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Sun M, Waters CM, Zhu A. Public willingness, attitudes and related factors toward cardiopulmonary resuscitation: A grounded theory study. Public Health Nurs 2024; 41:233-244. [PMID: 38111292 DOI: 10.1111/phn.13271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/21/2023] [Accepted: 11/30/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVES Despite receiving cardiopulmonary resuscitation (CPR) training, over 50% of bystanders were unable to actually perform CPR. Understanding public willingness and attitudes toward bystander CPR is crucial in explaining whether people initiate CPR. This study aimed to develop a theoretical understanding of factors that influence the public's willingness and attitudes to perform CPR. DESIGN This was a qualitative study using the grounded theory method. METHODS The data were collected from semi-structured interviews with 28 participants between August 2022 and November 2022. Purposive sampling and theoretical sampling were used to recruit participants. Interviews were recorded and transcribed. Data were analyzed using open, axial, and selective coding. RESULTS Nine categories and 24 subcategories were summarized from four aspects: willingness, attitudes, implementation, and training. Willingness included self-willingness, self-perception, and societal factors; attitudes covered personality traits, reactions to patients and environment; implementation comprised knowledge and skills, situational coping, and risk perception; training included CPR training accessibility and barriers to CPR training. A theoretical framework of public CPR willingness, attitudes, and their influencing factors was developed. CONCLUSION The public's CPR willingness, attitudes, training, and implementation were interrelated and influential. The findings may have significant implications for the development of legislation and policy related to CPR popularization and training.
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Affiliation(s)
- Mengxue Sun
- Xiangya Nursing School of Central South University, Changsha, Hunan, China
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Catherine M Waters
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, California, USA
| | - Aiqun Zhu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Emergency Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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AlShehri H, AlKulayb SM, Karhan HS, Al Wargash EA, Althobaiti RM, Alsinan MH, Al Mustanyir HA, Al-Swat G, Almakki RA, Alammari RM. Assessment of Knowledge, Attitudes, and Willingness Among People With and Without Heart Disease Relatives in Saudi Arabia Regarding Cardiopulmonary Resuscitation: A Cross-Sectional Study. Cureus 2023; 15:e51197. [PMID: 38283415 PMCID: PMC10818030 DOI: 10.7759/cureus.51197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Background Cardiopulmonary resuscitation (CPR) is a life-saving procedure that can be performed in many situations where a person's breathing or heartbeat has stopped, such as during a heart attack, suffocation, near drowning, or electrical injuries. Despite its importance, to our knowledge, no research has been conducted yet in our community on the differences in CPR knowledge, attitudes, and willingness between those with and without heart disease relatives. Objective This study aimed to assess the level of knowledge, attitude, and willingness of people with and without heart disease relatives to perform CPR in a case of cardiac arrest. Methods A descriptive cross-sectional study was carried out between July 2023 and October 2023 among the Saudi Arabia population using a self-administered online questionnaire focusing on the sociodemographic characteristics of participants and the level of knowledge, attitude toward CPR, and the willingness to perform CPR in a case of cardiac arrest. Results This study included 799 participants, with 331 males (41.4%) and 468 females (58.6%). Age distribution was mainly in the range of 18-25 years (241 participants, 30.2%). Geographically, the highest proportion was from the southern region (214 participants, 26.8%). The majority had a university degree (533 participants, 66.7%). Employment status varied, with 401 participants (50.2%) working outside the medical field. Monthly income showed that 297 (37.2%) had an income ranging from 2,000 to 10,000 SAR. The average daily sleep duration varied, with the majority (64.7%) reporting six to nine hours of sleep. Also, 44.2% of participants reported exercising. Regarding smoking status, 80.9% reported not smoking. A family history of heart disease was reported by 46.4% of participants, whereas 16.3% reported a personal diagnosis of heart disease. Regarding knowledge, 40.8% correctly identified when CPR should be performed. Only 40.4% correctly identified the first step in a CPR situation, and only 22.9% identified the correct sequence of steps for performing CPR. Additionally, only 66.5% correctly identified the emergency hotline number "Red Crescent." Furthermore, only 8.9% knew the correct compression/ventilation ratio for adults during CPR. As for the attitude, a significant percentage (65.0%) had not taken a CPR course. However, the majority (84.6%) expressed a strong desire to learn CPR. Interestingly, the participants showed a positive attitude toward CPR education. Among the participants, 53.9% responded that they performed CPR when encountering a situation that required it, while 46.1% did not. Regarding the participants' willingness to perform CPR on different individuals, the majority (74.1%) expressed their readiness to perform CPR whenever needed. Conclusion The findings demonstrated knowledge gaps, with misconceptions about CPR. However, participants generally expressed a positive attitude toward CPR education and a willingness to learn. Factors such as age showed a weak association with knowledge level, while gender, region, education, employment, and family history of heart disease did not significantly impact knowledge. The study highlighted the need for improved CPR education and awareness. Hence, we recommend CPR courses to be implemented as a graduation prerequisite. In addition to that, linking some government services to a first aid course would positively impact the general population's practices in CPR and other emergencies.
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Merchant AAH, Hassan S, Baig N, Atiq H, Mahmood S, Doll A, Naseer R, Haq ZU, Shehnaz D, Haider AH, Razzak J. Methodological analysis of a community-based training initiative using the EPIS framework: an ongoing initiative to empower 10 million bystanders in CPR and bleeding control. Trauma Surg Acute Care Open 2023; 8:e001132. [PMID: 38020852 PMCID: PMC10649812 DOI: 10.1136/tsaco-2023-001132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background Out-of-hospital cardiac arrest (OHCA) and life-threatening bleeding from trauma are leading causes of preventable mortality globally. Early intervention from bystanders can play a pivotal role in increasing the survival rate of victims. While great efforts for bystander training have yielded positive results in high-income countries, the same has not been replicated in low and middle-income countries (LMICs) due to resources constraints. This article describes a replicable implementation model of a nationwide program, aimed at empowering 10 million bystanders with basic knowledge and skills of hands-only cardiopulmonary resuscitation (CPR) and bleeding control in a resource-limited setting. Methods Using the EPIS (Exploration, Preparation, Implementation and Sustainment) framework, we describe the application of a national bystander training program, named 'Pakistan Life Savers Programme (PLSP)', in an LMIC. We discuss the opportunities and challenges faced during each phase of the program's implementation and identify feasible and sustainable actions to make them reproducible in similar low-resource settings. Results A high mortality rate owing to OHCA and traumatic life-threatening bleeding was identified as a national issue in Pakistan. After intensive discussions during the exploration phase, PLSP was chosen as a potential solution. The preparation phase oversaw the logistical administration of the program and highlighted avenues using minimal resources to attain maximum outreach. National implementation of bystander training started as a pilot in suburban schools and expanded to other institutions, with 127 833 bystanders trained to date. Sustainability of the program was targeted through its addition in a single national curriculum taught in schools and the development of a cohesive collaborative network with entities sharing similar goals. Conclusion This article provides a methodological framework of implementing a national intervention based on bystander response. Such programs can increase bystander willingness and confidence in performing CPR and bleeding control, decreasing preventable deaths in countries having a high mortality burden. Level of evidence Level VI.
