Abstract
Aim
Early basic life support is crucial to enhance survival from out-of-hospital cardiac
arrest but rates remain low, especially in households. High-risk groups’ training
has been advocated, but the optimal method is unclear. The CArdiac REhabilitation
and BAsic life Support (CAREBAS) project aims to compare the effectiveness of two
basic life support educational strategies implemented in a cardiac rehabilitation
program.
Methods
A community intervention study including consecutive patients enrolled on an exercise-based
cardiac rehabilitation program after acute coronary syndrome or revascularization
was conducted. A standard basic life support training (G-Stan) and a novel approach
integrating cardiopulmonary resuscitation hands-on rolling refreshers (G-CPR) were
randomly assigned to each group and compared. Basic life support performance was assessed
by means of simulation at baseline, following brief instruction and after the 2-month
program.
Results
114 participants were included and 108 completed the final evaluation (G-Stan:58,
G-CPR:50). Basic life support performance was equally poor at baseline and significantly
improved following a brief instruction. A better skill retention was found after the
2-month program in G-CPR, significantly superior for safety and sending for an automated
external defibrillator. Confidence and self-perceived preparation were also significantly
greater in G-CPR after the program.
Conclusions
Integrating cardiopulmonary resuscitation hands-on rolling refreshers in the training
of an exercise-based cardiac rehabilitation program is feasible and improves patients’
skill retention and confidence to perform a basic life support sequence, compared
to conventional training. Exporting this formula to other programs may result in increased
numbers of trained citizens, enhanced social awareness and bystander resuscitation.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ResuscitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Bystander efforts and 1-Year outcomes in out-of-hospital cardiac arrest.N Engl J Med. 2017; 376: 1737-1747
- Association of bystander and first-responder intervention with survival after out-of-hospital cardiac arrest in North Carolina, 2010–2013.JAMA. 2015; 314: 255-264
- Early cardiopulmonary resuscitation in out-of-hospital cardiac arrest.N Engl J Med. 2015; 372: 2307-2315
- Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis.Circ Cardiovasc Qual Outcomes. 2010; 3: 63-81
- EuReCa ONE—27 Nations, ONE Europe, ONE Registry.Resuscitation. 2016; 105: 188-195
- European resuscitation council guidelines for resuscitation 2015. Section 2. Adult basic life support and automated external defibrillation.Resuscitation. 2015; 95: 81-99
- Characteristics and outcome among patients having out of hospital cardiac arrest at home compared with elsewhere.Heart Br Card Soc. 2002; 88: 579-582
- Do dispatcher instructions facilitate bystander-initiated cardiopulmonary resuscitation and improve outcomes in patients with out-of-hospital cardiac arrest? A comparison of family and non-family bystanders.Resuscitation. 2014; 85: 315-319
- The spectrum of epidemiology underlying sudden cardiac death.Circ Res. 2015; 116: 1887-1906
- Heart disease and stroke statistics—2016 update: a report from the American Heart Association.Circulation. 2016; 133: e38-360
- ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC) Endorsed by: association for European Paediatric and Congenital Cardiology (AEPC).Eur Heart J. 2015; 36: 2793-2867
- European resuscitation council guidelines for resuscitation 2015. Section 10. Education and implementation of resuscitation.Resuscitation. 2015; 95: 288-301
- Exercise-based cardiac rehabilitation for coronary heart disease.J Am Coll Cardiol. 2016; 67: 1-12
- Incorporating cardiopulmonary resuscitation training into a cardiac rehabilitation programme: a feasibility study.Eur J Cardiovasc Nurs. 2018; 17: 148-158
- “Rolling Refreshers”: a novel approach to maintain CPR psychomotor skill competence.Resuscitation. 2009; 80: 909-912
- “Booster” training: evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest.Pediatr Crit Care Med J Soc Crit Care Med World Fed Pediatr Intensive Crit Care Soc. 2011; 12: e116-e121
- Low-dose, high-frequency CPR training improves skill retention of in-hospital pediatric providers.Pediatrics. 2011; 128: e145-e151
- Improved retention of chest compression psychomotor skills with brief “Rolling Refresher” training.J Soc Simul Healthc. 2017; 12: 213-219
- Recommendations in dispatcher-assisted bystander resuscitation from emergency call center.Med Intensiva Engl Ed. 2015; 39: 298-302
- Are we training the right people yet? A survey of participants in public cardiopulmonary resuscitation classes.Resuscitation. 1998; 37: 21-25
- Barriers and facilitators to CPR training and performing CPR in an older population most likely to witness cardiac arrest: a national survey.Resuscitation. 2013; 84: 1747-1752
- Cardiac arrest in private locations: different strategies are needed to improve outcome.Resuscitation. 2003; 58: 171-176
- Video-only cardiopulmonary resuscitation education for high-risk families before hospital discharge: a multicenter pragmatic trial.Circ Cardiovasc Qual Outcomes. 2016; 9: 740-748
- Cardiopulmonary resuscitation training for family members of patients on cardiac rehabilitation programmes in Scotland.Resuscitation. 1999; 40: 11-19
- A systematic review of basic life support training targeted to family members of high-risk cardiac patients.Resuscitation. 2016; 105: 70-78
- The effect of cardiopulmonary resuscitation training on psychological variables of cardiac rehabilitation patients.Resuscitation. 2006; 71: 89-96
- Comparing the effect of self-instruction with that of traditional instruction in basic life support courses—a systematic review.Resuscitation. 2016; 108: 8-19
- Self-motivated learning with gamification improves infant CPR performance, a randomised controlled trial.BMJ Simul Technol Enhanc Learn. 2015; 1: 71-76
- Basic life support skills of high school students before and after cardiopulmonary resuscitation training: a longitudinal investigation.Scand J Trauma Resusc Emerg Med. 2012; 20: 31
- Retention of first aid and basic life support skills in undergraduate medical students.Med Educ Online. 2014; 19: 24841
- A pilot study of flipped cardiopulmonary resuscitation training: which items can be self-trained?.Health Educ J. 2017; 76: 946-955
- Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the cardiac rehabilitation section of the European Association of Cardiovascular Prevention and Rehabilitation.Eur Heart J. 2010; 31: 1967-1974
- Can first aid training encourage individuals’ propensity to act in an emergency situation? A pilot study.Emerg Med J. 2014; 31: 518-520
Article info
Publication history
Published online: March 12, 2018
Accepted:
March 10,
2018
Received in revised form:
January 12,
2018
Received:
September 27,
2017
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at https://doi.org/10.1016/j.resuscitation.2018.03.018.
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
