Brief video training dramatically
boosts hands-only attempts at cardiopulmonary resuscitation
Study participants who viewed a brief hands-only cardiopulmonary
resuscitation (CPR) video were more likely to attempt CPR, and perform better
quality CPR in an emergency than participants who did not view the short videos,
according to research reported in Circulation: Cardiovascular Quality and Outcomes.
Survival rates from out-of-hospital cardiac arrests tend to be extremely low.
However, research has shown that bystander CPR can double - even triple - survival
from out-of-hospital cardiac arrest.
In the United States, bystanders attempt CPR only about 26 percent of the time,
according to Bentley J. Bobrow, M.D., lead author of the study and clinical associate
professor in the Department of Emergency Medicine in the Maricopa Medical Center
in Phoenix, Arizona and the University of Arizona Emergency Medicine Research
Center.
"Chest compression-only CPR, also known as hands-only CPR, has been shown
in studies to be at least as effective as standard CPR with mouth-to-mouth ventilation
for adult primary cardiac arrest victims," Bobrow said. "And because
of its simplicity, hands-only CPR may be quicker and easier for lay rescuers to
learn, remember and perform than conventional CPR."
Bobrow and colleagues conducted a study of 336 adults without recent CPR training
and randomized the participants into four groups:
- No training (control group of 51 participants)
- Ultra brief video (UBV): watched a 60-second video (95 participants)
- Brief video (BV): watched a five-minute video (99 participants)
- Brief video with practice (BVP): watched an eight-minute video with a practice
training session using a manikin (91 participants)
They then tested the participants' ability to perform CPR during an adult out-of-hospital
cardiac arrest simulation. About half of the trained participants underwent testing
immediately and half after two months. They found that nearly a quarter (23.5
percent) of the untrained group did not attempt any CPR vs. less than 1 percent
(.7 percent) from all the training groups combined. Trained subjects in the immediate
and delayed evaluation groups were significantly more likely to attempt CPR compared
to untrained subjects.
All training groups had significantly higher median compression rates compared
to the control group (62 compressions-per-minute). In the immediate testing group,
the median rates of compressions-per-minute were: UBV (96), BV (95), and BVP (99.5).
In the delayed testing group, the median compression rates were: UBV (94), BV
(92.5) and BVP (90). The ideal compression rate is 100 compressions per-minute,
according to the American Heart Association's 2010 Guidelines for CPR and Emergency
Cardiovascular Care.
All trained groups had significantly greater median compression depth compared
to the untrained group (30 mm). In the immediate testing group, the median compression
depths were: UBV (41 mm), BV (42 mm) and BVP (48 mm). In the delayed testing group,
the media compressions depths were: UBV (43 mm), BV (42.5) and BVP (46). The ideal
compression depth is 38 mm or greater.
There were no significant differences in the median compression rate and median
compression depth between participants tested immediately or tested two months
later.
"This is the first controlled, randomized investigation evaluating the
effectiveness of ultra-brief video training for teaching hands-only CPR to the
lay public," Bobrow said. "Given that the ultra-brief video training
in our study is only 60 seconds, the CPR performance results are striking. "This
finding has enormous public health implications because of the documented hesitancy
of untrained rescuers to even attempt CPR and because it is known that any bystander
resuscitation attempt improves outcomes compared to no CPR."
Co-authors are: Tyler F. Vadeboncoeur, M.D.; Daniel W. Spaite, M.D.; Jerald
Potts, Ph.D.; Kurt Denninghoff, M.D.; Vatsal Chikani, M.P.H.; Paula R. Brazil,
M.A.; Bob Ramsey, M.A.; and Benjamin Abella, M.D., M.Phil. Author disclosures
are on the manuscript.
The American Heart Association funded the study.
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