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Affiliation(s)
| | - Sheza Hassan
- Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Noor Baig
- Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Sindh, Pakistan
- Department of Emergency Medicine, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Huba Atiq
- Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Sindh, Pakistan
- Department of Emergency Medicine, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Sana Mahmood
- CITRIC Health Data Science Center, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Ann Doll
- Resuscitation Academy Foundation, Seattle, Washington, USA
| | | | - Zia Ul Haq
- Department of Public Health, Khyber Medical University, Peshawar, Pakistan
| | | | - Adil H. Haider
- Dean's Office, The Aga Khan University, Karachi, Sindh, Pakistan
- Department of Surgery and Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Junaid Razzak
- Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Sindh, Pakistan
- Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, USA
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Tamur S, Alasmari RM, Alnemari MA, Altowairgi MA, Altowairqi AH, Alshamrani NM, Aljaid M, Al-Malki S, Khayat A, Alzahrani A, Shams A. Knowledge and Attitudes around First Aid and Basic Life Support of Kindergarten and Elementary School Teachers and Parents in Taif City, Saudi Arabia. Children (Basel) 2023; 10:1266. [PMID: 37508763 PMCID: PMC10378546 DOI: 10.3390/children10071266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/05/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND The foremost cause of children's (1-19 year) death is inadvertent injuries. While most of these accidental harms occur at home and school, rapid and suitable parental and teacher intervention is required to increase the chances of a child's survival. Therefore, both parents and teachers of the children in kindergarten and elementary school must be knowledgeable in first aid practice and basic life support (BLS) training. OBJECTIVES In the current study, our ambition is to evaluate the orientation level, knowledge, and attitudes around first aid and BLS training of kindergarten and elementary school teachers and parents in the city of Taif, Makkah region. METHODS A cross-sectional study in Taif, Saudi Arabia, targeted kindergarten and elementary school teachers and parents of students enrolled at these levels. There were 648 participants included in this study. The researchers assessed teachers' and parents' knowledge and attitudes around first aid and BLS using a validated, self-administered online questionnaire. RESULTS The study included 648 participants, including 248 (38.3%) teachers and 400 (61.7%) parents. The socio-demographic analysis showed that 412 (63.6%) are females and 233 (36.5%) are between the ages of 36 and 45 years. Approximately 142 (21.9%) participants reported previous training in the cardiopulmonary resuscitation (CPR) program, though more than half of them (53.5%) had outdated certificates (more than 2 years). The mean total knowledge for our study was 4.6 ± 1.4, with 22.4% of the participants being educated about first aid support and expressing a fair level of CPR foundations. Only a small percentage (2.3%) of the participants exposed a good and adequate theoretical level of knowledge around CPR skills and performance, while most of the contributors unveiled a poor level of knowledge (over 75%). There were no statistically significant differences between parents and teachers (p > 0.05). Finally, numerous participants (85%) appreciated training in the CPR program, and the most common motive was a "wish to avoid unnecessary death". CONCLUSIONS We concluded that a sizable portion of the contributors expressed a lack of proficiency in the fundamental CPR training knowledge and skills, pointing to an alarming public concern. Promisingly, a sizable percentage of participants expressed motivated attitudes toward CPR training. Therefore, additional study and data are required to effectively combat injury, with an emphasis on investigating causes and risk factors, burden and socioeconomic health determinants, community awareness level and desire to contribute, and accessibility for disseminating specific intervention strategies.
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Affiliation(s)
- Shadi Tamur
- Department of Pediatrics, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | | | | | | | | | | | - Maryam Aljaid
- Department of Pediatrics, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Sultan Al-Malki
- Department of Pediatrics, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Abdullah Khayat
- Department of Pediatrics, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Ahmad Alzahrani
- Department of Pediatrics, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Anwar Shams
- Department of Pharmacology, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
- Centre of Biomedical Sciences Research (CBSR), Taif University, P.O. Box 11099, Taif 21974, Saudi Arabia
- High Altitude Research Center, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
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Shaukat N, Ali DM, Jaffer M, Jarrar Z, Ashraf N, Hassan S, Daudpota AA, Qadir MA, Khowaja AH, Razzak J. Lifesaving skills training in schools - A qualitative study to explore students, teachers, and parent's perceived opportunities and challenges. BMC Public Health 2023; 23:400. [PMID: 36849931 PMCID: PMC9970688 DOI: 10.1186/s12889-023-15284-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 02/15/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE The objective of this study is to explore the perception of teachers, parents and students' regarding implementation of a school-based lifesaving skills program and help predict potential barriers and solutions. METHODS This qualitative exploratory study was conducted in Karachi, Pakistan, from December 2020- to October 2021. We included students, teachers, and parents of secondary (grades VIII, IX, and X) and higher secondary level students (grades XI and XII) in Karachi, Pakistan's public and private schools and colleges. We selected one public, two semi-private, and two private schools. We recruited students, teachers, and parents through convenience sampling. We conducted fifteen focus group discussions (FGDs) with the students, six FGDs with the teachers, and eighteen in-depth interviews (IDIs) with parents. We transcribed the data from audio recordings and translated it into the English language. Finally, we manually analyzed the data using thematic analyses. RESULTS This study found that bystanders' main barriers to performing lifesaving skills are lack of knowledge, fear of legal involvement, fear of hurting the patient by incorrect technique, lack of empathy among community stakeholders, and gender bias. However, the participants had a positive and supportive attitude toward implementing lifesaving skills training in schools. They suggested starting student training in the early teenage years, preferred medical staff as trainers, and suggested frequent small sessions in English/Urdu both or Urdu language and training via theory and practical hands-on drills. Furthermore, the training was proposed to be integrated into the school curriculum to make it sustainable. Finally, the government needs to support the program and make the legal environment more conducive for bystanders. CONCLUSION This study identified the significant barriers to performing lifesaving skills in an emergency in a low- and middle-income country (LMIC). The participants supported implementing a national lifesaving skills program in schools and colleges. However, the participants expressed that support is needed by the government for sustainability, integrating lifesaving skills into the school curriculum, providing legal support to the bystanders, and creating awareness among the general public.
