The efficacy of an ACLS training program for resuscitation from cardiac arrest in a rural community*,**
Section snippets
INTRODUCTION
The advanced cardiac life support (ACLS) course was developed by the American Heart Association to improve the outcome for cardiac arrest victims.1 Emergency medical services agencies, medical schools, hospitals, and insurance companies have required ACLS training for health care providers, based on the assumption that such training will improve resuscitation from cardiac arrest. Evaluations of the effectiveness of ACLS training generally have focused on knowledge acquisition or skills
MATERIALS AND METHODS
In October 1989 a 42-bed rural community hospital held the first ACLS-provider training program for its staff in ten years. Before this course, none of the physicians and approximately 15% of the nurses and physician's assistants were certified in ACLS. The ACLS course trained approximately 70% of the nursing and physician's assistant staff and 50% of the physician staff. Prehospital care is provided only by emergency medical technicians (EMTs) with no defibrillation capabilities. During the
RESULTS
Overall, 29 patients suffered cardiac arrest in the pre-ACLS period, with two patients (7%) resuscitated successfully and transferred to urban medical centers. One patient survived to hospital discharge. In the period following the ACLS course, seven of 35 patients (20%) were resuscitated successfully and transferred to urban medical centers, with two patients surviving to hospital discharge (Figure). These overall differences are not statistically significant.
DISCUSSION
The ACLS course was developed by the American Heart Association to improve resuscitation from cardiac arrest. Although ACLS training has been widely accepted, few studies have addressed whether this educational program can make a difference in the resuscitation of patients in cardiac arrest. Most of the literature evaluating ACLS training has focused on knowledge acquisition on "objective" written examinations and skill performance during simulated resuscitations. To improve outcome from
CONCLUSION
ACLS training was associated with higher resuscitation rates from cardiac arrests in a rural community. The major impact was for patients in ventricular fibrillation/tachycardia. The data in this study support the concept that ACLS training should be provided to all health care personnel treating patients in cardiac arrest.
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Cited by (61)
European Resuscitation Council Guidelines 2021: Education for resuscitation
2021, ResuscitationEducation, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations
2020, ResuscitationCitation Excerpt :We recognize that the evidence in support of this recommendation comes from observational studies of very low certainty. However, pooling of the available evidence consistently favors ALS training, and having ALS-trained staff present during an attempted adult resuscitation has been found to reduce treatment errors such as incorrect rhythm assessment337 and time to ROSC.341 We recognize that the provision of accredited adult ACLS training may not be feasible or appropriate in low-resource settings.
Simulation-based education and the challenge of transfer
2019, Clinical Simulation: Education, Operations and Engineering
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Presented at the Society for Academic Emergency Medicine Annual Meeting in Washington, DC, May 1991
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Reprint no 47/1/52203