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The feasibility of a novel method of bystander CPR training: A pilot study
Journal Pre-proofs The Feasibility of a Novel Method of Bystander CPR Training: A Pilot Study Rebecca M. Kappus, Gary McCullough PII: DOI: Reference:
S0735-6757(19)30657-6 https://doi.org/10.1016/j.ajem.2019.10.003 YAJEM 158506
To appear in:
American Journal of Emergency Medicine
Received Date: Revised Date: Accepted Date:
28 August 2019 1 October 2019 5 October 2019
Please cite this article as: R.M. Kappus, G. McCullough, The Feasibility of a Novel Method of Bystander CPR Training: A Pilot Study, American Journal of Emergency Medicine (2019), doi: https://doi.org/10.1016/j.ajem. 2019.10.003
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
© 2019 Published by Elsevier Inc.
The Feasibility of a Novel Method of Bystander CPR Training: A Pilot Study Rebecca M. Kappusa, Gary McCulloughb a. Appalachian State University, Department of Health and Exercise Science, 1179 State Farm Rd, Boone, NC 28608-2071. b. Appalachian State University, Associate Dean of Research and Graduate Education, Director of the Beaver College of Health Sciences Institute for Health and Human Services, 1179 State Farm Rd, Boone, NC 28608-2071. Corresponding Author: Rebecca M. Kappus, PhD Assistant Professor Appalachian State University Department of Health and Exercise Science 1179 State Farm Rd Boone, NC 28608-2071 Phone: 828-262-7214 Fax: 828-262-3138 [email protected] Sources of Support: None. Word Count of Manuscript: 1242 Word Count of Abstract: 148 Abstract Sudden cardiac arrest is a leading cause of death in the United States, with many occurring out of the hospital. Immediate response by bystanders, through the initiation of cardiopulmonary resuscitation (CPR), leads to increased survival; however, many do not respond due to lack of training and education. This study sought to determine the efficacy of a training model developed to rapidly and effectively train large numbers of individuals on hands-only CPR. Thirty minute training sessions were developed to introduce hands-only CPR to faculty at a university, with questionnaires assessing confidence and knowledge of CPR. Faculty then went on to train their respective students. Ninety-six faculty and staff and 1615 students were trained within 3 weeks, demonstrating this model was effective in rapidly training large numbers of individuals in a short period of time while increasing CPR knowledge and confidence. This method may be effective in other community settings. Keywords: Bystander CPR; CPR training; Hands-Only CPR; Cardiac arrest; CPR education
Bystander CPR Training
Introduction Every year in the United States, there are over 356,000 cardiac arrests outside of a hospital setting and a survival rate of just 10% [1]. Survival rates improve considerably if the victim receives immediate cardiopulmonary resuscitation (CPR) and defibrillation with an automated external defibrillator (AED) [2, 3]. Because medical personnel response may take 7-8 minutes or longer [4], victim survival depends on the ability of the bystander to recognize an emergency and perform CPR until the arrival of trained responders. However, only 15-30% of cardiac arrest victims receive CPR from a bystander [5]. The reluctance in performing CPR is unclear but may be due to fear of liability, fear of transmitted diseases [6], inadequate training, complicated guidelines, and fear of failure [7]. Bystander CPR (CPR without rescue breaths), also called hands-only CPR, has been proven to be as effective as traditional CPR in treating cardiac arrest victims [8, 9] and may result in more effective CPR due to uninterrupted chest compressions and reduced time to initiation of chest compressions [10]. Because bystander CPR is easy to perform and recall, individuals trained in this method may be less hesitant to respond to an emergency. However, many people are unaware of hands-only CPR [11] and therefore there is an increased need to educate the public about this method. Due to its straightforward steps, it is simple to teach and can be introduced to large numbers of people with little time burden. The primary purpose of this intervention was to determine if short bouts of hands-only CPR and AED training were effective in improving confidence in the ability to perform CPR and use an AED, and if knowledge of CPR and AED procedures increased. A secondary purpose was to determine if the model of training in which the student becomes the teacher, would be effective in introducing large numbers of individuals to hands-only CPR, with minimal burden on participants.