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Affiliation(s)
- Natasha Shaukat
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan.
| | - Daniyal Mansoor Ali
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan
| | - Mehtab Jaffer
- School of Nursing & Midwifery, Aga Khan University, Karachi, Pakistan
| | - Zeerak Jarrar
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan
| | - Naela Ashraf
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan
| | - Sheza Hassan
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan
| | | | | | | | - Junaid Razzak
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan.,Department of Emergency Medicine, Weill Cornell Medicine, New York, USA
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Farquharson B, Dixon D, Williams B, Torrens C, Philpott M, Laidlaw H, McDermott S. The psychological and behavioural factors associated with laypeople initiating CPR for out-of-hospital cardiac arrest: a systematic review. BMC Cardiovasc Disord 2023; 23:19. [PMID: 36639764 PMCID: PMC9840280 DOI: 10.1186/s12872-022-02904-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/17/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Prompt, effective CPR greatly increases the chances of survival in out-of-hospital c ardiac arrest. However, it is often not provided, even by people who have previously undertaken training. Psychological and behavioural factors are likely to be important in relation to CPR initiation by lay-people but have not yet been systematically identified. METHODS Aim: to identify the psychological and behavioural factors associated with CPR initiation amongst lay-people. DESIGN Systematic review Data sources: Cochrane Library, MEDLINE, EMBASE, CINAHL, PsycInfo and Google Scholar. STUDY ELIGIBILITY CRITERIA Primary studies reporting psychological or behavioural factors and data on CPR initiation involving lay-people published (inception to 31 Dec 2021). STUDY APPRAISAL AND SYNTHESIS METHODS Potential studies were screened independently by two reviewers. Study characteristics, psychological and behavioural factors associated with CPR initiation were extracted from included studies, categorised by study type and synthesised narratively. RESULTS One hundred and five studies (150,820 participants) comprising various designs, populations and of mostly weak quality were identified. The strongest and most ecologically valid studies identified factors associated with CPR initiation: the overwhelming emotion of the situation, perceptions of capability, uncertainty about when CPR is appropriate, feeling unprepared and fear of doing harm. Current evidence comprises mainly atheoretical cross-sectional surveys using unvalidated measures with relatively little formal testing of relationships between proposed variables and CPR initiation. CONCLUSIONS Preparing people to manage strong emotions and increasing their perceptions of capability are likely important foci for interventions aiming to increase CPR initiation. The literature in this area would benefit from more robust study designs. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42018117438.
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Affiliation(s)
- Barbara Farquharson
- grid.11918.300000 0001 2248 4331NMAHP Research Unit, University of Stirling, Stirling, FK9 4LA UK
| | - Diane Dixon
- grid.7107.10000 0004 1936 7291University of Aberdeen, Aberdeen, UK
| | - Brian Williams
- grid.23378.3d0000 0001 2189 1357University of Highlands and Islands, Inverness, UK
| | - Claire Torrens
- grid.11918.300000 0001 2248 4331University of Stirling, Stirling, UK
| | - Melanie Philpott
- grid.11918.300000 0001 2248 4331University of Stirling, Stirling, UK
| | - Henriette Laidlaw
- grid.23378.3d0000 0001 2189 1357University of Highlands and Islands, Inverness, UK
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Alkubati SA, McClean C, Yu R, Albagawi B, Alsaqri SH, Alsabri M. Basic life support knowledge in a war-torn country: a survey of nurses in Yemen. BMC Nurs 2022; 21:141. [PMID: 35668520 PMCID: PMC9169348 DOI: 10.1186/s12912-022-00923-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/30/2022] [Indexed: 12/03/2022] Open
Abstract
Background Successful implementation of Basic life support (BLS) is critical to improving survival rates and outcomes, especially among healthcare workers. To our knowledge, there is no available literature pertaining to the level of BLS knowledge of health care professionals in Yemen. Methods Data was collected for this cross-sectional descriptive study from June to August 2020, using a 10-item questionnaire related to cardiopulmonary resuscitation (CPR) and BLS, along with questions on socio-demographic characteristics. Participants were nurses in public and private hospitals located in Al-Rahida and Al-dimna cities, Taiz governance and Hodeidah city, Hodeidah governance in Yemen. Results Out of 220 distributed questionnaires, 200 were returned with a response rate of 90.9%. More than a half (53.65%) of answer choices for BLS knowledge were correct. There was a significant difference in knowledge score based on level of education where those who had Bachelor degree had more knowledge (P = 0.000). Those who said they had received training in CPR or received information about CPR had significantly higher scores than those who did not receive (P = 0.000). Conclusions BLS knowledge among nurses in Yemen is below an acceptable level to ensure maximum survival in the event of cardiac arrest. Disseminating BLS information and training in a cost effective and efficient manner will provide a large benefit in terms of lives saved with minimal costs.
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Affiliation(s)
- Sameer A Alkubati
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail City, Saudi Arabia. .,Department of Nursing, Faculty of Medicine and Health Sciences, Hodeida University, Hodeida, Yemen.
| | | | - Rebecca Yu
- Saba University School of Medicine, The Bottom, Caribbean, Netherlands
| | - Bander Albagawi
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail City, Saudi Arabia
| | - Salman H Alsaqri
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail City, Saudi Arabia
| | - Mohammed Alsabri
- Al-Thawra Modern General Teaching Hospital, Sana'a City, Yemen. .,Pediatrics, Brookdale University Hospital Medical Center, Brooklyn, NY, 11212, USA.
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Vu DH, Hoang BH, Do NS, Do GP, Dao XD, Nguyen HH, Luu QT, Nguyen LH, Nakahara S. Why Bystanders Did Not Perform Cardiopulmonary Resuscitation on Out-of-Hospital Cardiac Arrest Patients: A Multi-Center Study in Hanoi (Vietnam). Prehosp Disaster Med 2022;:1-5. [PMID: 34991749 DOI: 10.1017/S1049023X21001369] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AIM The aim of this study was to determine why bystanders did not use formal Emergency Medical Services (EMS) or conduct cardiopulmonary resuscitation (CPR) on the scene for out-of-hospital cardiac arrest (OHCA) patients in Hanoi, Vietnam. METHODS This was a prospective, observational study of OHCA patients admitted to five tertiary hospitals in the Hanoi area from June 2018 through January 2019. The data were collected through interviews (using a structured questionnaire) with bystanders. RESULTS Of the 101 patients, 79% were aged <65 years, 71% were men, 79% were witnessed to collapse, 36% were transported to the hospital by formal EMS, and 16% received bystander CPR at the scene. The most frequently indicated reason for not using EMS by the attendants was "using a private vehicle or taxi is faster" (85%). The reasons bystanders did not conduct CPR at the scene included "not recognizing the ailment as cardiac arrest" (60%), "not knowing how to perform CPR" (33%), and "being afraid of doing harm to patients" (7%). Only seven percent of the bystanders had been trained in CPR. CONCLUSION The information revealed in this study provides useful information to indicate what to do to increase EMS use and CPR provision. Spreading awareness and training among community members regarding EMS roles, recognition of cardiac arrest, CPR skills, and dispatcher training to assist bystanders are crucial to improve the outcomes of OHCA patients in Vietnam.
