University of Washington-Harborview Center for Prehospital Emergency Care, Seattle, WA, USA.
Scand J Trauma Resusc Emerg Med. 2013 May 10;21:36. doi: 10.1186/1757-7241-21-36.
Cardiopulmonary resuscitation (CPR) improves outcomes after cardiac arrest. Much of the lay public is untrained in CPR skills. We evaluated the effectiveness of a compression-only CPR video self-instruction (VSI) with a personal manikin in the lay public.
Adults without prior CPR training in the past year or responsibility to provide medical care were randomized into one of three groups: 1) Untrained before testing, 2) 10-minute VSI in compressions-only CPR (CPR Anytime, American Heart Association, Dallas, TX), or 3) 22-minute VSI in compressions and ventilations (CPR Anytime). CPR proficiency was assessed using a sensored manikin. The primary outcome was composite skill competence of 90% during five minutes of skill demonstration. Evaluated were alternative cut-points for skill competence and individual components of CPR. 488 subjects (143 in untrained group, 202 in compressions-only group and 143 in compressions and ventilation group) were required to detect 21% competency with compressions-only versus 7% with untrained and 34% with compressions and ventilations.
Analyzable data were available for the untrained group (n = 135), compressions-only group (n = 185) and the compressions and ventilation group (n = 119). Four (3%) achieved competency in the untrained group (p-value = 0.57 versus compressions-only), nine (4.9%) in the compressions-only group, and 12 (10.1%) in the compressions and ventilations group (p-value 0.13 vs. compressions-only). The compressions-only group had a greater proportion of correct compressions (p-value = 0.028) and compressions with correct hand placement (p-value = 0.0004) compared to the untrained group.
VSI in compressions-only CPR did not achieve greater overall competency but did achieve some CPR skills better than without training.
心肺复苏（CPR）可改善心搏骤停后的预后。大多数非专业人员并未接受过 CPR 技能培训。我们评估了在非专业人员中使用仅按压式 CPR 视频自我指导（VSI）与个人模型的效果。
过去一年中未接受过 CPR 培训或无提供医疗护理责任的成年人被随机分为三组：1）测试前未经培训，2）仅接受 10 分钟的 VSI 培训（CPR Anytime，美国心脏协会，达拉斯，TX），或 3）仅接受 22 分钟的 VSI 培训（CPR Anytime），包括按压和通气。使用带传感器的模型评估 CPR 熟练度。主要结局是在五分钟技能演示中达到 90％的综合技能合格标准。评估了技能合格的替代切点和 CPR 的各个组成部分。需要 488 名受试者（未经培训组 143 名，仅按压组 202 名，按压和通气组 143 名）来检测仅按压组的 21％与未经培训组的 7％和按压和通气组的 34％的合格水平。
可分析数据可用于未经培训组（n = 135）、仅按压组（n = 185）和按压和通气组（n = 119）。未经培训组中有 4 名（3％）达到合格标准（p 值= 0.57 与仅按压组相比），仅按压组中有 9 名（4.9％），按压和通气组中有 12 名（10.1％）（p 值= 0.13 与仅按压组相比）。与未经培训组相比，仅按压组的正确按压比例更大（p 值= 0.028），正确手部放置的按压比例更大（p 值= 0.0004）。
仅按压式 CPR 的 VSI 培训并未提高整体合格率，但在某些 CPR 技能方面要好于未经培训。
