Cardiopulmonary Resuscitation Training in Select Rhode Island High Schools: A Descriptive Study.

Fewer than 15% of people who have out-of-hospital cardiac arrests survive, but chances of survival can be tripled with effective bystander cardiopulmonary resuscitation (CPR). The majority of states, including Rhode Island, require high school CPR training, yet the impact of this is not well studied. A 33-question REDCap survey regarding cardiac arrest preparedness, CPR education, and barriers to CPR training was emailed to high school staff in Rhode Island. There were 62 responses; 26% reported their school taught CPR and 94% felt it was important for students to have CPR certification. Barriers included time (85%), budget (82%), and materials (79%). Over 80% felt students would not be able to perform high-quality CPR or properly use a defibrillator. Despite laws requiring CPR training and the belief by school staff of the importance of CPR training, the majority of students are not receiving CPR training. Staff report students do not have the ability to perform effective CPR or use a defibrillator.

Parada cardiorrespiratória em ambiente pré-hospitalar: ocorrências atendidas pelo Serviço de Atendimento Móvel de Urgência de Belo Horizonte / Out-of-hospital cardiac arrest: cases assisted by the mobile emergency service of Belo Horizonte

Justificativa e objetivos: O Serviço de Atendimento Médico de Urgência de Belo Horizonte (SAMUBH), implantado em 2003, possui equipe preparada e ambulâncias equipadas para atendimento pré-hospitalar. Dentre os atendimentos, a parada cardiorrespiratória (PCR) é a ocorrência mais grave. O objetivo deste estudo foi analisar os casos de PCR pré-hospitalar em BH. Método: Estudo epidemiológico, descritivo e retrospectivo. Foram avaliadas as fichas de atendimento de pessoas que tiveram PCR atendidas pelo SAMU/BH em 2005. Utilizou-se instrumento com variáveis baseadas no estilo Utstein para a coleta de dados. Tratamento estatístico descritivo e de associação dos dados foi realizado. Resultados: No período foram atendidas 5.058 ocorrências, sendo 1.548 (30,2%) casos de PCR (68,8% masculinos), idade 0 a 106 anos, com predomínio de causas clínicas (62,2%). No município de BH, o tempo médio para atendimento (tempo-resposta) foi de 10,3 minutos e, em cidades da região metropolitana, de 18 minutos. Em 1.197 (77,3%) atendimentos a equipe apenas constatou o óbito. Manobras de RCP foram realizadas em 351 (22,7%) pessoas, e, 117 (33,3%) destas apresentavam fibrilação ventricular ou taquicardia ventricular sem pulso na avaliação inicial da equipe de atendimento. Sobrevida imediata ocorreu em 83 (23,6%) pessoas, sendo encaminhadas para diversos hospitais. Entre os fatores que influenciaram a sobrevida imediata pós-RCP destacam-se: tempo-resposta da ambulância, "PCR presenciada pela equipe" e ritmo cardíaco. Porém, na regressão logística, somente as duas últimas variáveis foram significativas. Conclusão: Os resultados mostram que o SAMU tem um papel significativo e de impacto positivo no atendimento a vítimas de PCR na comunidade.

Background and objectives: The Mobile Emergency Service of Belo Horizonte (SAMU/BH), initiated in 2003, has trained staff members and ambulances equipped for out-of-hospital (OH) healthcare, and cardiac arrest (CA) is the most stressful event faced. The aim of the study was to analyze out-of-hospital CA cases attended by the SAMU-BH. Method: Retrospective, descriptive and epidemiological study. All OH-CA patients' charts attended by the SAMU-BH in 2005 were reviewed, and data were collected by using an instrument elaborated in Utstein style. Descriptive and associations statistical analysis were performed to treat data. Results: During the period 5,058 patients were attended with 1,548 (30.2%) cases of OH-CA (68.8% males), age 0-106 years, and clinical causes were prevalent (62.2%). The ambulance time-response in BH city was of 10.3 minutes, and of 18 minutes in the great metropolitan area. The majority of patients (1,197; 77.3%) were already dead when the ALS team arrived. CPR-maneuvers were performed in 351 (22.7%) patients and 117 (33.3%) of them have shown ventricular fibrillation or pulseless ventricular tachycardia at the initial evaluation by the ALS team. Immediate recovery was obtained in 83 (23.6%) patients, and they were taken to a hospital. Ambulance time-response, witnessed CA-CPR by ALS team and initial cardiac rhythm were the main factors influencing the immediate CPR survival. Logistic regression, however, indicated only the last two variables as significant factors in short-term survival. Conclusion: Our results highlighted the importance of SAMU for increasing CPR survival in out-of-hospital cardiac arrest.