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Alsofayan YM, Althunayyan SM, Mohamed MA, Alhabeeb SH, Altuwaijri MI, Alhajjaj FS, Alowais JM. Out of Hospital Cardiac Arrest: Saudi Red Crescent Experience Throughout COVID-19 Era. Open Access Emerg Med 2021; 13:431-438. [PMID: 34588825 PMCID: PMC8473018 DOI: 10.2147/oaem.s334808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 09/13/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The quality of resuscitation for out hospital cardiac arrest (OHCA) during the COVID-19 era could be affected. We aim to describe prehospital healthcare providers' resuscitative efforts for OHCA cases and their definitive outcomes. PATIENTS AND METHODS This retrospective cross-sectional study included all OHCA cases between April and June 2021 across all regions in the Kingdom of Saudi Arabia (KSA). Demographic variables, response times, CPR providers, initial rhythm, use of AED/Defibrillator, medical interventions, ROSC data, and dispatch codes were extracted from a central electronic platform. RESULTS A total of 1307 OHCA cases were included in this study, males constituted 65% and 42% were ≥65 years. Although the median response time to initiate CPR was 13 min, 11% of OHCA cases had a response time between 0 and 6 min. About 75% of CPR was provided on scene by BLS units, 78% of OHCA cases had asystole as their initial rhythm, an AED/Defibrillator was used more than 90% of the time for pulseless VT/VF rhythm, and ROSC was achieved in 8% of OHCA patients. CONCLUSION During the COVID-19 pandemic, maintaining resuscitative efforts for OHCA continues in KSA. Closing knowledge gaps in the community and a better description of OHCA for the dispatcher could guide dispatch-assisted CPR and minimize OHCA response times.
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Affiliation(s)
- Yousef M Alsofayan
- Executive Directorate of Medical Affairs, Saudi Red Crescent Authority, Riyadh, Saudi Arabia
| | - Saqer M Althunayyan
- Department of Accident and Trauma, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed A Mohamed
- Executive Directorate of Medical Affairs, Saudi Red Crescent Authority, Riyadh, Saudi Arabia
| | - Saud H Alhabeeb
- Executive Directorate of Medical Affairs, Saudi Red Crescent Authority, Riyadh, Saudi Arabia
| | - Mohammad I Altuwaijri
- Executive Directorate of Medical Affairs, Saudi Red Crescent Authority, Riyadh, Saudi Arabia
| | - Fahad S Alhajjaj
- Department of Emergency Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Qassim, Saudi Arabia
| | - Jalal M Alowais
- Department of Surgery, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Bogue KA, Idriss SF, Sturkey D, Derouin A. Improving Youth Sports Safety: Implementing an Emergency Action Plan for Sudden Cardiac Arrest. J Pediatr Nurs 2021; 59:81-8. [PMID: 33549955 DOI: 10.1016/j.pedn.2020.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/20/2020] [Accepted: 10/01/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Children who participate in youth sports are at risk for sudden cardiac arrest (SCA) related to undetected cardiac anomalies or abrupt impact to the chest. Nurse-led interventions may prevent sudden cardiac death by helping leagues implement an emergency action plan to respond to SCA and improve safety. A youth soccer league in the Southeast with participants between the ages of 5-19 years, led by volunteer board members and coaches, did not have reliable access to automated external defibrillators or receive standardized education on SCA and cardiopulmonary resuscitation with a site-specific action plan. METHODS A nurse-led quality improvement pilot project used partnerships to provide league access to automated external defibrillators, institute preseason SCA and cardiopulmonary resuscitation training, and establish an emergency action plan for the league's volunteers. Anonymous pre- and post-training testing was conducted to measure participant knowledge, confidence, and willingness to respond to SCA. A cross-sectional survey, using a convenience sample of board members and coaches, evaluated sustainability of the intervention at midseason. INTERVENTION Training targeted board members (Blue Shirts) to serve as leaders on the field during an SCA event and educated coaches on activating the emergency action plan. RESULTS Blue Shirts and coaches showed significant (p < .05) improvement of knowledge, confidence, and willingness to respond to SCA after receiving the standardized preseason intervention; Blue Shirts' changes were sustained at midseason. CONCLUSION Nurses are ideal for helping youth sports leagues implement a sustainable SCA action plan based on best-practice recommendations for emergency health and safety.
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Noureddine S, Avedissian T, Khatib N, Irani J. Towards better out-of-hospital cardiopulmonary resuscitation: A survey of nurses. J Clin Nurs 2021; 30:3036-3044. [PMID: 33896056 DOI: 10.1111/jocn.15813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/24/2021] [Accepted: 04/06/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine the knowledge, attitude and practice of nurses in Lebanon regarding out-of-hospital resuscitation, compare hospital nurses to those who work in community settings on the variables of interest, determine the nurses' willingness to attempt resuscitation in the community and identify predictors of their willingness. BACKGROUND Only 5.5% of victims survive out-of-hospital cardiac arrest in Lebanon. There is no national guideline for cardiopulmonary resuscitation nor a policy for nurses' training in resuscitation in Lebanon for neither in-hospital nor out-of-hospital settings. However, some hospitals have their own policies. METHODS A cross-sectional descriptive design was used with a cluster sample of 692 working nurses. A 28-item questionnaire developed for this study was mailed to the nurses. Data were analysed with correlational and multivariable regression analyses. The STROBE checklist for observational studies was used in reporting this study. RESULTS Most nurses received cardiopulmonary resuscitation training, but 19.8% did not renew their certification in the past two years, because of limited training centres and lack of time. Only one third of the sample knew the first step to be taken in an arrest, yet 61% knew the compression-to-breath ratio. Nurses who work in community settings had significantly less frequent training in resuscitation than hospital nurses. Most nurses were willing to resuscitate in the community. In deciding to perform out-of-hospital cardiopulmonary resuscitation, the nurses were mostly influenced by their training, courage, recent practice, policy, fear of infection and hesitation to do mouth-to-mouth breathing. Receiving training, fear of being sued, religious beliefs, geographic location and believing in the importance of training laypeople in resuscitation predicted the nurses' willingness to perform resuscitation in the community. CONCLUSION Lebanon needs a national policy on cardiopulmonary resuscitation, regular training of all nurses and a Good Samaritan law. RELEVANCE TO CLINICAL PRACTICE This study informs policy related to nurses' training in out-of-hospital resuscitation.
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Affiliation(s)
- Samar Noureddine
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Tamar Avedissian
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Nina Khatib
- Life Support Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - Joanna Irani
- Life Support Center, American University of Beirut Medical Center, Beirut, Lebanon
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Pattanarattanamolee R, Sanglun RY, Nakahara S. Community-Based First Responder Network in Rural Thailand: A Case Study of Out-of-Hospital Cardiac Arrest. Prehosp Disaster Med 2021; 36:234-6. [PMID: 33599577 DOI: 10.1017/S1049023X20001545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recently, the Thai government introduced a novel program to train health volunteers as first responders to deal with increasing acute illness and injuries. This case study demonstrates the potential of this program to improve public access to emergency care through the integration of emergency care with a community-based health care system, specifically in a rural setting. A 39-year-old man collapsed with cardiac arrest in his village. Lay first responders from his neighborhood attended him immediately, administered chest compressions, and contacted Emergency Medical Services (EMS). They continued chest compressions until the EMS unit arrived. While the EMS transported him to the hospital, the patient attained return of spontaneous circulation and consciousness. He returned to his normal life without obvious neurological problems. The Thai strategy to develop a community-based first responder network through health volunteer training would address the issue of inequitable access to emergency care and improve patients’ chances of survival and prognoses.
