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BackgroundEducation for the lay public in basic life support (BLS) is critical for increasing bystander cardiopulmonary resuscitation (CPR) rates and improving survival from out-of-hospital cardiac arrest (OHCA). Despite years of implementation, the BLS training rate in China has remained modest. The aim of this study was to investigate the factors influencing the implementation of BLS training programs in emergency medical service (EMS) centers in China and to identify specific barriers and enablers.MethodsQualitative interviews were conducted with key informants from 40 EMS centers in Chinese cities. The participants included 11 directors/deputy directors, 24 training department leaders, and 5 senior trainers. The interview guide was based on the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Thematic content analysis was used to identify themes and patterns across the interviews.ResultsWe identified 16 factors influencing the implementation of BLS training programs encompassing the outer content, inner context, innovation and bridging factors. Some factors acted as either barriers or enablers at different EPIS stages. The main implementation barriers included limited external leadership, insufficient government investment, low public awareness, a shortage of trainers, an absence of incentives, an absence of authoritative courses and guidelines, a lack of qualification to issue certificates, limited academic involvement, and insufficient publicity. The main enablers were found to be supportive government leaders, strong public demand, adequate resources, program champions, available high-quality courses of high fitness within the local context, the involvement of diverse institutions, and effective publicity and promotion.ConclusionOur findings emphasize the diversity of stakeholders, the complexity of implementation, and the need for localization and co-construction when conducting BLS training for lay public in city EMS centers. Improvements can be made at the national level, city level, and EMS institutional level to boost priority and awareness, promote legislation and policies, raise sustainable resources, and enhance the technology of BLS courses.

Background: App-linked real-time feedback-devices for cardiopulmonary resuscitation (CPR) aim to improve laypersons’ resuscitation quality. Resuscitation guidelines recommend these technologies in training settings. This is the first study comparing resuscitation quality of all App-linked feedback-devices currently on market. Methods: A prospective randomised simulation study was performed. After standardised instructions, participants performed 2-minutes compression-only CPR on a manikin without feedback (baseline). Afterwards, participants performed 4 × 2 min CPR with four different feedback devices in randomised order (CorPatch® Trainer, CPRBAND AIO Training, SimCPR®ProTrainer, Relay Response™) (intervention). CPR metrics (chest compression depth (CD), chest compression rate (CR), percentage of correct CD/CR (%), correct hand position, correct chest recoil, and technical preparation-time) were assessed. Devices data were compared to the baseline group using Wilcoxon testing with IBM SPSS (primary outcome). Differences between devices were analysed with ANOVA testing (secondary outcome). Normally distributed data were described as mean ± standard deviation (SD) and non-normally distributed data as Median [Interquartile range (IQR). CPR self-confidence was measured by means of questionnaire before and after feedback devices’ use. Comparison was performed by students t-test. Results: Forty participants were involved. SimCPR®ProTrainer was the only device, which resulted in guideline-compliant chest compressions (Mean ± SD:5.37 ± 0.76) with improved chest compression depth (p

Background: Children are highly susceptible to injury and death from accidents. Appropriate intervention can limit disability and increase survival (Alshammari, 2021). In this review, we aim to assess the knowledge and attitudes of the public towards pediatric first aid in the Makkah region of Saudi Arabia. Methods: In this cross-sectional study, a self-administered questionnaire was distributed among residents of the Makkah region. Descriptive statistics were employed to express numerical variables and categorical variables. A p-value of < 0.05 was considered statistically significant. Results: The study included 397 respondents. More than half were female (60.2%). Approximately one-third of the respondents were aged > 50 years, and 28.5% were working or studying in the medical field. Most participants had heard about first aid (99.5%) and believed that training was required to provide first aid (93.7%). However, less than half of the respondents (45.1%) had attended first-aid training once. Almost half of the respondents (51.6%) had previously encountered an injury, accident, or medical emergency; of these, 77.6% had provided first aid to the individual who experienced the emergency, and the most common types of emergencies included cut wounds (38.5%), burns (37.6%), and fits (25.4%). Conclusion: First aid is an important tool for providing immediate emergency care for all people, and it is particularly important for children. Knowledge of and attitude towards first-aid tools are essential for providing first aid when needed. In contrast, training in first aid is crucial for providing appropriate first aid, particularly for children and young infants. [ABSTRACT FROM AUTHOR]

Background: The Automated External Defibrillator represents a cornerstone of life-saving interventions, essential for responding to cardiac emergencies both within hospital walls and in community settings. Nurses shoulder the responsibility of understanding the correct protocols for AED usage, as their proficiency can be pivotal in administering timely and effective interventions during instances of cardiac arrest, significantly increasing the chances of survival. Purpose: The aim of this study Assess of Sudanese nurses Competency in Automated External Defibrillator (AED) knowledge and performance: in Khartoum Sudan. Methods: A quasi-experimental study conducted in 2023 aimed to evaluate the competencies of 100 qualified nurses regarding their knowledge and performance related to Automated External Defibrillators (AEDs). Throughout the study, seminars and lectures were delivered to the nursing staff to enhance their understanding of AED usage. Nurse performance was measured by conducting an applied experiment involving a mannequin and an AED, and following the prescribed steps. Data collection was carried out using questionnaires and observation checklists, with subsequent analysis conducted using the statistical software SPSS. Result: The study findings indicate a predominant representation of female participants, comprising 65 % of the total sample, with a significant portion falling within the 18 to 30 years age bracket. Among the participants, the majority, at 56 %, held a B.Sc. degree, followed by diplomas (25 %), master's degrees (5 %), and Ph.D. qualifications (2 %). Surprisingly, 57 % of participants had not undergone prior training in AED usage. The study's pre-test mean for knowledge stood at 16 %, increasing substantially to 84 % in the post-test phase, with a statistically significant P-value of 0.000, reflecting a marked improvement in knowledge. Similarly, the pre-test mean for performance was 19.1 %, rising to 80.1 % in the post-test phase, with a corresponding P-value of 0.000, indicating a significant enhancement in performance. These findings collectively suggest a positive shift towards improved knowledge and performance in AED usage among the participants. Conclusion: Study concludes improves nurses’ knowledge and performance in Automated External Defibrillator.

A heart attack is the sudden cessation of effective heart function in a healthy-looking individual. Basic Life Support training becomes an important thing for the layman considering the many incidents of cardiac arrest outside the hospital that need a lot of time to get the help of trained health workers. The purpose of this social service is to increase knowledge and skills in the field of Basic Life Support, participants are able to practice handling code blue in accordance with the procedures and the flow of fast and precise. Specific targets to be achieved are the formation of Code Blue System at Pondok Pesantren Putra and the formation of BLS Citizen Community in Kediri. The method used in community service is by In-house training supported by lecture, demonstration and practice methods. The targets of this activity are the students who include 38 students who are given Basic Life Support training for one day, then compared the level of knowledge and attitude before and after (pre post-test design). Different test results of attitude before and after training is not different meaningful. However, it does not mean that the training process can be considered unsuccessful in improving the attitude of all participants, because the average attitudes value is still high, more than 4. This is presumably still good attitude retention from Basic Life Support training which has been given in the same population a year ago. [ABSTRACT FROM AUTHOR]

