miércoles, 9 de marzo de 2011

Brief video training dramatically boosts hands-only CPR attempts

Simply Watching a CPR Video Might Save Lives
Short message gives people confidence to help when someone has heart attack, experts say





URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_109603.html(*this news item will not be available after 06/06/2011)

Tuesday, March 8, 2011

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CPR


TUESDAY, March 8 (HealthDay News) -- A 60-second video showing what to do when someone's heart stops beating could help save lives, according to a new study that found those who viewed the demonstration were much more likely to take action than those who did not.

"Cardiac arrest is one of the leading causes of death in the United States," said Dr. Bentley Bobrow, lead author of the study, which was done in Arizona. "We were trying to figure out novel and effective ways to help the public understand what cardiac arrest is, and be willing and able to do CPR [cardiopulmonary-resuscitation]. Now you can watch a 60-second video at home, on the Internet, on your phone or while you're pumping gas."

The video could save thousands of lives, added Bobrow, an associate professor in the emergency medicine department at Maricopa Medical Center in Phoenix and director of the Arizona Department of Health Services, Bureau of Emergency Medical Services and Trauma System.

More than 300,000 cardiac arrests happen each year outside of hospitals in the United States, and fewer than 30 percent of the victims get CPR from a bystander, Bobrow said.

However, CPR given by a bystander can double or even triple the survival rates of people whose heart has stopped, according to research cited in the study. Survival rates, which vary widely from one community to another, can rage from 3 percent to 15 percent, said Dr. Michael Sayre, an associate professor of emergency medicine at Ohio State University and an American Heart Association spokesman.

"A lot of that [variation in rates] has to do with CPR," Sayre said. "People don't feel comfortable and don't know what to do. This study shows that a very short message can get people to give effective CPR."

The study, published online March 8 in Circulation: Cardiovascular Quality and Outcomes, looked at the impact of videos showing what's referred to as hands-only CPR, meaning a bystander calls 911 and then pumps the heart manually with rapid, deep chest compressions, with no mouth-to mouth breathing. The hands-only method has been shown to be just as effective as the more complex method that includes mouth-to-mouth resuscitation, according to research cited in the study.

When someone collapses, people are often hesitant to act because they lack confidence or are reluctant to perform mouth-to mouth resuscitation on a stranger. But doing nothing can be disastrous, whereas no harm can be done by an untrained layperson who tries to help, Bobrow said.

For the study, 336 participants were randomly divided into four groups: a control group that did not watch a video and three other groups that watched either a 60-second video, a five-minute video or an eight-minute video that included the opportunity to practice the skills demonstrated.

To test their skills, participants were asked to role-play what they would do if someone suddenly collapsed in their presence. A manikin programmed with software was used to gauge the rate and depth of chest compressions.

When tested two months later, fewer than 1 percent of those who had seen a video did nothing, compared with 23 percent of those who had not seen a video. Among all who intervened, those who had seen a video demonstrated significantly better skills than those who had not, the study found. The length of the video viewed did not matter, and comparable chest compression rates and depths were achieved regardless of which video the participants had seen.

Their rate and depth of chest compressions closely approximated established criteria for effective CPR, and their skills had not deteriorated after two months, the study found.

Sayre noted, however, that the study measured performance during a simulation and that it remains to be seen what would happen in a real-life scenario.

"What we don't know is how this will translate into actual emergency situations," Sayre said. "We need more information to make sure this will work, but I'm pretty confident it will."

Bobrow said the 60-second video could be used in movie theaters, at sporting events, on the Internet and "anywhere that large numbers of people gather."

Because cardiac arrest is so common, "we have to change the culture so that it is unacceptable for someone not to do CPR," he said. "Some effort at all is way better than nothing."

SOURCES: Bentley J. Bobrow, M.D., clinical associate professor, department of emergency medicine, Maricopa Medical Center, and medical director, Bureau of Emergency Medical Services and Trauma System, Arizona Department of Health Services, Phoenix; Michael Sayre, M.D., associate professor, emergency medicine, Ohio State University Medical Center, Columbus, Ohio; March 8, 2011, Circulation: Cardiovascular Quality and Outcomes, online

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Simply Watching a CPR Video Might Save Lives: MedlinePlus






Brief video training dramatically boosts hands-only CPR attempts
American Heart Association Rapid Access Journal Report


Study Highlights:

•Video training as brief as one minute led to participants being more likely to give hands-only CPR, at a rate and compression depth significantly closer to the ideal than those with no training.


