scholarly journals Young adults’ perception of mandatory CPR training in Australian high schools: a qualitative investigation

2018 ◽  
Vol 15 (2) ◽  
Author(s):  
Tiana Andrews ◽  
Luke Price ◽  
Brennen Mills ◽  
Lisa Holmes

IntroductionBystander cardiopulmonary resuscitation (CPR) can be performed by any member of the public who witnesses a cardiac arrest and has the knowledge, training and skills to perform it. Even though bystander CPR has been shown to greatly improve the victim’s chance of survival, its training and performance rates are alarmingly low.MethodsOne potentially effective intervention to tackle this issue is to implement mandatory CPR training programs in high schools. We undertook in-depth qualitative interviews with 28 recent Australian high school graduates. The interviews were transcribed and then analysed, with participants’ answers used to draw conclusions on the acceptability of mandatory CPR high school training.ResultsResults suggested those that had undertaken basic first aid training in high school would be more open and confident to perform bystander CPR. Among those who had not undertaken training, cost and access were identified as the key barriers. Regardless of whether participants had or had not previously undertaken training, they understood the importance of CPR for the treatment of cardiac arrest victims.ConclusionAmong our sample, there was overwhelming support for the concept of mandatory CPR training being implemented in high schools. Should such a program be applied, there is the potential for this to have an impact on bystander CPR provision, and hence cardiac arrest survival rates, within the wider Australian community.

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.


2016 ◽  
Author(s):  
Tina Fetner ◽  
Athena Elafros ◽  
Sandra Bortolin ◽  
Coralee Drechsler

In activists' circles as in sociology, the concept "safe space" has beenapplied to all sorts of programs, organizations, and practices. However,few studies have specified clearly what safe spaces are and how theysupport the people who occupy them. In this paper, we examine one sociallocation typically understood to be a safe space: gay-straight alliancegroups in high schools. Using qualitative interviews with young adults inthe United States and Canada who have participated in gay-straightalliances, we examine the experiences of safe spaces in these groups. Weunpack this complex concept to consider some of the dimensions along whichsafe spaces might vary. Participants identified several types of safespace, and from their observations we derive three inter-related dimensionsof safe space: social context, membership and activity.


2013 ◽  
Vol 48 (2) ◽  
pp. 242-247 ◽  
Author(s):  
Brett G. Toresdahl ◽  
Kimberly G. Harmon ◽  
Jonathan A. Drezner

Context: School-based automated external defibrillator (AED) programs have demonstrated a high survival rate for individuals suffering sudden cardiac arrest (SCA) in US high schools. Objective: To examine the relationship between high schools having an AED on campus and other measures of emergency preparedness for SCA. Design: Cross-sectional study. Setting: United States high schools, December 2006 to September 2009. Patients or Other Participants: Principals, athletic directors, school nurses, and certified athletic trainers represented 3371 high schools. Main Outcome Measure(s): Comprehensive surveys on emergency planning for SCA submitted by high school representatives to the National Registry for AED Use in Sports from December 2006 to September 2009. Schools with and without AEDs were compared to assess other elements of emergency preparedness for SCA. Results: A total of 2784 schools (82.6%) reported having 1 or more AEDs on campus, with an average of 2.8 AEDs per school; 587 schools (17.4%) had no AEDs. Schools with an enrollment of more than 500 students were more likely to have an AED (relative risk [RR] = 1.12, 95% confidence interval [CI] = 1.08, 1.16, P < .01). Suburban schools were more likely to have an AED than were rural (RR = 1.08, 95% CI = 1.04, 1.11, P < .01), urban (RR = 1.13, 95% CI = 1.04, 1.16, P < .01), or inner-city schools (RR = 1.10, 95% CI = 1.04, 1.23, P < .01). Schools with 1 or more AEDs were more likely to ensure access to early defibrillation (RR = 3.45, 95% CI = 2.97, 3.99, P < .01), establish an emergency action plan for SCA (RR = 1.83, 95% CI = 1.67, 2.00, P < .01), review the emergency action plan at least annually (RR = 1.99, 95% CI = 1.58, 2.50, P < .01), consult emergency medical services to develop the emergency action plan (RR = 1.18, 95% CI = 1.05, 1.32, P < .01), and establish a communication system to activate emergency responders (RR = 1.06, 95% CI = 1.01, 1.08, P < .01). Conclusions: High schools with AED programs were more likely to establish a comprehensive emergency response plan for SCA. Implementing school-based AED programs is a key step associated with emergency planning for young athletes with SCA.


CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S52-S53
Author(s):  
C. Vaillancourt ◽  
A. Kasaboski ◽  
M. Charette ◽  
L. Calder ◽  
L. Boyle ◽  
...  

Introduction: Most ambulance communication officers receive minimal education on agonal breathing, often leading to unrecognized out-of-hospital cardiac arrest (OHCA). We sought to evaluate the impact of an educational program on cardiac arrest recognition, and on bystander CPR and survival rates. Methods: Ambulance communication officers in Ottawa, Canada received additional training on agonal breathing, while the control site (Windsor, Canada) did not. Sites were compared to their pre-study performance (before-after design), and to each other (concurrent control). Trained investigators used a piloted-standardized data collection tool when reviewing the recordings for all potential OHCA cases submitted. OHCA was confirmed using our local OHCA registry, and we requested 9-1-1 recordings for OHCA cases not initially suspected. Two independent investigators reviewed medical records for non-OHCA cases receiving telephone-assisted CPR in Ottawa. We present descriptive and chi-square statistics. Results: There were 988 confirmed and suspected OHCA in the “before” (540 Ottawa; 448 Windsor), and 1,076 in the “after” group (689 Ottawa; 387 Windsor). Characteristics of “after” group OHCA patients were: mean age (68.1 Ottawa, 68.2 Windsor); Male (68.5% Ottawa, 64.8% Windsor); witnessed (45.0% Ottawa, 41.9% Windsor); and initial rhythm VF/VT (Ottawa 28.9, Windsor 22.5%). Before-after comparisons were: for cardiac arrest recognition (from 65.4% to 71.9% in Ottawa p=0.03; from 70.9% to 74.1% in Windsor p=0.37); for bystander CPR rates (from 23.0% to 35.9% in Ottawa p=0.0001; from 28.2% to 39.4% in Windsor p=0.001); and for survival to hospital discharge (from 4.1% to 12.5% in Ottawa p=0.001; from 3.9% to 6.9% in Windsor p=0.03). “After” group comparisons between Ottawa and Windsor (control) were not statistically different, except survival (p=0.02). Agonal breathing was common (25.6% Ottawa, 22.4% Windsor) and present in 18.5% of missed cases (15.8% Ottawa, 22.2% Windsor p=0.27). In Ottawa, 31 patients not in OHCA received chest compressions resulting from telephone-assisted CPR instructions. None suffered injury or adverse effects. Conclusion: While all OHCA outcomes improved over time, the educational intervention significantly improved OHCA recognition in Ottawa, and appeared to mitigate the impact of agonal breathing.


Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Jieun Pak ◽  
Tae Han Kim ◽  
Min Woo Kim ◽  
Jong Hwan Kim ◽  
Ki Jeong Hong ◽  
...  