Background: Basic life support (BLS) delivery improves prognosis following out-of-hospital cardiac arrest and forms an integral part of undergraduate medical curricula, although limited literature has assessed student confidence in utilizing these skills. An investigation of medical students’ self-reported confidence and hypothetical willingness to perform BLS was undertaken at the University of Bristol, within its peer-led BLS training scheme (RMD Bristol). Due to the study timing including COVID-19 restrictions (2020–21), changes in student confidence during this period could also be explored. Methods: A prospective cohort study of medical students participating in BLS training during 2018–2022 (N = 1084) was undertaken. Self-reported confidence and hypothetical willingness to perform BLS was assessed using pre- and post-training questionnaires (five-point Likert scale). Data were analyzed in three groups: 1) pre-COVID (including in-person training), 2) during COVID (virtual-only training), and 3) post-COVID (including in-person training). Results: 347 medical students completed 658 questionnaire responses. All training modes significantly increased self-reported confidence and hypothetical willingness to perform BLS (p < 0.05). Self-reported confidence reduced rapidly following virtual-only training. During the pandemic, a reduction in student-perceived willingness to provide BLS in an emergency was observed in a community but not a hospital setting. Conclusion: Peer-led BLS training is effective in improving medical students’ self-reported confidence and willingness to administer BLS, regardless of delivery mode. The COVID-19 pandemic influenced both the delivery of teaching and students’ attitudes towards performing BLS. Due to the rapid confidence fade after virtual-only training, BLS teaching with an in-person component may remain the most effective model for training medical students. Abstraite Contexte: L’administration des soins immédiats en réanimation (SIR) améliore le pronostic après un arrêt cardiaque extrahospitalier et fait partie intégrante des programmes d’études médicales de premier cycle, mais peu d’études ont évalué la confiance des étudiants dans l’utilisation de ces compétences. Une étude sur la confiance déclarée des étudiants en médecine et leur volonté hypothétique de pratiquer les SIR a été entreprise à l’Université de Bristol, dans le cadre de son programme de formation SIR dirigé par des pairs (RMD Bristol). Le calendrier de l’étude incluant les restrictions du COVID-19 (2020–21), les changements dans la confiance des étudiants au cours de cette période ont également pu être explorés. Méthodes: Une étude de cohorte prospective des étudiants en médecine qui ont suivi une formation SIR entre 2018 et 2022 (N = 1084) a été entreprise. La confiance auto déclarée et la volonté hypothétique de pratiquer les SIR ont été évaluées à l’aide de questionnaires avant et après la formation (échelle de Likert en 5 points). Les données ont été analysées en trois groupes : 1) pré-COVID (y compris la formation en personne), 2) pendant COVID (formation virtuelle uniquement) et 3) post-COVID (y compris la formation en personne). Résultats: 347 étudiants en médecine ont répondu à 658 questionnaires. Tous les modes de formation ont augmenté de manière significative la confiance déclarée et la volonté hypothétique d’effectuer les SIR (p < 0,05). La confiance déclarée a diminué rapidement après une formation uniquement virtuelle. Pendant la pandémie, une réduction de la volonté perçue par les étudiants de fournir des soins d’urgence a été observée dans un contexte communautaire mais pas dans un contexte hospitalier. Conclusion: La formation SIR menée par les pairs est efficace pour améliorer la confiance déclarée des étudiants en médecine et leur volonté de fournir les SIR, quel que soit le mode de formation. La pandémie de COVID-19 a influencé à la fois l’enseignement et l’attitude des étudiants à l’égard du BLS. En raison de la perte de confiance rapide après une formation uniquement virtuelle, l’enseignement des SIR avec une composante en personne peut rester le modèle le plus efficace pour la formation des étudiants en médecine. 抽象的 背景: 基本生命支援術（BLS）的施行改善了院外心臟驟停的預後，也是大學醫學課程的重要組成部分，但有關評估學生運用這些技能的信心的文獻卻很有限。布里斯托大學在其同伴引導BLS培訓計劃（RMD Bristol）中進行了一項關於醫學生自我報告在施行BLS的信心和意願的調查。由於研究期包括了COVID-19限制的時段（2020–21），因此可以同時探討於此期間學生信心的變化。 方法: 使用了前瞻性隊列的研究方法，而研究對象是在2018年至2022年進行了BLS培訓的醫學生（N = 1084）。利用培訓前和培訓後問卷（5點李克特量表）來評估他們自我報告的信心和意願。資料分析分為三組：1）COVID之前（包括面授培訓），2）COVID期間（僅虛擬培訓），3）COVID之後（包括面授培訓） 結果: 共有347名醫學生完成了658份問卷回答。結果顯示所有培訓方式都能顯著提高施行BLS的自信心和意願（p < 0.05）。而自我報告的信心在只接受虛擬培訓後有迅速降低的現象。另觀察所得，在大流行期間，如遇上緊急情況，學生在社區環境下施行BLS的意願有所下降，但在醫院環境下並未觀察到這種情況 結論: 不論何種培訓方式，同伴引導的BLS培訓有效地提高了醫學生施行BLS的信心和意願。COVID-19大流行影響了教學的方式和學生對施行BLS的態度。由於學生的信心在僅接受虛擬培訓後迅速消退，帶有面授形式的BLS教學可能仍然是培訓醫學生最有效的模式 背景: 基本生命支持术（BLS）的进行改善了院外心脏骤停的预后，也是医学本科课程的重要组成部分，但评估学生运用这些技能的信心的文献却很有限。布里斯托大学在同伴引导BLS培训计划（RMD Bristol）中进行了一项医学生自我报告在进行BLS时的信心和意愿的调查。基于研究期间包括了COVID-19限制的时段（2020–21），因此还可以探讨在此期间学生信心的变化 方法: 使用了前瞻性队列的研究方法，而研究对象是在2018年至2022年进行了BLS培训的医学生（N = 1084）。利用培训前和培训后问卷（5点李克特量表）来评估他们自我报告的信心和意愿。信息分析分为三组：1）COVID之前（包括面授培训），2）COVID期间（仅虚拟培训），3）COVID之后（包括面授培训） 结果: 共有347名医学生完成了658份问卷回答。结果显示所有培训方式都能显著提高进行BLS的自信心和意愿（p < 0.05）。而自我报告的信心在只接受虚拟培训后有迅速降低的现象。另就观察所见，在大流行期间，如遇上紧急情况，学生在社区环境下进行BLS的意愿有所下降，但在医院环境下没有观察到这种情况 结论: 不论何种培训方式，同伴引导的BLS培训有效地提高了医学生进行BLS的信心和意愿。COVID-19大流行影响了教学的方式和学生对进行BLS的态度。基于学生的信心在仅接受虚拟培训后迅速消退，带有面授形式的BLS教学可能仍然是培训医学生最有效的模式 Mots clés: Support de base (BLS); étudiants en médecine; pair enseignement; COVID 19; étude de confiance 關鍵字: 基本生活支持 (BLS); 醫學生; 同行 教學; 新冠肺炎; 信心研究 关键字: 基本生活支持 (BLS); 医学生; 同行 教学; 新冠肺炎; 信心研究

Background: A flipped classroom integrating clinical simulation has been shown to be effective for basic life support (BLS) competencies in nursing students. Cardiopulmonary arrests (CPAs) in pregnant women have a low incidence but high morbidity and mortality. Current trends show an increasing incidence; however, most official university nursing training curricula do not include specific training modules for BLS in pregnant women. This study aims to know the satisfaction and self-confidence of nursing students with respect to a training intervention regarding in BLS in pregnant women. Additionally, it aims to assess the adequacy of this intervention for acquiring the necessary knowledge on the subject. Methods: A cross-sectional study was conducted at the University of Jaen in 2022. Data were collected on sociodemographic factors, previous contact with the topic, and topic knowledge in addition to the use of an SCLS questionnaire to measure satisfaction. Participants took the BLS training (a flipped classroom integrating clinical simulation on this topic) before answering the questionnaire. Results: A total of 136 students participated. The mean score on the BLS questionnaire was 9.10 out of 10 (SD = 1.01). The mean score for the SCLS questionnaire for females was 62.36 (SD = 7.70) and 56.23 (SD = 16.94) for the male group. Age showed a statistically significant association with SCLS score: the score decreased with an increase in age (p < 0.001). Conclusions: The flipped classroom, integrating simulation for BLS in pregnant women, improves self-confidence, satisfaction, and knowledge on the topic.

