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KNOWLEDGE OF BLS IN GENERAL POPULATION IN VARIOUS DISTRICTS IN KERALA, INDIAS. NoTable of ContentPage No 1INTRODUCTION2REVIEW OF LITERATURE3AIMS & OBJECTIVES4MATERIALS & METHODS5RESULTS6DISCUSSION7CONSULATION 8LIMITATIONS 9BIBLIOGRAPHYList of TablesS. NoTable DescriptionPage No123456789101112List of Figure S. NoFigure DescriptionPage No123456789101112GlossaryAbbreviationsINTRODUCTIONINTRODUCTIONCardiovascular diseases (CVD) are the leading of death that has raced all other causes of death worldwide. About 17.7 million deaths in 2015 were due to CVDs that constitute to about one-third of the global deaths. ADDIN EN.CITE <EndNote><Cite><Year>2017</Year><RecNum>71</RecNum><DisplayText><style face="superscript">1</style></DisplayText><record><rec-number>71</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521783069">71</key></foreign-keys><ref-type name="Report">27</ref-type><contributors></contributors><titles><title>World Health Organization: Cardiovascular Diseases Fact Sheets</title></titles><dates><year>2017</year></dates><urls><related-urls><url> Despite the eventuality of CVDs in all countries, there are studies which have found substantial correlation of these diseases with sudden cardiac arrest.PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5UYWxhZWk8L0F1dGhvcj48WWVhcj4yMDEzPC9ZZWFyPjxS
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ADDIN EN.CITE.DATA 4-6 Knowing this peculiarity, the world countries have prepared for this dispute in a differential way with lot of inequalities. A recent analysis of the survival rate of out-of-hospital cardiac arrest patients in North America was 4.6% which was devoted mainly to the presence of advanced first responder systems for resuscitation.PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5OaWNob2w8L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxS
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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5OaWNob2w8L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA 7 Recently, the data from Danish Out-of-hospital-cardiac-arrest registry have also shown the expansion of bystander Cardiopulmonary Resuscitation (CPR) has increased from 21% in 2001 to 45% in 2010.PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BYWJlcmc8L0F1dGhvcj48WWVhcj4yMDE0PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA 8The advent of augmented reality using simulators like manikins, has not only amplified the scope of resuscitation training but also has its implications in teaching and learning of these life-saving techniques by both health care providers and non-health professionals as well. ADDIN EN.CITE <EndNote><Cite><Author>Chaballout</Author><Year>2016</Year><RecNum>80</RecNum><DisplayText><style face="superscript">9</style></DisplayText><record><rec-number>80</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521799840">80</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Chaballout, B.</author><author>Molloy, M.</author><author>Vaughn, J.</author><author>Brisson Iii, R.</author><author>Shaw, R.</author></authors></contributors><auth-address>Duke University, Trinity College of Arts & Sciences, Durham, NC, United States.</auth-address><titles><title>Feasibility of Augmented Reality in Clinical Simulations: Using Google Glass With Manikins</title><secondary-title>JMIR Med Educ</secondary-title><alt-title>JMIR medical education</alt-title></titles><periodical><full-title>JMIR Med Educ</full-title><abbr-1>JMIR medical education</abbr-1></periodical><alt-periodical><full-title>JMIR Med Educ</full-title><abbr-1>JMIR medical education</abbr-1></alt-periodical><pages>e2</pages><volume>2</volume><number>1</number><edition>2016/10/13</edition><keywords><keyword>Google Glass</keyword><keyword>augmented reality</keyword><keyword>clinical simulation</keyword><keyword>feasibility</keyword><keyword>student learning</keyword></keywords><dates><year>2016</year><pub-dates><date>Mar 7</date></pub-dates></dates><isbn>2369-3762 (Print)
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ADDIN EN.CITE.DATA 10 In middle and low- income, the data disclosing figures of SCDs are scarce and in most cases, these are either unattended or unreported. The CPR training if and when incorporated to the local publics will definitely prove to be a mainstay in unveiling the true estimates of SCDs in such countries and also will prove to be an effective armament in reviving the lives of moribund patients. Despite the excellence in evidences for simulators usage, there remain a huge lapse in employing and exploring the implications of CPR training in our country. The rationale of this study is to uncover the knowledge of Basic Life Support (BLS) resuscitation algorithm in the general population of Kerala.AIMS & OBJECTIVESAIMS AND OBJECTIVES:To assess the knowledge of BLS resuscitation algorithm among the general population in various districts in Kerala, India. To assess whether there is any difference in the knowledge level of the general population before and after the teaching session on BLS.REVIEW OF LITERATUREREVIEW?OF LITERATURECardiopulmonary resuscitation (CPR) increases the probability of survival of a person with cardiac arrest. Repeating training helps staff retain knowledge in CPR and in use of automated external defibrillators (AEDs). Retention of knowledge and skills during and after training in CPR is difficult and requires systematic training with appropriate methodology. In the following pages let us go through the literatures in the following order:A. Sudden Cardiac DeathB. Magnitude of the problemC. Role of Science and TechnologyD. Recognition of Manpower E. Knowledge and Training of CPRF. Effectiveness of various training methodsG. Most relevant studiesA. SUDDEN CARDIAC DEATH:SCD can manifest as ventricular tachycardia (VT), ventricular fibrillation (VF), pulseless electric activity (PEA), or asystole. In a significant proportion of patients, SCD can present without warning or a recognized triggering mechanism. The mean age of those affected is in the mid 60s, and at least 40% of patients will suffer SCD before the age of 65. Prospective assessments of SCD in the general population are likely to facilitate investigative and preventive approaches to this significant public health problem. ADDIN EN.CITE <EndNote><Cite><RecNum>81</RecNum><DisplayText><style face="superscript">11</style></DisplayText><record><rec-number>81</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521819689">81</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dan E. Arking, Sumeet S. Chugh, Aravinda Chakravarti, Peter M. Spooner</author></authors></contributors><titles><title>Genomics in Sudden Cardiac Death</title><secondary-title>Circulation Research</secondary-title></titles><periodical><full-title>Circulation Research</full-title></periodical><dates><year>2004</year></dates><urls></urls></record></Cite></EndNote>11B. MAGNITUDE OF PROBLEM:In 2015, an estimated 40 million deaths occurred due to NCDs, accounting for 70% of the overall total of 56 million deaths. The majority of such deaths were caused by the four main NCDs, namely: cardiovascular disease, 17.7 million deaths (accounting for 45% of all NCD deaths); cancer, 8.8 million deaths (22%); chronic respiratory disease, 3.9 million deaths (10%); and diabetes, 1.6 million deaths (4%). The risk of dying from any one of the four main NCDs between ages 30 and 70 decreased from 23% in 2000 to 19% in 2015. In high-income countries, age standardized cardiovascular mortality rates have declined rapidly in recent years, while mortality rates from the other main NCDs have fallen at a slower pace. Although age standardized cardiovascular mortality rates and chronic respiratory mortality rates have improved substantially in low- and middle-income countries (LMIC), they remain far higher than rates in high-income countries. India 61% of deaths from NCDs, accounting lives of 5,817,000 people and contributing to 23% risk of premature deaths from target NCDs. ADDIN EN.CITE <EndNote><Cite><Year>2017</Year><RecNum>82</RecNum><DisplayText><style face="superscript">12</style></DisplayText><record><rec-number>82</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521826660">82</key></foreign-keys><ref-type name="Report">27</ref-type><contributors></contributors><titles><title>World Health Organization: Non Communicable Diseases Progress Monitor 2017</title></titles><dates><year>2017</year></dates><urls><related-urls><url> the significant decline in coronary artery disease (CAD) mortality in the second half of the 20th century,1?sudden cardiac death (SCD) continues to claim 250 000 to 300 000 US lives annually.2?In North America and Europe the annual incidence of SCD ranges between 50 to 100 per 100 000 in the general population.3–6?Because of the absence of emergency medical response systems in most world regions, worldwide estimates are currently not available.7?However, even in the presence of advanced first responder systems for resuscitation of out-of-hospital cardiac arrest, the overall survival rate in a recent North American analysis was 4.6%.8? C. ROLE OF TECHNOLOGIES:A?mannequin?(also called a?manikin,?dummy,?lay figure?or?dress form) is an often articulated?doll?used by artists, tailors, dressmakers, windowdressers and others especially to display or fit?clothing. Laerdal was established as a children's book and toy company in 1940 with the mission of creating “children’s joy.” Over 100 million of Laerdal's Tomte cars were sold in 100 countries. Laerdal's Anne dolls became popular throughout Europe. Laerdal’s pioneering work with soft plastics would later be put to use to produce the first manikin used for resuscitation training, and change the course of the company. Later on, all were committed to one thing: our mission of Helping Save Lives. The vision transformed and said that no one should die or be disabled during birth or from sudden illness or trauma. Laerdal Global Health company provides affordable products and programs to help save the lives of mothers and babies at birth.The goal is to help save 500,000 more lives every year. By implementing what has been shown to work within resuscitation research, improving patient safety, and global health initiatives, the goal can be easily achieved. D. RECOGNITION OF MANPOWER:Abolfotouh MA et. al., (2017)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BYm9sZm90b3VoPC9BdXRob3I+PFllYXI+MjAxNzwvWWVh
