CPR Instruction by Videotape: Results of a Community Project,☆☆,,★★,,♢♢

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Abstract

Study objective: To increase the rate of bystander CPR in a community by use of a free, mailed, 10-minute videotape of CPR instruction.

Design: Prospective, randomized intervention trial. One half of the households (8,659) received the free videotape (videotape group) and were considered the intervention group, and one half (8,659) served as the control (no-videotape group). All households were followed from December 1991 to March 1993 to determine whether a cardiac arrest occurred and who initiated CPR. A telephone interview obtained additional information about circumstances of the arrest and whether members of the household viewed the videotape. Setting: City of Everett and South Snohomish County, Washington. A commercial mailing list was used to identify 17,318 households with a head of the household who was more than 50 years old. Participants: A case was defined as a cardiac arrest in which CPR was initiated or continued by emergency medical services personnel. Only cardiac arrests due to presumed underlying heart disease were included. Arrests occurring after arrival of emergency medical services personnel were not included. Interventions: The intervention was a free 10-minute videotape with CPR instructions mailed to the 8,659 intervention households. Paramedic run reports were reviewed and interviews were conducted with cardiac arrest bystanders to determine who initiated CPR and whether they had received and viewed the videotape. Results: Sixty-five cardiac arrests occurred in the study households: 31 in households that received the videotape and 34 in households that did not review the videotape. The overall rate of bystander CPR was 47% in the videotape group and 53% in the no-videotape group (P =NS). In nine cardiac arrests, an individual was present who had watched the videotape; six of these nine cases (66%) had bystander CPR. Conclusion: Mass mailings of CPR instructional videos are likely to be ineffective in increasing the rate of bystander CPR in a community. [Eisenberg M, Damon S, Mandel L, Tewodros A, Meischke H, Beaupied E, Bennett J, Guildner C, Ewell C, Gordon M: CPR instruction by videotape: Results of a community project. Ann Emerg Med February 1995;25:198-202.]

Section snippets

INTRODUCTION

The early initiation of CPR is a critical determinant in successful resuscitation from out-of-hospital cardiac arrest.1, 2 Early CPR can be achieved most expediently through bystander CPR.3 Programs designed to increase the rate of bystander CPR have had limited success. Mass training of citizens has been successful in only a few communities. Even in Seattle and King County, Washington, despite a large proportion of citizens trained in CPR, most cardiac arrests do not have bystander CPR.3 This

MATERIALS AND METHODS

A committee of emergency medical services (EMS) personnel, CPR instructors, and physicians defined the content for the videotape, titled "CPR: You Can Do It." An independent producer helped develop and produce a script for a 10-minute pilot videotape. We evaluated the pilot videotape by testing nearly 50 people who were 50 years or older. On the basis of the results of how well the subjects performed CPR after viewing the pilot videotape, we made minor modifications in the content.

In the final

RESULTS

A total of 65 cardiac arrests meeting the case definition occurred in the study community. Forty-five cardiac arrests occurred in nonstudy households and so were excluded from analysis. Among the 65 cases in the study households, 31 occurred in the intervention group and 34 occurred in the control group. There was one repeat episode of cardiac arrest in an intervention household, and this case was counted twice. The patient survived the first episode of cardiac arrest. Data are presented on the

DISCUSSION

There was no statistical difference between the incidence of bystander CPR in the videotape and no-videotape groups. The limited number of cardiac arrests in the community and the higher-than-expected rate of bystander CPR in the control no-videotape group reduced the possibility of demonstrating a benefit of the videotapes. The study was underpowered to demonstrate an effect on community rates of bystander CPR.

A failing of the study was the disappointingly small number of subjects (only nine)

CONCLUSION

Our study demonstrated no benefit of a communitywide CPR training program using videotapes mailed to individuals more than 50 years old. Although the study may have been too small to demonstrate such a benefit, the findings suggest that mass mailing of videotapes is of doubtful usefulness in increasing community rates of bystander CPR.

Acknowledgements

The authors thank the following individuals for making the study possible: Medic 7 and Everett Medics, Sue Eastman, and Dianne Torrance, Brehms, Eastman, Glade, Inc; Terry Meyer, KOMO TV; Chief Terry Ollis, Everett Fire Department; and Steve Call, Emergency Medical Services Division, Seattle/King County Department of Health. Shelley Dixon assisted in manuscript preparation.

References (4)

  • RO Cummins et al.

    Prehospital cardiopulmonary resuscitation: Is it effective?

    JAMA

    (1985)
  • M Eisenberg et al.

    Paramedic programs and out-of-hospital cardiac arrest: I. Factors associated with successful resuscitation

    Am J Public Health

    (1979)
There are more references available in the full text version of this article.

Cited by (0)

From the Center for Evaluation of Emergency Medical Services, Emergency Medical Services Division, King County Department of Health, Seattle*; the Departments of Medicine, Health Services§, and the Division of Research in Medical Education, University of Washington, Seattle; South Snohomish Medic 7, Mountlake Terrace; and Everett Fire Department#, Washington.

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Accepted for publication

Address for reprints: Mickey Eisenberg, MD, Center for Evaluation of Emergency Medical Services, King County Emergency Medical Services, 900 Fourth Avenue, Suite 850, Seattle, Washington 98164, 206-296-4693, Fax 206-296-4866

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Reprint no. 47/1/61959

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