The role of basic life support (BLS) vs. advanced life support (ALS) in pediatric trauma is controversial. Although ALS is widely accepted as the gold standard, previous studies have found no advantage of ALS over BLS care in adult trauma. The objective of this study was to evaluate whether ALS transport confers a survival advantage over BLS among severely injured children. A retrospective cohort study of data included in the Israeli National Trauma Registry from January 1, 2011, through December 31, 2020 was conducted. All the severely injured children (age < 18 years and injury severity score [ISS] ≥16) were included. Patient survival by mode of transport was analyzed using logistic regression. Of 3167 patients included in the study, 65.1% were transported by ALS and 34.9% by BLS. Significantly more patients transported by ALS had ISS ≥25 as well as abnormal vital signs at admission. The ALS and BLS cohorts were comparable in age, gender, mechanism of injury, and prehospital time. Children transported by ALS had higher in-hospital mortality (9.2% vs. 0.9%, p < 0.001). Following risk adjustment, patients transported by ALS teams were significantly more likely to die than patients transported by BLS (adjusted OR 2.27, 95% CI 1.05–5.41, p = 0.04). Patients with ISS ≥50 had comparable mortality rates in both groups (45.9% vs. 55.6%, p = 0.837) while patients with GCS <9 transported by ALS had higher mortality (25.9% vs. 11.5%, p = 0.019). Admission to a level II trauma center vs. a level I hospital was also associated with increased mortality (adjusted OR 2.78 (95% CI 1.75–4.55, p < 0.001). Among severely injured children, prehospital ALS care was not associated with lower mortality rates relative to BLS care. Because of potential confounding by severity in this retrospective analysis, further studies are warranted to validate these results. [ABSTRACT FROM AUTHOR]

Background: A flipped classroom integrating clinical simulation has been shown to be effective for basic life support (BLS) competencies in nursing students. Cardiopulmonary arrests (CPAs) in pregnant women have a low incidence but high morbidity and mortality. Current trends show an increasing incidence; however, most official university nursing training curricula do not include specific training modules for BLS in pregnant women. This study aims to know the satisfaction and self-confidence of nursing students with respect to a training intervention regarding in BLS in pregnant women. Additionally, it aims to assess the adequacy of this intervention for acquiring the necessary knowledge on the subject. Methods: A cross-sectional study was conducted at the University of Jaen in 2022. Data were collected on sociodemographic factors, previous contact with the topic, and topic knowledge in addition to the use of an SCLS questionnaire to measure satisfaction. Participants took the BLS training (a flipped classroom integrating clinical simulation on this topic) before answering the questionnaire. Results: A total of 136 students participated. The mean score on the BLS questionnaire was 9.10 out of 10 (SD = 1.01). The mean score for the SCLS questionnaire for females was 62.36 (SD = 7.70) and 56.23 (SD = 16.94) for the male group. Age showed a statistically significant association with SCLS score: the score decreased with an increase in age (p < 0.001). Conclusions: The flipped classroom, integrating simulation for BLS in pregnant women, improves self-confidence, satisfaction, and knowledge on the topic. [ABSTRACT FROM AUTHOR]

Background: Cardiac arrest is a common health issue in modern days and one of the emerging health issues in present days. One-third of client required cardiopulmonary resuscitation (CPR) before reaching to the hospital. Therefore some countries have been implanted Basic life support t raining compulsory for teachers and students. Material And Methods: A quantitative cross-sectional pilot study was conducted among school teachers. A total of 22 participants were selected using a non-probability purposive sampling technique. An evaluated the effectiveness of basic life support (BLS) among school teachers on Knowledge, attitude, and practice. The pre-test was assessed before the intervention and the post-test assessment was assessed at the end of 5th day. Result: On assessment, the majority of participants was male (72.7%), married 16(72.7%), and aged between 20 and 30 years old 10 (45.5%). Of the 14.3% of graduates, teaching experience varied from 6 to 10 years 16 (72.7%), and the majority of them were science teachers 17 (68.2%). The majority of teachers, 17 (68.2%) were Hindu don't have previous knowledge of 17(77.3%). There was a correlation between knowledge score and gender, experience, designation, and prior knowledge. Before the intervention of basic life support training, the majori ty of participants had poor knowledge12 (56.6%), post-test improved good knowledge 20(90.9%). Similarly, in the pretest, most of the participants had a negative attitude 16(72.7%), and a few after BLS showed a positive attitude 20(90.9%). Pretest practice skills had inadequate 17 (77.3%), moderate knowledge 5(22.7%), after the intervention, most of them 20(90.9%) had good knowledge. Conclusion: Basic life support (BLS) is the most effective intervention for school teachers. Most of the school teachers improved the knowledge, attitude and practice after the intervention. [ABSTRACT FROM AUTHOR]

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Limited research exists on the effect of adolescents' affections on the success of cardiopulmonary resuscitation (CPR) training and the adolescents' decision-making skills and practices during an occurrence of cardiac arrest. We aimed to evaluate the effect of CPR training on the knowledge, behaviour and affections of students aged 16–17 years. A pretest-posttest randomised controlled trial was carried out with 115 tenth-grade students from western Turkey. The one group received basic life support (BLS) training, while the other group were given hands-only CPR (HOCPR) training. The study data were collected using a socio-demographic data form, the Positive and Negative Affect Scale (PANAS) and a CPR questionnaire. The median change in positive affect in the BLS group was −2.964; the median in the HOCPR group was −1.206. No significant difference was found between the groups. In the BLS group, the median change in negative affect was −3.649, and the median was 2.568 in the HOCPR group. The change in knowledge scores was higher in the HOCPR group. There was no difference between training methods in affections changes. Both methods reduced students' anxiety about CPR and provided a positive change in their thoughts about intervening in an occurrence. [ABSTRACT FROM AUTHOR]

Introduction: The study aimed to assess the impact of a modified paediatric basic life support (BLS) training on paediatric nurses' knowledge and skills in the main tertiary level public hospital in Rwanda. Methods: A prospective, before-and-after educational intervention study was performed. Nurses working in the paediatric department at Centre Hospitalier Universitaire de Kigali (CHUK) were enrolled after consenting to the study. A modified BLS training was administered using didactic lectures, videos, case discussions, and simulations. Knowledge and skills were assessed before, immediately and six months after the training, using the American Heart Association (AHA) multiple-choice questions test and simulation scenarios. Ethical approval from the hospital's investigational review board was obtained before the start of the study. Results: Fifty-seven nurses working in paediatric department were included in the study, most with advanced nursing degrees. At baseline, only 3.5% scored above 80% on the knowledge test and none were able to perform high-quality one-rescuer CPR. Knowledge and high-quality one-rescuer CPR skills improved significantly immediately after the training, with 63.2% scoring above 80% and 63.2% capable of performing high-quality one-rescuer CPR (p

Introduction: Out-of-hospital cardiac arrest (OHCA) is a major cause of sudden cardiac death which can be prevented by early cardiopulmonary resuscitation (CPR). International bodies recommend that basic life support (BLS) skills be taught in schools in order to increase the rate of bystander CPR and reduce mortality from OHCA. We are not aware of any BLS education program for non-healthcare students in Nigeria. This study was to assess the awareness and attitude to acquiring BLS skills among university students. Methods: We conducted a cross-sectional study among final year university undergraduates using a questionnaire that assessed students' sociodemographic characteristics, awareness of CPR, previous experiences, and attitude to basic life support (BLS). Counts and proportions were compared for the demographic characteristics using Chi-squared and Fisher's exact tests. Results: Four hundred and seventy-five students from 15 faculties participated in this study, median age was 22.8 years (interquartile range: 21.2–24.5 years). Majority (82.5%) have heard of CPR, 29.7% have undergone CPR training; 77.3% of those who had been trained were confident that they could perform CPR. Previous CPR training was significantly associated with faculty, year of study and age. Eighty-nine (18.7%) students have witnessed someone die from a trauma. Four hundred and fifty (94.7%) respondents would like to get BLS training, 440 (92.6%) think that CPR training should be included in the school curriculum. Conclusion: There is good awareness and positive attitude to the acquisition and practice of cardiopulmonary resuscitation among university students in Nigeria. Few students however, have been trained to administer bystander cardiopulmonary resuscitation. Therefore, there is a need to implement university wide BLS education in Nigeria.

Abstract Background Traditional, instructor led, in-person training of CPR skills has become more challenging due to COVID-19 pandemic. We compared the learning outcomes of standard in-person CPR training (ST) with alternative methods of training such as hybrid or online-only training (AT) on CPR performance, quality, and knowledge among laypersons with no previous CPR training. Methods We searched PubMed and Google Scholar for relevant articles from January 1995 to May 2020. Covidence was used to review articles by two independent researchers. Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess quality of the manuscripts. Results Of the 978 articles screened, twenty met the final inclusion criteria. All included studies had an experimental design and moderate to strong global quality rating. The trainees in ST group performed better on calling 911, time to initiate chest compressions, hand placement and chest compression depth. Trainees in AT group performed better in assessing scene safety, calling for help, response time including initiating first rescue breathing, adequate ventilation volume, compression rates, shorter hands-off time, confidence, willingness to perform CPR, ability to follow CPR algorithm, and equivalent or better knowledge retention than standard teaching methodology. Conclusion AT methods of CPR training provide an effective alternative to the standard in-person CPR for large scale public training.