Methods This intervention was implemented in the fall semester of 2018 at Appalachian State University, located in Boone, North Carolina and was approved by the Appalachian State University institutional review board (19-0059). The targeted audience was faculty and staff of the Beaver College of Health Sciences at Appalachian State University. Training was available in 30 minute sessions over three separate dates. The average number of participants for each training session was approximately 20 participants, and 4 trainers were present per session. In-person training consisted of a personal story from a cardiac arrest survivor who received bystander CPR, a demonstration with step-by-step descriptions of appropriate handsonly CPR steps and AED usage, and practice of CPR steps and chest compressions on mannequins and practice with an AED trainer, completed under the guidance and instruction of the trainers. Hands-Only CPR utilizes 3 steps based on the American Red Cross instructions: 1) Check/Call; 2) Provide chest compressions; 3) Don’t stop. The aims of the training session were to emphasize the crucial role of CPR and AED use in a victim’s personal story to highlight the magnitude of simple chest compressions in survival, demonstrate the straight-forward steps in hands-only CPR, and allow participants the opportunity to perform hands-on practice and understand proper execution of chest compressions. A questionnaire was administered prior to training to determine baseline comfort and knowledge of CPR and AED use (Figure 1). The same questionnaire was administered following training to determine the efficacy of the intervention. In the following semester, trained faculty then taught hands-only CPR to the students enrolled in each of their courses, targeting the American Heart Month of February. Prior to the spring training, faculty were provided a hand-out outlining the steps for CPR and AED use as a
refresher, and a short video outlining CPR and AED steps to be shown during class. Mannequins were brought to each classroom for compressions practice. Results Ninety-six faculty and staff filled out the optional questionnaires before and following the training; and, of these, 27 participants were currently CPR certified. Prior to training, 52% of participants felt confident in their ability to perform CPR while 45% were confident in their ability to use an AED. Following training, 99% and 97% of participants, respectively, were confident in their ability to perform CPR and use an AED. Participants also improved their knowledge of material, with CPR knowledge improving from 60% to 87% accuracy and AED knowledge improving from 52% to 82% accuracy (Table 1). Of the 27 participants currently CPR certified and confident in their abilities, only 3 answered all questions correctly. In the spring semester training, over a three week time period, 1615 students in 68 classes in the Beaver College of Health Sciences were trained by 44 faculty on hands-only CPR and AED use. Discussion Bystander CPR can significantly improve survival rates of cardiac arrest, which currently hovers around 10%. Enhancing an individual’s comfort with CPR performance, implementing straightforward CPR training with minimal steps that are easy to perform and recall, and eliminating mouth-to-mouth contact from rescue breaths may result in increased willingness to respond. Results from this study highlight that effective bystander CPR and AED training can be done in large groups and in a short period of time, resulting in decreased burden on participants and trainers and increasing the number of individuals trained in this life-saving technique. Faculty time burden was 30 minutes in the fall semester for initial training, and approximately 30
minutes per class in the spring when training students. Trainer burden was approximately 12 hours in the fall semester. The improvement in scores demonstrates the training was effective in improving confidence and in educating the faculty/staff on proper CPR performance and AED use. This may result in increased responsiveness during a cardiac arrest and in more effective CPR, improving a victim’s chance of survival. The implementation of a follow-up survey and skills testing session will be included in future training sessions, in order to assess retention and quality of CPR skills. Follow up is recommended at 6 and 12 month intervals in order to assure the maintenance of skills and knowledge. A noteworthy finding is that those individuals currently certified in CPR did not answer questions correctly regarding appropriate CPR steps and AED use. These questions are reflective of questions used in a typical CPR training course and therefore would be expected to be answered correctly by the certified group. This finding suggests that participants, despite certification, may have performed incorrectly in an emergency situation, resulting in ineffective CPR and reduced survival. This highlights that this training is beneficial even for those certified in CPR/AED. Additionally, our training method in which the student becomes the trainer, was effective in training a total of just over 1700 participants in a short period of time with limited burden. When using the proposed training schematic (Figure 2), this may further increase the number of hands-only CPR/AED trained individuals in a variety of settings. Although this program was implemented as a pilot study at a university, our next steps are to spread this training method across an entire college campus, as well as throughout the local community. Outreach in community centers, senior centers, and office settings would lead to a significant increase in the
