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

Parental perceptions of the importance of pediatric out-of-hospital cardiopulmonary resuscitation for the survival rate in Saudi Arabia: a cross-sectional survey

BACKGROUND

Pediatric out-of-hospital cardiac arrest is associated with high morbidity and mortality rates. Cardiopulmonary resuscitation (CPR), the practice of chest compressions combined with rescue breathing, is crucial for the success of out-of-hospital resuscitation after sudden cardiac arrest. Thus, imparting the requisite knowledge and skills to parents/caregivers can significantly enhance survival rates. This study investigated parental awareness of the impact of out-of-hospital pediatric CPR on survival rates in Saudi Arabia.

METHODS

This cross-sectional study was conducted using an online questionnaire administered to Saudi parents from all regions of the Kingdom of Saudi Arabia. Data were collected using the convenience sampling method, as the questionnaire was distributed via social media platforms. The questionnaire consisted of five parts: (1) demographic data, (2) questions about parents' perception of basic life support (BLS), (3) evaluation of parents' knowledge of the impact of prehospital CPR on survival rates, (4) measurement of parents' competency in performing pediatric CPR, and (5) assessment of whether parents' confidence was affected by prior training. Statistical analyses were conducted using the chi-squared test or Fisher's exact test, and the t-test was used to compare the mean scores of the groups of parents with medical and non-medical professional backgrounds.

RESULTS

A total of 1,065 individuals responded to the survey. The respondents' mean age was 41 ± 0.2 years and 46.5% were men. We found that 73.9% of respondents had no prior experience with BLS, 87% had never taken a BLS course, and 61% did not know where to find one. The majority of participants agreed that bystander CPR contributes to overall survival rates, and 77% agreed to the importance of BLS training. Medical professionals showed a higher percentage of agreement on the importance of BLS than those from non-medical backgrounds (90% vs. 76%, p = 0.036), especially parents of high-risk children.

CONCLUSION

This study showed evidence of interest in CPR and BLS training in Saudi parents, despite the low levels of knowledge regarding BLS training.

Global prevalence of basic life support training: A systematic review and meta-analysis

BACKGROUND AND AIMS

Out-of-hospital cardiac arrest exerts a large disease burden, which may be mitigated by bystander cardiopulmonary resuscitation and automated external defibrillation. We aimed to estimate the global prevalence and distribution of bystander training among laypersons, which are poorly understood, and to identify their determinants.

METHODS

We searched electronic databases for cross-sectional studies reporting the prevalence of bystander training from representative population samples. Pooled prevalence was calculated using random-effects models. Key outcome was cardiopulmonary resuscitation training (training within two-years and those who were ever trained). We explored determinants of interest using subgroup analysis and meta-regression.

RESULTS

28 studies were included, representing 53,397 laypersons. Among national studies, the prevalence of cardiopulmonary resuscitation training within two-years and among those who were ever trained, and automated external defibrillator training was 10.02% (95% CI 6.60-14.05) and 39.64% (95%CI 29.11-50.67), and 15.70% (95% CI 10.17-22.18) respectively. Subgroup analyses by continent revealed pooled prevalence estimates of 31.58% (95%CI 18.70-46.09), 52.62% (95%CI 38.40-66.63), 18.93 (95%CI 0.00-62.94), 64.97% (95%CI 64.00-65.93), and 50.56% (95%CI 47.57-53.54) in Asia, Europe, Middle East, North America, and Oceania respectively, with significant subgroup differences (p<0.01). A country's income and cardiopulmonary resuscitation training (ever trained) (p=0.033) were positively correlated. Similarly, this prevalence was higher among the employed (p<0.00001) and highly educated (p<0.00001).

CONCLUSIONS

Large regional variation exists in data availability and bystander training prevalence. Socioeconomic status correlated with prevalence of bystander training, and regional disparities were apparent between continents. Bystander training should be promoted, particularly in Asia, Middle East, and low-income regions. Data availability should be encouraged from under-represented regions.