BackgroundSustaining Basic Life Support (BLS) training during the COVID-19 pandemic bears substantial challenges. The limited availability of highly qualified instructors and tight economic conditions complicates the delivery of these life-saving trainings. Consequently, innovative and resource-efficient approaches are needed to minimize or eliminate contagion while maintaining high training standards and managing learner anxiety related to infection risk.MethodsIn a non-inferiority trial 346 first-year medical, dentistry, and physiotherapy students underwent BLS training at AIXTRA—Competence Center for Training and Patient Safety at the University Hospital RWTH Aachen. Our objectives were (1) to examine whether peer feedback BLS training supported by tele-instructors matches the learning performance of standard instructor-guided BLS training for laypersons; and (2) to minimize infection risk during BLS training. Therefore, in a parallel group design, we compared arm (1) Standard Instructor Feedback (SIF) BLS training (Historical control group of 2019) with arm (2) a Tele-Instructor Supported Peer-Feedback (TPF) BLS training (Intervention group of 2020). Both study arms were based on Peyton's 4-step approach. Before and after each training session, objective data for BLS performance (compression depth and rate) were recorded using a resuscitation manikin. We also assessed overall BLS performance via standardized instructor evaluation and student self-reports of confidence via questionnaire. Non-inferiority margins for the outcome parameters and sample size calculation were based on previous studies with SIF. Two-sided 95% confidence intervals were employed to determine significance of non-inferiority.ResultsThe results confirmed non-inferiority of TPF to SIF for all tested outcome parameters. A follow-up after 2 weeks found no confirmed COVID-19 infections among the participants.ConclusionTele-instructor supported peer feedback is a powerful alternative to in-person instructor feedback on BLS skills during a pandemic, where infection risk needs to be minimized while maximizing the quality of BLS skill learning.Trial registrationhttps://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00025199, Trial ID: DRKS00025199.

BackgroundEye-tracking devices are an innovative tool to understand providers’ attention during stressful medical tasks. The knowledge about what gaze behaviors improve (or harm) the quality of clinical care can substantially improve medical training. The aim of this study is to identify gaze behaviors that are related to the quality of pediatric resuscitation.MethodsForty students and healthcare providers performed a simulated pediatric life support scenario, consisting of a chest compression task and a ventilation task, while wearing eye-tracking glasses. Skill Reporter software measured chest compression (CC) quality and Neo Training software measured ventilation quality. Main eye-tracking parameters were ratio [the number of participants who attended a certain area of interest (AOI)], dwell time (total amount of time a participant attended an AOI), the number of revisits (how often a participant returned his gaze to an AOI), and the number of transitions between AOIs.ResultsThe most salient AOIs were infant chest and ventilation mask (ratio = 100%). During CC task, 41% of participants also focused on ventilation bag and 59% on study nurse. During ventilation task, the ratio was 61% for ventilation bag and 36% for study nurse. Percentage of correct CC rate was positively correlated with dwell time on infant chest (p = 0.044), while the overall CC quality was negatively correlated with dwelling outside of pre-defined task-relevant AOIs (p = 0.018). Furthermore, more dwell time on infant chest predicted lower leakage (p = 0.042). The number of transitions between AOIs was unrelated to CC parameters, but correlated negatively with mask leak during ventilations (p = 0.014). Participants with high leakage shifted their gaze more often between ventilation bag, ventilation mask, and task-irrelevant environment.ConclusionInfant chest and ventilation mask are the most salient AOIs in pediatric basic life support. Especially the infant chest AOI gives beneficial information for the resuscitation provider. In contrast, attention to task-irrelevant environment and frequent gaze shifts seem to harm the quality of care.

The study aimed to assess the impact of a modified paediatric basic life support (BLS) training on paediatric nurses' knowledge and skills in the main tertiary level public hospital in Rwanda. A prospective, before-and-after educational intervention study was performed. Nurses working in the paediatric department at Centre Hospitalier Universitaire de Kigali (CHUK) were enrolled after consenting to the study. A modified BLS training was administered using didactic lectures, videos, case discussions, and simulations. Knowledge and skills were assessed before, immediately and six months after the training, using the American Heart Association (AHA) multiple-choice questions test and simulation scenarios. Ethical approval from the hospital's investigational review board was obtained before the start of the study. Fifty-seven nurses working in paediatric department were included in the study, most with advanced nursing degrees. At baseline, only 3.5% scored above 80% on the knowledge test and none were able to perform high-quality one-rescuer CPR. Knowledge and high-quality one-rescuer CPR skills improved significantly immediately after the training, with 63.2% scoring above 80% and 63.2% capable of performing high-quality one-rescuer CPR (p < 0.01). Six months later, only 45.6% scored above 80% and 15.8% were capable of performing high-quality one-rescuer CPR (p < 0.01). Some skills, such as delivering breaths using bag-mask device, showed better retention. In the paediatric department of the main public tertiary care hospital in Rwanda, nurses' baseline knowledge and skills in providing BLS was poor but can increase with focused BLS training. Due to the decline in knowledge and skills over six months, the use of debriefing and focused trainings following resuscitation events and improved implementation of yearly departmental refresher courses are recommended. [ABSTRACT FROM AUTHOR]

Introduction First Aid is the initial, immediate, life in curve rendered to an injured or sick person in life threatening situations by taking effective action to keep the injured or ill person alive in the best possible condition till emergency medical services and treatment can be obtained. First aid training among students is as an important capacity building component of pre-hospital care in communities. Aim: This literature review aimed to determine whether the published literature demonstrates the knowledge & skills about first aid and CPR in cases of emergency life saving skills developed by under graduate students who have learnt first aid from first aid providers. Methods An extensive search and numerous evaluation of the peer-reviewed literature was conducted for narrative review. Journal articles were retrieved from three databases (MEDLINE, CINAHL, ERIC) using the search terms 'first aid'; 'resuscitation'; 'training'; 'under graduate students'; and 'college'. Inclusion and exclusion criteria were applied and review findings organized thematically. Results The search yielded four primary studies of India & other countries under graduate students aged 18-23 years trained by professional first aid providers. Subsequent review identified emergent themes of resuscitative first aid and non-resuscitative first aid. Heterogeneity was apparent in training and evaluation methods, and study quality varied. Reported first aid knowledge retention was mixed. Conclusion There is a lack of quality evidence to guide optimal training methods and maximize first aid knowledge retention in under graduate college students. To date, research in this area has been limited. Further research is therefore recommended. Formal evaluation of first aid training providers can help guide training methods and maximize first aid knowledge retention in under graduate college students, thereby building more robust first aid capacity in the community. [ABSTRACT FROM AUTHOR]

The use of smartphone applications increases bystander CPR quality as well as the use of telephone CPR protocols. The present prospective, randomized, controlled manikin trial analyses the effects of a smartphone application (PocketCPR©) on CPR quality in a bystander CPR scenario compared to a dispatcher-assisted telephone CPR with the additional use of a metronome and verbal motivation. Methods: 150 laypersons were included to perform 8-minute CPR on a manikin. Volunteers were randomly assigned to one of three groups: (1) dispatcher-assisted telephone CPR (telephone-group), (2) dispatcher-assisted telephone CPR combined with the smartphone-application (telephone + app-group) and (3) dispatcher-assisted telephone CPR with additional verbal motivation ("push harder, release completely," every 20 seconds, starting after 60 seconds) and a metronome with 100 min−1 (telephone + motivation-group). Results: Median compression depth did not differ significantly between the study groups (p = 0.051). However, in the post hoc analysis median compression depth in the telephone + motivation-group was significantly elevated compared to the telephone + app-group (59 mm [IQR 47–67 mm] vs. 51 mm [IQR 46–57 mm]; p = 0.025). The median number of superficial compressions was significantly reduced in the telephone + motivation-group compared to the telephone + app-group (70 [IQR 3–362] vs. 349 [IQR 88–538]; p = 0.004), but not compared to the telephone-group (91 [IQR 4–449]; p = 0.707). In contrast to the other study groups, median compression depth of the telephone + motivation-group increased over time. Chest compressions with correct depth were found significantly more often in the telephone + app-group compared to the other study groups (p = 0.011). Median compression rate in the telephone + app-group was significantly elevated (108 min−1 [IQR 96–119 min−1]) compared to the telephone-group (78 min−1 [IQR 56–106 min−1]; p < 0.001) and the telephone + motivation-group (99 min−1 [IQR 91–101 min−1]; p < 0.001). Conclusions: The use of a smartphone application as well as verbal motivation by a dispatcher during telephone CPR leads to higher CPR quality levels compared to standard telephone CPR. Thereby, the use of the smartphone application mainly shows an increase in compression rate, while increased compression rate with simultaneously increased compression depth was only apparent in the telephone + motivation-group. [ABSTRACT FROM AUTHOR]

