Out-of-hospital cardiac arrest (OHCA) is an important public health issue. Chang Gung Memorial Hospital, a university affiliated medical center in Taoyuan city, northern Taiwan, actively cooperated with the government policy to donate a total of 250 automated external defibrillators (AED) and to deploy them in public areas during the period of 2012 to 2014. In addition, nearly 200 courses of cardiopulmonary resuscitation (CPR) education for healthcare providers and citizens were provided.

In order to keep the skills and the abilities of emergency medical responses in these 200 and more AED recipient areas, repeated CPR education and training should be implemented. Quality assurance and regular follow-up by medical directors with professional advice and feedback can therefore be provided at the same time. Therefore, this project aims to assess the quality of emergency responses in the recipient units in the next four years via regular follow-up by medical directors with advice and feedback. Continuing medical education of both e-learning and classes, online registration system, as well as first aid supplies will be provided at the regular follow-up visits. The results of this project will provide a feasible model of quality assurance of first aid and AED implementation program in the community.

The core value of the investigation is to provide high quality, convenient, time-saving, and cost-effective CPR training model. The training proctors will either instruct laypersons or healthcare providers to watch on-line video for 18 minutes at home then practice the skills for 30 minutes in the training scene or provide standard CPR program (90 minutes in the scene) and empower them with the life-saving skills of CPR. The American Heart Association's CPR with a DVD and laerdal QCPR manikin will be used to record. Participants will be randomly allocate into either the on-line or standard method of the training program. To assess the effects of training, the participants will receive written examinations before and after the course. The investigators will also follow up with the study participants and conduct CPR skills tests at 6 and 12 months from the time of training to assess whether the subjects retain their skills or if they have an opportunity to use the skills that they learned. Information about the willing of performing CPR and satisfaction to the training will also be collected.

Inclusion Criteria:

• Adults aged 20 and over
• Adults who have not attended CPR training for at least one year prior to enrollment

Exclusion Criteria:

• unable to kneel to practice CPR
• pregnant
• unwilling to sign informed consent