Very brief training for laypeople in hands-only cardiopulmonary resuscitation. Effect of real-time feedback

Background: Bystander cardiopulmonary resuscitation (CPR) improves survival from out-of-hospital cardiac arrest, but rates and performance quality remain low. Although training laypeople is a primary educational goal, the optimal strategy is not well defined. This study aimed to determine whether a short training with real-time feedback was able to improve hands-only CPR among untrained citizens. Methods: On the occasion of the 2015 World Heart Day and the European Restart a Heart Day, a pilot study involving 155 participants (81 laypeople, 74 health care professionals) was conducted. Participants were invited to briefly practice hands-only CPR on a manikin and were after evaluated during a 2-minute chest compression (CC) test. During training brief instructions regarding hand position, compression rate and depth according to the current guidelines were given and real-time feedback was provided by a Laerdal Skill Reporting System. Results: Mean CC rate was significantly higher among health care professionals than among laypeople (119.07 +/- 12.85 vs 113.02 +/- 13.90 min(-1); P = .006), although both met the 100-120 CC min(-1) criterion. Laypeople achieved noninferior results regarding % of CC at adequate rate (51.46% +/- 35.32% vs health care staff (55.97% +/- 36.36%; P = .43) and depth (49.88% +/- 38.58% vs 50.46% +/- 37.17%; P = .92), % of CC with full-chest recoil (92.77% +/- 17.17% vs 0.91% +/- 18.84; P = .52), and adequate hand position (96.94% +/- 14.78% vs 99.74 +/- 1.98%; P = .11). The overall quality performance was greater than 70%, noninferior for citizens (81.23% +/- 20.10%) vs health care staff (85.95% +/- 14.78%; P = .10). Conclusion: With a very brief training supported by hands-on instructor-led advice and visual feedback, naive laypeople are able to perform good-quality CC-CPR. Simple instructions, feedback, and motivation were the key elements of this strategy, which could make feasible to train big numbers of citizens. (C) 2016 Elsevier Inc. All rights reserved.