1. Afr J Emerg Med. 2023 Jun;13(2):114-119. doi: 10.1016/j.afjem.2023.04.004.

Epub
2023 May 15.

An evaluation of basic life support training among medical students in Southwest

Nigeria: A web-based study.

Onabanjo SO(1), Ibu FO(1), Adeyeye AA(1), Akodu BA(2), Adaramola OG(1), Popoola
AO(1).

Author information:
(1)Lagos University Teaching Hospital, Lagos, Nigeria.
(2)Consultant Family Physician, Lagos University Teaching Hospital, Lagos,
Nigeria.

BACKGROUND: Basic Life Support (BLS) is considered a lifesaving measure and

sound knowledge is expected among health professionals. Studies conducted among
medical doctors and students in many developing countries show deficiencies in
knowledge and practice of essential BLS skills. This study assessed the
awareness, knowledge, perception, practice, accessibility and barriers to BLS
training amongst medical students in South-Western Nigeria, exposing skill gaps
and training challenges to inform appropriate solutions.
METHODS: This was a cross-sectional descriptive e-survey involving 2nd - 6th
year medical students enrolled in 12 regional medical schools. Overall, 553
responses were received over a 3-month period from November 2020 to January 2021
and analyzed using IBM-SPSS 26.
RESULTS: Of the 553 respondents, 79.2% were aware of BLS however only 160 (29%)
respondents had good knowledge of BLS principles. Increasing age, higher level
of study, prior BLS training and being enrolled in College of Medicine,
University of Lagos (CMUL) were significantly associated with a higher knowledge
score (p<0.05). Majority (99.5%) considered BLS training necessary however, only
51.3% had prior training. Increased level of study correlated with prior BLS
training (p<0.05) alongside higher BLS uptake by respondents from CMUL (26.7%)
and College of Medicine, University of Ibadan (20.9%) compared to respondents
from other schools (p<0.05). Only 35.4% had ever done Cardiopulmonary
Resuscitation. Most respondents reported no confidence in performing BLS (67.1%)
or in using an Automated External Defibrillator (85.7%). Unavailability of
training opportunities in state (35%), town (42%) and cost (27%) were major
barriers to BLS training identified.
CONCLUSION: Despite a high level of awareness of BLS training, knowledge of BLS
principles and its practice is poor among Nigerian medical students, reflecting
a need to integrate stand-alone/structured BLS trainings into the medical
curriculum to increase participation and accessibility by medical students.

© 2023 The Authors. Published by Elsevier B.V. on behalf of African Federation

for Emergency Medicine.

DOI: 10.1016/j.afjem.2023.04.004
PMCID: PMC10205432
PMID: 37228447

Conflict of interest statement: The authors declared no conflicts of interests.

2. Nursing. 2021 Jun 1;51(6):24-30. doi: 10.1097/01.NURSE.0000751340.92329.ae.

AHA update: BLS, ACLS, and PALS.

Craig-Brangan KJ(1), Day MP.

Author information:
(1)Karen Jean Craig-Brangan is the owner, president, and CEO of EMS Educational
Services, Inc. in Cheltenham, Pa., as well as an American Heart Association
Training Center manager at Temple University Health System in Philadelphia, Pa.,
and Mary Patricia Day is a certified registered nurse anesthetist at Temple
University Hospital in Philadelphia, Pa.

The American Heart Association (AHA) recently released its 2020 guidelines for
advanced cardiovascular life support, basic life support, and pediatric advanced
life support. This article details these updates, as well as the latest AHA
recommendations for CPR and emergency cardiovascular care.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

DOI: 10.1097/01.NURSE.0000751340.92329.ae
PMID: 34014872 [Indexed for MEDLINE]

3. Cureus. 2022 Apr 3;14(4):e23775. doi: 10.7759/cureus.23775. eCollection 2022

Apr.

Impact of COVID-19 on Basic Life Support Training Among Medical Students: An

Experimental Study.

Rajaram N(1), Krishna H(2), Singh R(3), Narayan AK(1).

Author information:
(1)Anesthesiology and Critical Care, Andaman & Nicobar Islands Institute of
Medical Sciences (ANIIMS), Port Blair, IND.
(2)Anesthesiology and Critical Care, Chandramma Dayananda Sagar Institute of
Medical Education and Research, Kanakapura, IND.
(3)Paediatrics, Andaman & Nicobar Islands Institute of Medical Sciences
(ANIIMS), Port Blair, IND.

AIMS AND OBJECTIVES: Sudden cardiac death (SCD) is the most common cause of
mortality worldwide. Bystander cardiopulmonary resuscitation (CPR) improves the
victim's outcome, especially when the response time for advanced life support is
prolonged. We performed a study to estimate the difference in knowledge among
first-year medical students after basic life support (BLS) training (part of
their foundation course) before and during the novel COVID-19 pandemic.
MATERIALS AND METHODS: We recruited first-year medical college students (batch
of 2019-20: pre-COVID group - P and batch of 2020-21: COVID-19 era group - C)
who were undergoing BLS training for the first time and consented to this study.
Since the training was delayed and affected by COVID-19 for the batch of
2020-21, their training duration was shorter with more usage of audiovisual
aids. The difference in the change in knowledge (by a questionnaire with 10
questions of one mark each) after training by the two methods was
analysed. Analysis of variance, Wilcoxon signed-rank test, Mann-Whitney U test,
and chi-square tests was used as applicable to compare the groups, and p-value
<0.05 was considered significant. The results are analysed by IBM SPSS version
20.0 software (SPSS Inc, Chicago, IL, USA).
RESULTS: The median (inter-quartile range) marks in group P (89 students) in the
pre-test was 3 (4-2) and in the post-test was 6 (7-5) (out of 10). The
corresponding marks in group C (112 students) in the pre-test were 3 (4-2) and
in post-test was 7 (8-6). The knowledge improvement in group C was more with all
the three changes being significant (p=0.0001). In group C, females had more
improvement than males (p=0.0001).
CONCLUSION: We found a significant increase in the improvement of the knowledge
after the BLS training in group C compared to group P. In group C, the
improvement was better in females (59% increase in mean marks versus 22% in
males).

Copyright © 2022, Rajaram et al.

DOI: 10.7759/cureus.23775
PMCID: PMC9062686
PMID: 35509745

Conflict of interest statement: The authors have declared that no competing

interests exist.

4. Rev Esp Cardiol (Engl Ed). 2020 Jan;73(1):53-68. doi: 10.1016/j.rec.2018.11.013.

Epub 2019 Feb 23.

Training adult laypeople in basic life support. A systematic review.

[Article in English, Spanish]

González-Salvado V(1), Rodríguez-Ruiz E(2), Abelairas-Gómez C(3), Ruano-Raviña

A(4), Peña-Gil C(5), González-Juanatey JR(5), Rodríguez-Núñez A(6).

Author information:
(1)Servicio de Cardiología, Hospital Clínico Universitario de Santiago de
Compostela, Centro de Investigación Biomédica en Red de Enfermedades
Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto
de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain;
Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela,
A Coruña, Spain. Electronic address: [email protected].
(2)Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A
Coruña, Spain; Servicio de Medicina Intensiva, Hospital Clínico Universitario de
Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
(3)Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A
Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago
de Compostela, A Coruña, Spain; Facultad de Ciencias de la Educación,
Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
(4)Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago
de Compostela, Santiago de Compostela, A Coruña, Spain; Centro de Investigación
Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain.
(5)Servicio de Cardiología, Hospital Clínico Universitario de Santiago de
Compostela, Centro de Investigación Biomédica en Red de Enfermedades
Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto
de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain.
(6)Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A
Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago
de Compostela, A Coruña, Spain; Unidad de Cuidados Intensivos Pediátricos,
Hospital Clínico Universitario de Santiago de Compostela, Santiago de
Compostela, A Coruña, Spain; Escuela de Enfermería, Universidade de Santiago de
Compostela, Santiago de Compostela, A Coruña, Spain.

INTRODUCTION AND OBJECTIVES: Bystander assistance is decisive to enhance the

outcomes of out-of-hospital cardiac arrest. Despite an increasing number of
basic life support (BLS) training methods, the most effective formula remains
undefined. To identify a gold standard, we performed a systematic review
describing reported BLS training methods for laypeople and analyzed their
effectiveness.
METHODS: We reviewed the MEDLINE database from January 2006 to July 2018 using
predefined inclusion and exclusion criteria, considering all studies training
adult laypeople in BLS and performing practical skill assessment. Two reviewers
independently extracted data and evaluated the quality of the studies using the
MERSQI (Medical Education Research Study Quality Instrument) scale.
RESULTS: Of the 1263 studies identified, 27 were included. Most of them were
nonrandomized controlled trials and the mean quality score was 13 out of 18,
with substantial agreement between reviewers. The wide heterogeneity of
contents, methods and assessment tools precluded pooling of data. Nevertheless,
there was an apparent advantage of instructor-led methods, with
feedback-supported hands-on practice, and retraining seemed to enhance
retention. Training also improved attitudinal aspects.
CONCLUSIONS: While there were insufficiently consistent data to establish a gold
standard, instructor-led formulas, hands-on training with feedback devices and
frequent retraining seemed to yield better results. Further research on adult
BLS training may need to seek standardized quality criteria and validated
evaluation instruments to ensure consistency.

Copyright © 2018 Sociedad Española de Cardiología. Published by Elsevier España,

S.L.U. All rights reserved.

DOI: 10.1016/j.rec.2018.11.013
PMID: 30808611 [Indexed for MEDLINE]

5. Adv Med Educ Pract. 2016 Apr 9;7:241-2. doi: 10.2147/AMEP.S102111. eCollection
2016.

Improving basic life support training for medical students.

Lami M(1), Nair P(1), Gadhvi K(1).

Author information:
(1)Faculty of Medicine, Imperial College London, London, UK.

Comment in
Adv Med Educ Pract. 2016 Nov 25;7:645-646. doi: 10.2147/AMEP.S123246.

Questions have been raised about basic life support (BLS) training in medical
education. This article addresses the research evidence behind why BLS training
is inadequate and suggests recommendations for improving BLS training for
medical students.

DOI: 10.2147/AMEP.S102111
PMCID: PMC4833357
PMID: 27114720

6. PLoS One. 2023 Jun 29;18(6):e0287908. doi: 10.1371/journal.pone.0287908.

eCollection 2023.

Reflective practice improves Basic Life Support training outcomes: A randomized

controlled study.

Thommes MS(1)(2), Schmidt M(1)(2), Lambert SI(1)(2), Schauwinhold MT(1)(2),

Klasen M(1)(2), Sopka S(1)(2).

Author information:
(1)AIXTRA - Competence Center for Training and Patient Safety, Medical Faculty,
RWTH Aachen University, Aachen, Germany.
(2)Department of Anaesthesiology, University Hospital Aachen, Medical Faculty,
RWTH Aachen University, Aachen, Germany.

INTRODUCTION: Practical skills training is an essential part of medical

education. An important example is the training of Basic Life Support (BLS)
skills, which are key to improve patient outcomes in life-threatening
situations. However, despite practical training, BLS performance is often
sub-optimal even among healthcare professionals and medical students. Finding
more effective training methods is therefore of high importance. A promising
method to enhance learning outcomes is reflective practice. The goal of the
present study was to evaluate whether a short reflective practice intervention
following standard BLS training (Peyton's 4-step approach) improves BLS training
outcomes, reflected in higher BLS performance and higher self-confidence to
perform BLS.
METHOD: 287 first-year medical students were randomly assigned to one of two BLS
training conditions: 1) standard BLS training (ST), 2) ST followed by a
15-minute reflective practice exercise. Outcome parameters included objective
BLS performance data assessed by a resuscitation manikin, and students'
self-reported confidence in their BLS skills. Outcomes were assessed directly
after the training (T0) and re-assessed one week later (T1). A two-way mixed
model analysis of variance (ANOVA) was conducted to examine the effect of the
intervention on BLS performance and self-reported confidence. Significance was
determined by two-sided 95% confidence intervals.
RESULTS: The intervention group performed significantly more effective
compressions at T1 and began significantly faster with performing their first
chest compression at T0 and T1, in comparison to the control group. No
significant differences between study groups regarding their self-reported
confidence to perform BLS were observed.
CONCLUSION: This research shows that standard BLS training accompanied with a
simple, cost-effective reflective practice exercise can improve learners' BLS
skill acquisition and retention. This shows that reflective practice has the
potential to enhance practical skills training in medicine; yet, more empirical
studies are needed to examine its broader applicability.

Copyright: © 2023 Thommes et al. This is an open access article distributed

under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.

DOI: 10.1371/journal.pone.0287908
PMCID: PMC10309595
PMID: 37384610 [Indexed for MEDLINE]

Conflict of interest statement: The authors have declared that no competing

interests exist.

7. Acta Med Okayama. 2022 Jun;76(3):265-271. doi: 10.18926/AMO/63720.

The Impact of Medical Students Teaching Basic Life Support to Laypersons.

Kosaki Y(1), Naito H(1), Iida A(2), Ihoriya H(3), Nojima T(1), Yamada T(1),
Yamamoto H(1), Nakamura S(1), Mandai Y(4), Nakao A(1).

Author information:
(1)Department of Emergency, Critical Care, and Disaster Medicine, Okayama
University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.
(2)Department of Emergency Medicine, Japanese Red Cross Okayama Hospital.
(3)Department of General Medicine, Okayama University Hospital.
(4)Department of Emergency Medicine, The JIKEI University.
Basic life support (BLS) courses for laypersons, including cardiopulmonary
resuscitation (CPR) training, is known to improve outcomes of out-of-hospital
cardiac events. We asked medical students to provide BLS training for laypersons
as a part of their emergency medicine education and evaluated the effects of
training on the BLS skills of laypersons. We also used a questionnaire to
determine whether the medical students who provided the BLS training were
themselves more confident and motivated to perform BLS compared to students who
did not provide BLS training. The proportions of laypersons who reported
confidence in checking for a response, performing chest compressions, and
automated external defibrillator (AED) use were significantly increased after
the BLS training. The proportions of medical students who reported increased
confidence/motivation in terms of understanding BLS, checking for a response,
chest compression, use of AED, and willingness to perform BLS were significantly
greater among medical students who provided BLS instructions compared to those
who did not. BLS instruction by medical students was associated with an
improvement in laypersons' CPR accuracy and confidence in responding to cardiac
arrest. The results indicate that medical students could gain understanding,
confidence, and motivation in regard to their BLS skills by teaching BLS to
laypersons.

DOI: 10.18926/AMO/63720
PMID: 35790356 [Indexed for MEDLINE]

Conflict of interest statement: No potential conflict of interest relevant to

this article was reported.

8. Med Sci Educ. 2023 Feb 18;33(2):395-400. doi: 10.1007/s40670-023-01746-7.

eCollection 2023 Apr.

Comparison Between Self-Deliberate Practice and Directed Learning Training

Methods for Basic Life Support Knowledge and High-Quality Cardiopulmonary
Resuscitation Skill Retention in Second-Year Medical Students 3 and 6 Months
After Training.

Sianipar IR(1)(2), Tantri AR(1)(3), Muktiarti D(1)(4), Dwijayanti A(1)(5),

Manggala SK(3), Muliyah E(1).

Author information:
(1)Simulation-Based Medical Education and Research Center (SIMUBEAR), Indonesian
Medical Education and Research Institute (IMERI), Faculty of Medicine,
Universitas Indonesia, Education Tower, 8 - 9th Floor, Jl. Salemba Raya No. 6,
10430 Jakarta, Indonesia.
(2)Department of Medical Physiology and Biophysics, Faculty of Medicine,
Universitas Indonesia, Jl. Salemba Raya No. 6, Jakarta, 10430 Indonesia.
(3)Department of Anesthesiology and Intensive Care, Faculty of Medicine,
Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71,
Jakarta, 10430 Indonesia.
(4)Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto
Mangunkusumo Hospital, Jl. Diponegoro No. 71, Jakarta, 10430 Indonesia.
(5)Department of Medical Pharmacy, Faculty of Medicine, Universitas Indonesia,
Jl. Salemba Raya No. 6, Jakarta, 10430 Indonesia.

BACKGROUND: Cardiopulmonary resuscitation (CPR) requires well-trained medical

personnel. Multiple learning methods can be done for CPR skills training. This
study aimed to compare self-deliberate practice (SDP) method and directed
learning (DL) method to improve basic life support (BLS) knowledge and CPR skill
performance in medical students.
METHODS: This is an experimental, single-blind, randomized controlled trial
study of 40 medical students from February to July 2019. Forty subjects were
randomly assigned into SDP and DL groups through a voluntary sampling method.
Both groups attended a 1-day course and then practiced once a month for
3 months. The DL group had practice sessions with assigned tutors, while the SDP
group had to practice by themselves. Examination of BLS knowledge and CPR
performance quality (compression depth, rate, and performance score) was
collected before and after course lecture, after a skills training, 3 and
6 months after training.
RESULTS: Subject characteristics of both groups were comparable. Significant
knowledge and skill improvement were found in the DL group and the SDP group
when compared to their knowledge and skill before training. There were no
significant differences between both groups in BLS knowledge and CPR performance
quality in all examination periods.
CONCLUSION: Both SDP and DL teaching methods show significant improvement and
excellent retention in BLS knowledge and high-quality CPR performance. These two
learning methods are both feasible and bring positive results for students.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material
available at 10.1007/s40670-023-01746-7.

© The Author(s) under exclusive licence to International Association of Medical

Science Educators 2023. Springer Nature or its licensor (e.g. a society or other
partner) holds exclusive rights to this article under a publishing agreement
with the author(s) or other rightsholder(s); author self-archiving of the
accepted manuscript version of this article is solely governed by the terms of
such publishing agreement and applicable law.

DOI: 10.1007/s40670-023-01746-7
PMCID: PMC10226953
PMID: 37261012

Conflict of interest statement: Conflict of InterestThe authors declare no

competing interests.

9. West J Emerg Med. 2020 Dec 15;22(1):101-107. doi: 10.5811/westjem.2020.11.48536.

Medical and Physician Assistant Student Competence in Basic Life Support:

Opportunities to Improve Cardiopulmonary Resuscitation Training.

Gupta R(1), DeSandro S(2), Doherty NA(2), Gardner AK(2), Pillow MT(2).

Author information:
(1)Baylor College of Medicine, School of Medicine, Houston, Texas.
(2)Baylor College of Medicine, Department of Emergency Medicine, Houston, Texas.

INTRODUCTION: Medical and physician assistant (PA) students are often required
to have Basic Life Support (BLS) education prior to engaging in patient care.
Given the potential role of students in resuscitations, it is imperative to
ensure that current BLS training prepares students to provide effective
cardiopulmonary resuscitation (CPR). The objective of this study was to assess
whether current BLS training produces student providers who can deliver BLS in
an American Heart Association (AHA) guideline-adherent manner.
METHODS: Students at a US medical school were recruited by convenience sampling.
BLS performance immediately following a standard AHA BLS training course was
evaluated during a two-minute CPR cycle using manikins. We also collected
information on demographics, previous BLS training attendance, perceived comfort
in providing CPR, and prior experiences in healthcare and providing or observing
CPR.
RESULTS: Among 80 participants, we found that compression rate, depth, and
inter-compression recoil were AHA guideline-adherent for 90.0%, 68.8%, and 79.3%
of total compression time, respectively. Mean hands-off time was also within AHA
guidelines. Mean number of unsuccessful ventilations per cycle was 2.2.
Additionally, 44.3% of ventilations delivered were of adequate tidal volume,
12.2% were excessive, and 41.0% were inadequate. Past BLS course attendance,
prior healthcare certification, and previous provision of real-life CPR were
associated with improved performance.
CONCLUSION: Following BLS training, medical and PA students met a majority of
AHA compressions guidelines, but not ventilations guidelines, for over 70% of
CPR cycles. Maintaining compression depth and providing appropriate ventilation
volumes represent areas of improvement. Conducting regular practice and
involving students in real-life CPR may improve performance.

DOI: 10.5811/westjem.2020.11.48536
PMCID: PMC7806334
PMID: 33439814 [Indexed for MEDLINE]

Conflict of interest statement: Conflicts of Interest: By the WestJEM article

submission agreement, all authors are required to disclose all affiliations,
funding sources and financial or management relationships that could be
perceived as potential sources of bias. No author has professional or financial
relationships with any companies that are relevant to this study. There are no
conflicts of interest or sources of funding to declare.

10. J Educ Health Promot. 2023 Jun 30;12:218. doi: 10.4103/jehp.jehp_1045_22.

eCollection 2023.

Teaching basic life support for medical students: Assessment of learning and
knowledge retention.

Silva NLC(1), de Melo MDCB(2), Liu PMF(3), Campos JPR(4), Arruda MA(5).

Author information:
(1)Specialist in Health Systems and Services Management, Secretary of State for
Health of Minas Gerais, Brazil.
(2)Department of Pediatrics, Member of Health Technology Center and Telehealth
Center, Coordinator of Simulation Center, Faculty of Medicine at Universidade
Federal de Minas Gerais, Brazil.
(3)Department of Pediatrics, Subcoordinator of Simulation Center, Faculty of
Medicine, Universidade Federal de Minas Gerais, Brazil.
(4)Palliative Care Specialist, Hospital Felício Rocho, Minas Gerais State,
Brazil.
(5)General Practitioner, General Practitioner Health Center of the City Hall of
Belo Horizonte, Minas Gerais State, Brazil.

BACKGROUND: Education mediated by simulation is a widely used method for

teaching basic life support (BLS). The American Heart Association recommends
protocols based on scientific evidence to reduce sequelae and mortality. We
aimed to assess learning and retention of knowledge of BLS in students of the
first semester of the medical course using teaching methods of dialogic
expository class (group 1), expository and demonstrative class (group 2), and
the two previous methodologies associated with simulated practice (group 3), and
after 3 months, memory retention.
MATERIALS AND METHODS: This was an experimental, prospective, randomized study.
Participants were assessed in terms of performance in theoretical and simulated
practical tests, satisfaction with training (Likert scale), and knowledge
retention.
RESULTS: The practical test results were analyzed by two experienced observers.
Students had 20% progression in knowledge and 80% retention of knowledge after 3
months of exposure comparing the theoretical pre- and posttest. The students in
group 3 performed better than the others (P = 0.007) in the posttest. With the
simulated practice, the knowledge acquired was maintained after 3 months with a
mean performance of 90%, but in the test of the infant age group, there was a
loss of learning retention by 10%. There was no difference of the results
between the two evaluators (P < 0.001). The training was positively assessed by
the participants.
CONCLUSION: The use of different methodologies promoted knowledge progression,
with emphasis on simulated practice. Learning retention was maintained after 3
months. In order to teach BLS to infants, it may be necessary to improve
teaching techniques.

