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Extending the access to cardiopulmonary resuscitation (CPR) training to a wider public is an important step in increasing survivability of out-of-hospital cardiac arrest. However, often price and maintenance of CPR manikins are barriers that prevent training at schools. This study aims to evaluate the learning of hands-only (HO) CPR by practicing with a low-cost manikin (LoCoMan) with visual qualitative feedback and to compare the results with the skills acquired by practice on a conventional manikin. A quasi-experimental study with 193 schoolchildren (10 to 12 years old) who were allocated to two groups: the LoCoMan group was taught via an integrative approach (science combined with physical education (PE)) and practiced on a handmade manikin, and a control group practiced in a traditional setting with a commercial manikin (Resusci Junior, Laerdal, Norway). All participants practiced for 1 hands-on skill session before performing a post-test on an instrumented CPR manikin. The outcomes including HO-CPR performance variables were compared between groups. The LoCoMan and control groups both achieved acceptable percentage of HO-CPR quality (57% and 71%, p = 0.004). Among 6th-graders, there were no significant differences in HO-CPR quality between LoCoMan 68% and control 71%, p = 0.66. The control group achieved better chest compression depth while the LoCoMan group showed more compressions with adequate chest recoil. Conclusion: Schoolchildren are able to build and use a low-cost manikin with visual feedback. The integrative learning approach used in this study may be a feasible alternative methodology for training and learning HO-CPR in schools when commercial manikins are not available

Introducción: La primera causa de muerte prevenible por traumatismo son las hemorragias masivas. El uso del torniquete por parte de los servicios médicos de emergencias y población lega se ha ido extendiendo en las últimas décadas gracias a sus buenos resultados y escasas complicaciones. Conociendo que un mal control de la hemorragia puede traer graves consecuencias, se han iniciado varias iniciativas para que cualquier ciudadano sepa colocar un torniquete en caso de emergencia. Mejorar y diseñar estrategias que impliquen a la población lega podría disminuir la morbimortalidad de estos accidentes. Objetivo: Evaluar la eficacia de las instrucciones inmediatas en la técnica del torniquete en legos (vídeo vs infografía) comparándolos con una breve formación teórico-práctica. Metodología: Estudio cuasiexperimental con un grupo control (formación breve) y dos grupos experimentales (vídeo e infografía). Los datos fueron obtenidos a partir de una muestra de 126 alumnos de 1º de enfermería sin conocimientos previos en la materia, quienes participaron en una simulación clínica en la que demostraron sus habilidades en la colocación de un torniquete CAT®. Resultados: El grupo control consiguió mejores resultados que los grupos experimentales. Los errores más frecuentes de los participantes que usaron las instrucciones estaban relacionados con un mal ajuste del torniquete y falta de tensión. Solo el 27,66% de los alumnos que visualizaron el vídeo instructivo consiguió colocar un torniquete efectivo. Conclusiones: La formación breve en la técnica del torniquete en legos ha sido el método con mejores resultados. Las instrucciones inmediatas resultaron eficaces, aunque en menor medida. Se podría considerar la mejora e innovación en este tipo de instrucciones en futuras investigaciones, Introdución: A primeira causa de morte evitable por traumatismo son as hemorraxias masivas. O uso do torniquete por parte dos servizos médicos de emerxencias e poboación leiga foise estendendo nas últimas décadas grazas aos seus bos resultados e escasas complicacións. Coñecendo que un mal control da hemorraxia pode traer graves consecuencias, iniciáronse varias iniciativas para que calquera cidadán saiba colocar un torniquete en caso de emerxencia. Mellorar e deseñar estratexias que impliquen á poboación leiga podería diminuír a morbimortalidad destes accidentes. Obxectivo: Avaliar a eficacia das instrucións inmediatas na técnica do torniquete en leigos (vídeo vs infografía) comparándoos cunha breve formación teórico-práctica. Metodoloxía: Estudo cuasiexperimental cun grupo control (formación breve) e dous grupos experimentais (vídeo e infografía). Os datos foron obtidos a partir dunha mostra de 126 alumnos de 1º de enfermaría sen coñecementos previos na materia, quen participou nunha simulación clínica na que demostraron as súas habilidades na colocación dun torniquete CAT®. Resultados: O grupo control conseguiu mellores resultados que os grupos experimentais. Os erros máis frecuentes dos participantes que usaron as instrucións estaban relacionados cun mal axuste do torniquete e falta de