One-minute CPR training video improved attempt rate, skill of nonprofessionals

**Bobrow B. Circ Cardiovasc Qual Outcomes. 2011;4:220-226.**

Issue: April 2011

Individuals who were trained with a 60-second hands-only CPR training video had significantly higher rates of average compression and compression depth vs. a control group that did not view the video.

Investigators of the prospective study enrolled adults (n=336) who had not received previous CPR training and randomly assigned them into four training groups: no training (control; n=51); 60-second video training (n=95); 5-minute video training (n=99); and 8-minute video training that included mannequin practice (n=91). Participants had their CPR performance ability tested during an adult out-of-hospital cardiac arrest scenario using a CPR-sensing mannequin and computer software (Laerdal PC SkillReporting, Laerdal Medical).

After training, participants were randomly assigned to be tested either immediately or after a 2-month delay. Regardless of experimental group, researchers reported that, compared with control, video training had a significant effect on increasing average compression rate closer to the recommended 100/minute (P<.001 for all), as well as increasing the average compression depth (>38 mm; P<.0001 for all).

These findings, the researchers wrote, add to the current understanding of the effectiveness of CPR training, showing how adults without previous formal CPR training can learn, demonstrate and retain effective hands-only CPR skills with a single viewing of an ultra-brief, 60-second training video.

“Because of its brevity, the ultra-brief hands-only CPR video creates opportunities for frequent, recurrent training in multiple venues and the potential to increase the likelihood of lay citizens being recurrently and effectively trained in this technique,” they said. – by Brian Ellis

This article is very interesting. Out-of-hospital cardiac arrest at present has a miserable prognosis. In those reaching the hospital, only a very small number survive to leave the hospital without significant neurologic damage. Eventual return of spontaneous circulation is more likely if cardiac resuscitation is begun immediately, but as stated in the article, there are many barriers to the bystanders delivering effective CPR. Chief among them is the fear of performing mouth-to-mouth breathing.

There has for years been evidence from Gordon Ewy, MD, of University of Arizona, that cardiac compression was the effective activity in resuscitation (and that ventilation was less important). Now, the American Heart Association has adopted the change so that instead of ABC (airway, breathing, compression), the motto is now CAB. The study presented shows in an artificial, non-emergency setting that with extremely minimal training of hands-only resuscitation, the essential aspects of CPR can be learned. It also shows that for at least 2 months, the technique can be retained. Whether more people witnessing a real cardiac arrest will immediately perform CPR as a result is still an open question. If there is a significant increase in out-of-hospital resuscitations by this hands-only technique, the results will likely be similar to those with the old ABC technique as demonstrated by Svensson et al (N Engl J Med. 2010;363:434-442), but whether this will yield a better eventual prognosis for these patients has yet to be proved.

– Melvin Cheitlin, MD

Cardiology Today Editorial Board

Disclaimer: Dr. Cheitlin reported no relevant financial disclosures.

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