1. S18 Poster Presentations / Resuscitation 84S (2013) S8–S98
to 10 000 trained volunteers over the next 10 years, in Bucharest
only.
References
1. Orkin, Aaron M. Push hard, push fast, if you’re downtown: a citation review of
urban-centrism in American and European basic life support guidelines. Scand J
Trauma Resusc Emerg Med 2013;21:32 [PubMed].
2. Møller Nielsen A, Lou Isbye D, Knudsen Lippert F, Rasmussen LS. Engag-
ing a whole community in resuscitation. Resuscitation 2012;83:1067–71,
http://dx.doi.org/10.1016/j.resuscitation.2012.04.012. Epub 2012 May 3.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.058
AP027
Incidence of and factors associated with
“mouth-to-mouth ventilation-only
cardiopulmonary resuscitation (MMV-only
CPR)” for out-of-hospital cardiac arrest (OHCA)
cases: A nation-wide cohort study
Hideo Inaba1,∗, Takahisa Kamikura1, Taiki Nishi1,
Keiko Hirose1, Tetsuo Maeda1, Yutaka Yoshita2,
Keisuke Ohta3, Masaaki Hashimoto4
1 Kanazawa University Graduate School of Medicine,
Kanazawa, Japan
2 Komatsu Citizen’s Hospital, Komatsu, Japan
3 Ishikawa Prefectural Hospital, Kanazawa, Japan
4 Noto General Hospital, Nanao, Japan
Purpose of the study: Bystanders may perform MMV-only CPR
for OHCA patients. This study was aimed to elucidate the incidence
of and the factors associated with MMV-only CPR for OHCA cases.
Materials and methods: Data for bystander-witnessed OHCAs
having bystander CPR including MMV-only CPR were extracted
from the nation-wide database for 797,442 OHCAs that occurred
during the period from 2005 and 2011. Finally, 93,314 cases (MMV-
only = 1975, CC-only = 60,266 and CC + MMV = 31,073) excluding
the cases with incomplete data were analysed.
Results: The incidence of MMV-only CPR significantly decreased
after JRC guidelines 2006 during (2.9% in the period of 2005–2006
and 1.1% thereafter) in parallel with the increased incidence of
CC-only CPR (51.2% and 68.7%, respectively). Univariate analysis
followed by multiple logistic regression analysis disclosed that old
CPR guidelines (adjusted odds ratio, 95% confidence interval: 3.68,
3.36–4.03), female patient (1.27, 1.16–1.40), younger age (1.012,
1.009–1014), absence of telephone-CPR (1.46, 1.32–1.61), shorter
duration of bystander CPR (1.016, 1.008–1.023) and early bystander
CPR as assessed by a short interval of collapse-bystander CPR (1.014,
1.007–1.021) were significant factors associated with MMV-only
CPR. The overall rate of neurologically favourable one-month sur-
vival did not significantly differ between MMV-only and standard
(CC-only and CC + MMV) CPR; 4.6% vs. 5.5%, p = 0.07. However,
MMV-only CPR had lower incidences of neurologically favourable
one-month survival (5.2% vs. 7.5%, p = 0.004) and shockable initial
rhythm (20.6% vs. 24.0%, p = 0.007) in the subgroup of presumed
cardiac aetiology. Adjusted odds ratio (95% C.I.) for the survival of
MMV-only CPR were 0.643 (0.476–0.853) to CC + MMV and 0.610
(0.453–0.806) to CC-only-CPR in this subgroup.
Conclusions: Implementation of JRC guidelines decreased the
incidence of MMV-only CPR. MMV-only CPR may deteriorate the
outcome of OHCAs of cardiac aetiology. Repeated assessment of
cardiac arrest by telephone-CPR involving both dispatcher and
bystander may decrease the incidence of MMV-only CPR.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.059
AP028
A three-hour no hands-on practice program vs.
the four-hour traditional program for
laypersons
Renato Trifoni∗, Ergest Bombaj, Nickolaos
Tsaloukidis, Dimitrios Ouzounis, Christina
Marvaki, Maritsa Gourni, Genovefa Kolovou
Postgraduate Department, National and
Kapodistrian University, Athens, Greece
Purpose of the study: Combination of lecture, demonstration
and hands-on practice is the main method of CPR/AED training.
Innovative training methods such as videos with short interces-
sions of self-practice, computer training and mobile phone guiding
are considered quite effective, but still under research. Aim of this
study was to investigate the effectiveness of a three-hour no hands-
on practice training method and compare it, with the traditional
four-hour program for lay persons.
Materials and methods: 67 laypersons, with no previews
CPR and AED training, were randomly divided into two groups:
research group (n = 36) and control group (n = 31). They were
trained respectively in a three-hour no hands-on practice program
and a four-hour traditional program, and evaluated for their skills
at the end of each course by an experienced ERC course director
using an assessment tool.
Results: The internal reliability score of the assessment tool
was Cronbach’s a = 0.78. At least 52% of both groups applied cor-
rectly each skill, research and control groups had a mean score of
correct skill performance respectively 77.8 ± 17.8 and 91.8 ± 11.1,
p < 0.001. The research group lacked at the chest compressions skills
(correct implementation 63.9% vs. 96.8%, p = 0.001), to maintain the
correct compressions:ventilations ratio (77.8% vs. 96.8%, p = 0.024),
the monitoring of the AED audiovisual instructions (86.1% vs. 100%,
p = 0.03) and the implementation of the algorithm (52.8% vs. 77.4%,
p = 0.037). Also, the research group made more pauses during CPR
performance (p = 0.013), and provided less visual and auditory
stimuli when the heart rhythm was analyzed (p = 0.018). There
were no statistically significant differences regarding safety when
approaching the victim and administrating defibrillation, the appli-
cation of the rescue breaths and emergency services calling.
Conclusions: Our method increased CPR/AED skills more than
50%, but significantly less than the traditional four-hour train-
ing. Omitting hands-on practice does not affect appropriate victim
approaching, defibrillation and emergency services calling. Hands-
on practice, however, is very important for key point skills, such as
chest compressions and compressions:ventilations ratio and has an
important role on minimizing pauses during CPR.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.060