Background: Traditional, instructor led, in-person training of CPR skills has become more challenging due to COVID-19 pandemic. We compared the learning outcomes of standard in-person CPR training (ST) with alternative methods of training such as hybrid or online-only training (AT) on CPR performance, quality, and knowledge among laypersons with no previous CPR training. Methods: We searched PubMed and Google Scholar for relevant articles from January 1995 to May 2020. Covidence was used to review articles by two independent researchers. Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess quality of the manuscripts. Results: Of the 978 articles screened, twenty met the final inclusion criteria. All included studies had an experimental design and moderate to strong global quality rating. The trainees in ST group performed better on calling 911, time to initiate chest compressions, hand placement and chest compression depth. Trainees in AT group performed better in assessing scene safety, calling for help, response time including initiating first rescue breathing, adequate ventilation volume, compression rates, shorter hands-off time, confidence, willingness to perform CPR, ability to follow CPR algorithm, and equivalent or better knowledge retention than standard teaching methodology. Conclusion: AT methods of CPR training provide an effective alternative to the standard in-person CPR for large scale public training. [ABSTRACT FROM AUTHOR]

Out-of-hospital cardiac arrest (OHCA) is a major cause of sudden cardiac death which can be prevented by early cardiopulmonary resuscitation (CPR). International bodies recommend that basic life support (BLS) skills be taught in schools in order to increase the rate of bystander CPR and reduce mortality from OHCA. We are not aware of any BLS education program for non-healthcare students in Nigeria. This study was to assess the awareness and attitude to acquiring BLS skills among university students. We conducted a cross-sectional study among final year university undergraduates using a questionnaire that assessed students' sociodemographic characteristics, awareness of CPR, previous experiences, and attitude to basic life support (BLS). Counts and proportions were compared for the demographic characteristics using Chi-squared and Fisher's exact tests. Four hundred and seventy-five students from 15 faculties participated in this study, median age was 22.8 years (interquartile range: 21.2–24.5 years). Majority (82.5%) have heard of CPR, 29.7% have undergone CPR training; 77.3% of those who had been trained were confident that they could perform CPR. Previous CPR training was significantly associated with faculty, year of study and age. Eighty-nine (18.7%) students have witnessed someone die from a trauma. Four hundred and fifty (94.7%) respondents would like to get BLS training, 440 (92.6%) think that CPR training should be included in the school curriculum. There is good awareness and positive attitude to the acquisition and practice of cardiopulmonary resuscitation among university students in Nigeria. Few students however, have been trained to administer bystander cardiopulmonary resuscitation. Therefore, there is a need to implement university wide BLS education in Nigeria. [ABSTRACT FROM AUTHOR]

Objective: Professional training workshops are routinely conducted by Professional Development Center (PDC) of DUHS to provide students golden opportunities in hands on practice on simulators and also has been working as training center of AHA since 2010 for the BLS, ACLS and PALS provider and instructor courses while has been conducting BLS workshops from Nov, 2005. The objective of this study was to assess the perceptions of attending audience by post course evaluation form in BLS program. Methodology: This was a retrospective survey study. Data of BLS workshops from 2017 to 2018 was collected from PDC. Two thousand and fifty six healthcare students were enrolled in BLS course from Jan 2017 till Dec 2018. The calculated sample size was about 324 at 95% confidence level. Thus the final sample size was about 350. A post workshop evaluation questionnaire was used as a tool for data collection and it was analyzed on SPSS. Results: PDC has conducted 714 BLS provider courses since 2005 in which 8529 participants are trained till now. The results of the evaluation show that this workshop received higher score on all assessed sections i.e. more than 90% candidates marked agree & strongly agree. A clear majority of participants (97.8%) agreed that, their queries and questions were satisfactorily responded The structure and content of the workshop organized intensify participants’ skills and knowledge regarding BLS. Conclusion: Overall, Participants characterized the workshop as very useful and were very satisfied with the workshop facilitators and the topics discussed. [ABSTRACT FROM AUTHOR]

Background: Cardiopulmonary resuscitation success rates depend on the knowledge and skills of Adult basic life support (BLS) and advanced life support. The objective of the study was to find the level of awareness on BLS and skills among health personnel working in different departments of a rural teaching hospital. Methods: This descriptive cross-sectional study was conducted in a tertiary care hospital of Karnali Academy of Health Sciences, Jumla, Nepal. The awareness level about BLS was assessed using a structured questionnaire. Health personnel’s previous exposure to BLS and the inclusion of BLS in their curriculum was also assessed. Results: Among 91 participants,74% (n=67) heard about BLS,64% (n=58)have seen performing, and 25%(n=23) have performed CPR. Only 8%(n=7) attended a workshop on BLS. 43% (n=39) answered 100 and 46%(n=42) answered 30 compression per minute in adult during CPR.71%(n=65) knew the ratio of chest compression to breath in adults. Only 41%(n=37) identified anatomy/area mid-chest for chest compression. Only 40%(n=36) are familiar to the Heimlich maneuver and 5.5%(n=5) were aware of the sequence of BLS which is Head tilt, chin lift, check the pulse. Seventy-eight percent (n=71) responded that BLS training should be a part of the medical curriculum. The mean awareness of general medicine is significantly lower than the other two groups (P

Abstract Background Training lay rescuers in Basic Life Support (BLS) is essential to improve bystander cardiopulmonary resuscitation (CPR) rates; in addition, simple methods are needed to provide feedback on CPR performance. This study evaluated whether a simple observational checklist can be used by BLS instructors to adequately measure the quality of BLS performance as an alternative to other feedback devices. Methods The BLS performances of 152 first-year medical students (aged 21.4 ± 3.9 years) were recorded on video, and objective data regarding the quality of the BLS were documented using Laerdal PC SkillReporting software. The performances were categorized according to quality. Ten BLS instructors observed the videos and completed a ten-point checklist based on the Cardiff Test of BLS (version 3.1) to assess the performances. The validity of the checklist was reviewed using interrater reliability as well as by comparing the checklist-based results with objective performance data. Results Matching the checklist-based evaluation with the objective performance data revealed high levels of agreement for very good (82%) and overall insufficient (75%) performances. Regarding the checklist-based evaluation, interrater reliability depended on the checklist item; thus, some items were more easily identified correctly than others. The highest and lowest levels of agreement were observed for the items “undressed torso” and “complete release between compressions” (mean joint-probability 95 and 67%, respectively). Conclusions The observational checklist adequately distinguished sufficient from insufficient BLS performances and offered an assessment of items not incorporated by SkillReporting software such as the initial assessment or undressing the chest. Although its usefulness was reduced for scaling intermediate performance groups, the checklist may be overall a useful rating tool in BLS-training if objective feedback devices are not available, for example, due to large groups of participants or limited training time.

