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Evaluation of cpr knowledge and skills in a realistic setting
187
PO25
PO26
EFFECTS OF CPR-TRAINING
ON THE PERCEPTION OF COMPETENCE
EVALUATION
OF CPR KNOWLEDGE ANIt SKILLS IN A SF.ALISTlC SETTING
MHRJ
Former studies dealing with CPR- or first-aid-training of the public mainly fofusscd on the evaluation of knowledge and &ills. In our study we tried to bring the participation in e CPR-training in relation to the superior compla of competence. that meens the capability to act io a helping way when witnessiog 811emergenq. To investigate participants’ experience and behavior resp. their anticipated or intended reactions 614 test persons (585 participants of different cowses and a con~ol group of 89 non-patidpaots) were confronted with a short video showing a non-tieomatic emergency (uocooscioos victim) in its final sequence. loformations of the test persons on demographic characteristics, on iormer participation in tint-aid-courses, on motivation and on former e~eriences in emergencies were collected before. To measure the individual changes in emotionzJ condition induced by the perception of the video we used adjectice checklists directly before and after the presentation. Spontaneous reactions on the video and the anticipated behavior were registered by B questionnaire. We analysis of the adjective checklists showed significant changes in emotional condition between the two measuring points ‘“before”and “after video”, qualitatively corresponding to those in a real emergency (stress). The video therefore can be regarded as a realistic presentation of an emergency As to the intended behaviour resp. act we found that participation in a training increases the technical-practical and the psychic-emotional competence as well as the the feeling of responsibility and the willingness to intervene. Participants of special CPR-courses showed greater expressions; in these variables than participants of general first-aidEOUTSCS, and they again than participants of short courses directed to people applying for a driving linoce, and non-participants. Other factors with positive effect on these variables were the time interval, quality and number of former causes. and experience by profession or former emergencies.
A frequent dixxivantage of conventional evaluation stodies is their very abstract level when questionnaires are used, or that results are garbled by non-measurable effects of preparation. In our study we tried to avoid these disadva.ntages by unexpectedly coofronting a sample of former participants (n = 64) with a cardiac emergency: the test persons were visited at their homes without any aooo~ncement and asked to demonstrate the diagnostic and tl~erapeutic steps on a manoeqoin carried along with the investigator. The question was how fonoer participants were able to perform CPR in dependence on the time interval between training and test. T&ii+ ~hc .%ar&ir* aud Ollidciir~er ui the aoIe&iu iisdl Liurwirtoo a\ radug &sria we found that up to six months after training 61 percent of the test persons accomplished these standards. Tl~e next interval, 12 months, showed a dramatic decrease, only 24 percent passed the criteria, and 21 percent two years after training. There was no dependence on age or sex. Test persoos’ self-estimations of practical and psychic competence also decreased from 6 to 12 and 24 months but stayed on a higher level than the demonstrated performance. A more practical way of interpreting the data was the question whether the demonstrated performance would improve the chances of survival in case of a real emergency. Six months after training 90 percent of the test persons would improve the prognosis, after 12 and 24 months each time 71 percent. Analyzing the incorrect steps we found that the more important parameters as determining pulselessness and breathlessness or proper hand position for chest compression ranged at the end of the scale. Although the perfonoemx was not toa bad from a more practical point of view, the results again lay emphasis on the necessity of periodical refresher causes, begtoning shortly after the initial traioiog.
Evaluation; CPR performance
Social competence; helping behatioor
PO28
PO27 CARDIOPULMONARY RESUSClTATlON VALVE-MASK BY TWO RESCUERS MICHAEL
WITH MASK OR BAG- WHICH RHYTHM 7
?AUBIN. ? MARTIN P&L, GUNNAR KROESEN. ADOLF SCHINNERL
Unlv.Kllnlk
fQr Ardtsthesie und Allg.lntenslvmedlrln (Vorstand: Unlv.Prof.Dr,H.Benzer), Anichstral3e 35, A-6020 Innsbruck, bsterreleh
Two different ventilation-ComploSSion ratios of Cardiopulmonary Resuscitation (CPR) are taught worldwide: single operator technique with a 2:15 ratio and two operator technique with a I:5 ratio. Controversy exists which of the two techniques should be applied by different rSscuSts. In order to d~crS~sS the barrier to ventilele an unfamiliar person and to avoid the possibility of transmission of infection CPR by mask or by bag-valve-mask Sm generally accepted. Bag-VSIVS-mSSkS 818 widespread and are commonly used by persons with limited experience in CPR e.g. fire-men, nurses, dentists and family doctors. VSntilation by mask or bag-valve-mask can only be performed sufficiently from a position above the patients head. Therefore a second pwson is Sssential lo carry out IhS chest compression. The main complication of the conventional two operator rhythm (1 :5) is a dangerously high ventilation pressure followed by regurgitation of gastric content caussd by poor cooperation of the two rSscuSr~. Our proposal concSrns the groups, who should be trained in the different methods. Persons with limited rxpwience in CPR but equipped with maSk or bagvalve-mask should perform CPR in the one operator rhythm (2:15) but by two usinQ the mask. One carries out ventilation fwicS thS other chest compreSSion 15 time& The frequency of swious complications like aspiration of gastric content during CPA by persons with limited expedence may thus be reduced.