Comparing the effectiveness of a group-directed video instruction versus instructor-led traditional classroom instruction for learning cardiopulmonary resuscitation skills among first-year medical students: A prospective randomized controlled study

Introduction: Bystander cardiopulmonary resuscitation (CPR) training is inconsistent among students and the public. Existing CPR teaching courses are costly, time-consuming, and inconsistent. This study aimed to determine the association between overall CPR competency and two teaching modules, a group-directed video instruction module versus an instructor-led traditional classroom instruction module. Methods: This randomized prospective interventional study involved first year medical students of Universiti Sains Malaysia Health Campus from November 2018 until January 2019. Pass-fail scores representing the overall CPR, individual skill performance, and willingness to perform CPR for strangers and family members were collected. Factors associated with reluctance to perform CPR were assessed in a questionnaire. Results: A total of 99 participants were included, 50 in the group-directed video instruction as the intervention module and 49 in the traditional classroom instruction as the control module. There was no statistical significance between the pass and fail outcomes for both video module (p=0.436). Participants in both modules performed similarly in 8 out of 12 individual CPR skills. There was a significant difference in the distribution of skill scores between the pass and fail outcomes (p=<0.001). The intervention module is non-inferior compared to the control module, in relation to CPR willingness rates for strangers (p=0.999) and family members (p=0.117) after the training. Conclusions: The group-directed video self-instruction method is as effective as the instructor-led traditional classroom method to help participants to be competent and willing to perform CPR. It can be used as an independent or supplementary teaching tool for first-time learners and refreshers, especially in a group setting when teaching materials are limited.

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.

Cardiopulmonary resuscitation: Knowledge and Attitude of doctors from Lahore

OBJECTIVE

The objective of study was to assess the knowledge and attitude of doctors from Lahore regarding CPR as per American Heart Association (AHA) guidelines.

METHODS

The researchers visited various hospitals and filled e-questionnaires by interviewing respondents.The study was conducted at Jinnah Hospital Lahore, Mayo Hospital Lahore, Punjab Institute of Cardiology Lahore, Sir Ganga Ram Hospital Lahore, Services Hospital Lahore and Mid City Hospital. Data were analyzed using statistical package for social sciences (SPSS) 23 version. Knowledge was assessed based on the scores, with those scoring 10 or more being considered to have good knowledge while those having score less than 10 were considered to have poor knowledge. P values < 0.05 were considered statistically significant.

RESULTS

Out of 792 participants, 68 refused to take part in the study. The total respondents were 724 with the response rate of 91%. The knowledge regarding cardiopulmonary resuscitation of 601(83%) respondents was poor with only 123(17%) doctors having good knowledge. The doctors who received formal CPR training had better knowledge (20.17%) than the doctors who didn't get any training regarding CPR (4.69%). Anesthesiologists scored better among all specialties. The overall attitude of the doctors towards CPR was positive with 93.8% of the respondents willing to do CPR.

CONCLUSION

The overall knowledge of the doctors regarding CPR is not satisfactory. A practical and functional approach is needed to improve this situation. However, the attitude of the doctors towards CPR is positive.

Health-Care Providers' Knowledge, Attitudes, and Practices Regarding Adult Cardiopulmonary Resuscitation at Debre Markos Referral Hospital, Gojjam, Northwest Ethiopia

BACKGROUND

Cardiac arrest is one of the leading causes of death worldwide. Good knowledge, attitudes, and practices of health-care providers regarding cardiopulmonary resuscitation are vital to improve patient outcomes after cardiac arrest. This study aimed to assess knowledge, attitudes, and practices with regard to management of adult patients with cardiac arrest among health-care providers at Debre Markos Referral Hospital, Debre Markos, northwest Ethiopia in 2019.

METHODS

A hospital-based cross-sectional study was conducted from January to February, 2019 at Debre Markos Referral Hospital. All health-care providers who fulfilled the inclusion criteria were enrolled in the study. A pretested structured questionnaire was used for data collection. Data were entered into EpiData 3.1 and transferred to SPSS 20 for analysis.

RESULTS

Of the 352 health-care providers, 324 participated in the study for a response rate of 92%. Amajority (63%) were male. The age of male (80%) was 26-35 years old, with a mean of 29.28±4.8 years. A majority (77.8%) had inadequate knowledge about cardiopulmonary resuscitation. Almost all (97.8%) had no knowledge about cardiocerebral resuscitation. More than half (64.2%) had unfavorable attitudes toward CPR. Moreover, 288 (88.9%) had unsafe practices regarding cardiopulmonary resuscitation. The site and depth of chest compression was answered correctly by only 33 (10.2%) and 59 (18.2%) of participants, respectively.

CONCLUSION

Health-care providers' knowledge, attitudes, and practices were inadequate, unfavorable, and unsafe regarding the management of cardiac arrest. Training on the assessment of critically ill patients, cardiopulmonary resuscitation, and cardiocerebral resuscitation should be provided for health-care providers. Additionally, resuscitation equipment like defibrillators and emergency drugs should be available in all wards and emergency rooms.

Smartphone apps to support laypersons in bystander CPR are of ambivalent benefit: a controlled trial using medical simulation

Background

Bystander-initiated resuscitation is essential for surviving out-of-hospital cardiac arrest. Smartphone apps can provide real-time guidance for medical laypersons in these situations. Are these apps a beneficial addition to traditional resuscitation training?

