Purpose: The purpose of this study was to compare the difference in compression quality and fatigue levels in a rescuer for three different hand techniques used in cardiopulmonary resuscitation (CPR). Methods: The participants were paramedic students at the basic life support provider level. The hands-only CPR was performed for 10 minutes for each of the three hand techniques without disruption, and the quality of chest compressions and fatigue levels were analyzed. Results: There was no difference between the sexes in the chest compression quality and the physiologic parameters before and after compression. Among the quality indexes of chest compression with each of the techniques performed for 10 minutes, the mean depth (p<.01) and mean accuracy (p=.000) of the compression were found to be higher in the five finger fulcrum technique, while the mean compression rate and relaxation accuracy showed no significant differences. Regarding fatigue levels, the five finger fulcrum technique caused lesser subjective fatigue as compared to other techniques (p<.05), although the heart rate and blood pressure revealed no difference. Conclusion: The five finger fulcrum technique was found to be better than the other techniques in terms of chest compression quality and subjective levels of fatigue, indicating that it should be used in CPR education.
Purpose: This study set out to use a one-group pretest-posttest experimental design to develop a highly motivating CPR program for help care workers who lack CPR education, and to evaluate its effects on their knowledge about program application, attitude, and self-efficacy. Methods: For this purpose, 140 questionnaires were administered to subjects who underwent training at an educational institution for care workers in S city and G province. The program was developed from April, 25 to May, 15 in 2016, and the evaluation period was from May to July, 15. The collected data were analyzed through SPSS version 23, and a paired t-test was conducted. Results: The program spanned 240 minutes, including 80 minutes on theoretical education and 160 minutes on practical education. Knowledge of CPR in the post-test proved to be higher than that in the pre-test, from 6.4 to 9.2 (t=-15.72, p<.001),; the score on attitude increased from 38.4 to 41.7 (t=-5.89, p<.001),; and self-efficacy increased from 41.0 to 66.7 (t=-21.83, p<.001). Conclusion: The basic CPR education program emphasizing motivation was effective for the care worker trainees and could be used for other curriculum by expanding the scope of the subject.
Purpose: This study aimed to propose an effective one-rescuer infant cardiopulmonary resuscitation (CPR) chest compression technique by comparing the differences in efficacy, convenience, and pain levels between the two thumb-encircling and two finger techniques. Methods: Subjects were randomized to perform either two-thumb-encircling or two-finger technique for 8 minutes each on infant CPR manikins. After the chest compression, a survey was administered to the subjects to measure convenience and pain levels according to compression method. Results: Total compression depth over 8 minutes was significantly deeper for the two-thum-encircling technique ($43.5{\pm}4.8mm$) compared with the two-finger technique ($32.6{\pm}5.4mm$) (p<0.001). In terms of compression depth measured at 1-minute intervals, compression depth with the two-finger technique decreased from $38.3{\pm}4.23mm$ to $29.0{\pm}6.79mm$, whereas compression depth with the two-thumb-encircling technique did not show a significant change (from $43.7{\pm}4.12mm$ to $43.4{\pm}5mm$). The results of the survey indicated that, the majority of subjects found the two-thumb-encircling technique to be the most comfortable technique for compression depth (n=29, 64.4%). The majority of subjects (n=31, 68.9%) answered that the two-finger technique resulted in the most pain. Conclusion: Comparison of efficacy of the two-thumb-encircling and two-finger-techniques in the performance of one-rescuer infant CPR revealed that the two-thumb-encircling technique was more effective in maintaining chest compression depth.
Purpose: Advanced airway maintenance improves the quality of cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) patients. In this study, we evaluate the factors associated with advanced airway management while performing CPR for out-of-hospital cardiac arrest patients by 119 emergency medical technicians (EMTs). Methods: The observational analysis method was used ro retrospectively collect data from 119 rescue run sheets. This study was conducted in a fire station in Seoul, Korea. The subjects of this study were defined as OHCA patients who received CPR from July 2016 to June 2018. We divided the subjects into two groups according to whether advanced airway maintenance was performed or not, and then compared and analyzed both groups. We performed logistic regression analyses for characteristics that differed significantly between groups. Results: Out of 188 OHCA patients, 146 (77.7%) had received advanced airway management. Statistically significant differences in the logistic analysis were found regarding the total number of EMT professionals (adjusted odds ration [aOR]: 1.955; 95% confidence interval [CI]: 1.227-3.115; p=0.005) and scene-time (aOR:1.119;95%CI:1.019-1.228;p=0.019). Conclusion: Advanced airway maintenance while performing CPR for OHCA patients by EMT associated primarily with ensuring an adequate numbers of EMT professionals and sufficient scene time.
