Cardiopulmonary resuscitation training in secondary education: A prospective cross-sectional survey of 110 Hong Kong secondary schools

Yim, Vivian; Ip, Crystal Ming-Lai; Siu, Axel Yuet Chung; Leung, Ling Yan; Hung, Kevin Kei Ching; Graham, Colin A.; Song, Priscilla; Walline, Joseph Harold

doi:10.1177/1024907920971159

Cited by 3 publications

(4 citation statements)

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“…Moreover, there were fewer cardiac arrests in public places during the pandemic, which may have influenced the survival rate of patients with OHCA. Additionally, the lack of sufficient CPR training in HK [ 30 , 31 ] and the fear of COVID-19 may have affected the willingness of witnesses to perform CPR. Given that CPR is considered an aerosol-generating procedure with a significant risk of viral transmission, witnesses may have hesitated to perform it, potentially affecting the STA rate [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Out-of-Hospital Cardiac Arrest Before and During the COVID-19 Pandemic in Hong Kong: Registry-Based Study From 2017 to 2023

Xu,

Sun,

2024

JMIR Public Health Surveill

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Background The COVID-19 pandemic has exerted a significant toll on individual health and the efficacy of health care systems. However, the influence of COVID-19 on the frequency and outcomes of out-of-hospital cardiac arrest (OHCA) within the Chinese population, both before and throughout the entire pandemic period, remains to be clarified. Objective This study aimed to fill the gaps by investigating the prevalence and outcomes of OHCA in Hong Kong (HK) both before and during the whole pandemic period. Methods This is a retrospective regional registry study. The researchers matched OHCA data with COVID-19–confirmed case records between December 2017 and May 2023. The data included information on response times, location of OHCA, witness presence, initial rhythm, bystander cardiopulmonary resuscitation (CPR), use of public-access defibrillation, resuscitation in the accident and emergency department, and survival to admission. Descriptive analyses were conducted, and statistical tests such as analysis of variance and χ2 were used to examine differences between variables. The incidence of OHCA and survival rates were calculated, and logistic regression analysis was performed to assess associations. The prevalence of OHCA and COVID-19 during the peak of the pandemic was also described. Results A total of 43,882 cases of OHCA were reported in HK and included in our analysis. Around 13,946 cases were recorded during the prepandemic period (2017-2019), and the remaining 29,936 cases were reported during the pandemic period (2020-2023). During the pandemic period, the proportion of female patients increased to 44.1% (13,215/29,936), and the average age increased slightly to 76.5 (SD 18.5) years. The majority of OHCAs (n=18,143, 61.1% cases) occurred at home. A witness was present in 45.9% (n=10,723) of the cases, and bystander CPR was initiated in 44.6% (n=13,318) of the cases. There was a significant increase in OHCA incidence, with a corresponding decrease in survival rates compared to the prepandemic period. The location of OHCA shifted, with a decrease in incidents in public places and a potential increase in incidents at home. We found that CPR (odds ratio 1.48, 95% CI 1.17-1.86) and public-access defibrillation (odds ratio 1.16, 95% CI 1.05-1.28) were significantly associated with a high survival to admission rate during the pandemic period. There was a correlation between the development of OHCA and the prevalence of COVID-19 in HK. Conclusions The COVID-19 pandemic has had a significant impact on OHCA in HK, resulting in increased incidence and decreased survival rates. The findings highlight the importance of addressing the indirect effects of the pandemic, such as increased stress levels and strain on health care systems, on OHCA outcomes. Strategies should be developed to improve OHCA prevention, emergency response systems, and health care services during public health emergencies to mitigate the impact on population health.

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Section: Discussionmentioning

confidence: 99%

Out-of-Hospital Cardiac Arrest Before and During the COVID-19 Pandemic in Hong Kong: Registry-Based Study From 2017 to 2023

Xu,

Sun,

2024

JMIR Public Health Surveill

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“…This is somewhat consistent with the recent literature. 9,11,20,22 Many studies documented a positive association with teachers' willingness levels 10,20,23,24 and only one study found a link between perceived control behaviour and CPR implementation in school. 9 As for CPR training barriers, legal liability seems to be a worldwide concern.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…7 School principals on the other hand addressed; course time restriction, finding a trainer, inadequate funding and support, students and parents disapproval are perceived difficulties in implementing CPR training in their schools. 10 Given the very limited number of regional studies on CPR training in schools 11,12 and the aforementioned challenges highlighted from the experiences of communities who have pioneered the implementation of CPR training, [8][9][10] this study aims to survey the willingness of teaching staff in Kuwait to embark on such a project, in addition to perceived barriers and other factors influencing CPR training in high schools. Also, this study attempts to explore teaching staff views on the best approach to implement CPR training in high schools.…”

Section: Introductionmentioning

confidence: 99%

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High School Student CPR Training in Kuwait: A Cross-Sectional Study of Teacher Perspectives, Willingness, and Perceived Barriers

