EMS Corner: CPR Training and Re Training

Following training in CPR, how long is the ability to perform effective CPR retained?

Although skill retention from any learned competency varies by individual, the Advisory Council of First Aid and Aquatics Safety and Preparedness (ACFASP) conducted a scientific review in 2009 of 40 different studies on CPR skill retention. Based on their review of these studies, the ACFASP concluded;

– The data indicated substantial CPR skill degradation within 10 weeks after training

– The majority of skills deterioration seemed to occur in the first year

– There was no published evidence indicating adequate retention of CPR skills at 2 years (the typical duration of CPR certifications)

– Several studies reported improved retention when a brief refresher is conducted every 6-12 months

The ACFASP cited numerous limitations associated with their Scientific Review, including  the lack of any study with actual patient outcomes. (All studies used a CPR manikin as a surrogate for human patients) An additional limitation was the lack of a standard to evaluate satisfactory or unsatisfactory skill performance.

Bottom line according to the ACFASP Review – The majority of studies reviewed indicated substantial skill degradation within the first year of training while several studies suggested improved retention associated with brief (30 minute) refresher training.

It is for this reason that, for those clients SCS provides FA/CPR training for, we advocate scheduling FA and CPR training on alternating years allowing for brief CPR skills refresher training during the First Aid training on years between re-certifying CPR training

Cross Sensitivity in Atmosphere Meters

Cross sensitivity refers to a sensor’s ability to be affected by a gas or gasses other than the “target gas”. For example, the CO sensor in many meters is cross sensitive to hydrogen. This means the CO sensor will indicate the presence of CO when, in fact it is actually is in the presence of hydrogen. In the case of the MSA Orion for example, the reading will be about 70% of the actual PPM of hydrogen. Although cross sensitivities vary across manufacturers, all toxic gas sensors in portable meters are cross sensitive to various non-target gases.

The key is to be aware of what gases our sensors are cross sensitive to so we are not ‘fooled’ by an erroneous reading. Likewise, we can use this “cross sensitivity” to our advantage as is the case in the picture shown. In the corresponding photo (below), a hydrogen leak is being monitored and we can clearly see the CO sensor reacting to the hydrogen. At 81% LEL, the hydrogen has maxed the CO sensor at 999 ppm. However, the CO sensor will detect a hydrogen leak at a concentration as small as 2 ppm while the LEL sensor would require a minimum of 400 ppm hydrogen to read 1% LEL. Knowing the CO sensor is cross sensitive to hydrogen allows us to detect hydrogen at a much lower concentration than the LEL sensor alone allows. As you see, we can use cross sensitivity to our advantage if we understand it.

What this means for you

If monitoring a suspect atmosphere, keep cross sensitivity in mind.  If you enter a facility and obtain readings that are confusing or highly unusual you may be in the presence of a non-target gas.  Users should exercise a questioning attitude in proceeding further until the containment can be verified.  See the users manual of your meter for conversion charts and specific conversions for cross sensitive gasses as these will differ among varying models.

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What’s the advantage of on-site training over a quality computer based training (CBT) system?

Although many computer based training programs are available, many of which are good quality, there are many limitations to such a training format. The advantage to having an experienced and skilled instructor conducting training tailored specifically to you are numerous;

  • A skilled instructor will engage your employees in a manner that CBT training cannot; ensuring much higher information, understanding, and retention
  • It affords your employees an opportunity to ask questions and engage in discussion on the subject matter and how it applies to their unique work environment
  • It can incorporate your specific work policies and procedures as well as the hazards unique to your facility
  • It will often include hands-on training that cannot be duplicated through CBT
  • It allows for training the “safety process” as opposed to merely communicating safety rules