Methods

In this controlled trial, we assessed the impact of app use on the quality of resuscitation (hands-off time, assessment of the patient’s condition, quality of chest compression, body and arm positioning). Pupils who have previously undergone a standardised resuscitation training, encountered a simulated cardiac arrest either (i) without an app (control group); (ii) with facultative app usage; or (iii) with mandatory app usage. Measurements were compared using generalised linear regression.

Results

200 pupils attended this study with 74 pupils in control group, 65 in facultative group and 61 in mandatory group. Participants who had to use the app significantly delayed the check for breathing, call for help, and first compression, leading to longer total hands-off time. Hands-off time during chest compression did not differ significantly. The percentage of correct compression rate and correct compression depth was significantly higher when app use was mandatory. Assessment of the patient’s condition, and body and arm positioning did not differ.

Conclusions

Smartphone apps offering real-time guidance in resuscitation can improve the quality of chest compression but may also delay the start of resuscitation. Provided that the app gives easy-to-implement, guideline-compliant instructions and that the user is familiar with its operation, we recommend smartphone-guidance as an additional tool to hands-on CPR-training to increase the prevalence and quality of bystander-initiated CPR.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13049-021-00893-3.

Awareness of Iranian Medical Sciences Students Towards Basic Life Support; a Cross-Sectional study

Introduction

Augmentation of the number of trained basic life support (BLS) providers can remarkably reduce the number of cardiac arrest victims. The aim of this study was to evaluate the level of BLS awareness among students of medical sciences in Iran.

Methods

This multicenter cross-sectional study was performed on medical students at the 4 major medical schools in Tehran, the capital of Iran, between Jan 2018 and Feb 2019, using convenience sampling method. The level of medical sciences students' awareness of BLS was measured using an international questionnaire.

Results

Finally, 1210 students with the mean age of 21.2 ± 2.3 years completed the survey (79% female). 133 (10.9%) students had CPR experience and none had received any formal training. None of the responders could answer all questions correctly. The mean awareness score of participants was 11.93 ± 2.87 (range: 10.13 -17.25). The awareness score of participants was high in 49 (4.04 %) participants, moderate in 218 (18.01%), and low in 943 (77.93%) of studied cases.

Conclusion

Based on the findings of this study, more than 70% of the studied medical sciences students obtained a low score on BLS awareness.

Knowledge of non-healthcare individuals towards cardiopulmonary resuscitation: a cross-sectional study in Riyadh City, Saudi Arabia

Background

Most sudden cardiac arrests occur at home, with low rates of bystander cardiopulmonary resuscitation being performed. We aimed to assess knowledge of cardiopulmonary resuscitation among individuals in Riyadh City, Saudi Arabia, who are not involved in health care.

Methods

A community-based cross-sectional study was conducted between January and February 2020 in 4 different areas in Riyadh City: North, South, East, and West. The participants were surveyed using a validated self-administered questionnaire. The Statistical Package for Social Sciences version 25.0 was used for inferential statistics and binary logistic regression analysis.

Results

A total of 856 participants completed the questionnaire, 51.8% were unaware of cardiopulmonary resuscitation. Only 4.4% of the participants had attended a formal cardiopulmonary resuscitation training course, 5.1% were campaign attendees, and 38.7% acquired their experience through the media. Having a higher level of education was positively associated with having knowledge of cardiopulmonary resuscitation. The main concern among attendees of cardiopulmonary resuscitation training courses and campaigns was legal issues, whereas inadequate knowledge was the major barrier for those who had learned about cardiopulmonary resuscitation through the media.

Conclusion

The level of knowledge of cardiopulmonary resuscitation among non-health care individuals in Riyadh City was found to be insufficient. Therefore, coordinated efforts among different authorities should be considered to implement a structured strategy aiming to increase awareness and knowledge of cardiopulmonary resuscitation among non-health care individuals.

Evaluation of Awareness, Knowledge, and Attitudes Towards Basic Life Support Among Non-Medical Students at Two Academic Institutions in Jeddah, Saudi Arabia

BACKGROUND

Cardiac arrests are a leading cause of mortality in Saudi Arabia. Prompt and quick intervention using early cardiopulmonary resuscitation (CPR) can be a life-saving strategy. Sufficient knowledge and awareness regarding CPR are important in initial care, particularly during an out-of-hospital cardiac arrest. We aim to assess the knowledge, awareness, and attitude toward CPR among the students of King Abdulaziz University and Jeddah University.

