scholarly journals MP25: Assessing the learning impact of the Northern City of Heroes public exhibit on bystander cardiopulmonary resuscitation response

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S51-S51
Author(s):  
M. Moskalyk ◽  
R. Ohle ◽  
A. Henson ◽  
S. McIsaac ◽  
C. Barriault ◽  
...  

Innovation Concept: In Sudbury, ON 44% of out-of-hospital cardiac arrest (OHCA) patients receive bystander CPR (bCPR), and only 4.7% survive cardiac arrest. The Northern City of Heroes (NCH) community initiative was launched in April 2019 with a goal of improving survival from OHCA through hands-only bCPR in the municipality. One NCH initiative is an interactive exhibit at Science North, a science centre in Sudbury that hosts 250,000 visitors annually. The exhibit employs simulation trainers for CPR, accompanying signage and interactive elements. The goals of the exhibit are to activate bCPR, change and measure behaviours through exhibit interactions on how to deliver excellent CPR, and improve survival rates in OHCA patients. Methods: Data is being collected from 3000 visitors using self-reported surveying via SurveyGizmo to assess likelihood of performing bCPR, pre and post interacting with the exhibit. Visitor behaviour will be examined at the exhibit using video-recorded interactions and coding those behaviours using BORIS software. Behavioural data will be analyzed using the Visitor Engagement Framework (VEF) where initiation, transition and breakthrough learning-behaviours are coded and an exhibit Visitor Engagement Profile (VEP) is created. The VEF and VEP are tools used in informal learning settings to assess exhibit impacts on learning. Curriculum, Tool, or Material: The use of an easily-apprehendable, hands-on exhibit tool located in a public setting, such as a science centre, creates a platform for engaging large and diverse public audiences. This type of bCPR exhibitry has not been implemented in other similar environments. The informal learning setting allows the science centre staff to engage in personalized interactions that can solidify the quality of learning and confidence in employing the new skills developed. Conclusion: The NCH exhibit and new strategies for embedding informal curriculum are powerful tools to reach diverse audiences, build knowledge and skills, and have a measurable impact on bCPR and OHCA survival rates. Data is being captured and tracked by Health Sciences North around the City of Greater Sudbury's bCPR and OHCA survival rates to monitor long-term impacts of the NCH community initiatives. Limitations of the study may be found in the focused demographics as well as the nature of self-reported learning. Future research directions include broader geographical surveying to assess improvements in community response to OHCA as a direct result of an interactive bCPR exhibitry.

2020 ◽  
Vol 9 (21) ◽  
Author(s):  
Andrew Fu Wah Ho ◽  
Nurun Nisa Amatullah De Souza ◽  
Audrey L. Blewer ◽  
Win Wah ◽  
Nur Shahidah ◽  
...  

Background Outcomes of patients from out‐of‐hospital cardiac arrest (OHCA) vary widely globally because of differences in prehospital systems of emergency care. National efforts had gone into improving OHCA outcomes in Singapore in recent years including community and prehospital initiatives. We aimed to document the impact of implementation of a national 5‐year Plan for prehospital emergency care in Singapore on OHCA outcomes from 2011 to 2016. Methods and Results Prospective, population‐based data of OHCA brought to Emergency Departments were obtained from the Pan‐Asian Resuscitation Outcomes Study cohort. The primary outcome was Utstein (bystander witnessed, shockable rhythm) survival‐to‐discharge or 30‐day postarrest. Mid‐year population estimates were used to calculate age‐standardized incidence. Multivariable logistic regression was performed to identify prehospital characteristics associated with survival‐to‐discharge across time. A total of 11 465 cases qualified for analysis. Age‐standardized incidence increased from 26.1 per 100 000 in 2011 to 39.2 per 100 000 in 2016. From 2011 to 2016, Utstein survival rates nearly doubled from 11.6% to 23.1% ( P =0.006). Overall survival rates improved from 3.6% to 6.5% ( P <0.001). Bystander cardiopulmonary resuscitation rates more than doubled from 21.9% to 56.3% and bystander automated external defibrillation rates also increased from 1.8% to 4.6%. Age ≤65 years, nonresidential location, witnessed arrest, shockable rhythm, bystander automated external defibrillation, and year 2016 were independently associated with improved survival. Conclusions Implementation of a national prehospital strategy doubled OHCA survival in Singapore from 2011 to 2016, along with corresponding increases in bystander cardiopulmonary resuscitation and bystander automated external defibrillation. This can be an implementation model for other systems trying to improve OHCA outcomes.