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ADDIN EN.CITE.DATA 13 studied the effect of basic life-support (BLS) training on the attitudes of health-care providers toward initiating CPR and on use of AEDs, and to investigate the factors that influence these attitudes. A quasi-experimental study was conducted in two groups: health-care providers who had just attended a BLS–AED course (post-BLS group, n = 321), and those who had not (pre-BLS group, n = 421). All participants had previously received BLS training. Both groups were given a validated questionnaire to evaluate the status of life-support education and certification, attitudes toward use of CPR and AED and concerns regarding use of CPR and AED. Multiple linear regression analyses were applied to identify significant predictors of the attitude and concern scores. Results: Overall positive attitudes were seen in 53.4% of pre-BLS respondents and 64.8% of post-BLS respondents (χ2 = 9.66, p = 0.002). Positive attitude was significantly predicted by the recent completion of BLS training (β = 5.15, p < 0.001), the number of previous BLS training courses (β = 2.10, p = 0.008) and previous exposure to cardiac-arrest cases (β = 3.44, p = 0.018), as well as by low concern scores, (β = ?0.09, p < 0.001). Physicians had significantly lower concern scores than nurses (β = ?10.45, p = 0.001). Concern scores decreased as the duration of work experience increased (t = 2.19, p = 0.029). Cho GC et. al., (2010)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5DaG88L0F1dGhvcj48WWVhcj4yMDEwPC9ZZWFyPjxSZWNO
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ADDIN EN.CITE.DATA 14 in a study to identify the effect of basic life support (BLS) training on laypersons' willingness in performing standard CPR and hands only CPR have included non-medical personnel who applied for BLS training program that took place in 7 university hospitals in and around Korea for 6 months. Before and after BLS training, all the participants were given questionnaires for bystander CPR, and 890 respondents were included in the final analyses. Self-assessed confidence score for bystander CPR, using a visual analogue scale from 0 to 100, increased from 51.5+/-30.0 before BLS training to 87.0+/-13.7 after the training with statistical significance (p 0.001). Before the training, 19% of respondents reported willingness to perform standard CPR on a stranger, and 30.1% to perform hands only CPR. After the training, this increased to 56.7% of respondents reporting willingness to perform standard CPR, and 71.9%, hands only CPR, on strangers. Before and after BLS training, the odds ratio of willingness to perform hands only CPR versus standard CPR were 1.8 (95% CI 1.5-2.3) and 2.0 (95% CI 1.7-2.6) for a stranger, respectively. Most of the respondents, who reported they would decline to perform standard CPR, stated that fear of liability and fear of disease transmission were deciding factors after the BLS training. They suggested that BLS training increases laypersons' confidence and willingness to perform bystander CPR on a stranger. However, laypersons are more willing to perform hands only CPR rather than to perform standard CPR on a stranger regardless of the BLS training.Friesen J et. al., (2015)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Gcmllc2VuPC9BdXRob3I+PFllYXI+MjAxNTwvWWVhcj48
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ADDIN EN.CITE.DATA 15 has gained an instinct that cardiopulmonary resuscitation (CPR) can be taught successfully to the general public. CPR was considered a cost-effective intervention that requires minimal classroom training and low-cost equipment and supplies; it is commonly taught throughout much of the developed world. But, the simplicity of CPR training and its access for the general public may be misleading, as outcomes for patients in cardiopulmonary arrest are poor and survival is dependent upon a comprehensive "chain-of-survival," which is something not achieved easily in resource-limited health care settings. In addition to the significant financial and physical resources needed to both train and develop basic CPR capabilities within a community, there is a range of ethical questions that should also be considered. This report describes some of the financial and ethical challenges that might result from CPR training in low- and middle-income countries (LMICs). It is determined that for many health care systems, CPR training may have financial and ethically-deleterious, unintended consequences. Evidence shows Basic Life Support (BLS) skills training in a community is an effective intervention to improve public health. But, health care systems with limited resources should include CPR training only after considering the full implications of that intervention.Hirose K et. al., (2014)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Gcmllc2VuPC9BdXRob3I+PFllYXI+MjAxNTwvWWVhcj48
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ADDIN EN.CITE.DATA 15 have investigated the effects of basic life support (BLS) training on willingness of single rescuers to make emergency calls during out-of-hospital cardiac arrests (OHCAs) with no available help from others. Methods: A cross-over questionnaire survey was conducted with two questionnaires. Questionnaires were administered before and after two BLS courses in fire departments. One questionnaire included two scenarios which simulate OHCAs occurring in situations where help from other rescuers is available (Scenario-M) and not available (Scenario-S). The conventional BLS course was designed for multiple rescuers (Course-M), and the other was designed for single rescuers (Course-S). Of 2,312 respondents, 2,218 (95.9%) answered all questions and were included in the analysis. Although both Course-M and Course-S significantly augmented willingness to make early emergency calls not only in Scenario-M but also in Scenario-S, the willingness for Scenario-M after training course was significantly higher in respondents of Course-S than in those of Course-M (odds ratio 1.706, 95% confidential interval 1.301–2.237). Multiple logistic regression analysis for Scenario-M disclosed that post training (adjusted odds ratio 11.6, 95% confidence interval 7.84–18.0), age (0.99, 0.98–0.99), male gender (1.77, 1.39–2.24), prior BLS experience of at least three times (1.46, 1.25–2.59), and time passed since most recent training during 3 years or less (1.80, 1.25–2.59) were independently associated with willingness to make early emergency calls and that type of BLS course was not independently associated with willingness. Therefore, both Course-M and Course-S similarly augmented willingness in Scenario-M. However, in multiple logistic regression analyses for Scenario-S, Course-S was independently associated with willingness to make early emergency calls in Scenario-S (1.26, 1.00–1.57), indicating that Course-S more efficiently augmented willingness. Moreover, post training (2.30, 1.86–2.83) and male gender (1.26, 1.02–1.57) were other independent factors associated with willingness in Scenario-S. Shroeder D C et. al., (2017)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TY2hyb2VkZXI8L0F1dGhvcj48WWVhcj4yMDE3PC9ZZWFy
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ADDIN EN.CITE.DATA 16 have studied the educational aspects of teaching schoolchildren in CPR and to summarize campaigns related to a comprehensive establishment of lay-CPR worldwide. A literature research in PubMed was performed, the cutoff date was 27 February 2017. Overall, 192 abstracts were analyzed; 51 articles were considered relevant and included in the manuscript. An additional keyword research in Google revealed >230,000 entries, and 20 of those were included in the present manuscript. A minimum age of 12-13 years is required to achieve a comparable quality of CPR to adult basic life support (BLS). Key issues are (i) the correct detection of a cardiac arrest, (ii) a correctly performed call for help, (iii) thoracic compressions and (iv) if applicable, the initiation of adequate mouth-to-mouth ventilation. Practical training showed a significantly higher CPR quality compared to theoretical training only or to the use of instruction or online videos only. Worldwide implementation of a 2-h BLS training per year in children from the age of 12 or younger is recommended by the "Kids Save Lives"- statement since 2015. In Germany, implementation at the level of the federal states has progressed to different degrees.Swor,R et. al., (2006)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Td29yPC9BdXRob3I+PFllYXI+MjAwNjwvWWVhcj48UmVj
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ADDIN EN.CITE.DATA 17 have determined the factors associated with cardiopulmonary resuscitation (CPR) provision by CPR trained bystanders and to determine factors associated with CPR performance by trained bystanders. A structured telephone interview of adult cardiac-arrest bystanders was performed beginning two weeks after the incident. Elements gathered during interviews included bystander and patient demographics, identifying whether the bystander was CPR trained, when and by whom the CPR was performed, and describing the circumstances of the event. If CPR was not performed, we asked the bystanders why CPR was not performed. Logistic regression was used to calculate odds ratios and 95% confidence intervals (95% CI) for factors associated with CPR performance. Results: Of 868 cardiac arrests, 684 (78.1%) bystander interviews were completed. Of all bystanders interviewed, 69.6% were family members of the victims, 36.8% of the bystanders had more than a high-school education, and 54.1% had been taught CPR at some time. In 21.2% of patients, the bystander immediately started CPR, and in 33.6% of cases, someone started CPR before the arrival of emergency medical services (EMS). Important overall predictors of CPR performance were the following: witnessed arrest (OR = 2.3; 95% CI = 1.4 to 3.8); bystander was CPR trained (OR = 6.6; 95% CI = 3.5 to 12.5); bystander had more than a high-school education (OR = 2.0; 95% CI = 1.2 to 3.1), or arrest occurred in a public location (OR = 3.1; 95% CI = 1.7 to 5.8). These variables were significant predictors of CPR performance among CPR-trained bystanders, as was CPR training within five years (OR = 4.5; 95% CI = 2.8 to 7.3). Common reasons that the CPR-trained bystanders cited for not performing CPR were the following: 37.5% stated that they panicked, 9.1% perceived that they would not be able to do CPR correctly, and 1.1% thought that they would hurt the patient. Surprisingly, only 1.1% objected to performing mouth-to-mouth resuscitation. E. KNOWLEDGE OF BASIC LIFE SUPPORT:Akpek E A et. al., (2003) ADDIN EN.CITE <EndNote><Cite><Author>Akpek</Author><Year>2003</Year><RecNum>32</RecNum><DisplayText><style face="superscript">18</style></DisplayText><record><rec-number>32</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521116395">32</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Akpek, E. A.