Background: In-hospital cardiac arrest is a major cause of death in European countries, and survival of patients remains low ranging from 20% to 25%. Aims: The purpose of this study was to assess healthcare professionals' knowledge on cardiopulmonary resuscitation among university hospitals in 12 European countries and correlate it with the return of spontaneous circulation rates of their patients after in-hospital cardiac arrest. Methods and results: A total of 570 healthcare professionals from cardiology, anaesthesiology and intensive care medicine departments of European university hospitals in Italy, Poland, Hungary, Belgium, Spain, Slovakia, Germany, Finland, The Netherlands, Switzerland, France and Greece completed a questionnaire. The questionnaire consisted of 12 questions based on epidemiology data and cardiopulmonary resuscitation training and 26 multiple choice questions on cardiopulmonary resuscitation knowledge. Hospitals in Switzerland scored highest on basic life support (P =0.005) while Belgium hospitals scored highest on advanced life support (P <0.001) and total score in cardiopulmonary resuscitation knowledge (P =0.01). The Swiss hospitals scored highest in cardiopulmonary resuscitation training (P <0.001). Correlation between cardiopulmonary resuscitation knowledge and return of spontaneous circulation rates of patients with in-hospital cardiac arrest demonstrated that each additional correct answer on the advanced life support score results in a further increase in return of spontaneous circulation rates (odds ratio 3.94; 95% confidence interval 2.78 to 5.57; P <0.001). Conclusion: Differences in knowledge about resuscitation and course attendance were found between university hospitals in 12 European countries. Education in cardiopulmonary resuscitation is considered to be vital for patients' return of spontaneous circulation rates after in-hospital cardiac arrest. A higher level of knowledge in advanced life support results in higher return of spontaneous circulation rates. [ABSTRACT FROM AUTHOR]

Background: The immediate response to cardiac arrest is regarded as the most time-critical intervention. First responders for cardiac arrests in imaging departments are often radiology staff. The study aim was to determine radiology staff members’ confidence in initiating basic life support. Objectives: The objectives of this study included determining the general confidence levels regarding identifying cardiac arrest and initiation of basic life support (BLS) amongst Radiology staff within the studied sites, as well as to identify potential areas of uncertainty. Another objective included identifying what would contribute to increasing levels of confidence and competence in identifying cardiac arrest and initiating BLS. Method: A multi-centre cross-sectional survey was conducted using peer-validated, anonymous questionnaires. Questionnaires were distributed to radiology staff working in public sector hospitals within the Cape Town Metropole West. Due to the limited subject pool, a convenience sample was collected. Data were therefore statistically analysed using only summary statistics (mean, standard deviation, proportions, and so on), and detailed comparisons were not made. Results: We disseminated 200 questionnaires, and 74 were completed (37%). There were no incomplete questionnaires or exclusions from the final sample. Using a 10-point Likert scale, the mean ability to recognise cardiac arrest was 6.45 (SD ± 2.7), securing an airway 4.86 (SD ± 2.9), and providing rescue breaths and initiating cardiac compressions 6.14 (SD ± 2.9). Only two (2.7%) of the participants had completed a basic life support course in the past year; 11 (14.8%) had never completed any basic life support course and 28 (37.8%) had never completed any life support or critical care course. Radiologists, radiology trainees and nurses had the greatest confidence in providing rescue breaths and initiating cardiac compressions from all the groups. Conclusion: The study demonstrated a substantial lack of confidence in providing basic life support in the participating hospital imaging departments’ staff. The participants indicated that regular training and improved support systems would increase confidence levels and improve skills.

Introduction: The Knowledge of Basic Life Support (BLS) is very important, especially for medical students who will become future doctors. These simple life saving maneuvers can ensure the patient’s survival and reduce morbidity and mortality. Objective: The objective of this study was to determine the level of knowledge, attitude and practice of BLS among medical students of the Rawalpindi Medical University, Rawalpindi. Methods: In this descriptive cross sectional study, medical students (3rd & 4th year MBBS) of RMU (n=376) were inquired using a self-structured questionnaire of 20 questions regarding the knowledge, attitude and practice of BLS. After excluding the incomplete response forms, the data were analyzed using SPSS v. 22.0. Results: Twenty five percent students had good, 65.7% had average and 9.3% had poor knowledge of BLS. Out of 376, 12.76% respondents were satisfied with their present knowledge. The Majority (93.08%) had a positive attitude towards learning BLS. Only 6.6% had practiced BLS and 65.69% were unable to perform CPR independently. Conclusion: Majority had an average knowledge and a positive attitude towards BLS but very few could perform it independently. This demands that the practice should go hand in hand along with its knowledge.

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Background: The immediate response to cardiac arrest is regarded as the most time-critical intervention. First responders for cardiac arrests in imaging departments are often radiology staff. The study aim was to determine radiology staff members' confidence in initiating basic life support. Objectives: The objectives of this study included determining the general confidence levels regarding identifying cardiac arrest and initiation of basic life support (BLS) amongst Radiology staff within the studied sites, as well as to identify potential areas of uncertainty. Another objective included identifying what would contribute to increasing levels of confidence and competence in identifying cardiac arrest and initiating BLS. Method: A multi-centre cross-sectional survey was conducted using peer-validated, anonymous questionnaires. Questionnaires were distributed to radiology staff working in public sector hospitals within the Cape Town Metropole West. Due to the limited subject pool, a convenience sample was collected. Data were therefore statistically analysed using only summary statistics (mean, standard deviation, proportions, and so on), and detailed comparisons were not made. Results: We disseminated 200 questionnaires, and 74 were completed (37%). There were no incomplete questionnaires or exclusions from the final sample. Using a 10-point Likert scale, the mean ability to recognise cardiac arrest was 6.45 (SD ± 2.7), securing an airway 4.86 (SD ± 2.9), and providing rescue breaths and initiating cardiac compressions 6.14 (SD ± 2.9). Only two (2.7%) of the participants had completed a basic life support course in the past year; 11 (14.8%) had never completed any basic life support course and 28 (37.8%) had never completed any life support or critical care course. Radiologists, radiology trainees and nurses had the greatest confidence in providing rescue breaths and initiating cardiac compressions from all the groups. Conclusion: The study demonstrated a substantial lack of confidence in providing basic life support in the participating hospital imaging departments' staff. The participants indicated that regular training and improved support systems would increase confidence levels and improve skills. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization's endorsement of the "Kids save lives" statement fosters the implementation of cardiopulmonary resuscitation (CPR) training for school children worldwide. However, not every child achieves and maintains the recommended chest compression depth of 5-6cm.Purpose: To investigate the variability in compression depth for three age groups (grade 1: 12-14; grade 2: 14-16; grade 3: 16-18 years) as a function of physical characteristics and to define minimal compression excellence levels for training.Methods: Compression depth of 265 subjects (111 girls, 154 boys) aged 12-18 years from one secondary school was individually assessed and reported in percentiles per age group. Pearson correlations between physical characteristics and CPR variables were calculated. Excellence level was defined as the percentage compressions with depth 5-6cm.Results: In grade 1 (12-14 years), achieved excellence levels were 1% for girls and 23% for boys at the 75th percentile. In grade 2 (14-16 years), it increased to 24% for girls and 80% for boys. In grade 3 (16-18 years) finally, it was 59% for girls and 87% for boys. Significant positive correlations were found between CPR and physical variables (p<0.05), especially weight >50kg (p<0.01).Conclusion: A minimal excellence level of 25% is achievable by boys 12-14year and girls 14-16year and can be gradually improved to 60% and 90% according to age and gender. This might necessitate more exertion and training for some younger children, especially girls, and will probably be more easily achieved for children weighing >50kg. [ABSTRACT FROM AUTHOR]

Background: The knowledge and skills about the basic life support (BLS) and the advanced life support are the most important determining factors of the cardiopulmonary resuscitation (CPR) success rates. Objectives: To determine the level of awareness on BLS and skills among undergraduate and postgraduate students of medical and dental profession, as well as nursing students and interns in a tertiary care hospital. Materials and Methods: This descriptive cross-sectional study was conducted in a tertiary care hospital in South India. The awareness level on BLS and factors associated which include age, sex, level of training (undergraduate, internship, and postgraduate groups), course of study (nursing, dental, and medical groups), and previous exposure to BLS were assessed by using a structured questionnaire. The association of these variables with awareness level was assessed by independent t test, analysis of variance, and linear regression analysis. Results: Among 520 study subjects, 229 were students, 171 were interns, and 120 were postgraduate students. The overall mean score of awareness was 4.16 ± 1.40 (score range: 0-10). Age, sex, level of training, course of study, and previous exposure to BLS were significantly associated with awareness level in univariate analysis (P < 0.05). Linear regression model also showed that all the above variables were significantly associated with awareness level (P < 0.05). About 322 (61.9%) subjects attributed lack of awareness about BLS to lack of available professional training. About 479 (92.1%) responded that BLS training should be a part of medical curriculum. Conclusion: Awareness level on BLS is below average indicating the importance of professional training at all levels in a tertiary care health institution.

Cardiac arrest is a life-threatening emergency situation. The outcome depends on timely and effective cardio-pulmonary resuscitation (CPR). Successful CPR attempts in hospitals require well-equipped emergency trolleys and properly functioning equipment, as well as staffmembers skilled in performing CPR. The study aimed to determine whether the emergency trolleys in Botswana’s hospitals’ wards or units met the expected standards. The contents of the emergency trolleys in 20 wards or units of two referral government hospitals in Botswanawere audited by using a standardised checklist. No hospital ward or unit had all the expected equipment or drugs on its emergency trolley, some units failed to check their emergency trolleys’ contents daily. All 20 hospital wards or units that participated in this study, needed to improve the contents and maintenance of their emergency trolleys, otherwise in-hospital CPR efforts in Botswana might be doomed to failure, losing lives that could have been saved if emergency trolleys’ equipment and supplies had been up to standard.