Copyright: © 2023 Journal of Education and Health Promotion.

DOI: 10.4103/jehp.jehp_1045_22
PMCID: PMC10402818
PMID: 37546014

Conflict of interest statement: There are no conflicts of interest.

11. Arch Acad Emerg Med. 2023 Jul 11;11(1):e47. doi: 10.22037/aaem.v11i1.1975.
eCollection 2023.

Basic Life Support (BLS) Knowledge Among General Population; a Multinational

Study in Nine Arab Countries.

Shaheen N(1), Shaheen A(1), Diab RA(2)(3), Mohmmed A(1), Ramadan A(4), Swed
S(5), Wael M(6), Kundu M(7), Soliman S(8), Elmasry M(1), Shoib S(9)(10)(11)(12).

Author information:
(1)Alexandria University, Alexandria Faculty ofMedicine, Alexandria, Egypt.
(2)Al-Azhar University, Al-Azhar Faculty ofMedicine, Cairo, Egypt.
(3)Medical Research Group of Egypt, Cairo, Egypt.
(4)Helwan University, Faculty ofMedicine, Cairo, Egypt.
(5)Faculty ofMedicine, Aleppo University, Aleppo, Syria.
(6)An Najah National University, Faculty ofMedicine, Nablus, Palestine.
(7)Institute ofMedical Sciences & SUM Hospital, Bhubaneswar, India.
(8)The Pavlov First StateMedical University of St. Petersburg, Faculty
ofMedicine, St. Petersburg, Russia.
(9)Department of Psychiatry, Jawahar Lal NehruMemorial Hospital, Srinagar, Jammu
& Kashmir, India.
(10)Department of Health Services, Srinagar, 190001 India.
(11)Sharda University, Greater Noida, India (SSh).
(12)Psychosis Research Centre, University of SocialWelfare and Rehabilitation
Sciences, Tehran, Iran.

INTRODUCTION: Basic Life Support (BLS) is a medical treatment used in

life-threatening emergencies until the sufferer can be properly cared for by a
team of paramedics or in a hospital. This study aimed to assess the level of
knowledge regarding BLS and the contributing factors among the Arab non-medical
population.
METHODS: An online survey-based cross-sectional study was conducted among
non-medical populations in nine Arab countries between April 13, 2022, and June
30, 2022. The utilized questionnaire consisted of two parts: part one included
socio-demographic characteristics and part two measured knowledge of BLS through
an online survey.
RESULTS: The research included a total of 4465 participants. 2540 (56.89%) of
the participants were knowledgeable about BLS. The mean basic life support
knowledge scores of participants who received training were higher than those
who had not (20.11 ± 4.20 vs. 16.96 ± 5.27; p< 0.01). According to the nations,
Yemen scored the highest, while Morocco had the lowest levels of BLS knowledge
(19.86 ± 4.71 vs. 14.15 ± 5.10, respectively; p< 0.01). Additionally,
individuals who resided in urban areas scored on average higher than those who
did in rural areas (17.86 ± 5.19 vs. 17.13 ± 5.24, p= 0.032) in understanding
basic life support. Age, information sources, and previous training with
theoretical and practical classes were significant predictors of BLS knowledge.
CONCLUSION: The level of BLS knowledge among non-medical people in Arab nations
is moderate but insufficient to handle the urgent crises that we face
everywhere. In addition to physicians being required to learn the BLS
principles, non-medical people should also be knowledgeable of the necessary
actions to take in emergency events.

DOI: 10.22037/aaem.v11i1.1975
PMCID: PMC10440750
PMID: 37609539

Conflict of interest statement: The authors declare that they have no competing
interests.

12. Trials. 2021 Dec 20;22(1):946. doi: 10.1186/s13063-021-05908-z.

Comparison of extended reality and conventional methods of basic life support

training: protocol for a multinational, pragmatic, noninferiority, randomised
clinical trial (XR BLS trial).

Lee DK(#)(1)(2), Im CW(#)(1), Jo YH(3)(4), Chang T(5), Song JL(5), Luu C(5),
Mackinnon R(6), Pillai S(7), Lee CN(8), Jheon S(9), Ahn S(10), Won SH(10).

Author information:
(1)Department of Emergency Medicine, Seoul National University Bundang Hospital,
13620, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, Republic of
Korea.
(2)Department of Emergency Medicine, Seoul National University College of
Medicine, Seoul, Republic of Korea.
(3)Department of Emergency Medicine, Seoul National University Bundang Hospital,
13620, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, Republic of
Korea. [email protected].
(4)Department of Emergency Medicine, Seoul National University College of
Medicine, Seoul, Republic of Korea. [email protected].
(5)Division of Emergency and Transport Medicine, Department of Pediatrics,
Children's Hospital Los Angeles, Keck School of Medicine, University of Southern
California, Los Angeles, USA.
(6)Department of Anaesthesia, Royal Manchester Children's Hospital, Manchester,
UK.
(7)Centre for Healthcare Simulation, Yong Loo Lin School of Medicine, National
University of Singapore, Singapore, Singapore.
(8)Department of Surgery, Yong Loo Lin School of Medicine, National University
of Singapore, Singapore, Singapore.
(9)Department of Thoracic and Cardiovascular Surgery, Seoul National University
Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic
of Korea.
(10)Division of Statistics, Medical Research Collaborating Centre, Seoul
National University Bundang Hospital, Seongnam, Republic of Korea.
(#)Contributed equally
BACKGROUND: Conventional cardiopulmonary resuscitation (CPR) training for the
general public involves the use of a manikin and a training video, which has
limitations related to a lack of realism and immersion. To overcome these
limitations, virtual reality and extended reality technologies are being used in
the field of medical education. The aim of this study is to explore the efficacy
and safety of extended reality (XR)-based basic life support (BLS) training.
METHODS: This study is a prospective, multinational, multicentre, randomised
controlled study. Four institutions in 4 countries will participate in the
study. A total of 154 participants will be randomly assigned to either the XR
group or the conventional group stratified by institution and sex (1:1 ratio).
Each participant who is allocated to either group will be sent to a separate
room to receive training with an XR BLS module or conventional CPR training
video. All participants will perform a test on a CPR manikin after the training.
The primary outcome will be mean compression depth. The secondary outcome will
be overall BLS performance, including compression rate, correct hand position,
compression, and full release and hands-off time.
DISCUSSION: Using virtual reality (VR) to establish a virtual educational
environment can give trainees a sense of realism. In the XR environment, which
combines the virtual world with the real world, trainees can more effectively
learn various skills. This trial will provide evidence of the usefulness of XR
in CPR education.
TRIAL REGISTRATION: ClinicalTrials.gov NCT04736888. Registered on 29 January
2021.

© 2021. The Author(s).

DOI: 10.1186/s13063-021-05908-z
PMCID: PMC8687636
PMID: 34930418 [Indexed for MEDLINE]

Conflict of interest statement: You Hwan Jo and Sanghoon Jheon hold unlisted
shares of Tetra Signum, Inc. They will not obtain access to the study data and
will not participate in data analysis.

13. BMC Emerg Med. 2024 Sep 27;24(1):176. doi: 10.1186/s12873-024-01092-w.

Redesign of a virtual reality basic life support module for medical training - a
feasibility study.

Wiltvank IL(1), Besselaar LM(2), van Goor H(2), Tan ECTH(2).

Author information:
(1)Department of Surgery, Radboudumc, Nijmegen, The Netherlands.
[email protected].
(2)Department of Surgery, Radboudumc, Nijmegen, The Netherlands.

BACKGROUND: Healthcare providers, including medical students, should maintain

their basic life support (BLS) skills and be able to perform BLS in case of
cardiac arrest. Research shows that the use of virtual reality (VR) has
advantages such as improved accessibility, practice with lifelike situations,
and real-time feedback during individual training sessions. A VR BLS module
incorporating these advantages, called Virtual Life Support, has been developed
especially for the medical domain. Virtual Life Support was collaboratively
developed by software developers and stakeholders within the field of medical
education. For this study, we explored whether the first version of this module
capitalised on the advantages of VR and aimed to develop an understanding of
barriers to feasibility of use.
METHODS: This study was conducted to assess the feasibility of employing Virtual
Life Support for medical training and pinpoint potential obstacles. Four groups
of stakeholders were included through purposive sampling: physicians, BLS
instructors, educational experts, and medical students. Participants performed
BLS on a BLS mannequin while using Virtual Life Support and were interviewed
directly afterwards using semi-structured questions. The data was coded and
analysed using thematic analysis.
RESULTS: Thematic saturation was reached after seventeen interviews were
conducted. The codes were categorised into four themes: introduction, content,
applicability, and acceptability/tolerability. Sixteen barriers for the use of
Virtual Life Support were found and subsequently categorised into must-have
(restraining function, i.e. necessary to address) and nice to have features
(non-essential elements to consider addressing).
CONCLUSION: The study offers valuable insights into redesigning Virtual Life
Support for Basic Life Support training, specifically tailored for medical
students and healthcare providers, using a primarily qualitative approach. The
findings suggest that the benefits of virtual reality, such as enhanced realism
and immersive learning, can be effectively integrated into a single training
module. Further development and validation of VR BLS modules, such as the one
evaluated in this study, have the potential to revolutionise BLS training. This
could significantly improve both the quality of skills and the accessibility of
training, ultimately enhancing preparedness for real-life emergency scenarios.

© 2024. The Author(s).

DOI: 10.1186/s12873-024-01092-w
PMCID: PMC11438090
PMID: 39333990 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare no competing interests.

14. Indian Heart J. 2016 Jan-Feb;68(1):106-7. doi: 10.1016/j.ihj.2015.10.373. Epub

2016 Jan 11.

Life support training - Need of the hour in India.

Showkathali R(1).

Author information:
(1)Senior Consultant Interventional Cardiologist, MIOT International Hospital,
Chennai, India. Electronic address: [email protected].

DOI: 10.1016/j.ihj.2015.10.373
PMCID: PMC4774350
PMID: 26896277 [Indexed for MEDLINE]

15. J Clin Med. 2024 Jul 10;13(14):4032. doi: 10.3390/jcm13144032.

Tailored Basic Life Support Training for Specific Layperson Populations-A

Scoping Review.

Schnaubelt S(1)(2)(3)(4), Veigl C(1)(2), Snijders E(3), Abelairas Gómez C(5)(6),

Neymayer M(1)(2), Anderson N(7), Nabecker S(8), Greif R(9)(10); International
Liaison Committee on Resuscitation Education, Implementation and Teams Task
Force.

Author information:
(1)Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna,
Austria.
(2)PULS-Austrian Cardiac Arrest Awareness Association, 1090 Vienna, Austria.
(3)Department of Emergency Medicine, Antwerp University Hospital, 2650 Edegem,
Belgium.
(4)Emergency Medical Service Vienna, 1030 Vienna, Austria.
(5)Faculty of Education Sciences and CLINURSID Research Group, Universidade de
Santiago de Compostela, 15705 Santiago de Compostela, Spain.
(6)Simulation and Intensive Care Unit of Santiago (SICRUS) Research Group,
Health Research Institute of Santiago, University Hospital of Santiago de
Compostela-CHUS, 15706 Santiago de Compostela, Spain.
(7)Faculty of Medical and Health Sciences, University of Auckland, Auckland
1023, New Zealand.
(8)Department of Anesthesiology and Pain Management, Mount Sinai Hospital,
Toronto, ON M5G 1X5, Canada.
(9)Faculty of Medicine, University of Bern, 3012 Bern, Switzerland.
(10)School of Medicine, Sigmund Freud University Vienna, 1020 Vienna, Austria.

Background: Basic life support (BLS) is a life-saving link in the

out-of-hospital cardiac arrest chain of survival. Most members of the public are
capable of providing BLS but are more likely to do so confidently and
effectively if they undertake BLS training. Lay members of the public comprise
diverse and specific populations and may benefit from tailored BLS training.
Data on this topic are scarce, and it is completely unknown if there are any
benefits arising from tailored courses or for whom course adaptations should be
developed. Methods: The primary objective of this scoping review was to identify
and describe differences in patient, clinical, and educational outcomes when
comparing tailored versus standard BLS courses for specific layperson
populations. This review was undertaken as part of the continuous evidence
evaluation process of the International Liaison Committee on Resuscitation.
Results: A primary search identified 1307 studies and after title, abstract, and
full-text screening, we included eight publications reporting on tailored
courses for specific populations. There were no studies reporting direct
comparisons between tailored and standardized training. Seven (88%) studies
investigated courses tailored for individuals with a disability, and only one
study covered another specific population group (refugees). Overall, the quality
of evidence was low as the studies did not compare tailored vs. non-tailored
approaches or consisted of observational or pre-post-designed investigations.
Conclusions: Tailored BLS education for specific populations is likely feasible
and can include such groups into the pool of potential bystander resuscitation
providers. Research into comparing tailored vs. standard courses, their
cost-to-benefit ratio, how to best adapt courses, and how to involve members of
the respective communities should be conducted. Additionally, tailored courses
for first responders with and without a duty to respond could be explored.

DOI: 10.3390/jcm13144032
PMCID: PMC11277549
PMID: 39064072

Conflict of interest statement: This scoping review was part of the ILCOR
continuous evidence evaluation process, which is guided by a rigorous conflict
of interest policy (see www.ilcor.org). Sebastian Schnaubelt is an ILCOR EIT
Task Force member, ERC Advanced Life Support Science and Education Committee
member, and Vice Chair of the Austrian Resuscitation Council. Christoph Veigl is
a Young ERC committee member. Cristian Abelairas-Gomez is an ILCOR EIT Task
Force member and ERC Basic Life Support Science and Education Committee member.
Natalie Anderson is an ILCOR EIT Task Force member. Sabine Nabecker is an ILCOR
EIT Task Force member and ERC Instructor Educator Support Science and Education
Committee member. Robert Greif is the ERC Director of ILCOR and Guidelines, and
Chair of the ILCOR EIT Task Force Education. Apart from partly being the authors
of the studies included in this scoping review, none of the other authors
declare conflicts of interest.

16. AEM Educ Train. 2018 Mar 30;2(2):174-177. doi: 10.1002/aet2.10095. eCollection
2018 Apr.

Making Naloxone Rescue Part of Basic Life Support Training for Medical Students.

Jack HE(1)(2), Warren KE(1), Sundaram S(1), Gheihman G(1), Weems J(3), Raja
AS(4), Miller ES(4).

Author information:
(1)Harvard Medical School Boston MA.
(2)Institute of Psychiatry, Psychology, and Neuroscience King's College London
London UK.
(3)Department of Medicine Massachusetts General Hospital Boston MA.
(4)Department of Emergency Medicine Harvard Medical School Boston MA.

As opioid overdose deaths in the United States continue to climb, medical

students must be prepared to prevent and treat opioid use disorder and opioid
overdose. The administration of naloxone is an evidence-based way to reverse
overdoses and save lives. At our medical school, a coalition of medical
students, emergency medicine educators, and administrators worked together to
permanently integrate naloxone rescue training into the Basic Life Support (BLS)
curriculum required of all first-year medical students. This article outlines an
argument for the integration of naloxone rescue into BLS training and an
introduction to emergency medical care for medical students. The authors then
describe the steps that students took to transform this program from an original
pilot to a formally integrated curriculum offered to all first-year medical
students. The article highlights the role of medical student advocacy in
curriculum design and its potential to align medical training with community
health needs, such as the ongoing opioid epidemic.

DOI: 10.1002/aet2.10095
PMCID: PMC6001730
PMID: 30051085

17. Swiss Med Wkly. 2022 Mar 4;152:w30147. doi: 10.4414/smw.2022.w30147.

eCollection
2022 Feb 28.

Basic life support knowledge among Swiss conscripts: a national multicentre

survey.

Durr D(1), Carron PN(1)(2), Ageron FX(2), Stanga Z(3), Schneider A(1)(4), Maudet
L(2)(5), Beysard N(2).

Author information:
(1)Faculty of Biology and Medicine, University of Lausanne, Switzerland.
(2)Department of Emergency Medicine and Specialised Centre for Disaster Medicine
(CEFOCA), Lausanne University Hospital, Lausanne, Switzerland.
(3)Centre of Competence for Military and Disaster Medicine, Swiss Armed Foces
Medical Services, Federal Department of Defence, Civil Protection and Sport
DDPS, Ittigen, Switzerland.
(4)Department of Intensive Care Medicine, Lausanne University Hospital,
Lausanne, Switzerland.
(5)Department of Anaesthesiology, Lausanne University Hospital, Lausanne,
Switzerland.

BACKGROUND: Basic life support (BLS) is the first link in the chain of survival
and should be performed by every lay rescuer. Although international studies
have suggested that BLS knowledge was poor among the overall population, Swiss
data are scarce. Our objective in this study was to evaluate BLS knowledge among
Swiss conscripts, a semi-representative sample of Swiss young adults, during the
recruitment process and to identify potential characteristics related to
performance.
METHODS: A short online voluntary anonymous survey was proposed to Swiss
conscripts called to duty in the six national recruiting centres of the Swiss
Armed Forces during an 8-month period (2 February 2019 to 27 September 2019).
The survey was available in three official languages (French, German, and
Italian). Considered outcome was BLS knowledge evaluated on a Likert scale from
1 (very bad) to 6 (excellent). Univariate and multivariate ordinal logistic
regression analyses were performed to assess the relationship between BLS
knowledge and participants' characteristics.
RESULTS: Among the 19,247 conscripts called to service during the study period,
737 replied to the survey. Among them, 735 were included in the analyses (mean
age 19.8 years [± 2.1]). Of these, 144 (20%) had never received any BLS
training. The BLS knowledge survey was completely answered by 670 participants
(91%). 157 participants (23%) reached a BLS knowledge score ≥5. Out of 695
answers, 142 (20%) did not know the Swiss emergency phone number. Out of 670
answers, 364 (54%) believed that CPR could worsen the health status of a person
in cardiac arrest, whereas 413 (62%) agreed that BLS training should be
mandatory in secondary school. German as native language (odds ratio [OR] 1.3,
95% confidence interval [CI] 1.0-.8)], receipt of BLS training (OR 3.1, 95% CI
2.0-4.8), and female gender were associated with a higher BLS knowledge score.
Time since the last BLS training of ≥3 years (OR 0.5, 95% CI 0.4-0.7) and
unemployment (OR 0.3, 95% CI 0.1-0.9) were associated with a lower BLS knowledge
score. We found substantial agreement between conscripts' scores and their
self-assessments (weighted kappa with 74% agreement).
DISCUSSION AND CONCLUSION: Knowledge of the emergency phone number and BLS
principles was poor among Swiss conscripts participating in the study. However,
their awareness and motivation is high. The effect of training during boot camp
should be evaluated in further studies. Focusing on BLS training is essential
and should be promoted in educational and professional contexts.

DOI: 10.4414/smw.2022.w30147
PMID: 35262318 [Indexed for MEDLINE]

18. Open Access Emerg Med. 2020 Sep 28;12:211-217. doi: 10.2147/OAEM.S241598.
eCollection 2020.

Retention of Basic-Life-Support Knowledge and Skills in Second-Year Medical

Students.

Srivilaithon W(1), Amnuaypattanapon K(1), Limjindaporn C(1), Diskumpon N(1),

Dasanadeba I(1), Daorattanachai K(1).

Author information:
(1)Department of Emergency Medicine, Faculty of Medicine, Thammasat University,
Pathumthani, Thailand.

PURPOSE: Basic life support (BLS) training is crucial in improvement of

cardiopulmonary resuscitation (CPR) outcomes. Many studies have demonstrated
improvement of skills after BLS training but the skills significantly decrease
over time. Our study aimed to evaluate the retention of knowledge and skills
after training following 2010 BLS guidelines in second year medical students at
Faculty of Medicine, Thammasat University.
MATERIALS AND METHODS: One hundred and forty-nine second-year medical students
were enrolled in the prospective cohort study. Participants were tested for
knowledge and skills of BLS prior to training (pre-test), immediately after
training (post-test) and six months after training (retention test).
RESULTS: The mean scores of pre-test, immediate post-test and retention-test
were 8.52 (SD 1.88), 12.12 (SD 1.52) and 10.83 (SD 1.95), respectively.
Improvement in knowledge score post-test and retention test were 3.60 (95% CI
3.22,3.99 P<0.001) and 2.31 (95% CI 1.92,2.70 P<0.001) respectively, compared
with pre-test score. In post-test, detection skill, activation skill and
compression skill were improved 1.67 (95% CI 1.28,2.19 P<0.001), 5.15 (95% CI
3.41,7.77 P<0.001) and 3.88 times (95% CI 2.24,6.71 P<0.001) compared with
pre-test evaluation. Comparison between retention test and pre-test was improved
detection skill 1.72 (95% CI 1.31,2.26 P<0.001), activation skill 4.4 (95% CI
2.93,6.75 P<0.001) and compression skill 2.56 (95% CI 1.44,4.57 P=0.001).
Knowledge decreased 1.29 times in retention test compared with post-test (95% CI
-1.67,0.92 P<0.001). In retention test, detection skill increased 1.03 times
(95% CI 0.81,1.29 P = 0.810), activation skill decreased 0.86 times (95% CI
0.98,1.10 P =0.24) and compression skill decreased 0.66 times (95% CI 0.45,0.98
P=0.04) compared with post-test.
CONCLUSION: Knowledge and skills of BLS significantly improved after training in
second year medical students. However, the knowledge decreased at 6 months after
training although the BLS skills still remained.

© 2020 Srivilaithon et al.

DOI: 10.2147/OAEM.S241598
PMCID: PMC7533909
PMID: 33061682

Conflict of interest statement: The authors report no conflicts of interest in

this work.

19. Medicina (Kaunas). 2022 Aug 10;58(8):1073. doi: 10.3390/medicina58081073.

Basic Life Support Knowledge among Junior Medical and Dental Students,
Communication Channels, and the COVID-19 Pandemic.

Ricci G(1), Herren T(1), Taramarcaz V(1), Schnetzler N(1), Dupuis F(2), Schiffer
E(3), Suppan M(3), Suppan L(1).

Author information:
(1)Division of Emergency Medicine, Department of Anesthesiology, Clinical
Pharmacology, Intensive Care and Emergency Medicine, University of Geneva
Hospitals and Faculty of Medicine, 1211 Geneva, Switzerland.
(2)Ecole de Santé de Suisse Romande (ESSR), 1207 Geneva, Switzerland.
(3)Division of Anesthesiology, Department of Anesthesiology, Clinical
Pharmacology, Intensive Care and Emergency Medicine, University of Geneva
Hospitals and Faculty of Medicine, 1211 Geneva, Switzerland.

