Prospective, randomized trial of the effectiveness and retention of 30-min layperson training for cardiopulmonary resuscitation and automated external defibrillators: The American Airlines Study.

OBJECTIVE A head-to-head trial was conducted to compare laypersons' long-term retention of life-saving psychomotor and cognitive skills learned in the traditional multi-hour training format for basic cardiopulmonary resuscitation and automated external defibrillator use to those learned in an abbreviated (30 min) course. METHODS Laypersons were randomized to either: (1) the traditional multi-hour Heartsaver-Automated External Defibrillator (Heartsaver-AED) group; or (2) the 30-min course group (cardiopulmonary resuscitation, choking, and automated external defibrillator use). Immediately after training, and at 6 months, participants were provided identical individual testing scenarios. In addition to audio-video recordings, computerized recordings of compression rate/depth, ventilation rates, and related pauses were obtained and subsequently rated by blinded reviewers. RESULTS Performance following 30-min training was either equivalent or superior (p<0.007) to the multi-hour Heartsaver-Automated External Defibrillator training in all measurements, both immediately and 6 months after training. Although retention of certain skills deteriorated over the 6 months among a significant number of participants from both groups, 84% of the 30-min training group still was judged, overall, to perform cardiopulmonary resuscitation adequately. Moreover, 93% still were performing chest compressions adequately and 93% continued to apply the automated external defibrillator and deliver shocks correctly. CONCLUSIONS Using innovative learning techniques, 30-min cardiopulmonary resuscitation and automated external defibrillator training is as effective as traditional multi-hour courses, even after 6 months. Thirty-minute courses should decrease labor intensity, demands on resources, and time commitments for cardiopulmonary resuscitation courses, thus facilitating more widespread and frequent retraining.

[1]  P. Wollan,et al.  Improved retention of the EMS activation component (EMSAC) in adult CPR education. , 1997, Resuscitation.

[2]  Nancy C. Zajano,et al.  The problem of poor retention of cardiopulmonary resuscitation skills may lie with the instructor, not the learner or the curriculum. , 1991, Resuscitation.

[3]  R. Brennan,et al.  Are we training the right people yet? A survey of participants in public cardiopulmonary resuscitation classes. , 1998, Resuscitation.

[4]  W. Kaye,et al.  Cardiopulmonary resuscitation performance of subjects over forty is better following half-hour video self-instruction compared to traditional four-hour classroom training. , 2000, Resuscitation.

[5]  J. Ornato,et al.  Improving survival from sudden cardiac arrest: the "chain of survival" concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. , 1991, Circulation.

[6]  A L Kellermann,et al.  Randomized, controlled trial of video self-instruction versus traditional CPR training. , 1998, Annals of emergency medicine.

[7]  G. Sternbach,et al.  Retention of cardiopulmonary resuscitation skills by medical students. , 1983, Journal of medical education.

[8]  Subcommittees.  2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. , 2005 .

[9]  A. Handley,et al.  Four-step CPR--improving skill retention. , 1998, Resuscitation.

[10]  R. Brennan,et al.  Skill mastery in public CPR classes. , 1998, The American journal of emergency medicine.

[11]  W. Kaye,et al.  CPR training without an instructor: development and evaluation of a video self-instructional system for effective performance of cardiopulmonary resuscitation. , 1997, Resuscitation.

[12]  J. Ornato,et al.  Improving survival from sudden cardiac arrest , 1991 .

[13]  Graham Nichol,et al.  Effectiveness of a 30-min CPR self-instruction program for lay responders: a controlled randomized study. , 2005, Resuscitation.

[14]  R. Wootton,et al.  Telemedicine and cardiopulmonary resuscitation: the value of video-link and telephone instruction to a mock bystander , 1999, Journal of telemedicine and telecare.

[15]  L Nyberg,et al.  Activity in motor areas while remembering action events , 2000, Neuroreport.

[16]  Shelley E. Taylor,et al.  Cardiopulmonary resuscitation skills retention in family members of cardiac patients. , 1990 .

[17]  L. Rasmussen,et al.  Laypersons may learn basic life support in 24min using a personal resuscitation manikin. , 2006, Resuscitation.

[18]  N. Mulligan,et al.  Memory of action events: the role of objects in memory of self- and other-performed tasks. , 2001, The American journal of psychology.

[19]  K. Kelly,et al.  Education in adult basic life support training programs. , 1993, Annals of emergency medicine.

[20]  A. Handley,et al.  Trials of teaching methods in basic life support (3): comparison of simulated CPR performance after first training and at 6 months, with a note on the value of re-training. , 2002, Resuscitation.

[21]  M. Hazinski,et al.  Education in resuscitation: an ILCOR symposium: Utstein Abbey: Stavanger, Norway: June 22-24, 2001. , 2003, Circulation.

[22]  Jean C. O'Connor,et al.  Simple CPR: A randomized, controlled trial of video self-instructional cardiopulmonary resuscitation training in an African American church congregation. , 1999, Annals of emergency medicine.

[23]  R. Shadmehr,et al.  Neural correlates of motor memory consolidation. , 1997, Science.