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Wyckoff MH, Singletary EM, Soar J, Olasveengen TM, Greif R, Liley HG, Zideman D, Bhanji F, Andersen LW, Avis SR, Aziz K, Bendall JC, Berry DC, Borra V, Böttiger BW, Bradley R, Bray JE, Breckwoldt J, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Cheng A, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Davis PG, de Almeida MF, de Caen AR, de Paiva EF, Deakin CD, Djärv T, Douma MJ, Drennan IR, Duff JP, Eastwood KJ, El-Naggar W, Epstein JL, Escalante R, Fabres JG, Fawke J, Finn JC, Foglia EE, Folke F, Freeman K, Gilfoyle E, Goolsby CA, Grove A, Guinsburg R, Hatanaka T, Hazinski MF, Heriot GS, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hung KKC, Hsu CH, Ikeyama T, Isayama T, Kapadia VS, Kawakami MD, Kim HS, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lockey AS, Malta Hansen C, Markenson D, Matsuyama T, McKinlay CJD, Mehrabian A, Merchant RM, Meyran D, Morley PT, Morrison LJ, Nation KJ, Nemeth M, Neumar RW, Nicholson T, Niermeyer S, Nikolaou N, Nishiyama C, O'Neil BJ, Orkin AM, Osemeke O, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, Reynolds JC, Ristagno G, Roehr CC, Sakamoto T, Sandroni C, Sawyer T, Schmölzer GM, Schnaubelt S, Semeraro F, Skrifvars MB, Smith CM, Smyth MA, Soll RF, Sugiura T, Taylor-Phillips S, Trevisanuto D, Vaillancourt C, Wang TL, Weiner GM, Welsford M, Wigginton J, Wyllie JP, Yeung J, Nolan JP, Berg KM. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group. Resuscitation 2021; 169:229-311. [PMID: 34933747 PMCID: PMC8581280 DOI: 10.1016/j.resuscitation.2021.10.040] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.
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Wyckoff MH, Singletary EM, Soar J, Olasveengen TM, Greif R, Liley HG, Zideman D, Bhanji F, Andersen LW, Avis SR, Aziz K, Bendall JC, Berry DC, Borra V, Böttiger BW, Bradley R, Bray JE, Breckwoldt J, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Cheng A, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Davis PG, de Almeida MF, de Caen AR, de Paiva EF, Deakin CD, Djärv T, Douma MJ, Drennan IR, Duff JP, Eastwood KJ, El-Naggar W, Epstein JL, Escalante R, Fabres JG, Fawke J, Finn JC, Foglia EE, Folke F, Freeman K, Gilfoyle E, Goolsby CA, Grove A, Guinsburg R, Hatanaka T, Hazinski MF, Heriot GS, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hung KKC, Hsu CH, Ikeyama T, Isayama T, Kapadia VS, Kawakami MD, Kim HS, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lockey AS, Malta Hansen C, Markenson D, Matsuyama T, McKinlay CJD, Mehrabian A, Merchant RM, Meyran D, Morley PT, Morrison LJ, Nation KJ, Nemeth M, Neumar RW, Nicholson T, Niermeyer S, Nikolaou N, Nishiyama C, O'Neil BJ, Orkin AM, Osemeke O, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, Reynolds JC, Ristagno G, Roehr CC, Sakamoto T, Sandroni C, Sawyer T, Schmölzer GM, Schnaubelt S, Semeraro F, Skrifvars MB, Smith CM, Smyth MA, Soll RF, Sugiura T, Taylor-Phillips S, Trevisanuto D, Vaillancourt C, Wang TL, Weiner GM, Welsford M, Wigginton J, Wyllie JP, Yeung J, Nolan JP, Berg KM. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group. Circulation 2021; 145:e645-e721. [PMID: 34813356 DOI: 10.1161/cir.0000000000001017] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.