tensión. Tan só o 27,66% dos alumnos que visualizaron o vídeo instrutivo conseguiu colocar un torniquete efectivo. Conclusións: A formación breve na técnica do torniquete en leigos foi o método con mellores resultados. As instrucións inmediatas resultaron eficaces, pero en menor medida. Podería considerarse a mellora e a innovación deste tipo de instrucións en futuras investigacións, Introduction: The first preventable cause of death from trauma is massive bleeding. The use of the tourniquet by emergency medical services and laypeople has been increasing in recent decades thanks to its good results and few complications. Knowing that a bad control of bleeding can bring serious consequences, several initiatives have been initiated to ensure that every citizen knows how to place a tourniquet in an emergency. Improving and designing strategies that involve laypeople could decrease the morbimortality of these accidents. Objective: Evaluate the effectiveness of immediate instructions on the tourniquet technique in laypeople (video vs infographic) by comparing them with a brief theoretical and practical training. Methodology: Quasi-experimental study with a control group (short training) and two experimental groups (video and infographic). Data were obtained from a sample of 126 nursing students with no previous knowledge of the subject, who participated in a clinical simulation in which they demonstrated their skills placing a CAT® tourniquet. Results: The control group achieved better results than the experimental groups. The most frequent errors of the participants who used the instructions were related to poor tourniquet adjustment and lack of tension. 27.66% of the students who viewed the instructional video managed to place an effective tourniquet. Conclusions: Brief training in tourniquet technique in laypeople was the most successful method. Immediate instructions were effective, although to a lesser extent. Improvement and innovation in this type of instructions could be considered in future research

Introducción: La supervivencia de las víctimas de parada cardíaca extrahospitalaria aumentaría sustancialmente si los testigos fueran capaces de realizar la secuencia de soporte vital básico correctamente. Las aplicaciones móviles, en concreto los asistentes de voz, se están evaluando en el campo de la medicina como potenciales herramientas en su asistencia. Objetivos: Evaluar el uso de un chatbot como guía de actuación en soporte vital básico en personas adultas legas. Otros objetivos propuestos fueron analizar la interacción y la percepción de los participantes con el asistente, evaluar la realización de la secuencia y la calidad de las compresiones torácicas realizadas bajo las indicaciones del chatbot. Metodología: Se realizó un estudio de simulación cuasi-experimental con una muestra de conveniencia de 50 estudiantes de primer curso del Grado en Enfermería de la Universidad de Santiago de Compostela. En esta prueba los participantes debían realizar compresiones torácicas siguiendo las instrucciones del asistente ante una parada cardiaca simulada. Los materiales utilizados fueron una hoja de evaluación, un cuestionario de usabilidad, un maniquí Little Anne, una tablet con la App QCRP instructor y un ordenador con el asistente de voz. Resultados: El 100% de los participantes realizaron compresiones ininterrumpidas logrando un ritmo medio de 110 compresiones/minuto. En un período inferior a cuatro minutos los participantes lograron iniciar y mantener compresiones torácicas durante dos minutos. Respecto a la calidad global, el 20,6% alcanzaron la profundidad correcta del tórax (entre 5 y 6 centímetros) y el 35,2% realizaron compresiones torácicas de calidad. Prácticamente la totalidad de la muestra valoró positivamente el uso de esta aplicación en un supuesto caso real. Conclusión: El asistente de voz resulta útil en la capacitación a personas legas para identificar y activar la cadena de supervivencia, Introdución: A supervivencia das vítimas de parada cardíaca extra-hospitalaria aumentaría substancialmente se as testemuñas fosen capaces de realizar a secuencia de soporte vital básico correctamente. As aplicacións móbiles, en concreto os asistentes de voz, están a avaliarse no campo da medicina como potenciais ferramentas na súa asistencia. Obxectivos: Avaliar o uso dun chatbot como guía de actuación en soporte vital básico en persoas adultas leigas. Outros obxectivos propostos foron analizar a interacción e a percepción dos participantes co asistente, avaliar a realización da secuencia e a calidade das compresións torácicas realizadas baixo as indicacións do chatbot. Metodoloxía: Realizouse un estudo de simulación cuasi-experimental cunha mostra de conveniencia de 50 estudantes de primeiro curso do Grao en Enfermería da Universidade de Santiago de Compostela. Nesta proba os participantes