills of Iranian general dental practitioners to perform cardiopulmonary resuscitation

BACKGROUND

When cardiopulmonary arrest occurs, the dentist's ability to perform cardiopulmonary resuscitation (CPR) is the most important factor to minimize morbidity and mortality. This study assessed the basic life support (BLS) knowledge and performance of general dental practitioners in Hamadan, Iran.

MATERIALS AND METHODS

The participants in the study were 80 Iranian general dental practitioners who were chosen randomly. Their CPR knowledge was evaluated by verbal questions and their CPR skills were determined by CPR execution on a special manikin. Nearly 39% (n = 31) of dentists answered none of the questions and only 2.50% (n = 2) answered all of the questions correctly. Thirty six dentists had been participated CPR course after graduation.

RESULT

There was a significant difference between dentists who participated in CPR training course and those that did not participate (P value = 0.000). Only 3.75% (n = 3) were able to perform CPR properly.

CONCLUSION

The results showed that the amount of CPR knowledge and skills were low in participated Iranian general dental practitioners. However, CPR training courses after graduation increased the amount of knowledge significantly, thus, retraining CPR courses is necessary for dentists.

[Teaching basic life support to the general population. Alumni intervention analysis]

OBJECTIVES

The aim of this study was to investigate the rate at which the alumni of basic life support courses witnessed and intervened in out-of-hospital emergency situations, and to identify the variables characterizing those alumni associated with a greater number of witnessing events and interventions. An analysis of the efficiency of the courses was also carried out.

DESIGN

A descriptive, cross-sectional study was made.

SETTING

A district in the province of Almería (Spain).

PATIENTS

Alumni of a mass basic life support training program targeted to the general population «Plan Salvavidas» conducted between 2003-2009.

INTERVENTIONS

In 2010 the alumni were administered a telephone survey asking whether they had witnessed an emergency situation since attending the program, with the collection of information related to this emergency situation.

MAIN VARIABLES OF INTEREST

Rate of out-of-hospital emergencies witnessed by the alumni. Rate of intervention of the alumni in emergency situations. Variables characterizing alumni with a greater likelihood of witnessing an emergency situation.

RESULTS

A total of 3,864 trained alumni were contacted by telephone. Of 1,098 respondents, 63.9% were women, and the mean age was 26.61±10.6 years. Of these alumni, 11.75% had witnessed emergency situations, an average of three years after completing the course. Of these emergencies, 23.3% were identified as cardiac arrest. The alumni intervened in 98% of the possible cases. In 63% of the cases, there was no connection between the alumni and the victim. The majority of the emergency situations occurred in the street and in public spaces. A greater likelihood of witnessing an emergency situation was associated with being a healthcare worker and with being over 18 years of age.

CONCLUSIONS

The rate of out-of-hospital emergencies witnessed by these alumni after the course was 11.75%. The level of intervention among the alumni was high. The most efficient target population consisted of healthcare workers.

A multicenter controlled trial on knowledge and attitude about cardiopulmonary resuscitation among secondary school children in Malaysia

BACKGROUND

We performed a multicenter controlled trial to assess the knowledge and attitude (KA) about cardiopulmonary resuscitation (CPR) among secondary school children in a district in Malaysia.

METHODS

This was a prospective intervention study. The primary endpoint of the study was to determine the level of KA about resuscitation after CPR training. The six schools and classes from selected schools were chosen by randomization among the form three and four classes using sealed envelopes. A fully validated questionnaire consisting of three sections (sociodemographic, knowledge and attitude) was given to the pupils before and 2 weeks after the intervention. The intervention group was given a lecture, video show, pamphlet and 1-h practical session on CPR training. The control group received a placebo in order to overcome the learning effect. The maximum scores for the knowledge and attitude sections were 72 and 28, respectively. Repeated measures ANOVA analysis was used for specific objectives to determine the changes in knowledge and attitude level pre- and post-intervention for both study groups. P-values less than 0.05 were taken as significant at 95% confidence intervals.