Background and objective: The prognosis of cardiac arrest victims strongly

depends on the prompt provision of Basic Life Support (BLS) maneuvers. Medical
students should therefore be proficient in this area, but many lack essential
BLS knowledge. The goal of this prospective, closed web-based study was to
determine whether a short intervention designed to motivate first-year medical
students to follow a blended BLS course could lead to a significant improvement
in BLS knowledge in the following year. Materials and Methods: A fully automated
web-based questionnaire was administered to second-year medical students one
year after they had been given the opportunity of following a blended BLS course
(e-learning and practice session). The primary outcome was the difference, on a
6-question score assessing essential BLS knowledge, between these students and
those from the 2020 promotion since the latter had not been offered the optional
BLS course. Results: The score was similar between the two study periods (3.3 ±
0.8 in 2022 vs. 3.0 ± 1.0 in 2020, p = 0.114), but no firm conclusion could be
drawn since participation was much lower than expected (17.9% in 2022 vs. 43.7%
in 2020, p < 0.001). Therefore, a second questionnaire was created and
administered to understand the reasons underlying this low participation.
Conclusions: There was a lack of improvement in BLS knowledge in second-year
medical students after the introduction of an optional introductory BLS course
in the first-year curriculum, but the limited participation rate precludes
drawing definitive conclusions. Ineffective communication appears to be the
cause of this low participation rate, but a lack of motivation in the aftermath
of the COVID-19 pandemic cannot be ruled out. Corrective actions should be
considered to enhance communication, restore motivation, and ultimately improve
BLS knowledge among medical and dental students.

DOI: 10.3390/medicina58081073
PMCID: PMC9416785
PMID: 36013540 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare no conflict of interest.

20. J Healthc Eng. 2023 Jan 5;2023:9936114. doi: 10.1155/2023/9936114. eCollection

2023.

Knowledge regarding Basic Life Support among Health Care Workers of the Hospital
of Nepal.

Chaudhary GP(1), Sah K(2), Malla J(2), Das N(2), Chaudhary S(2), Chaudhary I(2),
Pandey J(1).

Author information:
(1)Department of Pharmacy, Crimson College of Technology, Pokhara University,
Devinagar-11, Butwal 32900, Nepal.
(2)Department of Medical-Surgical Nursing, Unique College of Medical Science and
Hospital Pvt. Ltd., Purbanchal University, Saptari 56400, Nepal.

Basic life support refers to a sequence of care provided to patients who are
experiencing respiratory arrest, cardiac arrest, or airway obstruction. It is a
specific level of prehospital medical care provided by the trained responders,
including emergency medical technicians, in the absence of advanced medical care
to maintain the patient's life. BLS course trains participants to promptly
recognize several life-threatening emergencies, give high-quality chest
compressions, deliver appropriate ventilations, and provide early use of an AED.
According to American Heart Association (AHA) guidelines, every missed minute in
applying defibrillation in a cardiac arrest decreases the survival rate by
70%-10%. According to European Resuscitation Council (ERC), early resuscitation
and prompt defibrillation (within 1-2 minutes) can result in >60% survival. A
quantitative, descriptive study design is used in this study. A purposive
sampling technique was used, and the sample size was 95. A
self-structuredclose-ended questionnaire was used to assess the level of
knowledge of the participants. The finding revealed that among 95 participants,
only 12% had adequate, 55% had moderate, and 32% had inadequate knowledge about
Basic Life Support. The study showed that knowledge among healthcare workers
about basic life support is insufficient for the majority of participants. There
is a significant association between dependent and independent variables.

Copyright © 2023 Gautam Prasad Chaudhary et al.

DOI: 10.1155/2023/9936114
PMCID: PMC9836805
PMID: 36644299 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare that they have no conflicts
of interest.

21. Indian J Crit Care Med. 2020 Jul;24(7):599-600. doi:

10.5005/jp-journals-10071-23475.

Knowledge and Attitudes toward Basic Life Support among Medical Students in
Oman.

Albadi S(1), Al-Hadi H(1), Nadar SK(1).

Author information:
(1)Department of Medicine, Sultan Qaboos University, Muscat, Oman.

BACKGROUND: This study aimed to assess the level of knowledge regarding the
basic life support (BLS) and attitudes related to BLS training and to identify
the factors affecting these among medical students in Oman.
MATERIALS AND METHODS: This prospective cross-sectional questionnaire-based
study was carried out during the period July 2017 to February 2018 at Medical
College of Sultan Qaboos University, Muscat, Oman. Validated questionnaires in
English were distributed among undergraduate medical students from 1st to 7th
years.
RESULTS: A total of 304 medical students completed the questionnaire with a
response rate of 82.7%. The mean knowledge score of the participants was
slightly high (5.5 ± 2.1) and median score of 5. About 53.6% of the participants
had insufficient knowledge level. The scores increased with increase in the year
of training. More than half (64.5%) of the participants had no previous BLS
training. Students who attended previous BLS training showed higher knowledge
scores (p < 0.001). Majority of the participants (97.4%) supported including of
BLS in the undergraduate medical curriculum. Majority of the students (74%) were
not reluctant to perform BLS on a stranger, although there was some reluctance
among the female students.
CONCLUSION: Our findings show that medical students in Oman had insufficient
knowledge about BLS. However, they showed positive attitudes toward BLS training
and were not reluctant to provide BLS to a stranger if required. These
highlights the importance to provide sufficient BLS training for medical
students early in their course.
HOW TO CITE THIS ARTICLE: Albadi S, Al-Hadi H, Nadar SK. Knowledge and Attitudes
toward Basic Life Support among Medical Students in Oman. Indian J Crit Care Med
2020;24(7):599-600.

Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.

DOI: 10.5005/jp-journals-10071-23475
PMCID: PMC7482346
PMID: 32963449

Conflict of interest statement: Source of support: Nil Conflict of interest:

None
22. BMC Med Educ. 2022 Mar 3;22(1):140. doi: 10.1186/s12909-022-03206-z.

Basic life support, a necessary inclusion in the medical curriculum: a

cross-sectional survey of knowledge and attitude in Uganda.

Ssewante N(1), Wekha G(2), Iradukunda A(2), Musoke P(2), Kanyike AM(3),
Nabukeera G(4), Wamala NK(5), Zziwa W(6), Kamuhangire L(7), Kajjimu J(8), Luggya
TS(9), Tagg A(10)(11).

Author information:
(1)School of Medicine, College of Health Sciences, Makerere University, Kampala,
Uganda. [email protected].
(2)School of Medicine, College of Health Sciences, Makerere University, Kampala,
Uganda.
(3)Faculty of Health Sciences, Busitema University, Mbale, Uganda.
(4)School of Medicine, Kabale University, Kabale, Uganda.
(5)Faculty of Clinical Medicine and Dentistry, Kampala International University,
Ishaka-Bushenyi, Uganda.
(6)Faculty of Medicine, Gulu University, Gulu, Uganda.
(7)Faculty of Biology, Medicine, and Health, King Caesar University, Kampala,
Uganda.
(8)Faculty of Medicine, Mbarara University of Science and Technology, Mbarara,
Uganda.
(9)Department of Anesthesia and Emergency Medicine, Makerere University,
Kampala, Uganda.
(10)Emergency Department, Western Hospital-Footscray, Footscray, Victoria,
Australia.
(11)School of Medicine, University of Melbourne, Melbourne, Victoria, Australia.

BACKGROUND: Uganda continues to depend on a health system without a well-defined

emergency response system. This is in the face of the rising cases of
out-of-hospital cardiac arrest contributed largely to the high incidence of road
traffic accidents. Non-communicable diseases are also on the rise further
increasing the incidence of cardiac arrest. Medical students are key players in
the bid to strengthen the health system which warrants an assessment of their
knowledge and attitude towards BLS inclusion in their study curriculum.
METHODS: A descriptive cross-sectional study was conducted in 2021 among
undergraduate medical students across eight public and private universities in
Uganda. An online-based questionnaire was developed using Google forms and
distributed via identified WhatsApp groups. Chi-square or Fisher's exact test
and logistic regression were performed in STATA 15 to assess the association
between knowledge of BLS and demographics. P < 0.05 was considered statistically
significant.
RESULTS: Out of the total 354 entries obtained, 351 were analyzed after
eligibility screening. Of these, (n = 250, 71.2%) were male less than 25 years
(n = 273, 77.8%). Less than half (n = 150, 42.7%) participants had undergone
formal BLS training. Less than a third of participants (n = 103, 29.3%) had good
knowledge (≥ 50%) with an overall score of 42.3 ± 12.4%. Age (p = 0.045), level
of academic progress (p = 0.001), and prior BLS training (p = 0.033) were
associated with good knowledge. Participants with prior training were more
likely to have more BLS knowledge (aOR: 1.7, 95% CI: 1.1-2.7, p = 0.009). The
majority (n = 348, 99.1%) believed that BLS was necessary and would wish
(n = 343, 97.7%) to have it included in their curriculum.
CONCLUSIONS: Undergraduate medical students have poor BLS knowledge but
understand its importance. Institutions need to adopt practical teaching methods
such as clinical exposures, field experience in collaboration with local
implementers, and participating in community health promotion campaigns.
© 2022. The Author(s).

DOI: 10.1186/s12909-022-03206-z
PMCID: PMC8892119
PMID: 35241065 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare that they have no competing
interests.

23. Front Med (Lausanne). 2022 May 12;9:825823. doi: 10.3389/fmed.2022.825823.

eCollection 2022.

Innovative Tele-Instruction Approach Impacts Basic Life Support Performance: A

Non-inferiority Trial.

Schauwinhold MT(1)(2), Schmidt M(1)(2), Rudolph JW(3)(4), Klasen M(1)(2),

Lambert SI(1)(2), Krusch A(1)(2), Vogt L(1)(2), Sopka S(1)(2).

Author information:
(1)AIXTRA-Competence Center for Training and Patient Safety, Medical Faculty,
RWTH Aachen University, Aachen, Germany.
(2)Department of Anaesthesiology, University Hospital RWTH Aachen, Medical
Faculty, RWTH Aachen University, Aachen, Germany.
(3)Center for Medical Simulation, Boston, MA, United States.
(4)Department of Anaesthesiology, Critical Care and Pain Medicine, Massachusetts
General Hospital, Harvard Medical School, Boston, MA, United States.

BACKGROUND: Sustaining Basic Life Support (BLS) training during the COVID-19
pandemic bears substantial challenges. The limited availability of highly
qualified instructors and tight economic conditions complicates the delivery of
these life-saving trainings. Consequently, innovative and resource-efficient
approaches are needed to minimize or eliminate contagion while maintaining high
training standards and managing learner anxiety related to infection risk.
METHODS: In a non-inferiority trial 346 first-year medical, dentistry, and
physiotherapy students underwent BLS training at AIXTRA-Competence Center for
Training and Patient Safety at the University Hospital RWTH Aachen. Our
objectives were (1) to examine whether peer feedback BLS training supported by
tele-instructors matches the learning performance of standard instructor-guided
BLS training for laypersons; and (2) to minimize infection risk during BLS
training. Therefore, in a parallel group design, we compared arm (1) Standard
Instructor Feedback (SIF) BLS training (Historical control group of 2019) with
arm (2) a Tele-Instructor Supported Peer-Feedback (TPF) BLS training
(Intervention group of 2020). Both study arms were based on Peyton's 4-step
approach. Before and after each training session, objective data for BLS
performance (compression depth and rate) were recorded using a resuscitation
manikin. We also assessed overall BLS performance via standardized instructor
evaluation and student self-reports of confidence via questionnaire.
Non-inferiority margins for the outcome parameters and sample size calculation
were based on previous studies with SIF. Two-sided 95% confidence intervals were
employed to determine significance of non-inferiority.
RESULTS: The results confirmed non-inferiority of TPF to SIF for all tested
outcome parameters. A follow-up after 2 weeks found no confirmed COVID-19
infections among the participants.
CONCLUSION: Tele-instructor supported peer feedback is a powerful alternative to
in-person instructor feedback on BLS skills during a pandemic, where infection
risk needs to be minimized while maximizing the quality of BLS skill learning.
TRIAL REGISTRATION:
https://www.drks.de/drks_web/navigate.do?
navigationId=trial.HTML&TRIAL_ID=DRKS00025199,
Trial ID: DRKS00025199.

Copyright © 2022 Schauwinhold, Schmidt, Rudolph, Klasen, Lambert, Krusch, Vogt

and Sopka.

DOI: 10.3389/fmed.2022.825823
PMCID: PMC9134732
PMID: 35646961

Conflict of interest statement: The authors declare that the research was
conducted in the absence of any commercial or financial relationships that could
be construed as a potential conflict of interest.

24. J Emerg Med. 2014 May;46(5):695-700. doi: 10.1016/j.jemermed.2013.08.055. Epub

2013 Oct 22.

Perceptions of basic, advanced, and pediatric life support training in a United

States medical school.

Pillow MT(1), Stader D(2), Nguyen M(3), Cao D(2), McArthur R(4), Hoxhaj S(5).

Author information:
(1)Section of Emergency Medicine, Baylor College of Medicine, Houston, Texas;
Simulation Program, Baylor College of Medicine, Houston, Texas.
(2)Department of Emergency Medicine, Carolinas Medical Center, Charlotte, North
Carolina.
(3)Department of Emergency Medicine, New York Presbyterian, New York, New York.
(4)Department of Emergency Medicine, Beth Israel Deaconess, New York, New York.
(5)Section of Emergency Medicine, Baylor College of Medicine, Houston, Texas.

BACKGROUND: Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and
Pediatric Advanced Life Support (PALS) are integral parts of emergency
resuscitative care. Although this training is usually reserved for residents,
introducing the training in the medical student curriculum may enhance
acquisition and retention of these skills.
OBJECTIVES: We developed a survey to characterize the perceptions and needs of
graduating medical students regarding BLS, ACLS, and PALS training.
METHODS: This was a study of graduating 4th-year medical students at a U.S.
medical school. The students were surveyed prior to participating in an ACLS
course in March of their final year.
RESULTS: Of 152 students, 109 (71.7%) completed the survey; 48.6% of students
entered medical school without any prior training and 47.7% started clinics
without training; 83.4% of students reported witnessing an average of 3.0
in-hospital cardiac arrests during training (range of 0-20). Overall, students
rated their preparedness 2.0 (SD 1.0) for adult resuscitations and 1.7 (SD 0.9)
for pediatric resuscitations on a 1-5 Likert scale, with 1 being unprepared. A
total of 36.8% of students avoided participating in resuscitations due to lack
of training; 98.2%, 91.7%, and 64.2% of students believe that BLS, ACLS, and
PALS, respectively, should be included in the medical student curriculum.
CONCLUSIONS: As per previous studies that have examined this topic, students
feel unprepared to respond to cardiac arrests and resuscitations. They feel that
training is needed in their curriculum and would possibly enhance perceived
comfort levels and willingness to participate in resuscitations.

Copyright © 2014 Elsevier Inc. All rights reserved.

DOI: 10.1016/j.jemermed.2013.08.055
PMID: 24161229 [Indexed for MEDLINE]

25. Int J Emerg Med. 2023 Jul 24;16(1):44. doi: 10.1186/s12245-023-00521-0.

Basic life support awareness among medical undergraduate students in Syria,

Iraq, and Jordan: a multicenter cross-sectional study.

Alkarrash MS(1), Shashaa MN(1), Kitaz MN(1), Rhayim R(1), Ismail M(1), Swed
S(2), Hafez W(3)(4), Kaadan MI(5)(6), Koumakli H(7), Alhisah N(8), Al-Haider
A(9), Al-Salloum S(10), Cherrez-Ojeda I(11)(12).

Author information:
(1)Faculty of Medicine, University of Aleppo, Aleppo, Syria.
(2)Faculty of Medicine, University of Aleppo, Aleppo, Syria.
[email protected].
(3)Department of Internal Medicine, Medical Research Division, The National
Research Centre, Cairo, Egypt.
(4)NMC Royal Hospital, 16Th Street, Khalifa City, Abu Dhabi, UAE.
(5)Department of Medicine, Boston Medical Center, Boston, MA, USA.
(6)Department of Medicine, Boston University School of Medicine, Boston, MA,
USA.
(7)Faculty of Medicine, University of Albaath, Homs, Syria.
(8)Faculty of Medicine, University of October 6 University, Madaba, Jordan.
(9)Faculty of Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq.
(10)Emergency Department, Aleppo University Hospital, Aleppo, Syria.
(11)Universidad Espíritu Santo, Samborondón, Ecuador.
(12)Respiralab Research Group, Guayaquil, Ecuador.

BACKGROUND AND AIMS: Basic life support (BLS) training rates vary widely
worldwide, and there is a general scarcity of surveys that assess students'
knowledge and awareness of BLS in middle eastern nations. This study aims to
evaluate medical students' knowledge and awareness towards basic life support.
METHODS: A cross-sectional study, using an online web-based questionnaire,
assessing BLS awareness and knowledge, was conducted from 3 to 30 November 2021.
The study included 2114 medical students from Syria, Iraq, and Jordan. The
questionnaire consisted of three sections: demographic baseline characteristics,
knowledge about BLS, and ability to apply basic life support. A binominal
logistic regression was done between the total score and other demographic
characteristics to determine if we could predict the research sample's
appropriate knowledge of BLS level.
RESULTS: There was a moderate knowledge of BLS and cardiopulmonary resuscitation
(CPR) skills among participating students with an average score of 19.67 (0-34).
Seventy-eight of the participants (1656) stated that they have not attended a
basic life support course. There was a significant difference between the
participants from different countries, where the mean score in Syria, Jordan,
and Iraq was 18.3, 24.3, and 18.8, respectively (p < 0.05). Considering the
level of knowledge, 18.3%, 72.8%, and 8.9% of the participants had a high,
intermediate, and low level, respectively. Furthermore, students who took a BLS
course had a higher level of knowledge than those who did not, with an odds
ratio of 5.168 (p value < 0.0001).
CONCLUSION: The overall knowledge of medical students' basic life support
knowledge is insufficient and need to be greatly improved. According to this
study, previous participation in basic life support training had a positive
effect on knowledge level. As a result, universities must establish basic life
support programs as quickly as possible.

© 2023. The Author(s).

DOI: 10.1186/s12245-023-00521-0
PMCID: PMC10364399
PMID: 37482609

Conflict of interest statement: The authors declare no competing interests.

26. Clin Exp Emerg Med. 2020 Dec;7(4):245-249. doi: 10.15441/ceem.19.095. Epub 2020
Dec 31.

Outcome of basic life support training among primary school students in

Southeast Asia.

Suwanpairoj C(1), Wongsombut T(1), Maisawat K(1), Torod N(1), Jaengkrajan A(1),
Sritharo N(1), Atthapreyangkul N(1)(2), Wittayachamnankul B(1)(2).

Author information:
(1)Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
(2)Department of Emergency Medicine, Chiang Mai University, Chiang Mai,
Thailand.

OBJECTIVE: This study aimed to evaluate how BLS courses affect primary school
students' knowledge, attitudes, and life support skills; investigate how medical
students' knowledge and competence in teaching BLS can improve by serving as
instructors.
METHODS: This experimental study was conducted in a rural primary school.
First-year medical students conducted a BLS course for grade 4 and 5 primary
school students with a 6-7:1 ratio of trainees-to-trainer. All trainers had
completed a BLS course before the course. This 3.5-hour simulation-based course
covered chest compressions and automated external defibrillator use. The pre-
and post-course assessments included multiple choice questions toward BLS,
practical skills test, and attitude test. For medical students, evaluation was
conducted by attitude test, both pre- and post-teaching.
RESULTS: The mean pre- and post-test scores increased from 5.74±0.10 to
9.43±0.13 (P<0.01). The increase in the scores was the same for both the
students and the teachers (3.05±0.60 vs. 3.68±0.16, P=0.33). After the course,
more than 90% of the students could perform all the procedures involved in BLS
and automated external defibrillation. Medical students showed an improved
understanding of CPR and confidence in performing and teaching CPR (both,
P<0.01).
CONCLUSION: Primary school students can learn how to perform BLS through
simulation-based learning. Simulation-based training can improve their attitude
and provide them with knowledge and crucial skill sets, improving their
confidence in performing BLS. Furthermore, teachers' attitudes and confidence
toward CPR improved after teaching CPR.

DOI: 10.15441/ceem.19.095
PMCID: PMC7808835
PMID: 33440101

Conflict of interest statement: No potential conflict of interest relevant to

this article was reported.

27. Simul Healthc. 2019 Dec;14(6):372-377. doi: 10.1097/SIH.0000000000000391.

Learning Impacts of Pretraining Video-Assisted Debriefing With Simulated Errors

or Trainees' Errors in Medical Students in Basic Life Support Training: A
Randomized Controlled Trial.

Li Q(1), Lin J, Fang LQ, Ma EL, Liang P, Shi TW, Xiao H, Liu J.

Author information:
(1)From the Department of Anesthesiology, West China Hospital of Sichuan
University, Chengdu, Sichuan, People's Republic of China.

BACKGROUND: Previous studies demonstrated that pretraining video-assisted

debriefing (VAD) with trainees' errors (TE) videotaped in a skills pretest
improved skill learning of basic life support (BLS). However, conducting a
pretest and preparing TE video examples is resource intensive. Exposing
individual trainee's errors to peers might be a threat to learners'
psychological safety. We hypothesized pretraining VAD with simulated errors (SE,
performed by actors) might have the same beneficial effect on skills learning as
pretraining VAD with TE, but avoid drawbacks of TE.
METHODS: Three hundred twenty-two third-year medical students were randomized
into 3 groups (the control [C], TE, SE). A videotaped BLS skills pretest was
conducted in 3 groups. Then, group C received traditional training with
concurrent feedback. Video-assisted debriefing with TE in the pretest or SE was
delivered in groups TE or SE, respectively, followed by BLS training without any
feedback. Basic life support skills were retested 1 week later (posttest).
Students completed a survey to express their preference to TE or SE for VAD in
the future.
RESULTS: Higher BLS skills scores were observed in groups TE (85.7 ± 7.0) and SE
(86.8 ± 7.5) in the posttest, compared with group C (68.7 ± 13.3, P < 0.001). No
skills difference was observed between group TE and SE in the posttest. More
trainees (65.8%) preferred SE for VAD.
CONCLUSIONS: Pretraining VAD with SE had an equivalent beneficial effect as VAD
with TE on BLS skills learning in medical students. More trainees preferred SE
for VAD with regard to psychological safety.

DOI: 10.1097/SIH.0000000000000391
PMID: 31652180 [Indexed for MEDLINE]

28. Resusc Plus. 2022 Nov 10;12:100325. doi: 10.1016/j.resplu.2022.100325.

eCollection 2022 Dec.

Piloting a Basic Life Support instructor course: A short report.

Nabecker S(1), Balmer Y(2), van Goor S(3), Greif R(2)(4).

Author information:
(1)Department of Anesthesiology and Pain Management, Sinai Health System,
University of Toronto, Toronto, Canada.
(2)Department of Anaesthesiology and Pain Medicine, Bern University Hospital,
University of Bern, Bern, Switzerland.
(3)Emergency Medical Service Public Health Service Haaglanden, Den Haag, the
Netherlands.
(4)School of Medicine, Sigmund Freud University Vienna, Vienna, Austria.

AIM: The aim was to describe a new shortened pilot of the European Resuscitation
Council's standard Basic Instructor Course.
METHODS: The four-hour pilot followed a blended learning strategy (pre-course
preparation, on-site small-group sessions). Each participant taught a short
Basic Life Support competency to the group (micro-teaching) and received the
group's feedback. A feedback "drill" session followed. Primary quantitative
outcome was the proportion of Basic Instructor Course participants subsequently
teaching Basic Life Support. Post-course teachings were recorded and compared to
standard eight-hour Basic Instructor Courses. Participants' open feedback
question answers were qualitatively analyzed and presented descriptively.
RESULTS: This pilot Basic Instructor Course taught 31 healthcare providers in 4
courses in 2019-2021 (aged 31.5 ± 12.9 years; 61 % women; 29 % physicians; 71 %
medical students; 21 % no teaching experience). Participants reported that they
gained most from micro-teaching (64 %), and advice on their teaching (50 %).
Some judged the course as being too long (29 %). Twenty-seven pilot course
participants (87 %) (including three instructor candidates) started teaching,
whereas only nine of 37 participants of the 3 courses (24 %, including three
instructor candidates) from the standard eight-hour course did.
CONCLUSION: Participants of the pilot shortened Basic Instructor Course in a
healthcare setting were successfully trained to teach European Resuscitation
Council's Basic Life Support provider courses in a short four-hour format. The
pilot course seems to enable future instructors to teach Basic Life Support
provider courses. Higher motivation to teach resulted in four times as many
instructors who taught courses after the pilot course compared to the standard
course.

© 2022 The Authors.

DOI: 10.1016/j.resplu.2022.100325
PMCID: PMC9664389
PMID: 36386768

Conflict of interest statement: S.N. is European Resuscitation Council SEC-IES

committee member (Instructor-Educator-Support Science and Education Committee),
and Canadian Anesthesiologists’ CEPD (Continuing Education and Professional
Development) Committee member. S.N. is currently also Handling Guest editor of
the Special Edition on Resuscitation Education in the Resuscitation plus
journal. R.G. is European Resuscitation Council’s Director of Guidelines and
ILCOR, and ILCOR (International Liaison Committee on Resuscitation) Task Force
Chair Education, Implementation, Team. R.G. is Board member of the Resuscitation
plus journal and is currently also Guest editor of the Special Edition on
Resuscitation Education in the Resuscitation plus journal. S.vG. is educational
co-chair of the European Resuscitation Council’s Science and Education Committee
Basic Life Support. R.G. and Y.B. taught during these pilot courses.

29. Cureus. 2024 Nov 13;16(11):e73637. doi: 10.7759/cureus.73637. eCollection 2024

Nov.

Evaluating the Effectiveness of Basic Life Support (BLS) and Advanced

Cardiovascular Life Support (ACLS) Training for Family Medicine Residents in
Saudi Arabia.

Althobaiti R(1), Aldhahi R(1), Althobaiti M(2), AlSaleem LS(3), Alkhaldi H(1),
Almutairi N(1), Ahmed I(4).

Author information:
(1)Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU.
(2)Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh,
SAU.
(3)Pediatrics, King Faisal Specialist Hospital and Research Center (KFSHRC),
Riyadh, SAU.
(4)Family Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU.

BACKGROUND: This study aims to assess the knowledge level of family medicine
physicians in Saudi Arabia, regarding basic life support (BLS) and advanced
cardiovascular life support (ACLS). Recognizing the importance of timely and
effective resuscitation in emergency medical care, the study explores the
physicians' proficiency in key resuscitation concepts and identifies areas for
improvement.
METHODOLOGY: Conducted as an observational cross-sectional study in Saudi
Arabia, the research involved family medicine physicians from major hospital
centers. A self-administered questionnaire, adapted from previous studies, was
utilized to collect demographic data and assess knowledge related to BLS and
ACLS.
RESULTS: The demographic analysis revealed a predominantly male participant base
(52.3%), with a majority having clinical practice experience of five years or
less (74.4%). The survey highlighted positive trends in BLS course attendance,
with 60.5% having undergone training within the last year. However, the study
identified gaps in ACLS course attendance, as 37.2% reported never having
attended such a course. The knowledge assessment unveiled varying proficiency
levels among participants, with critical gaps identified in recognizing the full
form of automated external defibrillator (AED) (28.5%) and airway maneuvers
(20.9%).
CONCLUSION: This study highlights the need for ongoing education in
resuscitation for family medicine physicians, with targeted interventions to
address gaps in AED use and airway management. While BLS course attendance shows
proactive engagement, increased focus on ACLS training is necessary to further
improve resuscitation skills.

Copyright © 2024, Althobaiti et al.

DOI: 10.7759/cureus.73637
PMCID: PMC11646160
PMID: 39677275

Conflict of interest statement: Human subjects: Consent for treatment and open
access publication was obtained or waived by all participants in this study.
Institutional Review Board of Imam Mohammad Ibn Saud Islamic University issued
approval 461/2023. Animal subjects: All authors have confirmed that this study
did not involve animal subjects or tissue. Conflicts of interest: In compliance
with the ICMJE uniform disclosure form, all authors declare the following:
Payment/services info: All authors have declared that no financial support was
received from any organization for the submitted work. Financial relationships:
All authors have declared that they have no financial relationships at present
or within the previous three years with any organizations that might have an
interest in the submitted work. Other relationships: All authors have declared
that there are no other relationships or activities that could appear to have
influenced the submitted work.

30. Emerg (Tehran). 2018;6(1):e36. Epub 2018 Jun 16.

Awareness of Basic Life Support among Egyptian Medical Students; a

Cross-Sectional Study.

Ghanem E(1)(2), Elgazar M(1), Oweda K(1), Tarek H(1), Assaf F(1), Ahmed
El-Husseny MW(3), Elgebaly A(1), Abushouk AI(2)(4).

Author information:
(1)Faculty of Medicine Al-Azhar University, Cairo, Egypt.
(2)Cross Sectional Research Group of Egypt, Cairo, Egypt.
(3)Faculty of Medicine, Fayoum University, Fayoum, Egypt.
(4)Faculty of Medicine, Ain Shams University, Cairo, Egypt.
INTRODUCTION: It is important for all medical and paramedical staff to be aware
of basic life support (BLS) maneuvers. In this study, we aimed to evaluate the
level of BLS awareness among Egyptian medical students.
METHODS: The level of BLS knowledge was assessed using a validated questionnaire
and the results were analyzed using an answer key, prepared from the Advanced
Cardiac Life Support (ACLS) manual. We used the Student's t-test to analyze the
association between awareness level and year of study, previous BLS training and
practical experience.
RESULTS: A total of 823 medical students with the mean age of 20.3 ± 2.7 years,
from Al-Azhar medical schools completed the questionnaire (463 and 360 in
academic and clinical years, respectively). About 72% and 84% of students failed
to recognize the proper point of chest compression in adults and infants,
respectively. Moreover, the majority (80%) did not know how to give rescue
breathing in infants. Only 18% of students correctly identified early signs of
shock and only 22% knew how to help patients with myocardial infarction. Being
in clinical years, previous BLS training or practical experience were
significantly associated with higher BLS knowledge scores (p < 0.001).
CONCLUSION: The level of BLS awareness among Egyptian medical students is
generally poor. Introduction of regular BLS courses into the undergraduate
curriculum is a must to increase the level of BLS knowledge among Egyptian
future physicians.

PMCID: PMC6036537
PMID: 30009238

Conflict of interest statement: None to Declare

31. Med Teach. 2011;33(10):e549-55. doi: 10.3109/0142159X.2011.600360.

Pre-training evaluation and feedback improve medical students' skills in basic

life support.

Li Q(1), Ma EL, Liu J, Fang LQ, Xia T.

Author information:
(1)West China Hospital of Sichuan University, Chengdu, Sichuan 610041, PR China.

BACKGROUND: Evaluation and feedback are two factors that could influence
simulation-based medical education and the time when they were delivered
contributes their different effects.
AIM: To investigate the impact of pre-training evaluation and feedback on
medical students' performance in basic life support (BLS).
METHODS: Forty 3rd-year undergraduate medical students were randomly divided
into two groups, C group (the control) and pre-training evaluation and feedback
group (E&F group), each of 20. After BLS theoretical lecture, the C group
received 45 min BLS training and the E&F group was individually evaluated
(video-taped) in a mock cardiac arrest (pre-training evaluation). Fifteen
minutes of group feedback related with the students' BLS performance in
pre-training evaluation was given in the E&F group, followed by a 30-min BLS
training. After BLS training, both groups were evaluated with one-rescuer BLS
skills in a 3-min mock cardiac arrest scenario (post-training evaluation). The
score from the post-training evaluation was converted to a percentage and was
compared between the two groups.
RESULTS: The score from the post-training evaluation was higher in the E&F group
(82.9 ± 3.2% vs. 63.9 ± 13.4% in C group).
CONCLUSIONS: In undergraduate medical students without previous BLS training,
pre-training evaluation and feedback improve their performance in followed BLS
training.
DOI: 10.3109/0142159X.2011.600360
PMID: 21942491 [Indexed for MEDLINE]

32. JAMA Netw Open. 2023 Mar 1;6(3):e233338. doi:

10.1001/jamanetworkopen.2023.3338.

Training in Basic Life Support and Bystander-Performed Cardiopulmonary

Resuscitation and Survival in Out-of-Hospital Cardiac Arrests in Denmark, 2005
to 2019.

Jensen TW(1)(2)(3), Ersbøll AK(3)(4), Folke F(2)(3)(5), Wolthers SA(1)(2),

Andersen MP(6), Blomberg SN(1)(2)(3), Andersen LB(1), Lippert F(2)(3),
Torp-Pedersen C(6)(7), Christensen HC(1)(2)(8).

Author information:
(1)Prehospital Center Region Zealand, Næstved, Denmark.
(2)Department of Clinical Medicine, University of Copenhagen, Copenhagen,
Denmark.
(3)Copenhagen Emergency Medical Services, Copenhagen, Denmark.
(4)National Institute of Public Health, University of Southern Denmark,
Copenhagen, Denmark.
(5)Department of Cardiology, Herlev Gentofte University Hospital, Gentofte,
Denmark.
(6)Department of Cardiology, Nordsjaellands Hospital, Hillerød, Denmark.
(7)Department of Clinical Medicine, Aalborg University Hospital, University of
Copenhagen, Copenhagen, Denmark.
(8)Danish Clinical Quality Program (RKKP), National Clinical Registries,
Department of Clinical Medicine, Denmark.

IMPORTANCE: Strategies to improve survival from out-of-hospital cardiac arrest

(OHCA) include mass education of laypersons with no official duty to respond to
OHCA. In Denmark, basic life support (BLS) course attendance has been mandated
by law in October 2006 for obtaining a driver's license for all vehicles and in
vocational education programs.
OBJECTIVES: To examine the association between yearly BLS course participation
rate and bystander cardiopulmonary resuscitation (CPR) and 30-day survival from
OHCA and to examine if bystander CPR rate acted as a mediator on the association
between mass education of laypersons in BLS and survival from OHCA.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study included outcomes for all
OHCA incidents from the Danish Cardiac Arrest Register between 2005 and 2019.
Data concerning BLS course participation were supplied by the major Danish BLS
course providers.
MAIN OUTCOMES AND MEASURES: The main outcome was 30-day survival of patients who
experienced OHCA. Logistic regression analysis was used to examine the
association between BLS training rate, bystander CPR rate, and survival, and a
bayesian mediation analysis was conducted to examine mediation.
RESULTS: A total of 51 057 OHCA incidents and 2 717 933 course certificates were
included. The study showed that the annual 30-day survival from OHCA increased
by 14% (odds ratio [OR], 1.14; 95% CI, 1.10-1.18; P < .001) when BLS course
participation rate increased by 5% in analysis adjusted for initial rhythm,
automatic external defibrillator use, and mean age. An average mediated
proportion of 0.39 (95% QBCI, 0.049-0.818; P = .01). In other words, the last
result indicated that 39% of the association between mass educating laypersons
in BLS and survival was mediated through an increased bystander CPR rate.
CONCLUSIONS AND RELEVANCE: In this cohort study of Danish BLS course
participation and survival, a positive association was found between annual rate
of mass education in BLS and 30-day survival from OHCA. The association of BLS
course participation rate on 30-day survival was mediated by the bystander CPR
rate; approximately 60% of the association of BLS course participation rate on
30-day survival was based on factors other than increased CPR rates.

DOI: 10.1001/jamanetworkopen.2023.3338
PMCID: PMC10020888
PMID: 36929397 [Indexed for MEDLINE]

Conflict of interest statement: Conflict of Interest Disclosures: Dr Lippert

reported receiving grants from Laerdal Foundation and grants from Trygfoundation
outside the submitted work. Dr Torp-Pedersen reported receiving grants from
Bayer and Novo Nordisk for studies outside the submitted work. No other
disclosures were reported.

33. Am J Emerg Med. 2023 May;67:135-143. doi: 10.1016/j.ajem.2023.02.028. Epub 2023

Feb 25.

Bystander basic life support and survival after out-of-hospital cardiac arrest:
A propensity score matching analysis.

Lafrance M(1), Recher M(2), Javaudin F(3), Chouihed T(4), Wiel E(5), Helft G(6),
Hubert H(7), Canon V(7); GR-RéAC(8).

Author information:
(1)Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de
santé et des pratiques médicales, F-59000 Lille, France; French National
Out-of-Hospital Cardiac Arrest Registry, RéAC, F-59000 Lille, France. Electronic
address: [email protected].
(2)Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de
santé et des pratiques médicales, F-59000 Lille, France.
(3)Department of Emergency Medicine, CHU Nantes, F-44000 Nantes, France.
(4)Emergency Department, University Hospital of Nancy, F-54000 Nancy, France;
INSERM, UMRS 1116, University Hospital of Nancy, F-54000 Nancy, France.
(5)Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de
santé et des pratiques médicales, F-59000 Lille, France; French National
Out-of-Hospital Cardiac Arrest Registry, RéAC, F-59000 Lille, France; SAMU du
Nord and Emergency Department for Adults, Lille University Hospital, F-59000
Lille, France.
(6)Cardiology Department, Assistance Publique Hôpitaux de Paris,
Pitie-Salpêtrière Hospital, F-75013 Paris, France.
(7)Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de
santé et des pratiques médicales, F-59000 Lille, France; French National
Out-of-Hospital Cardiac Arrest Registry, RéAC, F-59000 Lille, France.
(8)French National Out-of-Hospital Cardiac Arrest Registry, RéAC, F-59000 Lille,
France.

INTRODUCTION AND OBJECTIVES: In out-of-hospital cardiac arrest, early

recognition, calling for emergency medical assistance, and early cardiopulmonary
resuscitation are acknowledged to be the three most important components in the
chain of survival. However, bystander basic life support (BLS) initiation rates
remain low. The objective of the present study was to evaluate the association
between bystander BLS and survival after an out-of-hospital cardiac arrest
(OHCA).
METHODS: We conducted a retrospective cohort study of all patients with OHCA
with a medical etiology treated by a mobile intensive care unit (MICU) in France
from July 2011 to September 2021, as recorded in the French National OHCA
Registry (RéAC). Cases in which the bystander was an on-duty fire fighter,
paramedic, or emergency physician were excluded. We assessed the characteristics
of patients who received bystander BLS vs. those who did not. The two classes of
patient were then matched 1:1, using a propensity score. Conditional logistic
regression was then used to probe the putative association between bystander BLS
and survival.
RESULTS: During the study, 52,303 patients were included; BLS was provided by a
bystander in 29,412 of these cases (56.2%). The 30-day survival rates were 7.6%
in the BLS group and 2.5% in the no-BLS group (p < 0.001). After matching,
bystander BLS was associated with a greater 30-day survival rate (odds ratio
(OR) [95% confidence interval (CI)] = 1.77 [1.58-1.98]). Bystander BLS was also
associated with greater short-term survival (alive on hospital admission; OR
[95%CI] = 1.29 [1.23-1.36]).
CONCLUSIONS: The provision of bystander BLS was associated with a 77% greater
likelihood of 30-day survival after OHCA. Given than only one in two OHCA
bystanders provides BLS, a greater focus on life saving training for laypeople
is essential.

Copyright © 2023 Elsevier Inc. All rights reserved.

DOI: 10.1016/j.ajem.2023.02.028
PMID: 36871482 [Indexed for MEDLINE]

Conflict of interest statement: Declaration of Competing Interest The authors

declare that they have no known competing financial interests or personal
relationships that could have appeared to influence the work reported in this
paper.

34. Prehosp Emerg Care. 2017 Jul-Aug;21(4):442-447. doi:

10.1080/10903127.2017.1294224. Epub 2017 Mar 24.

Basic Life Support Access to Injectable Epinephrine across the United States.

Brasted ID, Dailey MW.

BACKGROUND: Aggressive epinephrine administration has growing support in the

treatment of anaphylaxis, a life-threatening allergic reaction. Emergency
Medical Services (EMS) providers are frequently in a position to provide the
first care to someone experiencing an anaphylactic reaction. Intramuscular
injection of epinephrine is the definitive pharmacologic treatment for many
associated symptoms. While easy to use, epinephrine autoinjectors (EAI) are
prohibitively expensive, having increased in price ten-fold in ten years. Some
states and EMS departments have begun expanding the scope of practice to allow
Basic Life Support (BLS) providers, previously restricted to noninvasive
therapies, to administer epinephrine by syringe.
OBJECTIVES: To compile a current and comprehensive list of how epinephrine is
carried and used by EMS across the USA.
METHODS: An online survey focusing on anaphylaxis protocols and epinephrine
administration was sent to state EMS medical directors and officials in all 50
states. Follow-up telephone calls were made to ensure compliance. Data were
analyzed with descriptive statistics.
RESULTS: Forty-nine of the 50 states in the USA provided a survey response.
Texas responded but declined to participate in the survey because of practice
variability across the state. In the other states, the form of epinephrine
allowed or required on BLS ambulances was consistent with the scope of practice
of their Basic Emergency Medical Technician (EMT). Thirteen states had training
programs to allow BLS providers to inject epinephrine; 7 were considering it; 29
were not. Twenty-seven states specified EAI as the only form of epinephrine
required or allowed on their BLS ambulances. No states reported allowing any
level of EMS provider below EMT to use alternatives to EAI.
CONCLUSION: This study confirms that many states have expanded the training of
BLS providers to include the use of syringe injectable epinephrine. Even so, the
majority of states relied on EAI in BLS ambulances.

DOI: 10.1080/10903127.2017.1294224
PMID: 28339320 [Indexed for MEDLINE]

35. Prehosp Disaster Med. 2021 Oct;36(5):553-560. doi: 10.1017/S1049023X21000674.

Epub 2021 Jul 13.

Peer Education Model for Basic Life Support Training among High School Children:
A Randomized Trial.

Kesici S(1), Bayrakci Z(2), Birbilen AZ(3), Hanalioglu D(3), Öztürk Z(4), Teksam
Ö(5), Hüyüklü İ(6), Durgu E(6), Bayrakci B(7).

Author information:
(1)Instructor of Pediatric Intensive Care Unit, Hacettepe University İhsan
Doğramacı Children's Hospital, Ankara, Turkey.
(2)Student, Bahcesehir High School Ankara Campus, AnkaraTurkey.
(3)Fellow of Pediatric Emergency Medicine Unit, Hacettepe University İhsan
Doğramacı Children's Hospital, Ankara, Turkey.
(4)Fellow of Pediatric Intensive Care Unit, Hacettepe University İhsan Doğramacı
Children's Hospital, Ankara, Turkey.
(5)Professor, Director of Pediatric Emergency Medicine Unit, Hacettepe
University İhsan Doğramacı Children's Hospital, Ankara, Turkey.
(6)Teacher, Bahcesehir High School Ankara Campus, AnkaraTurkey.
(7)Professor, Director of Pediatric Intensive Care Unit, Hacettepe University
İhsan Doğramacı Children's Hospital, Ankara, Turkey.

BACKGROUND AND OBJECTIVES: The aim of the study was to test the effectiveness of
the peer education method on the learning and application of Basic Life Support
(BLS) in high school students and to test the effectiveness of the peer
education model on the BLS instructor training.
METHODS: High school grade one students were included in the study. Students
were divided in two groups (Group A and Group B). Peer instructors who were
trained by health professionals trained students in Group A. Peer instructors
who were trained by their peers trained students in Group B. Pre- and
post-training awareness and knowledge tests were applied to measure the
awareness and knowledge of all students. Students' success in applying BLS steps
was evaluated by a practical exam that was coordinated by physicians using a
checklist.
RESULTS: Result of the pre-post training awareness questionnaire, pre-post
training knowledge tests, and practical exam indicated that instructors trained
by their peers were as effective as the instructors trained by medical
physicians in terms of giving BLS training to high school students. In the
16-step BLS application competence evaluation, the students in Group A applied
BLS with a success rate of 90.2% and in Group B with a success rate of 93.4%.
CONCLUSION: In the current study, it was shown that the peer education model is
effective in BLS training and BLS instructor training in high school students.
This novel method of peer education gives an opportunity to overcome the stated
shortage in the budget and in trained instructors.

DOI: 10.1017/S1049023X21000674
PMID: 34254577 [Indexed for MEDLINE]

36. Cureus. 2023 Dec 6;15(12):e50080. doi: 10.7759/cureus.50080. eCollection 2023

Dec.

Assessment of Basic Life Support Knowledge Among Medical Students in Jordan:

Implications for Improving Out-of-Hospital Cardiac Arrest and Road Traffic
Accident Survival Rates.

Al-Husinat L(1), Nusir M(2), Al-Gharaibeh H(2), Nusir M(2), Haddad F(3), Al
Modanat Z(2), Varrassi G(4).

Author information:
(1)Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk
University, Irbid, JOR.
(2)Department of Clinical Sciences, Faculty of Medicine, Yarmouk University,
Irbid, JOR.
(3)Clinical Research, Center for Advanced Kidney Research, St Clair Shores, USA.
(4)Pain Medicine, Paolo Procacci Foundation, Rome, ITA.

This study aimed to assess the level of basic life support (BLS) knowledge among
fifth- and sixth-year medical students in Jordan, identify differences in
knowledge levels between male and female students and between different
universities, and provide insights into the current status of BLS training in
medical education in Jordan. The study had 570 respondents, with females
constituting 61.1% of the sample. The total average score for medical students
was 12.24/17 (72%), and there was a considerable variation in the response rate
between universities. The study found that students whose source of knowledge
was previous college courses had the highest mean score, and only 24.9% knew the
proper position of both hands while doing chest compressions. The study
underscores the importance of adequate BLS training for healthcare providers to
improve survival rates and reduce mortality and morbidity associated with
out-of-hospital cardiac arrest and road traffic accidents. The findings of this
study could inform future interventions aimed at improving BLS knowledge and
skills.

Copyright © 2023, Al-Husinat et al.

DOI: 10.7759/cureus.50080
PMCID: PMC10770436
PMID: 38186516

Conflict of interest statement: The authors have declared that no competing

interests exist.

37. BMC Nurs. 2022 Jun 6;21(1):141. doi: 10.1186/s12912-022-00923-0.

Basic life support knowledge in a war-torn country: a survey of nurses in Yemen.

Alkubati SA(1)(2), McClean C(3), Yu R(3), Albagawi B(4), Alsaqri SH(4), Alsabri
M(5)(6).

Author information:
(1)Department of Medical Surgical Nursing, College of Nursing, University of
Hail, Hail City, Saudi Arabia. [email protected].
(2)Department of Nursing, Faculty of Medicine and Health Sciences, Hodeida
University, Hodeida, Yemen. [email protected].
(3)Saba University School of Medicine, The Bottom, Caribbean, Netherlands.
(4)Department of Medical Surgical Nursing, College of Nursing, University of
Hail, Hail City, Saudi Arabia.
(5)Al-Thawra Modern General Teaching Hospital, Sana'a City, Yemen.
[email protected].
(6)Pediatrics, Brookdale University Hospital Medical Center, Brooklyn, NY,
11212, USA. [email protected].

BACKGROUND: Successful implementation of Basic life support (BLS) is critical to

improving survival rates and outcomes, especially among healthcare workers. To
our knowledge, there is no available literature pertaining to the level of BLS
knowledge of health care professionals in Yemen.
METHODS: Data was collected for this cross-sectional descriptive study from June
to August 2020, using a 10-item questionnaire related to cardiopulmonary
resuscitation (CPR) and BLS, along with questions on socio-demographic
characteristics. Participants were nurses in public and private hospitals
located in Al-Rahida and Al-dimna cities, Taiz governance and Hodeidah city,
Hodeidah governance in Yemen.
RESULTS: Out of 220 distributed questionnaires, 200 were returned with a
response rate of 90.9%. More than a half (53.65%) of answer choices for BLS
knowledge were correct. There was a significant difference in knowledge score
based on level of education where those who had Bachelor degree had more
knowledge (P = 0.000). Those who said they had received training in CPR or
received information about CPR had significantly higher scores than those who
did not receive (P = 0.000).
CONCLUSIONS: BLS knowledge among nurses in Yemen is below an acceptable level to
ensure maximum survival in the event of cardiac arrest. Disseminating BLS
information and training in a cost effective and efficient manner will provide a
large benefit in terms of lives saved with minimal costs.

© 2022. The Author(s).

DOI: 10.1186/s12912-022-00923-0
PMCID: PMC9169348
PMID: 35668520

Conflict of interest statement: The authors declare that they have no conflict
of interest.

38. Resuscitation. 2018 May;126:147-153. doi: 10.1016/j.resuscitation.2018.02.031.

Epub 2018 Mar 6.

Self-learning basic life support: A randomised controlled trial on learning

conditions.

Pedersen TH(1), Kasper N(2), Roman H(3), Egloff M(2), Marx D(2), Abegglen S(4),
Greif R(5).

Author information:
(1)Department of Anaesthesiology and Pain Therapy, Bern University Hospital,
University of Bern, Bern, Switzerland. Electronic address:
[email protected].
(2)Department of Anaesthesiology and Pain Therapy, Bern University Hospital,
University of Bern, Bern, Switzerland.
(3)Bern Institute of Primary Care (BIHAM), University of Bern, Bern,
Switzerland.
(4)University of Bern, Institute of Psychology, Clinical Psychology and
Psychotherapy, University of Bern, Bern, Switzerland.
(5)Department of Anaesthesiology and Pain Therapy, Bern University Hospital,
University of Bern, Bern, Switzerland; ERC Research NET, Niel, Belgium.

AIM OF THE STUDY: To investigate whether pure self-learning without instructor

support, resulted in the same BLS-competencies as facilitator-led learning, when
using the same commercially available video BLS teaching kit.
METHODS: First-year medical students were randomised to either BLS self-learning
without supervision or facilitator-led BLS-teaching. Both groups used the
MiniAnne kit (Laerdal Medical, Stavanger, Norway) in the students' local
language. Directly after the teaching and three months later, all participants
were tested on their BLS-competencies in a simulated scenario, using the Resusci
Anne SkillReporter™ (Laerdal Medical, Stavanger, Norway). The primary outcome
was percentage of correct cardiac compressions three months after the teaching.
Secondary outcomes were all other BLS parameters recorded by the SkillReporter
and parameters from a BLS-competence rating form.
RESULTS: 240 students were assessed at baseline and 152 students participated in
the 3-month follow-up. For our primary outcome, the percentage of correct
compressions, we found a median of 48% (interquartile range (IQR) 10-83) for
facilitator-led learning vs. 42% (IQR 14-81) for self-learning (p = 0.770)
directly after the teaching. In the 3-month follow-up, the rate of correct
compressions dropped to 28% (IQR 6-59) for facilitator-led learning (p = 0.043)
and did not change significantly in the self-learning group (47% (IQR 12-78),
p = 0.729).
CONCLUSIONS: Self-learning is not inferior to facilitator-led learning in the
short term. Self-learning resulted in a better retention of BLS-skills three
months after training compared to facilitator-led training.

Copyright © 2018 Elsevier B.V. All rights reserved.

DOI: 10.1016/j.resuscitation.2018.02.031
PMID: 29522830 [Indexed for MEDLINE]

39. J Med Internet Res. 2021 Feb 23;23(2):e25125. doi: 10.2196/25125.

Differences in Basic Life Support Knowledge Between Junior Medical Students and
Lay People: Web-Based Questionnaire Study.

Sturny L(1), Regard S(1), Larribau R(1), Niquille M(1), Savoldelli GL(2)(3),
Sarasin F(1), Schiffer E(2), Suppan L(1).

Author information:
(1)Division of Emergency Medicine, Department of Anesthesiology, Clinical
Pharmacology, Intensive Care and Emergency Medicine, University of Geneva
Hospitals and Faculty of Medicine, Geneva, Switzerland.
(2)Division of Anesthesiology, Department of Anesthesiology, Clinical
Pharmacology, Intensive Care and Emergency Medicine, University of Geneva
Hospitals and Faculty of Medicine, Geneva, Switzerland.
(3)Unit of Development and Research in Medical Education, Faculty of Medicine,
University of Geneva, Geneva, Switzerland.

BACKGROUND: Early cardiopulmonary resuscitation and prompt defibrillation

markedly increase the survival rate in the event of out-of-hospital cardiac
arrest (OHCA). As future health care professionals, medical students should be
trained to efficiently manage an unexpectedly encountered OHCA.
OBJECTIVE: Our aim was to assess basic life support (BLS) knowledge in junior
medical students at the University of Geneva Faculty of Medicine (UGFM) and to
compare it with that of the general population.
METHODS: Junior UGFM students and lay people who had registered for BLS classes
given by a Red Cross-affiliated center were sent invitation links to complete a
web-based questionnaire. The primary outcome was the between-group difference in
a 10-question score regarding cardiopulmonary resuscitation knowledge. Secondary
outcomes were the differences in the rate of correct answers for each individual
question, the level of self-assessed confidence in the ability to perform
resuscitation, and a 6-question score, "essential BLS knowledge," which only
contains key elements of the chain of survival. Continuous variables were first
analyzed using the Student t test, then by multivariable linear regression.
Fisher exact test was used for between-groups comparison of binary variables.
RESULTS: The mean score was higher in medical students than in lay people for
both the 10-question score (mean 5.8, SD 1.7 vs mean 4.2, SD 1.7; P<.001) and
6-question score (mean 3.0, SD 1.1 vs mean 2.0, SD 1.0; P<.001). Participants
who were younger or already trained scored consistently better. Although the
phone number of the emergency medical dispatch center was well known in both
groups (medical students, 75/80, 94% vs lay people, 51/62, 82%; P=.06), most
participants were unable to identify the criteria used to recognize OHCA, and
almost none were able to correctly reorganize the BLS sequence. Medical students
felt more confident than lay people in their ability to perform resuscitation
(mean 4.7, SD 2.2 vs mean 3.1, SD 2.1; P<.001). Female gender and older age were
associated with lower confidence, while participants who had already attended a
BLS course prior to taking the questionnaire felt more confident.
CONCLUSIONS: Although junior medical students were more knowledgeable than lay
people regarding BLS procedures, the proportion of correct answers was low in
both groups, and changes in BLS education policy should be considered.

©Ludovic Sturny, Simon Regard, Robert Larribau, Marc Niquille, Georges Louis
Savoldelli, François Sarasin, Eduardo Schiffer, Laurent Suppan. Originally
published in the Journal of Medical Internet Research (http://www.jmir.org),
23.02.2021.

DOI: 10.2196/25125
PMCID: PMC7943337
PMID: 33620322 [Indexed for MEDLINE]

Conflict of interest statement: Conflicts of Interest: None declared.

40. BMJ Open. 2021 Dec 13;11(12):e051959. doi: 10.1136/bmjopen-2021-051959.

Skill decay following Basic Life Support training: a systematic review protocol.

Stanley B(1), Burton T(1), Percival H(1), Beesley E(1), Coffin N(1)(2), Hulme
J(1)(3), Owen A(1)(4), Alderman J(5)(4).

Author information:
(1)Resuscitation for Medical Disciplines, University of Birmingham College of
Medical and Dental Sciences, Birmingham, UK.
(2)Department of Intensive Care Medicine, Salford Royal NHS Foundation Trust,
Salford, UK.
(3)Department of Intensive Care Medicine, Sandwell and West Birmingham Hospitals
NHS Trust, Birmingham, UK.
(4)Department of Anaesthesia and Intensive Care Medicine, University Hospitals
Birmingham NHS Foundation Trust, Birmingham, UK.
(5)Resuscitation for Medical Disciplines, University of Birmingham College of
Medical and Dental Sciences, Birmingham, UK [email protected].

INTRODUCTION: Survival from out of hospital cardiac arrest (OHCA) is lower in

the UK than in several developed nations. Bystander cardiopulmonary
resuscitation (CPR) is associated with increased rates of survival to hospital
discharge following OHCA, prompting the introduction of several initiatives by
the UK government to increase rates of bystander CPR, including the inclusion of
Basic Life Support (BLS) teaching within the English national curriculum. While
there is clear benefit in this, increasing evidence suggests poor retention of
skills following BLS teaching. The aim of this systematic review is to summarise
the literature regarding skill decay following BLS training, reporting
particularly the time period over which this occurs, and which components of
would-be rescuers' performance of the BLS algorithm are most affected.
METHODS AND ANALYSIS: A search will be conducted to identify studies in which
individuals have received BLS training and received subsequent assessment of
their skills at a later date. A search strategy comprising relevant Medical
Subject Headings (MeSH) terms and keywords has been devised with assistance from
an experienced librarian. Relevant databases will be searched with titles,
abstract and full-text review conducted independently by two reviewers. Data
will be extracted from included studies by two reviewers, with meta-analysis
conducted if the appropriate preconditions (such as limited heterogeneity) are
met.
ETHIC AND DISSEMINATION: No formal ethical approval is required for this
systematic review. Results will be disseminated in the form of manuscript
submission to a relevant journal and presentation at relevant meetings. To
maximise the public's access to this review's findings, any scientific report
will be accompanied by a lay summary posted via social media channels, and a
press release disseminated to national and international news agencies.
PROSPERO REGISTRATION NUMBER: CRD42021237233.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No

commercial re-use. See rights and permissions. Published by BMJ.

DOI: 10.1136/bmjopen-2021-051959
PMCID: PMC8672002
PMID: 34903542 [Indexed for MEDLINE]

Conflict of interest statement: Competing interests: None declared.

41. Adv Med Educ Pract. 2011 Jul 26;2:187-91. doi: 10.2147/AMEP.S22948. Print 2011.

Comparison of peer-led versus professional-led training in basic life support

for medical students.

Fujiwara T(1), Nishimura M, Honda R, Nishiyama T, Nomoto M, Kobayashi N, Ikeda

M.

Author information:
(1)Division of Educational Training, Kurashiki Central Hospital, Kurashiki,
Japan.

Comment in
Adv Med Educ Pract. 2016 May 31;7:329-30. doi: 10.2147/AMEP.S107776.

BACKGROUND: The effect of peer-led training in basic life support (BLS) in the
education of medical students has not been assessed.
SUBJECTS AND METHODS: This study was a randomized controlled trial with a
blinded outcome assessor. A total of 74 fourth-year medical students at Ehime
University School of Medicine, Japan were randomly assigned to BLS training
conducted by either a senior medical student (peer-led group) or a health
professional (professional-led group). The primary outcome measure was the
percentage of chest compressions with adequate depth (38-51 mm) by means of a
training mannequin evaluated 20 weeks after BLS training. Secondary outcome
measures were compression depth, compression rate, proportion of participants
who could ensure adequate compression depth (38-51 mm) and adequate compression
rate (90-110/minute), and retention of BLS knowledge as assessed by 22-point
questionnaire.
RESULTS: Percentage chest compressions with adequate depth (mean ± SD) was 54.5%
± 31.8% in the peer-led group and 52.4% ± 35.6% in the professional-led group.
The 95% confidence interval (CI) of difference of the means was -18.7% to 22.8%.
The proportion of participants who could ensure an adequate mean compression
rate was 17/23 (73.9%) in the peer-led group but only 8/22 (36.4%) in the
professional-led group (P = 0.011). On the 22-point questionnaire administered
20 weeks after training, the peer-led group scored 17.2 ± 2.3 whereas the
professional-led group scored 17.8 ± 2.0. The 95% CI of difference of the means
was -1.72 to 0.57.
CONCLUSION: Peer-led training in BLS by medical students is feasible and as
effective as health professional-led training.

DOI: 10.2147/AMEP.S22948
PMCID: PMC3661254
PMID: 23745089

42. World J Emerg Med. 2016;7(4):263-269. doi: 10.5847/wjem.j.1920-

8642.2016.04.004.

Is current training in basic and advanced cardiac life support (BLS & ACLS)
effective? A study of BLS & ACLS knowledge amongst healthcare professionals of
North-Kerala.

Nambiar M(1), Nedungalaparambil NM(1), Aslesh OP(1).

Author information:
(1)Department of Emergency Medicine, Academy of Medical Sciences, Pariyaram,
Kannur, Kerala, India.

BACKGROUND: Healthcare professionals are expected to have knowledge of current

basic and advanced cardiac life support (BLS/ACLS) guidelines to revive
unresponsive patients.
METHODS: A cross-sectional study was conducted to evaluate the current practices
and knowledge of BLS/ACLS principles among healthcare professionals of
North-Kerala using pretested self-administered structured questionnaire. Answers
were validated in accordance with American Heart Association's BLS/ACLS teaching
manual and the results were analysed.
RESULTS: Among 461 healthcare professionals, 141 (30.6%) were practicing
physicians, 268 (58.1%) were nurses and 52 (11.3%) supporting staff. The maximum
achievable score was 20 (BLS 15/ACLS 5). The mean score amongst all healthcare
professionals was 8.9±4.7. The mean score among physicians, nurses and support
staff were 8.6±3.4, 9±3.6 and 9±3.3 respectively. The majority of healthcare
professionals scored ≤50% (237, 51.4%); 204 (44.3%) scored 51%-80% and 20
(4.34%) scored >80%. Mean scores decreased with age, male sex and across
occupation. Nurses who underwent BLS/ACLS training previously had significantly
higher mean scores (10.2±3.4) than untrained (8.2±3.6, P=0.001). Physicians with
<5 years experience (P=0.002) and nurses in the private sector (P=0.003) had
significantly higher scores. One hundred and sixty three (35.3%) healthcare
professionals knew the correct airway opening manoeuvres like head tilt, chin
lift and jaw thrust. Only 54 (11.7%) respondents were aware that atropine is not
used in ACLS for cardiac arrest resuscitation and 79 (17.1%) correctly opted
ventricular fibrillation and pulseless ventricular tachycardia as shockable
rhythms. The majority of healthcare professionals (356, 77.2%) suggested that
BLS/ACLS be included in academic curriculum.
CONCLUSION: Inadequate knowledge of BLS/ACLS principles amongst healthcare
professionals, especially physicians, illuminate lacunae in existing training
systems and merit urgent redressal.
DOI: 10.5847/wjem.j.1920-8642.2016.04.004
PMCID: PMC5143309
PMID: 27942342

Conflict of interest statement: The authors declare there is no competing

interest related to the study, authors, other individuals or organizations.

43. J Clin Diagn Res. 2016 Jul;10(7):OC33-7. doi: 10.7860/JCDR/2016/19221.8197.

Epub
2016 Jul 1.

Quality of Basic Life Support - A Comparison between Medical Students and

Paramedics.

Körber MI(1), Köhler T(1), Weiss V(2), Pfister R(1), Michels G(1).

Author information:
(1)Department III of Internal Medicine, University of Cologne , Heart Center,
Germany .
(2)Institute of Medical Statistics, Informatics and Epidemiology, University of
Cologne , Cologne, Germany .

INTRODUCTION: Poor survival rates after cardiac arrest can partly be explained
by poor basic life support skills in medical professionals.
AIM: This study aimed to assess quality of basic life support in medical
students and paramedics.
MATERIALS AND METHODS: We conducted a prospective observational study with 100
early medical students (group A), 100 late medical students (group B) and 100
paramedics (group C), performing a 20-minute basic life support simulation in
teams of two. Average frequency and absolute number of chest compressions per
minute (mean (±SD)), chest decompression (millimetres of compression remaining,
mean (±SD)), hands-off-time (seconds/minute, mean (±SD)), frequency of switching
positions between ventilation and chest compression (per 20 minutes) and rate of
sufficient compressions (depth ≥50mm) were assessed as quality parameters of
CPR.
RESULTS: In groups A, B and C the rates of sufficiently deep chest compressions
were 56%, 42% and 52%, respectively, without significant differences. Male
gender and real-life CPR experience were significantly associated with deeper
chest compression. Frequency and number of chest compressions were within
recommended goals in at least 96% of all groups. Remaining chest compressions
were 6 mm (±2), 6 mm (±2) and 5 mm (±2) with a significant difference between
group A and C (p=0.017). Hands-off times were 6s/min (±1), 5s/min (±1) and
4s/min (±1), which was significantly different across all three groups.
CONCLUSION: Overall, paramedics tended to show better quality of CPR compared to
medical students. Though, chest compression depth as an important quality
characteristic of CPR was insufficient in almost 50% of participants, even in
well trained paramedics. Therefore, we suggest that an effort should be made to
find better ways to educate health care professionals in BLS.

DOI: 10.7860/JCDR/2016/19221.8197
PMCID: PMC5020289
PMID: 27630885

44. Subst Abus. 2017 Apr-Jun;38(2):123-128. doi: 10.1080/08897077.2016.1275925.

Epub
2016 Dec 27.
Opioid overdose prevention training with naloxone, an adjunct to basic life
support training for first-year medical students.

Berland N(1), Fox A(2), Tofighi B(3), Hanley K(4)(5).

Author information:
(1)a New York University School of Medicine , New York , New York , USA.
(2)b Department of Medicine , Division of General Internal Medicine , Albert
Einstein College of Medicine , Bronx , New York , USA.
(3)c Department of Population Health , New York University School of Medicine ,
New York , New York , USA.
(4)d Department of Medicine , New York University School of Medicine , New York
, New York , USA.
(5)e Primary Care Residency Program, New York University School of Medicine ,
New York , New York , USA.

BACKGROUND: Opioid overdose deaths have reached epidemic proportions in the

United States. This problem stems from both licit and illicit opioid use.
Prescribing opioids, recognizing risky use, and initiating prevention, including
opioid overdose prevention training (OOPT), are key roles physicians play. The
American Heart Association (AHA) modified their basic life support (BLS)
algorithms to consider naloxone in high-risk populations and when a pulse is
appreciated; however, the AHA did not provide OOPT. The authors' intervention
filled this training deficiency by teaching medical students opioid overdose
resuscitation with a Train-the-Trainer model as part of mandatory BLS training.
METHODS: The authors introduced OOPT, following a Train-the-Trainer model, into
the required basic life support (BLS) training for first-year medical students
at a single medical school in a large urban area. The authors administered pre-
and post-evaluations to assess the effects of the training on opioid overdose
knowledge, self-reported preparedness to respond to opioid overdoses, and
attitudes towards patients with substance use disorders (SUDs).
RESULTS: In the fall 2014, 120 first-year medical students received OOPT.
Seventy-three students completed both pre- and posttraining evaluations.
Improvements in knowledge about and preparedness to respond to opioid overdoses
were statistically significant (P < .01) and large (Cohen's D = 2.70 and Cohen's
D = 2.10, respectively). There was no statistically significant change in
attitudes toward patients with SUDs.
CONCLUSIONS: The authors demonstrated the effectiveness of OOPT as an adjunct to
BLS in increasing knowledge about and preparedness to respond to opioid
overdoses; improving attitudes toward patients with SUDs likely requires
additional intervention. The authors will characterize knowledge and
preparedness durability, program sustainability, and long-term changes in
attitudes in future evaluations. These results support dissemination of OOPT as
a part of BLS training for all medical students, and potentially all BLS
providers.

DOI: 10.1080/08897077.2016.1275925
PMCID: PMC5920678
PMID: 28027016 [Indexed for MEDLINE]

45. Resuscitation. 2011 May;82(5):577-83. doi: 10.1016/j.resuscitation.2011.01.022.

Epub 2011 Feb 25.

Differential effects of ageing and BLS training experience on attitude towards

basic life support.

Enami M(1), Takei Y, Inaba H, Yachida T, Ohta K, Maeda T, Goto Y.

Author information:
(1)Department of Emergency Medical Science, Kanazawa University Graduate School
of Medicine, 13-1 Takaramachi, Kanazawa 920-8641, Japan.

PURPOSE OF STUDY: To determine the effects of ageing and training experience on

attitude towards performing basic life support (BLS).
METHODS: We gave a questionnaire to attendants of the courses for BLS or safe
driving in authorised driving schools. The questionnaire included questions
about participants' backgrounds. The questionnaire explored the participant's
willingness to perform BLS in four hypothetical scenarios related to early
emergency call, cardiopulmonary resuscitation (CPR) under their own initiative,
telephone-assisted compression-only CPR and use of an automated external
defibrillator (AED), respectively.
RESULTS: There were significant differences in gender, occupation, residential
area, experience of BLS training, and knowledge of AED use among the young
(17-29 y, N = 6122), middle-aged (30-59 y, N = 827) and elderly (>59 y, N =
15,743) groups. In all four scenarios, the proportion of respondents willing to
perform BLS was lowest in the elderly group. More respondents in the elderly
group were willing to follow the telephone-assisted instruction rather than
performing CPR under their own initiative. Multiple logistic regression analysis
confirmed ageing as an independent factor related to negative attitude in all
scenarios. Gender, occupation, resident area, experience with BLS training and
knowledge about AED use were other independent factors. Prior BLS training did
not increase willingness to make an emergency call.
CONCLUSION: The aged population has a more negative attitude towards performing
BLS. BLS training should be modified to help the elderly gain confidence with
the essential elements of BLS, including making early emergency calls.

Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.resuscitation.2011.01.022
PMID: 21353735 [Indexed for MEDLINE]

46. Am J Emerg Med. 2020 Apr;38(4):720-726. doi: 10.1016/j.ajem.2019.06.008. Epub

2019 Jun 5.

Basic life support training: Demonstration versus lecture - A randomised

controlled trial.

Hansen C(1), Bang C(1), Rasmussen SE(2), Nebsbjerg MA(2), Lauridsen KG(1),
Bjørnshave Bomholt K(2), Krogh K(3), Løfgren B(4).

Author information:
(1)Research Center for Emergency Medicine, Aarhus University Hospital, Palle
Juul-Jensens Blvd. 161, 8200 Aarhus, Denmark; Department of Internal Medicine,
Randers Regional Hospital, Skovlyvej 15, 8930 Randers, Denmark; Clinical
Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers, Denmark.
(2)Research Center for Emergency Medicine, Aarhus University Hospital, Palle
Juul-Jensens Blvd. 161, 8200 Aarhus, Denmark.
(3)Department of Anesthesia and Intensive Care, Aarhus University Hospital,
Palle Juul-Jensens Blvd. 99, 8200 Aarhus, Denmark; Centre for Health Sciences
Education, Aarhus University, Palle Juul-Jensens Blvd. 82, INCUBA Skejby
building B, 8200 Aarhus, Denmark.
(4)Research Center for Emergency Medicine, Aarhus University Hospital, Palle
Juul-Jensens Blvd. 161, 8200 Aarhus, Denmark; Department of Internal Medicine,
Randers Regional Hospital, Skovlyvej 15, 8930 Randers, Denmark; Clinical
Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers, Denmark;
Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Blvd. 82,
INCUBA Skejby building 2, 8200 Aarhus, Denmark; Department of Cardiology, Aarhus
University Hospital, Palle Juul-Jensens Blvd. 69, 8200 Aarhus, Denmark.
Electronic address: [email protected].

INTRODUCTION: Basic life support (BLS) and the use of an automated external
defibrillator (AED) improve survival from cardiac arrest. The gold standard for
teaching BLS/AED is yet to be identified. The aim of this study was to compare
the learning outcome of an instructor-led demonstration with a formal lecture
for introducing BLS/AED skills. We hypothesized that a demonstration was
superior to a lecture.
METHODS: First year-medical students were randomised to either a demonstration
or a lecture using PowerPoint® Presentation for skill introduction during
European Resuscitation Council BLS/AED courses. Participants were skill-tested
after training and required to perform all skills correctly to pass the test.
Finally, all participants were asked to state their preferred teaching method.
RESULTS: Overall, 247 participants were included in the analysis (demonstration
group: 124, lecture group: 123). Pass rate was 63% in both groups, p = 1.00.
Both groups performed median compression rates within guidelines
recommendations, p = 0.09. Mean compression depth was 55 mm (10 mm) in the
demonstration group compared with 52 mm (10 mm) in the lecture group, p = 0.05.
Median tidal volume was 265 (192, 447) ml and 405 (262, 578) ml, p < 0.001,
respectively. The lecture group was 3 s faster at initiating BLS, p < 0.001. In
total, 226 (91%) participants preferred demonstration on a manikin for
introducing BLS/AED.
CONCLUSION: There was no statistically significant difference in pass rate when
comparing a demonstration with a lecture for introducing BLS/AED. The lecture
group was slightly faster at initiating BLS. Most participants preferred a
demonstration as introduction.

Copyright © 2019 Elsevier Inc. All rights reserved.

DOI: 10.1016/j.ajem.2019.06.008
PMID: 31189497 [Indexed for MEDLINE]

Conflict of interest statement: Declaration of Competing Interest None to

declare.

47. Healthcare (Basel). 2023 Jul 24;11(14):2110. doi: 10.3390/healthcare11142110.

Framework Development of Non-Face-to-Face Training of Basic Life Support for

Laypersons: A Multi-Method Study.

Han S(1), Lee CA(2), Jeong WJ(3), Park J(2), Park HA(2).

Author information:
(1)Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital,
170 Jomaru-ro, Bucheon 14584, Republic of Korea.
(2)Department of Emergency Medicine, Hallym University, Dongtan Sacred Heart
Hospital, Hwaseong 14068, Republic of Korea.
(3)Department of Emergency Medicine, Catholic University of Korea, St. Vincent's
Hospital, Suwon 16247, Republic of Korea.

The spread of infectious diseases has accelerated the transition from

face-to-face (F2F) to non-F2F (NF2F) education. To maintain the effect of
successful NF2F education in cardiopulmonary resuscitation, reorganizing the
curriculum to suit the NF2F educational environment is necessary. We propose an
appropriate learning curriculum for NF2F basic life support (BLS) training for
laypersons based on expert surveys and learners' performance outcomes. This
study included three stages and used multiple methods. A draft curriculum was
created through a literature review and three-round Delphi approach, and then
applied as a test for actual education. After the training, the final curriculum
of the NF2F BLS training for laypersons was proposed by reflecting on the
performance outcomes of learners and expert opinions. NF2F theoretical education
was simplified into five content items: concept of chain of survival, legal
protection for first aiders, importance of bystander cardiopulmonary
resuscitation, how to recognize a patient in cardiac arrest and activate the
emergency medical services system, and reduced training time. In the hands-on
skills session, it was recommended to practice chest compressions using a simple
intuitive feedback device and to use automated external defibrillators
step-by-step more than in F2F training. In conclusion, NF2F training is a
suitable option for BLS training methods in situations where F2F training is
difficult.

DOI: 10.3390/healthcare11142110
PMCID: PMC10378845
PMID: 37510551

Conflict of interest statement: The authors declare no conflict of interest.

48. Arch Acad Emerg Med. 2021 May 20;9(1):e40. doi: 10.22037/aaem.v9i1.1231.
eCollection 2021.

Awareness of Iranian Medical Sciences Students Towards Basic Life Support; a

Cross-Sectional study.

Akhlaghdoust M(1)(2), Safari S(1)(2), Davoodi P(3), Soleimani S(4), Khorasani

M(4), Raoufizadeh F(4), Karimi H(5), Etesami E(5), Hamzehloei Z(4), Sadeghi
SS(4), Heidaresfahani L(4), Ebadi Fard Azar T(4), Afshari Badrloo H(4).

Author information:
(1)Functional Neurosurgery Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran.
(2)USERN Office, Functional Neurosurgery Research Center, Shahid Beheshti
University of Medical Sciences, Tehran, Iran.
(3)Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars
Hospital, Iran University of Medical Sciences, Tehran, Iran.
(4)Islamic Azad University, TehranMedical Sciences Branch, Tehran, Iranslamic
Azad University, TehranMedical Sciences Branch, Tehran, Iran.
(5)Science and Research Branch, Islamic Azad University, Tehran, Iran.

INTRODUCTION: Augmentation of the number of trained basic life support (BLS)

providers can remarkably reduce the number of cardiac arrest victims. The aim of
this study was to evaluate the level of BLS awareness among students of medical
sciences in Iran.
METHODS: This multicenter cross-sectional study was performed on medical
students at the 4 major medical schools in Tehran, the capital of Iran, between
Jan 2018 and Feb 2019, using convenience sampling method. The level of medical
sciences students' awareness of BLS was measured using an international
questionnaire.
RESULTS: Finally, 1210 students with the mean age of 21.2 ± 2.3 years completed
the survey (79% female). 133 (10.9%) students had CPR experience and none had
received any formal training. None of the responders could answer all questions
correctly. The mean awareness score of participants was 11.93 ± 2.87 (range:
10.13 -17.25). The awareness score of participants was high in 49 (4.04 %)
participants, moderate in 218 (18.01%), and low in 943 (77.93%) of studied
cases.
CONCLUSION: Based on the findings of this study, more than 70% of the studied
medical sciences students obtained a low score on BLS awareness.

DOI: 10.22037/aaem.v9i1.1231
PMCID: PMC8221544
PMID: 34223185

Conflict of interest statement: None to Declare.

49. Resuscitation. 2013 Sep;84(9):1274-8. doi: 10.1016/j.resuscitation.2013.04.017.

Epub 2013 May 9.

Pre-training evaluation and feedback improved skills retention of basic life

support in medical students.

Li Q(1), Zhou RH, Liu J, Lin J, Ma EL, Liang P, Shi TW, Fang LQ, Xiao H.

Author information:
(1)Department of Anesthesiology, West China Hospital of Sichuan University,
Chengdu, Sichuan 610041, PR China.

BACKGROUND: Pre-training evaluation and feedback have been shown to improve

medical students' skills acquisition of basic life support (BLS) immediately
following training. The impact of such training on BLS skills retention is
unknown. This study was conducted to investigate effects of pre-training
evaluation and feedback on BLS skills retention in medical students.
METHODS: Three hundred and thirty 3rd year medical students were randomized to
two groups, the control group (C group) and pre-training evaluation and feedback
group (EF group). Each group was subdivided into four subgroups according to the
time of retention-test (at 1-, 3-, 6-, 12-month following the initial training).
After a 45-min BLS lecture, BLS skills were assessed (pre-training evaluation)
in both groups before training. Following this, the C group received 45 min
training. 15 min of group feedback corresponding to students' performance in
pre-training evaluation was given only in the EF group that was followed by 30
min of BLS training. BLS skills were assessed immediately after training
(post-test) and at follow up (retention-test).
RESULTS: No skills difference was observed between the two groups in
pre-training evaluation. Better skills acquisition was observed in the EF group
(85.3 ± 7.3 vs. 68.1 ± 12.2 in C group) at post-test (p<0.001). In all
retention-test, better skills retention was observed in each EF subgroup,
compared with its paired C subgroup.
CONCLUSIONS: Pre-training evaluation and feedback improved skills retention in
the EF group for 12 months after the initial training, compared with the control
group.

Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.resuscitation.2013.04.017
PMID: 23665155 [Indexed for MEDLINE]

50. J Pharm Bioallied Sci. 2024 Jul;16(Suppl 3):S2877-S2879. doi:

10.4103/jpbs.jpbs_542_24. Epub 2024 Jul 5.

Effectiveness of Hands-On Training Regarding Basic Life Support (BLS) on

Knowledge Among Saveetha College of Arts and Science Final Year Students.

Dayana B(1), Shek Abdullah M(2), Priyadarsini A(3), Cecyli C(1), Jagadeeswari
J(4).

Author information:
(1)Department of Medical Surgical Nursing, Saveetha College of Nursing, SIMATS,
Thandalam, Chennai, Tamil Nadu, India.
(2)B.Sc (Nursing) IV Year Student, Saveetha College of Nursing, SIMATS,
Thandalam, Chennai, Tamil Nadu, India.
(3)Department of Child Health Nursing, Saveetha College of Nursing, SIMATS,
Thandalam, Chennai, Tamil Nadu, India.
(4)Department of Obstetrics and Gynaecological Nursing, Saveetha College of
Nursing, SIMATS, Thandalam, Chennai, Tamil Nadu, India.

BACKGROUND: Cardiac disorders are major global death causes, necessitating

emergency measures in sudden cardiac arrests. Successful cardiopulmonary
resuscitation, performed by medical team members, significantly reduces death
rates from cardiac arrest, a growing concern across all age groups.
AIM: The study evaluates the impact of hands-on basic life support (BLS)
training program on final-year students' knowledge of BLS.
MATERIALS AND METHODS: A pre- and post-test study was conducted among 60
students at Saveetha College of Liberal Arts and Science. A convenient sampling
technique was used to select the samples. The demographic variables were
collected by using multiple-choice questionnaires.
RESULT: Results showed an effective level of knowledge and skill in BLS,
indicating the need for further research.
CONCLUSION: The study concludes that the level of knowledge and skill among
final-year students of Saveetha College of Arts and Science was found to be
effective in gaining knowledge regarding BLS in the post-test.

Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.

DOI: 10.4103/jpbs.jpbs_542_24
PMCID: PMC11426882
PMID: 39346372

Conflict of interest statement: The authors no conflicts of interest.

51. BMC Med Educ. 2018 Jun 18;18(1):142. doi: 10.1186/s12909-018-1241-z.

Peers versus professional training of basic life support in Syria: a randomized

controlled trial.

Abbas F(1), Sawaf B(2), Hanafi I(3), Hajeer MY(4), Zakaria MI(2), Abbas W(3),
Alabdeh F(5), Ibrahim N(6).

Author information:
(1)Faculty of Medicine, Damascus University, Fayez Mansour St. Al-Mezzeh,
Damascus, Syria. [email protected].
(2)Faculty of Medicine, Syrian Private University, Damascus, Syria.
(3)Faculty of Medicine, Damascus University, Fayez Mansour St. Al-Mezzeh,
Damascus, Syria.
(4)University of Damascus Dental School, Damascus, Syria.
(5)Emergency Department, Damascus Hospital, Damascus, Syria.
(6)Syrian Private University, Damascus, Syria.

BACKGROUND: Peer training has been identified as a useful tool for delivering
undergraduate training in basic life support (BLS) which is fundamental as an
initial response in cases of emergency. This study aimed to (1) Evaluate the
efficacy of peer-led model in basic life support training among medical students
in their first three years of study, compared to professional-led training and
(2) To assess the efficacy of the course program and students' satisfaction of
peer-led training.
METHODS: A randomized controlled trial with blinded assessors was conducted on
72 medical students from the pre-clinical years (1st to 3rd years in Syria) at
Syrian Private University. Students were randomly assigned to peer-led or to
professional-led training group for one-day-course of basic life support skills.
Sixty-four students who underwent checklist based assessment using objective
structured clinical examination design (OSCE) (practical assessment of BLS
skills) and answered BLS knowledge checkpoint-questionnaire were included in the
analysis.
RESULTS: There was no statistically significant difference between the two
groups in delivering BLS skills to medical students in practical (P = 0.850) and
BLS knowledge questionnaire outcomes (P = 0.900). Both groups showed
statistically significant improvement from pre- to post-course assessment with
significant statistical difference in both practical skills and theoretical
knowledge (P-Value < 0.001). Students were satisfied with the peer model of
training.
CONCLUSION: Peer-led training of basic life support for medical students was
beneficial and it provided a quality of education which was as effective as
training conducted by professionals. This method is applicable and desirable
especially in poor-resource countries and in crisis situation.

DOI: 10.1186/s12909-018-1241-z
PMCID: PMC6006697
PMID: 29914441 [Indexed for MEDLINE]

Conflict of interest statement: ETHICS APPROVAL AND CONSENT TO PARTICIPATE: This

study was approved by the institutional review board (IRB) at the Syrian Private
University (SPU) and it was rated as a study with humans not on humans. A
written consent was obtained of all participants. COMPETING INTERESTS: None of
the authors have any competing interests. The authors alone are responsible for
the content and writing of the article. No conflict of interest is declared.
PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.

52. PLoS One. 2021 Jul 22;16(7):e0254923. doi: 10.1371/journal.pone.0254923.

eCollection 2021.

Peer video feedback builds basic life support skills: A randomized controlled
non-inferiority trial.

Sopka S(1)(2), Hahn F(1), Vogt L(1)(2), Pears KH(1), Rossaint R(2), Rudolph
J(3), Klasen M(1).

Author information:
(1)Medical Faculty, AIXTRA-Competency Center for Training and Patient Safety,
RWTH Aachen University, Aachen, Germany.
(2)Medical Faculty, Department of Anaesthesiology, University Hospital Aachen,
RWTH Aachen University, Aachen, Germany.
(3)Center for Medical Simulation, Boston, MA, United States of America.

INTRODUCTION: Training Basic Life Support saves lives. However, current BLS
training approaches are time-consuming and costly. Alternative cost-efficient
and effective training methods are highly needed. The present study evaluated
whether a video-feedback supported peer-guided Basic Life Support training
approach achieves similar practical performance as a standard instructor-guided
training in laypersons.
METHODS: In a randomized controlled non-inferiority trial, 288 first-year
medical students were randomized to two study arms with different Basic Life
Support training methods: 1) Standard Instructor Feedback (SIF) or 2) a Peer
Video Feedback (PVF). Outcome parameters were objective data for Basic Life
Support performance (compression depth and rate) from a resuscitation manikin
with recording software as well as overall Basic Life Support performance and
subjective confidence. Non-inferiority margins (Δ) for these outcome parameters
and sample size calculation were based on previous studies with Standard
Instructor Feedback. Two-sided 95% confidence intervals were employed to
determine significance of non-inferiority.
RESULTS: Results confirmed non-inferiority of Peer Video Feedback to Standard
Instructor Feedback for compression depth (proportion difference PVF-SIF = 2.9%;
95% CI: -8.2% to 14.1%; Δ = -19%), overall Basic Life Support performance
(proportion difference PVF-SIF = 6.7%; 95% CI: 0.0% to 14.3%; Δ = -27%) and
subjective confidence for CPR performance (proportion difference PVF-SIF =
-0.01; 95% CI: -0.18-0.17; Δ = -0.5) and emergency situations (proportion
difference PVF-SIF = -0.02; 95% CI: -0.21-0.18; Δ = -0.5). Results for
compression rate were inconclusive.
DISCUSSION: Peer Video Feedback achieves comparable results as standard
instructor-based training methods. It is an easy-to-apply and cost-efficient
alternative to standard Basic Life Support training methods. To improve
performance with respect to compression rate, additional implementation of a
metronome is recommended.

DOI: 10.1371/journal.pone.0254923
PMCID: PMC8297748
PMID: 34293034 [Indexed for MEDLINE]

Conflict of interest statement: The authors have declared that no competing

interests exist.

53. Resuscitation. 2022 Jan;170:167-177. doi: 10.1016/j.resuscitation.2021.11.006.

Epub 2021 Nov 16.

Socio-demographic characteristics of basic life support course participants in

Denmark.

Jensen TW(1), Folke F(2), Andersen MP(3), Blomberg SN(4), Jørgensen AJ(4),
Holgersen MG(5), Ersbøll AK(6), Hendriksen OM(7), Lippert F(4), Torp-Pedersen
C(8), Christensen HC(9).

Author information:
(1)Copenhagen Emergency Medical Services & Department of Clinical Medicine,
University of Copenhagen, Copenhagen, Denmark. Electronic address:
[email protected].
(2)Head of Research Dep., Copenhagen Emergency Medical Services & Department of
Cardiology, Herlev Gentofte University Hospital, Copenhagen & Department of
Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
(3)Department of Cardiology, Nordsjaellands Hospital, Hillerød, Denmark.
(4)Copenhagen Emergency Medical Services & Department of Clinical Medicine,
University of Copenhagen, Copenhagen, Denmark.
(5)Paediatric Pulmonary Service, Department of Paediatrics and Adolescent
Medicine, Copenhagen University Hospital, Rigshospitalet & Department of
Clinical Medicine, University of Copenhagen, Denmark.
(6)National Institute of Public Health, University of Southern Denmark,
Copenhagen, Denmark.
(7)Prehospital Center Region Zealand, Næstved & Department of Clinical Medicine,
University of Copenhagen, Copenhagen, Denmark.
(8)Department of Cardiology, Nordsjaellands Hospital, Hillerød, Denmark; Aalborg
University Hospital, Aalborg & Department of Clinical Medicine, University of
Copenhagen, Copenhagen, Denmark.
(9)Copenhagen Emergency Medical Services & Danish Clinical Quality Program
(RKKP), National Clinical Registries & Department of Clinical Medicine,
University of Copenhagen, Copenhagen, Denmark.

BACKGROUND: Bystander-initiated basic life support (BLS) plays an important role

in improving survival after out-of-hospital cardiac arrest. In 2009, laws
mandating BLS course participation when acquiring a driver's licence were
implemented in Denmark. The aim of this study was to characterise Danish BLS
course participants.
METHODS: This study is a Danish, registry-based, follow-up study that examined
all Danish BLS course participants from 2016 to 2019. Data concerning BLS course
participation were supplied by the major Danish BLS course providers.
Socio-economic and healthcare data on all Danish inhabitants were assessed using
national registers from Statistics Denmark.
RESULTS: Between January 1, 2016, and January 1, 2020, 3.6% of the entire adult
population of Denmark attended certified BLS courses annually. Since the
implementation of a law mandating BLS course participation when acquiring a
driver licence in 2009, approximately 44% of the adult population has
participated in a BLS course. BLS course participants were commonly younger and
healthier than the general population (mean 31.3 years old vs. 51.3 years old,
P < 0.001). Furthermore, law-mandated BLS course participants had a lower
disposable income (adjusted OR: 0.23; 95% CI: 0.23-0.23; P < 0.001) and were
more likely to live in rural areas (adjusted OR: 0.57; 95% CI: 0.57-0.58;
P < 0.001).
CONCLUSION: In Denmark, 3.6% of the entire adult population attend certified
courses annually. BLS participants are commonly male, younger, healthier, less
likely to have small children in the household, and more likely to live in rural
areas. Law-mandated BLS course participation prior to acquiring a driver's
licence has been successful in reaching segments of the society that are known
to have limited participation.

Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

DOI: 10.1016/j.resuscitation.2021.11.006
PMID: 34798179 [Indexed for MEDLINE]

54. Ann Med Surg (Lond). 2023 Mar 16;85(4):684-688. doi:

10.1097/MS9.0000000000000273. eCollection 2023 Apr.

Basic life support knowledge among healthcare providers in Afghanistan: a

cross-sectional study of current competencies and areas for improvement.

Nemat A(1)(2)(3), Nedaie MH(2), Essar MY(4), Ashworth H(5), Aminpoor H(4),
Sediqi AW(1), Mowlabaccus WB(6), Ahmad S(7).

Author information:
(1)Department of Cardiology, Ariana Medical Complex.
(2)Department of Microbiology, Kabul University of Medical Sciences.
(3)Department of Global Public Health, Karolinska institutet Stockholm, Sweden.
(4)Kabul University of Medical Sciences, Kabul, Afghanistan.
(5)Department of Emergency Medicine, Highland Hospital, Alameda Health System,
Oakland, California, USA.
(6)Department of Medicine, Northampton General Hospital, UK.
(7)Department of Medicine, District Headquarters Teaching Hospital, Faisalabad,
Pakistan.
Basic life support (BLS) is a type of emergency care provided by healthcare
workers and public safety professionals to individuals experiencing cardiac
arrest, respiratory distress, or other cardiopulmonary emergencies. Despite
having a high burden of cardiovascular disease and trauma from conflict in
Afghanistan, little is known about the level of BLS knowledge Afghani healthcare
workers have. A cross-sectional study was conducted in Kabul, Afghanistan, to
assess healthcare workers' training and knowledge of BLS. The study, which took
place from March to June 2022 across multiple public and private hospitals, was
approved by the institutional ethics committee of Ariana Medical Complex. The
sample size was calculated using a nonprobability convenience sampling method,
and the study population consisted of healthcare workers actively working in a
health center who were willing to complete a questionnaire. The results of the
study showed that most participants (71.3%) were in the 21-30-year-old age
range, and a third (32.3%) were doctors. 95.3% of participants had poor
knowledge of BLS, with a mean score of 4.47±1.58 out of 13. Additionally, it was
evident from questionnaire responses that providers are not adequately
performing BLS. These findings suggest that further work, including regular BLS
courses, is necessary to improve the knowledge and practice of BLS by healthcare
workers in Afghanistan.

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

DOI: 10.1097/MS9.0000000000000273
PMCID: PMC10129222
PMID: 37113965

Conflict of interest statement: None.Sponsorships or competing interests that

may be relevant to content are disclosed at the end of this article.

55. Indian J Crit Care Med. 2018 Jul;22(7):498-502. doi: 10.4103/ijccm.IJCCM_94_18.

Impact of Additional Short Session of Video Training on Performance of Basic

Life Support Skills in 2(nd)-Year Medical Students.

Arora V(1), Bala M(2), Chawla S(3).

Author information:
(1)Department of Anaesthesia, Dr Y S Parmar Government Medical College, Nahan,
Himachal Pradesh, India.
(2)Department of Microbiology, Dr Y S Parmar Government Medical College, Nahan,
Himachal Pradesh, India.
(3)Department of Community Medicine, Dr Y S Parmar Government Medical College,
Nahan, Himachal Pradesh, India.

CONTEXT: Basic life support (BLS) is a core life-saving skill which everyone
should know, but knowledge of BLS is poor even among medical students.
AIMS: The aim of our study was to assess the knowledge regarding BLS among
medical students and see impact of training and also to know whether a short
session of video training made an impact on their cardiopulmonary resuscitation
(CPR) skills.
SETTINGS AND DESIGN: Ninety-two 2nd-year medical students were included in the
study.
MATERIALS AND METHODS: Their baseline knowledge regarding BLS was assessed
before workshop with pretest 1. Following workshop posttest 1 and 1 month later,
posttest 2 was conducted. A short duration video training on BLS was done after
posttest 2 and its impact was assessed 2 months later with performance of CPR
skills on a mannequin.
STATISTICAL ANALYSIS USED: Data analysis was done using SPSS version 23.0.
Pearson's Chi-square test was used to evaluate the differences between groups
for categorized variables. Unpaired and paired t-test was used to calculate the
difference of means for quantitative variables.
RESULTS: There was significant improvement in knowledge regarding BLS after the
workshop. Even after 1 month, though there was decline in knowledge, still it
was significantly higher than the baseline. Short duration video training
session did not lead to any improvement in BLS skills.
CONCLUSIONS: BLS training should start early in medical curriculum with
reinforcement at regular intervals. Single short duration video training session
did not have any impact on improvement of skills.

DOI: 10.4103/ijccm.IJCCM_94_18
PMCID: PMC6069311
PMID: 30111924

Conflict of interest statement: There are no conflicts of interest.

56. Arch Acad Emerg Med. 2019 Jan 20;7(1):e4. eCollection 2019 Winter.

Continuous Education of Basic Life Support (BLS) through Social Media; a

Quasi-Experimental Study.

Zia Ziabari SM(1), Monsef Kasmaei V(1), Khoshgozaran L(1)(2), Shakiba M(2).

Author information:
(1)Department of Emergency Medicine, School of Medicine, Guilan University of
Medical Sciences, Rasht, Iran.
(2)Guilan Road Trauma Research Center, School of Health, Guilan University of
Medical Sciences, Rasht, Iran.

INTRODUCTION: It is imperative, if not fundamental, for medical students to

receive continuing education in Basic life support (BLS). This present study
aimed to investigate the effectiveness of continuing education using social
media in this regard.
METHODS: In this quasi-experimental study, a questionnaire containing 20 items
about BLS awareness was completed by the interns who were trained monthly in the
emergency medicine training course. Then half of the interns received distant
education through Telegram software up to three months, and the other did not
receive any further education. Again, both groups completed the questionnaire at
the end of the third month.
RESULTS: 100 medical interns with the mean age of 25.05 ± 1.26 years were
allocated to two groups of 50 subjects (65.0% female). Two groups were similar
regarding the mean age (p = 0.304), gender (p = 0.529), mean awareness score at
the beginning of the study (p = 0.916), and average pre-internship exam score (p
= 0.080). The mean awareness score of medical interns increased significantly in
intervention (11.44 ± 2.37 to 14.88 ± 1.97, p < 0.0001) and control (11.38 ±
3.22 to 12.54 ± 3.04, p < 0.0001) groups at second examination. But mean
difference of awareness score, before and after the education, was significantly
higher in intervention group (3.44 ± 1.48 versus 1.16 ± 1.51; p < 0.0001).
CONCLUSION: The increase in the BLS awareness score was significantly higher in
medical interns who were continuously educated using Telegram social media
software.

PMCID: PMC6377214
PMID: 30847439

Conflict of interest statement: We know of no conflicts of interest associated

with this publication, and there has been no significant financial support for
this work that could have influenced its outcome. As Corresponding Author, I
confirm that the manuscript has been read and approved for submission by all the
named authors.

57. Ann Intern Med. 2015 Nov 3;163(9):681-90. doi: 10.7326/M15-0557. Epub 2015 Oct
13.

Outcomes of Basic Versus Advanced Life Support for Out-of-Hospital Medical

Emergencies.

Sanghavi P, Jena AB, Newhouse JP, Zaslavsky AM.

Comment in
Ann Intern Med. 2015 Nov 3;163(9):721-2. doi: 10.7326/M15-2192.
Ann Intern Med. 2016 Jul 5;165(1):68-9. doi: 10.7326/L15-0627.
Ann Intern Med. 2016 Jul 5;165(1):69. doi: 10.7326/L15-0626.
Ann Intern Med. 2016 Jul 5;165(1):69-70. doi: 10.7326/L15-0628.
Ann Intern Med. 2016 Jul 5;165(1):70-1. doi: 10.7326/L16-0010.
Ann Intern Med. 2016 Jul 5;165(1):71. doi: 10.7326/L16-5011.

BACKGROUND: Most Medicare patients seeking emergency medical transport are

treated by ambulance providers trained in advanced life support (ALS). Evidence
supporting the superiority of ALS over basic life support (BLS) is limited, but
some studies suggest ALS may harm patients.
OBJECTIVE: To compare outcomes after ALS and BLS in out-of-hospital medical
emergencies.
DESIGN: Observational study with adjustment for propensity score weights and
instrumental variable analyses based on county-level variations in ALS use.
SETTING: Traditional Medicare.
PATIENTS: 20% random sample of Medicare beneficiaries from nonrural counties
between 2006 and 2011 with major trauma, stroke, acute myocardial infarction
(AMI), or respiratory failure.
MEASUREMENTS: Neurologic functioning and survival to 30 days, 90 days, 1 year,
and 2 years.
RESULTS: Except in cases of AMI, patients showed superior unadjusted outcomes
with BLS despite being older and having more comorbidities. In propensity score
analyses, survival to 90 days among patients with trauma, stroke, and
respiratory failure was higher with BLS than ALS (6.1 percentage points [95% CI,
5.4 to 6.8 percentage points] for trauma; 7.0 percentage points [CI, 6.2 to 7.7
percentage points] for stroke; and 3.7 percentage points [CI, 2.5 to 4.8
percentage points] for respiratory failure). Patients with AMI did not exhibit
differences in survival at 30 days but had better survival at 90 days with ALS
(1.0 percentage point [CI, 0.1 to 1.9 percentage points]). Neurologic
functioning favored BLS for all diagnoses. Results from instrumental variable
analyses were broadly consistent with propensity score analyses for trauma and
stroke, showed no survival differences between BLS and ALS for respiratory
failure, and showed better survival at all time points with BLS than ALS for
patients with AMI.
LIMITATION: Only Medicare beneficiaries from nonrural counties were studied.
CONCLUSION: Advanced life support is associated with substantially higher
mortality for several acute medical emergencies than BLS.
PRIMARY FUNDING SOURCE: National Science Foundation, Agency for Healthcare
Research and Quality, and National Institutes of Health.

DOI: 10.7326/M15-0557
PMCID: PMC4945100
PMID: 26457627 [Indexed for MEDLINE]
58. J Family Med Prim Care. 2021 Jul;10(7):2684-2691. doi:
10.4103/jfmpc.jfmpc_2557_20. Epub 2021 Jul 30.

Awareness and attitude about basic life support among medical school students in
Jeddah University, 2019: A cross-sectional study.

Alghamdi YA(1), Alghamdi TA(2), Alghamdi FS(2), Alghamdi AH(3).

Author information:
(1)Deparment of Family and Community Medicine, AlBaha University, AlBaha, Saudi
Arabia.
(2)King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.
(3)Joint Program of Community Medicine and Preventive Medicine, Jeddah, Saudi
Arabia.

OBJECTIVES: To measure the level of knowledge and awareness towards basic life
support (BLS) among students in preclinical years at Jeddah University (JU), and
to determine their willingness to participate in BLS training in the near
future.
SUBJECTS AND METHODS: A cross-sectional study was conducted among first-,
second-, and third-year medical students of JU. A 27-item questionnaire measured
the level of awareness and knowledge about BLS, including: 1) basic Information
(seven items); 2) rescue reflex (eight items); and 3) CPR technique and process
(12 items). Demographic and academic data, experience and exposure to BLS, and
attitude regarding BLS (six items) were analysed as factors of adequate
knowledge.
RESULTS: One hundred and four male students participated and 65 (62.5%) of them
were in the second academic year. The correct answers varied from 10.6% to
67.3%, with eight items having <30% correct answers; and seven items showed >50%
correct answers. Mean (SD) and median (P75) overall knowledge scores were 37.86
(13.92) and 37.04 (44.44) out of 100, respectively. Twenty-four (23.11%)
participants attended a training course in BLS and 13 (12.5%) have ever
performed BLS, either voluntarily or not voluntarily, and 18 (17.3%) felt that
their current knowledge was sufficient. Knowledge level showed no statistically
significant association with any of the investigated factors.
CONCLUSION: There is an urgent need to integrate BLS courses to medical students
to enrich their knowledge and improve resuscitation skills and ensure
implementation of correct resuscitation techniques.

Copyright: © 2021 Journal of Family Medicine and Primary Care.

DOI: 10.4103/jfmpc.jfmpc_2557_20
PMCID: PMC8415673
PMID: 34568155

Conflict of interest statement: There are no conflicts of interest.

59. West Afr J Med. 2023 Jul 28;40(7):697-703.

High-Impact Medical Education in Basic Life Support: A Comparative Study of

Doctors and Medical Students in a Tertiary Hospital.

Owobu AC(1), Omosofe FO(2), Owobu CI(3), Azeke TA(3), Oyewusi MA(1), Ileli
SO(1), Ugbeni HE(1).

Author information:
(1)Department of Paediatrics, Irrua Specialist Teaching Hospital, Auchi Road,
Irrua, Edo State, Nigeria. Email: [email protected].
(2)Department of Anesthesia, Irrua Specialist Teaching Hospital, Auchi Road,
Irrua, Edo State, Nigeria.
(3)Department of Anatomic Pathology, Irrua Specialist Teaching Hospital, Auchi
Road, Irrua, Edo State, Nigeria.

INTRODUCTION: Although very crucial in medicine, mastery of cardiopulmonary

resuscitation remains poor in many low and-medium income countries (LMICs) due
mainly to the lack of readily accessible training facilities and expertise.
SUBJECTS AND METHODS: The current study was aimed at evaluating the knowledge of
Basic Life Support (BLS) among senior-level medical students and doctors in
Nigeria, as well as to evaluate the value of a video teaching method in
improving the knowledge base of BLS. It was a two-cohort prospective study
carried out over a duration of one month. Each group of participants had an
initial assessment of their knowledge of Basic Life Support using a
questionnaire. Thereafter, the 45-minute CHEMPIONS-BLS video was projected. On
completion of the video session, the same questionnaire was again administered
to each group of participants. This was followed by a practical, hands-on
workshop at the skills laboratory. Data was collected using the questionnaires
and comparisons were made between the pre and post-test responses.
RESULTS: Seventy-five medical students and 41 doctors were enrolled into this
study. Overall, their knowledge of BLS and their exposure to previous BLS
training were poor, but there was a significant improvement in the mean scores,
and the overall performance after viewing the video just one time; t = 27.30, p
= .000 and χ² = 116.01; p = .000 respectively.
CONCLUSION: This study reveals poor knowledge and exposure to basic life support
training among both medical students and practicing doctors. It further reveals
the value of a novel training method in improving BLS knowledge.

Publisher: INTRODUCTION: Bien que cruciale en médecine, la maîtrise de la

réanimation cardio-pulmonaire reste faible dans de nombreux pays à revenu faible
et moyen (PRFM), principalement en raison du manque d’infrastructures de
formation et d’expertise facilement accessibles.
SUJETS ET MÉTHODES: La présente étude visait à évaluer les connaissances en
matière de réanimation cardio-pulmonaire de base (Basic Life Support - BLS)
parmi les étudiants en médecine et les médecins au Nigeria, ainsi qu’à évaluer
la valeur d’une méthode d’enseignement par vidéo pour améliorer la base de
connaissances en BLS. Il s’agissait d’une étude prospective à deux cohortes
menée sur une durée d’un mois. Chaque groupe de participants a fait l’objet
d’une évaluation initiale de ses connaissances en matière de réanimation
cardio-pulmonaire à l’aide d’un questionnaire. Ensuite, la vidéo CHEMPIONS-BLS
de 45 minutes a été projetée. À l’issue de la séance vidéo, le même
questionnaire a été administré à chaque groupe de participants. Cette séance a
été suivie d’un atelier pratique au laboratoire de compétences. Les données ont
été collectées à l’aide des questionnaires et des comparaisons ont été faites
entre les réponses avant et après le test.
RÉSULTATS: Soixante-quinze étudiants en médecine et 41 médecins ont participé à
cette étude. Dans l’ensemble, leur connaissance du BLS et leur exposition à une
formation BLS antérieure étaient faibles, mais il y a eu une amélioration
significative des scores moyens et de la performance globale après avoir
visionné la vidéo une seule fois ; t = 27,30, p = .000 et χ² = 116,01 ; p = .000
respectivement.
CONCLUSION: Cette étude révèle que les étudiants en médecine et les médecins en
exercice ont une connaissance et une exposition insuffisantes à la formation aux
soins de base en réanimation. Elle révèle également l’intérêt d’une nouvelle
méthode de formation pour améliorer les connaissances en matière de BLS.
MOTS CLÉS: Soins de base en réanimation (BLS), Réanimation cardiopulmonaire
(RCP), Éducation médicale, Arrêt cardiaque extrahospitalier (OHCA), Formation
post-COVID, Formation médicale continue (FMC), Hôpital universitaire spécialisé
d’Irrua (ISTH), Le Nigeria.

Copyright © 2023 by West African Journal of Medicine.

PMID: 37515775 [Indexed for MEDLINE]

Conflict of interest statement: The Authors declare that no competing interest

exists.

60. CJEM. 2022 Jun;24(4):408-418. doi: 10.1007/s43678-022-00291-3. Epub 2022 Apr

19.

Early or late booster for basic life support skill for laypeople: a
simulation-based randomized controlled trial.

Boet S(1)(2)(3)(4)(5)(6), Waldolf R(7)(8)(9), Bould C(10), Lam S(11), Burns

JK(11), Moffett S(10), McBride G(10), Ramsay T(11), Bould MD(7)(11)(12).

Author information:
(1)Department of Anesthesiology and Pain Medicine, The Ottawa Hospital,
University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8M2, Canada. [email protected].
(2)Department of Innovation in Medical Education, University of Ottawa, Ottawa,
ON, Canada. [email protected].
(3)Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa,
ON, Canada. [email protected].
(4)Institut du Savoir Montfort, Ottawa, ON, Canada. [email protected].
(5)Faculty of Medicine, Francophone Affairs, University of Ottawa, Ottawa, ON,
Canada. [email protected].
(6)Faculty of Education, University of Ottawa, Ottawa, ON, Canada. [email protected].
(7)Department of Innovation in Medical Education, University of Ottawa, Ottawa,
ON, Canada.
(8)Institut du Savoir Montfort, Ottawa, ON, Canada.
(9)Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.
(10)Department of Anesthesiology and Pain Medicine, The Ottawa Hospital,
University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8M2, Canada.
(11)Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa,
ON, Canada.
(12)Department of Anesthesiology, The Children's Hospital of Eastern Ontario,
University of Ottawa, Ottawa, ON, Canada.

PURPOSE: Retention of skills and knowledge has been shown to be poor after
resuscitation training. The effect of a "booster" is controversial and may
depend on its timing. We compared the effectiveness of an early versus late
booster session after Basic Life Support (BLS) training for skill retention at
4 months.
METHODS: We performed a single-blind randomized controlled trial in a simulation
environment. Eligible participants were adult laypeople with no BLS training or
practice in the 6 months prior to the study. We provided participants with
formal BLS training followed by an immediate BLS skills post-test. We then
randomized participants to one of three groups: control, early booster, or late
booster. Based on their group allocation, participants attended a brief BLS
refresher at either 3 weeks after training (early booster), at 2 months after
training (late booster), or not at all (control). All participants underwent a
BLS skills retention test at 4 months. We measured BLS skill performance
according to the Heart and Stroke Foundation's skills testing checklist for
adult CPR and the use of an automated external defibrillator.
RESULTS: A total of 80 laypeople were included in the analysis (control group,
n = 28; early booster group, n = 23; late booster group, n = 29). The late
booster group achieved better skill retention (mean difference in checklist
score at retention compared to the immediate post-test = - 0.8 points out of 15,
[95% CI - 1.7, 0.2], P = 0.10) compared to the early booster (- 1.3, [- 2.6,
0.0], P = 0.046) and control group (- 3.2, [- 4.7, - 1.8], P < 0.001).
CONCLUSION: A late booster session improves BLS skill retention at 4 months in
laypeople.
TRIAL REGISTRATION NUMBER: NCT02998723.

Publisher: RéSUMé: OBJECTIF: Il a été démontré que la rétention des compétences

et des connaissances est faible après une formation en réanimation. L'effet d'un
"booster" est controversé et peut dépendre de son moment. Nous avons comparé
l'efficacité d'une session de rappel précoce ou tardive après la formation Basic
Life Support (BLS) pour le maintien des compétences après quatre mois. MéTHODES:
Nous avons réalisé un essai contrôlé randomisé en simple aveugle dans un
environnement de simulation. Les participants éligibles étaient des laïcs
adultes n'ayant pas suivi de formation ou pratiqué le BLS dans les 6 mois
précédant l'étude. Nous avons fourni aux participants une formation BLS formelle
suivie d'un post-test immédiat sur les compétences BLS. Nous avons ensuite
randomisé les participants dans l'un des trois groupes suivants: groupe témoin,
rappel précoce ou rappel tardif. En fonction de leur répartition dans le groupe,
les participants ont assisté à un bref rappel de BLS soit 3 semaines après la
formation (rappel précoce), soit 2 mois après la formation (rappel tardif), soit
pas du tout (groupe témoin). Tous les participants ont été soumis à un test de
maintien des compétences BLS après quatre mois. Nous avons mesuré la performance
des compétences BLS selon la liste de contrôle des compétences de la Fondation
des maladies du cœur pour la RCP chez l'adulte et l'utilisation d'un
défibrillateur externe automatisé. RéSULTATS: Au total, 80 profanes ont été
inclus dans l'analyse (groupe témoin, n = 28; groupe de rappel précoce, n = 23;
groupe de rappel tardif, n = 29). Le groupe de rappel tardif a obtenu un
meilleur maintien des compétences (différence moyenne du score de la liste de
contrôle au moment du maintien par rapport au post-test immédiat = -0,8 points
sur 15, [IC 95% -1,7, 0,2], P = 0,10) par rapport au groupe de rappel précoce
(-1,3, [-2,6, 0,0], P = 0,046) et au groupe témoin (-3,2, [-4,7, -1,8],
P < 0,001). CONCLUSION: Une session de rappel tardive améliore la rétention des
compétences BLS à 4 mois chez les profanes.

© 2022. The Author(s), under exclusive licence to Canadian Association of

Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence
(ACMU).

