A community training scheme in cardiopulmonary resuscitation.

Abstract

Community instruction in basic life support and resuscitation techniques has been offered in Brighton Health District since 1978. Classes are held frequently for the general public and businesses, schools, and other organisations. First aid care for unconscious patients, the treatment of respiratory obstruction or failure, and the recognition and management of cardiac arrest is taught in a single two hour session. Over 20 000 people have been taught, up to 40 at a time in multiple groups of six to eight, by lay instructors usually supervised by ambulancemen trained to "paramedic" standards. Fifty four incidents have been reported to us in which techniques learnt in the classes have been implemented. Five patients recovered after first aid support but subsequently did not seek medical treatment. Of the 34 patients reviewed in hospital, at least 20 survived to be discharged. We believe that intervention may have been life saving in 16 instances. The benefit of cardiopulmonary resuscitation for victims who may have been asystolic is, however, difficult to quantify because the outcome without intervention cannot be predicted accurately.Community training in basic life support should be considered in association with ambulances equipped for resuscitation and hospital intensive care and cardiac care units as an integrated service for the victims of sudden circulatory or respiratory emergencies. The

Resuscitation from out-of-hospital cardiac arrest: is survival dependent on who is available at the scene?

“…Community training is being provided in Brighton14 and Seattle15; in Seattle nearly 60% of residents aged 12 years and over have had some formal training in cardiopulmonary resuscitation, but this may not be the most effective or cost–effective way of improving survival in Nottingham, for we would need to train about half a million people if we are to provide community resuscitation similar to that in Seattle.…”

Circumstances of out of hospital cardiac arrest in patients with ischaemic heart disease

“…At the time of our study one of the three centres had an active programme for citizen initiated CPR but, although all emergency ambulances carried defibrillators, no public access defibrillators were available. 13…”

Do resuscitation schemes save lives?

“…Having completed a training programme, the next step should be its validation Unfortunately, there is no programme to assess the standard attained by Heartsaver trainees, since no formal testing takes place immediately after training As far as the retention of skills is concerned, existing evidence suggests that it might be low, '' and therefore the need for booster training must be examined Finally, there is a need for adeduate assessment of skill application in the field Whilst the attention of the mass media has been drawn to those instances in which a Heartsaver trainee has been successful, such figures are meanmgful only in relation to the numbers who have attempted resuscitation There is also a need to estimate how many trainees had been so confused by the potential emergency that they had abandoned rescue and simply walked away from the scene 3 Save a Life and Heartsaver represent the first largescale initiative aimed at teaching the public how to cope with cardiac arrest, and it is possible that the benefits of such training may be manifested in a broader awareness of emergencies and emergency procedures However, it is also to be expected that there are areas which require attention and improvement and in summary the following suggestions are made 9 A controlled follow-up investigation . Either a reduction in the scope of the training course or a substantial increase in teaching time or both .…”