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Dong XJ, Zhang L, Yu YL, Shi SX, Yang XC, Zhang XQ, Tian S, Myklebust H, Li GH, Zheng ZJ. The general public's ability to operate automated external defibrillator: A controlled simulation study. World J Emerg Med 2020; 11:238-245. [PMID: 33014220 DOI: 10.5847/wjem.j.1920-8642.2020.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Automated external defibrillators (AEDs) enable laypeople to provide early defibrillations to patients undergoing cardiac arrest, but scant information is available on the general public's ability to use AEDs. This study assessed the ability of laypeople to operate AEDs, the effect of a 15-minute training, and whether skills differed by age. METHODS From May 1 to December 31, 2018, a prospective simulation study was conducted with 94 laypeople aged 18-65 years (32 aged 18-24 years, 34 aged 25-54 years, and 28 aged 55-65 years) with no prior AED training. The participants' AED skills were assessed individually pre-training, post-training, and at a three-month follow-up using a simulated cardiac arrest scenario. The critical actions and time intervals were evaluated during the AED operating process. RESULTS Only 14 (14.9%) participants (eight aged 18-24 years, four aged 25-54 years, and two aged 55-65 years) successfully delivered defibrillations before training. AED operation errors were more likely to occur among the participants aged 55-65 years than among other age groups. After training, the proportion of successful defibrillations increased significantly (18-24 years old: 25.0% vs. 71.9%, P<0.01; 25-54 years old: 11.8% vs. 70.6%, P<0.01; 55-65 years old: 7.1% vs. 67.9%, P<0.01). After three months, 26.1% of the participants aged 55-65 years successfully delivered defibrillations, which was significantly lower than that of participants aged 18-24 years (54.8%) and 25-54 years (64.3%) (P=0.02). There were no differences in time measures among three age groups in each test. CONCLUSIONS The majority of untrained laypeople cannot effectively operate AEDs. More frequent training and refresher courses are crucial to improve AED skills.
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Affiliation(s)
- Xue-Jie Dong
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yue-Lin Yu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Shu-Xiao Shi
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao-Chen Yang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao-Qian Zhang
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shuang Tian
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | | | - Guo-Hong Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Zhi-Jie Zheng
- School of Public Health, Peking University, Beijing, China
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You KM, Shin J, Lee SJ, Lee HJ, Jung JH, Son YJ, Hwang SY. Video-enhanced follow-up training improves basic life support skills retention in laypersons: A prospective randomized controlled trial. HONG KONG J EMERG ME 2019. [DOI: 10.1177/1024907919894418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Retraining and retention for basic life support skills after initial basic life support education are important for high-quality basic life support performance at the scene. Objectives: We investigated whether delivery of a personal-training video clip reduced basic life support skill degradation in laypersons. Methods: After a basic life support layperson training course, the participants were randomized to the video group and control group. The layperson learners in the video group were provided with a video clip of themselves during basic life support education course and a follow-up text message every 3 months after initial basic life support course. The control group only received a follow-up text message every 3 months, without a video clip. The performances of all participants were reviewed initially and after 12 months in each group. Results: The total number of participants was 186. Among them, 22 in the video group and 29 in the control group completed the follow-up and final basic life support skill tests. In the control group, basic life support skill level of the participants was at 60.1% after 12 months compared with the initial test and 79.8% in the video group. The performance differences in each basic life support skill score between the initial and follow-up test at 12 months were significantly different between the video group and control group: non-compression, 0.0 (0.0–1.0) versus 1.0 (1.0–2.0); compression, 1.0 (0.0–1.3) versus 1.0 (0.0–4.0); automated external defibrillator, 2.0 (1.0–3.0) versus 3.0 (2.0–4.5) and total score, 4.0 (2.0–5.0) versus 6.0 (3.0–9.5), respectively (all p-values < 0.05). Conclusion: Delivery of a basic life support personal-training video clip to laypersons who received basic life support training can reduce performance degradation at 12 months.