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Alhussein RM, Albarrak MM, Alrabiah AA, Aljerian NA, Bin Salleeh HM, Hersi AS, Wani TA, Al Aseri ZA. Knowledge of non-healthcare individuals towards cardiopulmonary resuscitation: a cross-sectional study in Riyadh City, Saudi Arabia. Int J Emerg Med 2021; 14:11. [PMID: 33568064 PMCID: PMC7876786 DOI: 10.1186/s12245-021-00335-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 02/02/2021] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
| | | | - Abdulaziz A Alrabiah
- Department of Emergency Medicine, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Kingdom of Saudi Arabia
| | - Nawfal A Aljerian
- Department of Emergency Medicine, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard, Riyadh, Saudi Arabia.,Medical Referrals Center-Ministry of Health, Riyadh, Saudi Arabia
| | - Hashim M Bin Salleeh
- Department of Emergency Medicine, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Kingdom of Saudi Arabia
| | - Ahmad S Hersi
- Department of Cardiac Sciences, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Kingdom of Saudi Arabia
| | - Tariq A Wani
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Zohair A Al Aseri
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia. .,Departments of Emergency Medicine and Critical Care, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Kingdom of Saudi Arabia.
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Chow SKY. Bystanders' Views on the Use of Automated External Defibrillators for Out-of-Hospital Cardiac Arrest: Implications for Health Promotions. Int J Environ Res Public Health 2021; 18:ijerph18031241. [PMID: 33573184 PMCID: PMC7908230 DOI: 10.3390/ijerph18031241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/23/2021] [Accepted: 01/26/2021] [Indexed: 11/21/2022]
Abstract
Despite the widespread availability of automated external defibrillators, not everyone is enthusiastic about using them. The aim of this study was to examine the reasons for not using an automated external defibrillator (AED) and predictors of the reasons. The study had a cross-sectional design using an online survey. Data were collected in eighteen districts in Hong Kong to be representative of the city. The questionnaire consisted of questions on demographics, knowledge and attitude towards AED use, reasons for not using AED, and whether the kind of victim could affect the decision of the bystanders. There was a high significant correlation between knowledge and attitude, with r = 0.782 and p < 0.001. Of the respondents, 53.3% agreed that the kind of victim would affect their willingness to operate an AED. A binary logistic regression model revealed that a higher education (OR 6.242, 95% CI: 1.827–21.331), concern about the kind of victim involved (OR 2.822, 95% CI: 1.316–6.052), and a younger age were significant predictors of worrying about taking on responsibility in using AED. Other than knowledge, other barriers included a desire to avoid legal liability, and the kind of victim they encountered. Life experiences in adulthood could possibly affect the social responsibility and influence the behaviors of adults to operate AEDs.
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Affiliation(s)
- Susan Ka Yee Chow
- School of Nursing, Tung Wah College, 31 Wylie Road, Homantin, Kowloon, Hong Kong, China
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Teng Y, Li Y, Xu L, Chen F, Chen H, Jin L, Chen J, Huang J, Xu G. Awareness, knowledge and attitudes towards cardiopulmonary resuscitation among people with and without heart disease relatives in South China: a cross-sectional survey. BMJ Open 2020; 10:e041245. [PMID: 33361079 PMCID: PMC7768962 DOI: 10.1136/bmjopen-2020-041245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the awareness, knowledge and attitudes towards cardiopulmonary resuscitation (CPR) among relatives of people with and without heart disease and their influence in South China. DESIGN This is a cross-sectional survey. Logistic regression was used to evaluate the demographic factors associated with CPR training, learning and knowledge. SETTING The study was conducted in two hospitals, the largest cardiovascular institute and the largest eye care centre in South China. PARTICIPANTS Healthy individuals who accompanied their relatives with heart disease to the outpatient department of cardiovascular disease and systemically healthy patients who came for regular ophthalmic examination and had no relatives with heart disease were consecutively recruited for the study. A total of 1644 respondents with heart disease relatives and 813 respondents without heart disease relatives completed the survey. RESULTS Thirty three per cent of respondents never heard of CPR and only 11% had received CPR training. Factors associated with a higher rate of CPR training were higher level of education and income (p<0.001). Most respondents stated that CPR training was necessary and would like to learn CPR. However, only one-third considered it beneficial to perform CPR as a layperson. In addition, healthcare respondents (p<0.001), younger (p<0.05) and more educated respondents (p<0.001) earned higher scores on the knowledge of CPR skills. Only 5.3% had perfect scores on a CPR skills test. Notably, respondents with relatives suffering from heart disease had significantly less training experience and CPR knowledge than those without (p<0.001). CONCLUSIONS Although the attitudes towards learning CPR are very positive, there was a lack of knowledge on this topic among the general public. This study demonstrates an urgent need to boost awareness and training in CPR in South China, especially among people whose relatives have heart disease.
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Affiliation(s)
- Yun Teng
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yunxuan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Liya Xu
- Tufts University, Medford, Massachusetts, USA
| | - Fanyu Chen
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Hailiu Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jimei Chen
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jingjing Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Gang Xu
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
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Janatolmakan M, Nouri R, Soroush A, Andayeshgar B, Khatony A. Barriers to the success of cardiopulmonary resuscitation from the perspective of Iranian nurses: A qualitative content analysis. Int Emerg Nurs 2020; 54:100954. [PMID: 33360362 DOI: 10.1016/j.ienj.2020.100954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/26/2020] [Accepted: 11/21/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The survival rate following Cardiopulmonary Resuscitation (CPR) has been reported to be 7-26.7%. Various studies have shown that CPR failure is high in many countries. This study was aimed to explore the barriers to the success of CPR from the perspective of Iranian nurses. METHODS Participants were 14 Iranian nurses recruited through purposive sampling. In-depth semi-structured interviews were used to collect data. Data were analyzed using qualitative content analysis. RESULTS The barriers to successful CPR were developed in three main categories and nine subcategories. Some of the barriers to CPR success were: "delayed attendance of the CPR team and start of CPR", "inadequate experience and skill of the CPR team", "poor access to special units", "insufficient and deficient CPR equipment", "poor CPR location", "critical clinical conditions of the patient", and "interference of the patient's family members. CONCLUSION The results showed that human and environmental factors can result in CPR failure. These barriers can be minimized by measures such as empowerment of the CPR team, and providing the necessary facilities and equipment.