MATERIALS AND METHODS

A descriptive, cross-sectional study design with a sample of 1053 non-medical students, regardless of their academic year, was conducted from May to July 2019 at both universities. Data were analyzed through chi-square and analysis of variance where a P-value <0.05 was considered statistically significant.

RESULTS

Out of 1053 students, 28.7% received CPR training. Also, the majority of the subjects were female 71%. The science department provided the largest response. Results showed that chest pain was the most observed early sign of cardiac arrest among participants by a percentage of 84.6. Majority of the participants (90.9%) felt no hesitation in performing early CPR on a family member. Additionally, committing a mistake was the most feared factor that deterred students from performing CPR.

CONCLUSION

Knowledge and awareness of CPR among non-medical university students were poor, despite positive attitudes toward it. Integrating mandatory CPR courses in the orientation and in the first year of the undergraduate curriculum could increase awareness and improve the outcomes of out-of-hospital cardiac arrest (OHCA).

Basic life support knowledge in Germany and the influences of demographic factors

BACKGROUND

In the developed world, cardiovascular diseases still contribute to mortality and morbidity, leading to significantly increased deaths in recent years. Thus, it is necessary for a layperson to provide the best possible basic life support (BLS) until professional help is available. Since information on current BLS knowledge in Germany is not available, but necessary to be able to make targeted improvements in BLS education, we conducted this study.

METHODS

A cohort survey using convenience sampling (non-probability) method was conducted with questions found in emergency medicine education. People coming to the emergency room of two big university hospitals located in the South (Munich) and western part (Cologne) of Germany were asked to participate in the survey between 2016 and 2017. Primary outcome measures were the proportion of correct answers for each emergency scenario in relationship to age, region, profession and first-aid training.

RESULTS

Altogether 1003 people (504 from Cologne; 499 from Munich) took part in the questionnaire. 54.7% were female and 45.3% were male aging from 19 to 52 with a mean of 37.2 years. Although over 90% had taken part in first aid training, many people were lacking first aid knowledge, with less than 10% choosing the correct frequency for chest compression. Hereby demographic factors had a significant influence (p<0.05) in the given answers (Friedmann-and-Wilcoxon Test).

CONCLUSION

Overall, results of our survey indicate a clear lack of BLS knowledge. With this information, targeted measures for improving BLS knowledge should be conducted. Additionally, further studies on the feasibility and efficiency of teaching methods are needed.

A Cross-International Study to Evaluate Knowledge and Attitudes Related to Basic Life Support among Undergraduate Nursing Students-A Questionnaire Study

Practicing the algorithms of basic life support (BLS) is essential in order to take adequate measures to save lives, and future nursing staff should be advanced when it comes to performing lifesaving activities. The purpose of the study was to analyse the theoretical and practical knowledge of nursing students (within the undergraduate course) with regards to the basic life support (BLS). The study has a prospective, comparative and descriptive nature. Three countries that educate nursing students within the undergraduate course participated in the project. Data was collected with the use of a questionnaire based on the guidelines of the European Resuscitation Council (ERC 2015). The study was carried out among a total of 748 respondents from three countries: Poland (n = 189, 25.3%), Lithuania (n = 500, 66.8%) and Spain (n = 59; 7.9%). The average age of respondents was 23.41 (SD ± 5.90). The average score obtained by the respondents who answered the questions was 11.13 with a standard deviation of SD ± 2.29. The conducted study revealed that a substantial number of the respondents who participated in the study obtained an average result concerning theoretical and practical knowledge of BLS. It was also confirmed that the additional education in the form of first aid training courses has a major impact on improving the levels of knowledge among the students in each of the analysed country.

Assessment on CPR Knowledge and AED Availability in Saudi Malls by Security Personnel: Public Safety Perspective

Security personnel are the first ones who attend the scene in the case of out-of-hospital cardiac arrest (OHCA) at malls. Cardiopulmonary resuscitation (CPR) is not enough for those patients; they need an automated external defibrillator (AED) to bring the heart to function normally. This study aimed to assess the current status of CPR and AED knowledge and availability in Saudi malls by security personnel. Using a descriptive design, a study was conducted at seven malls located in the Eastern Province of Saudi Arabia. Two hundred and fifty participants were surveyed using the American Heart Association (AHA) 2015 guidelines to assess CPR and AED knowledge and availability in Saudi malls. The sample mean age was 32.60 years (SD = 10.02), and 87% of participants were working as security personnel. The majority of the participants had not received training about CPR and AED (75.8% and 95.2%, respectively). Common misconceptions are fallen into all categories of CPR and AED knowledge. Correctly answered statements ranged from 7.2% in the compression rate to 24.2% in hand placement. The study results indicated a poor training knowledge of CPR and AED in public settings. Integrating high-quality CPR and AED knowledge within the school and college curricula is a vital need. However, in order to maximize the survival rate, it is important to set laws and legislation adopted by stakeholders and decision makers to advocate the people who try to help, mandate AED installation in crowded places, and mandate teaching hands-only CPR and AED together as a package.