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Affiliation(s)
- Kyoung Min You
- Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jonghwan Shin
- Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Se Jong Lee
- Department of Emergency Medicine, Sejong Hospital, Bucheon, Republic of Korea
| | - Hui Jai Lee
- Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jin Hee Jung
- Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Yeong Ju Son
- Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Seong Youn Hwang
- Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
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Effectiveness of Knowledge Translation Strategies in Audiovisual Language Compared With Other Languages to Improve Health Outcomes in Individuals and the General Population: Systematic Review. ACTA ACUST UNITED AC 2019; 48:105-126. [PMID: 30981325 DOI: 10.1016/j.rcp.2017.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/24/2017] [Accepted: 07/10/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Knowledge translation (KT) not only encompasses a series of final actions in areas of dissemination, but also the identification of strategies for the implementation of this process. OBJECTIVE To evaluate the effectiveness of KT strategies in audiovisual language compared with other languages to improve health outcomes in the general population. METHODS We performed a search in MEDLINE, CENTRAL, PsycARTICLES, the WHO International Clinical Trials Registry Platform, EMBASE and LILACS. RESULTS We included 63 studies encompassing a broad range of study populations, languages that were compared to audiovisual language and measurement scales for outcomes. These studies presented a high risk of bias and the quality of evidence was not sufficient to draw conclusions about the effectiveness of the evaluated languages for knowledge translation. CONCLUSIONS We identified different languages that could be used in knowledge translation. The knowledge and the effects produced as a result of the strategy diminish as time progresses, regardless of the type of language used. This is an important point to consider when implementing this type of strategy.
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Public knowledge, attitudes and willingness regarding bystander cardiopulmonary resuscitation: A nationwide survey in Taiwan. J Formos Med Assoc 2018; 118:572-581. [PMID: 30190091 DOI: 10.1016/j.jfma.2018.07.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/11/2018] [Accepted: 07/23/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND A low bystander cardiopulmonary resuscitation (CPR) rate is one of the factors associated with low cardiac arrest survival. This study aimed to assess knowledge, attitudes, and willingness towards performing CPR and the barriers for implementation of bystander-initiated CPR. METHODS Telephone interviews were conducted using an author-designed and validated structured questionnaire in Taiwan. After obtaining a stratified random sample from the census, the results were weighted to match population data. The factors affecting bystander-initiated CPR were analysed using logistic regression. RESULTS Of the 1073 respondents, half of them stated that they knew how to perform CPR correctly, although 86.7% indicated a willingness to perform CPR on strangers. The barriers to CPR performance reported by the respondents included fear of legal consequences (44%) and concern about harming patients (36.5%). Most participants expressed a willingness to attend only an hour-long CPR course. Respondents who were less likely to indicate a willingness to perform CPR were female, healthcare providers, those who had no cohabiting family members older than 65 years, those who had a history of a stroke, and those who expressed a negative attitude toward CPR. CONCLUSION The expressed willingness to perform bystander CPR was high if the respondents possessed the required skills. Attempts should be made to recruit potential bystanders for CPR courses or education, targeting those respondent subgroups less likely to express willingness to perform CPR. The reason for lower bystander CPR willingness among healthcare providers deserves further investigation.
