• Artificial intelligence (AI)
• Cardiac arrest
• Cardiopulmonary resuscitation (CPR)
• Healthcare integration
• Machine learning (ML)
• Reinforcement learning (RL)

• Natural Sciences and Engineering Research Council of Canada
• Khalifa University, SFU Grant

• Airway management
• Cardiopulmonary resuscitation
• Emergency Medical Technicians
• Emergency medical services
• Heart arrest
• Intubation, intratracheal

• Advanced Cardiac Life Support
• cardiopulmonary resuscitation
• passive oxygenation
• pharyngeal oxygen delivery device
• supraglottic airway

• Cardiopulmonary Resuscitation/instrumentation
• Cardiopulmonary Resuscitation/methods
• Manikins
• Humans
• Oxygen/administration & dosage
• Oxygen Inhalation Therapy/instrumentation
• Pharynx
• Heart Arrest/therapy
• Masks
• Equipment Design

• Advanced Life Support
• emergency medical services
• naloxone
• opioid associated out-of-hospital cardiac arrest
• out-of-hospital cardiac arrest

• Humans
• Naloxone/therapeutic use
• Out-of-Hospital Cardiac Arrest/drug therapy
• Male
• Female
• Middle Aged
• Emergency Medical Services/methods
• Emergency Medical Services/statistics & numerical data
• Narcotic Antagonists/therapeutic use
• Aged
• Opiate Overdose/drug therapy
• Prevalence
• Adult
• Logistic Models
• Drug Overdose/drug therapy

• Cost-effectiveness
• automatic external defibrillator
• cost-utility
• economic evaluation
• out-of-hospital cardiac arrest

• Editorials
• cardiopulmonary resuscitation
• quality improvement
• respiration
• unconsciousness

• Humans
• Out-of-Hospital Cardiac Arrest
• Sweden
• Cardiopulmonary Resuscitation

• cardiopulmonary resuscitation
• heart arrest
• mouth breathing
• out-of-hospital cardiac arrest
• resuscitation

• Adolescent
• Adult
• Humans
• Cardiopulmonary Resuscitation/methods
• Emergency Medical Services/methods
• Out-of-Hospital Cardiac Arrest/diagnosis
• Out-of-Hospital Cardiac Arrest/therapy
• Pilot Projects
• Sweden

• CPR pillow
• Cardiopulmonary resuscitation
• Hands-only CPR
• Mannequin

• Neurological outcomes
• Out-of-hospital cardiac arrest
• Population-based study
• Secular changes in the care and outcomes

• Humans
• Female
• Aged
• Male
• Out-of-Hospital Cardiac Arrest/epidemiology
• Out-of-Hospital Cardiac Arrest/therapy
• Japan/epidemiology
• Cardiopulmonary Resuscitation/methods
• Incidence
• Odds Ratio

• automated external defibrillator
• barrier
• cardiopulmonary resuscitation
• community willingness
• factor

• Child, Preschool
• Humans
• Male
• Cardiopulmonary Resuscitation
• Databases, Factual
• Educational Status
• Emergency Medical Services
• Out-of-Hospital Cardiac Arrest/therapy

• National University of Malaysia (UKM)

• Automatic external defibrillator
• Cardiac arrest
• Cardiopulmonary resuscitation
• Out of hospital cardiac arrest
• Pre-arrival care

• Cardiac Arrest
• Drowning
• International Liaison Committee on Resuscitation
• Resuscitation

• drones
• emergency medical service
• face to face teaching
• medical and healthcare
• out of hospital cardiac arrest
• rural area
• simulation in medical education
• simulation medicine
• simulation trainer
• virtual learning environment

• Compression-only resuscitation
• Defibrillation
• Number needed to treat
• Out-of-hospital cardiac arrests

• cardiopulmonary resuscitation
• extended reality
• systematic review
• virtual reality

• Humans
• Adult
• Cardiopulmonary Resuscitation/methods
• Systematic Reviews as Topic
• Learning
• Virtual Reality
• Defibrillators

• cardiopulmonary resuscitation
• cpr
• cpr attitude
• cpr knowledge
• cpr perceptions
• medical school
• non-medical staff

• health care
• medical research

• CPR
• Cardiac arrest
• Emergency communication
• Emergency medical dispatch
• Emergency medical services

• Cardiopulmonary Resuscitation/methods
• Communication
• Emergency Medical Dispatcher
• Emergency Medical Service Communication Systems
• Emergency Medical Services
• Humans
• Out-of-Hospital Cardiac Arrest/therapy
• Retrospective Studies

• T32 HS000078 AHRQ HHS

It has been proved that bystander cardiopulmonary resuscitation (CPR) saves lives and it is important to rise the willingness of the general population to help cardiac arrest victims. The primary objective of the present study is to assess the levels of the knowledge and attitude toward CPR among the young population who underwent the largest CPR training session in an official attempt to enter the Guinness Book of Records.

