Basic life support skills of high school students before and after cardiopulmonary resuscitation training: a longitudinal investigation

Theresa M Meissner, Cordula Kloppe, Christoph Hanefeld, Theresa M Meissner, Cordula Kloppe, Christoph Hanefeld

Abstract

Background: Immediate bystander cardiopulmonary resuscitation (CPR) significantly improves survival after a sudden cardiopulmonary collapse. This study assessed the basic life support (BLS) knowledge and performance of high school students before and after CPR training.

Methods: This study included 132 teenagers (mean age 14.6 ± 1.4 years). Students completed a two-hour training course that provided theoretical background on sudden cardiac death (SCD) and a hands-on CPR tutorial. They were asked to perform BLS on a manikin to simulate an SCD scenario before the training. Afterwards, participants encountered the same scenario and completed a questionnaire for self-assessment of their pre- and post-training confidence. Four months later, we assessed the knowledge retention rate of the participants with a BLS performance score.

Results: Before the training, 29.5% of students performed chest compressions as compared to 99.2% post-training (P < 0.05). At the four-month follow-up, 99% of students still performed correct chest compressions. The overall improvement, assessed by the BLS performance score, was also statistically significant (median of 4 and 10 pre- and post-training, respectively, P < 0.05). After the training, 99.2% stated that they felt confident about performing CPR, as compared to 26.9% (P < 0.05) before the training.

Conclusions: BLS training in high school seems highly effective considering the minimal amount of previous knowledge the students possess. We observed significant improvement and a good retention rate four months after training. Increasing the number of trained students may minimize the reluctance to conduct bystander CPR and increase the number of positive outcomes after sudden cardiopulmonary collapse.

Figures

Figure 1
Figure 1
lllustration of the overall basic life support performance of teenagers.