proportion of the population able to respond to cardiac arrest safely and effectively, with minimal time burden on participants. Considering cardiac arrest is a leading cause of death in the United States, the ability to recognize a cardiac arrest and immediately respond will have the potential to save thousands of lives. Acknowledgements This study was made possible due to faculty and staff volunteers from the Beaver College of Health Sciences. We thank Dr. Marie Huff, Dean of the Beaver College of Health Sciences, Appalachian State’s Health Promotion Office, and the Omar Carter Foundation for their support and assistance. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
References [1] Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation. 2018; 137:e67-e492. [2] Cummins RO, Eisenberg MS, Hallstrom AP, Litwin PE. Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. Am J Emerg Med. 1985; 3:114-9. [3] Berdowski J, Blom MT, Bardai A, Tan HL, Tijssen JG, Koster RW. Impact of onsite or dispatched automated external defibrillator use on survival after out-of-hospital cardiac arrest. Circulation. 2011; 124:2225-32. [4] Becker LB, Ostrander MP, Barrett J, Kondos GT. Outcome of CPR in a large metropolitan area--where are the survivors? Ann Emerg Med. 1991; 20:355-61. [5] De Maio VJ, Stiell IG, Spaite DW, Ward RE, Lyver MB, Field BJ, 3rd, et al. CPR-only survivors of out-of-hospital cardiac arrest: implications for out-of-hospital care and cardiac arrest research methodology. Ann Emerg Med. 2001; 37:602-8. [6] Cho GC, Sohn YD, Kang KH, Lee WW, Lim KS, Kim W, et al. The effect of basic life support education on laypersons' willingness in performing bystander hands only cardiopulmonary resuscitation. Resuscitation. 2010; 81:691-4. [7] Swor R, Khan I, Domeier R, Honeycutt L, Chu K, Compton S. CPR training and CPR performance: do CPR-trained bystanders perform CPR? Acad Emerg Med. 2006; 13:596-601. [8] Rea TD, Fahrenbruch C, Culley L, Donohoe RT, Hambly C, Innes J, et al. CPR with chest compression alone or with rescue breathing. N Engl J Med. 2010; 363:423-33. [9] Svensson L, Bohm K, Castren M, Pettersson H, Engerstrom L, Herlitz J, et al. Compressiononly CPR or standard CPR in out-of-hospital cardiac arrest. N Engl J Med. 2010; 363:434-42.
[10] Sayre MR, Berg RA, Cave DM, Page RL, Potts J, White RD, et al. Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee. Circulation. 2008; 117:2162-7. [11] Urban J, Thode H, Stapleton E, Singer AJ. Current knowledge of and willingness to perform Hands-Only CPR in laypersons. Resuscitation. 2013; 84:1574-8.
Figure 1. Questionnaire Provided Before and Following Training Session. The purpose of this survey is to gather information about current knowledge of hands-only (or “compressions” only) cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use. Your participation is voluntary and your responses or lack thereof will result in no plenty. Your responses will be combined with many other volunteers and will be unable to be traced back to you. 1. Do you feel confident with your ability to administer hands-only CPR, if required today? Yes No 2. Do you feel confident with your ability to use an AED, if required today? Yes No 3. Are you currently certified in CPR? Yes No 4. What is the first step of compression-only CPR? Call 9-1-1 Check for Breathing Provide Chest Compressions Check the Scene for Safety 5. Effective chest compressions… Allow the chest to return to its normal position Are done fast at a rate of 100 – 120 compressions per minute Are smooth, regular and performed straight up and down All of the above 6. You should continue chest compressions until… The person shows signs of life. Another trained responder or EMS personnel arrives and takes over You are too exhausted to continue. All of the above 7. What should you do before the AED analyzes the heart rhythm? Ensure that no one, including you, is touching the person. Ensure that the person’s airway is open. Ensure the person is breathing. None of the above. 8. The proper placement of AED pads is… Chest and stomach Upper left and lower right sides of the chest.
Upper right and lower left sides of the chest. Upper right and upper left sides of the chest.
Figure 2. Schematic of training implementation.
