Web-based Compared to Personal Automated External Defibrillator Assisted Cardiopulmonary Resuscitation Training for Dental Students: Randomized Controlled Trial (Preprint)
Authors: Postina Antonia , Hoffmann Jürgen , Mutzbauer Till Sebastian 
Published: April 2020

BACKGROUND

Cardiopulmonary resuscitation (CPR) is rarely performed by dental staff. The availability of automated external defibrillators (AED) is increasing. Tutor-instructed training with a manikin is the most common way to teach CPR. Internet-learning approaches, such as video-based teaching, are gaining popularity and may be the only option to provide CPR instruction in the COVID-19 pandemic situation.

OBJECTIVE

This pilot study has been designed to compare the CPR performance of dental students during a simulated cardiac arrest in a mandatory training course after a personal tutor demonstration and a web-based video demonstration. The main hypothesis was that more than 70% of the participants of the tutor-instructed group would start CPR within 10 seconds (s), while only up to 30% of the participants of the web-based video-instructed group would start within this time.

METHODS

One group of dental students received a 5.5 minutes (min) AED-CPR demonstration by a tutor on a manikin (T-/control group n=23 teams of two). A second group watched a 7min web-based AED-CPR instruction video (W-/intervention group n=23 teams of two). No repetition was offered, no questions or practice allowed. CPR performance was video-recorded and analyzed by two examiners.

RESULTS

No differences concerning the onset and quality of CPR were found. Students started CPR after detection of cardiac arrest with a minimum delay (median=6s (T)/6s (W); IQR=5/7; P=.52). Tidal volume and chest compression depths were insufficient in both groups (tidal volume: median=14 milliliters (ml) (T)/58ml (W); IQR=218.5/148.5; P=.9; depths: median=30 millimeters (mm) (T)/20mm (W); IQR=12.5/10; P=.02). Tutor-instructed teams compressed deeper, but both groups did not meet the recommended standard. Chest compression rate was in the recommended interval (median=113 (T)/111 (W) compressions; IQR=24.5/20; P=.46). More students of the web-based video-instructed group had problems using the AED (T=7 teams; W=14; P=.04) but all except one team continued CPR. They did not focus on the problems with the AED and were able to trigger a shock (T=21; W=19 teams; P=.38). Restart of CPR after the shock within 10s was achieved at almost equal time intervals (median=5s (T)/6s (W); IQR=3/4; P=.54).

CONCLUSIONS

Dental students can acquire basic knowledge in AED-assisted CPR in similar quality by a short web-based video simulation compared with a short demonstration by a tutor. Contrary to expectations, most parameters of CPR/AED performance quality of the web-based training group were not different to the tutor-instructed group. The recommended tidal volume had not been achieved in both groups. Chest compression depth seems to be a parameter more difficult to teach to the web-based video-instructed group. No delays of standard CPR measures were observed after detection of cardiac arrest in both groups. The use of the AED did not distract the attention of the rescuers from the simulated patient.

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