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CCPR training

Question Type:
Intervention
Full Question:
Among communities who are caring for patients in cardiac arrest in any setting  (P), does does teaching compression-only CPR  (I), compared with conventional CPR (C), change Survival rates, bystander CPR rates, willingness to provide CPR (O)?
Consensus on Science:
For the critical outcome of neurologically intact survival at hospital discharge, we found very-low-quality evidence (downgraded for serious imprecision) from 2 observational studies (n=1767)(Bobrow 2010, 1447; Panchal 2013, 435) that documented survival to hospital discharge for adults receiving bystander CPR from the same statewide database; one reported on events of cardiac origin,(Bobrow 2010, 1447) and the other reported on events of noncardiac origin.(Panchal 2013, 435) Both studies demonstrated no difference in neurologically intact survival (odds ratio [OR], 1.41; 95% CI, 0.92–2.14). For the critical outcome of bystander CPR rates, we found very-low-quality evidence (downgraded for serious imprecision and serious risk of bias) from 1 observational study, which showed a higher proportion of bystander CPR performed with compression-only CPR than with conventional CPR over the 5-year study period (34.3% versus 28.6%).(Bobrow 2010, 1447)For the important outcome of willingness to perform CPR, we found very-low-quality evidence (downgraded for very serious risk of bias, very serious indirectness, and serious imprecision) from 1 randomized trial documenting that family members of hospitalized adults who were given a compression-only CPR training kit were more likely to express willingness to perform CPR (34%) than family members given a conventional CPR training kit, but this difference did not achieve statistical significance (28%; OR, 1.30; 95% CI, 0.85–1.98).(Blewer 2012, 787)
Treatment Recommendation:
We suggest that communities may train bystanders in compression-only CPR for adult OHCA as an alternative to training in conventional CPR (weak recommendation, very-low-quality evidence).Values, Preferences, and Task Force InsightsIn making this recommendation, we took into account that willingness to perform bystander CPR in the community may be increased when compression-only CPR is offered as an alternative technique.(Shibata 2000, 187; Lam 2007, 325; Taniguchi 2007, 82; Cho 2010, 691) Accordingly, communities should consider existing bystander CPR rates and other factors, such as local epidemiology of OHCA and cultural preferences, when deciding on the optimal community CPR training strategy.Compression-only CPR instruction has been proposed for several reasons, including overcoming barriers to providing CPR, simplicity in delivery so that all lay providers are able to provide CPR, ease of instruction, etc. Recognizing that a proportion of cardiac arrests are caused by asphyxia (eg, drowning or with cardiac arrests involving children) and in these cases compression-only CPR may not be as effective as conventional CPR, the EIT Task Force suggests that communities consider epidemiology of cardiac arrest in their locale, their bystander CPR response rates, and cultural preferences along with this systematic review to decide on their optimal community CPR training strategy.
CoSTR Attachments:
CCPR training_EIT 881_Feb 8_n.docx    
EIT 881 - List of included studies_n.docx    
EIT 881 communications ATT00006.htm    
EIT 881 Data Collection Form Template_jd_n.xlsx    
EIT 881 Evidence tables_jd_n.docx    
EIT 881 Recommendations_jd_n.docx    

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