Aims: Feedback is vital for the effective delivery of skills-based education. We sought to compare the sandwich technique and learning conversation structured methods of feedback delivery in competency-based basic life support (BLS) training.Methods: Open randomised crossover study undertaken between October 2014 and March 2015 at the University of Birmingham, United Kingdom. Six-hundred and forty healthcare students undertaking a European Resuscitation Council (ERC) BLS course were enrolled, each of whom was randomised to receive teaching using either the sandwich technique or the learning conversation. Fifty-eight instructors were randomised to initially teach using either the learning conversation or sandwich technique, prior to crossing-over and teaching with the alternative technique after a pre-defined time period. Outcome measures included skill acquisition as measured by an end-of-course competency assessment, instructors' perception of teaching with each feedback technique and candidates' perception of the feedback they were provided with.Results: Scores assigned to use of the learning conversation by instructors were significantly more favourable than for the sandwich technique across all but two assessed domains relating to instructor perception of the feedback technique, including all skills-based domains. No difference was seen in either assessment pass rates (80.9% sandwich technique vs. 77.2% learning conversation; OR 1.2, 95% CI 0.85-1.84; p=0.29) or any domain relating to candidates' perception of their teaching technique.Conclusions& Relevance: This is the first direct comparison of two feedback techniques in clinical medical education using both quantitative and qualitative methodology. The learning conversation is preferred by instructors providing competency-based life support training and is perceived to favour skills acquisition. [ABSTRACT FROM AUTHOR]

Aim Assessment skills are often neglected in resuscitation training and it has been shown that the ERC BLS/AED instructor course may be insufficient to prepare candidates for an assessment role. We have introduced an Assessment Training Programme (ATP) to improve assessors’ decision making. In this article we present our ATP and an observational study of candidates’ confidence levels upon completing both an ERC BLS/AED instructor course and our ATP. Methods Forty-seven candidates undertook the ERC instructor course and 20 qualified ERC BLS/AED instructors undertook the ATP. Pre- and post-course questionnaires were completed. Confidence was assessed on ten-point Visual Analogue Scales (VAS). Results Overall confidence on the ERC BLS/AED instructor course rose from 5.9 (SD 1.8) to 8.7 (SD 1.4) ( P < 0.001). A more modest improvement was witnessed on the ATP, rising from 8.2 (SD 1.4) to 9.6 (SD 0.5) ( P < 0.001). Upon completion of their respective courses, assessors (mean 9.6, SD 0.5) were significantly more confident at assessing than instructors (mean 8.7, SD 0.5) ( P < 0.001). Confidence in assessing individual algorithm components was similar on both courses. On the post-course questionnaire those on the ATP remained significantly more confident at assessing borderline candidates compared to instructors ( P < 0.001), with no difference for clear pass ( P = 0.067) or clear fail ( P = 0.060) candidates. Conclusion The ATP raises the confidence of assessing BLS/AED candidates to a level above that of the ERC instructor course alone. We advocate that resuscitation organisations consider integrating an ATP into their existing training structure. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the long-term effectiveness of 15-min refresher basic life support (BLS) training following 45-min chest compression-only BLS training. Methods After the 45-min chest compression-only BLS training, the participants were randomly assigned to either the refresher BLS training group, which received a 15-min refresher training 6 months after the initial training (refresher training group), or to the control group, which did not receive refresher training. Participants’ resuscitation skills were evaluated by a 2-min case-based scenario test 1 year after the initial training. The primary outcome measure was the number of appropriate chest compressions during a 2-min test period. Results 140 participants were enrolled and 112 of them completed this study. The number of appropriate chest compressions performed during the 2-min test period was significantly greater in the refresher training group (68.9 ± 72.3) than in the control group (36.3 ± 50.8, p = 0.009). Time without chest compressions was significantly shorter in the refresher training group (16.1 ± 2.1 s versus 26.9 ± 3.7 s, p < 0.001). There were no significant differences in time to chest compression (29.6 ± 16.7 s versus 34.4 ± 17.8 s, p = 0.172) and AED use between the groups. Conclusions A short-time refresher BLS training program 6 months after the initial training can help trainees retain chest compression skills for up to 1 year. Repeated BLS training, even if very short, would be adopted to keep acquired CPR quality optimal (UMIN-CTR UMIN 000004101). [ABSTRACT FROM AUTHOR]

Introduction: Chest compressions depth and complete chest recoil are both important for high-quality Cardio-Pulmonary Resuscitation (CPR). It has been demonstrated that anthropometric variables affect chest compression depth, but there are no data about they could influence chest recoil. The aim of this study was to verify whether physical attributes influences chest recoil in lay rescuers.Methods: We evaluated 1 minute of compression-only CPR performed by 333 laypersons immediately after a Basic Life Support and Automated External Defibrillation (BLS/AED) course. The primary endpoint was to verify whether anthropometric variables influence the achievement a complete chest recoil. Secondary endpoint was to verify the influence of anthropometric variables on chest compression depth.Results: We found a statistically significant association between weight and percentage of compressions with correct release (p≤0.001) and this association was found also for height, BMI and sex. People who are heavier, who are taller, who have a greater BMI and who are male are less likely to achieve a complete chest recoil. Regarding chest compressions depth, we confirm that the more a person weighs, the more likely the correct depth of chest compressions will be reached.Conclusions: Anthropometric variables affect not only chest compression depth, but also complete chest recoil. CPR instructors should tailor their attention during training on different aspect of chest compression depending on the physical characteristics of the attendee. [ABSTRACT FROM AUTHOR]

Background: At the International Medical University (IMU), a half day cardiac life support teaching session was provided to fourth year medical students which included training on the use of the defibrillator machine, how to handle cardiac or respiratory arrest and drugs used for resuscitation. A new CLS (cardiac life support) training session was introduced and increased to a oneday course where students were given practical training first, which included 5 stations (airway equipment, mega codes, drugs for resuscitation, defibrillator use and cardiac rhythm identification) , MCQ (multiple choice questions) test and a mega code (practical)assessment. Objective: To evaluate the students' knowledge on cardiac resuscitation after a change in the delivery of the cardiac life support training (CLS). Methodology: Group I, consisted of 82 students taught using the traditional teaching and Group II consisted of 77 students taught using hands on simulation. The students in both groups had an online manual to read prior to the session, were given an identical written exam six months after the CLS training. Group II, however, had an online pre-test. Results: There was a statistical difference in the final mean marks between the two groups with group II scoring higher (67.3) than group 1 (62.1). No significant marks difference was noted between male and female students for both the cohorts. Conclusion: There is a significant difference in medical students' knowledge when cardiac life support is taught using simulation. IMU has adopted the new teaching method with simulated training for the cardiac life support courses with plans to implement higher fidelity and technology to the existing simulated teaching in other areas of medicine. [ABSTRACT FROM AUTHOR]

The process of cardiopulmonary resuscitation (CPR) involves various components that must be followed to deliver high quality of CPR. While the components commonly apply to CPR for all ages from infant to adult, there are several different suggestions for infant CPR such as two-thumb CPR and two-finger CPR. However, the comprehensive evaluation based on all these components has been difficult in the absence of proper evaluation tool. Here, we developed a new manikin-integrated, digital measuring system that objectively estimates overall performance of infant CPR by evaluating individual CPR components one by one including different hand placements. The system collects and analyzes data to present estimations in digital scores according to a new evaluation index constructed based on the previously verified one. The feasibility of the system was validated through simulations with beginners and experts in first aid, resulting in statistically significant differences between the two groups with the indication of specific weaknesses for each group which may provide a basis for creating customized CPR training strategy in compliance with the personal level. We believe that the system would become a valuable assessment tool not only for infant CPR but also for the CPR technique, in general, by reflecting every component in the evaluation. [ABSTRACT FROM PUBLISHER]