The Effect of Cardiopulmonary Resuscitation and Cardiac Chest Pain Management Training on Perceived Control, Depression, Stress and Anxiety in the Spouses of the Patients with Myocardial Infarction: A Randomized Controlled Trial

Background:

Sudden cardiac death is the most common cause of mortality worldwide. Most cases occur at home and the individuals most likely witnessed are family members. Spouses play a significant role in the recovery of such patients. We aimed to investigate the effect of Cardiopulmonary Resuscitation (CPR) and cardiac chest pain management trainings on the perceived control, depression, stress and anxiety in the spouses of the patients with Myocardial Infarction (MI).

Methods:

The present randomized controlled trial study was performed on 78 spouses of the patients admitted to Cardiac Care Unit of the hospitals affiliated to Shiraz University of Medical Sciences from August 2013 to April 2014. The subjects were randomly assigned into intervention (n=40) and control groups (n=38). The intervention group took part in educational workshop on CPR and cardiac chest pain management and followed-up for six weeks. Data were collected using Depression Anxiety Stress (DASS) Scale and Rotter’s internal-external locus of Control Scale. Statistical methods of data analysis included descriptive statistics, Chi-squared test, paired sample t-test, independent sample t-test, one way analysis of covariance, and multivariate analysis of covariance.

Results:

There were significant differences between intervention and control groups in perceived control and DASS subscales. After the intervention, perceived control scores reduced from 9.42±3.33 to 8.15±3.65 (P=0.001); depression from 28.85±11.99 to 21.65±8.64 (P=0.001); anxiety from 26.6±9.46 to 20.70±6.29 (P=0.02); and stress from 30.20±10.91 to 24.32±10.23 (P=0.01) in the intervention group.

Conclusion:

CPR and cardiac chest pain management trainings could effectively improve the perceived control, depression, anxiety, and stress in the spouses of the patients with MI.

Trial Registration Number: IRCT201310128124N2.

Mapping the public first-aid training landscape: a scoping review

While the public can play a vital role in saving lives during emergencies, intervention is only effective if people have the skills, confidence, and willingness to help. This review employs a five-stage framework to systematically analyse first aid and emergency helping literature from 22 countries (predominately in Asia, Australia, Europe, and the United States). The review covers 54 articles that investigate public first-aid knowledge and uptake of first-aid training (40); public confidence in first-aid skills and willingness to help during an emergency (21); and barriers to or enablers of learning first aid and delivering first aid in an emergency (25). The findings identify high levels of perceived knowledge, confidence, and willingness to help, supporting the contention that the public can play a vital role during an emergency. However, the findings also point to low uptake levels, low tested skill-specific knowledge, and barriers to learning first aid and helping, indicating that the first-aid training landscape is in need of improvement.

Development, validation and translation of cardiopulmonary resuscitation and automated external defibrillator training and placement bilingual questionnaire

Objectives

This paper describes the development and translation of a questionnaire purported to measure (1) the perception of the placement strategy of automated external defibrillator, (2) the perception on the importance of bystander cardiopulmonary resuscitation and automated external defibrillator (3) the perception on the confidence and willingness to apply these two lifesaving interventions as well as (4) the fears and concerns in applying these two interventions. For construct validation, exploratory factor analysis was performed using principal axis factoring and promax oblique rotation and confirmatory factor analysis performed using partial least square.

Results

Five factors with eigenvalue > 1 were identified. Pattern matrix analysis showed that all items were loaded into the factors with factor loading > 0.4. One item was subsequently removed as Cronbach’s alpha > 0.9 which indicates redundancy. Confirmatory factor analysis demonstrated acceptable factor loadings except for one item which was subsequently removed. Internal consistency and discriminant validity was deemed acceptable with no significant cross-loading.

Evaluating the awareness of ordinary people about relief operations and cardiopulmonary resuscitation when facing out-of-hospital cardiac arrest

Introduction:

The aim of this paper is to evaluate the awareness of ordinary people about relief operations and accurate cardiopulmonary resuscitation when facing out-of-hospital cardiac arrest.