2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Sajithkumar P ◽  
Dr. Ratna Prakash

Prosocial behaviour refers to the behaviours that benefit people (Penner, Dovidio, Piliavin, & Schroder, 2005). Prosocial behaviours are performed to benefit others, rather than to benefit the self. Typically, pro-social behaviors are an outgrowth of positive experiences and emotions (Aydinli et al, 2013). Feelings of empathy, compassion, and sympathy are also associated with helping, particularly when individuals recognize a moral obligation to care for others. According to World Health Organization, Pro-social behavior can emerge, however, from traumatic and painful experiences. Cardiac arrest is a major public health issue, with more than 500000 deaths of children and adults per year even in developed countries. Despite significant scientific advances in care of cardiac arrest victims, there remain striking disparities in survival rates for both in-hospital and out-of-hospital cardiac arrest. It is seen that survival can vary among geographic regions by as much as 6-fold for victims in pre-hospital setting. For out of hospital cardiac arrest victims, the key determinants of survival are the timely performance of first responder or bystander cardiopulmonary resuscitation (CPR) and defibrillation for those in ventricular fibrillation and pulse less ventricular tachycardia. Only a minority of cardiac arrest victims receive potentially lifesaving bystander CPR, thus indicating that there should be some hindrances for the first responders from the general public to perform this in the right time (Bhanji et al, 2015).


2020 ◽  
Vol 9 (21) ◽  
Author(s):  
Shir Lynn Lim ◽  
Karen Smith ◽  
Kylie Dyson ◽  
Siew Pang Chan ◽  
Arul Earnest ◽  
...  

Background Incidence and outcomes of out‐of‐hospital cardiac arrest (OHCA) vary between communities. We aimed to examine differences in patient characteristics, prehospital care, and outcomes in Singapore and Victoria. Methods and Results Using the prospective Singapore Pan‐Asian Resuscitation Outcomes Study and Victorian Ambulance Cardiac Arrest Registry, we identified 11 061 and 32 003 emergency medical services‐attended adult OHCAs between 2011 and 2016 respectively. Incidence and survival rates were directly age adjusted using the World Health Organization population. Survival was analyzed with logistic regression, with model selection via backward elimination. Of the 11 061 and 14 834 emergency medical services‐treated OHCAs (overall mean age±SD 65.5±17.2; 67.4% males) in Singapore and Victoria respectively, 11 054 (99.9%) and 5595 (37.7%) were transported, and 440 (4.0%) and 2009 (13.6%) survived. Compared with Victoria, people with OHCA in Singapore were older (66.7±16.5 versus 64.6±17.7), had less shockable rhythms (17.7% versus 30.3%), and received less bystander cardiopulmonary resuscitation (45.7% versus 58.5%) and defibrillation (1.3% versus 2.5%) (all P <0.001). Age‐adjusted OHCA incidence and survival rates increased in Singapore between 2011 and 2016 ( P <0.01 for trend), but remained stable, though higher, in Victoria. Likelihood of survival increased significantly ( P <0.001) with arrest in public locations (adjusted odds ratio [aOR] 1.81), witnessed arrest (aOR 2.14), bystander cardiopulmonary resuscitation (aOR 1.72), initial shockable rhythm (aOR 9.82), and bystander defibrillation (aOR 2.04) but decreased with increasing age (aOR 0.98) and emergency medical services response time (aOR 0.91). Conclusions Singapore reported increasing OHCA incidence and survival rates between 2011 and 2016, compared with stable, albeit higher, rates in Victoria. Survival differences might be related to different emergency medical services practices including patient selection for resuscitation and transport.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Eloi Marijon ◽  
Audrey Uy-Evanado ◽  
Florence Dumas ◽  
Carmen Teodeorescu ◽  
Kyndaron Reinier ◽  
...  