Introduction: Bystander CPR is an important prognostic factor for outcome in out-of-hospital cardiac arrest (OHCA). Dispatcher-assisted(DA) CPR program have shown to successfully increase rate of bystander CPR in communities. However DA-CPR is usually targeted for bystanders with no or lower level of CPR training compared to bystanders who are able to perform CPR without dispatcher assistance. We evaluated the effect of bystander CPR separately according to presence of dispatcher assistance on neurologic outcome. Methods: Retrospective analysis was performed using nationwide OHCA database from 2014 to 2017. Adult EMS treated OHCA with presumed cardiac origin were enrolled. EMS witnessed arrest and arrest occurred during ambulance transport were excluded. Bystander CPR was classified into 2 groups according to presence of DA-CPR instruction from emergency medical dispatch center. Rate of favorable neurologic outcome (CPC 1 or 2) was compared according to type of bystander CPR. Multivariable logistic regression model was used to estimate effect of bystander CPR type on outcomes. Results: Total of 72,314 eligible OHCA were enrolled for final analysis. Proportion of patients with favorable neurologic outcome was highest in bystander CPR without dispatcher assistance. (8.6% for bystander CPR without DA, 5.0% for bystander CPR with DA and 2.9% for no bystander CPR, p<0.01). Bystander CPR with DA was associated with higher chance of good neurological recovery than no bystander CPR, effect on neurologic outcome was significantly different than bystander CPR without DA(adjusted OR with 95% CI (bystander CPR with DA as reference): 0.61[0.55-0.67] for no-bystander CPR , 1.24[1.14–1.36] for bystander CPR without DA) Conclusion: Bystander CPR with DA showed positive effect on neurologic outcome compared to no-bystander CPR. However bystander CPR with DA was less effective than bystander CPR performed without dispatcher assistance. To improve quality of bystander CPR with dispatcher assistance, strategy to monitor and give feedback bystander CPR during dispatcher assistance should be developed and implemented in dispatch center.


Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Paige Meskers ◽  
Vanessa Mejia ◽  
Jessica Salerno ◽  
Leonard Weiss ◽  
David D Salcido

Introduction: Bystander CPR may increase out-of-hospital cardiac arrest survival rates. Incorporating CPR education into high school curricula is an efficient way to teach a large number of individuals CPR. Pennsylvania, unlike most states, does not require CPR training prior to graduation, and the prevalence of school training programs is not known. Objective: The goal of this study was to describe the distribution and characteristics of CPR training practices in high schools across Pennsylvania. Methods: As part of an ongoing public health project, we developed and administered a 7-question survey designed to determine if school districts offer CPR training programs, and if so, query key details about those programs. Using the Pennsylvania Education Names and Addresses database, we compiled contact information for all Pennsylvania school districts. Student researchers then contacted district personnel by telephone or email to administered the survey. Survey results were tabulated and summarized, and basic comparative statistics were calculated using Stata (ver. 15). Geographic patterns were assessed using QGIS (ver. 3.0.1) To understand the role of race and economics in availability of CPR training, our analyses incorporated census data on median income, race and ethnicity. Results: Between July 2018 and May 2019, we attempted to contact all 500 school districts in Pennsylvania, 494 of which were determined to have high schools within the district. We received survey responses from 446 (90%) school districts. Of those, 255 (57%) offered some form of CPR education and 141 (32%) of those programs were mandatory. Of the 255 districts that offered programs, 157 (62%) programs certified students as CPR providers. School districts that have CPR training have a median household income on average $4906 higher than school districts without CPR training. Clusters of districts with and without training were observed, however these clusters did not correlate with state geographic divisions, white race or Hispanic ethnicity. Conclusion: In Pennsylvania, where CPR training is not mandatory in high schools, at least half of all schools have training programs. Factors determining program adoption are unclear.


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.


Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Victoria L Vetter ◽  
Katherine F Dalldorf ◽  
Joseph Rossano ◽  
Maryam Y Naim ◽  
Andrew C Glatz ◽  
...  