Purpose: Out-of-hospital traumatic cardiac arrest (TCA) often has a poor prognosis despite rescue efforts. Although the incidence and mortality of out-of-hospital cardiac arrest have increased, bystander cardiopulmonary resuscitation (CPR) has decreased in some countries during the COVID-19 pandemic. In the prehospital setting, immediate treatment of cardiac arrest is required without knowing the patient's COVID-19 status. Because COVID-19 is usually transmitted through the respiratory tract, airway management can put medical personnel at risk for infection. This study explored whether on-scene treatments involving CPR for TCA patients changed during the COVID-19 pandemic in Korea. Methods: This retrospective study used data from emergency medical services (EMS) run sheets in Gangwon Province from January 2019 to December 2021. Patients whose initial problem was cardiac arrest and who received CPR were included. Data in 2019 were classified as pre-COVID-19 and all subsequent data (from 2020 and 2021) as post-COVID-19. Age, sex, possible cause of cardiac arrest, and treatments including airway maneuvers, oropharyngeal airway (OPA) or i-gel insertion, endotracheal intubation (ETI), bag-valve mask (BVM) ventilation, intravenous (IV) line establishment, neck collar application, and wound dressing with hemostasis were investigated. Results: During the study period, 2,007 patients received CPR, of whom 596 patients had TCA and 367 had disease-origin cardiac arrest (DCA). Among the patients with TCA, 192 (32.2%) were pre-COVID-19 and 404 (67.8%) were post-COVID-19. In the TCA group, prehospital treatments did not decrease. The average frequencies were 59.7% for airway maneuvers, 47.5% for OPA, 57.4% for BVM, and 51.3% for neck collar application. The rates of ETI, i-gel insertion, and IV-line establishment increased. The treatment rate for TCA was significantly higher than that for DCA. Conclusions: Prehospital treatments by EMS workers for patients with TCA did not decrease during the COVID-19 pandemic. Instead, the rates of ETI, i-gel insertion, and IV-line establishment increased.
Objective: The purpose of this study was to apply the Basic CPR(Cardiopulmonary resuscitation) training education program and identify its effects on knowledge of Basic CPR and skills of Basic CPR in second grade high school students. Methods: The training program was conducted for 16 weeks between March 26 and July 9, 2005 using a non-equivalent control group pretest-post test design by dividing 60 students in a half for both the experimental group and the control group. General characteristics, the effect of the education were evaluated with $x^2-test$, t-test, ANCOVA, Repeated Measure ANOVA and Bonferonni with SPSS 11.0/pc. Result: After the CPR education program application, knowledge score in the experimental group increased to 20.57 right after the education from 9.32, the score measured before the training, 19.11 after 8 weeks and 18.29 after 12 weeks. On the contrary, the control group's score showed no significant before the training. According to the result of knowledge score comparison between the experimental and control group at each point in time, the experimental group had a significantly high score in knowledge at every point(p<0.001). In the effect durability for knowledge of the training education program in process time after the training program in the experimental group, the durability of effect was identified despite the elapsing time. Scores of skills for Basic CPR increased from 1.21, the score measured before the training program, to 30.07 right after the education, 23.50 after 8 weeks and 17.57 after 12 weeks in experimental group. On the contrary, the control group showed an immaterial increase. According to the result of skill score comparison between the experimental and control group at each point in time, the experimental group had a significantly high score in skill at every point(p<0.001). The score for skill increased significantly right after the education compared to the score prior to the education. Conclusions: These findings suggest that Basic CPR training education program facilitate knowledge of CPR and skill of CPR in high school students. Therefore, it would be necessary to include the Basic CPR training program in high school education curriculum. However, the effect of Basic CPR knowledge maintains for a few period, and the effect of maintaining the skill is shorter than the maintenance of knowledge so regular reeducation is considered to be needed.
Purpose: This study was undertaken to identify the association between CPR knowledge, attitude, and teacher efficacy on the performance confidence of CPR. We further investigated methods to enhance the performance ability of CPR among elementary, middle, and high school teachers. Methods: The study design was a descriptive survey conducted from October 15 to December 31, 2022, enrolling 155 elementary, middle, and high school teachers. The data were analyzed by applying Multiple regression, Pearson's correlation coefficient, one way ANOVA and Scheffé test using the SPSS/WIN 23.0 program. Results: The performance confidence of CPR among elementary, middle, and high school teachers showed a significant positive correlation with CPR knowledge (r=.49, p<.001), CPR attitude (r=.26, p<.001), and teacher efficacy (r=.25, p=.002). The factors affecting performance confidence in CPR were CPR knowledge (β=.49, p<.001), gender (β=-.26, p<.001), CPR attitude (β=.20, p=.003), health status (β=.14, p=.038), and teacher efficacy (β=.14, p=.032); these factors explained 40.5%. Conclusion: Results from the study indicate that performance confidence of CPR can be enhanced by providing frequent education on CPR knowledge and attitudes. Moreover, educational programs will aid in maintaining good health and enhance teacher efficacy.