debían realizar compresións torácicas seguindo as instrucións do asistente ante unha parada cardíaca simulada. Os materiais utilizados foron unha folla de avaliación, un cuestionario de usabilidade, un maniquí Little Anne, unha tableta coa App QCRP instrutor e un computador co asistente de voz. Resultados: O 100% dos participantes realizaron compresións ininterrompidas logrando un ritmo medio de 110 compresións/minuto. Nun período inferior a catro minutos os participantes lograron comezar e manter compresións torácicas durante dous minutos. Respecto á calidade global, o 20,6% alcanzaron a profundidade correcta do tórax (entre 5 e 6 centímetros) e o 35,2% realizaron compresións torácicas de calidade. Practicamente a totalidade da mostra valorou positivamente o uso desta aplicación nun suposto caso real. Conclusión: O asistente de voz resulta útil na capacitación a persoas leigo para identificar e activar a cadea de supervivencia, Introduction: Survival of out-of-hospital cardiac arrest victims would increase substantially if the witnesses were able to perform the basic life support sequence correctly. Mobile applications, specifically voice assistants, are being evaluated in the field of medicine as potential tools in their attendance. Objectives: To evaluate the use of a chatbot as an action guide in basic life support in adult legates. Other proposed objectives were to analyze the interaction and perception of the participants with the assistant, to evaluate the performance of the sequence and the quality of chest compressions performed under the instructions of the chatbot. Methodology: A quasi-experimental simulation study was conducted with a convenience sample of 50 first-year students of the Degree in Nursing from the University of Santiago de Compostela. In this test the participants had to perform chest compressions following the assistant’s instructions before a simulated cardiac arrest. The materials used were an evaluation sheet, a usability questionnaire, a Little Anne mannequin, a tablet with the QCRP instructor app and a computer with the voice assistant. Results: 100% of participants performed uninterrupted compressions achieving an average rate of 110 compressions/minute. In a period of less than four minutes the participants were able to start and maintain chest compressions for two minutes. Regarding overall quality, 20,6% reached the correct thorax depth (between 5 and 6 centimeters) and 35,2% performed quality chest compressions. Practically the whole sample assessed positively the use of this application in a real case scenario. Conclusion: The voice assistant is useful in training lay people to identify and activate the survival chain

Foreign body airway obstruction (FBAO) is a relatively common emergency and a potential cause of sudden death both in children and older people; bystander immediate action will determine the victim’s outcome. Although many school children’s basic life support (BLS) training programs have been implemented in recent years, references to specific training on FBAO are lacking. Therefore, the aim was to assess FBAO-solving knowledge acquisition in 10–13-year-old school children. A quasi-experimental non-controlled simulation study was carried out on 564 ten-to-thirteen-year-old children from 5 schools in Galicia (Spain). Participants received a 60-min training led by their physical education teachers (5 min theory, 15 min demonstration by the teacher, and 30 min hands-on training) on how to help to solve an FBAO event. After the training session, the school children’s skills were assessed in a standardized adult’s progressive FBAO simulation scenario. The assessment was carried out by proficient researchers utilizing a comprehensive checklist specifically designed to address the variables involved in resolving a FBAO event according with current international guidelines. The assessment of school children’s acquired knowledge during the simulated mild FBAO revealed that 62.2% of participants successfully identified the event and promptly encouraged the simulated patient to cough actively. When the obstruction progressed, its severity was recognized by 86.2% and back blows were administered, followed by abdominal thrusts by 90.4%. When the simulated victim became unconscious, 77.1% of children identified the situation and immediately called the emergency medical service and 81.1% initiated chest compressions. No significant differences in performance were detected according to participants’ age. Conclusion: A brief focused training contributes to prepare 10–13-year-old school children to perform the recommended FBAO steps in a standardized simulated patient. We consider th