Methods:

This was a cross-sectional study including 500 ordinary people who were randomly selected over a 3-month period in Ahvaz County, Ahvaz, Iran, and then asked to perform resuscitation operation on medical moulages. Their performance was then evaluated using a 21-item checklist.

Results:

The awareness of participants about relief operations were only acceptable in 9 cases. Only 1 (0.2%) of them was able to detect a pulse and blood circulation as well as to relieve any airway obstruction. 7 (1.4%) were able to correctly find the position on the chest where external cardiac massage (ECM) should be performed. And only 1 could perform ECM at a rate of 100-120 compressions/min.

Conclusion:

Results obtained from the present study does not confirm the awareness of ordinary people when encountering OHCA. Hence, it is essential to hold related training courses at appropriate intervals to improve their skills and knowledge.

Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: A systematic review

AIM

To determine whether training history (including number of times and duration since last training), knowledge, self-efficacy or willingness are associated with cardiopulmonary resuscitation (CPR) psychomotor skills.

METHODS

Eight databases were systematically searched from January 2005 to February 2018 for articles that involved adult layperson participants and explored an association between training history, knowledge, self-efficacy or willingness and CPR psychomotor skills or survival outcomes after real CPR attempts.

RESULTS

Thirty-four articles with a total of 35,421 participants were included. CPR training was found to improve psychomotor skills, compared to no training, and any previous training was associated with better skills, compared to no previous training, however only the use of a popular song promoted meaningful retention of a specifically targeted skill, compared to standard training methods. Skills deteriorated within 3 months, then plateaued from 3 to 6 months. Self-efficacy was weakly associated with skill level, however knowledge was not associated with skill level. No studies assessed the association between willingness and psychomotor skills.

CONCLUSION

All laypeople should attend an instructor-led CPR training session with real-time or delayed feedback to improve CPR skills. Training sessions should utilise combinations of validated skill-specific training strategies, preferably including popular songs and feedback to help ensure skills retention. Refresher training, which focusses on skills and self-confidence rather than knowledge, should be undertaken every 3-6 months, although this timeframe needs further validation. All future studies assessing CPR psychomotor skills should adhere to a standardised reporting outcome list (proposed in this paper) to ensure consistency and comparability of results.

The evaluation of laypersons awareness of basic life support at the university in Izmir

Objectives

Basic Life Support (BLS) is the application of cardiopulmonary resuscitation (CPR) in order to save the lives of cardiac arrest victims by members of the public pending the arrival of the Emergency Medical Service (EMS). The aim of this study was to evaluate the effectiveness of training in order to ensure society understands the importance of early initiation of BLS, and to provide information concerning BLS and automated external defibrillators (AED).

Methods

This study consisted of 150 participants, of whom none were healthcare professionals. The research data were collected from 150 pre-tests and 100 post-tests. A Comparison of nominal data was analyzed by both McNemar's test and Pearson's chi-square exact test.

Results

Of the participants, 39% had received the BLS training prior to the study. It was observed that the participants' desire for applying BLS increased from 43% to 78% post training, and the ratio of ability to distinguish the need for BLS increased from 54% to 79%. Our results also indicated that the knowledge level of the CPR application increased after the study. The proportion of participants who knew the purpose of using AED increased from 79.8% to 95.7%.

Conclusions

It was concluded that the BLS Awareness training increased in relation to the application of BLS, improved the BLS knowledge and increased awareness of the use of AED.

Knowledge of Nonmedical Individuals about Cardiopulmonary Resuscitation in Case of Cardiac Arrest: A Cross-Sectional Study in the Population of Jeddah, Saudi Arabia

Introduction

In cardiac arrest victims, providing a high-quality cardiopulmonary resuscitation (CPR) is a fundamental component of initial care, especially in the out-of-hospital settings. In this study, we sought to assess the knowledge of nonmedical people regarding cardiopulmonary resuscitation in the case of out-of-hospital cardiac arrest.

Methods

A cross-sectional survey containing 22 questions was administered to individuals aged ≥ 18 years, who were not health care providers. Sample included residents of Jeddah, Saudi Arabia. The survey included knowledge about cardiac arrest findings, previous experience with CPR, knowledge of basic life support (BLS), and concerns related to CPR.

Results

The fully completed survey forms of 600 respondents were analysed. Out of these, 28.7% stated that they had previously received training in CPR. Regarding manifestations of cardiac arrest, 40.7% suggested loss of consciousness, 36.8% suggested cessation of breathing, and 24.7% suggested cessation of circulation. Only 11.7% among respondents were found to be able to perform chest compressions. Also, only 9.2% could perform mouth-to-mouth ventilation, and 29.5% were able to perform both. While 55.5% knew the location for performing chest compressions, 44.7% knew the correct depth, and only 18.5% knew the correct compression–ventilation rate. Bystander CPR had been performed by only 10.7%.