Through a cross-sectional design, the study had 2,528 subjects, who met the inclusion and exclusion criteria during the largest CPR training session at the King Abdul-Aziz Sports City Stadium, Makkah city, Saudi Arabia.

Descriptive statistics showed that two-thirds (72%) of the subjects were in the age category of less than 20 years. At least 50% of the subjects had a Bachelor’s degree. Overall, the findings of this study suggested a good level of knowledge and attitude against CPR and this is might be attributed to certain factors which are mainly the high level of education, age, and gender factors (P value < 0.05).

Our findings support the need for proper and high-quality training for each member in the community about CPR as well as using social media and online training to highlight the importance of CPR among the young population.

• bystander CPR
• cardiac arrest
• child
• compression-only CPR
• out-of-hospital cardiac arrest
• pediatric

• Asphyxia
• Cardiac arrest
• Etiology
• Global ischemia
• Hypoxia-ischemia
• Sudden cardiac death
• Ventricular fibrillation

Compressions given during cardiopulmonary resuscitation generate small, ineffective passive ventilations through oscillating waves. Positive end-expiratory pressure increases the volume of these passive ventilations; however, its effect on passive ventilation is unknown. Our objective was to determine if increasing positive end-expiratory pressure during cardiopulmonary resuscitation increases passive ventilation generated by compressions to a clinically significant point. This study was conducted on 13 Landrace-Yorkshire pigs. After inducing cardiac arrest with bupivacaine, cardiopulmonary resuscitation was performed with a LUCAS 3.1. During cardiopulmonary resuscitation, pigs were ventilated at a positive end-expiratory pressure of 0, 5, 10, 15, 20 cmH₂O (randomly determined) for 9 min. Using the NM3 respiratory monitoring device, expired minute ventilation and volumetric capnography were measured. Arterial blood gas was obtained for each positive end-expiratory pressure level to compare the effects of positive end-expiratory pressure on carbon dioxide.

Increasing positive end-expiratory pressure from 0 to 20 cmH₂O increased the mean (SEM) expired minute ventilation from 6.33 (0.04) to 7.33 (0.04) mL/min. With the 5-cmH₂O incremental increases in positive end-expiratory pressure from 0 to 20 cmH₂O, volumetric capnography increased from a mean (SEM) of 94.19 (0.78) to 115.18 (0.8) mL/min, except for 15 cmH₂O, which showed greater carbon dioxide exhalation with volumetric capnography compared with 20 cmH₂O. PCO₂ declined significantly as positive end-expiratory pressure was increased from 0 to 20 cmH₂O.

When increasing positive end-expiratory pressure from 0 to 20, the contribution to overall ventilation from gas oscillations generated by the compressions became more significant, and may even lead to hypocapnia, especially when using positive end-expiratory pressures between 15 and 20.

• Cardiac arrest
• Compressions
• Resuscitation
• Tidal volume
• Ventilation

• cardiac arrest
• cardiology
• emergency medicine
• sudden death

To investigate the structural validity and internal consistency of a cardiopulmonary resuscitation attitudes questionnaire among Allied Health Professions (AHP) university students.

Structural validity of a 17-item questionnaire was tested using principal component analysis. A group of AHP university students completed the questionnaire. Internal consistency of the questionnaire was measured by Cronbach’s α.

A total of 856 AHP students completed the questionnaire (mean age= 20.8 (±1.1) years, 74.0% were females). The analysis reduced a 17-item questionnaire to an 11-item questionnaire. The final questionnaire had three distinct factors; (1) attitudes towards mouth-to-mouth ventilation (MMV), (2) attitudes towards chest compressions (CC), and (3) the importance of cardiopulmonary resuscitation (CPR). It had factor loadings ranging from 0.629 to 0.878 and could explain 66% of the variance in the attitude. The questionnaire had acceptable internal consistency (Cronbach α=0.83; 95% CI=81.5) and was feasible with no floor or ceiling effect.

The 11-item CPR attitude questionnaire had acceptable structural validity and internal consistency and good parsimony and unidimensionality. The questionnaire can be used to measure the university students’ attitude and assess the effectiveness of CPR training activities. Future studies are required to measure the responsiveness and applicability to other cohorts.

