Effectiveness of the BBC's 999 training roadshows on cardiopulmonary resuscitation: video performance of cohort of unforewarned participants at home six months afterwards

BMJ 1996;313:912-916 (12 October)

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Effectiveness of the BBC's 999 training roadshows on cardiopulmonary resuscitation: video performance of cohort of unforewarned participants at home six months afterwards

C Ll Morgan, research officer,^a P D Donnelly, senior lecturer,^a C A Lester, research officer,^a D H Assar, project manager ^a

^a Centre for Applied Public Health Medicine, University of Wales College of Medicine, Cardiff F1 8UL

Correspondence to: Dr Donnelly.

Abstract

Objective: To examine the competence of a cohort trained incardiopulmonary resuscitation by the BBC's 999 training roadshows.
Design: Descriptive cohort study applying an innovative testingprocedure to a nationwide systematic sample. The test samplereceived an unsolicited home visit and without warning wererequired to perform cardiopulmonary resuscitation on a manikinwhile being videoed. The videos were then analysed for effectivenessand safety using the new test.
Setting: Nine cities and surrounding areas in the United Kingdom.
Subjects: 280 people aged between 11 and 72.
Results: Thirty three (12%) trainees were able to perform effectivecardiopulmonary resuscitation, but of these 14 (5%) performedone or more elements in a way that was deemed to be potentiallyinjurious. Thus only 19 (7%) trainees were able at six monthsto provide safe cardiopulmonary resuscitation. In addition,large numbers of subjects failed to shout for help, effectivelyassess the status of the patient, or alert an ambulance. Significantlybetter performances were recorded by those under 45 years old(31 (14%) v 2 (4%) gave effective performances respectively,P<0.05), those who had attended a subsequent cardiopulmonaryresuscitation course (8 (40%) v 25 (10%) gave effective performancesrespectively, P<0.0001), and those confident in their initialability (26 (20%) v 7 (6%) gave effective performances respectively,P<0.005). Females were significantly less likely than malesto perform procedures in a harmful way (117 (62%) v 10 (12%)performed safely respectively, P<0.005).
Conclusion: Television is an effective means of generating largetraining cohorts. Volunteers will cooperate with unsolicitedtesting in their home, such testing being a realistic simulationof the stress and lack of forewarning that would surround areal event. Under such conditions the performance of cardiopulmonaryresuscitation was disappointing. However, retraining greatlyimproves performance.

Key messages

Training for the lay public in cardiopulmonary resuscitation has increased with such initiatives as BBC television's 999 national roadshows, but the effectiveness of this training has not been rigorously evaluated
In this study 280 people who had attended a roadshow were tested, unforewarned, six months later in their home, their management of a simulated case of cardiac arrest being videotaped for later analysis
Only 12% of subjects performed cardiopulmo- nary resuscitation effectively
As well as performing cardiopulmonary resusci- tation ineffectively, 39% of subjects performed one or more procedures in a way that could complicate the recovery of a casualty
Although the 999 roadshows undoubtedly recruit many lay people, attention should now be given to retraining strategies

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