</author><author>Kayhan, Z.</author></authors></contributors><auth-address>Department of Anesthesiology, Baskent University Faculty of Medicine, 06490 Ankara, Turkey. elifakpek@</auth-address><titles><title>Knowledge of basic life support: a pilot study of the Turkish population by Baskent University in Ankara</title><secondary-title>Resuscitation</secondary-title><alt-title>Resuscitation</alt-title></titles><periodical><full-title>Resuscitation</full-title><abbr-1>Resuscitation</abbr-1></periodical><alt-periodical><full-title>Resuscitation</full-title><abbr-1>Resuscitation</abbr-1></alt-periodical><pages>187-92</pages><volume>58</volume><number>2</number><edition>2003/08/12</edition><keywords><keyword>Adult</keyword><keyword>*Cardiopulmonary Resuscitation/education</keyword><keyword>Female</keyword><keyword>Health Knowledge, Attitudes, Practice</keyword><keyword>Humans</keyword><keyword>Internship and Residency</keyword><keyword>Male</keyword><keyword>Nurses</keyword><keyword>Pilot Projects</keyword><keyword>Retention (Psychology)</keyword><keyword>Students, Medical</keyword><keyword>Surveys and Questionnaires</keyword><keyword>Turkey</keyword></keywords><dates><year>2003</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>0300-9572 (Print)
0300-9572</isbn><accession-num>12909381</accession-num><urls><related-urls><url>(03)00126-6/fulltext</url></related-urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>18 have recruited a total of 494 participants and they were scheduled to take Baskent University's basic life support (BLS) training programme in 2001-02 were asked to complete a 25-item questionnaire prior to the course. The questionnaire investigated the demographic characteristics of the subjects, their knowledge of the theoretical and practical aspects of BLS, and personal experience and attitudes related to BLS. The 'non-medical group' included 179 laypersons, and the 'medical group' was composed of medical students (n=220), residents (n=69) and clinical nurses (n=26). One-hundred and twenty-six (25.5%) of the participants had an encounter with some form of medical emergency event in their past and 207 (41.9%) had taken a BLS course previously. The most commonly cited anxiety about performing BLS was the fear of further harming the victim (56.9%). Nine of the participants said they would not perform mouth-to-mouth ventilation (1.8%). Compared to the other participants, individuals with previous emergency experience, and those who had previous BLS training answered significantly more of the theoretical questions correctly. However, neither of these groups performed significantly better than the other participants in the practical questions (P>0.05 for both comparisons). Based on our findings, we recommend that BLS training for medical undergraduates, other medical personnel and laypersons be improved and standardized throughout Turkey.Angulo-Menéndez P et. al., (2017) ADDIN EN.CITE <EndNote><Cite><Author>Angulo-Menendez</Author><Year>2017</Year><RecNum>18</RecNum><DisplayText><style face="superscript">19</style></DisplayText><record><rec-number>18</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521116395">18</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Angulo-Menendez, P.</author><author>Lana Perez, A.</author><author>Moris de la Tassa, J.</author></authors></contributors><auth-address>. migupau@.</auth-address><titles><title>[Knowledge and willingness to perform basic life support by local police officers]</title><secondary-title>An Sist Sanit Navar</secondary-title><alt-title>Anales del sistema sanitario de Navarra</alt-title></titles><periodical><full-title>An Sist Sanit Navar</full-title><abbr-1>Anales del sistema sanitario de Navarra</abbr-1></periodical><alt-periodical><full-title>An Sist Sanit Navar</full-title><abbr-1>Anales del sistema sanitario de Navarra</abbr-1></alt-periodical><pages>177-185</pages><volume>40</volume><number>2</number><edition>2017/08/03</edition><dates><year>2017</year><pub-dates><date>Aug 31</date></pub-dates></dates><orig-pub>Conocimientos y disposicion para realizar soporte vital basico por agentes de la policia local.</orig-pub><isbn>1137-6627 (Print)
1137-6627</isbn><accession-num>28765657</accession-num><urls><related-urls><url> have determined the knowledge and willingness of local police officers (PO) to perform cardiopulmonary resuscitation (CPR), as well as to explore the association between CPR training and these variables. Cross-sectional study with a sample of 390 PO from Asturias (Spain). An anonymous questionnaire was used to measure nine basic aspects of CPR from the European Resuscitation Council and four indicators of attitude towards performing CPR in a real context. Information on CPR training and its periodicity was also collected, as well as basic socio-demographic and occupational variables. Lack of CPR training was seen in 19.7% of PO, and 36.4% had received such training more than two years ago. Almost one out of four PO had performed at least one CPR in a real situation (24.1%), of which 9.6% had not been trained. The least remembered aspects of CPR were depth (11%) and frequency of chest compressions (24.4%). Only 49.7% of the agents felt sufficiently prepared to perform a CPR. Knowledge and disposition were significantly associated with having received training with a periodicity of less than two years. Aroor AR et. al., (2014)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Bcm9vcjwvQXV0aG9yPjxZZWFyPjIwMTQ8L1llYXI+PFJl
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ADDIN EN.CITE.DATA 20 have determined the level of awareness on BLS and skills among undergraduate and postgraduate students of medical and dental profession, as well as nursing students and interns in a tertiary care hospital. This study was conducted in a tertiary care hospital in South India. The awareness level on BLS and factors associated which include age, sex, level of training (undergraduate, internship, and postgraduate groups), course of study (nursing, dental, and medical groups), and previous exposure to BLS were assessed by using a structured questionnaire. The association of these variables with awareness level was assessed by independent t test, analysis of variance, and linear regression analysis. Among 520 study subjects, 229 were students, 171 were interns, and 120 were postgraduate students. The overall mean score of awareness was 4.16 +/- 1.40 (score range: 0-10). Age, sex, level of training, course of study, and previous exposure to BLS were significantly associated with awareness level in univariate analysis (P < 0.05). Linear regression model also showed that all the above variables were significantly associated with awareness level (P < 0.05). About 322 (61.9%) subjects attributed lack of awareness about BLS to lack of available professional training. About 479 (92.1%) responded that BLS training should be a part of medical curriculum. Baduni N et. al., (2014)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5CYWR1bmk8L0F1dGhvcj48WWVhcj4yMDE0PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA 21 studied the awareness of Basic Life Support (BLS) among dental students and practitioners in New Delhi. This study was conducted by assessing responses to 20 selected questions pertaining to BLS among dental students, resident doctors/tutors, faculty members and private practitioners in New Delhi. All participants were given a printed questionnaire where they had to mention their qualifications and clinical experience, apart from answering 20 questions. One hundred and four responders were included. Sadly, none of our responders had complete knowledge about BLS. The maximum mean score (9.19 +/- 1.23) was obtained by dentists with clinical experience between 1-5 years. Caves ND, et, al., (2006)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5DYXZlczwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl
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ADDIN EN.CITE.DATA 22 in a study to explore the willingness of Hong Kong medical students to perform basic life support and mouth-to-mouth ventilation during an out-of-hospital cardiac arrest have issued a questionnaire to survey Year 4 medical students at the end of their undergraduate anaesthesia attachment, during which basic life support (BLS) skills were taught. The survey was conducted during July and August 2003, approximately two months after Hong Kong was removed from the World Health Organisation SARS Infected Areas list, and was designed to examine student confidence in BLS skills, their perceptions of the risks associated with performing BLS and their willingness to perform BLS in varying situations. The response rate was over 60% (35 from a possible 54). Students were positive regarding the adequacy of their BLS training. They were concerned about disease transmission during resuscitation but were less positive regarding whether the risks had increased due to SARS. In all situations they were significantly more likely to perform mouth-to-mouth ventilation for a family member compared with a stranger (p < 0.001) and to withhold mouth-to-mouth ventilation if either vomit or blood were present in the victim's mouth.Kila T et. al., (2012) ADDIN EN.CITE <EndNote><Cite><Author>Kila</Author><Year>2012</Year><RecNum>1</RecNum><DisplayText><style face="superscript">23</style></DisplayText><record><rec-number>1</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1520994805">1</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kila, T.</author><author>Yockopua, S.</author></authors></contributors><titles><title>Knowledge of cardiopulmonary resuscitation among doctors at the Port Moresby General Hospital</title><secondary-title>P N G Med J</secondary-title><alt-title>Papua and New Guinea medical journal</alt-title></titles><periodical><full-title>P N G Med J</full-title><abbr-1>Papua and New Guinea medical journal</abbr-1></periodical><alt-periodical><full-title>P N G Med J</full-title><abbr-1>Papua and New Guinea medical journal</abbr-1></alt-periodical><pages>76-87</pages><volume>55</volume><number>1-4</number><edition>2012/03/01</edition><keywords><keyword>Adult</keyword><keyword>*Cardiopulmonary Resuscitation</keyword><keyword>Child</keyword><keyword>*Clinical Competence</keyword><keyword>Cross-Sectional Studies</keyword><keyword>Hospitals, General</keyword><keyword>Humans</keyword><keyword>Medical Staff, Hospital/*education</keyword><keyword>Papua New Guinea</keyword><keyword>Surveys and Questionnaires</keyword></keywords><dates><year>2012</year><pub-dates><date>Mar-Dec</date></pub-dates></dates><isbn>0031-1480 (Print)