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Viewing an ultra-brief chest compression only video improves some measures of bystander CPR performance and responsiveness at a mass gathering event. Resuscitation 2017; 118:96-100. [DOI: 10.1016/j.resuscitation.2017.07.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/09/2017] [Accepted: 07/10/2017] [Indexed: 11/15/2022]
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Bhanji F, Donoghue AJ, Wolff MS, Flores GE, Halamek LP, Berman JM, Sinz EH, Cheng A. Part 14: Education: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2016; 132:S561-73. [PMID: 26473002 DOI: 10.1161/cir.0000000000000268] [Citation(s) in RCA: 202] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Del Rios M, Aldeen A, Campbell T, Demertsidis E, Heinert S, Sinchi J, Hoek TV. Save-a-life at the ballpark: 10-min spectator training achieves proficiency in cardiac arrest response. Resuscitation 2015; 87:21-5. [DOI: 10.1016/j.resuscitation.2014.10.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 10/19/2014] [Accepted: 10/28/2014] [Indexed: 11/27/2022]
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Godfred R, Huszti E, Fly D, Nichol G. A randomized trial of video self-instruction in cardiopulmonary resuscitation for lay persons. Scand J Trauma Resusc Emerg Med 2013; 21:36. [PMID: 23663288 PMCID: PMC3700766 DOI: 10.1186/1757-7241-21-36] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 04/08/2013] [Indexed: 11/18/2022] Open
Abstract
Background Cardiopulmonary resuscitation (CPR) improves outcomes after cardiac arrest. Much of the lay public is untrained in CPR skills. We evaluated the effectiveness of a compression-only CPR video self-instruction (VSI) with a personal manikin in the lay public. Methods Adults without prior CPR training in the past year or responsibility to provide medical care were randomized into one of three groups: 1) Untrained before testing, 2) 10-minute VSI in compressions-only CPR (CPR Anytime, American Heart Association, Dallas, TX), or 3) 22-minute VSI in compressions and ventilations (CPR Anytime). CPR proficiency was assessed using a sensored manikin. The primary outcome was composite skill competence of 90% during five minutes of skill demonstration. Evaluated were alternative cut-points for skill competence and individual components of CPR. 488 subjects (143 in untrained group, 202 in compressions-only group and 143 in compressions and ventilation group) were required to detect 21% competency with compressions-only versus 7% with untrained and 34% with compressions and ventilations. Results Analyzable data were available for the untrained group (n = 135), compressions-only group (n = 185) and the compressions and ventilation group (n = 119). Four (3%) achieved competency in the untrained group (p-value = 0.57 versus compressions-only), nine (4.9%) in the compressions-only group, and 12 (10.1%) in the compressions and ventilations group (p-value 0.13 vs. compressions-only). The compressions-only group had a greater proportion of correct compressions (p-value = 0.028) and compressions with correct hand placement (p-value = 0.0004) compared to the untrained group. Conclusions VSI in compressions-only CPR did not achieve greater overall competency but did achieve some CPR skills better than without training.
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Affiliation(s)
- Rachel Godfred
- University of Washington-Harborview Center for Prehospital Emergency Care, Seattle, WA, USA
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Kozłowski D, Kłosiewicz T, Kowalczyk A, Kowalczyk AK, Koźluk E, Dudziak M, Homenda W, Raczak G. The knowledge of public access to defibrillation in selected cities in Poland. Arch Med Sci 2013; 9:27-33. [PMID: 23515455 PMCID: PMC3598127 DOI: 10.5114/aoms.2013.33345] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 05/15/2012] [Accepted: 09/21/2012] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The Public Access to Defibrillation (PAD) program was designed to raise the awareness of sudden cardiac death (SCA) pre-hospital management among the community. The goal of the following research was to confirm the final impact of the Polish PAD program on various resident groups that differ by age, training and education level. MATERIAL AND METHODS The trial total number of participants reached 404 people from three cities divided into two groups. In group one (n = 295) were randomly selected people inside the trial area and in group two (n = 109) we had individuals who were theoretically trained in basic life support (BLS) algorithms, including the use of an automatic external defibrillator (AED). The research method was based on two different questionnaires completed by participants from each group. RESULTS The greatest knowledge of SCA, as well as the use of AED, and the best practical skills, were possessed by the residents of cities with a population over 100 000, aged between 18 and 30 years, who completed secondary or higher education (31.7%). The group with the smallest knowledge about SCA lived in the country (10.7%). The second group with little knowledge of the subject consisted mostly of individuals with primary education (4.19%) or professional abilities and over 50 years old (2.16%). CONCLUSIONS There must be some actions taken in order to increase the community awareness concerning automatic defibrillation. Training on AED and the possibility of practical exercise needs to be organized and should be conducted especially among residents of the countryside and people under 30 or over 50 years old.