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Affiliation(s)
- Maryam Janatolmakan
- Clinical Research Development Centre, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roghayeh Nouri
- Clinical Research Development Centre, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Soroush
- Clinical Research Development Centre, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bahare Andayeshgar
- Clinical Research Development Centre, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Khatony
- Clinical Research Development Centre, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran; Health Institute, Social Development and Health Promotion Research Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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17
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Riccò M, Berrone M, Vezzosi L, Gualerzi G, Canal C, De Paolis G, Schallenberg G. Factors influencing the willingness to perform bystander cardiopulmonary resuscitation on the workplace: a study from North-Eastern Italy. Acta Biomed 2020; 91:e2020180. [PMID: 33525292 PMCID: PMC7927506 DOI: 10.23750/abm.v91i4.8593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 07/11/2019] [Indexed: 11/23/2022]
Abstract
Background: Early bystander cardiopulmonary resuscitation (CPR) improves the chances of successful resuscitation and survival. However, few data are available regarding the willingness to perform CPR among First Aid Attendants on the Workplace (FAAWs) in Italy. The present study was performed in order to identify current attitudes of Italian FAAWs towards CPR. Methods: Between February and June 2017, FAAWs from the Autonomous Province of Trento were asked about their willingness to perform CPR through a structured questionnaire assessing their knowledge about CPR, and the reasons for hesitancy. A cumulative knowledge score (KS) was eventually calculated. Results: A total of 123 FAAWs (male 57.7%, mean age 45.2 years ± 10.1) completed the questionnaire. About 1/3 of participants (32.5%) had previously performed First Aid procedures. Overall, 77.2% exhibited willingness to perform CPR, and such attitude was more frequently reported by subjects younger than 40 years (29.5% vs. 10.7% in older subjects; p=0.045), perceiving First Aid training as useful (98.9% vs. 84.7%, p=0.002), and exhibiting a better knowledge of CPR (KS≥75%: 47.4% vs. 15.3%). The reasons for the unwillingness were inadequate knowledge and doubt regarding whether they could perform the techniques effectively. Eventually, KS was identified as the main predictor for willingness to perform CPR (OR 4.450, 95%CI 1.442-14.350). Conclusions: Willingness to perform CPR was seemingly high, and knowledge of CPR techniques was its main predictor. These findings emphasize the importance for an accurate CPR training, as well as for the surveillance of the quality of qualification courses.(www.actabiomedica.it)
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Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
| | - Mirco Berrone
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
| | - Luigi Vezzosi
- Azienda Socio Sanitaria Territoriale di Cremona, Direzione Medica Ospedale di Cremona.
| | - Giovanni Gualerzi
- School of Medicine and Surgery, Department of Medicine and Surgery, University of Parma, Parma (PR).
| | - Chiara Canal
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
| | - Giuseppe De Paolis
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
| | - Gert Schallenberg
- Provincial Agency for Health Services (APSS) of the Autonomous Province of Trento Department of Prevention, Operative Unit for Health and Safety in the Workplaces, Trento (TN).
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Do SN, Luong CQ, Pham DT, Nguyen CV, Ton TT, Pham TT, Hoang QT, Hoang HT, Nguyen DT, Khuong DQ, Nguyen QH, Nguyen TA, Pham HT, Nguyen MH, McNally BF, Ong ME, Nguyen AD. Survival after out-of-hospital cardiac arrest, Viet Nam: multicentre prospective cohort study. Bull World Health Organ 2020; 99:50-61. [PMID: 33658734 DOI: 10.2471/blt.20.269837] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/14/2020] [Accepted: 10/06/2020] [Indexed: 11/27/2022] Open
Abstract
Objective To investigate factors associated with survival after out-of-hospital cardiac arrest in Viet Nam. Methods We did a multicentre prospective observational study of people (> 18 years) presenting with out-of-hospital cardiac arrest (not caused by trauma) to three tertiary hospitals in Viet Nam from February 2014 to December 2018. We collected data on characteristics, management and outcomes of patients with out-of-hospital cardiac arrest and compared these data by type of transportation to hospital and survival to hospital admission. We assessed factors associated with survival to admission to and discharge from hospital using logistic regression analysis. Findings Of 590 eligible people with out-of-hospital cardiac arrest, 440 (74.6%) were male and the mean age was 56.1 years (standard deviation: 17.2). Only 24.2% (143/590) of these people survived to hospital admission and 14.1% (83/590) survived to hospital discharge. Most cardiac arrests (67.8%; 400/590) occurred at home, 79.4% (444/559) were witnessed by bystanders and 22.3% (124/555) were given cardiopulmonary resuscitation by a bystander. Only 8.6% (51/590) of the people were taken to hospital by the emergency medical services and 32.2% (49/152) received pre-hospital defibrillation. Pre-hospital defibrillation (odds ratio, OR: 3.90; 95% confidence interval, CI: 1.54-9.90) and return of spontaneous circulation in the emergency department (OR: 2.89; 95% CI: 1.03-8.12) were associated with survival to hospital admission. Hypothermia therapy during post-resuscitation care was associated with survival to discharge (OR: 5.44; 95% CI: 2.33-12.74). Conclusion Improvements are needed in the emergency medical services in Viet Nam such as increasing bystander cardiopulmonary resuscitation and public access defibrillation, and improving ambulance and post-resuscitation care.