0031-1480</isbn><accession-num>25338477</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>23 have assessed the knowledge among doctors at Port Moresby General Hospital of basic life support and cardiopulmonary resuscitation (CPR) for children and adults, based on Australian Resuscitation Council Guidelines. 87 (81%) of 107 questionnaires were returned from 15 consultants (17% of respondents), 51 registrars (59%)--of whom 39 (45%) were in training--and 21 resident medical officers (24%). The respondents were based in internal medicine, surgery, emergency medicine, anaesthetics, obstetrics and gynaecology, paediatrics and smaller disciplines (ear, nose and throat, ophthalmology, intensive care, radiology, psychiatry and pathology). Knowledge of CPR in this study population was uneven and overall inadequate. Only 51 respondents (59%) knew that basic CPR was a priority over intubation. 72 (83%) knew the correct compression: ventilation ratio for children but only 38 (44%) knew this for adults. 33 (38%) knew the correct compression rate for children and 29 (33%) for adults. 40 (46%) knew the correct compression depth for children and 35 (40%) for adults. 60 (69%) knew the sites for defibrillator pads. Knowledge of types of defibrillator and shockable rhythms was poor: 21 (24%) gave two correct arrhythmias for defibrillation and 44 (51%) gave one. Medical officers in training appeared to have better knowledge than their colleagues in postgraduate training programs. They have concluded that doctors working in emergency medicine, anaesthetics and intensive care had better knowledge of adult resuscitation than their counterparts in the other adult disciplines and had similar knowledge of paediatric resuscitation to that of their paediatric counterparts, although overall knowledge was incomplete in all groups. Lima SG et. al., (2009)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5MaW1hPC9BdXRob3I+PFllYXI+MjAwOTwvWWVhcj48UmVj
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ADDIN EN.CITE.DATA 24 assessed the impact of a permanent training program in BLS and ALS on the knowledge of nursing professionals. Nursing professionals of a tertiary level hospital. were recruited and assessments were carried out before and after training. The critical points of the International Liaison Committee on Resuscitation (ILCOR) analysis were addressed. RESULTS: 213 professionals were assessed (76 nurses, 35.7%; 38 assistants, 17.8%; and 99 technicians, 46.7%). Pre-course assessment average grades were statistically different (p<0.001) among assistants (3.25), technicians (3.96) and nurses (4.69). Single professional without kids showed performance significantly superior to married professional with kids (p=0.02 and 0.004 respectively). Pre-training level of knowledge was inversely proportional to the time elapsed since the completion of undergraduate course or technical course. Main deficiencies were related to the initial approach of airways, to post-resuscitation cares and to the external cardiac massage technique. The post-course general average grade was 7.26. Assistants achieved a performance of 131.2%, technicians, of 78.9% and the nurses, of 85%, with no significant statistic difference (p=0.43).Passali C et. al., (2011)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5QYXNzYWxpPC9BdXRob3I+PFllYXI+MjAxMTwvWWVhcj48
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ADDIN EN.CITE.DATA 25 have compared and assessed the theoretical knowledge on BLS and ALS in nurses and doctors. A total of 82 nurses and 134 doctors agreed to respond to a questionnaire containing demographic questions, resuscitation experience questions and 15 theoretical knowledge questions. The study demonstrated that nurses and doctors working in Greece have knowledge gaps in current BLS and ALS guidelines. However, resuscitation training had a positive effect on theoretical CPR knowledge. Furthermore, nurses and doctors who worked in high-risk areas for cardiac arrest, scored significantly higher than those who worked in low-risk areas. Those who had encountered more than 5 cardiac arrests the previous year, scored significantly better. Finally the percentage of nurses who had attended the ALS course was quite low thus ALS training should be incorporated into the nursing curriculum.Roshana1 S et. al., (2012) ADDIN EN.CITE <EndNote><Cite><Author>Roshana</Author><Year>2012</Year><RecNum>14</RecNum><DisplayText><style face="superscript">26</style></DisplayText><record><rec-number>14</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521116395">14</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Roshana, S.</author><author>Kh, B.</author><author>Rm, P.</author><author>Mw, S.</author></authors></contributors><auth-address>Department of Family Medicine and Emergency, Kist Medical College Hospital, Imadol, Lalitpur, Nepal.
Department of Internal Medicine, Kist Medical College Hospital, Imadol, Lalitpur, Nepal.</auth-address><titles><title>Basic life support: knowledge and attitude of medical/paramedical professionals</title><secondary-title>World J Emerg Med</secondary-title><alt-title>World journal of emergency medicine</alt-title></titles><periodical><full-title>World J Emerg Med</full-title><abbr-1>World journal of emergency medicine</abbr-1></periodical><alt-periodical><full-title>World J Emerg Med</full-title><abbr-1>World journal of emergency medicine</abbr-1></alt-periodical><pages>141-5</pages><volume>3</volume><number>2</number><edition>2012/01/01</edition><keywords><keyword>Attitude</keyword><keyword>Basic life support (BLS)</keyword><keyword>Cardiopulmonary resuscitation (CPR)</keyword><keyword>Knowledge</keyword><keyword>Training</keyword></keywords><dates><year>2012</year></dates><isbn>1920-8642 (Print)</isbn><accession-num>25215053</accession-num><urls><related-urls><url> in their study have explored the knowledge attitude towards basic life support (BLS) among medical/paramedical professionals. An observational study was conducted by assessing response to self prepared questionnaire consisting of the demographic information of the medical/paramedical staff, their personnel experience/attitude and knowledge of BLS based on the 2005 BLS Guidelines of European Resuscitation Council. After excluding incomplete questionnaires, the data from 121 responders (27 clinical faculty members, 21 dental and basic sciences faculty members, 29 house officers and 44 nurses and health assistants) were analyzed. Only 9 (7.4%) of the 121 responders answered !11, 53 (43%) answered 7-10, and 58 (48%) answered <7 of 15 questions correctly. The clinical faculty members, house officers and nurses/HA had a mean score of 7.4±3.15, 7.37±2.02 and 6.63±2.16 respectively, while dental/basic sciences faculty members attained a least mean score of 4.52 ±2.13 (P<0.001). Those who had received cardiopulmonary resuscitation (CPR) training within 5 years obtained a highest mean score of 8.62±2.49, whereas those who had the training more than 5 years back or no training obtained a mean score of 5.54±2.38 and 6.1±2.29 respectively (P=0.001). Those who were involved in resuscitation frequently had a higher median score of 8 in comparison to those who were seldom involved or not involved at all (P<0.001). F. EFFECTIVENESS OF VARIOUS TRAINING METHODS:Aaberg AM et. al., (2014)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BYWJlcmc8L0F1dGhvcj48WWVhcj4yMDE0PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA 8 have evaluated the current knowledge on basic life support (BLS) in Danish high school students and benefits of a single training session run by junior doctors. Methods: Six-hundred-fifty-one students were included. They underwent one 45-minute BLS training session including theoretical aspects and hands-on training with mannequins. The students completed a baseline questionnaire before the training session and a follow-up questionnaire one week later. The questionnaire consisted of an eight item multiple-choice test on BLS knowledge, a four-level evaluation of self-assessed BLS skills and evaluation of fear based on a qualitative description and visual analog scale from 0 to 10 for being first responder. Results: Sixty-three percent of the students (413/651) had participated in prior BLS training. Only 28% (179/651) knew how to correctly recognize normal breathing. The majority was afraid of exacerbating the condition or causing death by intervening as first responder. The response rate at follow-up was 61% (399/651). There was a significant improvement in correct answers on the multiple-choice test (p < .001). The proportion of students feeling well prepared to perform BLS increased from 30% to 90% (p < .001), and the level of fear of being first responder was decreased 6.8 ± 2.2 to 5.5 ± 2.4 (p < .001).Ahn C et. al., (2016) ADDIN EN.CITE <EndNote><Cite><Author>Ahn</Author><Year>2016</Year><RecNum>44</RecNum><DisplayText><style face="superscript">27</style></DisplayText><record><rec-number>44</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521116395">44</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ahn, C.</author><author>Cho, Y.</author><author>Oh, J.</author><author>Song, Y.</author><author>Lim, T. H.</author><author>Kang, H.</author><author>Lee, J.</author></authors></contributors><auth-address>Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea; Convergence Technology Center for Disaster Preparedness, Hanyang University, Seoul, Republic of Korea.