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Affiliation(s)
- Dariusz Kozłowski
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland
- Chair of Health Sciences, Pomeranian Academy, Slupsk, Poland
| | | | - Adam Kowalczyk
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland
| | | | - Edward Koźluk
- 1 Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Maria Dudziak
- Noninvasive Diagnostic Cardiovascular Department, Medical University of Gdansk, Poland
| | | | - Grzegorz Raczak
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland
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Yeung J, Okamoto D, Soar J, Perkins GD. AED training and its impact on skill acquisition, retention and performance--a systematic review of alternative training methods. Resuscitation 2011; 82:657-64. [PMID: 21458137 DOI: 10.1016/j.resuscitation.2011.02.035] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 01/28/2011] [Accepted: 02/15/2011] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The most popular method of training in basic life support and AED use remains instructor-led training courses. This systematic review examines the evidence for different training methods of basic life support providers (laypersons and healthcare providers) using standard instructor-led courses as comparators, to assess whether alternative method of training can lead to effective skill acquisition, skill retention and actual performance whilst using the AED. METHOD OVID Medline (including Medline 1950-November 2010; EMBASE 1988-November 2010) was searched using "training" OR "teaching" OR "education" as text words. Search was then combined by using AND "AED" OR "automatic external defibrillator" as MESH words. Additionally, the American Heart Association Endnote library was searched with the terms "AED" and "automatic external defibrillator". Resuscitation journal was hand searched for relevant articles. RESULTS 285 articles were identified. After duplicates were removed, 172 references were reviewed for relevance. From this 22 papers were scrutinized and 18 were included. All were manikin studies. Four LOE 1 studies, seven LOE 2 studies and three LOE 4 studies were supportive of alternative AED training methods. One LOE 2 study was neutral. Three LOE 1 studies provided opposing evidence. CONCLUSION There is good evidence to support alternative methods of AED training including lay instructors, self directed learning and brief training. There is also evidence to support that no training is needed but even brief training can improve speed of shock delivery and electrode pad placement. Features of AED can have an impact on its use and further research should be directed to making devices user-friendly and robust to untrained layperson.
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Affiliation(s)
- Joyce Yeung
- University of Warwick, Warwick Medical School, UK
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Meischke H, Diehr P, Phelps R, Damon S, Rea T. Psychologic effects of automated external defibrillator training: a randomized trial. Heart Lung 2011; 40:502-10. [PMID: 21411144 DOI: 10.1016/j.hrtlng.2010.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 12/23/2010] [Accepted: 12/27/2010] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of this study was to test whether an automated external defibrillator (AED) training program would positively affect the mental health of family members of high-risk patients. METHODS A total of 305 patients with ischemic heart disease and their family members were randomized to 1 of 4 AED training programs: 2 video-based training programs and 2 face-to-face training programs that emphasized self-efficacy and perceived control. Patients and family members were surveyed at baseline and 3 and 9 months postischemic event on demographic characteristics, measures of quality of life (Short Form-36), self-efficacy, and perceived control. For this study, family members were the focus rather than the patients. RESULTS Regression analyses showed that family members in the face-to-face training programs did not score better on any of the mental health status variables than family members who participated in the other training programs except for an increase in self-efficacy beliefs at 3 months after training. CONCLUSION The findings suggest that a specifically designed AED training program emphasizing self-efficacy and perceived control beliefs is not likely to enhance family member mental health.
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Affiliation(s)
- Hendrika Meischke
- Department of Health Services, University of Washington, Seattle, Washington 98195-7232, USA.
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Mancini ME, Soar J, Bhanji F, Billi JE, Dennett J, Finn J, Ma MHM, Perkins GD, Rodgers DL, Hazinski MF, Jacobs I, Morley PT. Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2010; 122:S539-81. [PMID: 20956260 DOI: 10.1161/circulationaha.110.971143] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Soar J, Mancini ME, Bhanji F, Billi JE, Dennett J, Finn J, Ma MHM, Perkins GD, Rodgers DL, Hazinski MF, Jacobs I, Morley PT. Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2010; 81 Suppl 1:e288-330. [PMID: 20956038 PMCID: PMC7184565 DOI: 10.1016/j.resuscitation.2010.08.030] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol,United Kingdom.