• allied health professions
• attitude
• cardiopulmonary resuscitation
• questionnaire psychometric properties

• AHA Scientific Statements
• analgesics, opioid
• heart arrest
• naloxone
• out-of-hospital cardiac arrest
• pharmacoepidemiology
• public policy
• resuscitation

• American Heart Association
• Analgesics, Opioid/adverse effects
• Emergency Medical Services/standards
• Humans
• Out-of-Hospital Cardiac Arrest/chemically induced
• Risk Factors
• United States

• Acute heart failure
• Acute myocardial infarction
• Cardiac arrest
• Cardiogenic shock
• Female
• Sex differences
• Spontaneous coronary artery dissection
• Takotsubo cardiomyopathy

• Cardiopulmonary resuscitation
• Emergency medical dispatch
• Out-of-hospital cardiac arrest
• Videoconferencing

• Community Health
• health education

• Cardiopulmonary Resuscitation
• Cross-Sectional Studies
• Female
• Humans
• Intention
• Male
• Students
• Surveys and Questionnaires
• Universities

• Lay rescuers
• Out-of-hospital cardiac arrest
• Scoping review
• Willingness to perform CPR

• basic life support
• cardiopulmonary resuscitation
• chest compression-only
• mouth-to-mouth resuscitation
• out-of-hospital cardiac arrest

Up to 70% of out-of-hospital cardiac arrests are witnessed by family members, friends, and other bystanders. These bystanders can play a vital role in delivering help, before professional help arrives. Mandatory nationwide training of schoolchildren has shown the highest impact in improving the bystander cardiopulmonary resuscitation (CPR) rate. In our study, we compared the competency of different classes of schoolchildren from middle school onward in learning hands-only CPR.

This study was conducted in four schools. Schoolchildren were divided into three groups as middle school (6^th to 8^th standard) (MS), secondary school (9^th and 10^th standard) (SC), and senior secondary school (11^th and 12^th standard) (SN). Training module consisted of slide presentation on “hands-only CPR” of 1 h, video demonstration of 30 min, and hands-on session of 2.5 h. Students were then individually assessed for the skills.

A total of 810 children were enrolled and trained. Initial approach was performed correctly by 68% of MS, 79.3% of SC, and 82.4% of SN school children, whereas 49.4% of MS, 61.3% of SC, and 72.5% of SN correctly performed chest compression in terms of rate, depth, and duration. Median compression depth and maximum duration of CPR achieved were significantly different across class groups (P < 0.001) Compression depth and duration of chest compression were positively correlated with children's age, height, weight, and body mass index (P < 0.001).

Theoretical training on hands-only CPR can be started at the middle school level, and practical training can be incorporated in school curricula from secondary school.

• Cardiopulmonary resuscitation
• bystander
• children
• school

To determine if 5-minute compression-only cardiopulmonary resuscitation (CCO-CPR) instruction is as effective as 30-minute instruction in improving participant knowledge and comfort with performing CCO-CPR as well as teaching CPR quality and responsiveness to an Out of Hospital Cardiac Arrest (OHCA).

A prospective randomized controlled trial of university undergraduates was performed. Participants were randomized to either a 5-minute (experimental) or 30-minute (control) CCO-CPR instruction class. Pre- and post-testing was performed with a written and simulation test. Measurements collected assessed rate and depth of compressions, time to call 911, and time to start chest compressions. Prior to instruction, subjects’ baseline measurements of CPR performance were evaluated during a standardized sudden death scenario using a Laerdal Skillreporter^TM mannequin. The written test and scenario were repeated after either the five or 30 ​minute CCO-CPR instruction using the same outcome measures. Statistical tests of association for categorical variables were assessed using the chi-square test and the independent samples t-test was utilized for continuous variables. All tests were two-sided and the level of significance was set at α ​= ​0.05.

Among the 59 participants, 28 received 5 ​minutes of instruction and 31 received 30 ​minutes. Fifteen (25.4%) individuals reported prior CPR training. Post intervention, all measurements reached statistically significant improvements in each group but there was no difference between the two groups improvement in depth of compressions (experimental group: 41.8 ​mm, 95% CI 36.6–43.4 vs control group: 46.5 ​mm, 95% CI 40.9–48.3, p ​= ​0.06), compressions per minute (114.3 cpm, 95% CI 105.5–122.0 vs 121.1 cpm, 95% CI 115.1–131.4, p ​= ​0.10), time to starting chest compressions (13.5 vs 12.4 ​sec, p ​= ​0.45), or time to calling 911 (8.34 vs 7.65 ​sec, p ​= ​0.58). Further, there was a statistically significant improvement in participants that said they would probably or definitely perform CCO-CPR in real life after both interventions but no difference between the groups (100% of the experimental group and 93.5% of the control group p ​< ​0.49).

Five-minute instruction is not inferior to 30-minute instruction at teaching undergraduate students how to perform quality bystander CCO-CPR.