Convergence Technology Center for Disaster Preparedness, Hanyang University, Seoul, Republic of Korea.</auth-address><titles><title>Evaluation of Smartphone Applications for Cardiopulmonary Resuscitation Training in South Korea</title><secondary-title>Biomed Res Int</secondary-title><alt-title>BioMed research international</alt-title></titles><periodical><full-title>Biomed Res Int</full-title><abbr-1>BioMed research international</abbr-1></periodical><alt-periodical><full-title>Biomed Res Int</full-title><abbr-1>BioMed research international</abbr-1></alt-periodical><pages>6418710</pages><volume>2016</volume><edition>2016/09/27</edition><dates><year>2016</year></dates><accession-num>27668257</accession-num><urls><related-urls><url> have applied many smartphone-based applications (apps) for cardiopulmonary resuscitation (CPR) training. They investigated the conformity and the learnability/usability of these apps for CPR training and real-life supports. Methods. We conducted amixedmethod, sequential explanatory study to assess CPR training apps downloaded on two apps stores in South Korea. Apps were collected with inclusion criteria as follows, Korean-language instruction, training features, and emergency supports for real-life incidents, and analyzed with two tests; 15 medical experts evaluated the apps’ contents according to current Basic Life Support guidelines in conformity test, and 15 nonmedical individuals examined the apps using System Usability Scale (SUS) in the learnability/usability test. Results. Out of 79 selected apps, five apps were included and analyzed. For conformity (ICC, 0.95, ? < 0.001), means of all apps were greater than 12 of 20 points, indicating that they were well designed according to current guidelines. Three of the five apps yielded acceptable level (greater than 68 of 100 points) for learnability/usability. Aloush S et. al., (2018)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BbG91c2g8L0F1dGhvcj48WWVhcj4yMDE4PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA 28 have assessed the effectiveness of a basic life support (BLS) educational course given to 110 middle school children, using a pretest posttest design. In the pretest, students were asked to demonstrate BLS on a manikin to simulate a real-life scenario. After the pretest, a BLS training course of two sessions was provided, followed by posttest on the same manikin. Students were assessed using an observational sheet based on the American Heart Association's BLS guidelines. In the pretest, students showed significant weakness in the majority of guidelines. In the posttest, they demonstrated significant improvement in their BLS skills. BLS training in the middle school was effective, considering the lack of previous skills. It is recommended that BLS education be compulsory in the school setting.Aqel AA et. al., (2014)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BcWVsPC9BdXRob3I+PFllYXI+MjAxNDwvWWVhcj48UmVj
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ADDIN EN.CITE.DATA 29 have examined the effects of using high-fidelity simulators on knowledge and skills acquisition and retention with university students. A randomized two-arm trial using two different educational approaches on 90 nursing students assigned randomly to two groups was used at two points of time. The results showed significant differences in favor of the participants in the high-fidelity simulator group on both the acquisition and retention of knowledge and skills over time. However, a significant loss of cardiopulmonary resuscitation knowledge and skills occurred at 3 months after training in both groups. The findings of this study may assist educators in integrating high-fidelity simulators in education and training. In addition, the findings may help nursing educators to arrange additional cardiopulmonary resuscitation training sessions in order to improve cardiac arrested patients' outcomes. High-fidelity simulation (HFS) provides students with interactive learning experiences in a safe controlled environment. HFS enables teachers to implement critical clinical scenarios, such as cardiac arrest, without risk to patients. Integrating the simulation training into nursing curricula will help to overcome the challenges that face many courses, specifically the shortage of clinical areas for training and the increase in numbers of nursing students.Beck S et. al., (2015)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5CZWNrPC9BdXRob3I+PFllYXI+MjAxNTwvWWVhcj48UmVj
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ADDIN EN.CITE.DATA 30 in their study to test whether the hands-on BLS training of the students that was provided by peers was inferior to the training by professional instructors using a predefined noninferiority margin of 5% the students from eight different schools were trained in one 45 min practice session to perform BLS based on the educational framework provided by "einlebenretten" were recruited. The students were randomly assigned to be trained either by peer-instructors (students in the same school who had been instructed in advance) or by professional instructors. In a structured practical assessment, the eight essential skills of BLS were tested and the examination was scored as either pass or fail. The study included 1087 students 14-18 years of age. The performance in the assessment was similar between the two groups: 40.3% (n=471) of the students in the peer-led group and 41.0% (n=466) in the professional-led group passed the examination.Beilec G et. al., (2014)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5CaWVsZWM8L0F1dGhvcj48WWVhcj4yMDE0PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA 31 have evaluated the level of basic life support (BLS) knowledge and skills in physical education students instructed with the use of different methods. Second-year physical education students (n=104, M age=20+/-0.6 years) were randomly assigned to three groups: experimental 1 (E1), experimental 2 (E2), and control (C). Group E1 students participated in a 2-hour BLS course based on computer-assisted presentations. Group E2 trainees practiced BLS algorithm in pairs during a 2-hour course. No manikins were used in both intervention groups. Students of Group C were asked to learn BLS algorithm on their own. All groups fulfilled a 10-question multiple-choice test on BLS at the beginning and the end of the experiment. After completing the course participants performed BLS on a manikin. The results of knowledge test were not significant before an experiment but differed essentially among the groups afterward (analysis of variance contrast analysis, p<.05). Regardless of teaching method used, no significant differences were found among the students in preparatory BLS actions and cardiopulmonary resuscitation (CPR) performance on a manikin. The level of CPR performance was very low in all groups.Bjorshol CA et. al., (2009)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Cam9yc2hvbDwvQXV0aG9yPjxZZWFyPjIwMDk8L1llYXI+
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ADDIN EN.CITE.DATA 32 in their study have included 5382 employees at Stavanger University Hospital and were asked to learn or refresh their BLS skills with the personal resuscitation manikin and video instruction. Prior to and nine months after training, all employees were asked to rate their BLS skills on a scale from one to five. Additionally, randomly chosen study subjects were tested for BLS skills pre-training and six months post-training during 2min of resuscitation on a manikin. In total, 5118 employees took part in the BLS training program. The number of correct chest compressions increased significantly from 60 (5-102) to 119 (75-150) in the pre- vs. post-training periods, respectively, P<0.01, but the number of correct MTM ventilations did not change. Self-reported BLS skills increased from 3.1 (+/-1.0) pre-training to 3.8 (+/-0.8) post-training, P=0.031.Fonseca del Pozo1, FJ et. al., (2016)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Gb25zZWNhIERlbCBQb3pvPC9BdXRob3I+PFllYXI+MjAx
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ADDIN EN.CITE.DATA 33 have examined the effectiveness of a “cardiopul-monary resuscitation song” in improving the basic life support skills of secondary school students. This pre-test/post-test control design study enrolled secondary school students from two middle schools randomly chosen in Córdoba, Andalucia, Spain. The study included 608 teenagers. A random sample of 87 students in the intervention group and 35 in the control group, aged 12-14 years were selected. The intervention included a cardiopulmonary resuscitation song and video. A questionnaire was conducted at three-time points: pre-intervention, one month and eight months post-intervention. On global knowledge of cardiopulmonary resusci-tation, there were no significant differences between the intervention group and the control group in the trial pre-intervention and at the month post-intervention. However, at 8 months there were significant differences with a p-value = 0.000 (intervention group, 95% CI: 6.39 to 7.13 vs. control group, 95% CI: 4.75 to 5.92), (F (1,120) =16.644, p=0.000). In addition, significant differences about students’ basic life support knowledge about chest compressions at eight months post-intervention (F (1,120) =15.561, p=0.000) were found.Choi HS et. al., (2015) ADDIN EN.CITE <EndNote><Cite><Author>Choi</Author><Year>2015</Year><RecNum>34</RecNum><DisplayText><style face="superscript">34</style></DisplayText><record><rec-number>34</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521116395">34</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Choi, H. S.</author><author>Lee, D. H.</author><author>Kim, C. W.</author><author>Kim, S. E.</author><author>Oh, J. H.</author></authors></contributors><auth-address>Emergnecy Medicine Department, Chung-Ang University Hospital, 102, Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea.</auth-address><titles><title>Peer-assisted learning to train high-school students to perform basic life-support</title><secondary-title>World J Emerg Med</secondary-title><alt-title>World journal of emergency medicine</alt-title></titles><periodical><full-title>World J Emerg Med</full-title><abbr-1>World journal of emergency medicine</abbr-1></periodical><alt-periodical><full-title>World J Emerg Med</full-title><abbr-1>World journal of emergency medicine</abbr-1></alt-periodical><pages>186-90</pages><volume>6</volume><number>3</number><edition>2015/09/25</edition><keywords><keyword>Basic life support</keyword><keyword>Education</keyword><keyword>Peer-assisted learning</keyword></keywords><dates><year>2015</year></dates><isbn>1920-8642 (Print)</isbn><accession-num>26401178</accession-num><urls><related-urls><url> have tested whether the inclusion of cardiopulmonary resuscitation (CPR) in formal education has been a useful approach to providing basic life support (BLS) services. However, because not all students have been able to learn directly from certified instructors, we studied the educational efficacy of the use of peer-assisted learning (PAL) to train high-school students to perform BLS services. This study consisted of 187 high-school students: 68 participants served as a control group and received a 1-hour BLS training from a school nurse, and 119 were included in a PAL group and received a 1-hour CPR training from a PAL leader. Participants' BLS training was preceded by the completion of questionnaires regarding their background. Three months after the training, the participants were asked to respond to questionnaires about their willingness to perform CPR on bystander CPR and their retention of knowledge of BLS. We found no statistically signifi cant difference between the control and PAL groups in their willingness to perform CPR on bystanders (control: 55.2%, PAL: 64.7%, P=0.202). The PAL group was not signifi cantly different from the control group (control: 60.78±39.77, PAL: 61.76±17.80, P=0.848) in retention of knowledge about BLS services.De Paiva, EF et. al., (2014)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5kZSBQYWl2YTwvQXV0aG9yPjxZZWFyPjIwMTQ8L1llYXI+