The aim of the study was to explore feasibility of basic life support (BLS) guided through smart glasses (SGs) when assisting fishermen bystanders. Twelve participants assisted a simulated out-of-hospital cardiac arrest on a fishing boat assisted by the dispatcher through the SGs. The SGs were connected to make video calls. Feasibility was assessed whether or not they needed help from the dispatcher. BLS-AED steps, time to first shock/compression, and CPR’s quality (hands-only) during 2 consecutive minutes (1st minute without dispatcher feedback, 2nd with dispatcher feedback) were analyzed. Reliability was analyzed by comparing the assessment of variables performed by the dispatcher through SGs with those registered by an on-scene instructor. Assistance through SGs was needed in 72% of the BLS steps, which enabled all participants to perform the ABC approach and use AED correctly. Feasibility was proven that dispatcher’s feedback through SGs helped to improve bystanders’ performance, as after dispatcher gave feedback via SGs, only 3% of skills were incorrect. Comparison of on-scene instructor vs. SGs assessment by dispatcher differ in 8% of the analyzed skills: greatest difference in the "incorrect hand position during CPR" (on-scene: 33% vs. dispatcher: 0%). When comparing the 1st minute with 2nd minute, there were only significant differences in the percentage of compressions with correct depth (1st:48 ± 42%, 2nd:70 ± 31, p = 0.02). Using SGs in aquatic settings is feasible and improves BLS. CPR quality markers were similar with and without SG. These devices have great potential for communication between dispatchers and laypersons but need more development to be used in real emergencies

[Abstract] Since a great number of infant cardiopulmonary arrests occur outside of the hospital, it is crucial to train laypersons in cardiopulmonary resuscitation techniques, especially those professionals that will work with infants and children. The main objective of this study was to evaluate the efectiveness of ventilations performed by professional training students. The secondary objective was to analyze the preference between different ventilation and chest-compression methods. The sample consisted of 32 professional training students, 15 preschool students, and 17 physical education students. The activity was conducted separately for each group, and we provided a 10 min theoretical training about infant basic life support followed by a 45 min practical training using a Laerdal Little Anne QCPR CPR manikin. A practical test in pairs was organized to record the ventilation as performed by the participants, establishing the difference between the efficacious and the non-efficacious ones. Furthermore, we handed out a survey before and after training to evaluate their knowledge. More than 90% of the students completely agreed with the importance of learning cardiopulmonary resuscitation techniques for their professional future. More than half of the sample considered that they perform the rescue breathings with the mouth-to-mouth method better. We observed that through mouth-to-mouth-nose ventilations, the number of effective ventilations was significantly higher than the effective ventilations provided by a self-inflating bag and mask (EffectiveMtoMN 6.42 ± 4.27 vs. EffectiveMask 4.75 ± 3.63 (p = 0.007)), which was the preferred method. In terms of the compression method, hands encircling the chest was preferred by more than 85% of students. Mouth-to-mouth nose ventilation is more efficient than bag-face-mask ventilation in CPR as performed by professional training and physical activity students. This fact must be considered to provide higher-quality training s

Previous pilot experience has shown the ability of visually impaired and blind people (BP) to learn basic life support (BLS), but no studies have compared their abilities with blindfolded people (BFP) after participating in the same instructor-led, real-time feedback training. Twenty-nine BP and 30 BFP participated in this quasi-experimental trial. Training consisted of a 1 h theoretical and practical training session with an additional 30 min afterwards, led by nurses with prior experience in BLS training of various collectives. Quantitative quality of chest compressions (CC), AED use and BLS sequence were evaluated by means of a simulation scenario. BP’s median time to start CC was less than 35 s. Global and specific components of CC quality were similar between groups, except for compression rate (BFP: 123.4 + 15.2 vs. BP: 110.8 + 15.3 CC/min; p = 0.002). Mean compression depth was below the recommended target in both groups, and optimal CC depth was achieved by 27.6% of blind and 23.3% of blindfolded people (p = 0.288). Time to discharge was significantly longer in BFP than BP (86.0 + 24.9 vs. 66.0 + 27.0 s; p = 0.004). Thus, after an adapted and short training program, blind people were revealed to have abilities comparable to those of blindfolded people in learning and performing the BLS sequence and CC