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Public CPR Training Kiosks: Good Idea for CPR?

At an American Heart Association Resuscitation Science symposium in November 2013, a research team from the University of Arizona presented their findings on a short study they conducted at the Dallas / Fort Worth International Airport.

In the study, they set up an AHA CPR training kiosk offering fast, one-minute training sessions in hands-only CPR. The kiosk played a short video offering instructions, and then a 30-second test that evaluated test-takers on the rate and depth of their compressions as well as hand placement.

During the study, approximately 50 participants were given the training, while another 50 were not. None of the participants had undergone previous CPR training.  Later, all participants were given the chance to deliver emergency CPR to a dummy in a simulation of a sudden cardiac arrest. The results showed that the participants who received training reacted faster in calling 911, providing chest compressions, and had better technique in delivering CPR.
 

Significance of the Findings

The findings of this study are important, because for years the healthcare sector has been aware that bystander CPR is often the cardiac arrest victim’s only chance for survival.

According to the American Heart Association:

  • Approximately 383,000 cardiac arrests happen every year in the United States.
  • More than 88% of cardiac arrests happen in the home—not in a hospital or healthcare facility.
  • When sudden cardiac arrest occurs, a fast response is vital—brain death can occur after as little as four minutes.
  • However, the average emergency response time throughout the country is approximately eight to twelve minutes.

This is why bystander CPR is so crucial to the survival of cardiac arrest victims. Four out of five cardiac arrests occur in the home—that’s hundreds of thousands each year. Only approximately 32% of these victims receive CPR from a bystander, and only about 2% receive treatment with an AED. As a result only about 8% of people who experience cardiac arrest outside of a hospital survive.

The American Heart Association has conducted studies demonstrating the willingness of the general public to perform CPR in an emergency situation. Unfortunately, as many as 70% of people surveyed have said that they would feel uncomfortable administering CPR—and one of the key reasons involves a lack of training or a lack of confidence in their skills.

The answer seems obvious—more people need to learn CPR and feel confident in their skills, so that more cardiac arrest victims outside of the hospital can receive lifesaving treatment before the emergency response team arrives. But people are busy—and it can be challenging to fit CPR training into an already hectic life. It’s possible that the perception of CPR classes being difficult and time-consuming keeps many people out of the classroom.

But, clearly, CPR training does not have to be time-consuming. The University of Arizona study shows that just one minute of training outside of a classroom can give people the skills and confidence they need to respond in an emergency situation.

Can these results be repeated on a larger scale? It’s not clear yet—but the positive results of the smaller study bode well for a wider application in the future.
 

What Is Hands-Only CPR?

In the study, participants were taught only hands-only CPR—not CPR with rescue breaths. The training they received only had two steps:

    1. Call 911.

    2.Push hard and fast in the center of the chest.

The study’s designers hoped that the simplicity of the training would make it easier for participants to remember and use the skills, and this seems to be the result.

Hands-only CPR was endorsed by the American Heart Association as a simpler method of CPR training that should work for bystanders in many situations. It has been shown to be as effective as mouth-to-mouth CPR in most situations. It has also been demonstrated that bystanders are more likely to use it in emergency situations—making it a more accessible tool for saving lives.

There are several reasons why bystanders might be more likely to use hands-on CPR than the traditional mouth-to-mouth version. One is that, even for people who have been trained in mouth-to-mouth CPR, this process can be difficult to remember—especially if it has been a while since the last training session. Remembering the timing of breaths to compressions can be a challenge for those who do not use the skills every day.

In addition, there is a significant “ick” factor in delivering mouth-to-mouth CPR for some bystanders. Some people are rightly concerned about the possibility of catching a communicable disease from a victim of cardiac arrest, and this could slow down their response to give CPR in an emergency situation—or make them reluctant to provide it entirely.

In most cases, hands-only CPR is invariably better than no CPR—even in cases where mouth-to-mouth would be more effective. However, there are instances when mouth-to-mouth CPR is recommended over the hands-on method. These include:

  • When the victim is an infant or child.
  • When the victim is suffering from breathing problems.
  • In instances of drowning.

Experts also recommend that mouth-to-mouth CPR be used rather than the hands-on method in rural or more isolated areas, when emergency response services are more likely to take a long time to arrive. However, even in these circumstances, hands-only CPR is better than none.

The University of Arizona study sought to make the CPR training they provided as easy, fast, and simple as possible—to show what impact the most minimal amount of training could still provide. The results were encouraging. Those who received the training were demonstrated to be more confident in their skills—and more willing to provide CPR in an emergency situation. They were also shown to have better technique overall than the control group that did not receive training. It’s possible that this study will result in CPR kiosks offering fast, one-minute training in other high-traffic areas throughout the country—and, possibly, a measurable decrease in the deaths of victims of cardiac arrest outside the hospital.


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