Abstract: Introduction: Previous studies reveal pediatric resident resuscitation skills are inadequate, with little improvement during residency. The Accreditation Council for Graduate Medical Education highlights the need for documenting incremental acquisition of skills, i.e. “Milestones”. We developed a simulation-based teaching approach “Rapid Cycle Deliberate Practice” (RCDP) focused on rapid acquisition of procedural and teamwork skills (i.e. “first-five minutes” (FFM) resuscitation skills). This novel method utilizes direct feedback and prioritizes opportunities for learners to “try again” over lengthy debriefing. Participants: Pediatric residents from an academic medical center. Methods: Prospective pre-post interventional study of residents managing a simulated cardiopulmonary arrest. Main outcome measures include: (1) interval between onset of pulseless ventricular tachycardia to initiation of compressions and (2) defibrillation. Results: Seventy pediatric residents participated in the pre-intervention and fifty-one in the post-intervention period. Baseline characteristics were similar. The RCDP-FFM intervention was associated with a decrease in: no-flow fraction: [pre: 74% (5–100%) vs. post: 34% (26–53%); p <0.001)], no-blow fraction: [pre: 39% (22–64%) median (IQR) vs. post: 30% (22–41%); p =0.01], and pre-shock pause: [pre: 84s (26–162) vs. post: 8s (4–18); p <0.001]. Survival analysis revealed RCDP-FFM was associated with starting compressions within 1min of loss of pulse: [Adjusted Hazard Ratio (HR): 3.8 (95% CI: 2.0–7.2)] and defibrillating within 2min: [HR: 1.7 (95% CI: 1.03–2.65)]. Third year residents were significantly more likely than first years to defibrillate within 2min: [HR: 2.8 (95% CI: 1.5–5.1)]. Conclusions: Implementation of the RCDP-FFM was associated with improvement in performance of key measures of quality life support and progressive acquisition of resuscitation skills during pediatric residency. [Copyright &y& Elsevier]

Background: The knowledge and skills about the basic life support (BLS) and the advanced life support are the most important determining factors of the cardiopulmonary resuscitation (CPR) success rates. Objectives: To determine the level of awareness on BLS and skills among undergraduate and postgraduate students of medical and dental profession, as well as nursing students and interns in a tertiary care hospital. Materials and Methods: This descriptive cross-sectional study was conducted in a tertiary care hospital in South India. The awareness level on BLS and factors associated which include age, sex, level of training (undergraduate, internship, and postgraduate groups), course of study (nursing, dental, and medical groups), and previous exposure to BLS were assessed by using a structured questionnaire. The association of these variables with awareness level was assessed by independent t test, analysis of variance, and linear regression analysis. Results: Among 520 study subjects, 229 were students, 171 were interns, and 120 were postgraduate students. The overall mean score of awareness was 4.16 ± 1.40 (score range: 0-10). Age, sex, level of training, course of study, and previous exposure to BLS were significantly associated with awareness level in univariate analysis (P < 0.05). Linear regression model also showed that all the above variables were significantly associated with awareness level (P < 0.05). About 322 (61.9%) subjects attributed lack of awareness about BLS to lack of available professional training. About 479 (92.1%) responded that BLS training should be a part of medical curriculum. Conclusion: Awareness level on BLS is below average indicating the importance of professional training at all levels in a tertiary care health institution. [ABSTRACT FROM AUTHOR]

Introduction: Basic life support (BLS) with cardiopulmonary resuscitation (CPR) provided at the right time greatly improves survival following cardiac arrest. Adequate knowledge and skills related to BLS are essential requisites for medical students. This study aimed to explore the knowledge, attitudes, and practices related to BLS among undergraduate medical students of a medical college in Tamil Nadu, India. Materials and Methods: This was a descriptive, cross-sectional study conducted among 241 undergraduate medical students of a medical college in Tamil Nadu, between May and July 2012, using a pretested, semi-structured questionnaire devised based on American Heart Association Guidelines for BLS and CPR 2010. Results: The mean knowledge score of the participants was 4.55 ± 1.21 out of a possible high score of 6. The level of knowledge and attitudes related to BLS varied depending on the year of study, and this difference was statistically significant (p<0.05). The knowledge score decreased with increasing duration of training. The higher the year of study, the more positive the participants' attitudes were. Only 12.9% of the participants had ever practised BLS. Twenty-one (21) participants (8.7%) expressed reluctance about performing BLS in a hospital setting, and 57.3% of the participants expressed reluctance about performing BLS in an out-of-hospital setting. Fear of acquiring infection, causing harm to the victim, and lack of confidence were the common causes for participants' reluctance. Conclusions: The study reveals inadequate knowledge and practices related to BLS among students. The differences in knowledge and attitudes among students, depending on the year of study, point to the need for frequent refresher training and motivation of students. [ABSTRACT FROM AUTHOR]

Background: Efficiently performed basic life support (BLS) after cardiac arrest is proven to be effective. However, cardiopulmonary resuscitation (CPR) is strenuous and rescuers’ performance declines rapidly over time. Audio-visual feedback devices reporting CPR quality may prevent this decline. We aimed to investigate the effect of various CPR feedback devices on CPR quality. Methods: In this open, prospective, randomised, controlled trial we compared three CPR feedback devices (PocketCPR®, CPRmeter®, iPhone app PocketCPR®) with standard BLS without feedback in a simulated scenario. 240 trained medical students performed single rescuer BLS on a manikin for 8min. Effective compression (compressions with correct depth, pressure point and sufficient decompression) as well as compression rate, flow time fraction and ventilation parameters were compared between the four groups. Results: Study participants using the PocketCPR® performed 17±19% effective compressions compared to 32±28% with CPRmeter®, 25±27% with the iPhone app PocketCPR®, and 35±30% applying standard BLS (PocketCPR® vs. CPRmeter® p =0.007, PocketCPR® vs. standard BLS p =0.001, others: ns). PocketCPR® and CPRmeter® prevented a decline in effective compression over time, but overall performance in the PocketCPR® group was considerably inferior to standard BLS. Compression depth and rate were within the range recommended in the guidelines in all groups. Conclusion: While we found differences between the investigated CPR feedback devices, overall BLS quality was suboptimal in all groups. Surprisingly, effective compression was not improved by any CPR feedback device compared to standard BLS. All feedback devices caused substantial delay in starting CPR, which may worsen outcome. [ABSTRACT FROM AUTHOR]

Abstract: Although fatal drowning rarely occurs in swimming pools, this event has a very grave impact on the swimming pool employees, notably when they have been directly involved in the rescue and resuscitation. At the same time, very little data is available on the incidence, causes and outcome of pool drowning. It is important that pool lifeguards understand that a cardiac arrest after drowning is different from the primary cardiac arrest due to an infarction or ventricular fibrillation and that oxygen is the most vital aspect of the resuscitation measures. The use of a pool safety plan and the implementation of a checklist, training in realistic pool-related resuscitation scenarios and record keeping of accidents and near-accidents may be helpful to be better prepared for a drowning incident. [Copyright &y& Elsevier]

Background: Within cardiopulmonary resuscitation external chest compressions (ECC) are of outstanding importance. Frequent training in Basic Life Support (BLS) may improve the performance, but the perfect method or environment is still a matter of research. The objective of this study was to evaluate whether practical performance and retention of skills in resuscitation training may be influenced by the gender composition in learning groups. Methods: Participants were allocated to three groups for standardized BLS-training: Female group (F): only female participants; Male group (M): only male participants; Standard group (S): male and female participants. All groups were trained with the standardized 4-step-approach method. Assessment of participants' performance was done before training (t1), after one week (t2) and eight months later (t3) on a manikin in the same cardiac arrest single-rescuer -scenario. Participants were 251 Laypersons (mean age 21; SD 4; range 18-42 years; females 63%) without previous medical knowledge. Endpoints: compression rate 90-110/min; mean compression depth 38-51 mm. Standardized questionnaires were used for the evaluation of attitude and learning environment. Results: After one week group F performed significantly better with respect to the achievement of the correct mean compression depth (F: 63% vs. S: 43%; p = 0.02). Moreover, groups F and S were the only groups which were able to improve their performance concerning the mean compression rate (t1: 35%; t3: 52%; p = 0.04). Female participants felt more comfortable in the female-only environment. Conclusions: Resuscitation training in gender-segregated groups has an effect on individual performance with superior ECC skills in the female-only learning groups. Female participants could improve their skills by a more suitable learning environment, while male participants in the standard group felt less distracted by their peers than male participants in the male-only group. [ABSTRACT FROM AUTHOR]