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 Few Americans are trained in cardiopulmonary resuscitation, or CPR,
and many people who do learn how to do this don't practice or take
refresher courses over the years to keep their skills fresh.
Improving CPR training might help people retain these lessons longer
and increase the long odds that cardiac arrest patients survive long
enough to leave a hospital.
"The delivery of high quality CPR is one of the most critical
components to improve survival from cardiac arrest," said Dr. Adam
Cheng, lead author of new CPR training recommendations from the
American Heart Association (AHA).
Cardiac arrest involves the abrupt loss of heart function, breathing
and consciousness. Unlike a heart attack, which happens when blood
flow to a portion of the heart is blocked, cardiac arrest occurs
when the heart's electrical system malfunctions, disrupting the
heart's rhythm or halting it altogether. Cardiac arrest may occur
with no warning and is often fatal.
Chest compressions or CPR can help restore circulation, increasing
the odds of survival. Bystander CPR generally won't restore a normal
heart rhythm, but it can buy time by maintaining blood flow to vital
organs.
"We need to do a better job of communicating the importance of high
quality CPR, and working with policy makers to ensure CPR training
becomes a mandatory part of school curriculum as kids are growing
up," Cheng, of the University of Calgary in Canada, said by email.
With new recommendations for CPR training, the AHA is striving to
double survival rates from cardiac arrest to 38 percent when the
arrest happens in a hospital and to 15.8 percent when it happens
outside a hospital by 2020. They're also trying to double the
proportion of cases when bystanders perform CPR until an ambulance
arrives to 62 percent by 2020.
The AHA argues that learners should get shorter, more frequent
practice instruction sessions to help them retain knowledge, receive
regular structured feedback, and training experiences tied to real
world situations.
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Beyond this, faculty coaching is key, and instruction might benefit
from gamification, social and digital media to help learners retain
what they're taught, according to the guidelines published in
Circulation.
Among other things, the guidelines stress that CPR learners should
practice until they demonstrate mastery of skills, and be assessed
using a variety of tools throughout their CPR course to make sure
they're grasping the material.
Instructors should also get continuous coaching and training to make
sure they're using the latest and most effective tools available to
reach students.
The new CPR training approach should be used for all types of
learners, whether they're medical professionals or high school
students or people in the community.
Doctors, nurses and other health professionals might benefit from
better feedback in CPR training because clinicians often
overestimate how well they have mastered new skills, said Dr. Lorrel
Brown of the University of Louisville School of Medicine, who
directs the CPR advocacy group Alive in 5 (www.alivein5.org).
For a layperson, however, the main issue with CPR training is that
it's too expensive to justify the cost when they don't need to know
CPR for work, Brown said by email.
"Of course, there is more research to be done on improving survival
following cardiac arrest, preventing cardiac arrest in the first
place, and early recognition of victims so they get help quickly,"
Brown said. "However, the low-hanging fruit in the field is simply
getting more victims to have higher quality CPR - that is the single
most modifiable factor influencing survival."
SOURCE: http://bit.ly/2Ldszua Circulation, online June 21, 2018.
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