Quality of chest compressions by Down syndrome people: A pilot trial

doi:10.1016/j.resuscitation.2015.01.022

Resuscitation

Volume 89, April 2015, Pages 119-122

https://doi.org/10.1016/j.resuscitation.2015.01.022 Get rights and content

Abstract

Introduction

Immediate bystander cardiopulmonary resuscitation (CPR) is essential for survival after out-of-hospital cardiac arrest. Down syndrome (DS) citizens have improved their active engagement in society. The objective of this pilot trial was to investigate if they are able to perform quality chest compression-only CPR after a brief training.

Methods

Nineteen DS young people (15–30 year old) and 20 University level subjects (18–29 year old) were trained by means of a short video and a brief hands-on session on manikins, to perform chest compression-only CPR. All participants were naïve in CPR. Chest compression (CC) quality (percentage of correct CC, CC rate and depth and chest complete release) was measured during a 2 min test. CPR quality goal was according to 2010 European Resuscitation Council guidelines.

Results

DS people had similar weight, lower height and a higher BMI than controls. They were able to deliver chest compression-only CPR but with higher mean CC rate (140 ± 30 vs 123 ± 12 CC/min, p = 0.03), less mean CC depth (35.4 ± 10.3 vs 47.2 ± 9.6 mm, p = 0.03) and lower % of full correct CC (13 ± 18 vs 39 ± 37, p = 0.02) than controls. Differences were maintained when first and second minute of test were compared.

Conclusions

After a short instruction based on a brief video and hands-on session DS people were able to deliver CC but with poor quality.

Introduction

In case of cardiac arrest, immediate initiation of cardiopulmonary resuscitation (CPR) by bystanders improves survival.1, 2 However, the number of laypeople who deliver first aid after witnessing an accident remains to be poor.³ Everyone should be informed and trained to detect a cardiac arrest victim and to immediately start good quality CPR as an essential link of the chain of survival.⁴

In recent years, many institutions have targeted efforts at training laypeople in compression-only CPR skills and have designed CPR training programs and resources to be applied in schools as well as in other settings.5, 6, 7 Brief videos have been used to train laypeople on the provision of compression-only CPR.⁵

Down syndrome (DS) is the most common genetic cause of intellectual disability. As a result of improvement in medicine, technology, and education, the life expectancy and quality of individuals with DS is nearly comparable to the general population in developed countries. Due to health and social policy strategies as well as multifaceted efforts DS citizens have increased their active presence in the society and try to gain integration. Offering DS individuals the same learning and training options as laypersons may be a good way of improving their self-steam and active role in society.⁸

Due to the fact that we were not aware of prior experiences about CPR training of DS people we designed the “Yes, we also can!” pilot trial. We hypothesized that DS young persons were capable of learning and performing quality chest compressions (CC) similarly to laypeople. The aim of this study was to assess the ability of young people with DS to perform good quality compression-only CPR in a manikin after a brief training supported by a brief funny video in comparison with university students. Primary endpoint was CC depth, CC rate and composite CC quality.

Section snippets

Study design and selection of participants

This study was designed as a prospective investigation and it was conducted in April 2014 in Galicia, Spain. The study sample was divided into two groups: experimental (DS) and control.

DS subjects: The participants were recruited at the Down Compostela Foundation. This is a not-for-profit organization where DS and other disabled people go for training and education to live independently. Currently, a total of 68 DS persons aged from newborn to adulthood use the facility. All DS persons older

Results

DS individuals had lower height and slightly higher BMI than controls (Table 1).

CC quality results are shown in Table 2. CC rate, percentage of shallow CC, and percentage of CC without complete release were significantly higher in DS subjects than in controls. Mean CC depth, percentage of CC delivered at recommended rate, and the percentage of the composite variable “full correct CC” were significantly lower in the experimental group than in controls. The applied work measured as CC rate × CC

Discussion

Layperson information and training is essential to increase bystander CPR rates and out-of-hospital cardiac arrest outcome.³ Although several training methods and programs have been implemented, we lack evidences about the best in terms of feasibility, usefulness and cost-efficiency. Hands-only CC is a proposed alternative to standard CPR for laypeople in witnessed unexpected cardiac arrest, because it delivers substantially more compressions per minute and may be easier to remember and perform.

Conclusions

After short instruction based on a brief video and hands-on session DS young people with mild or moderate intellectual disability and without physical disability were able to deliver CC but failed to achieve good CC quality.

Conflict of interest statement

The authors declare that they have no conflicts of interest related to the present study.

Acknowledgement

We would like to thank all the people (members, staff, families) of the Down Compostela Foundation.

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^☆: A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2015.01.022.

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Simulation and educationQuality of chest compressions by Down syndrome people: A pilot trial☆

Abstract

Introduction

Methods

Results

Conclusions

Introduction

Section snippets

Study design and selection of participants

Results

Discussion

Conclusions

Conflict of interest statement

Acknowledgement

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Resuscitation

Am J Emerg Med

Resuscitation

J Emerg Med

J Emerg Med

Resuscitation

Simulation and education
Quality of chest compressions by Down syndrome people: A pilot trial☆