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ADDIN EN.CITE.DATA 35 have evaluated the results of cardiopulmonary resuscitation (CPR) training of communities in four Brazilian cities, using personal resuscitation manikins. Methods: In total, 9,200 manikins were distributed in Apucarana, Itanhaem, Maringá, and Sao Carlos, which are cities where the populations range from 80,000 to 325,000 inhabitants. Elementary and secondary school teachers were trained on how to identify a cardiac arrest, trigger the emergency system, and perform chest compressions. The teachers were to transfer the training to their students, who would then train their families and friends. Results: In total, 49,131 individuals were trained (6.7% of the population), but the original strategy of using teachers and students as multipliers was responsible for only 27.9% of the training. A total of 508 teachers were trained, and only 88 (17.3%) transferred the training to the students. Furthermore, the students have trained only 45 individuals of the population. In Maringá and S~ao Carlos, the strategy was changed and professionals in the primary health care system were prepared and used as multipliers. This strategy proved extremely effective, especially in Maringá, where 39,041 individuals were trained (79.5% of the total number of trainings). Community health care providers were more effective in passing the training to students than the teachers (odds ratio [OR] = 7.12; 95% confidence interval [CI] = 4.74 to 10.69; p < 0.0001).Graham CA et. al., (1994) ADDIN EN.CITE <EndNote><Cite><Author>Graham</Author><Year>1994</Year><RecNum>12</RecNum><DisplayText><style face="superscript">36</style></DisplayText><record><rec-number>12</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1520995487">12</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Graham, C. A.</author><author>Guest, K. A.</author><author>Scollon, D.</author></authors></contributors><auth-address>Faculty of Medicine, University of Glasgow, UK.</auth-address><titles><title>Cardiopulmonary resuscitation. Paper 2: A survey of basic life support training for medical students</title><secondary-title>J Accid Emerg Med</secondary-title><alt-title>Journal of accident & emergency medicine</alt-title></titles><periodical><full-title>J Accid Emerg Med</full-title><abbr-1>Journal of accident & emergency medicine</abbr-1></periodical><alt-periodical><full-title>J Accid Emerg Med</full-title><abbr-1>Journal of accident & emergency medicine</abbr-1></alt-periodical><pages>165-7</pages><volume>11</volume><number>3</number><edition>1994/09/01</edition><keywords><keyword>Attitude of Health Personnel</keyword><keyword>Cardiopulmonary Resuscitation/*education</keyword><keyword>Curriculum</keyword><keyword>*Education, Medical, Undergraduate/statistics & numerical data</keyword><keyword>Heart Arrest/therapy</keyword><keyword>Humans</keyword><keyword>Life Support Care</keyword><keyword>Scotland</keyword><keyword>Students, Medical/*psychology/statistics & numerical data</keyword><keyword>Surveys and Questionnaires</keyword></keywords><dates><year>1994</year><pub-dates><date>Sep</date></pub-dates></dates><isbn>1351-0622 (Print)
1351-0622</isbn><accession-num>7804581</accession-num><urls><related-urls><url> presented the results of a survey of Basic Life Support (BLS) training, based on experience gained by undergraduate medical students who had just completed their first clinical year (third year) at the University of Glasgow. Data were collected on the amount and quality of BLS training received, along with students' own perceptions of their confidence in providing BLS in a cardiac arrest resuscitation attempt. The results made interesting, but not surprising, reading with only 15% of students appearing to have been adequately taught BLS at any point during their third year. Students want more training and 98% see resuscitation as an important topic in the curriculum. Self-perceived confidence in performing BLS in an acute resuscitation situation is low. With no evidence to suggest that the situation is any different elsewhere in the UK, it is recommended that undergraduate resuscitation training is improved to reflect the importance that medical students attach to it.Isbye,D et. al., (2007)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Jc2J5ZTwvQXV0aG9yPjxZZWFyPjIwMDc8L1llYXI+PFJl
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ADDIN EN.CITE.DATA 37 have evaluate the effect of mass distribution of CPR instructional materials among schoolchildren. About 35 002 resuscitation manikins to pupils (12 to 14 years of age) at 806 primary schools. Using the enclosed 24-minute instructional DVD, they trained in CPR and subsequently used the kit to train family and friends (second tier). They completed a questionnaire on who had trained in CPR using the kit. Teachers also were asked to evaluate the project. The incidence of bystander CPR in out-of-hospital cardiac arrest in the months following the project was compared with the previous year. In total, 6947 questionnaires (19.8%) were returned. The 6947 kits had been used to train 17 140 from the second tier (mean, 2.5 persons per pupil; 95% confidence interval, 2.4 to 2.5). The teachers had used a mean of 64 minutes (95% confidence interval, 60 to 68) for preparation and a mean of 13 minutes (95% confidence interval, 11 to 15) to tidy up. Incidence of bystander CPR in the months after the project did not increase significantly compared with the previous year (25.0% versus 27.9%; P_0.16). Lee JH et, al., (2016)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5MZWU8L0F1dGhvcj48WWVhcj4yMDE2PC9ZZWFyPjxSZWNO
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ADDIN EN.CITE.DATA 38 assessed the effectiveness of various BLS training durations for acquiring cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) skills. They randomised 485 South Korean nonmedical college students into four levels of BLS training: level 1 (40 min), level 2 (80 min), level 3 (120 min), and level 4 (180 min). Before and after each level, the participants completed questionnaires regarding their willingness to perform CPR and use AEDs, and their psychomotor skills for CPR and AED use were assessed using a manikin with Skill-Reporter_ software. There were no significant differences between levels 1 and 2, although levels 3 and 4 exhibited significant differences in the proportion of overall adequate chest compressions (? < 0.001) and average chest compression depth (? = .003). All levels exhibited a greater posttest willingness to perform CPR and use AEDs (all, ? < 0.001).Robak O, et. al., (2006)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Sb2JhazwvQXV0aG9yPjxZZWFyPjIwMDY8L1llYXI+PFJl
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ADDIN EN.CITE.DATA 39 have enrolled Medical students in their curriculum to pass a 2 semester problem based learning session about the principles of cardiac arrest, CPR, BLS and defibrillation (CPR-D). Then the students taught cardiac arrest survivors who were randomly chosen out of a cardiac arrest database of our emergency department. Both, the student and the Sudden Cardiac Death (SCD) survivor were asked about their skills and knowledge via questionnaires immediately after the course. The questionnaires were then used to evaluate if this new teaching strategy is useful for learning CPR via a problem-based-learning course. The survey was grouped into three categories, namely "Use of AED", "CPR-D" and "Training". In addition, there was space for free answers where the participants could state their opinion in their own words, which provided some useful hints for upcoming programs. This new learning-by-teaching strategy was highly accepted by all participants, the students and the SCD survivors. Most SCD survivors would use their skills in case one of their relatives goes into cardiac arrest (96%). Furthermore, 86% of the trainees were able to deal with failures and/or disturbances by themselves. On the trainer's side, 96% of the students felt to be well prepared for the course and were considered to be competent by 96% of their trainees.G. MOST RELEVANT STUDIES:Meissner, TM et. al., (2012)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NZWlzc25lcjwvQXV0aG9yPjxZZWFyPjIwMTI8L1llYXI+
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ADDIN EN.CITE.DATA 40 in their study have assessed the basic life support (BLS) knowledge and performance of high school students before and after CPR training. Methods: This study included 132 teenagers (mean age 14.6 ± 1.4 years). Students completed a two-hour training course that provided theoretical background on sudden cardiac death (SCD) and a hands-on CPR tutorial. They were asked to perform BLS on a manikin to simulate an SCD scenario before the training. Afterwards, participants encountered the same scenario and completed a questionnaire for self-assessment of their pre- and post-training confidence. Four months later, we assessed the knowledge retention rate of the participants with a BLS performance score. Results: Before the training, 29.5% of students performed chest compressions as compared to 99.2% post-training (P < 0.05). At the four-month follow-up, 99% of students still performed correct chest compressions. The overall improvement, assessed by the BLS performance score, was also statistically significant (median of 4 and 10 preand post-training, respectively, P < 0.05). After the training, 99.2% stated that they felt confident about performing CPR, as compared to 26.9% (P < 0.05) before the training.Rahman, NA., et. al., (2013) ADDIN EN.CITE <EndNote><Cite><Author>Rahman</Author><Year>2013</Year><RecNum>45</RecNum><DisplayText><style face="superscript">41</style></DisplayText><record><rec-number>45</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521116395">45</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Rahman, N. H.</author><author>Keng Sheng, C.</author><author>Kamauzaman, T. H.</author><author>Md Noh, A. Y.</author><author>Wahab, S. F.</author><author>Zaini, I. Z.</author><author>Fauzi, M. H.</author><author>Ab Rahman, A.</author><author>Dzulkifli, N. S.</author></authors></contributors><auth-address>Department of Emergency Medicine, School of Medical Sciences, Kubang Kerian 16150, Malaysia. nhliza@.</auth-address><titles><title>A multicenter controlled trial on knowledge and attitude about cardiopulmonary resuscitation among secondary school children in Malaysia</title><secondary-title>Int J Emerg Med</secondary-title><alt-title>International journal of emergency medicine</alt-title></titles><periodical><full-title>Int J Emerg Med</full-title><abbr-1>International journal of emergency medicine</abbr-1></periodical><alt-periodical><full-title>Int J Emerg Med</full-title><abbr-1>International journal of emergency medicine</abbr-1></alt-periodical><pages>37</pages><volume>6</volume><number>1</number><edition>2013/10/19</edition><dates><year>2013</year><pub-dates><date>Oct 17</date></pub-dates></dates><isbn>1865-1372 (Print)