Conclusion

In our sample, we found lack of knowledge regarding CPR. We advise for a coordinated national effort to improve the public awareness about CPR performance. This may include mass education, specialized training, and setting legislations.

Assessment of the levels of awareness toward cardiopulmonary resuscitation: A community-based study in Northern Saudi Arabia

BACKGROUND

Cardiopulmonary resuscitation (CPR) is a procedure performed in an emergency when the heart stops. Early initiation of CPR can save many lives. Thus, the aim of the present study was to assess the level of awareness toward CPR in a community-based study in Northern Saudi Arabia.

MATERIALS AND METHODS

This is a cross-sectional survey conducted in the city of Hail, Northern Saudi Arabia. Data about CPR were obtained from 442 Saudi volunteers living in the city of Hail.

RESULTS

A family history of ischemic heart disease was indicated in 148/442 (33.5%) of the participants. On asking the participants whether they have previous information about CPR, about 258/442 (58.4%) persons indicated "Yes," 118/442 (26.6%) replied "May be," and the remaining 66/442 (15%) replied "No."

CONCLUSION

The study showed a high level of awareness about CPR, which might be attributed to the majority of highly educated participants. Effective and sustainable public CPR training programs are needed to be implemented to preserve better knowledge and awareness of CPR in the general population.

Basic Life Support Knowledge Among a Nonmedical Population in Jeddah, Saudi Arabia: Cross-Sectional Study

Background

Providing basic life support (BLS) at the site of an accident is crucial to increase the survival rates of the injured people. It is especially relevant when health care is far away.

Objective

The aim of our study is to assess the BLS knowledge level of the Saudi Arabian population and identify influencing factors associated with level of knowledge about BLS.

Methods

Our study is a cross-sectional descriptive study, which was conducted using a self-administered online questionnaire derived from the BLS practice test. The Saudi population was the target population. The questionnaire was divided into two parts: one contained demographic data and the second part contained questions to test the population’s perception about how to perform BLS techniques properly. The data were collected between July and August 2017. Statistically significant differences were defined as those with a P value <.05, and a score of five or more was considered a passing score on the second part. We used SPSS version 21 for data analysis.

Results

Our study included 301 participants. Our participants’ BLS online exam scores ranged from 0 to 10, with a mean of 4.1 (SD 1.7). Only 39.2% (118/301) of the participants passed the test. The percentage of bachelor’s degree or higher holders constituted 60.1% (181/301) of the study population. In addition, higher income was significantly associated with higher scores on the test (P=.04).

Conclusions

This study demonstrated that the theoretical knowledge level of BLS among the general population in Jeddah was below average. There is a critical need to increase the public’s exposure to BLS education through raising awareness campaigns and government-funded training programs that aim to curb the incidence of out-of-hospital cardiac arrest mortalities in the Saudi community.

Medical Correctness and User Friendliness of Available Apps for Cardiopulmonary Resuscitation: Systematic Search Combined With Guideline Adherence and Usability Evaluation

Background

In case of a cardiac arrest, start of cardiopulmonary resuscitation by a bystander before the arrival of the emergency personnel increases the probability of survival. However, the steps of high-quality resuscitation are not known by every bystander or might be forgotten in this complex and time-critical situation. Mobile phone apps offering real-time step-by-step instructions might be a valuable source of information.

Objective

The aim of this study was to examine mobile phone apps offering real-time instructions in German or English in case of a cardiac arrest, to evaluate their adherence to current resuscitation guidelines, and to test their usability.

Methods

Our 3-step approach combines a systematic review of currently available apps guiding a medical layperson through a resuscitation situation, an adherence testing to medical guidelines, and a usability evaluation of the determined apps. The systematic review followed an adapted preferred reporting items for systematic reviews and meta-analyses flow diagram, the guideline adherence was tested by applying a conformity checklist, and the usability was evaluated by a group of mobile phone frequent users and emergency physicians with the system usability scale (SUS) tool.