DALLAS, March 8, 2011 — Study participants who viewed a brief hands-only cardiopulmonary resuscitation (CPR) video were more likely to attempt CPR, and perform better quality CPR in an emergency than participants who did not view the short videos, according to research reported in Circulation: Cardiovascular Quality and Outcomes.

Each year, almost 300,000 people suffer out-of-hospital cardiac arrests in the United States. Survival rates from these events tend to be extremely low. However, research has shown that bystander CPR can double — even triple — survival from out-of-hospital cardiac arrest.

In the United States, bystanders attempt CPR only about 26 percent of the time, according to Bentley J. Bobrow, M.D., lead author of the study and clinical associate professor in the Department of Emergency Medicine in the Maricopa Medical Center in Phoenix, Arizona and the University of Arizona Emergency Medicine Research Center.

“Chest compression-only CPR, also known as hands-only CPR, has been shown in studies to be at least as effective as standard CPR with mouth-to-mouth ventilation for adult primary cardiac arrest victims,” Bobrow said. “And because of its simplicity, hands-only CPR may be quicker and easier for lay rescuers to learn, remember and perform than conventional CPR.”

Bobrow and colleagues conducted a study of 336 adults without recent CPR training and randomized the participants into four groups:

•No training (control group of 51 participants)
•Ultra brief video (UBV): watched a 60-second video (95 participants)
•Brief video (BV): watched a five-minute video (99 participants)
•Brief video with practice (BVP): watched an eight-minute video with a practice training session using a manikin (91 participants)
They then tested the participants’ ability to perform CPR during an adult out-of-hospital cardiac arrest simulation. About half of the trained participants underwent testing immediately and half after two months. They found that nearly a quarter (23.5 percent) of the untrained group did not attempt any CPR vs. less than 1 percent (.7 percent) from all the training groups combined. Trained subjects in the immediate and delayed evaluation groups were significantly more likely to attempt CPR compared to untrained subjects.

All training groups had significantly higher median compression rates compared to the control group (62 compressions-per-minute). In the immediate testing group, the median rates of compressions-per-minute were: UBV (96), BV (95), and BVP (99.5). In the delayed testing group, the median compression rates were: UBV (94), BV (92.5) and BVP (90).

The ideal compression rate is 100 compressions per-minute, according to the American Heart Association’s 2010 Guidelines for CPR and Emergency Cardiovascular Care.

All trained groups had significantly greater median compression depth compared to the untrained group (30 mm). In the immediate testing group, the median compression depths were: UBV (41 mm), BV (42 mm) and BVP (48 mm). In the delayed testing group, the media compressions depths were: UBV (43 mm), BV (42.5) and BVP (46). The ideal compression depth is 38 mm or greater.

There were no significant differences in the median compression rate and median compression depth between participants tested immediately or tested two months later.

“This is the first controlled, randomized investigation evaluating the effectiveness of ultra-brief video training for teaching hands-only CPR to the lay public,” Bobrow said. “Given that the ultra-brief video training in our study is only 60 seconds, the CPR performance results are striking. “This finding has enormous public health implications because of the documented hesitancy of untrained rescuers to even attempt CPR and because it is known that any bystander resuscitation attempt improves outcomes compared to no CPR.”

Co-authors are: Tyler F. Vadeboncoeur, M.D.; Daniel W. Spaite, M.D.; Jerald Potts, Ph.D.; Kurt Denninghoff, M.D.; Vatsal Chikani, M.P.H.; Paula R. Brazil, M.A.; Bob Ramsey, M.A.; and Benjamin Abella, M.D., M.Phil. Author disclosures are on the manuscript.

The American Heart Association funded the study.


The American Heart Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding

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NR11 – 1036 (Circ Outcomes/Bobrow)

Additional resources:

•Hands OnlyTM CPR: http://handsonlycpr.org/.
•Hands OnlyTM CPR video demonstration: www.youtube.com/watch?v=zuJkRpJ7Fxg&feature=relmfu.
•2010 Guidelines for CPR and Emergency Cardiovascular Care: www.heart.org/cprguidelines.
Brief video training dramatically boosts hands-only CPR attempts

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