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Kopacek KB, Dopp AL, Dopp JM, Vardeny O, Sims JJ. Pharmacy students' retention of knowledge and skills following training in automated external defibrillator use. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2010; 74:109. [PMID: 21045951 PMCID: PMC2933018 DOI: 10.5688/aj7406109] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVES To assess pharmacy students' retention of knowledge about appropriate automated external defibrillator use and counseling points following didactic training and simulated experience. DESIGN Following a lecture on sudden cardiac arrest and automated external defibrillator use, second-year doctor of pharmacy (PharmD) students were assessed on their ability to perform basic life support and deliver a shock at baseline, 3 weeks, and 4 months. Students completed a questionnaire to evaluate recall of counseling points for laypeople/the public. ASSESSMENT Mean time to shock delivery at baseline was 74 ± 25 seconds, which improved significantly at 3 weeks (50 ± 17 seconds, p < 0.001) and was maintained at 4 months (47 ± 18 seconds, p < 0.001). Recall of all signs and symptoms of sudden cardiac arrest and automated external defibrillator counseling points was diminished after 4 months. CONCLUSION Pharmacy students can use automated external defibrillators to quickly deliver a shock and are able to retain this ability after 4 months. Refresher training/courses will be required to improve students' retention of automated external defibrillator counseling points to ensure their ability to deliver appropriate patient education.
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Calle PA, De Paepe P, Van Sassenbroeck D, Monsieurs K. External artifacts by advanced life support providers misleading automated external defibrillators. Resuscitation 2008; 79:482-9. [DOI: 10.1016/j.resuscitation.2008.07.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Revised: 06/05/2008] [Accepted: 07/08/2008] [Indexed: 10/21/2022]
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Andresen D, Arntz HR, Gräfling W, Hoffmann S, Hofmann D, Kraemer R, Krause-Dietering B, Osche S, Wegscheider K. Public access resuscitation program including defibrillator training for laypersons: A randomized trial to evaluate the impact of training course duration. Resuscitation 2008; 76:419-24. [DOI: 10.1016/j.resuscitation.2007.08.019] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2007] [Revised: 08/01/2007] [Accepted: 08/08/2007] [Indexed: 10/22/2022]
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Bardy GH, Lee KL, Mark DB, Poole JE, Toff WD, Tonkin AM, Smith W, Dorian P, Yallop JJ, Packer DL, White RD, Longstreth W, Anderson J, Johnson G, Bischoff E, Munkers CD, Brown A, McNulty S, Ray LD, Clapp-Channing NE, Rosenberg Y, Salive M, Schron EB. Rationale and design of the Home Automatic External Defibrillator Trial (HAT). Am Heart J 2008; 155:445-54. [PMID: 18294476 DOI: 10.1016/j.ahj.2007.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Accepted: 12/03/2007] [Indexed: 10/22/2022]
Abstract
Most cardiac arrests occur in the home, where emergency medical services (EMS) systems are challenged to provide timely care. Because a large proportion of sudden cardiac arrests (SCAs) are due to ventricular tachycardia or ventricular fibrillation, home use of an automated external defibrillator (AED) might offer an opportunity to decrease mortality in those at risk. Predicting who will have a cardiac arrest in the general population is difficult. Individuals at high risk are usually easily identified and may become candidates for implantable cardioverter defibrillators. It is within the population at lower risk where home AEDs may be most useful. The purpose of the Home Automatic External Defibrillator Trial (HAT) is to test whether providing home access to an AED can improve survival in patients at modest risk of SCA, such as those surviving an anterior myocardial infarction but in whom implantable cardioverter defibrillator therapy is not deemed necessary. Between January 23, 2003, and October 20, 2005, 7001 patients were enrolled, with completion of follow-up scheduled for September 30, 2007. Randomization was conducted in a 1:1 fashion between control therapy, comprising the standard lay response to SCA (calling the EMS and performing cardiopulmonary resuscitation), and the use of an AED first, followed by calling the EMS and performing cardiopulmonary resuscitation. The primary end point is all-cause mortality. Secondary outcomes include survival from SCA (witnessed and unwitnessed, in home and out of home), incremental cost-effectiveness, and quality of life measures for both the patient and the spouse/companion. The results of the trial should be available in mid 2008.