RESULTS

The mean (SD) total knowledge scores for the intervention (n = 216) and control (n = 252) groups were 62.43 (13.68) and 62.29 (12.11), respectively (maximum score 72) (p > 0.05). On the other hand, the mean (SD) total attitude scores for the intervention and the control groups were 19.33 (4.51) and 17.85 (4.52), respectively (maximum score 28) (p < 0.001). There were significant differences in mean knowledge and attitude scores between the intervention and control groups with regard to time (pre- and post-intervention). The mean difference in knowledge and attitude scores between both study groups was 8.31 (p < 0.001) and 2.39 (p < 0.001), respectively.

CONCLUSIONS

The level of knowledge and attitudes of secondary school children was shown to be acceptable prior to the intervention. Furthermore, a brief CPR training program improved their level of knowledge and attitudes significantly as compared to those who had never been trained.

Can mass education and a television campaign change the attitudes towards cardiopulmonary resuscitation in a rural community?

BACKGROUND

Survival after out-of-hospital cardiac arrest (OHCA) is improved when bystanders provide Basic Life Support (BLS). However, bystander BLS does not occur frequently. The aim of this study was to assess the effects on attitudes regarding different aspects of resuscitation of a one-year targeted media campaign and widespread education in a rural Danish community. Specifically, we investigated if the proportion willing to provide BLS and deploy an automated external defibrillator (AED) increased.

METHODS

BLS and AED courses were offered and the local television station had broadcasts about resuscitation in this study community. A telephone enquiry assessed the attitudes towards different aspects of resuscitation among randomly selected citizens before (2008) and after the project (2009).

RESULTS

For responses from 2008 (n = 824) to 2009 (n = 815), there was a significant increase in the proportions who had participated in a BLS course within the past 5 years, from 34% to 49% (p = 0.0001), the number willing to use an AED on a stranger (p < 0.0001), confident at providing chest compressions (p = 0.03), and confident at providing mouth-to-mouth ventilations (MMV) (p = 0.048). There was no significant change in the proportions willing to provide chest compressions (p = 0.15), MMV (p = 0.23) or confident at recognizing a cardiac arrest (p = 0.09). The most frequently reported reason for not being willing to provide chest compressions, MMV and use an AED was insecurity about how to perform the task.

CONCLUSION

A targeted media campaign and widespread education can significantly increase the willingness to use an AED, and the confidence in providing chest compressions and MMV. The willingness to provide chest compressions and MMV may be less influenced by a targeted campaign.

Practical skills training influences knowledge and attitude of dental students towards emergency medical care

BACKGROUND

Medical emergencies in dental practice are generally perceived as being rare. Nonetheless, recent studies have shown that incidents occur on a regular basis. Therefore, patients have the right to expect necessary skills to manage life-threatening situations from every dentist.

OBJECTIVE

To observe students' attitude and self-assessment towards emergency medical care (EMC) and its practical appliance.

MATERIAL AND METHODS

Students of dentistry took part in small group sessions for adult and paediatric basic life support. Participants filled out pre-post questionnaires regarding knowledge and attitude towards EMC (6, respectively, 10-point Likert scale). Additionally, feedback was asked for the quality of course and tutors.

RESULTS

Forty dental students in their last 2 years of study registered for the EMC courses. The majority had never attended any first-aid course; the mean age was 25% and 75% were women. A comparison between pre- and post-evaluation showed that the participation in practical training easily enhances the students' awareness of EMC importance as well as self-confidence in managing emergencies. After the course, 71% shared the opinion that retraining should be obligatory for all medical personnel. At the same time, students' self-assessment of confidence for specific tasks got significant upgrades in every aspect.

CONCLUSION

The evaluation data clearly show the participants' needs to deal with topics of EMC within the curriculum of dentistry. The proposed course is able to change participants' attitudes towards EMC and its importance for their daily practice. The considerable enhancement of self-confidence in performing EMC-techniques might also lead to more willingness to manage emergency situations.

Effect of Severe Acute Respiratory Syndrome on Bystander Willingness to Perform Cardiopulmonary Resuscitation (CPR)–Is Compression–Only Preferred to Standard CPR?

