Cardiopulmonary resuscitation performance of subjects over forty is betterfollowing half-hour video self-instruction compared to traditional four-hour classroom training

Cardiopulmonary resuscitation (CPR) training is not well targeted to family members of individuals at highest risk of cardiac arrest. Participants in traditional CPR classes (TRAD) average 31 years of age, while family member s of cardiac patients average 55 years. Video self-instruction (VSI) can re ach older individuals and others who do not participate in TRAD classes. VS I is a combination of a 34-min videotape and an inexpensive manikin intende d for use in the home, where three-quarters of all out-of-hospital cardiac arrests occur. We exposed 202 subjects 40 years of age and older (mean age 59.4 years, S.D. = 10.9) to either TRAD or VSI, and tested them individuall y immediately following training using validated methods including measurem ent by means of a Laerdal-Skillmeter(R) manikin. According to American Hear t Association (AHA) criteria, VSI subjects performed an average of 20.8% of all compressions and 25.1% of all ventilations correctly, compared with 3. 4% of compressions and 1.7% of ventilations by TRAD subjects (P < 0.0001). VSI subjects performed an average of 10.1 of the total 14 CPR assessment an d sequence skills correctly, compared with an average of 4.7 for TRAD (P < 0.0001). On a measure of overall performance, 62.7% of the VSI subjects wer e rated 'competent' or better (i.e. capable of performing CPR that 'would p robably be effective'), compared to 6.1% of TRAD subjects (P < 0.0001). Onl y 17.8% of VSI subjects were rated as 'not competent' (i.e. unable to obtai n a combination of any chest rise and any compression of the sternum) compa red with 69.1% of TRAD subjects. VSI provides an effective, convenient, and inexpensive means of training persons over 40 years of age that achieves s kill performance superior to TRAD. (C) 2000 Elsevier Science Ireland Ltd. A ll rights reserved.