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Reder S, Cummings P, Quan L. Comparison of three instructional methods for teaching cardiopulmonary resuscitation and use of an automatic external defibrillator to high school students. Resuscitation 2006; 69:443-53. [PMID: 16678958 DOI: 10.1016/j.resuscitation.2005.08.020] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2005] [Revised: 08/25/2005] [Accepted: 08/25/2005] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate new instructional methods for teaching high school students cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) knowledge, actions and skills. METHODS We conducted a cluster-controlled trial of 3 instructional interventions among Seattle area high school students, with random allocation based on classrooms, during 2003-04. We examined two new instructional methods: interactive-computer training and interactive-computer training plus instructor-led (hands-on) practice, and compared them with traditional classroom instruction that included video, teacher demonstration and instructor-led (hands-on) practice, and with a control group. We assessed CPR and AED knowledge, performance of key AED and CPR actions, and essential CPR ventilation and compressions skills 2 days and 2 months after training. All outcomes were transformed to a scale of 0-100%. RESULTS For all outcome measures mean scores were higher in the instructional groups than in the control group. Two days after training all instructional groups had mean CPR and AED knowledge scores above 75%, with use of the computer program scores were above 80%. Mean scores for key AED actions were above 80% for all groups with training, with hands-on practice enhancing students' positive outcomes for AED pad placement. Students who received hands-on practice more successfully performed CPR actions than those in the computer program only group. In the 2 hands-on practice groups the scores for 3 of the outcomes ranged from 57 to 74%; they were 32 to 54% in the computer only group. For the outcome of continuing CPR until the AED was available scores were high, 89 to 100% in all 3 training groups. Mean CPR skill scores were low in all groups. The highest mean score for successful ventilations was 15% and for compressions, 29%. The pattern of results was similar after 2 months. CONCLUSIONS We found evidence that interactive computer based self instruction alone was sufficient to teach CPR and AED knowledge and AED actions to high school students. All forms of instruction were highly effective in teaching AED use. In contrast to AED skills, CPR remains a set of difficult psychomotor skills that is challenging to teach to high school students as well as other members of the lay public.
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Hoke RS, Chamberlain DA, Handley AJ. A reference automated external defibrillator provider course for Europe. Resuscitation 2006; 69:421-33. [PMID: 16678325 DOI: 10.1016/j.resuscitation.2005.10.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2005] [Accepted: 10/10/2005] [Indexed: 11/26/2022]
Abstract
BACKGROUND Scientific evidence is scarce in relation to the effectiveness of different methods of teaching automated external defibrillator (AED) use to laypeople. A reference course is needed in order to test new courses or methods against a comparative standard. OBJECTIVE To propose a reference AED provider course that can be used as a comparator when testing new courses or teaching methods. METHODS All national resuscitation councils that are represented in the European Resuscitation Council were sent a questionnaire about the AED provider courses run by them or under their auspices. RESULTS Sixteen national resuscitation councils responded to the enquiry. Apart from the individual course timetables, there was remarkable consistency amongst the European countries as regards organisation, structure, content and methods. CONCLUSIONS A reference AED provider course for laypeople, based on a synthesis of existing European courses, is suggested as a tool for research. Prior completion of a basic life support provider course is mandatory. Course duration is 2 h 45 min (excluding breaks), with 1 h 40 min practice time for the participants, 25 min for theory, 20 min for practical demonstrations by the instructor and 20 min for introduction, discussion and closure. A manual is distributed at the start of the course. The ratio of instructors to participants is one to six. Lectures are interactive between the instructor and the class. AED use is practised in groups of six participants. Participants prove their competency by means of a formal test that simulates a cardiac arrest scenario. Using this course as a comparator during research into the methodology of AED teaching would provide a reference against which other courses could be tested.
