The association of layperson characteristics with the quality of simulated cardiopulmonary resuscitation performance

doi:10.5847/wjem.j.1920-8642.2017.01.002

Abstract

Abstract:

BACKGROUND: Few studies have examined the association of layperson characteristics with cardiopulmonary resuscitation (CPR) provision. Previous studies suggested provider characteristics, including age and gender, were associated with CPR quality, particularly chest compression (CC) depth. We sought to determine the association of subject characteristics, including age and gender with layperson CPR quality during an unannounced simulated CPR event. We hypothesized shallower CC depth in females, and older-aged subjects.

METHODS: As part of a larger multicenter randomized controlled trial of CPR training for cardiac patients' caregivers, CPR skills were assessed 6 months after training. We analyzed associations between subject characteristics and CC rate, CC depth and no-flow time. Each variable was analyzed independently; significant predictors determined via univariate analysis were assessed in a multivariate regression model.

RESULTS: A total of 521 laypersons completed a 6-month CPR skills assessment and were included in the analysis. Mean age was 51.8±13.7 years, 75% were female, 57% were Caucasian. Overall, mean CC rate was 88.5±25.0 per minute, CC depth was 50.9±2.0 mm, and mean no-flow time was 15.9±2.7 sec/min. CC depth decreased significantly in subjects >62 years (P<0.001). Male subjects performed deeper CCs than female subjects (47.5±1.7 vs. 41.9±0.6, P<0.001).

CONCLUSION: We found that layperson age >62 years and female gender are associated with shallower CC depth.

Key words: Cardiac arrest, Cardiopulmonary resuscitation, Bystander, CPR quality, Layperson, Demographics

Marion Leary, David G. Buckler, Daniel J. Ikeda, Daiane A. Saraiva, Robert A. Berg, Vinay M. Nadkarni, Audrey L. Blewer, Benjamin S. Abella. The association of layperson characteristics with the quality of simulated cardiopulmonary resuscitation performance[J]. World Journal of Emergency Medicine, 2017, 8(1): 12-18.

Figures/Tables 5

Figure 1.

Table 1

Table 2

Figure 2.

Table 3

Factors significantly associated with CPR quality in multivariate analysis

Variables	Coefficient (95%CI)	P value
Chest compression rate
Race
White (Baseline)	-	-
Black	0.649 (-4.730, 6.027)	NS
Other	13.228 (4.121, 22.335)	0.004
Global P value		0.014
How long since last CPR training, n (%)
Never (Baseline)	-	-
<2 years	11.693 (3.850, 19.536)	0.004
2-5 years	7.383 (0.577, 14.190)	0.034
6-10 years	9.206 (1.962, 16.449)	0.013
>10 years	-4.173 (-9.791, 1.444)	NS
Global P value		0.0002
Mode of teaching
VSI (Baseline)	-	-
Video-only	1.734 (-2.604, 6.072)	NS
Global P value		NS
Site
Site 1 (Baseline)	-	-
Site 2	-1.073 (-7.332, 5.187)	NS
Site 3	-3.602 (-11.358, 4.153)	NS
Site 4	-9.066 (-17.976, -0.156)	0.05
Site 5	-0.846 (-8.391, 6.699)	NS
Site 6	-7.080 (-17.799, 3.640)	NS
Site 7	-1.419 (-9.529, 6.692)	NS
Site 8	-5.340 (-21.256, 10.576)	NS
Global P value		NS
Chest compression depth
Age quartiles (yr)
<43 (Baseline)	-	-
44-52	0.516 (-2.161, 3.194)	NS
53-61	-2.445 (-5.112, 0.225)	0.08
>62	-7.155 (-9.890, -4.420)	0.000
Global P value		0.000
Gender
Female (Baseline)	-	-
Male	5.811 (3.616, 8.006)	0.000
Global P value		0.000
Race
White (Baseline)	-	-
Black	-2.121 (-4.486, 0.243)	0.08
Other	-1.261 (-5.301, 2.779)	NS
Global P value		NS
Mode of teaching
Video-only (Baseline)	-	-
VSI	5.418 (3.528, 7.309)	0.000
Global P value		0.000
Site
Site 1 (Baseline)	-	-
Site 2	1.674 (-1.065, 4.414)	NS
Site 3	-2.355 (-5.765, 1.056)	NS
Site 4	-1.904 (-5.802, 2.005)	NS
Site 5	-3.260 (-6.587, 0.665)	0.06
Site 6	0.946 (-3.720, 5.612)	NS
Site 7	2.501 (-1.065, 6.067)	NS
Site 8	-2.312 (-9.255, 4.631)	NS
Global P value		0.05
Hands-off time
Race
White (Baseline)	-	-
Black	2.717 (-0.550, 5.983)	NS
Other	3.744 (-1.234, 8.722)	NS
Global P value		NS
Education
High school (Baseline)	-	-
Some College/Voc	-3.857 (-7.211, -0.504)	0.02
College	-4.947 (-8.438, -1.455)	0.006
Graduate	0.343 (-4.043, 4.728)	NS
Global P value		0.01
Mode of teaching
Video-only (Baseline)	-	-
VSI	-1.173 (-3.876, 1.531)	NS
Global P value		NS
Site
Site 1 (Baseline)	-	-
Site 2	2.632 (-1.462, 6.726)	NS
Site 3	3.121 (-1.702, 7.945)	NS
Site 4	1.855 (-3.681, 7.392)	NS
Site 5	3.361 (-1.022, 7.744)	NS
Site 6	0.264 (-6.056, 6.583)	NS
Site 7	-1.462 (-7.221, 4.297)	NS
Site 8	10.242 (-2.566, 23.051)	NS
Global P value		NS

Table 3

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Variables	All Subjects
Age, Mean (yr±SD)	51.8±13.7
Gender, n (%)
Female	393 (75)
Male	128 (25)
Race, n (%)
White	285 (55)
Black	196 (38)
Other	35 (7)
Education, n (%)
High school	178 (34)
Some college/Voc	129 (25)
College	137 (26)
Graduate	76 (15)
Relationship, n (%)
Spouse	192 (37)
Immediate family	223 (43)
Other	101 (20)
How long since last CPR training, n (%)
Never	243 (47)
<2 years	46 (9)
2-5 years	64 (12)
6-10 years	55 (11)
>10 years	111 (21)
Mode of teaching, n (%)
Video-only	236 (45)
VSI kit	285 (55)
BMI, n (%)
Underweight	2 (1)
Normal	63 (26)
Overweight	73 (30)
Obese	105 (43)
Site, n (%)
Site 1	129 (23)
Site 2	154 (30)
Site 3	64 (11)
Site 4	41 (7)
Site 5	89 (16)
Site 6	28 (5)
Site 7	57 (10)
Site 8	10 (2)

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