BackgroundCardiopulmonary resuscitation (CPR) training has traditionally involved classroom-based courses or, more recently, home-based video self-instruction. These methods typically require preparation and purchase fee; which can dissuade many potential bystanders from receiving training. This study aimed to evaluate the effectiveness of teaching compression-only CPR to previously untrained individuals using our 6-min online CPR training video and skills practice on a homemade mannequin, reproduced by viewers with commonly available items (towel, toilet paper roll, t-shirt).MethodsParticipants viewed the training video and practiced with the homemade mannequin. This was a parallel-design study with pre and post training evaluations of CPR skills (compression rate, depth, hand position, release), and hands-off time (time without compressions). CPR skills were evaluated using a sensor-equipped mannequin and two blinded CPR experts observed testing of participants.ResultsTwenty-four participants were included: 12 never-trained and 12 currently certified in CPR. Comparing pre and post training, the never-trained group had improvements in average compression rate per minute (64.3 to 103.9, p = 0.006), compressions with correct hand position in 1 min (8.3 to 54.3, p = 0.002), and correct compression release in 1 min (21.2 to 76.3, p < 0.001). The CPR-certified group had adequate pre and post-test compression rates (>100/min), but an improved number of compressions with correct release (53.5 to 94.7, p < 0.001). Both groups had significantly reduced hands-off time after training. Achieving adequate compression depths (>50 mm) remained problematic in both groups. Comparisons made between groups indicated significant improvements in compression depth, hand position, and hands-off time in never-trained compared to CPR-certified participants. Inter-rater agreement values were also calculated between the CPR experts and sensor-equipped mannequin.ConclusionsA brief internet-based video coupled with skill practice on a homemade mannequin improved compression-only CPR skills, especially in the previously untrained participants. This training method allows for widespread compression-only CPR training with a tactile learning component, without fees or advance preparation.

A 35 year-old man with no significant past medical history presented to the emergency department (ED) after abusing phencyclidine (PCP). Responding to command auditory hallucinations, he attempted to swallow his 4 cm 9 8 cm smartphone. On arrival, he was agitated but alert, handling his secretions poorly and in moderate respiratory distress. An electronic device was clearly protruding from his oropharynx. He was tachypneic (24 respirations/min) with an oxygen saturation of 92 % on room air, a heart rate of 131 beats per minute and a blood pressure of 137/64 mmHg.Emergency physicians immediately attempted to remove the device with Magill forceps, but were unsuccessful. A ''trauma code'' was announced bringing a surgical intensivist, an anesthesiologist, and appropriate nursing staff to the bedside, while simultaneously indicating that an operating room (OR) should be prepared. The patient was emergently transported to the OR and ''double prepped'' for both emergent cricothyrotomy and oropharyngeal intubation. The device was successfully removed under procedural sedation without the need for surgical intervention. A mucosal tear was noted in the posterior pharynx. The patient became markedly agitated post-procedure, and, given the recent trauma, was intubated for airway protection. He subsequently developed bilateral pneumothoraces and significant subcutaneous emphysema throughout his neck and upper torso.Diagnosis: Posterior pharyngeal rupture and bilateral pneumothoraces following attempted foreign body ingestion (Fig. 1). Computerized tomography of the neck and chest revealed a defect in the posterior wall of the oropharynx at the C2 level, along with significant mediastinal air and right-greater-than-left pneumothoraces. The patient was treated with a right-sided chest tube and was observed in the intensive care unit. He was treated for 7 days with broad-spectrum antibiotics, specifically, piperacillin and tazobactam. He did not require surgical repair of the pharyngeal defect and was discharged from the hospital 2 weeks later.