Education and evaluation in emergency cardiac care programs (CPR and advanced cardiac life support): State of the art

To increase the survival rate for out-of-hospital cardiac arrest, improvements in training must be made so that lay rescuers are motivated and have the ability to get involved. To overcome some of the fear and lack of involvement, better education strategies are needed. Adults learn didactic information through understanding and skills through repetition and reinforcement. Due to the fact that there is limited time that adults will commit to learning CPR, methods of simplification of the techniques need to be used so that there can be sufficient repetition and reinforcement. Teaching two-rescuer CPR to lay rescuers should not routinely be done. Most adults, particularly those around high-risk individuals, should learn one-rescuer CPR. Infant resuscitation should be taught predominantly to those around small children. Methods of reinforcement through the mass media should be attempted on a routine basis. Whenever possible the courses should be spread over a period of time to allow for repetition and reinforcement, thereby maximizing learning. Advanced cardiac life support (ACLS) should be widely taught to health professionals. ACLS instruction needs to be spread over time, whenever logistically possible, to enhance learning and retention. Good, validated examinations are needed and should be routinely rotated. Better methods of evaluation are needed to look at the benefit of these types of programs and to improve the cost-benefit ratio.