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Affiliation(s)
- Son N Do
- Emergency Department, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000, Viet Nam
| | - Chinh Q Luong
- Emergency Department, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000, Viet Nam
| | - Dung T Pham
- Department of Nutrition and Food Safety, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Chi V Nguyen
- Emergency Department, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000, Viet Nam
| | - Tra T Ton
- Emergency Department, Cho Ray Hospital, Ho Chi Minh City, Viet Nam
| | - Thao Tn Pham
- Intensive Care Unit, Cho Ray Hospital, Ho Chi Minh City, Viet Nam
| | - Quoc Ta Hoang
- Emergency Department, Hue Central General Hospital, Hue, Viet Nam
| | - Hanh T Hoang
- Intensive Care Unit, Hue Central General Hospital, Hue, Viet Nam
| | - Dat T Nguyen
- Emergency Department, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000, Viet Nam
| | - Dai Q Khuong
- Emergency Department, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000, Viet Nam
| | - Quan H Nguyen
- Emergency Department, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000, Viet Nam
| | - Tuan A Nguyen
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
| | - Hanh Tm Pham
- Department of Epidemiology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - My H Nguyen
- Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Bryan F McNally
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, United States of America
| | - Marcus Eh Ong
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Anh D Nguyen
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
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Barbic D, Duncan K, Trainor R, Ertel EA, Enos MK, Philips H, Besserer F, Grunau B, Kestler A, Christenson J, Scheuermeyer FX. A Survey of the Public's Ability to Recognize and Willingness to Intervene in Out-of-hospital Cardiac Arrest and Opioid Overdose. Acad Emerg Med 2020; 27:305-308. [PMID: 31930625 DOI: 10.1111/acem.13916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 01/04/2020] [Indexed: 11/28/2022]
Affiliation(s)
- David Barbic
- Department of Emergency Medicine St Paul’s Hospital Vancouver BC
- Centre for Health Evaluation and Outcomes Sciences St Paul’s Hospital Vancouver BC
- Department of Emergency Medicine University of British Columbia Vancouver BC
| | - Kevin Duncan
- Faculty of Medicine University of British Columbia Vancouver BC
| | - Ryan Trainor
- Faculty of Medicine University of British Columbia Vancouver BC
| | - Emily A. Ertel
- Faculty of Medicine University of British Columbia Vancouver BC
| | - Megan K. Enos
- Department of Family Medicine University of British Columbia Vancouver BC
| | - Hannah Philips
- Faculty of Science University of British Columbia Vancouver BC
| | - Floyd Besserer
- Department of Emergency Medicine Prince George Regional Hospital and the University of British Columbia Prince George BC Canada
| | - Brian Grunau
- Department of Emergency Medicine St Paul’s Hospital Vancouver BC
- Centre for Health Evaluation and Outcomes Sciences St Paul’s Hospital Vancouver BC
- Department of Emergency Medicine University of British Columbia Vancouver BC
| | - Andrew Kestler
- Department of Emergency Medicine St Paul’s Hospital Vancouver BC
- Centre for Health Evaluation and Outcomes Sciences St Paul’s Hospital Vancouver BC
- Department of Emergency Medicine University of British Columbia Vancouver BC
| | - Jim Christenson
- Department of Emergency Medicine St Paul’s Hospital Vancouver BC
- Centre for Health Evaluation and Outcomes Sciences St Paul’s Hospital Vancouver BC
- Department of Emergency Medicine University of British Columbia Vancouver BC
| | - Frank X. Scheuermeyer
- Department of Emergency Medicine St Paul’s Hospital Vancouver BC
- Centre for Health Evaluation and Outcomes Sciences St Paul’s Hospital Vancouver BC
- Department of Emergency Medicine University of British Columbia Vancouver BC
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Isma'eel H, Noureddine S, Mohammad M, Zgheib A, Abou Arbid S, Njeim M, Nasr S, Bassil R, Sarkis A, Abi Saleh B, El Sayed M. Out-of-hospital cardiopulmonary resuscitation: a position statement of the Lebanese Society of Cardiology and the Lebanese Society of Emergency Medicine. Cardiovasc Diagn Ther 2019; 9:609-612. [PMID: 32038951 DOI: 10.21037/cdt.2019.11.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Out of hospital cardiac arrest (OHCA) is a leading cause of death worldwide. Early cardiopulmonary resuscitation (CPR) and early defibrillation are key to improving outcomes of patients with OHCA including return of spontaneous circulation (ROSC) and survival to hospital discharge with good neurologic outcomes. Lebanon like other developing countries, suffers from absence of organized prehospital cardiac arrest care bundle and from absence of a legal framework for community involvement in cardiac arrest care. Scientific societies, involved non-governmental organizations (NGOs) and local governmental stakeholders organized a national meeting to launch a strategy aiming at improving OHCA outcomes in Lebanon. This article represents a position statement of the Lebanese Society of Cardiology and the Lebanese Society of Emergency Medicine summarizing the strategy to improve out-of-hospital CPR. Participating stakeholders developed and submitted a law proposal of a "Good Samaritan Law" to the Lebanese parliament. Several of activities were also launched aiming at establishing public access defibrillation programs and at training bystanders in different areas in Lebanon to perform bystander CPR and use automated external defibrillators (AEDs). Additional recommendations were proposed to local emergency medical system (EMS) agencies to improve prehospital care and introduce medical direction to prehospital activities.
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Affiliation(s)
- Hussain Isma'eel
- Clinical Medicine, Vascular Medicine Program, Division of Cardiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Samar Noureddine
- Graduate Division, School of Nursing, American University of Beirut, Beirut, Lebanon
| | | | - Ali Zgheib
- Division of Cardiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Samer Abou Arbid
- Division of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mario Njeim
- Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Samer Nasr
- Department of Cardiology, Mount Lebanon Hospital, Beirut, Lebanon
| | - Rania Bassil
- Saint Joseph University and Keserwan Medical Center, Beirut, Lebanon
| | - Anthony Sarkis
- Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Bernard Abi Saleh
- Section of Electrophysiology, Division of Cardiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mazen El Sayed
- Emergency Medical Services and Prehospital Care, Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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21
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Becker TK, Gul SS, Cohen SA, Maciel CB, Baron-Lee J, Murphy TW, Youn TS, Tyndall JA, Gibbons C, Hart L, Alviar CL. Public perception towards bystander cardiopulmonary resuscitation. Emerg Med J 2019; 36:660-665. [DOI: 10.1136/emermed-2018-208234] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 08/21/2019] [Accepted: 08/25/2019] [Indexed: 11/04/2022]
Abstract
ObjectiveBystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest (OHCA) improves survival and neurological outcomes. Nonetheless, many OHCA patients do not receive bystander CPR during a witnessed arrest. Our aim was to identify potential barriers to bystander CPR.MethodsParticipants at CPR training events conducted in the USA between February and May 2018 answered a 14-question survey prior to training. Respondents were asked about their overall comfort level performing CPR, and about potential concerns specific to performing CPR on a middle-aged female, a geriatric male, and male and female adolescent patients. Open-ended responses were analysed qualitatively by categorising responses into themes.ResultsOf the 677 participants, 582 (86.0%) completed the survey, with 509 (88.1%) between 18 and 29 years of age, 341 (58.6%) without prior CPR training and 556 (96.0%) without prior CPR experience. Across all four scenarios of patients in cardiac arrest, less than 65% of respondents reported that they would be ‘Extremely Likely’ (20.6%–29.1%) or ‘Moderately Likely’ (26.9%–34.8%) to initiate CPR. The leading concerns were ‘causing injury to patient’ for geriatric (n=193, 63.1%), female (n=51, 20.5%) and adolescent (n=148, 50.9%) patients. Lack of appropriate skills was the second leading concern when the victim was a geriatric (n=41, 13.4%) or adolescent (n=68, 23.4%) patient, whereas for female patients, 35 (14.1%) were concerned about exposing the patient or the patient’s breasts interfering with performance of CPR and 15 (6.0%) were concerned about being accused of sexual assault. Significant differences were observed in race, ethnicity and age regarding the likelihood of starting to perform CPR on female and adolescent patients.ConclusionsParticipants at CPR training events have multiple concerns and fears related to performing bystander CPR. Causing additional harm and lack of skills were among the leading reservations reported. These findings should be considered for improved CPR training and public education.