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Affiliation(s)
- Robert Sebastian Hoke
- Department of Cardiology-Angiology, University of Leipzig, Johannisallee 32, 04103 Leipzig, Germany.
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Friedman FD, Dowler K, Link MS. A public access defibrillation programme in non-inpatient hospital areas. Resuscitation 2006; 69:407-11. [PMID: 16563600 DOI: 10.1016/j.resuscitation.2005.09.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2005] [Revised: 09/12/2005] [Accepted: 09/12/2005] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Automatic external defibrillators (AED) have proven to be valuable and life saving for out of hospital cardiac arrests. Their use in hospital arrests is less well documented, but they offer the opportunity to improve survival in the hospital setting also. METHODS The implementation of a public access defibrillation (PAD) programme at a tertiary care hospital is described, with reference specifically to targeting areas where time from arrest to arrival of defibrillation would be greater than 3 min. RESULTS Nine AEDs were placed in areas of the hospital distant from inpatient or outpatient floors. The locations of the AEDs were chosen based on a 3 min walk from currently available defibrillators to all areas of the hospital, including parking garages and walkways from building to building. In this programme AED use in non-inpatient hospital locations resulted in the resuscitation of a patient in ventricular fibrillation. CONCLUSION PAD in non-inpatient hospital settings can be life saving and similar programmes should be considered for other hospitals.
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Affiliation(s)
- Franklin D Friedman
- Tufts University School of Medicine, Emergency Physician, Tufts-New England Medical Center, Tufts-New England Medical Center, 750 Washington Street, Boston, MA 02111, USA.
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Affiliation(s)
- Mithilesh K Das
- Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Abstract
Immediate defibrillation is the single most effective therapy to reverse ventricular fibrillation cardiac arrest today. The once physician-only skill of defibrillation has entered mainstream society and is saving the lives of many sudden cardiac arrest (SCA) victims in a variety of settings. The automated external defibrillator (AED) and the concept of public access defibrillation (PAD) are a result of collaborative efforts between the American Heart Association (AHA) and medical manufacturers. Today, airports, airlines, casinos, cruise ships, and other public venues have modernized their first aid kits to include an AED. The success of these programs has ignited a trend in public safety and subsequently marketed the worth of AEDs in the home. Although optimal placement of AEDs remains uncertain, PAD is showing great promise in reducing the death rate from SCA. The lay public, both trained and untrained, is emerging as the next level of emergency care responders able to use a defibrillator.
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Affiliation(s)
- Sherry Caffrey
- Department of Aviation, O'Hare International Airport, Chicago, Illinois 60666, USA.
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Meischke HW, Rea TD, Eisenberg MS, Rowe SM. Intentions to use an automated external defibrillator during a cardiac emergency among a group of seniors trained in its operation. Heart Lung 2002; 31:25-9. [PMID: 11805746 DOI: 10.1067/mhl.2002.119833] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE By decreasing the time to defibrillation, automated external defibrillators (AEDs) provide an opportunity for lay people to improve survival in out-of-hospital sudden cardiac arrest. We examined how beliefs, expectations, and actual performance are related to intentions to use an AED during a future heart emergency among a group of seniors. DESIGN AND OUTCOME MEASURES One hundred fifty-nine seniors who had been previously trained in the operation of an AED were tested on their AED skills and asked about their perceptions regarding their AED skills; their expectations that an AED would save the life of a cardiac arrest victim; and their intentions to use an AED during a future cardiac event. RESULTS Logistic regression analyses showed that greater self-perceived ability to use an AED better actual performance on skills assessment but not expectations regarding the efficacy of AED treatment were independently associated with positive intentions to use an AED in a future heart emergency. CONCLUSIONS The likelihood that an elderly lay bystander will actually use an AED during a cardiac event may be closely tied to perceptions of his or her ability to operate an AED.
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