References

    1. Trappe H. Plötzlicher Herztod: Häufigkeit, Risikoidentifikation, Behandlungsstrategien. Der Kardiologe. 2007;1:261–271. doi: 10.1007/s12181-007-0030-4.
    1. Statistisches Bundesamt Deutschland: Todesursachen. (accessed July 22, 2011)
    1. Fredriksson M, Herlitz J, Nichol G. Variation in outcome in studies of out-of-hospital cardiac arrest: a review of studies conforming to the Utstein guidelines. Am J Emerg Med. 2003;21:276–281. doi: 10.1016/S0735-6757(03)00082-2.
    1. Lindner TW, Søreide E, Nilsen OB, Torunn MW, Lossius HM. Good outcome in every fourth resuscitation attempt is achievable--an Utstein template report from the Stavanger region. Resuscitation. 2011;82:1508–1513. doi: 10.1016/j.resuscitation.2011.06.016.
    1. Perkins GD, Brace SJ, Smythe M, Ong G, Gates S. Out-of-hospital cardiac arrest: recent advances in resuscitation and effects on outcome. Heart. 2012;98:529–535. doi: 10.1136/heartjnl-2011-300802.
    1. Holmberg M, Holmberg S, Herlitz J. Effect of bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients in Sweden. Resuscitation. 2000;47:59–70. doi: 10.1016/S0300-9572(00)00199-4.
    1. 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. doi: 10.1111/j.1553-2712.2006.tb01017.x.
    1. Lund-Kordahl I, Olasveengen TM, Lorem T, Samdal M, Wik L, Sunde K. Improving outcome after out-of-hospital cardiac arrest by strengthening weak links of the local Chain of Survival; quality of advanced life support and post-resuscitation care. Resuscitation. 2010;81:422–426. doi: 10.1016/j.resuscitation.2009.12.020.
    1. Herlitz J, Eek M, Holmberg M, Engdahl J, Holmberg S. Characteristics and outcome among patients having out of hospital cardiac arrest at home compared with elsewhere. Heart. 2002;88:579–582. doi: 10.1136/heart.88.6.579.
    1. Weisfeldt ML, Sitlani CM, Ornato JP, Rea T, Aufderheide TP, Davis D, Dreyer J, Hess EP, Jui J, Maloney J, Sopko G, Powell J, Nichol G, Morrison LJ. Survival after application of automatic external defibrillators before arrival of the emergency medical system: evaluation in the resuscitation outcomes consortium population of 21 million. J Am Coll Cardiol. 2010;55:1713–1720. doi: 10.1016/j.jacc.2009.11.077.
    1. van Alem AP, Vrenken RH, de Vos R, Tijssen JGP, Koster RW. Use of automated external defibrillator by first responders in out of hospital cardiac arrest: prospective controlled trial. BMJ. 2003;327:1312. doi: 10.1136/bmj.327.7427.1312.
    1. Auble TE, Menegazzi JJ, Paris PM. Effect of out-of-hospital defibrillation by basic life support providers on cardiac arrest mortality: a metaanalysis. Ann Emerg Med. 1995;25:642–648. doi: 10.1016/S0196-0644(95)70178-8.
    1. Gundry JW, Comess KA, DeRook FA, Jorgenson D, Bardy GH. Comparison of naive sixth-grade children with trained professionals in the use of an automated external defibrillator. Circulation. 1999;100:1703–1707.
    1. Tanigawa K, Iwami T, Nishiyama C, Nonogi H, Kawamura T. Are trained individuals more likely to perform bystander CPR? An observational study. Resuscitation. 2011;82:523–528. doi: 10.1016/j.resuscitation.2011.01.027.
    1. Jones I, Whitfield R, Colquhoun M, Chamberlain D, Vetter N, Newcombe R. At what age can schoolchildren provide effective chest compressions? An observational study from the Heartstart UK schools training programme. BMJ. 2007;334:1201. doi: 10.1136/.
    1. Hanefeld C. A first city-wide early defibrillation project in a German city: 5-year results of the Bochum against sudden cardiac arrest study. Scand J Trauma Resusc Emerg Med. 2010;18:31. doi: 10.1186/1757-7241-18-31.
    1. Koster RW, Baubin M, Bossaert L, Caballero A, Cassan P, Castrén M, Granja C, Handley AJ, Monsieurs KG, Perkins GD, Raffay V, Sandroni C. Basismaßnahmen zur Wiederbelebung Erwachsener und Verwendung automatisierter externer Defibrillatoren: Sektion 2 der Leitlinien zur Reanimation 2010 des European Resuscitation Council. Notfall Rettungsmedizin. 2010;13:523–542. doi: 10.1007/s10049-010-1368-x.
    1. Chugh SS, Reinier K, Teodorescu C, Evanado A, Kehr E, Al Samara M, Mariani R, Gunson K, Jui J. Epidemiology of sudden cardiac death: clinical and research implications. Prog Cardiovasc Dis. 2008;51:213–228. doi: 10.1016/j.pcad.2008.06.003.
    1. Lotfi K, White L, Rea T, Cobb L, Copass M, Yin L, Becker L, Eisenberg M. Cardiac Arrest in Schools. Circulation. 2007;116(12):1374–1379. doi: 10.1161/CIRCULATIONAHA.107.698282.
