title: A randomised control trial to compare retention rates of two cardiopulmonary resuscitation instruction methods in the novice.
abstract: Studies show that after implementation of chest compression only CPR (CCC) in the community, there was an increase in bystander CPR rates and survival of OHCA victims. There have been very few studies to compare the retention rates of CCC and conventional CPR (CVC) in lay people.
  
  
  
  First year nursing students were randomised into one of the two CPR training methods: CVC - 30 chest compressions, followed by 2 mouth-to-mouth ventilations; and CCC - 100 chest compressions with 10s of rest before the next compression cycle. Within each group, they were sub-randomised into two groups for locating chest compression landmark: 2F - 2 finger-breadth proximal from xiphoid process, identified by tracing the lower margin of the victim's rib cage; or SL - shown the approximate location on the lower half of the sternum. 6 months later, participants underwent an unannounced test to perform one-man CPR on a moulaged mannikin.
  
  
  
  During the test, CVC groups did significantly fewer chest compressions per minute than CCC groups (57.8±23.7 vs 77.7±24.2, adjusted p<0.001). SL groups compressed significantly deeper than 2F groups (34.3±11.5cm vs 27.3±13.7cm, adjusted p<0.001), and was associated with higher rate of correct landmark for chest compression. 50.0% of the participants did not compress at the correct location. For those who were trained in CVC, only 3.7% were able to perform ≥10 effective ventilations in 5min.
  
  
  
  CCC, with SL as the method to locate landmark for chest compression, should be taught to lay people.
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore. Electronic address: lim.swee.han@singhealth.com.sg.
authors.forename: Swee Han
authors.initials: SH
authors.lastname: Lim
authors.affiliation: SingHealth Pathology Residency Program, Singapore, Singapore.
authors.forename: Sze Jet
authors.initials: SJ
authors.lastname: Aw
authors.affiliation: SingHealth Internal Medicine Residency Program, Singapore, Singapore.
authors.forename: May Anne
authors.initials: MA
authors.lastname: Cheong
authors.affiliation: School of Health Sciences (Nursing), Nanyang Polytechnic, Singapore, Singapore.
authors.forename: Jenny
authors.initials: J
authors.lastname: Chew
authors.affiliation: Nursing Department, Institute of Technical Education College East, Singapore, Singapore.
authors.forename: Ai Choo
authors.initials: AC
authors.lastname: Ler
authors.affiliation: School of Health Sciences (Nursing), Nanyang Polytechnic, Singapore, Singapore.
authors.forename: Li Ping
authors.initials: LP
authors.lastname: Yong
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Yiong Huak
authors.initials: YH
authors.lastname: Chan
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Ma Thin Mar
authors.initials: MTM
authors.lastname: Win
authors.affiliation: Nursing Department, Institute of Technical Education College East, Singapore, Singapore.
authors.forename: Nagamal
authors.initials: N
authors.lastname: Suppiah
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000379:methods*; D005260:Female; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D008297:Male; D008348:Manikins; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy; D011897:Random Allocation; D013338:Students, Nursing
keywords: Chest compression only CPR; Lay people; Locating landmark for chest compression; Mannikin studies; Mouth-to-mouth ventilations; Retention skill of CPR