Fit-cardiopulmonary resuscitation approach in public mass cardiopulmonary resuscitation teaching: A randomized control trial.

OBJECTIVES: To improve public awareness and the rate of bystander cardiopulmonary resuscitation (CPR), a novel and exciting approach called fit-CPR that incorporates mass CPR with high-intensity physical activity into the beat of locally favoured music was proposed. This study was conducted to measure the effectiveness of fit-CPR compared to the standard classroom method (CCM). METHODS: Between 30th August to 29th November 2018, 129 participants from Syiah Kuala University, Banda Aceh, Indonesia, were randomized to learn CPR, either through fit-CPR or CCM protocol. All participants underwent pre, post, and 6-month retention tests. Each test had a 10-item questionnaire with CPR performance on a manikin that was assessed using a validated checklist. RESULTS: Sixty-one (47.3%) participants completed the fit-CPR while 68 (52.7%) completed the CCM. There was a significant improvement in knowledge, performance, and quality of CPR from pre, post, and 6-month retention tests (p<0.01) in both groups. On high-quality CPR, the fit-CPR and CCM groups obtained an increased score of 285.0% and 151%, respectively, p=0.014 between pre and immediate post-test. Knowledge scores between fit-CPR and CCM groups showed an increase of 79.5% and 111.2%, respectively, p=0.002. Fit-CPR was completed between 52.5-57.5 minutes, while CCM took 75 minutes. CONCLUSION: The fit-CPR demonstrated a comparable outcome to standard CPR when teaching to the mass public with less time spent.

Improving door-to-doctor and door-to-analgesia time in a tertiary teaching hospital emergency department through a novel 'Red Box' system.

OBJECTIVE: To evaluate the effectiveness of a new patient flow system, `The Red Box` on the quality of patient care in respect of the time taken for the care to be delivered to the patient. METHODS: A pre-post study was conducted looking at the door-to-doctor (DTD) and door-to-analgesia (DTA) times for cases presenting to the Emergency Department (ED) of a tertiary teaching hospital `The National University of Malaysia Medical Center` between the periods of July and September 2005 against July and September 2008. Demographic data, ED presentation time, time seen by first doctor, and time first analgesia given were collected in both periods and analyzed. RESULTS: A total of 1,000 cases were enrolled. Group A (pre-Red Box) and group B (post-Red Box) comprised 500 cases each. The mean DTD time for group A was 29 minutes (SD +/- 3 minutes) and for group B was 3 minutes (SD +/- 1 minute), with a 98.8% reduction (p<0.001). For DTA time, group A recorded a mean of 46 minutes (SD +/- 3 minutes), and group B recorded a mean of 9 minutes (SD +/- 2 minutes), an 80.4% reduction (p<0.001). CONCLUSION: The implementation of a red box system improved the quality of emergency patient care in the ED of a tertiary teaching hospital as evidenced by significant reductions in DTD and DTA time.