• Cardiopulmonary Resuscitation/methods
• Cardiopulmonary Resuscitation/statistics & numerical data
• Community Participation/methods
• Community Participation/statistics & numerical data
• Humans
• Out-of-Hospital Cardiac Arrest/therapy

Introduction

One purpose of the hands-only cardiopulmonary resuscitation (HOCPR) program is to simplify CPR instruction to encourage more bystanders to take action during cardiac arrest. Although the program has been successfully implemented in traditional classroom settings, the utility of large-scale training events has not been well-explored. We hypothesized that CPR knowledge and comfort levels would increase through a large-scale, multi-community HOCPR training event. We also explored what effect this training event had on perceived barriers to bystander-performed CPR.

Methods

A convenience sample participated in HOCPR training on a single day across 10 Texas cities. A sub-sample completed training questionnaires, including a five-item CPR pre- and post-test. A follow-up questionnaire was conducted two years after the event. The primary outcome of interest was the difference in cardiopulmonary resuscitation (CPR) knowledge and comfort level between pre- and post-event questionnaires. Demographic contributions were also assessed.

Results

A total of 4,253 participants were trained, 1,416 were enrolled upon submitting matching pre- and post-event questionnaires, and 101 (14%) submitted follow-up questionnaires. Mean knowledge scores increased from pre-training (2.7 ± 1.6 standard deviation (SD)) to post-training (4.7 ± 0.76 SD) (p < 0.001). Follow-up test scores (3.8 ± 1.1 SD) remained higher than pre-test scores (p < 0.001). Comfort with HOCPR increased from 59% (95% confidence interval (CI) 56 - 61) to 96% (95% CI 95 - 97). Pre- and post-knowledge scores differed significantly by education level (p < 0.001), ethnicity (p < 0.001), and income (p < 0.001). Education contributed significantly to comfort at both pre- (p = 0.015) and post-training (p = 0.026), but ethnicity and income did not. Before training, the most common barrier to performing CPR was lack of knowledge 59% (95% CI 55 - 62); after training, the most common barrier was fear of causing harm 34% (95% CI 29 - 40).

Conclusions

This study demonstrated that medical students were successfully able to conduct large-scale HOCPR training that improved CPR knowledge and comfort levels among participants across multiple metropolitan areas. Knowledge retention remained higher at two-years for participants of a follow-up questionnaire. Medical students can use the experiences from this training event as a template to organize similar large-scale training events in the future.

• cardiopulmonary resuscitation
• community participation
• education
• medical students

• cardiopulmonary resuscitation
• emergency medical technician
• minute ventilation
• out‐of‐hospital
• out‐of‐hospital cardiac arrest
• paramedic
• prehospital
• respiration
• respiratory rate
• tidal volume
• ventilation
• ventilation rate

• Cardiac arrest
• Cardiopulmonary resuscitation
• Education
• Families
• Mobile application

• Epidemiology
• Out-of-hospital cardiac arrest
• Registry
• Resuscitation
• Utstein template

• bystander CPR
• cardiopulmonary resuscitation
• drowning
• outcome

Little is known about whether cardiopulmonary resuscitation (CPR) training can increase bystander CPR in the community or the appropriate target number of CPR trainings. Herein, we aimed to demonstrate community‐wide aggressive dissemination of CPR training and evaluate temporal trends in bystander CPR.

We provided CPR training (45‐minute chest compression–only CPR plus automated external defibrillator use training or the conventional CPR training), targeting 16% of residents. All emergency medical service–treated out‐of‐hospital cardiac arrests of medical origin were included. Data on patients experiencing out‐of‐hospital cardiac arrest and bystander CPR quality were prospectively collected from September 2010 to December 2015. The primary outcome was the proportion of high‐quality bystander CPR. During the study period, 57 173 residents (14.7%) completed the chest compression–only CPR training and 32 423 (8.3%) completed conventional CPR training. The proportion of bystander CPR performed did not change (from 43.3% in 2010 to 42.0% in 2015; P for trend=0.915), but the proportion of high‐quality bystander CPR delivery increased from 11.7% in 2010 to 20.7% in 2015 (P for trend=0.015). The 1‐year increment was associated with high‐quality bystander CPR (adjusted odds ratio, 1.461; 95% CI, 1.055–2.024). Bystanders who previously experienced CPR training were 3.432 times (95% CI, 1.170–10.071) more likely to perform high‐quality CPR than those who did not.

We trained 23.0% of the residents in the medium‐sized city of Osaka, Japan, and demonstrated that the proportion of high‐quality CPR performed on the scene increased gradually, whereas that of bystander CPR delivered overall remained stable.

• bystander cardiopulmonary resuscitation
• cardiac arrest
• cardiopulmonary resuscitation
• chest compression
• education

• CPR
• compressions
• life-saving
• ski hill
• toboggan