ABSTRACT: Ambulance personnel play an essential role in the 'Chain of Survival'. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island.
The Basic Life Support (BLS) and Automated External Defibrillator (AED) skills of the ambulance personnel were tested in a simulated cardiac arrest. Points were given according to a scoring sheet. One sample t test was used to analyze the deviation from optimal care according to the 2005 guidelines. After each assessment, individual feedback was given.
On 3 consecutive days, we assessed the individual EMS teams responding to OHCA on the island. Overall, 70% of the maximal points were achieved. The hands-off ratio was 40%. Correct compression/ventilation ratio (30:2) was used by 80%. A mean compression depth of 40-50 mm was achieved by 55% and the mean compression depth was 42 mm (SD 7 mm). The mean compression rate was 123 per min (SD 15/min). The mean tidal volume was 746 ml (SD 221 ml). Only the mean tidal volume deviated significantly from the recommended (p = 0.01). During the rhythm analysis, 65% did not perform any visual or verbal safety check.
The EMS providers achieved 70% of the maximal points. Tidal volumes were larger than recommended when mask ventilation was applied. Chest compression depth was optimally performed by 55% of the staff. Defibrillation safety checks were not performed in 65% of EMS providers.
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 05/2012; 20:34. · 1.85 Impact Factor
ABSTRACT: Training of healthcare staff in cardiopulmonary resuscitation (CPR) is time-consuming and costly. It has been suggested to replace instructor facilitated (IF) training with an automated voice advisory manikin (VAM), which increases skill level by continuous verbal feedback during individual training.
To compare a VAM (ResusciAnne CPR skills station, Laerdal Medical A/S, Norway) with IF training in CPR using a bag-valve-mask (BVM) in terms of skills retention after 3 months.
Forty-three second year medical students were included and CPR performance (ERC Guidelines for Resuscitation 2005) was assessed in a 2 min test before randomisation to either IF training in groups of 8 or individual VAM training. Immediately after training and after 3 months, CPR performance was assessed in identical 2 min tests. Laerdal PC Skill Reporting System 2.0 was used to collect data. To quantify CPR performance a scoring system based on the Cardiff test was used. Groups were compared with a Mann Whitney rank sum test.
There was no statistically significant difference between the two groups when considering change in overall CPR performance score from before training to 3 months after training (P=0.12). However, the IF group performed significantly better than the VAM group in the total score, both immediately after (P=0.0008) and 3 months after training (P=0.02). This difference was primarily related to the BVM skills.
Skill retention in CPR using a bag-valve-mask was better after 3 months when training with an instructor than with an automated voice advisory manikin.
Resuscitation 09/2008; 79(1):73-81. · 3.60 Impact Factor
ABSTRACT: Because most cardiac arrests occur at home, widespread training is needed to increase the incidence of cardiopulmonary resuscitation (CPR) by lay persons. The aim of this study was to evaluate the effect of mass distribution of CPR instructional materials among schoolchildren.
We distributed 35,002 resuscitation manikins to pupils (12 to 14 years of age) at 806 primary schools. Using the enclosed 24-minute instructional DVD, they trained in CPR and subsequently used the kit to train family and friends (second tier). They completed a questionnaire on who had trained in CPR using the kit. Teachers also were asked to evaluate the project. The incidence of bystander CPR in out-of-hospital cardiac arrest in the months following the project was compared with the previous year. In total, 6947 questionnaires (19.8%) were returned. The 6947 kits had been used to train 17,140 from the second tier (mean, 2.5 persons per pupil; 95% confidence interval, 2.4 to 2.5). The teachers had used a mean of 64 minutes (95% confidence interval, 60 to 68) for preparation and a mean of 13 minutes (95% confidence interval, 11 to 15) to tidy up. Incidence of bystander CPR in the months after the project did not increase significantly compared with the previous year (25.0% versus 27.9%; P=0.16).
CPR training can be disseminated in a population by distributing personal resuscitation manikins among children in primary schools. The teachers felt able to easily facilitate CPR training. The incidence of bystander CPR did not increase significantly in the months following the project.
Circulation 10/2007; 116(12):1380-5. · 14.74 Impact Factor
ABSTRACT: As 70-80% of cardiac arrests occur at home, widespread training is needed to increase the likelihood of basic life support (BLS) being performed before the arrival of Emergency Medical Services personnel. Teaching BLS in public schools has been recommended to achieve this.
To compare BLS skill retention in school children with adults when using a simple personal resuscitation manikin.
The MiniAnne (Laerdal Medical, Norway) was distributed to 76 pupils (age 12-14 years) in three public schools and to 194 employees (age 22-51 years) in an insurance company. Using the enclosed DVD, the participants carried out a 24 min BLS course and took home the manikin for subsequent self-training. After 3 months, skill retention was assessed using the ResusciAnne and the PC Skill reporting System 2.0 (Laerdal Medical, Norway) in a 5 min test. A combined score ranging from 12 to 52 points was calculated and in addition, 12 different variables were compared.
The combined score was significantly higher in adults (35 points versus 32 points, P=0.0005). The adults performed significantly better than the children in all but four variables. 'Ventilation-compression ratio' and 'hand-position' were not significantly different. The children performed significantly better in the variables 'total compressions' (median 199 versus 154, P=0.0003), and 'hands-off time' (median 158.5s versus 188.5s, P<0.0001).
Three months after a BLS course, adults had higher overall BLS skill retention scores than school children when using a simple personal resuscitation manikin.
Resuscitation 09/2007; 74(2):296-302. · 3.60 Impact Factor