Objective:

The effect of the severe acute respiratory syndrome (SARS) outbreak on the willingness of laypersons to provide bystander cardiopulmonary resuscitation (CPR) using standard CPR (SCPR) or compression-only CPR (CCPR) was evaluated.The preferred type of SCPR in the post-SARS era was assessed.

Methods:

A descriptive study was conducted through telephone interviews. Persons who attended a CPR coursefrom January 2000 through February 2003 answered a structured questionnaire. The respondents' willingnessto perform SCPR or CCPR during a witnessed cardiac arrest of an average adult stranger or that of a family member in the pre-SARS and the post-SARS era was surveyed.

Results:

Data for 305 respondents were processed. For the scenario of cardiac arrest of an average stranger, more respondents would perform CCPR than SCPR in the pre-SARS era (83.6% vs. 61.3%, p <0.001) and in the post- SARS era (77.4% vs. 28.9%, p <0.001). In the scenario of the cardiac arrest of a family member, more would perform CCPR than SCPR in the pre-SARS era (92.8% vs. 87.2%, p <0.001) and in the post-SARS era (92.8% vs. 84.9%, p <0.001). After SARS, more respondents were unwilling to perform SCPR (p <0.001) and CCPR (p <0.001) on strangers. After SARS, more respondents were unwilling to perform SCPR on a family member (p = 0.039), but there was no difference in the preference to perform CCPR (p = 1.000).

Conclusions:

Concerns about SARS adversely affected the willingness of respondents to perform SCPR or CCPRon strangers and to perform SCPR on family members.Compression-only CPR was preferred to SCPR to resuscitate strangers experiencing cardiac arrest after the emergence of SARS.

First aid and harm minimization for victims of road trauma: a population study

INTRODUCTION

This project examined the use of first aid by bystanders at road traffic crashes (RTC) and was undertaken in the context of increasing average ambulance response times to RTC throughout Australia and the potential impact of early first aid intervention on the mortality and morbidity associated with RTC. The aim of this project was to acquire knowledge about the prevalence of first aid training; the incidence of being a bystander and of providing first aid; the range of first aid skills being utilized; the motivation to intervene; and, the perceived impact of first aid training.

METHODS

An Internet-based survey was distributed to a potential population of 12,500 road users and a total of 773 responded. Descriptive and comparative statistical analysis of quantitative data and thematic analysis of qualitative data were completed.

RESULTS

Seventy-seven percent (77%) of participants had first aid training at some stage in their lives; 28% held a current first aid certificate; 11% had provided first aid at RTC; 75.3% who had provided first aid were travelling in a vehicle. Having first aid training increased the likelihood of intervention and of owning a first aid kit or pocket mask.

CONCLUSIONS

First aid training, even if it is not current, is an enabler for providing first aid at RTCs. The first aid skills most commonly used were changing posture, opening an airway, and providing comfort and reassurance. Key concerns for first aiders included a feeling of a lack of follow-up, and lack of an opportunity to debrief. Strategies to increase first aid training, to improve information and support, and to increase the knowledge of first aider's are discussed.

Are trained individuals more likely to perform bystander CPR? An observational study

BACKGROUND

This study aimed to evaluate the association of cardiopulmonary resuscitation (CPR) training with bystander resuscitation performance and patient outcomes after out-of-hospital cardiac arrest (OHCA).

METHODS

This was a prospective, population-based cohort study of all persons aged 18 years or older with OHCA of presumed intrinsic origin and their rescuers from January through December 2008 in Takatsuki, Osaka prefecture, Japan. Data on resuscitation of OHCA patients were obtained by emergency medical service (EMS) personnel in charge based on the Utstein style. Rescuers' characteristics including experience of CPR training were obtained by EMS personnel interview on the scene. The primary outcome was the attempt of bystander CPR.

RESULTS

Data were collected for 120 cases out of 170 OHCAs of intrinsic origin. Among the available cases, 60 (50.0%) had previous CPR training (trained rescuer group). The proportion of bystander CPR was significantly higher in the trained rescuer group than in the untrained rescuer group (75.0% and 43.3%; p = 0.001). Bystanders who had previous experience of CPR training were 3.40 times (95% confidence interval 1.31-8.85) more likely to perform CPR compared with those without previous CPR training. The number of patients with neurologically favorable one-month survival was too small to evaluate statistical difference between the groups (2 [3.3%] in the trained rescuer group versus 1 [1.7%] in the untrained rescuer group; p = 0.500).

CONCLUSIONS

People who had experienced CPR training had a greater tendency to perform bystander CPR than people without experience of CPR training. Further studies are needed to prove the effectiveness of CPR training on survival.

Performance of supraglottic airway devices and 12 month skill retention: a randomized controlled study with manikins

PURPOSE

Airway management for successful ventilation by laypersons and inexperienced healthcare providers is difficult to achieve. Bag-valve mask (BVM) ventilation requires extensive training and is performed poorly. Supraglottic airway devices (SADs) have been successfully introduced to clinical resuscitation practice as an alternative. We evaluated recently introduced (i-gel™ and LMA-Supreme™) and established SADs (LMA-Unique™, LMA-ProSeal™) and BVM used by laypeople in training sessions on manikins.

METHODS

In this randomized controlled study, 267 third-year medical students participated with informed consent and IRB approval. After brief standardized training, each participant applied all devices in a randomized order. Success of device application and ventilation was recorded. Without further training, skill retention was assessed in the same manner 12 months later. Outcome parameters were the number of application attempts, application time, tidal volume and gastric inflation rate recorded at successful attempts, and subjective ease-of-use rating by the participants.

RESULTS

i-gel™ and LMA-Supreme™ were the most successful in the first attempt at both assessments and in the subjective ease-of-use rating. The shortest application time was found with BVM (8 ± 5s in 2008 vs. 9 ± 5s in 2009) and i-gel (10 ± 3s vs. 12 ± 5s). Tidal volumes were disappointing with no device reaching 50% volume within the recommended range (0.4-0.6L). Gastric inflation rate was highest with BVM (18% vs. 20%) but significantly lower with all SADs (0.4-6%; p < 0.001 for 2008 and 2009).

CONCLUSION

SADs showed clear advantages over BVM. Compared with LMA-Unique™ and LMA-ProSeal™, i-gel™ and LMA-Supreme™ led to higher first-attempt success rates and a shorter application time.

Public knowledge of cardiopulmonary resuscitation in Republic of Slovenia

AIM

In a case of cardiac arrest lay people in Republic of Slovenia rarely start basic life support procedures. The aim of this study was to determine the extent of knowledge about and attitude towards cardiopulmonary resuscitation in lay population.

METHOD

A cross-sectional telephone survey using computer-assisted telephone interview method was performed in August and September 2006. Questionnaire contained sections regarding participant demographics, knowledge of cardiac arrest signs and of cardiopulmonary resuscitation procedures (CPR), previous courses of CPR training, and the awareness of emergency phone contact number.

RESULTS

We interviewed 500 subjects. Nearly 70% of subjects had attended courses on CPR, but nearly 80% of them did so more than 10 years ago. Less than half of the subjects knew that CPR include rescue breathing (47%) and chest compressions (44.6%). Subjects who passed training on CPR knew that twice more often (p < 0.001). Knowledge on resuscitation skills was generally poor. Only 1.2% knew the rate of chest compressions, 2.2% knew the correct compressions-to-ventilations ratio in adult CPR, and only 3 out of 500 subjects (0.6%) knew both. Correct site and correct strength for chest compressions were stated in 37.6% and 13.0%, respectively. Both the correct site and the correct strength were stated more often in CPR-trained group (p = 0.002 and p = 0.02, respectively).

CONCLUSION

Lay public in Republic of Slovenia has poor knowledge on CPR. Knowledge is better in trained versus untrained individuals. Educational campaign in the community would improve response to cardiac emergencies.