    1. NPD Group Report (3/18/04) Buying Habits of Teens and Twens. ICSC Spring 2003 in: Mediamark Research Inc.: Teen Market Profile. New York; 2004.
    1. Becker L, Eisenberg M, Fahrenbruch C, Cobb L. Public locations of cardiac arrest. Implications for public access defibrillation. Circulation. 1998;97:2106–2109.
    1. Kelley J, Richman P, Ewy G, Clark L, Bulloch B, Bobrow B. Eighth grade students become proficient at CPR and use of an AED following a condensed training programme. Resuscitation. 2006;71:229–236. doi: 10.1016/j.resuscitation.2006.03.015.
    1. Fleischhackl R, Nuernberger A, Sterz F, Schoenberg C, Urso T, Habart T, Mittlboeck M, Chandra-Strobos N. School children sufficiently apply life supporting first aid: a prospective investigation. Crit Care. 2009;13:R127. doi: 10.1186/cc7984.
    1. Biarent D, Bingham R, Eich C, López-Herce J, Maconochie I, Rodrίguez-Núñez A, Rajka T, Zideman D. Lebensrettende Maßnahmen bei Kindern ("paediatric life support") Notfall Rettungsmed. 2010;13:635–664. doi: 10.1007/s10049-010-1372-1.
    1. Cave DM, Aufderheide TP, Beeson J, Ellison A, Gregory A, Hazinski MF, Hiratzka LF, Lurie KG, Morrison LJ, Mosesso VN, Nadkarni V, Potts J, Samson RA, Sayre MR, Schexnayder SM. Importance and Implementation of Training in Cardiopulmonary Resuscitation and Automated External Defibrillation in Schools: A Science Advisory From the American Heart Association. Circulation. 2011;123:691–706. doi: 10.1161/CIR.0b013e31820b5328.
    1. Darley J, Latané B. Bystander intervention in emergencies: Diffusion of responsibility. J Pers Soc Psychol. 1968;8:377–383.
    1. Cramer RE, Mcmaster MR, Bartell PA, Dragna M. Subject Competence and Minimization of the Bystander Effect. J Appl Social Pyschol. 1988;18:1133–1148. doi: 10.1111/j.1559-1816.1988.tb01198.x.
    1. Fischer P, Krueger JI, Greitemeyer T, Vogrincic C, Kastenmüller A, Frey D, Heene M, Wicher M, Kainbacher M. The bystander-effect: A meta-analytic review on bystander intervention in dangerous and non-dangerous emergencies. Psychol Bull. 2011;137:517–537.
    1. Vaillancourt C, Stiell IG, Wells GA. Understanding and improving low bystander CPR rates: a systematic review of the literature. CJEM. 2008;10:51–65.
    1. Roppolo LP, Pepe PE. Retention, retention, retention: targeting the young in CPR skills training! Crit Care. 2009;13:185. doi: 10.1186/cc7997.
    1. Breckwoldt J. Starting at school. Notfall Rettungsmed. 2009;12:39–44. doi: 10.1007/s10049-009-1209-y.
    1. Breckwoldt J, Schloesser S, Arntz H. Perceptions of collapse and assessment of cardiac arrest by bystanders of out-of-hospital cardiac arrest (OOHCA) Resuscitation. 2009;80:1108–1113. doi: 10.1016/j.resuscitation.2009.06.028.
    1. Waalewijn RA, de Vos R, Tijssen JG, Koster RW. Survival models for out-of-hospital cardiopulmonary resuscitation from the perspectives of the bystander, the first responder, and the paramedic. Resuscitation. 2001;51:113–122. doi: 10.1016/S0300-9572(01)00407-5.
    1. Lawson L, March J. Automated external defibrillation by very young, untrained children. Prehosp Emerg Care. 2002;6:295–298. doi: 10.1080/10903120290938328.
    1. Gallagher EJ, Lombardi G, Gennis P. Effectiveness of bystander cardiopulmonary resuscitation and survival following out-of-hospital cardiac arrest. JAMA. 1995;274:1922–1925. doi: 10.1001/jama.1995.03530240032036.
    1. Ko PC, Chen W, Lin C, Ma MH, Lin F. Evaluating the quality of prehospital cardiopulmonary resuscitation by reviewing automated external defibrillator records and survival for out-of-hospital witnessed arrests. Resuscitation. 2005;64:163–169. doi: 10.1016/j.resuscitation.2004.08.013.
    1. Schmidt RA, Lee TD. Motor control and learning: A behavioral emphasis. 4. Champaign, IL: Human Kinetics; 2005.
    1. Isbye DL, Rasmussen LS, Ringsted C, Lippert FK. Disseminating cardiopulmonary resuscitation training by distributing 35,000 personal manikins among school children. Circulation. 2007;116:1380–1385. doi: 10.1161/CIRCULATIONAHA.107.710616.
    1. Todd KH, Heron SL, Thompson M, Dennis R, O'Connor J, Kellermann AL. Simple CPR: A randomized, controlled trial of video self-instructional cardiopulmonary resuscitation training in an African American church congregation. Ann Emerg Med. 1999;34:730–737. doi: 10.1016/S0196-0644(99)70098-3.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться