Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 10, 118-125 2025 Publisher: Learning Gate DOI: 10.55214/2576-8484.v9i10.10372 © 2025 by the authors; licensee Learning Gate © 2025 by the authors; licensee Learning Gate History: Received: 1 August 2025; Revised: 3 September 2025; Accepted: 5 September 2025; Published: 6 October 2025 * Correspondence: emtec@eulji.ac.kr Effect of infectious disease on paramedic students’ willingness to perform mouth to mouth ventilation at a university Jee Hee Kim1, Tai-Hwan Uhm2*, Sang-Kyu Park3 1Department of Paramedicine, Kangwon National University, 346, Hwangjogil, Dogye-eup, Samcheok, 25949, Republic of Korea; Kjh1962@hanmail.net (J.H.K.). 2Department of Paramedicine, Eulji University, 553, Sanseongdaero, Seongnam, 13135, Republic of Korea; emtec@eulji.ac.kr (T.H.U.). 3Department of Paramedicine, Gachon University, 191, Hambakmoero, Incheon, 21936, Republic of Korea; psk9322@gachon.ac.kr (S.K.P.). Abstract: This study was conducted to confirm factors that negatively affect mouth-to-mouth ventilation (MMV) by laypersons. An internet non-face-to-face survey was conducted using NAVER Office with 101 respondents out of 157 paramedic students at a university. Whether or not to apply MMV according to the infection status of adults, children, and infants was analyzed through the Chi- Square test for each variable. There was a statistically significant difference between the proportion of willingness to perform MMV for suspected infection adult patients by male and female students (p=.004), for non-infection adult patients by training session (p=.030), for non-infection adult patients by experience in providing CPR (p=.011), for infection child patients by male and female students (p=.011), for suspected infection child patients by male and female students (p=.040), and for infection infant patients by male and female students (p=.011). Concerns over infection had a negative impact on paramedic students’ willingness to perform MMV. Keywords: Experience, Female, Infection, Male, Paramedic students, Training. 1. Introduction The core American Heart Association (AHA) emergency cardiovascular care (ECC) educational concept includes hands-on practice to meet psychomotor and non-technical or leadership skill performance objectives [1], but there is a limit to developing the willingness to perform cardiopulmonary resuscitation (CPR). In general, education is achieved through the appropriate harmony of not only knowledge and skill but also attitude. To develop willingness to perform CPR, misunderstandings about brain death, fear of performing CPR incorrectly, concern for injuring the victim, physical limitations, fear of infection, victim characteristics, and fear of liability must be overcome [2]. With concerns over infection growing due to the recent COVID-19 pandemic, the fear of infection could be a negative factor in providing CPR. It should be taught that the risk of infection from CPR is low [3]. Fear of infection to the public acts as a barrier to performing CPR [4-13]. The AHA guidelines for CPR and ECC also emphasize pushing hard and fast in chest compressions to lower concerns about infection caused by contact. They focus on enhancing the effectiveness of out-of-hospital CPR while increasing blood flow to the brain and facilitating implementation by making it easier for laypersons to learn. The recommendation of compression-only (CO) CPR helps laypersons perform CPR without concerns about infection caused by mouth-to-mouth ventilation (MMV). CO-CPR is effective for cardiac arrest with cardiac etiology, but MMV and chest compressions are required for children and infant patients, who usually have cardiac arrest due to dyspnea [14-19]. If the factors that negatively affect MMV are analyzed in detail, it would be possible to further increase the willingness to 119 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 10: 118-125, 2025 DOI: 10.55214/2576-8484.v9i10.10372 © 2025 by the authors; licensee Learning Gate perform CPR by using the identified factors for layperson CPR education. This study was conducted to confirm these factors in detail, assuming that the infection condition of cardiac arrest patients will negatively affect MMV by laypersons. 2. Materials and Methods From September 27 to October 8, 2021, an internet non-face-to-face survey was conducted using NAVER Office on a total of 157 paramedic students, including 46 freshmen, 29 sophomores, 37 juniors, and 45 seniors. The survey designed for this study consisted of 25 questions to analyze the effects of infection on the respondents' willingness to perform CPR. It confirmed previous CPR training and experience of providing CPR, self-assessed scores on CPR knowledge, skills, and attitudes using by Likert scale. The respondents were asked to answer their willingness to perform CPR with 'yes or no' under conditions that do not involve body substance isolation, according to the cardiac arrest patients (adult, child, and infant), possibility of infection (infected, suspected, and non-infected), and CPR methods (MMV). The collected data were analyzed using SPSS 20.0 for Windows (IBM Inc., New York, USA) at the ⍺=.05 (two-tailed). Whether to apply or not MMV according to the infection status of adults, children, and infants was analyzed through the Chi-Square test for each variable. In addition, a reliability analysis was conducted on 18 questions that investigated the willingness to perform MMV. Since Cronbach's ⍺ was .889, the questions had good internal consistency. This investigation was conducted with the consent of the students, and there was no disadvantage to responding; consent could be withdrawn at any time. To induce sincere answers, the name and school number were entered, but personal information was discarded while organizing the data. 3. Results and Discussion The average age of the respondents was 21.2 years old, and 101 respondents out of 157 eligible students, including 63 females and 38 males, responded to the survey. The freshman was the largest group with 38 respondents, followed by 27 juniors, and 18 sophomores and seniors. 97 respondents had experience in CPR training, and the highest number of training sessions attended was 57, while 90 respondents had no experience in providing CPR. Self-assessed CPR scores were 4.1 in knowledge, 4.0 in skill, and 4.2 in attitude [Table 1]. 120 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 10: 118-125, 2025 DOI: 10.55214/2576-8484.v9i10.10372 © 2025 by the authors; licensee Learning Gate Table 1. Characteristics of respondents (N=101). Respondents N (%) Age, M(SD) 21.2(2.23) Sex male 38(37.6) female 63(62.4) Paramedic student freshman 38(37.6) sophomore 18(17.8) junior 27(26.7) senior 18(17.8) Previous CPR training yes 97(96.0) no 4(4.0) Number of CPR training, M(IQR) 2.6(2.0) 0 4(4.0) 1 57(56.4) 2 11(10.9) 3 5(5.0) 4 8(7.9) 5 8(7.9) 8≤ 8(7.9) Experience in providing CPR yes 11(10.9) no 90(89.1) Number of providing CPR, M(SD) 0.6(2.87) 0 90(89.1) 1 5(5.0) 2 1(1.0) 3 1(1.0) 4 1(1.0) 5 1(1.0) 6≤ 2(2.0) Self-assessed score*, M(SD) knowledge 4.1(0.70) performance 4.0(0.72) attitude 4.2(0.71) Note: M: mean, SD: standard deviation, CPR: cardiopulmonary resuscitation, IQR: interquartile range. *Likert scale: 1, not at all; 2, not really; 3, undecided; 4, somewhat; 5, very much. Twelve adults, 17 children, and 17 infants responded that MMV and chest compression could be performed on patients with infected cardiac arrest, but 73 adults, 74 children, and 69 infants responded that only chest compression could be performed. Twenty-four adults, 28 children, and 31 infants responded that MMV and chest compression could be performed on patients with suspected cardiac arrest, but 82 adults, 79 children, and 81 infants responded that only chest compression could be performed. Eighty-three adults, 83 children, and 81 infants responded that MMV and chest compression could be performed on patients with non-infected cardiac arrest, but 99 adults, 96 children, and 96 infants responded that only chest compression could be performed. There was no difference in the willingness to perform CPR according to the age of the infected patient, but there was a difference in the willingness to perform CPR according to the infection status 121 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 10: 118-125, 2025 DOI: 10.55214/2576-8484.v9i10.10372 © 2025 by the authors; licensee Learning Gate and CPR method. In MMV and chest compression, the willingness to perform CPR increased relatively rapidly in the order of infection, suspected infection, and non-infection. However, in CO- CPR, the willingness to perform CPR increased relatively slowly. Overall, the willingness to perform chest compression on non-infected patients was the greatest [Table 2]. Table 2. Respondents’ willingness to perform cardiopulmonary resuscitation according to infection (N=101). Patient Willingness*(%) Mouth-to-mouth ventilation & chest compression Compression-only Adult Infection 12(11.9) 73(72.3) Suspected Infection 24(23.8) 82(81.2) Non-Infection 83(82.2) 99(98.0) Child Infection 17(16.8) 74(73.3) Suspected Infection 28(27.7) 79(78.2) Non-Infection 83(82.2) 96(95.0) Infant Infection 17(16.8) 69(68.3) Suspected Infection 31(30.7) 81(80.2) Non-Infection 81(80.2) 96(95.0) Note: *The number of respondents who answered yes. There was a statistically significant difference between the proportion of willingness to perform MMV for suspected infection adult patients by male and female students, and the association between these variables was moderate (p=.004; contingency coefficient=.276). Female students' willingness to perform MMV (14.3%) was small. There was a statistically significant difference between the proportion of willingness to perform MMV for non-infection adult patients by training session, and the association between these variables was moderate (p=.030; contingency coefficient=.221). Students with more than twice the training session's willingness in MMV (92.5%) were large. There was a statistically significant difference between the proportion of willingness to perform MMV for non-infection adult patients by experience in providing CPR, and the association between these variables was moderate (p=.011; contingency coefficient=.244). Students with no experience in CPR's willingness in MMV (92.5%) was large [Table 3]. 122 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 10: 118-125, 2025 DOI: 10.55214/2576-8484.v9i10.10372 © 2025 by the authors; licensee Learning Gate Table 3. Respondents are willing to perform mouth-to-mouth ventilation on an adult according to the infection, n(%). Patient Infection Suspected infection Non-infection Mouth-mouth ventilation Yes. No. Yes. No. Yes. No. Gender Male 10(26.3) 28(73.7) 15(39.5) 23(60.5) 32(84.2) 6(15.8) Female 2(3.2) 61(96.8) 9(14.3) 54(85.7) 51(81.0) 12(19.0) p; contingency coefficient <.001* .004; .276 .679 Number of CPR training sessions 1 3(5.3) 54(94.7) 9(15.8) 48(84.2) 43(75.4) 14(24.6) 2≤ 6(15.0) 34(85.0) 12(30.0) 28(70.0) 37(92.5) 3(7.5) p; contingency coefficient .104* .094 .030; .221 Experience in providing CPR yes. 1(9.1) 10(90.9) 1(9.1) 10(90.9) 6(54.5) 5(45.5) no. 11(12.2) 79(87.8) 23(25.6) 67(74.4) 77(85.6) 13(14.4) p; contingency coefficient .762* .226* .011; .244 Note: CPR: cardiopulmonary resuscitation. *Expected frequency of one or more cells is less than 5. There was a statistically significant difference between the proportion of willingness to perform MMV for infected child patients by male and female students, and the association between these variables was moderate (p=.011; contingency coefficient=.244). Female students' willingness to perform MMV (9.5%) was small. There was a statistically significant difference between the proportion of willingness to perform MMV for suspected infected child patients by male and female students, and the association between these variables was moderate (p=.040; contingency coefficient=.200). Female students' willingness to perform MMV (20.6%) was relatively small [Table 4]. Table 4. Respondents willing to perform mouth-to-mouth ventilation for a child according to infection n(%). Patient Infection Suspected infection Non-infection Mouth-mouth ventilation Yes. No. Yes. No. Yes. No. Gender Male 11(28.9) 27(71.1) 15(39.5) 23(60.5) 32(84.2) 6(15.8) Female 6(9.5) 57(90.5) 13(20.6) 50(79.4) 51(81.0) 12(19.0) p; contingency coefficient .011; .244 .040; .200 .679 Number of CPR training sessions 1 4(7.0) 53(93.0) 11(19.3) 46(80.7) 44(77.2) 13(22.8) 2≤ 10(25.0) 30(75.0) 14(35.0) 26(65.0) 36(90.0) 4(10.0) p; contingency coefficient .013* .082 .102* Experience in providing CPR yes. 1(9.1) 10(90.9) 1(9.1) 10(90.9) 7(63.6) 4(36.4) no. 16(17.8) 74(82.2) 27(30.0) 63(70.0) 76(84.4) 14(15.6) p; contingency coefficient .467* .144* .089 Note: CPR: cardiopulmonary resuscitation. *Expected frequency of one or more cells is less than 5. There was a statistically significant difference between the proportion of willingness to perform MMV for infection in infant patients by male and female students, and the association between these variables was moderate (p=.011; contingency coefficient=.244). Female students' willingness to perform MMV (9.5%) was small [Table 5]. 123 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 10: 118-125, 2025 DOI: 10.55214/2576-8484.v9i10.10372 © 2025 by the authors; licensee Learning Gate Table 5. Respondents willing to perform mouth-to-mouth ventilation for an infant according to infection n(%). Patient Infection Suspected infection Non-infection Mouth-mouth ventilation Yes. No. Yes. No. Yes. No. Gender Male 11(28.9) 27(71.1) 15(39.5) 23(60.5) 32(84.2) 6(15.8) Female 6(9.5) 57(90.5) 16(25.4) 47(74.6) 49(77.8) 14(22.2) p; contingency coefficient .011; .244 .137 .432 Number of CPR training sessions 1 4(7.0) 53(93.0) 13(22.8) 44(77.2) 45(78.9) 12(21.1) 2≤ 10(25.0) 30(75.0 15(37.5) 25(62.5) 33(82.5) 7(7.5) p; contingency coefficient .013* .116 .664 Experience in providing CPR yes. 1(9.1) 10(90.9) 1(9.1) 10(90.9) 7(63.6) 4(36.4) no. 16(17.8) 74(82.2) 30(33.3) 60(66.7) 74(82.2) 16(17.8) p; contingency coefficient .467* .110* .114* Note: CPR: cardiopulmonary resuscitation. *Expected frequency of one or more cells is less than 5. Although the willingness to perform MMV differed greatly depending on the patient's infection status, the willingness to perform CO-CPR was relatively small, so CO-CPR amid a pandemic is expected to help activate CPR. However, since the willingness to perform CO-CPR for infected patients was small, it is necessary to strengthen CO-CPR through infection prevention education. Concerns over infection have reduced paramedic students’ willingness to perform MMV. The statistically significant small willingness of female students to perform MMV was consistent with the results of previous studies [20-22]. It is believed that education, which can reduce women’s fear of infection, should be further strengthened. However, previous studies investigated willingness to perform standard CPR rather than MMV, and there was no statistically significant difference between male and female students in this study's willingness to perform CO-CPR. Students who trained in CPR more than twice showed a greater willingness to perform MMV, which is consistent with previous studies indicating that training enhances willingness [23-27]. Previous studies did not separate and investigate willingness to perform MMV, and in this study, the difference between once and twice or more was analyzed because more than half of the students were trained once. It is interpreted that the students who trained more than twice had a high willingness, because the training interval was relatively short. Since knowledge and skill decline 3-12 months after training, it is estimated that willingness will decline after several months as well. Therefore, it is judged that it is necessary to analyze the optimal training interval rather than the number of training sessions. The AHA Guidelines: Resuscitation Education Science, mentioned that the addition of booster training to the CPR education is related to maintenance of skills, and the application of spaced learning compared to intensive learning improves clinical performance and technical skills. It indirectly supports the importance of the optimal training interval [1]. The reason why students with no experience in providing CPR were willing to perform MMV on non-infected adult patients is believed to be due to the growing awareness of infection among students who had experience in providing CPR. In a study published in 2008, it was found that the experience of providing CPR increased willingness to perform [23, 28], but in this study, paramedic students who experienced the COVID-19 pandemic were respondents, which is interpreted as a result of increased awareness of infection. It is believed that infection prevention should be strengthened in CPR education, as laypersons are more likely to hesitate not only with mouth-to-mouth ventilation (MMV) but also with CO-CPR. 124 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 10: 118-125, 2025 DOI: 10.55214/2576-8484.v9i10.10372 © 2025 by the authors; licensee Learning Gate 4. Conclusion Concerns over infection had a negative impact on the paramedic students’ willingness to perform MMV. In particular, female students had a small willingness to perform MMV for suspected infection adult patients, infection & suspected infection child patients, and infection infant patients. Students who trained more than twice had a greater willingness to perform MMV for non-infected adult patients, and students who had no experience in providing CPR had a greater willingness to perform MMV for non-infected adult patients. Transparency: The authors confirm that the manuscript is an honest, accurate, and transparent account of the study; that no vital features of the study have been omitted; and that any discrepancies from the study as planned have been explained. This study followed all ethical practices during writing. Copyright: © 2025 by the authors. This open-access article is distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). References [1] A. Cheng et al., "Part 6: Resuscitation education science: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care," Circulation, vol. 142, no. 16_Suppl_2, pp. S551- S579, 2020. https://doi.org/10.1161/CIR.00000000000009 [2] T.-H. Uhm, J.-H. Kim, S.-K. Park, E.-J. Kwag, and Y.-L. Ham, "Comparison of knowledge and performance after cardiopulmonary resuscitation training at 3, 6, 9 months," Indian Journal of Public Health Research & Development, vol. 10, no. 11, pp. 36-41, 2019. https://doi.org/10.5958/0976-5506.2019.04283.9 [3] B. Brenner, "Willingness of male homosexuals to perform mouth-to-mouth resuscitation," Resuscitation, vol. 27, no. 1, pp. 23-30, 1994. https://doi.org/10.1016/0300-9572(94)90017-5 [4] C. Lester, P. D. Donnelly, and D. Assar, "Lay CPR trainees: Retraining, confidence and willingness to attempt resuscitation 4 years after training," Resuscitation, vol. 45, no. 2, pp. 77-82, 2000. https://doi.org/10.1016/s0300- 9572(00)00170-2 [5] M. W. Hubble, M. Bachman, R. Price, N. Martin, and D. Huie, "Willingness of high school students to perform cardiopulmonary resuscitation and automatic external defibrillation," Prehospital Emergency Care, vol. 7, no. 2, pp. 219- 224, 2003. [6] T. C. Johnston, M. J. Clark, G. A. Dingle, and G. FitzGerald, "Factors influencing queenslanders’ willingness to perform bystander cardiopulmonary resuscitation," Resuscitation, vol. 56, no. 1, pp. 67-75, 2003. https://doi.org/10.1016/S0300-9572(02)00277-0 [7] S. Hamasu et al., "Effects of BLS training on factors associated with attitude toward CPR in college students," Resuscitation, vol. 80, no. 3, pp. 359-364, 2009. https://doi.org/10.1016/j.resuscitation.2008.11.023 [8] J. L. Winkelman, R. Fischbach, and E. F. Spinello, "Assessing CPR training: The willingness of teaching credential candidates to provide CPR in a school setting," Education for Health, vol. 22, no. 3, pp. 1-11, 2009. [9] G. C. Cho et al., "The effect of basic life support education on laypersons’ willingness in performing bystander hands only cardiopulmonary resuscitation," Resuscitation, vol. 81, no. 6, pp. 691-694, 2010. https://doi.org/10.1016/j.resuscitation.2010.02.021 [10] S. Savastano and V. Vanni, "Cardiopulmonary resuscitation in real life: The most frequent fears of lay rescuers," Resuscitation, vol. 82, no. 5, pp. 568-571, 2011. https://doi.org/10.1016/j.resuscitation.2010.12.010 [11] B. K. Kanstad, S. A. Nilsen, and K. Fredriksen, "CPR knowledge and attitude to performing bystander CPR among secondary school students in Norway," Resuscitation, vol. 82, no. 8, pp. 1053-1059, 2011. https://doi.org/10.1016/j.resuscitation.2011.03.033 [12] S. Y. Liaw et al., "Improving perception and confidence towards bystander cardiopulmonary resuscitation and public access automated external defibrillator program: How does training program help?," International Journal of Emergency Medicine, vol. 13, pp. 1-7, 2020. https://doi.org/10.1186/s12245-020-00271-3 [13] Q. Huang, C. Hu, and J. Mao, "Are Chinese students willing to learn and perform bystander cardiopulmonary resuscitation?," The Journal of Emergency Medicine, vol. 51, no. 6, pp. 712-720, 2016. https://doi.org/10.1016/j.jemermed.2016.02.033 [14] M. Kuisma and A. Alaspää, "Out-of-hospital cardiac arrests of non-cardiac origin: Epidemiology and outcome," European Heart Journal, vol. 18, no. 7, pp. 1122-1128, 1997. https://doi.org/10.1093/oxfordjournals.eurheartj.a015407 https://creativecommons.org/licenses/by/4.0/ https://doi.org/10.1161/CIR.00000000000009 https://doi.org/10.5958/0976-5506.2019.04283.9 https://doi.org/10.1016/s0300-9572(00)00170-2 https://doi.org/10.1016/s0300-9572(00)00170-2 https://doi.org/10.1016/S0300-9572(02)00277-0 https://doi.org/10.1016/j.resuscitation.2008.11.023 https://doi.org/10.1016/j.resuscitation.2010.02.021 