Table 1. Questionnaire Results Before and Following Training Session: Percent Correct CPR Q1 PRE POST Currently CPR certified (%) Not CPR certified (%)
CPR Q2
CPR Q3
AED Q1
AED Q2
PRE
POST
PRE
POST
PRE
POST
PRE
POST
63
74
85
96
82
93
85
93
52
74
26
78
67
87
70
93
63
83
28
77
S0735-6757(19)30657-6 https://doi.org/10.1016/j.ajem.2019.10.003 YAJEM 158506
To appear in:
American Journal of Emergency Medicine
Received Date: Revised Date: Accepted Date:
28 August 2019 1 October 2019 5 October 2019
Please cite this article as: R.M. Kappus, G. McCullough, The Feasibility of a Novel Method of Bystander CPR Training: A Pilot Study, American Journal of Emergency Medicine (2019), doi: https://doi.org/10.1016/j.ajem. 2019.10.003
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
© 2019 Published by Elsevier Inc.
The Feasibility of a Novel Method of Bystander CPR Training: A Pilot Study Rebecca M. Kappusa, Gary McCulloughb a. Appalachian State University, Department of Health and Exercise Science, 1179 State Farm Rd, Boone, NC 28608-2071. b. Appalachian State University, Associate Dean of Research and Graduate Education, Director of the Beaver College of Health Sciences Institute for Health and Human Services, 1179 State Farm Rd, Boone, NC 28608-2071. Corresponding Author: Rebecca M. Kappus, PhD Assistant Professor Appalachian State University Department of Health and Exercise Science 1179 State Farm Rd Boone, NC 28608-2071 Phone: 828-262-7214 Fax: 828-262-3138 [email protected] Sources of Support: None. Word Count of Manuscript: 1242 Word Count of Abstract: 148 Abstract Sudden cardiac arrest is a leading cause of death in the United States, with many occurring out of the hospital. Immediate response by bystanders, through the initiation of cardiopulmonary resuscitation (CPR), leads to increased survival; however, many do not respond due to lack of training and education. This study sought to determine the efficacy of a training model developed to rapidly and effectively train large numbers of individuals on hands-only CPR. Thirty minute training sessions were developed to introduce hands-only CPR to faculty at a university, with questionnaires assessing confidence and knowledge of CPR. Faculty then went on to train their respective students. Ninety-six faculty and staff and 1615 students were trained within 3 weeks, demonstrating this model was effective in rapidly training large numbers of individuals in a short period of time while increasing CPR knowledge and confidence. This method may be effective in other community settings. Keywords: Bystander CPR; CPR training; Hands-Only CPR; Cardiac arrest; CPR education
Bystander CPR Training
Introduction Every year in the United States, there are over 356,000 cardiac arrests outside of a hospital setting and a survival rate of just 10% [1]. Survival rates improve considerably if the victim receives immediate cardiopulmonary resuscitation (CPR) and defibrillation with an automated external defibrillator (AED) [2, 3]. Because medical personnel response may take 7-8 minutes or longer [4], victim survival depends on the ability of the bystander to recognize an emergency and perform CPR until the arrival of trained responders. However, only 15-30% of cardiac arrest victims receive CPR from a bystander [5]. The reluctance in performing CPR is unclear but may be due to fear of liability, fear of transmitted diseases [6], inadequate training, complicated guidelines, and fear of failure [7]. Bystander CPR (CPR without rescue breaths), also called hands-only CPR, has been proven to be as effective as traditional CPR in treating cardiac arrest victims [8, 9] and may result in more effective CPR due to uninterrupted chest compressions and reduced time to initiation of chest compressions [10]. Because bystander CPR is easy to perform and recall, individuals trained in this method may be less hesitant to respond to an emergency. However, many people are unaware of hands-only CPR [11] and therefore there is an increased need to educate the public about this method. Due to its straightforward steps, it is simple to teach and can be introduced to large numbers of people with little time burden. The primary purpose of this intervention was to determine if short bouts of hands-only CPR and AED training were effective in improving confidence in the ability to perform CPR and use an AED, and if knowledge of CPR and AED procedures increased. A secondary purpose was to determine if the model of training in which the student becomes the teacher, would be effective in introducing large numbers of individuals to hands-only CPR, with minimal burden on participants.
