Sunday, 7 August 2016

Susie Cartledge improving survival odds with targeted CPR training

Susie Cartledge with the Laerdal CPR training kitsEvery year in Australia there are 25,000 out-of-hospital cardiac arrests (OHCA), and fewer than 10 per cent of those will survive. Monash University PhD candidate Susie Cartledge hopes to improve the odds with targeted cardiopulmonary resuscitation (CPR) training to high-risk groups and their families at Cabrini’s Cardiac Rehabilitation Program with her Australian-first research.

Given that 75 per cent of OHCAs occur in the home, and currently less than 40 per cent of those OHCAs receive bystander CPR, Susie is investigating whether training family members of those patients attending a cardiac rehabilitation program following a heart attack or cardiac event, will better equip them with skills to deliver CPR in the event of a future cardiac emergency in the home.

Cardiac rehabilitation is a service routinely offered to patients and their family members, who have been diagnosed with cardiovascular disease or have suffered a recent cardiac event such as a heart attack. The program provides supervised exercise, education and support. Surprisingly however, not many programs across Australia provide CPR training as part of the education component.

As a registered nurse and first aid instructor, Susie first saw a need for this training to be included in the program after realising that many people who attend cardiac rehabilitation have not received CPR training recently, if ever.

“The aim is to ensure that not only more people are being trained in life-saving skills but that the people who are most likely to witness an out-of-hospital cardiac arrest are targeted and offered the opportunity to train,” she said.

Cabrini has partnered with the Australian Resuscitation Outcomes Consortium (Aus-ROC) based at SPHPM to trial CPR training to both patients and their family members in the cardiac rehabilitation program at the hospital.

Susie’s PhD research has involved three separate but related studies that then informed this feasibility study to assess whether CPR training, can be incorporated into a cardiac rehabilitation outpatient program for cardiac patients and their family members.

“Delivering CPR from bystanders more than doubles the chance of survival, but bystanders often lack training and fear harming the victim — providing CPR training to households at higher risk of OHCA has the opportunity to contribute to better survival outcomes for patients.

“This is the first time this has been researched and put into practice in Australia and most likely internationally, so it is very exciting. I have held three classes so far and recruited nearly fifty participants who have had very positive feedback about the training,” Susie said.

The training that is being trialled is a new form of self-instructional video training. Participants receive a training kit that includes an instructional DVD, an inflatable reusable CPR training mannequin and a mock cardboard defibrillator.

Using this kit, they learn the skills of CPR while having the support of the cardiac rehabilitation nurses there to correct their technique and answer questions. They can then take the kit home and train other family members and friends.

“From the data collected so far it is clear that participants are coming out of the training with new found skills, are more confident and willing to provide CPR should the need arise. The majority of these have gone on to train at least one or two other people.” Susie said.

1 comment:

  1. An interesting study. There are two comments that I would make about this. Firstly, unlike the AMBU manikin pictured in the picture, the Laerdal blow up manikins do not simulate the compression force required to do effective compressions on an adult, therefore participants may know a technique but will not have an effective mastery. Evidence suggests that even with a proper manikin simulator (e.g. AMBU) only 46% of adults (including health professionals) are able to achieve adequate depth of compression on an adult. Secondly, as most SCA events happen in elderly patients, quite often the first and only first rescuer on scene is elderly and/or frail and therefore least capable of being to be able to deliver effective compressions to an adult using the ARC kneeling technique. I have had success teaching these rescuers an alternate pedal technique that means they can achieve and maintain depth of compression that they otherwise could not. This technique has many benefits over the traditional technique and a paper has been sent to the ARC for consideration. Unfortunately as with most innovation in resuscitation practice in Australia, the ARC does not as a rule consider any recommendation (regardless of evidence) that comes from outside their own organisation. I think the results of the study may be presenting a false sense of the usefulness of this skill in the subjects, given the shortcomings in the methodology and may only be result in a knowledge gain (health literacy) rather than skills.



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