1865-1372</isbn><accession-num>24135122</accession-num><urls><related-urls><url> in their multicenter controlled trial to assess the knowledge and attitude (KA) about cardiopulmonary resuscitation (CPR) among secondary school children in a district in Malaysia have determined the level of KA about resuscitation after CPR training. The six schools and classes from selected schools were chosen by randomization among the form three and four classes using sealed envelopes. A fully validated questionnaire consisting of three sections (sociodemographic, knowledge and attitude) was given to the pupils before and 2 weeks after the intervention. The intervention group was given a lecture, video show, pamphlet and 1-h practical session on CPR training. The control group received a placebo in order to overcome the learning effect. The maximum scores for the knowledge and attitude sections were 72 and 28, respectively. Repeated measures ANOVA analysis was used for specific objectives to determine the changes in knowledge and attitude level pre- and post-intervention for both study groups. P-values less than 0.05 were taken as significant at 95% confidence intervals. Results: The mean (SD) total knowledge scores for the intervention (n = 216) and control (n = 252) groups were 62.43 (13.68) and 62.29 (12.11), respectively (maximum score 72) (p > 0.05). On the other hand, the mean (SD)total attitude scores for the intervention and the control groups were 19.33 (4.51) and 17.85 (4.52), respectively (maximum score 28) (p < 0.001). There were significant differences in mean knowledge and attitude scores between the intervention and control groups with regard to time (pre- and post-intervention). The mean difference in knowledge and attitude scores between both study groups was 8.31 (p < 0.001) and 2.39 (p < 0.001), respectively.Sopka S et. al., (2013)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Tb3BrYTwvQXV0aG9yPjxZZWFyPjIwMTM8L1llYXI+PFJl
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ADDIN EN.CITE.DATA 42 in their study was have evaluated whether practical performance and retention of skills in resuscitation training may be influenced by the gender composition in learning groups. Methods: Participants were allocated to three groups for standardized BLS-training: Female group (F): only female participants; Male group (M): only male participants; Standard group (S): male and female participants. All groups were trained with the standardized 4-step-approach method. Assessment of participants’ performance was done before training (t1), after one week (t2) and eight months later (t3) on a manikin in the same cardiac arrest single-rescuer -scenario. Participants were 251 Laypersons (mean age 21; SD 4; range 18–42 years; females 63%) without previous medical knowledge. Endpoints: compression rate 90-110/min; mean compression depth 38–51 mm. Standardized questionnaires were used for the evaluation of attitude and learning environment. Results: After one week group F performed significantly better with respect to the achievement of the correct mean compression depth (F: 63% vs. S: 43%; p = 0.02). Moreover, groups F and S were the only groups which were able to improve their performance concerning the mean compression rate (t1: 35%; t3: 52%; p = 0.04). Female participants felt more comfortable in the female–only environment.Hirose T et. al., (2014)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5IaXJvc2U8L0F1dGhvcj48WWVhcj4yMDE0PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA 43 have examined the effectiveness of a simplified cardiopulmonary resuscitation (CPR) training program for non-medical staff working at a university hospital. Methods: Before and immediately after a 45-min CPR training program consisting of instruction on chest compression and automated external defibrillator (AED) use with a personal training manikin, CPR skills were automatically recorded and evaluated. Participants’ attitudes towards CPR were evaluated by a questionnaire survey.Results: From September 2011 through March 2013, 161 participants attended the program. We evaluated chest compression technique in 109 of these participants. The number of chest compressions delivered after the program versus that before was significantly greater (110.8 ± 13.0/min vs 94.2 ± 27.4/min, p < 0.0001), interruption of chest compressions was significantly shorter (0.05 ± 0.34 sec/30 sec vs 0.89 ± 3.52 sec/30 sec, p < 0.05), mean depth of chest compressions was significantly greater (57.6 ± 6.8 mm vs 52.2 ± 9.4 mm, p < 0.0001), and the proportion of incomplete chest compressions of <5 cm among all chest compressions was significantly decreased (8.9 ± 23.2% vs 38.6 ± 42.9%, p < 0.0001). Of the 159 participants who responded to the questionnaire survey after the program, the proportion of participants who answered ‘I can check for a response,’ ‘I can perform chest compressions,’ and ‘I can absolutely or I think I can use an AED’ increased versus that before the program (81.8% vs 19.5%, 77.4% vs 10.1%, 84.3% vs 23.3%, respectively).Matsubara, TM et. al., (2015)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYXRzdWJhcmE8L0F1dGhvcj48WWVhcj4yMDE1PC9ZZWFy
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ADDIN EN.CITE.DATA 44 have determined the effect of Japanese obligatory basic life support training for new driver’s license applicants on their willingness to carry out basic life support. They distributed a questionnaire to 9,807 participants of basic life support courses in authorized driving schools from May 2007 to April 2008 after the release of the 2006 Japanese guidelines. The questionnaire explored the participants’ willingness to perform basic life support in four hypothetical scenarios: cardiopulmonary resuscitation on one’s own initiative; compression-only cardiopulmonary resuscitation following telephone cardiopulmonary resuscitation; early emergency call; and use of an automated external defibrillator. The questionnaire was given at the beginning of the basic life support course in the first 6-month termand at the end in the second 6-month term. The 9,011 fully completed answer sheets were analyzed. The training significantly increased the proportion of respondents willing to use an automated external defibrillator and to perform cardiopulmonary resuscitation on their own initiative in those with and without prior basic life support training experience. It significantly increased the proportion of respondents willing to carry out favorable actions in all four scenarios. In multiple logistic regression analysis, basic life support training and prior training experiences within 3 years were associated with the attitude. The analysis of reasons for unwillingness suggested that the training reduced the lack of confidence in their skill but did not attenuate the lack of confidence in detection of arrest or clinical judgment to initiate a basic life support action.Narayan DP et. al., (2015) ADDIN EN.CITE <EndNote><Cite><Author>Narayan</Author><Year>2015</Year><RecNum>21</RecNum><DisplayText><style face="superscript">45</style></DisplayText><record><rec-number>21</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521116395">21</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Narayan, D. P.</author><author>Biradar, S. V.</author><author>Reddy, M. T.</author><author>Bk, S.</author></authors></contributors><auth-address>Department of Public Health Dentistry, Vydehi Institute of Dental Sciences and Research Center, Bangalore, India.</auth-address><titles><title>Assessment of knowledge and attitude about basic life support among dental interns and postgraduate students in Bangalore city, India</title><secondary-title>World J Emerg Med</secondary-title><alt-title>World journal of emergency medicine</alt-title></titles><periodical><full-title>World J Emerg Med</full-title><abbr-1>World journal of emergency medicine</abbr-1></periodical><alt-periodical><full-title>World J Emerg Med</full-title><abbr-1>World journal of emergency medicine</abbr-1></alt-periodical><pages>118-22</pages><volume>6</volume><number>2</number><edition>2015/06/10</edition><keywords><keyword>Attitude</keyword><keyword>Basic life support</keyword><keyword>Cardiopulmonary resuscitation</keyword><keyword>Knowledge</keyword></keywords><dates><year>2015</year></dates><isbn>1920-8642 (Print)</isbn><accession-num>26056542</accession-num><urls><related-urls><url> have assessed the knowledge about and attitude towards basic life support (BLS) among dental interns and postgraduate students in Bangalore city, India. This study was conducted among dental interns and postgraduate students from May 2014 to June 2014 since few studies have been conducted in Bangalore city. A questionnaire with 17 questions regarding the knowledge about and attitude towards BLS was distributed to 202 study participants. The data analyzed using the Chi-square test showed that dental interns and postgraduate students had average knowledge about BLS. In the 201 participants, 121 (59.9%) had a positive attitude and 81 (40.1%) had a negative attitude towards BLS.?zbilgin, S et. al., (2015) ADDIN EN.CITE <EndNote><Cite><Author>Ozbilgin</Author><Year>2015</Year><RecNum>23</RecNum><DisplayText><style face="superscript">46</style></DisplayText><record><rec-number>23</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521116395">23</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ozbilgin, S.</author><author>Akan, M.</author><author>Hanci, V.</author><author>Aygun, C.</author><author>Kuvaki, B.</author></authors></contributors><auth-address>Department of Anaesthesiology and Reanimation, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.</auth-address><titles><title>Evaluation of Public Awareness, Knowledge and Attitudes about Cardiopulmonary Resuscitation: Report of Izmir</title><secondary-title>Turk J Anaesthesiol Reanim</secondary-title><alt-title>Turkish journal of anaesthesiology and reanimation</alt-title></titles><periodical><full-title>Turk J Anaesthesiol Reanim</full-title><abbr-1>Turkish journal of anaesthesiology and reanimation</abbr-1></periodical><alt-periodical><full-title>Turk J Anaesthesiol Reanim</full-title><abbr-1>Turkish journal of anaesthesiology and reanimation</abbr-1></alt-periodical><pages>396-405</pages><volume>43</volume><number>6</number><edition>2016/07/02</edition><keywords><keyword>Cardiopulmonary resuscitation</keyword><keyword>attitudes</keyword><keyword>cardiac arrest</keyword><keyword>healthy knowledge</keyword><keyword>survey</keyword></keywords><dates><year>2015</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>2149-0937 (Print)
