Video-Only Cardiopulmonary Resuscitation Education for High-Risk Families Before Hospital Discharge: A Multicenter Pragmatic Trial.
Video-Only Cardiopulmonary Resuscitation Education for High-Risk Families Before Hospital Discharge: A Multicenter Pragmatic Trial.
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DOI：
10.1161/circoutcomes.116.002493
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发表时间：
2016-11
期刊：
影响因子：
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通讯作者：
CHIP Study Group*
中科院分区：
文献类型：
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作者：
Blewer AL;Putt ME;Becker LB;Riegel BJ;Li J;Leary M;Shea JA;Kirkpatrick JN;Berg RA;Nadkarni VM;Groeneveld PW;Abella BS;CHIP Study Group*
美国的CPR培训率很低，这突显了开发更简单、具有更广泛传播潜力的CPR教育方法的必要性。确保长期保留技能所需的最低限度培训的特点仍然很差。我们比较了随机接受仅视频训练(VO；没有人体模型)和视频自学工具包(VSI；人体模型)训练的外行人的CPR技能保持情况。我们假设VO训练在胸部按压(CC)率方面不逊于VSI方法。我们采用多中心实用设计，对医院心脏病房的高危心脏病患者家属进行了一项前瞻性整群随机试验。八家医院被随机选择，在出院前使用志愿者培训师提供VO或VSI培训。在训练后6个月评估心肺复苏技能。与VSI相比，接受VO训练的患者的平均CC率被评估为8 CC/min(CPM)的非劣势边际；作为次要结果，CC深度的平均差异被评估。2012年2月至2015年5月，1464名受试者完成技能评估，522名受试者完成技能评估。平均CC率为87.7(VO)cpm和89.3(VSI)cpm；根据−1.6(90%CI：−5.2，2.1)的平均差值，我们得出VO的非劣势。平均CC厚度分别为40.2 mm(VO)和45.8 mm(VSI)，−5.6(95%CI：−7.6，−3.7)。经多因素回归校正后，结果相似。在这项关于CPR技能保留的大型前瞻性试验中，与VSI训练相比，VO训练在CC率方面并不逊色。VSI组CC深度大于VSI组。这些发现表明，在广泛传播基本CPR技能的努力中存在潜在的权衡；VO培训可能允许更大的可扩展性和传播，但可能会减少CC深度。网址：ClinicalTrials.gov，标识：NCT01514656。
CPR training rates in the US are low, highlighting the need to develop CPR educational approaches that are simpler, with broader dissemination potential. The minimum training required to ensure long-term skill retention remains poorly characterized. We compared CPR skill retention among laypersons randomized to training with video-only (VO; no manikin) to those trained with a video self-instruction kit (VSI; with manikin). We hypothesized that VO training would be non-inferior to the VSI approach with respect to chest compression (CC) rate. We performed a prospective cluster randomized trial of CPR education for family members of high-risk cardiac patients on hospital cardiac units, using a multicenter pragmatic design. Eight hospitals were randomized to offer either VO or VSI training before discharge using volunteer trainers. CPR skills were assessed six months post-training. Mean CC rate among those trained with VO compared to VSI was assessed with a non-inferiority margin set at 8 CC per min (cpm); as a secondary outcome, mean differences in CC depth were assessed. From 2/2012 to 5/2015, 1464 subjects were enrolled and 522 subjects completed a skills assessment. The mean CC rates were 87.7(VO) cpm and 89.3 (VSI) cpm; we concluded non-inferiority for VO based on a mean difference of −1.6 (90% CI: −5.2, 2.1). The mean CC depth was 40.2 mm (VO) and 45.8 mm (VSI) with a mean difference of −5.6 (95% CI: −7.6, −3.7). Results were similar after multivariate regression adjustment. In this large prospective trial of CPR skill retention, VO training yielded a non-inferior difference in CC rate compared to VSI training. CC depth was greater in the VSI group. These findings suggest a potential trade-off in efforts for broad dissemination of basic CPR skills; VO training might allow for greater scalability and dissemination, but with a potential reduction in CC depth. URL: ClinicalTrials.gov, Identifier: NCT01514656.