Results

The structured search in Google Play Store and Apple App Store resulted in 3890 hits. After removing redundant ones, 2640 hits were checked for fulfilling the inclusion criteria. As a result, 34 apps meeting all inclusion criteria were identified. These included apps were analyzed to determine medical accuracy as defined by the European Resuscitation Council’s guidelines. Only 5 out of 34 apps (15%, 5/34) fulfilled all criteria chosen to determine guideline adherence. All other apps provided no or wrong information on at least one relevant topic. The usability of 3 apps was evaluated by 10 mobile phone frequent users and 9 emergency physicians. Of these 3 apps, solely the app “HELP Notfall” (median=87.5) was ranked with an SUS score above the published average of 68. This app was rated significantly superior to “HAMBURG SCHOCKT” (median=55; asymptotic Wilcoxon test: z=−3.63, P<.01, n=19) and “Mein DRK” (median=32.5; asymptotic Wilcoxon test: z=−3.83, P<.01, n=19).

Conclusions

Implementing a systematic quality control for health-related apps should be enforced to ensure that all products provide medically accurate content and sufficient usability in complex situations. This is of exceptional importance for apps dealing with the treatment of life-threatening events such as cardiac arrest.

Evaluation of public awareness, knowledge and attitudes towards basic life support: a cross-sectional study

BACKGROUND

Out-of-hospital cardiac arrest is a major cause of mortality worldwide. When basic life support techniques are implemented quickly, the chance of survival is doubled. Therefore, this study evaluated public awareness, knowledge and attitudes towards basic life support in Jordan.

METHODS

A descriptive, cross-sectional design with a convenience sample of 300 Jordanian adults aged over 18 years, recruited from three metropolitan areas in the northern, middle and southern regions.

RESULTS

A total of 87 participants (29%) stated that they have received training about cardiopulmonary resuscitation (CPR). Among them, 20 participants (23%) received their training through the media. The highest response rate for cardiac arrest signs was chest pain (n = 129, 43%). Participants who received training had greater knowledge of the three signs of consciousness evaluation. The numbers of participants who received training and performed chest compression, mouth-to-mouth ventilation, and both compression and ventilation were higher than those who did not receive training. Overall, 256 participants (88.3%) reported that they would perform CPR on someone from their family without hesitation. The most important concern about performing CPR was making a mistake.

CONCLUSIONS

Improving knowledge about cardiopulmonary resuscitation is an important topic, which can be achieved by training the general population. Media can play an important role in this issue.

Current Status of Knowledge about Cardiopulmonary Resuscitation among the University Students in the Northern Region of Saudi Arabia

Background

Sudden cardiac arrest is a major public health problem in the world. Immediate initiation of high-quality cardiopulmonary resuscitation (CPR) significantly increased patient survival rate. Therefore, it is very important to train young people and increase public awareness of CPR for the long-term benefit of the community.

Objective

We aimed at estimating the level of knowledge and attitude towards cardiopulmonary resuscitation (CPR) among the university students in the northern region of Saudi Arabia.

Methodology

A cross-sectional, prospective study was conducted among the students of four northern region universities of Saudi Arabia (Jouf, Hail, Northern Borders, and Tabuk) between March and November 2017. A self-administered questionnaire was prepared in both Arabic and English languages and distributed to all the participants. All the data were collected and analyzed by using SPSS version 21.

Results

A total of 947 students from four universities completed the questionnaire: Jouf (57%), Hail (15%), Northern Borders (13%), and Tabuk (15%). Although 72% of students have previous knowledge about CPR, 49% of them lack knowledge about a medical emergency. Moreover, 59% failed to answer regarding CPR where only 41% wrote the ABC steps in the correct sequence. However, 67% of the participants had very poor knowledge, 89% of participants desired to receive additional CPR training course, and 49% of the students thought that CPR training should be a mandatory graduation requirement for all universities. There were no significant differences between male and female students. Students from medicine-related colleges have significantly (p < 0.001) more knowledge and scored better compared with non-medicine-related colleges. Tabuk University scored better compared to the others, but the overall knowledge and attitude scored were low.

Conclusions

Overall knowledge about CPR among the university students was not satisfactory; however, attitude towards CRP training was very positive. Our results suggested that there is a need for improvement of CPR education among Saudi university students, which will help to reduce the cardiac arrest mortality rate among the community.

School Children Save Lives

Sudden cardiac death is one of the most common causes of preventable death in the industrialized world. In countries with organized emergency health services, it is possible to increase the rate of resuscitation performed by the public and save more lives. Increasing the rate of correct intervention by those witnessing sudden cardiac death requires an increase in the number of adults with training in CPR in society. Resuscitation training should begin in the school years to reach the whole of society within time. As school children with training in CPR increase, the proportion of individuals in society with training and the desire to help others increases, which causes a general increase in resuscitation rates. To teach children "Basic Life Support" the training models should be applied in theory, with training kits, and accompanied by educators, with a variety of figures based on video or computer based training. One of the most important steps in increasing the resuscitation rates performed by the public globally and enhancing survival is through training school children.

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.