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22
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Vattanavanit V, Uppanisakorn S, Nilmoje T. Post out-of-hospital cardiac arrest care in a tertiary care center in southern Thailand: From emergency department to intensive care unit. HONG KONG J EMERG ME 2019. [DOI: 10.1177/1024907919830896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Out-of-hospital cardiac arrest results in a high mortality rate. The 2015 American Heart Association guideline for post-cardiac arrest was launched and adopted into our institutional policy. Objectives: We aimed to evaluate post-cardiac arrest care and compare the results with the 2015 American Heart Association guideline and clinical outcomes of out-of-hospital cardiac arrest patients. Methods Included in this study were all adult patients who survived out-of-hospital cardiac arrest and were admitted to the Medical Intensive Care Unit of Songklanagarind Hospital, Thailand. The retrospective review was from 1 January 2016 to 31 December 2017. Results: From a total of 161 post-cardiac arrest patients admitted to the medical intensive care unit, 69 out-of-hospital cardiac arrest patients were identified. The most common cause of arrest was presumed cardiac in origin (45.0%) in which the majority was acute myocardial infarction (67.8%). Coronary intervention and targeted temperature management were performed in 27.5% and 13% of all out-of-hospital cardiac arrest patients, respectively. Survival to hospital discharge was 42%. Independent factors associated with survival to discharge were shockable rhythms, lower adrenaline doses, and the absence of hypotension at medical intensive care unit admission. Conclusion: Compliance with the 2015 American Heart Association post-cardiac arrest care guideline was low in our institution, especially in coronary intervention and targeted temperature management.
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Affiliation(s)
- Veerapong Vattanavanit
- Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | | | - Thanapon Nilmoje
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
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Moon S, Ryoo HW, Ahn JY, Park JB, Lee DE, Kim JH, Jin SC, Lee KW. A 5-year change of knowledge and willingness by sampled respondents to perform bystander cardiopulmonary resuscitation in a metropolitan city. PLoS One 2019; 14:e0211804. [PMID: 30730932 DOI: 10.1371/journal.pone.0211804] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 01/20/2019] [Indexed: 11/30/2022] Open
Abstract
Background Nationwide and regional interventions can help improve bystander cardiopulmonary resuscitation (CPR) awareness, knowledge, and the willingness. Periodic community investigation will help monitor the effect. This study aimed to compare the experience of CPR education, CPR knowledge, and CPR willingness, during a 5-year interval. Methods This is a pre and post study. Two surveys were done in February 2012 and December 2016. National and regional intervention including legislation promoting public involvement, standardizing CPR education programs, training CPR instructors, and installing supporting organizations were done at the period. In both surveys, respondents were selected via quota sampling in Daegu Metropolitan City and answered the survey through face-to-face interview. Respondents’ general demographic characteristics, CPR educational experience, CPR knowledge and CPR willingness were questioned. Results Total of 2141 respondents (1000 in 2012, 1141 in 2016) were selected. The percentage of respondents who received CPR education itself and recent education were higher after intervention compared to before intervention (36.2% vs. 55.1%, 16.9% vs. 30.1%, respectively). Correct knowledge of performing CPR seems to be improved overall (1.6% vs. 11.7%, odd ratio 14.28, 95% confidence interval 5.68–35.94). However, less respondents were willing to perform CPR on strangers (54.5% vs 35.0%). Conclusion Nationwide and regional interventions to promote bystander CPR and CPR education were associated with increased CPR education experience and improved correct CPR knowledge in performing bystander CPR. Willingness to perform bystander CPR on family did not increase significantly and CPR willingness to strangers was decreased. Additional legal and technological measures should be implemented to promote bystander CPR.
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Hoang BH, Dao XD, Nakahara S, Sakamoto T. The need for improving access to emergency care through community involvement in low- and middle-income countries: A case study of cardiac arrest in Hanoi, Vietnam. Emerg Med Australas 2018; 30:867-869. [PMID: 30008174 DOI: 10.1111/1742-6723.13134] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/27/2018] [Accepted: 05/24/2018] [Indexed: 11/30/2022]
Abstract
Out-of-hospital cardiac arrest patients require immediate interventions by bystanders and emergency medical services (EMS). However, in many low- and middle-income countries (LMIC), bystanders witnessing a cardiac arrest rarely perform chest compressions and contact EMS. This paper attempts to draw lessons from a case of a patient with a cardiac arrest who could have survived with immediate interventions. A 40 year old man collapsed following electrocution at a construction site. His colleagues immediately transferred him to hospital via taxi, without performing chest compressions. At the hospital he showed ventricular fibrillation; resuscitation attempts failed and he died. Ventricular fibrillation due to electrocution is a benign type of cardiac arrest. The chance of survival increases with immediate chest compressions and prompt defibrillation. We discuss the reasons why the bystanders did not perform resuscitation or contact EMS and identify approaches for the improvement of pre-hospital care in LMICs.
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Affiliation(s)
- Bui Hai Hoang
- Emergency Department and Intensive Care Unit, Hanoi Medical University, Hanoi, Vietnam
| | - Xuan Dung Dao
- Emergency Department and Intensive Care Unit, Hanoi Medical University, Hanoi, Vietnam
| | - Shinji Nakahara
- Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Tetsuya Sakamoto
- Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan
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Smith CM, Lim Choi Keung SN, Khan MO, Arvanitis TN, Fothergill R, Hartley-Sharpe C, Wilson MH, Perkins GD. Barriers and facilitators to public access defibrillation in out-of-hospital cardiac arrest: a systematic review. Eur Heart J Qual Care Clin Outcomes 2017; 3:264-273. [PMID: 29044399 DOI: 10.1093/ehjqcco/qcx023] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 07/12/2017] [Indexed: 11/14/2022]
Abstract
Public access defibrillation initiatives make automated external defibrillators available to the public. This facilitates earlier defibrillation of out-of-hospital cardiac arrest victims and could save many lives. It is currently only used for a minority of cases. The aim of this systematic review was to identify barriers and facilitators to public access defibrillation. A comprehensive literature review was undertaken defining formal search terms for a systematic review of the literature in March 2017. Studies were included if they considered reasons affecting the likelihood of public access defibrillation and presented original data. An electronic search strategy was devised searching MEDLINE and EMBASE, supplemented by bibliography and related-article searches. Given the low-quality and observational nature of the majority of articles, a narrative review was performed. Sixty-four articles were identified in the initial literature search. An additional four unique articles were identified from the electronic search strategies. The following themes were identified related to public access defibrillation: knowledge and awareness; willingness to use; acquisition and maintenance; availability and accessibility; training issues; registration and regulation; medicolegal issues; emergency medical services dispatch-assisted use of automated external defibrillators; automated external defibrillator-locator systems; demographic factors; other behavioural factors. In conclusion, several barriers and facilitators to public access defibrillation deployment were identified. However, the evidence is of very low quality and there is not enough information to inform changes in practice. This is an area in urgent need of further high-quality research if public access defibrillation is to be increased and more lives saved. PROSPERO registration number CRD42016035543.
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Affiliation(s)
- Christopher M Smith
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham B9 5SS, UK
| | | | - Mohammed O Khan
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry CV4 7AL, UK
| | | | - Rachael Fothergill
- London Ambulance Service NHS Trust, 18-20 Pocock Street, London SE1 0BW, UK
| | | | - Mark H Wilson
- Imperial College, Neurotrauma Centre, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Gavin D Perkins
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham B9 5SS, UK
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