Methods This intervention was implemented in the fall semester of 2018 at Appalachian State University, located in Boone, North Carolina and was approved by the Appalachian State University institutional review board (19-0059). The targeted audience was faculty and staff of the Beaver College of Health Sciences at Appalachian State University. Training was available in 30 minute sessions over three separate dates. The average number of participants for each training session was approximately 20 participants, and 4 trainers were present per session. In-person training consisted of a personal story from a cardiac arrest survivor who received bystander CPR, a demonstration with step-by-step descriptions of appropriate handsonly CPR steps and AED usage, and practice of CPR steps and chest compressions on mannequins and practice with an AED trainer, completed under the guidance and instruction of the trainers. Hands-Only CPR utilizes 3 steps based on the American Red Cross instructions: 1) Check/Call; 2) Provide chest compressions; 3) Don’t stop. The aims of the training session were to emphasize the crucial role of CPR and AED use in a victim’s personal story to highlight the magnitude of simple chest compressions in survival, demonstrate the straight-forward steps in hands-only CPR, and allow participants the opportunity to perform hands-on practice and understand proper execution of chest compressions. A questionnaire was administered prior to training to determine baseline comfort and knowledge of CPR and AED use (Figure 1). The same questionnaire was administered following training to determine the efficacy of the intervention. In the following semester, trained faculty then taught hands-only CPR to the students enrolled in each of their courses, targeting the American Heart Month of February. Prior to the spring training, faculty were provided a hand-out outlining the steps for CPR and AED use as a
refresher, and a short video outlining CPR and AED steps to be shown during class. Mannequins were brought to each classroom for compressions practice. Results Ninety-six faculty and staff filled out the optional questionnaires before and following the training; and, of these, 27 participants were currently CPR certified. Prior to training, 52% of participants felt confident in their ability to perform CPR while 45% were confident in their ability to use an AED. Following training, 99% and 97% of participants, respectively, were confident in their ability to perform CPR and use an AED. Participants also improved their knowledge of material, with CPR knowledge improving from 60% to 87% accuracy and AED knowledge improving from 52% to 82% accuracy (Table 1). Of the 27 participants currently CPR certified and confident in their abilities, only 3 answered all questions correctly. In the spring semester training, over a three week time period, 1615 students in 68 classes in the Beaver College of Health Sciences were trained by 44 faculty on hands-only CPR and AED use. Discussion Bystander CPR can significantly improve survival rates of cardiac arrest, which currently hovers around 10%. Enhancing an individual’s comfort with CPR performance, implementing straightforward CPR training with minimal steps that are easy to perform and recall, and eliminating mouth-to-mouth contact from rescue breaths may result in increased willingness to respond. Results from this study highlight that effective bystander CPR and AED training can be done in large groups and in a short period of time, resulting in decreased burden on participants and trainers and increasing the number of individuals trained in this life-saving technique. Faculty time burden was 30 minutes in the fall semester for initial training, and approximately 30
minutes per class in the spring when training students. Trainer burden was approximately 12 hours in the fall semester. The improvement in scores demonstrates the training was effective in improving confidence and in educating the faculty/staff on proper CPR performance and AED use. This may result in increased responsiveness during a cardiac arrest and in more effective CPR, improving a victim’s chance of survival. The implementation of a follow-up survey and skills testing session will be included in future training sessions, in order to assess retention and quality of CPR skills. Follow up is recommended at 6 and 12 month intervals in order to assure the maintenance of skills and knowledge. A noteworthy finding is that those individuals currently certified in CPR did not answer questions correctly regarding appropriate CPR steps and AED use. These questions are reflective of questions used in a typical CPR training course and therefore would be expected to be answered correctly by the certified group. This finding suggests that participants, despite certification, may have performed incorrectly in an emergency situation, resulting in ineffective CPR and reduced survival. This highlights that this training is beneficial even for those certified in CPR/AED. Additionally, our training method in which the student becomes the trainer, was effective in training a total of just over 1700 participants in a short period of time with limited burden. When using the proposed training schematic (Figure 2), this may further increase the number of hands-only CPR/AED trained individuals in a variety of settings. Although this program was implemented as a pilot study at a university, our next steps are to spread this training method across an entire college campus, as well as throughout the local community. Outreach in community centers, senior centers, and office settings would lead to a significant increase in the
