title: Very brief training for laypeople in hands-only cardiopulmonary resuscitation. Effect of real-time feedback.
abstract: 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 SkillReporting 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).
  
  
  CONCLUSIONS
  With a very brief training supported by hands-on instructor-led advice and visual feedback, naïve 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.
authors.affiliation: Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, SERGAS, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain. Electronic address: violeta.gonzalez.salvado@sergas.es.
authors.forename: Violeta
authors.initials: V
authors.lastname: González-Salvado
authors.affiliation: University School of Nursing, Universidade de Vigo, Pontevedra, Spain; CLINURSID Research Group, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Felipe
authors.initials: F
authors.lastname: Fernández-Méndez
authors.affiliation: CLINURSID Research Group, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; School of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Faculty of Education and Sport Sciences, Universidade de Vigo, Pontevedra, Spain; REMOSS Research Group, Universidade de Vigo, Pontevedra, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Barcala-Furelos
authors.affiliation: Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, SERGAS, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Institute of Health Research of Santiago (IDIS), A Coruña, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Peña-Gil
authors.affiliation: Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, SERGAS, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Institute of Health Research of Santiago (IDIS), A Coruña, Spain.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: González-Juanatey
authors.affiliation: CLINURSID Research Group, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; School of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Institute of Health Research of Santiago (IDIS), A Coruña, Spain; Paediatric Emergency and Critical Care Division, Hospital Clínico Universitario de Santiago de Compostela, SERGAS, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rodríguez-Núñez
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000193:education*; D005260:Female; D000068156:Formative Feedback; D006801:Humans; D008297:Male; D008348:Manikins; D009042:Motivation; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D010865:Pilot Projects; D013997:Time Factors