Emergency Medicine. CPR - Basic-life-support - Iwo-rSscuer technique
PO25
PO26
EFFECTS OF CPR-TRAINING
ON THE PERCEPTION OF COMPETENCE
EVALUATION
OF CPR KNOWLEDGE ANIt SKILLS IN A SF.ALISTlC SETTING
MHRJ
Former studies dealing with CPR- or first-aid-training of the public mainly fofusscd on the evaluation of knowledge and &ills. In our study we tried to bring the participation in e CPR-training in relation to the superior compla of competence. that meens the capability to act io a helping way when witnessiog 811emergenq. To investigate participants’ experience and behavior resp. their anticipated or intended reactions 614 test persons (585 participants of different cowses and a con~ol group of 89 non-patidpaots) were confronted with a short video showing a non-tieomatic emergency (uocooscioos victim) in its final sequence. loformations of the test persons on demographic characteristics, on iormer participation in tint-aid-courses, on motivation and on former e~eriences in emergencies were collected before. To measure the individual changes in emotionzJ condition induced by the perception of the video we used adjectice checklists directly before and after the presentation. Spontaneous reactions on the video and the anticipated behavior were registered by B questionnaire. We analysis of the adjective checklists showed significant changes in emotional condition between the two measuring points ‘“before”and “after video”, qualitatively corresponding to those in a real emergency (stress). The video therefore can be regarded as a realistic presentation of an emergency As to the intended behaviour resp. act we found that participation in a training increases the technical-practical and the psychic-emotional competence as well as the the feeling of responsibility and the willingness to intervene. Participants of special CPR-courses showed greater expressions; in these variables than participants of general first-aidEOUTSCS, and they again than participants of short courses directed to people applying for a driving linoce, and non-participants. Other factors with positive effect on these variables were the time interval, quality and number of former causes. and experience by profession or former emergencies.
A frequent dixxivantage of conventional evaluation stodies is their very abstract level when questionnaires are used, or that results are garbled by non-measurable effects of preparation. In our study we tried to avoid these disadva.ntages by unexpectedly coofronting a sample of former participants (n = 64) with a cardiac emergency: the test persons were visited at their homes without any aooo~ncement and asked to demonstrate the diagnostic and tl~erapeutic steps on a manoeqoin carried along with the investigator. The question was how fonoer participants were able to perform CPR in dependence on the time interval between training and test. T&ii+ ~hc .%ar&ir* aud Ollidciir~er ui the aoIe&iu iisdl Liurwirtoo a\ radug &sria we found that up to six months after training 61 percent of the test persons accomplished these standards. Tl~e next interval, 12 months, showed a dramatic decrease, only 24 percent passed the criteria, and 21 percent two years after training. There was no dependence on age or sex. Test persoos’ self-estimations of practical and psychic competence also decreased from 6 to 12 and 24 months but stayed on a higher level than the demonstrated performance. A more practical way of interpreting the data was the question whether the demonstrated performance would improve the chances of survival in case of a real emergency. Six months after training 90 percent of the test persons would improve the prognosis, after 12 and 24 months each time 71 percent. Analyzing the incorrect steps we found that the more important parameters as determining pulselessness and breathlessness or proper hand position for chest compression ranged at the end of the scale. Although the perfonoemx was not toa bad from a more practical point of view, the results again lay emphasis on the necessity of periodical refresher causes, begtoning shortly after the initial traioiog.
Evaluation; CPR performance
Social competence; helping behatioor
PO28
PO27 CARDIOPULMONARY RESUSClTATlON VALVE-MASK BY TWO RESCUERS MICHAEL
WITH MASK OR BAG- WHICH RHYTHM 7
?AUBIN. ? MARTIN P&L, GUNNAR KROESEN. ADOLF SCHINNERL
Unlv.Kllnlk
fQr Ardtsthesie und Allg.lntenslvmedlrln (Vorstand: Unlv.Prof.Dr,H.Benzer), Anichstral3e 35, A-6020 Innsbruck, bsterreleh
Two different ventilation-ComploSSion ratios of Cardiopulmonary Resuscitation (CPR) are taught worldwide: single operator technique with a 2:15 ratio and two operator technique with a I:5 ratio. Controversy exists which of the two techniques should be applied by different rSscuSts. In order to d~crS~sS the barrier to ventilele an unfamiliar person and to avoid the possibility of transmission of infection CPR by mask or by bag-valve-mask Sm generally accepted. Bag-VSIVS-mSSkS 818 widespread and are commonly used by persons with limited experience in CPR e.g. fire-men, nurses, dentists and family doctors. VSntilation by mask or bag-valve-mask can only be performed sufficiently from a position above the patients head. Therefore a second pwson is Sssential lo carry out IhS chest compression. The main complication of the conventional two operator rhythm (1 :5) is a dangerously high ventilation pressure followed by regurgitation of gastric content caussd by poor cooperation of the two rSscuSr~. Our proposal concSrns the groups, who should be trained in the different methods. Persons with limited rxpwience in CPR but equipped with maSk or bagvalve-mask should perform CPR in the one operator rhythm (2:15) but by two usinQ the mask. One carries out ventilation fwicS thS other chest compreSSion 15 time& The frequency of swious complications like aspiration of gastric content during CPA by persons with limited expedence may thus be reduced.
Emergency Medicine. CPR - Basic-life-support - Iwo-rSscuer technique