Hands-Only Cardiopulmonary Resuscitation Education: A Comparison of On-Screen With Compression Feedback, Classroom, and Video Education
Debra G. Heard, PhD
Correspondence information about the author PhD Debra G. Heard
We compare 3 methods of hands-only cardiopulmonary resuscitation (CPR) education, using performance scores. A paucity of research exists on the comparative effectiveness of different types of hands-only CPR education. This study also includes a novel kiosk approach that has not previously been studied, to our knowledge.
A randomized, controlled study compared participant scores on 4 hands-only CPR outcome measures after education with a 25- to 45-minute practice-while-watching classroom session (classroom), 4-minute on-screen feedback and practice session (kiosk), and 1-minute video viewing (video only). Participants took a 30-second compression test after initial training and again after 3 months.
After the initial education session, the video-only group had a lower total score (compressions correct on hand placement, rate, and depth) (–9.7; 95% confidence interval [CI] –16.5 to –3.0) than the classroom group. There were no significant differences on total score between classroom and kiosk participants. Additional outcome scores help explain which components negatively affect total score for each education method. The video-only group had lower compression depth scores (–9.9; 95% CI –14.0 to –5.7) than the classroom group. The kiosk group outperformed the classroom group on hand position score (4.9; 95% CI 1.3 to 8.6) but scored lower on compression depth score (–5.6; 95% CI –9.5 to –1.8). The change in 4 outcome variables was not significantly different across education type at 3-month follow-up.
Participants exposed to the kiosk session and those exposed to classroom education performed hands-only CPR similarly, and both groups showed skill performance superior to that of participants watching only a video. With regular retraining to prevent skills decay, the efficient and free hands-only CPR training kiosk has the potential to increase bystander intervention and improve survival from out-of-hospital cardiac arrest.
Hypothermic Cardiac Arrest With Full Neurologic Recovery After Approximately Nine Hours of Cardiopulmonary Resuscitation: Management and Possible Complications
Alessandro Forti, MD, Pamela Brugnaro, MD, Simon Rauch, MD, Manuela Crucitti, MD, Hermann Brugger, MD, Giovanni Cipollotti, MD, Giacomo Strapazzon, MD, PhD.
We describe full neurologic recovery from accidental hypothermia with cardiac arrest despite the longest reported duration of mechanical cardiopulmonary resuscitation (CPR) and extracorporeal life support (8 hours, 42 minutes). Clinical data and blood samples were obtained from emergency medical services (EMS) and the intensive care department. A 31-year-old man experienced a witnessed hypothermic cardiac arrest with a core temperature of 26°C (78.8°F) during a summer thunderstorm; he received mechanical CPR for 3 hours and 42 minutes, followed by 5 hours of extracorporeal life support. The use of a standard operating procedure that integrates a technical mountain rescue performed by EMS, optimizes prolonged CPR to the hub hospital, and enables prompt placement of extracorporeal life support is described and discussed. Three months postaccident, the patient had recovered completely (Cerebral Performance Category score of 1) and resumed normal daily life. Neurologically intact survival from hypothermic cardiac arrest is common, suggesting that aggressive resuscitation measures are warranted. There is a need for the establishment of a clear standard operating procedure and multiteam education and training to further optimize the patient survival chain from on-site triage and treatment to inhospital extracorporeal life support and postresuscitation care.