Purpose : The purpose of this study was to provide an appropriated direction for cardiopulmonary resuscitation(CPR) education by analyzing the attitude, knowledge and self efficacy of CPR for Chinese students in Korea. Methods : The questionaries were obtained from 179 Chinese students who studied in K university at G city from Sep 24, 2012 to Oct 4, 2012. The collected data were analyzed using SPSS WIN 19.0 program. Results : About 40% of the subjects had experienced CPR training. In cardiac arrest situation, 82.6% of the respondents were willing to CPR on family members and 58.1% of the respondents were willing to CPR on strangers. They had a very low CPR knowledge level (mean 34.4 out of 100) and self efficacy (4.6 out of 10). The self-efficacy was related to CPR willingness but not to CPR knowledge. Conclusion : It is important to enhance CPR performance for layperson education in Chinese students.
Purpose: Bystander CPR has demonstrated improved survival of out-of-hospital cardiac arrest. The purpose of this study was to evaluate the effects of CPR education in the rural community. Method: One hundred eighty-nine rural laypersons (105 in the experimental group and 84 in the control group) participated in this study. In the experimental group, questionnaires were completed after participating in a small group BLS (Basic Life Support) course. In the control group questionnaires were collected from two rural health service centers. Data were analysed using $X^2$test, independent t-test and paired t-test. Result: There were significant differences in barriers to performing CPR, attitude and intention toward CPR and necessity recognition between the two groups. Conclusion: The proportion of positive attitudes toward CPR and willingness to perform CPR was higher in the experimental group than the control group. CPR education increased anxiety of being sued because of a bad outcome. For future CPR education for laypersons, the reluctance of bystanders to perform CPR should be reconsidered and CPR education should be extended to the rural community.
Objective : This study is an experimental study which is designed to examine the differences between knowledge and self-confidence before and after theory education(CPR PPT material) based on guidelines of CPR and emergency cardiac treatment of American Heart Association(AHA, 2005) and video self-instruction program for the general public by Korean Association of Cardiopulmonary Resuscitation(KACPR), trace CPR performance ability after CPR and AED education and investigate the accuracy of artificial respiration and chest compression, and know the difference in CPR performance abilities including AED. Methods : Subjects of this study include ground crews and staffs at M airport in G province equipped with emergency equipments for CPR according to Art. 47, Sec. 2 of Emergency Medical Law, airport police, rent-a-cops, security guard, quarantine officer, custom officer, and communication, electricity, civil engineering, facility management staff, airport fire fighting staff, air mechanic, traffic controller, and airport management team among airport facility management staffs. They were given explanation of necessity of research and 147 of 220 subjects who gave consent to this research but 73 who were absent from survey were excluded were used as subjects of this study. of 147 subjects, there were 102 men and 45 women. Results : 1) Knowledge score of CPR was $6.18{\pm}0.87$ before instruction and it was increased to $15.12{\pm}1.78$ after instruction, and there was statistically significant difference. 2) Self-confidence score in CPR was $3.16{\pm}0.96$ before instruction and it was increased to $7.05{\pm}0.75$ after instruction, and there was statistically significant difference. 3) Total average score in CPR performance ability after instruction was 7.46 out of 9, performance ability was highest in confirmation of response as 144(97.95%), follwed by request of help as 140(95.25%) and confirmation of respiration as 135(91.83%), and lowest in performing artificial respiration twice(gross elevation of chest) as 97(65.98%). Accuracy of artificial respiration(%) was $28.60{\pm}16.88$ and that of chest compression(%) was $73.10{\pm}22.16$. 4) Performance ability of AED after instruction showed proper performance in power on by 141(95.91%) and attaching pad by 135(91.83%), hand-off for analyzing rhythm showed 'accuracy' in 115(78.23%) and 'non-performance' in 32(21.77%), delivery of shock and hand-off confirmation showed 'accuracy' in 109(74.14%) and 'inaccuracy' in 38(25.86%), and beginning chest compression immediately after AED was done by 105(71.42%).
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