Background: Sports-related sudden cardiac arrest (sport SCA) has always attracted attention and the United States and European Union have developed divergent strategies for prevention over the last decade; notably regarding screening of younger athletes but also for SCA prevention in middle-aged and senior individuals. In this context, the extent to which outcomes of sports SCA differ between Europe and the USA have not been characterized. Methods: SCA cases aged 15-75 years were identified in two large prospective, population-based SCA programs, one in the Paris region (Paris-SDEC) and the other in a Northwestern US metro region (Oregon-SUDS) between 2002 and 2012. Cases of SCA, occurring during sports activity were compared between the two regions. Results: Of the 7,357 cases studied, 290 (4%) occurred during sports, with very similar proportions in both regions: 86 out of 1,894 (4.5%) in Oregon and 204 out of 5,463 (3.8%) in Paris. Subjects’ characteristics of cases in both programs were very similar (Paris vs. Oregon, respectively, for all results following), regarding age (50.7±14 vs. 50.4±13 years, P=0.55), male proportion (94%vs. 92%, P=0.53), past medical history of ≥2 cardiovascular risk factors (16% vs. 23%, P=0.16) and/or heart disease (10% vs. 8%, P=0.55). There was a high proportion of witnessed events in both populations (89% vs. 90%, P=0.94). However, we observed significant differences with more bystander cardiopulmonary resuscitation in Paris (63% vs. 48%, P=0.02), faster response time in Oregon (8.3±6 vs. 6.9±4 min, P=0.05), and more initially shockable rhythms in Oregon (52% vs. 70%, P=0.006). Overall, resuscitation outcomes were very similar for return of spontaneous circulation (26% vs. 33%, P=0.21) and survival to hospital discharge (27% vs. 26%, P=0.80). Conclusions: On either side of the Atlantic, burden and characteristics of sports-related SCA are very similar. Survival rates are approximately one in four cases. Optimizing bystander cardiopulmonary resuscitation rates and emergency response times could further improve outcomes. Deployment of uniform, effective strategies for screening and prevention are likely to make the greatest impact on sports SCA.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kristian Kragholm ◽  
Monique Anderson ◽  
Carolina Malta Hansen ◽  
Phillip J. Schulte ◽  
Michael C. Kurz ◽  
...  

Introduction: How long resuscitation attempts should be continued before termination of efforts is not clear in patients with out-of-hospital cardiac arrest (OHCA). We studied outcomes in patients with return of spontaneous circulation (ROSC) across quartiles of time from 9-1-1 call to ROSC. Hypothesis: Survival with favorable neurological outcome is seen in all time intervals from 9-1-1 call to ROSC. Methods: Using data from Resuscitation Outcomes Consortium (ROC) Prehospital Resuscitation clinical trials: IMpedance valve and an Early vs. Delayed analysis (PRIMED) available via National Institute of Health, patients with ROSC not witnessed by the emergency medical service (EMS) were identified and grouped by quartiles of time from 9-1-1 call to ROSC. We defined favorable neurological outcome as modified Rankin Scale (mRS) scores of ≤3. Results: Included were 3,431 OHCA patients with ROSC. Median time from 9-1-1 call to ROSC was 22.8 min (25%-75% 17 min–29.2 min); 953 (27.8%) survived to discharge (20.4% mRS ≤3). Significant survival and favorable neurological outcome were seen in each quartile (Figure). In patients who received bystander cardiopulmonary resuscitation (CPR), survival rates were 60.9%, 33.2%, 18.3% and 11.1% across quartiles of time to ROSC versus (vs.) 51.5%, 25.6%, 13.3% and 8.9% in patients without bystander CPR; corresponding rates of favorable neurological outcome were 50.7%, 23.8%, 12.2% and 9.1% vs. 40.1%, 16.6%, 8% and 4.8%. Correspondingly, survival rates in defibrillated patients were 70.1%, 45.9%, 25.5% and 16.4% vs. 36.3%, 9.5%, 6% and 3.4% in non-defibrillated patients; corresponding rates of favorable neurological outcome were 59.8%, 33.4%, 18.3% and 11.4% vs. 24.4%, 4.1%, 1.9% and 1.8%. Conclusions: Survival with favorable neurological outcome was seen in all quartiles of time to ROSC, even in cases without bystander CPR or shocks delivered. This suggests that EMS personnel should not terminate resuscitation efforts too early.


CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S60
Author(s):  
C. Vaillancourt ◽  
M. Charette ◽  
K. Cyr ◽  
S. Hodges ◽  
V. Thiruganasambandamoorthy ◽  
...  

Introduction: 9-1-1 telecommunicators receive minimal education on agonal breathing, often resulting in unrecognized out-of-hospital cardiac arrest (OHCA). We successfully piloted an educational intervention that significantly improved telecommunicators’ OHCA recognition and bystander CPR rates in Ottawa. We sought to better understand the operations of Canadian 9-1-1 communications centers (CC) in preparation for a multi-centre study of this intervention. Methods: We conducted a National survey of all Canadian CCs. Survey domains included information on organizational structure, dispatch system used, education curriculum, and performance monitoring. It was peer-reviewed, translated in French, pilot-tested, and distributed electronically using a modified Dillman method. We designated respondents in each CC before distribution and used targeted follow-up and small incentives to increase response rate. Respondents also described functioning of neighboring CCs if known. Results: We received information from 51/51 provincial and 1/25 territorial CCs, representing 99.7% of the Canadian population. CCs largely utilize the Medical Dispatch Priority System (MPDS) platform (93%), many are Province/Ministry regulated (50%) and most require a High School diploma as minimum entry level education (78%). Telecommunicators receive initial in-class training (median 1.3 months, IQR 0.3-1.9; range 0.1-2.2), often followed by a preceptorship (84.4%) (median 1.0 months, IQR 0.7-1.7; range 0.4-6.0). Educational curriculum includes information on agonal breathing in 41% of CC, without audio examples in 34%. Among responding CCs, over 39,000 suspected OHCA 9-1-1 calls are received annually. Few CCs maintain local performance statistics on OHCA recognition (25%), bystander CPR rates (25%) or survival rates (50%). Most (97%) expressed interest in future research collaborations. Conclusion: Most Canadian telecommunicators receive no or minimal education in recognizing agonal breathing. Further training and improved OHCA monitoring may assist recognition and enhance outcomes.


