CPRandAEDsinSchoolsWhynoteveryone?Whynoteverywhere?HowtoImplementaCPRandAEDTrainingPrograminMySchool/College/University:andInnovationsLikeHowToStoptheZombieApocalypseSpeakers•StuBerger,MD–ProfessorandViceChairofPediatrics;ChiefofPediatricCardiology;DirectorProjectADAM-UCDavis•JeffRanous,PhD,ATC,NREMT–DirectorStateandCommunityAdvocacyAHA•EdStapleton,EMT-P–ProgramCommitteeChairECCU;StonyBrookUniversity•IrfinAsif,MD–ViceChairAcademicsandResearch,DirectorSportsMedicineFellowship,UniversityofSouthCarolina•JenniferEdwards,BA–DirectorofOperations,ACTFoundationofCanadaSpeakers•StuBerger(8minutes)–Introduction,reviewof4recentimportantstudiesandacalltoarms•JeffRanous(8minutes)–Maps,states,legislation,barriers;areweatthe“tippingpoint”forall50states•EdStapleton(8minutes)–TheNewYorkschoolexperience•IrfAsif(8minutes)–Thecollege/universitylevel;barriersandkeystosuccess•JenniferEdwards(8minutes)–TheZombieApocalypse,masstrainingandassortedstrategies•StuBerger(2minutes)–SummaryRECENTAHADATA•1.6millionhighschoolstudentswillhavebeentrainedinCPR-AEDusethisyear•27stateswithlegislationthusfarwithformandatoryCPReducation•GoalfortraininghighschoolstudentsinCPR-AEDusefornextyearis2.5millionSomeveryrecentandimportantstudies•JAMA–2studiesonCPReducation–Japanesestudy–NorthCarolina•JAHA–CARESregistryreviewofOHCAsurvivalinchildren•NEJM–EarlyCPRinOHCAJapaneseStudyNakaharaJAMA2015•167,912bystander-witnessedOHCAsofpresumedcardiacorigin•2005-2007•JapaneseNationalOHCAregistry•Evaluated:–Incidenceofbystanderpre-hospitalintervention–Neurologicallyintactsurvivalat1monthoratdischargeJapaneseStudyNakaharaJAMA2015•Theage-adjustedproportionofneurologicallyintactsurvivalincreasedovertimefrom3.3%to8.2%•Stillnotgreat,butbetter•WHYTHEIMPROVEMENT?JapaneseStudyNakaharaJAMA2015•DURINGTHISSTUDYPERIOD–TheratesofbystanderCPRincreasedfrom38.6%to50.9%–Therateofbystander-onlyCPRincreasedfrom0.1%to2.3%–TherateofcombinedbystanderplusEMSdefibrillationincreasedfrom0.1%to1.4%–EMSONLYdefibrillationdecreasedfrom26.6%to23.5%NorthCarolinaStudyHansenJAMA2015•ExaminedthetemporalchangesinresuscitationperformedbybystandersandfirstrespondersFOLLOWINGSTATE-WIDEINITIATIVEStoimproveresuscitationeffortsinNorthCarolinabetween2010-2013•4,961patientswithOHCAintheCARESregistryfrom2010to2013NorthCarolinaStudyHansenJAMA2015•Initiatives–TrainmembersofthegeneralpopulationinCPRandintheuseofAEDs–Trainfirstrespondersinteam-basedCPRincludingAEDuseandhighperformanceCPR–TraindispatchcenterstorecognizecardiacarrestNorthCarolinaStudyHansenJAMA2015•TheadministrationofbystanderCPRandfirstresponderdefibrillationincombinationincreasedfrom14.1%in2010to23.1%in2013(p<.01)•Survivalwithfavorableneurologicoutcomeincreasedfrom7.1%in2010to9.7%in2013andwasfavorablyassociatedwithbystanderinitiatedCPR(p=.02)NorthCarolinaStudyHansenJAMA2015•ComparedwithsurvivalfollowingEMS-initiatedCPRanddefibrillation(15.2%),survivalfollowingbystander-initiatedCPRanddefibrillation(33.6%),survivalfollowingbystanderCPRandfirstresponderdefibrillation(24.2%)andsurvivalfollowingfirstresponderCPRanddefibrillation(25.2%)WEREHIGHERJAHA2015Jayaram,McNally,etal.•SurvivalAfterOut-of-HospitalCardiacArrestinChildren–ProspectiveCARESregistry–Children<18yearsoldfromOctober2005toDecember2013–Assessedsurvivaltohospitaldischargebyage,sexandrace•...
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