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Signa Vitae

Journal of Anaesthesia, Intensive Care and Emergency Medicine

Does basic life support training simplification foster retention of life saving maneuvers?

Abstract

Objectives. Simplification of Basic Life Support was proposed with the introduction of Chest-Compression only Cardio-Pulmonary Resuscitation (CC-CPR) as an alternative to Standard CPR (S-CPR). This study aimed to compare retention of knowledge, in the general public, of both CPR techniques (CC-CPR vs. S-CPR).

Design, setting and participants. Multicentric prospective comparative cohort study. A training program was conducted among 906 individuals who were assigned to CC-CPR or to S-CPR group. They were evaluated before training (T0), after training (T1) and six months later (T2) on 17 CPR assessment criteria, they were evaluated twice at each time period and one global CPR performance score.

Results. Initial knowledge was low. At T1, all CPR performance criteria improved significantly. Results were similar in both groups except for the rate of trainees calling for help and the time to turn on the automated external defibrillator and to deliver the first shock. At T2, the knowledge level was lower than at T1. Finally, CPR performance score was lower in both groups at T2 compared to T1 but statistically higher than at T0. CPR performance score was higher in the CC-CPR group than in the S-CPR group at T2 (p=0.041).

Conclusions. Performance score was significantly higher in the CC-CPR group. CC-CPR training seems to result in better retention and a faster reaction in the setting of an out of hospital cardiac arrest. Moreover, the retention of knowledge among a trained population fades partially with time. Regular CPR training should therefore be proposed to avoid the loss of benefit with time.

Key words: cardio-pulmonary resuscitation, basic life support, chest compression, mouth-to-mouth ventilation, training, retention

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Mechanical CPR devices

Abstract

It is recognized that the quality of cardiopulmonary resuscitation (CPR) is an important predictor of outcome from cardiac arrest. Mechanical chest-compression devices provide an alternative to manual CPR. Physiological and animal data suggest that mechanical chest-compression devices are more effective than manual CPR. Consequently, there has been much interest in the development of new techniques and devices to improve the efficacy of CPR. This review will consider the evidence and current indications for the use of some of the more common mechanical devices developed to increase the safety and efficacy of CPR administration.

Key words: cardiac arrest, chest compression, automatic mechanical devices, piston chest compression, LUCAS, vest CPR, Autpulse – load distributing band CPR, cost effectiveness, outcome, survival

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