2019 ◽  
Author(s):  
Alan M. Batt ◽  
Chelsea Lanos ◽  
Dalal Al-Hasan ◽  
Assim Alhmoudi ◽  
Megan Anderson ◽  
...  

AbstractBackgroundOut-of-hospital cardiac arrest (OHCA) is a major cause of mortality worldwide. Recent studies demonstrated low survival rates in Middle Eastern countries. Anecdotally there are unique demographic, cultural and logistical challenges in this region. However, there remains a paucity of data published on OHCA in the Middle East. In order to address OHCA in a meaningful manner in the region, we first need to quantify the issue.MethodsWe conducted a scoping review of published and grey literature on OHCA in the Gulf Cooperative Council region that utilised Arksey and O’Malley’s framework. Electronic databases and grey literature sources were identified and searched. Subject matter experts in the region were consulted. All types of studies in English and Arabic were included.ResultsA total of 24 studies were included from Saudi Arabia, the UAE, Oman, Kuwait, and Qatar. No literature was identified from the state of Bahrain. OHCA victims in the region are younger, predominantly male, and more co-morbid than those in Western studies. We observed low Emergency Medical Service utilisation, low bystander cardiopulmonary resuscitation, return of spontaneous circulation, and survival to discharge rates across the region. There are differences in characteristics of OHCA among ethnic groups.Discussion and conclusionsWe identified unique characteristics associated with OHCA in the region, variances in processes and outcomes when compared to Western studies, and a lack of coordinated effort to research and address OHCA. We recommend creating lead agencies responsible for coordinating and developing strategies such as community response, public education, and reporting databases.


2021 ◽  
Vol 5 (1) ◽  
pp. 58-64
Author(s):  
Mary McCormack ◽  
Carole Zarcone ◽  
Kendra Hoepper ◽  
Pamela Watters

Background: More than 350,000 episodes of out-of-hospital cardiac arrest (OHCA) occur annually in the United States, with less than half of the victims receiving bystander cardiopulmonary resuscitation (CPR). Provision of bystander CPR has been noted to increase survival rates two to three-fold; however, bystander CPR is initiated in less than 50 % of out of OHCA episodes in the United States.Aim: The purpose of this pilot study was to create a sudden cardiac arrest safety net on a college campus. The American Heart Association (AHA) CPR in Schools Program© was provided to college students, athletes, faculty and staff.Method: A multi-group educational intervention with a pre- and post-test design. Results: Participant knowledge level of CPR and AED use significantly improved on the post test. Additionally, after attending the sessions participants reported an increase in comfort level performing CPR and improved knowledge of the locations of the AEDs on campus. As a result of the program, nine additional AED’s have been placed in high-traffic areas on campus.Conclusion: Empowering laypersons with the skills and knowledge to respond to potential episodes of OHCA are integral steps towards improving patient outcomes.


2021 ◽  
Vol 13 (9) ◽  
pp. 365-372
Author(s):  
Nigel Rees ◽  
Lee Beever ◽  
Neil Vaughan ◽  
Carl Powell ◽  
Adam Fletcher ◽  
...  

The UK average survival rate from out of hospital cardiac arrest (OHCA) is 8.6%, which is significantly lower than in comparable countries where survival rates can exceed 20%. A cardiac arrest victim is two to four times more likely to survive OHCA with bystander cardiopulmonary resuscitation (CPR). Mandatory teaching of CPR in schools is an effective way, endorsed by the World Health Organization, to train the entire population and improve the bystander CPR rate. Despite this, as with other UK home nations, there is significant variation in provision of CPR training within schools in Wales. Virtual reality (VR) technology offers an accessible, immersive way to teach CPR skills to schoolchildren. Computer scientists at the University of Chester and the Welsh Ambulance Services NHS Trust developed Virtual Cardio Pulmonary Resuscitation (VCPR), which can be used to teach children CPR skills. There were three stages: identifying requirements and specifications; development of a prototype; and management—development of software, further funding and exploring opportunities for commercialisation.


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