Integration of basic life support training into exercise-based cardiac rehabilitation programs

Abstract

Bystander cardiopulmonary resuscitation (CPR) and early defibrillation are well-recognised factors leading to better prognosis of out-of-hospital cardiac arrest (OHCA). Efforts to reinforce the local chain of survival, with great emphasis in promoting laypeople training in basic life support (BLS), have translated into enhanced outcomes and survival from OHCA. Targeted BLS training for high-risk groups such as cardiac patients and their families has been recommended, but the optimal method has not been defined. The principal aim of this thesis is to assess the feasibility and effectiveness of a novel BLS training strategy for cardiac patients at risk and their families, merged in an exercise-based cardiac rehabilitation (CR) program. Results display poor baseline BLS skills and confidence of patients and their relatives, which were enhanced after a brief BLS instruction. Additionally, a CPR retraining strategy integrated in the supervised exercise training of patients in a CR program served to prevent their skills deterioration and increase their confidence to act in case of OHCA. This formula also showed a positive effect on skill retention in the family environment. This may suggest the feasibility of this formula to effectively train cardiac patients and their relatives in BLS taking advantage of CR programs, enhancing awareness on the role of bystanders to provide early assistance to OHCA and contributing to increase the number of trained citizens in BLS.