https://doi.org/10.1016/j.resuscitation.2010.12.010 https://doi.org/10.1016/j.resuscitation.2011.03.033 https://doi.org/10.1186/s12245-020-00271-3 https://doi.org/10.1016/j.jemermed.2016.02.033 https://doi.org/10.1093/oxfordjournals.eurheartj.a015407 125 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 10: 118-125, 2025 DOI: 10.55214/2576-8484.v9i10.10372 © 2025 by the authors; licensee Learning Gate [15] J. López-Herce et al., "Characteristics and outcome of cardiorespiratory arrest in children," Resuscitation, vol. 63, no. 3, pp. 311-320, 2004. https://doi.org/10.1016/j.resuscitation.2004.06.008 [16] J. López-Herce et al., "Long-term outcome of paediatric cardiorespiratory arrest in Spain," Resuscitation, vol. 64, no. 1, pp. 79-85, 2005. https://doi.org/10.1016/j.resuscitation.2004.07.010 [17] J. Herlitz, J. Engdahl, L. Svensson, M. Young, K.-A. Ängquist, and S. Holmberg, "Characteristics and outcome among children suffering from out of hospital cardiac arrest in Sweden," Resuscitation, vol. 64, no. 1, pp. 37-40, 2005. https://doi.org/10.1016/j.resuscitation.2004.06.019 [18] D. L. Atkins et al., "Epidemiology and outcomes from out-of-hospital cardiac arrest in children: The resuscitation outcomes consortium epistry-cardiac arrest," Circulation, vol. 119, no. 11, pp. 1484-1491, 2009. https://doi.org/10.1161/CIRCULATIONAHA.108.802678 [19] T. Kitamura et al., "Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: A prospective, nationwide, population-based cohort study," The Lancet, vol. 375, no. 9723, pp. 1347-1354, 2010. https://doi.org/10.1016/S0140-6736(10)60064-5 [20] K. Sipsma, B. A. Stubbs, and M. Plorde, "Training rates and willingness to perform CPR in King County, Washington: a community survey," Resuscitation, vol. 82, no. 5, pp. 564-567, 2011. https://doi.org/10.1016/j.resuscitation.2010.12.007 [21] S.-H. Leem, "Analysis of factors for intention to perform cardiopulmonary resuscitation," The Korean Journal of Emergency Medical Services, vol. 17, no. 3, pp. 169-179, 2013. https://doi.org/10.14408/KJEMS.2013.17.3.169 [22] K. S. Chew et al., "The influence of past experiences on future willingness to perform bystander cardiopulmonary resuscitation," International Journal of Emergency Medicine, vol. 12, pp. 1-7, 2019. https://doi.org/10.1186/s12245- 019-0256-5 [23] N. Kuramoto et al., "Public perception of and willingness to perform bystander CPR in Japan," Resuscitation, vol. 79, no. 3, pp. 475-481, 2008. https://doi.org/10.1016/j.resuscitation.2008.07.005 [24] A. Bohn et al., "Teaching resuscitation in schools: Annual tuition by trained teachers is effective starting at age 10. A four-year prospective cohort study," Resuscitation, vol. 83, no. 5, pp. 619-625, 2012. https://doi.org/10.1016/j.resuscitation.2012.01.020 [25] J. Urban, H. Thode, E. Stapleton, and A. J. Singer, "Current knowledge of and willingness to perform Hands-Only™ CPR in laypersons," Resuscitation, vol. 84, no. 11, pp. 1574-1578, 2013. https://doi.org/10.1016/j.resuscitation.2013.04.014 [26] H. Matsubara et al., "Effects of obligatory training and prior training experience on attitudes towards performing basic life support: A questionnaire survey," Acute Medicine & Surgery, vol. 2, no. 2, pp. 105-113, 2015. https://doi.org/10.1002/ams2.79 [27] S. R. Karuthan et al., "Knowledge of and willingness to perform Hands-Only cardiopulmonary resuscitation among college students in Malaysia," Medicine, vol. 98, no. 51, pp. 1-7, 2019. https://doi.org/10.1097/MD.0000000000018466 [28] H. Lee and K. Yoo, "A study on the metabus-based equipment monitoring system," Journal of Internet Technology, vol. 1, no. 3, pp. 99-105, 2023 https://doi.org/10.60032/JIIT.2023.1.3.99 https://doi.org/10.1016/j.resuscitation.2004.06.008 https://doi.org/10.1016/j.resuscitation.2004.07.010 https://doi.org/10.1016/j.resuscitation.2004.06.019 https://doi.org/10.1161/CIRCULATIONAHA.108.802678 https://doi.org/10.1016/S0140-6736(10)60064-5 https://doi.org/10.1016/j.resuscitation.2010.12.007 https://doi.org/10.14408/KJEMS.2013.17.3.169 https://doi.org/10.1186/s12245-019-0256-5 https://doi.org/10.1186/s12245-019-0256-5 https://doi.org/10.1016/j.resuscitation.2008.07.005 https://doi.org/10.1016/j.resuscitation.2012.01.020 https://doi.org/10.1016/j.resuscitation.2013.04.014 https://doi.org/10.1002/ams2.79 https://doi.org/10.1097/MD.0000000000018466 https://doi.org/10.60032/JIIT.2023.1.3.99