proportion of the population able to respond to cardiac arrest safely and effectively, with minimal time burden on participants. Considering cardiac arrest is a leading cause of death in the United States, the ability to recognize a cardiac arrest and immediately respond will have the potential to save thousands of lives. Acknowledgements This study was made possible due to faculty and staff volunteers from the Beaver College of Health Sciences. We thank Dr. Marie Huff, Dean of the Beaver College of Health Sciences, Appalachian State’s Health Promotion Office, and the Omar Carter Foundation for their support and assistance. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
References [1] Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation. 2018; 137:e67-e492. [2] Cummins RO, Eisenberg MS, Hallstrom AP, Litwin PE. Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. Am J Emerg Med. 1985; 3:114-9. [3] Berdowski J, Blom MT, Bardai A, Tan HL, Tijssen JG, Koster RW. Impact of onsite or dispatched automated external defibrillator use on survival after out-of-hospital cardiac arrest. Circulation. 2011; 124:2225-32. [4] Becker LB, Ostrander MP, Barrett J, Kondos GT. Outcome of CPR in a large metropolitan area--where are the survivors? Ann Emerg Med. 1991; 20:355-61. [5] De Maio VJ, Stiell IG, Spaite DW, Ward RE, Lyver MB, Field BJ, 3rd, et al. CPR-only survivors of out-of-hospital cardiac arrest: implications for out-of-hospital care and cardiac arrest research methodology. Ann Emerg Med. 2001; 37:602-8. [6] Cho GC, Sohn YD, Kang KH, Lee WW, Lim KS, Kim W, et al. The effect of basic life support education on laypersons' willingness in performing bystander hands only cardiopulmonary resuscitation. Resuscitation. 2010; 81:691-4. [7] Swor R, Khan I, Domeier R, Honeycutt L, Chu K, Compton S. CPR training and CPR performance: do CPR-trained bystanders perform CPR? Acad Emerg Med. 2006; 13:596-601. [8] Rea TD, Fahrenbruch C, Culley L, Donohoe RT, Hambly C, Innes J, et al. CPR with chest compression alone or with rescue breathing. N Engl J Med. 2010; 363:423-33. [9] Svensson L, Bohm K, Castren M, Pettersson H, Engerstrom L, Herlitz J, et al. Compressiononly CPR or standard CPR in out-of-hospital cardiac arrest. N Engl J Med. 2010; 363:434-42.
[10] Sayre MR, Berg RA, Cave DM, Page RL, Potts J, White RD, et al. Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee. Circulation. 2008; 117:2162-7. [11] Urban J, Thode H, Stapleton E, Singer AJ. Current knowledge of and willingness to perform Hands-Only CPR in laypersons. Resuscitation. 2013; 84:1574-8.
Figure 1. Questionnaire Provided Before and Following Training Session. The purpose of this survey is to gather information about current knowledge of hands-only (or “compressions” only) cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use. Your participation is voluntary and your responses or lack thereof will result in no plenty. Your responses will be combined with many other volunteers and will be unable to be traced back to you. 1. Do you feel confident with your ability to administer hands-only CPR, if required today? Yes No 2. Do you feel confident with your ability to use an AED, if required today? Yes No 3. Are you currently certified in CPR? Yes No 4. What is the first step of compression-only CPR? Call 9-1-1 Check for Breathing Provide Chest Compressions Check the Scene for Safety 5. Effective chest compressions… Allow the chest to return to its normal position Are done fast at a rate of 100 – 120 compressions per minute Are smooth, regular and performed straight up and down All of the above 6. You should continue chest compressions until… The person shows signs of life. Another trained responder or EMS personnel arrives and takes over You are too exhausted to continue. All of the above 7. What should you do before the AED analyzes the heart rhythm? Ensure that no one, including you, is touching the person. Ensure that the person’s airway is open. Ensure the person is breathing. None of the above. 8. The proper placement of AED pads is… Chest and stomach Upper left and lower right sides of the chest.
Upper right and lower left sides of the chest. Upper right and upper left sides of the chest.
Figure 2. Schematic of training implementation.
Table 1. Questionnaire Results Before and Following Training Session: Percent Correct CPR Q1 PRE POST Currently CPR certified (%) Not CPR certified (%)
CPR Q2
CPR Q3
AED Q1
AED Q2
PRE
POST
PRE
POST
PRE
POST
PRE
POST
63
74
85
96
82
93
85
93
52
74
26
78
67
87
70
93
63
83
28
77