ArticleResuscitation plus2026
Feasibility of public CPR training kiosks to increase bystander resuscitation: a Monte Carlo simulation study.
Article in Resuscitation plus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Survival after out-of-hospital cardiac arrest (OHCA) depends on immediate bystander cardiopulmonary resuscitation (CPR), yet rates range from 42 % to 70 % in Canada. Traditional CPR education faces barriers of access, retention, and scalability. Public CPR kiosks are a novel alternative, but their potential population-level impact is uncertain. Methods: We developed a Monte Carlo and queueing-based simulation model to estimate the effect of CPR kiosks on bystander CPR in Toronto, Canada. The model incorporated venue-specific passer volumes, funnel attrition (approach, engagement, practice, competence), demographic witness likelihood, post-training willingness to act, and skill retention. Outcomes included competent trainees, witness-weighted trainees, additional CPR attempts, change in citywide bystander CPR, lives saved, and cost-effectiveness. We modeled deployment of 30 kiosks across four venue types-mega-volume public spaces ( Results: Median annual throughput per kiosk ranged from 488 competent trainees (95 % credible interval [CrI], 94-1550) at small sites (0.5 million passers) to 19,618 (95 % CrI, 3706-50,000) at mega-sites (40 million passers). Witness-weighted trainees were highest in hospitals and pharmacies, reflecting more caregivers and seniors. Training increased willingness to act from 40 % to 60-80 %; this action uplift strongly influenced outcomes. In Toronto, a blended network of 30 kiosks (6 mega, 8 hospital, 8 community, 8 large) increased bystander CPR by 7.5-8.0 percentage points, with a 90-95 % probability of meeting or exceeding a 5-point target within one year. This translated to ∼150 additional CPR attempts and 15 lives saved annually. Costs were ∼$10,000 per life saved and ∼$1250 per quality-adjusted life year (QALY). Conclusions: Simulation modeling suggests CPR kiosks can feasibly and cost-effectively increase bystander CPR, with impact shaped by visibility, action willingness, and targeting individuals most likely to witness arrest.
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