title: Continuous chest compression cardiopulmonary resuscitation training promotes rescuer self-confidence and increased secondary training: a hospital-based randomized controlled trial*.
abstract: OBJECTIVE
  Recent work suggests that delivery of continuous chest compression cardiopulmonary resuscitation is an acceptable layperson resuscitation strategy, although little is known about layperson preferences for training in continuous chest compression cardiopulmonary resuscitation. We hypothesized that continuous chest compression cardiopulmonary resuscitation education would lead to greater trainee confidence and would encourage wider dissemination of cardiopulmonary resuscitation skills compared to standard cardiopulmonary resuscitation training (30 compressions: two breaths).
  
  
  METHODS
  Prospective, multicenter randomized study.
  
  
  METHODS
  Three academic medical center inpatient wards.
  
  
  METHODS
  Adult family members or friends (≥ 18 yrs old) of inpatients admitted with cardiac-related diagnoses.
  
  
  METHODS
  In a multicenter randomized trial, family members of hospitalized patients were trained via the educational method of video self-instruction. Subjects were randomized to continuous chest compression cardiopulmonary resuscitation or standard cardiopulmonary resuscitation educational modes.
  
  
  METHODS
  Cardiopulmonary resuscitation performance data were collected using a cardiopulmonary resuscitation skill-reporting manikin. Trainee perspectives and secondary training rates were assessed through mixed qualitative and quantitative survey instruments.
  
  
  RESULTS
  Chest compression performance was similar in both groups. The trainees in the continuous chest compression cardiopulmonary resuscitation group were significantly more likely to express a desire to share their training kit with others (152 of 207 [73%] vs. 133 of 199 [67%], p = .03). Subjects were contacted 1 month after initial enrollment to assess actual sharing, or "secondary training." Kits were shared with 2.0 ± 3.4 additional family members in the continuous chest compression cardiopulmonary resuscitation group vs. 1.2 ± 2.2 in the standard cardiopulmonary resuscitation group (p = .03). As a secondary result, trainees in the continuous chest compression cardiopulmonary resuscitation group were more likely to rate themselves "very comfortable" with the idea of using cardiopulmonary resuscitation skills in actual events than the standard cardiopulmonary resuscitation trainees (71 of 207 [34%] vs. 57 of 199 [28%], p = .08).
  
  
  CONCLUSIONS
  Continuous chest compression cardiopulmonary resuscitation education resulted in a statistically significant increase in secondary training. This work suggests that implementation of video self-instruction training programs using continuous chest compression cardiopulmonary resuscitation may confer broader dissemination of life-saving skills and may promote rescuer comfort with newly acquired cardiopulmonary resuscitation knowledge.
  
  
  BACKGROUND
  URL: http://clinicaltrials.gov. Unique identifier: NCT01260441.
authors.affiliation: Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Audrey L
authors.initials: AL
authors.lastname: Blewer
authors.forename: Marion
authors.initials: M
authors.lastname: Leary
authors.forename: Emily C
authors.initials: EC
authors.lastname: Esposito
authors.forename: Mariana
authors.initials: M
authors.lastname: Gonzalez
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
authors.forename: Bentley J
authors.initials: BJ
authors.lastname: Bobrow
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Abella
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000379:methods*; D004493:Education / Q000379:methods; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012649:Self Concept; D016037:Single-Blind Method; D014741:Video Recording
references.citation: Circulation. 2007 Sep 18;116(12):1380-5
references.pmid: 17724257
references.citation: Lancet. 2010 Apr 17;375(9723):1347-54
references.pmid: 20202679
references.citation: Resuscitation. 2000 May;44(3):187-93
references.pmid: 10825619
references.citation: Circulation. 2010 Nov 2;122(18 Suppl 3):S676-84
references.pmid: 20956220
references.citation: Arch Intern Med. 1995 May 8;155(9):938-43
references.pmid: 7726702
references.citation: Resuscitation. 2001 May;49(2):201-5
references.pmid: 11382527
references.citation: Resuscitation. 2007 Sep;74(3):476-86
references.pmid: 17442479
references.citation: Acad Emerg Med. 2010 Mar;17(3):269-75
references.pmid: 20370759
references.citation: Circ Cardiovasc Qual Outcomes. 2011 Mar;4(2):220-6
references.pmid: 21386066
references.citation: N Engl J Med. 2000 May 25;342(21):1546-53
references.pmid: 10824072
references.citation: JAMA. 2010 Oct 6;304(13):1447-54
references.pmid: 20924010
references.citation: Circ Cardiovasc Qual Outcomes. 2010 Jan;3(1):63-81
references.pmid: 20123673
references.citation: Resuscitation. 2001 Jul;50(1):27-37
references.pmid: 11719126
references.citation: Circulation. 2007 Dec 18;116(25):2908-12
references.pmid: 18071077
references.citation: Resuscitation. 1999 Jan;40(1):11-9
references.pmid: 10321843
references.citation: Resuscitation. 2011 Mar;82(3):319-25
references.pmid: 21146914
references.citation: CJEM. 2008 Jan;10(1):51-65
references.pmid: 18226319
references.citation: BMJ. 2011 Jan 27;342:c7106
references.pmid: 21273279
references.citation: Circulation. 2007 Dec 18;116(25):2900-7
references.pmid: 18071072
references.citation: Resuscitation. 2004 Apr;61(1):41-7
references.pmid: 15081180
references.citation: Resuscitation. 2000 Jan;43(2):101-10
references.pmid: 10694169
references.citation: Resuscitation. 2003 Aug;58(2):171-6
references.pmid: 12909379
references.citation: Resuscitation. 2011 Jan;82(1):3-9
references.pmid: 21093974
references.citation: Lancet. 2007 Mar 17;369(9565):920-6
references.pmid: 17368153
references.citation: Circulation. 2007 Nov 27;116(22):2525-30
references.pmid: 17998457
references.citation: Lancet. 2010 Nov 6;376(9752):1552-7
references.pmid: 20951422
references.citation: Circulation. 2010 Nov 2;122(18 Suppl 3):S640-56
references.pmid: 20956217
references.citation: Hong Kong Med J. 2010 Jun;16(3):165-70
references.pmid: 20519751
references.citation: Circulation. 2008 Feb 5;117(5):704-9
references.pmid: 18195177
references.citation: JAMA. 2008 Sep 24;300(12):1423-31
references.pmid: 18812533
references.citation: Circulation. 2001 Nov 13;104(20):2465-70
references.pmid: 11705826
references.citation: Resuscitation. 2005 Oct;67(1):31-43
references.pmid: 16154678
references.citation: Ann Emerg Med. 1998 Mar;31(3):364-9
references.pmid: 9506495
references.citation: Crit Care Med. 2000 Sep;28(9):3289-95
references.pmid: 11008994
references.citation: Resuscitation. 2008 Aug;78(2):119-26
references.pmid: 18502559
references.citation: J Hosp Med. 2011 Sep;6(7):428-32
references.pmid: 21916007
references.citation: Arch Intern Med. 1989 Jan;149(1):61-4
references.pmid: 2912416
references.citation: Acad Emerg Med. 1997 Jun;4(6):540-4
references.pmid: 9189184