Alhasan¹,

Fakhraldeen²,

Alqabandi³

et al. 2022

OAEM

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Background School cardiopulmonary resuscitation (CPR) training has not been previously implemented nor studied in the Arabian Peninsula, and this is due to the challenges that this training imposes. This study aims to determine high school teacher perspectives, willingness, and barriers as related to CPR student training in high schools. Methods An anonymous, voluntary, cross-sectional electronic questionnaire, primarily based on the theory of planned behavior (TPB) was distributed to high school principals and teachers from 20 local (public and private) high schools between October and December 2021. The questionnaire was a 4-part (demographics, willingness, barriers, implementation approach), 23-variable tool. Results Eighty-four out of 88 participants were included in the analysis from 20 high schools. The overall willingness to teach CPR to students was 4.2 ± 0.9, and this willingness was significantly associated with being a female ( p = 0.019), being a teacher ( p = 0.036), having a family history of cardiovascular disease ( p = 0.007), previous school CPR campaigns ( p = 0.02), and all TPB factors: attitude ( p = 0.001), subjective norms ( p = 0.011), and perceived behaviour control ( p = 0.007). As for perceived barriers, there was moderate concern regarding the absence of the Good Samaritan law (3.8 ± 1.1) and CoVID-19 transmission (3.5 ± 1.3). High school teaching staff recommended formal legislation of CPR training from the Ministry of Education (MoE) and favoured CPR training delivery by healthcare professionals. However, they were willing to conduct CPR training themselves with regular training, material integration into the curriculum, and online teaching material access. Conclusion High school teachers are willing to teach students CPR. They need MoE legislation, appropriate training, online material, and a standardized database. Teaching staff also recommend specific training session settings. CoVID-19 and Good Samaritan law are moderate barriers. A number of factors influence teaching staff willingness to conduct CPR training. From this analysis, we recommend piloting CPR training in Kuwait high schools with consideration to the identified influential factors and barriers.

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Out-of-Hospital Cardiac Arrest Before and During the COVID-19 Pandemic in Hong Kong: Registry-Based Study From 2017 to 2023 (Preprint)

Xu,

Sun,

2024

Preprint

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BACKGROUND The COVID-19 pandemic has exerted a significant toll on individual health and the efficacy of health care systems. However, the influence of COVID-19 on the frequency and outcomes of out-of-hospital cardiac arrest (OHCA) within the Chinese population, both before and throughout the entire pandemic period, remains to be clarified. OBJECTIVE This study aimed to fill the gaps by investigating the prevalence and outcomes of OHCA in Hong Kong (HK) both before and during the whole pandemic period. METHODS This is a retrospective regional registry study. The researchers matched OHCA data with COVID-19–confirmed case records between December 2017 and May 2023. The data included information on response times, location of OHCA, witness presence, initial rhythm, bystander cardiopulmonary resuscitation (CPR), use of public-access defibrillation, resuscitation in the accident and emergency department, and survival to admission. Descriptive analyses were conducted, and statistical tests such as analysis of variance and <i>χ</i><sup>2</sup> were used to examine differences between variables. The incidence of OHCA and survival rates were calculated, and logistic regression analysis was performed to assess associations. The prevalence of OHCA and COVID-19 during the peak of the pandemic was also described. RESULTS A total of 43,882 cases of OHCA were reported in HK and included in our analysis. Around 13,946 cases were recorded during the prepandemic period (2017-2019), and the remaining 29,936 cases were reported during the pandemic period (2020-2023). During the pandemic period, the proportion of female patients increased to 44.1% (13,215/29,936), and the average age increased slightly to 76.5 (SD 18.5) years. The majority of OHCAs (n=18,143, 61.1% cases) occurred at home. A witness was present in 45.9% (n=10,723) of the cases, and bystander CPR was initiated in 44.6% (n=13,318) of the cases. There was a significant increase in OHCA incidence, with a corresponding decrease in survival rates compared to the prepandemic period. The location of OHCA shifted, with a decrease in incidents in public places and a potential increase in incidents at home. We found that CPR (odds ratio 1.48, 95% CI 1.17-1.86) and public-access defibrillation (odds ratio 1.16, 95% CI 1.05-1.28) were significantly associated with a high survival to admission rate during the pandemic period. There was a correlation between the development of OHCA and the prevalence of COVID-19 in HK. CONCLUSIONS The COVID-19 pandemic has had a significant impact on OHCA in HK, resulting in increased incidence and decreased survival rates. The findings highlight the importance of addressing the indirect effects of the pandemic, such as increased stress levels and strain on health care systems, on OHCA outcomes. Strategies should be developed to improve OHCA prevention, emergency response systems, and health care services during public health emergencies to mitigate the impact on population health.

show abstract

Cardiopulmonary resuscitation training in secondary education: A prospective cross-sectional survey of 110 Hong Kong secondary schools

Cited by 3 publications

References 20 publications

Out-of-Hospital Cardiac Arrest Before and During the COVID-19 Pandemic in Hong Kong: Registry-Based Study From 2017 to 2023

Out-of-Hospital Cardiac Arrest Before and During the COVID-19 Pandemic in Hong Kong: Registry-Based Study From 2017 to 2023

High School Student CPR Training in Kuwait: A Cross-Sectional Study of Teacher Perspectives, Willingness, and Perceived Barriers

Out-of-Hospital Cardiac Arrest Before and During the COVID-19 Pandemic in Hong Kong: Registry-Based Study From 2017 to 2023 (Preprint)

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