Keeping Bystanders Active: Resuscitating Resuscitation Skills

Knowledge in pre-hospital emergency and risk management among outdoor adventure practitioners in East Africa afro-alpine mountains

INTRODUCTION

The enjoyment of nature and other benefits of outdoor activities happen amid inherent hazards. This calls for knowledge and competency in emergency and risk management. Practitioners in outdoor activities, such as mountaineering, thus need to be knowledgeable on how to manage risks and attend to emergencies in their practice. The study sought to establish the preparedness of East African mountaineering practitioners in prehospital emergency and risk management. It sought to establish their knowledge on prehospital emergency and risk management, based on their age, gender, level of education and refresher training.

METHODS

The study purposively sampled one hundred and thirty six (N = 136) outdoor adventure practitioners from the Afro-alpine mountain areas in East Africa. It was hypothesized that there would be no significant relationship between the outdoor practitioners' knowledge in prehospital emergency risk management and their age, gender, level of education, refresher training. Somers' d was used to test the hypotheses.

RESULTS

It was established that the knowledge scores of prehospital emergency and risk management for the mountaineering practitioners was low. It was also established that the knowledge scores of outdoor practitioners were not dependent on their age, gender, and work experience. However, there was a significant relationship between the outdoor adventure practitioners' knowledge scores and their highest level of education as well as refresher training.

CONCLUSIONS

The study concluded that there were gaps in the knowledge of prehospital risk management of the East African Afro-alpine mountaineering practitioners. It recommends frequent and regular training and re-certification among outdoor adventure practitioners in order to raise the knowledge in prehospital emergency risk management.

Efficacy of a five-minute compression-only cardiopulmonary resuscitation class compared to thirty-minute instruction among college students

Objective

To determine if 5-minute compression-only cardiopulmonary resuscitation (CCO-CPR) instruction is as effective as 30-minute instruction in improving participant knowledge and comfort with performing CCO-CPR as well as teaching CPR quality and responsiveness to an Out of Hospital Cardiac Arrest (OHCA).

Methods

A prospective randomized controlled trial of university undergraduates was performed. Participants were randomized to either a 5-minute (experimental) or 30-minute (control) CCO-CPR instruction class. Pre- and post-testing was performed with a written and simulation test. Measurements collected assessed rate and depth of compressions, time to call 911, and time to start chest compressions. Prior to instruction, subjects’ baseline measurements of CPR performance were evaluated during a standardized sudden death scenario using a Laerdal Skillreporter^TM mannequin. The written test and scenario were repeated after either the five or 30 ​minute CCO-CPR instruction using the same outcome measures. Statistical tests of association for categorical variables were assessed using the chi-square test and the independent samples t-test was utilized for continuous variables. All tests were two-sided and the level of significance was set at α ​= ​0.05.

Results

Among the 59 participants, 28 received 5 ​minutes of instruction and 31 received 30 ​minutes. Fifteen (25.4%) individuals reported prior CPR training. Post intervention, all measurements reached statistically significant improvements in each group but there was no difference between the two groups improvement in depth of compressions (experimental group: 41.8 ​mm, 95% CI 36.6–43.4 vs control group: 46.5 ​mm, 95% CI 40.9–48.3, p ​= ​0.06), compressions per minute (114.3 cpm, 95% CI 105.5–122.0 vs 121.1 cpm, 95% CI 115.1–131.4, p ​= ​0.10), time to starting chest compressions (13.5 vs 12.4 ​sec, p ​= ​0.45), or time to calling 911 (8.34 vs 7.65 ​sec, p ​= ​0.58). Further, there was a statistically significant improvement in participants that said they would probably or definitely perform CCO-CPR in real life after both interventions but no difference between the groups (100% of the experimental group and 93.5% of the control group p ​< ​0.49).

Conclusion

Five-minute instruction is not inferior to 30-minute instruction at teaching undergraduate students how to perform quality bystander CCO-CPR.