2149-276x</isbn><accession-num>27366536</accession-num><urls><related-urls><url> in their study have evaluated the awareness, level of knowledge and attitudes of the public to CPR and BLS. A 21-question survey was administered to individuals aged ≥18 years on a busy street in a city of a western region of Turkey. Topics such as knowledge about cardiac arrest findings, previous experience of CPR, knowledge of BLS and concerns related to CPR were questioned. The fully completed forms of 533 people were evaluated. There were 40.7% who stated that they had received training in CPR. For signs of cardiac arrest, 40.7% answered loss of consciousness, 49.3% answered cessation of breathing and 60.7% answered cessation of circulation. It was found that 35.5% could perform only chest compressions, 27.6% could perform mouth-to-mouth ventilation and 28.7% able to perform both. While 52.0% knew the location for performing chest compressions, 34.3% knew the correct depth and 15.6% knew the correct compression–ventilation rate. Bystander CPR was performed by 3.6%.Schro?der H et. al., (2017)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TY2hyb2RlcjwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+
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ADDIN EN.CITE.DATA 47 have evaluated the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton's four-step approach for BLS training. A study group of first-year medical students (n = 334) without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb's Learning Styles Inventory. Students' BLS performances were assessed before and after a four-step BLS training approach lasting 4 hours. Standardized BLS training was provided by an educational staff consisting of European Resuscitation Council-certified advanced life support providers and instructors. Pre- and post-intervention BLS performance was evaluated using a single-rescuer-scenario and standardized questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely disagree). The recorded points of measurement were the time to start, depth, and frequency of ECC. The study population was categorized according to learning styles: diverging (5%, n = 16), assimilating (36%, n = 121), converging (41%, n = 138), and accommodating (18%, n = 59). Independent of learning styles, both male and female participants showed significant improvement in cardiopulmonary resuscitation (CPR) performance. Based on the Kolb learning styles, no significant differences between the four groups were observed in compression depth, frequency, time to start CPR, or the checklist-based assessment within the baseline assessment. A significant sex effect on the difference between pre- and post-interventional assessment points was observed for mean compression depth and mean compression frequency.MATERIALS & METHODSStudy site: This study was conducted in the Department of Emergency medicine. ……………….Study population: All the participants participated in public BLS. At Public schools, colleges, offices where BLS training will be conducted in various districts in Kerala, India.Study design: The current study was a interventional studySample size: 1000 (atleast 500 as per statistical calculation), Needs to calculate.Sampling method: All the eligible subjects were recruited into the study consecutively by convenient sampling till the sample size is reached.Study duration: The data collection for the study was done between October 2017 to March 2018 for a period of 6 months.Inclusion Criteria:All ages between 16-69 years old.Exclusion criteria:Physically and mentally disabled peoplePregnant ladiesMedical personnel’sPeople who have already been trained in BLSEthical considerations: Study was approved by institutional human ethics committee. Informed written consent was obtained from all the study participants and only those participants willing to sign the informed consent were included in the study. The risks and benefits involved in the study and voluntary nature of participation were explained to the participants before obtaining consent. Confidentiality of the study participants was maintained. Permission for conducting the study was obtained from the Head of Department of the respective institutions where the public BLS was held. The investigator was explained the purpose and importance of the study to the participants and obtain consent for the study. Data collection tools: All the relevant parameters were documented in a structured study proforma. Information was collected using a pre-tested and post- tested validated questionnaire. The questionnaire was designed based on the available literature and was consist of 3 parts. The 1st part was included socio- demographic details of the participant. The 2nd part was assessed the knowledge of BLS resuscitation algorithm, each correct answer was marked as 1 and each wrong answer was marked as 0. The 2nd part was given before and after BLS training. Teaching session on BLS was conducted with a video and hands on session. The 3rd part of the questionnaire was assessed the participants knowledge and experience in BLS training with a feedback.Score less than 6- poor knowledge. Score 7-12 medium knowledge. Score equal or greater than 13 good knowledge.OBSERVATIONS AND RESULTSRESULTS:DISCUSSIONDISCUSSION:It is said that practice makes perfect. Our aim is to help healthcare providers be their best– every time. However, research shows that skills decline as soon as 3 months after training -- and most healthcare providers don’t get the experience they need to maintain skills outside of infrequent training intervals. Short, but focused sessions, known as low-dose high-frequency training, have been shown to help healthcare providers, not only to maintain competence over time, but also to improve skills.PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TdWxsaXZhbjwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+
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ADDIN EN.CITE.DATA 48 Low-dose high-frequency training is a skill-building approach to improve retention of clinical knowledge and skills through targeted, short, simulation-based learning activities.Healthcare providers do not get the opportunity to maintain their skills outside of infrequent training intervals. Research shows that skill retention declinces as soon as three months after training. ADDIN EN.CITE <EndNote><Cite><Author>Oermann</Author><Year>2011</Year><RecNum>68</RecNum><DisplayText><style face="superscript">49</style></DisplayText><record><rec-number>68</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521267092">68</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Oermann, M. H.</author><author>Kardong-Edgren, S. E.</author><author>Odom-Maryon, T.</author></authors></contributors><auth-address>University of North Carolina at Chapel Hill, School of Nursing, 433 Carrington Hall, CB #7460, Chapel Hill, NC 27599-7460 USA. moermann@email.unc.edu</auth-address><titles><title>Effects of monthly practice on nursing students' CPR psychomotor skill performance</title><secondary-title>Resuscitation</secondary-title><alt-title>Resuscitation</alt-title></titles><periodical><full-title>Resuscitation</full-title><abbr-1>Resuscitation</abbr-1></periodical><alt-periodical><full-title>Resuscitation</full-title><abbr-1>Resuscitation</abbr-1></alt-periodical><pages>447-53</pages><volume>82</volume><number>4</number><edition>2011/01/14</edition><keywords><keyword>Adult</keyword><keyword>Cardiopulmonary Resuscitation/education/*nursing</keyword><keyword>Education, Nursing/*methods</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Heart Arrest/*therapy</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>*Manikins</keyword><keyword>*Professional Competence</keyword><keyword>Psychomotor Performance/*physiology</keyword><keyword>Students, Nursing/*psychology</keyword></keywords><dates><year>2011</year><pub-dates><date>Apr</date></pub-dates></dates><isbn>0300-9572</isbn><accession-num>21227563</accession-num><urls></urls><electronic-resource-num>10.1016/j.resuscitation.2010.11.022</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>49A study in Pediatrics showed that frequent short training sessions, known as low-dose, high-frequency training, more than doubled retention of high-quality CPR skills. In this study, the percentage of healthcare providers performing excellent CPR went from 26 to 65% when retrained 3 times during a six-month period. ADDIN EN.CITE <EndNote><Cite><Author>Sutton</Author><Year>2011</Year><RecNum>69</RecNum><DisplayText><style face="superscript">50</style></DisplayText><record><rec-number>69</rec-number><foreign-keys><key app="EN" db-id="wf0wzwte5r5eswes5dxpp5f2axsarvpte0dd" timestamp="1521267175">69</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Sutton, Robert M.</author><author>Niles, Dana</author><author>Meaney, Peter A.</author><author>Aplenc, Richard</author><author>French, Benjamin</author><author>Abella, Benjamin S.</author><author>Lengetti, Evelyn L.</author><author>Berg, Robert A.</author><author>Helfaer, Mark A.</author><author>Nadkarni, Vinay</author></authors></contributors><titles><title>Low-Dose, High-Frequency CPR Training Improves Skill Retention of In-Hospital Pediatric Providers</title><secondary-title>Pediatrics</secondary-title></titles><periodical><full-title>Pediatrics</full-title></periodical><pages>e145-e151</pages><volume>128</volume><number>1</number><dates><year>2011</year><pub-dates><date>03/09/accepted</date></pub-dates></dates><pub-location>Elk Grove Village, IL, USA</pub-location><publisher>American Academy of Pediatrics</publisher><isbn>0031-4005
1098-4275</isbn><accession-num>PMC3387915</accession-num><urls><related-urls><url> Low-dose high-frequency training enables you to keep skills sharp using short, frequent training intervals to maintain competence – and confidence– over time. BIBLIOGRAPHYREFERENCE: ADDIN EN.REFLIST 1.World Health Organization: Cardiovascular Diseases Fact Sheets. 2017.2.Talaei M, Sarrafzadegan N, Sadeghi M, Oveisgharan S, Marshall T, Thomas GN, et al. Incidence of cardiovascular diseases in an Iranian population: the Isfahan Cohort Study. Arch Iran Med. 2013;16(3):138-44.3.Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010;121(7):e46-e215.4.Byrne R, Constant O, Smyth Y, Callagy G, Nash P, Daly K, et al. Multiple source surveillance incidence and aetiology of out-of-hospital sudden cardiac death in a rural population in the West of Ireland. 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