Introduction: Thirty eight states have laws requiring education of high school students on cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AED). No study has measured the association of these laws and outcomes. Hypothesis: Out of hospital cardiac arrests (OHCAs) occurring in states with CPR high school education laws will have higher bystander CPR, survival, and favorable neurological survival than states without such laws. Methods: We conducted an analysis of the Cardiac Arrest Registry to Enhance Survival database and included all nontraumatic OHCAs with at least 50% population catchment from 1/2013-12/2017 in all ages. We excluded OHCAs witnessed by 911 responders, in healthcare facilities, or nursing homes. Outcomes were bystander CPR, survival to hospital discharge and neurologically favorable survival (Cerebral Performance Category score of 1 or 2 at hospital discharge). Chi-square tests were used to assess associations. Results: The 110,902 subjects with OHCA included Male, 64.0%; <18 yrs., 3.2%; <35 yrs., 10.7%; <50 yrs., 23.9%; White, 49.3%; Black, 19.1%; Hispanic, 2.3%; Other, 2.9%; Unknown, 26.5%. Most OHCAs occurred at home, 81.4%. 44.4% were witnessed by bystanders. 75.5% occurred in states with CPR high school education laws. A higher percent of OHCAs received bystander CPR prior to emergency medical services (EMS) arrival in states with CPR high school education laws (40.1%) compared to states without laws (37.0%) (p<0.001). Bystander CPR was less common in males (40.3% vs. 37.7% for females), those >50 yrs. (38.9% vs. 40.7% for ≤50 yrs.), Black and Hispanic subjects (25.7% and 34.9%, respectively, vs. 42.4% for Whites) (p<0.001 for all). Overall survival to hospital discharge was 10.4%; 8.8% had a favorable neurological outcome. A higher percent survived to hospital discharge in states with CPR high school education laws (11.0%) compared to states without laws (8.7%) (p<0.001). Neurologically favorable survival was more likely in states with CPR high school education laws, (9.3%) compared to states without laws (7.5%) (p<0.001). Conclusions: Bystander CPR, survival to hospital discharge, and neurologically favorable survival was higher in states that had CPR high school education laws.


2018 ◽  
Vol 198 (3) ◽  
pp. 240-246
Author(s):  
Nikita S. Kalluri ◽  
Anita Knopov ◽  
Ricky Kue

Out-of-hospital cardiac arrest (OHCA) survival rates have been shown to be lower than cardiac arrest survival rates occurring in the hospital setting. Bystander cardiopulmonary resuscitation (CPR) can significantly improve survival. PumpStart, a community service-learning program developed by medical students, was formed to increase education on compression-only CPR to local high school students and foster leadership and mentorship skills in participating medical students. 1-hr sessions were administered at local high schools throughout the metro—Boston area. A single semester “pilot” phase and “first-year” implementation phase were reviewed. Anonymous pre-/postassessment surveys were completed by participants. Medical students also completed surveys assessing their comfort in teaching CPR. Surveys over both pilot semester and first year phases were reviewed. Participants reported significant improvements in CPR technique and confidence in acquired skills for both the pilot semester (31% vs. 82%, p < .05) and first year implementation (33% vs. 86%, p < .05). Medical students reported significantly higher confidence levels regarding abilities to answer questions about CPR, serving as mentors, and facilitating training sessions for new medical students after participating in PumpStart ( p < .05). PumpStart was successful in providing CPR awareness to high school students, as well as the opportunity to learn about teaching and mentoring for medical students. Such a program can be easily reproduced by other health care organizations with the goal to increase opportunities for bystander CPR and improving OHCA survival rates nationally.


2020 ◽  
Author(s):  
Susmita Roy Chowdhury ◽  
Venkataraman Anantharaman

Abstract Background: Bystander cardiopulmonary resuscitation (CPR) rates remain fairly low through most communities despite multiple interventions through the years. Understanding the attitudes and fears behind CPR training and performance would help target education and training to raise the rates of bystander CPR and consequently survival rates of victims. 7909 participants at a single-day mass CPR training session in Singapore were given survey questionnaires to fill out. 6473 people submitted completed forms upon the conclusion of the training session. Some issues looked at were overall level of difficulty of CPR, difficulty levels of specific skills, attitudes towards refresher training, attitudes towards performing CPR and fears when doing so.Results: The mean level of difficulty of CPR was rated 3.98 (scale of 1-10), with those with previous CPR training rating it easier. The skills rated most difficult were performing mouth-to mouth breathing and chest compressions, while the easiest rated was recognising non-responsiveness. A majority (69.7%) would agree to go for refresher training every 2 years and 88.7% felt everyone should be trained in CPR. 71.6% would perform full CPR for a member of public in cardiac arrest and only 20.7% would prefer to only do chest-compressions. The most cited fear was a low level of confidence, and fears of acquiring infections or aversion to mouth-to-mouth breathing were low.Conclusions: The survey results show that most participants in Singapore are keen to perform conventional CPR for a member of public and can help to target future CPR training accordingly.


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