DOI: 10.1007/s43678-022-00291-3
PMID: 35438450 [Indexed for MEDLINE]

61. Resuscitation. 2007 Jun;73(3):417-24. doi: 10.1016/j.resuscitation.2006.10.017.

Epub 2007 Feb 1.

An evaluation of objective feedback in basic life support (BLS) training.

Spooner BB(1), Fallaha JF, Kocierz L, Smith CM, Smith SC, Perkins GD.

Author information:
(1)Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.

BACKGROUND: Studies show that acquisition and retention of BLS skills is poor,
and this may contribute to low survival from cardiac arrest. Feedback from
instructors during BLS training is often lacking. This study investigates the
effects of continuous feedback from a manikin on chest compression and
ventilation techniques during training compared to instructor feedback alone.
MATERIALS AND METHODS: A prospective randomised controlled trial. First-year
healthcare students at the University of Birmingham were randomised to receive
training in standard or feedback groups. The standard group were taught by an
instructor using a conventional manikin. The feedback group used a
'Skillreporter' manikin, which provides continuous feedback on ventilation
volume and chest compression depth and rate in addition to instructor feedback.
Skill acquisition was tested immediately after training and 6 weeks later.
RESULTS: Ninety-eight participants were recruited (conventional n=49;
Skillreporter n=49) and were tested after training. Sixty-six students returned
(Skillreporter n=34; conventional n=32) for testing 6 weeks later. The
Skillreporter group achieved better compression depth (39.96mm versus 36.71mm,
P<0.05), and more correct compressions (58.0% versus 40.4%, P<0.05) at initial
testing. The Skillreporter group also achieved more correct compressions at week
6 (43.1% versus 26.5%, P<0.05).
CONCLUSIONS: This study demonstrated that objective feedback during training
improves the performance of BLS skills significantly when tested immediately
after training and at re-testing 6 weeks later. However, CPR performance
declined substantially over time in both groups.

DOI: 10.1016/j.resuscitation.2006.10.017
PMID: 17275158 [Indexed for MEDLINE]

62. World J Emerg Med. 2012;3(2):141-5. doi:

10.5847/wjem.j.issn.1920-8642.2012.02.011.

Basic life support: knowledge and attitude of medical/paramedical professionals.

Roshana S(1), Kh B(1), Rm P(2), Mw S(1).

Author information:
(1)Department of Family Medicine and Emergency, Kist Medical College Hospital,
Imadol, Lalitpur, Nepal.
(2)Department of Internal Medicine, Kist Medical College Hospital, Imadol,
Lalitpur, Nepal.

BACKGROUND: Basic life support (BLS), a key component of the chain of survival
decreases the arrest - cardiopulmonary resuscitation interval and increases the
rate of hospital discharge. The study aimed to explore the knowledge of and
attitude towards basic life support (BLS) among medical/paramedical
professionals.
METHODS: An observational study was conducted by assessing response to self
prepared questionnaire consisting of the demographic information of the
medical/paramedical staff, their personnel experience/attitude and knowledge of
BLS based on the 2005 BLS Guidelines of European Resuscitation Council.
RESULTS: After excluding incomplete questionnaires, the data from 121 responders
(27 clinical faculty members, 21 dental and basic sciences faculty members, 29
house officers and 44 nurses and health assistants) were analyzed. Only 9 (7.4%)
of the 121 responders answered ≥11, 53 (43%) answered 7-10, and 58 (48%)
answered <7 of 15 questions correctly. The clinical faculty members, house
officers and nurses/HA had a mean score of 7.4±3.15, 7.37±2.02 and 6.63±2.16
respectively, while dental/basic sciences faculty members attained a least mean
score of 4.52 ±2.13 (P<0.001). Those who had received cardiopulmonary
resuscitation (CPR) training within 5 years obtained a highest mean score of
8.62±2.49, whereas those who had the training more than 5 years back or no
training obtained a mean score of 5.54±2.38 and 6.1±2.29 respectively (P=0.001).
Those who were involved in resuscitation frequently had a higher median score of
8 in comparison to those who were seldom involved or not involved at all
(P<0.001).
CONCLUSIONS: The average health personnel in our hospital lack adequate
knowledge in CPR/BLS. Training and experience can enhance knowledge of CPR of
these personnel. Thus standard of CPR/BLS training and assessment are
recommended at our hospital.

DOI: 10.5847/wjem.j.issn.1920-8642.2012.02.011
PMCID: PMC4129799
PMID: 25215053

Conflict of interest statement: Conflicts of interest: The authors declare that

there is no conflict of interest.

63. Adv Physiol Educ. 2014 Mar;38(1):42-5. doi: 10.1152/advan.00102.2013.

Evaluation of retention of knowledge and skills imparted to first-year medical

students through basic life support training.

Pande S(1), Pande S, Parate V, Pande S, Sukhsohale N.

Author information:
(1)Department of Physiology, Dr. Panjabrao Deshmukh Memorial Medical College,
Amravati, Maharashtra, India;

Poor awareness among medical graduates about basic life support (BLS) is a
matter of great concern. The presence of a trained rescuer is the key
determinant of ultimate survival from life-threatening emergencies. To achieve
this goal, early exposure to such life-saving skills is the right decision to
foster these skills for medical students, which can be reenforced in succeeding
years. Forty-two first-year medical students participated in this study. The
entire procedure consisted of faculty training, assessment of knowledge of
students by a pretest questionnaire, a lecture, a demonstration, and hands-on
training using a mannequin (with special emphasis on the site, depth, rate, and
sustainment of uninterrupted chest compressions). Posttest 1 was conducted to
assess the knowledge gained. The retention of knowledge and skills in the second
year was evaluated by posttest 2 and directly observed procedural skills,
respectively. Student feedback was collected on five-point Likert scale.
Analysis using a Freidman test indicated the mean rank for posttest 1 (2.81) to
be significantly higher than the pretest (1.26), indicating a gain in knowledge.
The mean rank for posttest 2 (1.93) was lower than for posttest 1 (2.81) but was
significantly higher compared with the pretest (1.26), indicating a significant
retention of knowledge during the second year. Directly observed procedural
skill evaluation showed that 7% students could perform all the seven steps
correctly and that 74% students could perform three or more steps correctly,
signifying a good retention of skill. Two students taught BLS skills to their
family members as well. The results of this study suggest that the program
provides students with sound basic knowledge and adequate practical skills in
BLS.

DOI: 10.1152/advan.00102.2013
PMID: 24585468 [Indexed for MEDLINE]

64. Resuscitation. 2020 Jul;152:141-148. doi: 10.1016/j.resuscitation.2020.04.041.

Epub 2020 May 15.

Implementation of basic life support training for school children: Online

education for potential instructors? Results of a cluster randomised,
controlled, non-inferiority trial.

Napp A(1), Kosan J(1), Hoffend C(1), Häge A(1), Breitfeld P(1), Doehn C(1),
Daubmann A(2), Kubitz J(1), Beck S(3).

Author information:
(1)Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf,
Martini-Str. 52, 20246 Hamburg, Germany.
(2)Department of Medical Biometry and Epidemiology, University Medical Center
Hamburg-Eppendorf, Martini-Str. 52, 20246 Hamburg, Germany.
(3)Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf,
Martini-Str. 52, 20246 Hamburg, Germany. Electronic address: [email protected].

AIM OF THE STUDY: Comprehensive training of the population in basic life support
(BLS) increases the chance of survival in cardiac arrest. To implement BLS
trainings at schools a high number of instructors will be needed. This
non-inferiority study investigated, if online education is effective to prepare
instructors to teach BLS compared to face-to-face education.
METHODS: A cluster randomised, controlled, single blinded study was performed in
2018 in Hamburg, Germany. A mixed group of potential instructors were allocated
alternately to either the intervention or control group and participated in a
four-hour instructor training. The instructor training of the control group was
realised by trained educators. The intervention group participated in a
self-regulated online training with hands-on training supported by peers.
Instructors provided BLS training for high school students. The primary endpoint
was a mean score in the BLS skills assessment of the students. The secondary
endpoint was teaching effectiveness of the instructors.
RESULTS: BLS assessments of 808 students of 46 classes, who were taught by 74
instructors could be analysed. The students trained by interventional
instructors achieved 0.14 points less (95% CI: -0.27 to 0.56) compared to
students trained by control instructors (9.34 vs. 9.48). The non-inferiority
could not be confirmed. The teaching performance in the intervention group was
better in some aspects compared to the control group.
CONCLUSION: Integrating all results of this study, online education may be an
effective alternative to prepare potential BLS instructors. Using free online
courses, motivated persons can independently acquire necessary skills to become
instructors and autonomously realise low cost BLS trainings at schools.

Copyright © 2020 Elsevier B.V. All rights reserved.

DOI: 10.1016/j.resuscitation.2020.04.041
PMID: 32422244 [Indexed for MEDLINE]

65. J Med Life. 2010 Oct-Dec;3(4):465-7.

Importance of basic life support training for first and second year medical
students--a personal statement.

Tipa RO(1), Bobirnac G.

Author information:
(1)Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
[email protected]

INTRODUCTION: Current studies show that there is a significant lack of knowledge

regarding the typical signs and risk factors associated with serious medical
conditions among medical students and laypersons. Basic life support consists of
a number of medical procedures provided to patients with life threatening
conditions of the body that cause pain or dysfunction to the person.
FURTHER DEVELOPMENTS: In spite of the fact that this programme is not included
in the curricula, students might receive this information from various persons,
even though these persons are not specialized in the domain of giving first aid.
Learning medicine without placing patients at an increased risk of complications
is of utmost importance in the medical profession. High-fidelity patient
simulators can potentially achieve this, and, therefore they are increasingly
used in the training of medical students. Recent studies regarding simulation
training show that the simulation-based intervention offers a positively
evaluated possibility to enhance students' skills in recognizing and handling
emergencies improving the ability to manage medical emergencies.
CONCLUSION: Understanding BLS courses and more than that, practicing these
techniques is by far the most challenging task confronting first aid. Taking
everything into consideration, we believe that an adequate education in first
aid and basic life support should be considered an essential aspect of the
medical curriculum.

PMCID: PMC3019063
PMID: 21254750 [Indexed for MEDLINE]

66. Resuscitation. 2019 Jun;139:122-132. doi: 10.1016/j.resuscitation.2019.03.026.

Epub 2019 Mar 26.

Self-learning training versus instructor-led training for basic life support: A

cluster randomised trial.

Bylow H(1), Karlsson T(2), Claesson A(3), Lepp M(4), Lindqvist J(5), Herlitz
J(6).

Author information:
(1)Department of Molecular and Clinical Medicine, Institute of Medicine,
Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. Electronic
address: [email protected].
(2)Health Metrics Unit, Institute of Medicine, Sahlgrenska Academy at University
of Gothenburg, Gothenburg, Sweden.
(3)Department of Medicine, Centre for Resuscitation Science, Karolinska
Institute, Stockholm, Sweden.
(4)Institute of Health and Care Sciences, Sahlgrenska Academy, University of
Gothenburg, Sweden; Østfold University College, Halden, Norway; School of
Nursing and Midwifery, Griffith University, Australia.
(5)Centre of Registers Västra Götaland, Gothenburg, Sweden.
(6)Department of Molecular and Clinical Medicine, Institute of Medicine,
Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Centre of
Registers Västra Götaland, Gothenburg, Sweden; Prehospen-Centre of Prehospital
Research, Faculty of Caring Science, Work Life and Social Welfare, University of
Borås, Sweden.

AIM: To compare the effectiveness of two basic life support (BLS) training
interventions.
METHODS: This experimental trial enrolled 1301 lay people in BLS training. The
participants were cluster randomised to either self-learning training or to
traditional instructor-led training. Both groups used the Mini-Anne Kit (Laerdal
Medical, Stavanger, Norway) and standardised film instructions. After training,
the participants practical skills were measured on a Resusci Anne manikin and an
AED trainer with the PC SkillReporting system (Laerdal Medical, Stavanger,
Norway). The primary outcome was the total score from the modified Cardiff Test
of basic life support with automated external defibrillation (19-70 points), six
months after training. The secondary outcomes were total score directly after
training and quality of individual variables, self-assessed knowledge,
confidence and willingness to act, directly and six months after training.
RESULTS: For primary outcome six months after training there was no
statistically significant difference (p = 0.44) between the total score for the
self-learning group (n = 670; median 59, IQR 55-62) compared with the
instructor-led group (n = 561; median 59, IQR 55-63). The instructor-led
training resulted in a statistically significant higher total score (median 61
versus 59, p < 0.0001), self-assessed knowledge and willingness to act, directly
after training (secondary outcomes) compared with the self-learning training.
CONCLUSIONS: There was no statistically significant difference in practical
skills or willingness to act when comparing self-learning training with
instructor-led training six months after training in BLS. However, directly
after the intervention, practical skills were better when the training was led
by an instructor.

Copyright © 2019 Elsevier B.V. All rights reserved.

DOI: 10.1016/j.resuscitation.2019.03.026
PMID: 30926451 [Indexed for MEDLINE]

67. BMJ Open. 2021 Nov 30;11(11):e052478. doi: 10.1136/bmjopen-2021-052478.

Training frequency for educating schoolchildren in basic life support: very

brief 4-month rolling-refreshers versus annual retraining-a 2-year prospective
longitudinal trial.

Abelairas-Gómez C(1)(2)(3), Martinez-Isasi S(4)(3)(5), Barcala-Furelos R(6)(7),

Varela-Casal C(6)(7), Carballo-Fazanes A(1)(3)(5), Pichel-López M(6), Fernández
Méndez F(6), Otero-Agra M(6), Sanchez Santos L(8), Rodriguez-Nuñez
A(1)(3)(5)(9).

Author information:
(1)Simulation and Intensive Care Unit of Santiago (SICRUS), Health Research
Institute of Santiago, University Hospital of Santiago de Compostela- CHUS,
Santiago Compostela, Spain.
(2)Faculty of Education Sciences, Universidade de Santiago de Compostela, Spain,
Santiago Compostela, Spain.
(3)CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and
Medicine Department, University of Santiago de Compostela, Santiago de
Compostela, Spain.
(4)Simulation and Intensive Care Unit of Santiago (SICRUS), Health Research
Institute of Santiago, University Hospital of Santiago de Compostela- CHUS,
Santiago Compostela, Spain [email protected].
(5)Faculty of Nursing, Universidade de Santiago de Compostela, Santiago
Compostela, Spain.
(6)REMOSS Research Group, Faculty of Education and Sport Sciences, University of
Vigo, Vigo, Spain.
(7)Faculty of Education and Sport Sciences, Universidad de Vigo, Vigo, Spain.
(8)Pediatric, Health area of Santiago de Compostela-Barbanza, Santiago de
Compostela, Spain.
(9)Pediatric Intensive Care Unit, University Hospital of Santiago de
Compostela-CHUS, Santiago de Compostela, Spain.

OBJECTIVE: To compare the effectiveness of 4-month rolling-refreshers and annual

retraining in basic life support (BLS) on a sample of schoolchildren.
DESIGN: Prospective longitudinal trial.
SETTING AND PARTICIPANTS: Four hundred and seventy-two schoolchildren (8-12
years old).
INTERVENTIONS: Schoolchildren were instructed in BLS and then split into the
following three groups: control group (CG), standard group (SG) and
rolling-refresher group (RRG). Their BLS skills were assessed within 1 week (T1)
and 2 years later (T2). Moreover, CG did not receive any additional training; SG
received one 50 min retraining session 1 year later; RRG participated in very
brief (5 min) rolling-refreshers that were carried out every 4 months.
PRIMARY AND SECONDARY OUTCOMES: Hands-on skills of BLS sequence and
cardiopulmonary resuscitation.
RESULTS: BLS sequence performance was similar in all groups at T1, but SG and
RRG followed the steps of the protocol in more proportion than CG at T2. When
compared at T2, RRG showed higher proficiency than SG in checking safety,
checking response, opening the airway and alerting emergency medical services.
In addition, although the mean resuscitation quality was low in all groups, RRG
participants reached a higher percentage of global quality cardiopulmonary
resuscitation (CG: 16.4±24.1; SG: 25.3±28.8; RRG: 29.9%±29.4%), with a higher
percentage of correct chest compressions by depth (CG: 3.9±11.8; SG: 10.8±22.7;
RRG: 15.5±26.1 mm).
CONCLUSIONS: In 8-to-12-year-old schoolchildren, although annual 50 min
retraining sessions help to maintain BLS performance, 4-month very brief
rolling-refreshers were shown to be even more effective. Thus, we recommend
implementing baseline BLS training at schools, with subsequently brief
rolling-refreshers.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No

commercial re-use. See rights and permissions. Published by BMJ.

DOI: 10.1136/bmjopen-2021-052478
PMCID: PMC8634240
PMID: 34848519 [Indexed for MEDLINE]

Conflict of interest statement: Competing interests: None declared.

68. JNMA J Nepal Med Assoc. 2018 Jul-Aug;56(212):774-780. doi: 10.31729/jnma.3645.

An Experience of Video Based Training on Basic Life Support.

Shrestha R(1), Shrestha A(2), Batajoo KH(3), Thapa R(4), Acharya S(2),
Bajracharya S(2), Singh S(5).

Author information:
(1)Department of General Practice and Emergency Medicine, Kathmandu University
School of Medical Sciences, Dhulikhel, Kavre, Nepal.
(2)Department of General Practice and Emergency Medicine, Patan Academy of
Health Sciences, Patan, Nepal.
(3)Department of General Practice and Emergency Medicine, KIST Medical College
and Teaching Hospital, Imadol, Nepal.
(4)Department of General Practice and Emergency Medicine, Kathmandu Medical
college and Teaching Hospital, Nepal.
(5)Department of Emergency Medicine, Nepal Mediciti Hospital, Kathmandu, Nepal.

INTRODUCTION: Basic life support is foundation to save lives. In contrast to the

developed countries, there is still no national standard BLS training module in
Nepal. Basic life support training is being provided by various institutions but
lack in consistency and coordination. The Nepal basic life support Course is the
video based training in Nepali language with reference to recent advances which
was intended for all health care personnel of Nepal in urban as well as rural
setting. We aimed to describe the features of this video based training module
in local language, to analyse the differences of knowledge before and after the
training and to find out the participants perception and satisfaction with this
course.
METHODS: This is a descriptive cross-sectional study based on data of trainings
conducted over the study period. Ethical approval was taken. The post-test score
was recorded and compared with the occupational using ANOVA. On the spot and
delayed feedbacks from the participants were collected voluntarily and
summarized.
RESULTS: Total of 576 participants (435 clinical doctors, 92 nurses/paramedics,
18 non-clinical doctors and 41 intern doctors) successfully completed the
training. The difference in post test scores (mean = 12.9±1.8) among the
different occupational background was not significant (P=0.159). The feedbacks
from the participants were mostly positive and encouraging.
CONCLUSIONS: The knowledge of basic life support improved significantly
irrespective of the occupation of the participants. A universal, nationwide
video based training module in Nepali language should be developed focusing all
health care personnel of urban as well rural Nepal.

DOI: 10.31729/jnma.3645
PMCID: PMC8827550
PMID: 30387468 [Indexed for MEDLINE]

Conflict of interest statement: None.

69. Eur J Emerg Med. 2014 Apr;21(2):142-4. doi: 10.1097/MEJ.0b013e328360a0f4.

Successful implementation of the European Resuscitation Council basic life

support course as mandatory peer-led training for medical students.

Grove EL(1), Løfgren B.

Author information:
(1)aDepartment of Cardiology, Aarhus University Hospital bResearch Center for
Emergency Medicine, Aarhus University, Aarhus cDepartment of Internal Medicine,
Regional Hospital of Randers, Randers, Denmark.

We aimed to implement the European Resuscitation Council (ERC) basic life

support (BLS) and automated external defibrillator (AED) course as a mandatory
peer-led training programme for medical students and to evaluate the
satisfaction with this course. Medical students certified as ERC BLS/AED
instructors were recruited as student trainers and organizers of the course,
which was included as a mandatory part of the curriculum for second-year medical
students before first clinical rotation. After each course, questionnaires were
distributed to evaluate the peer-led training programme. In total, 146 students
were trained and assessed. The quality of the course was rated as 9.4±0.8
(10-point scale, 10 being best), and the majority (95%) felt better prepared for
their clinical rotation. Implementation of the ERC BLS/AED course as a mandatory
peer-led training programme for medical students is feasible. The course has
been very well accepted and the students feel better prepared for their first
clinical rotation.

DOI: 10.1097/MEJ.0b013e328360a0f4
PMID: 23510898 [Indexed for MEDLINE]

70. Turk J Emerg Med. 2019 Jan 18;19(1):26-29. doi: 10.1016/j.tjem.2018.11.002.

eCollection 2019 Jan.

The evaluation of laypersons awareness of basic life support at the university

in Izmir.

Pehlivan M(1), Mercan NC(1), Çinar İ(1), Elmali F(2), Soyöz M(3).

Author information:
(1)Vocational School of Health Services, Izmir Katip Celebi University, Izmir,
Turkey.
(2)Department of Biostatistics, Faculty of Medicine, Izmir Katip Celebi
University, Izmir, Turkey.
(3)Department of Medical Biology and Genetics, Faculty of Medicine, Izmir Katip
Çelebi University, Izmir, Turkey.

OBJECTIVES: Basic Life Support (BLS) is the application of cardiopulmonary

resuscitation (CPR) in order to save the lives of cardiac arrest victims by
members of the public pending the arrival of the Emergency Medical Service
(EMS). The aim of this study was to evaluate the effectiveness of training in
order to ensure society understands the importance of early initiation of BLS,
and to provide information concerning BLS and automated external defibrillators
(AED).
METHODS: This study consisted of 150 participants, of whom none were healthcare
professionals. The research data were collected from 150 pre-tests and 100
post-tests. A Comparison of nominal data was analyzed by both McNemar's test and
Pearson's chi-square exact test.
RESULTS: Of the participants, 39% had received the BLS training prior to the
study. It was observed that the participants' desire for applying BLS increased
from 43% to 78% post training, and the ratio of ability to distinguish the need
for BLS increased from 54% to 79%. Our results also indicated that the knowledge
level of the CPR application increased after the study. The proportion of
participants who knew the purpose of using AED increased from 79.8% to 95.7%.
CONCLUSIONS: It was concluded that the BLS Awareness training increased in
relation to the application of BLS, improved the BLS knowledge and increased
awareness of the use of AED.

DOI: 10.1016/j.tjem.2018.11.002
PMCID: PMC6370912
PMID: 30793062

71. J Educ Health Promot. 2022 Jun 11;11:165. doi: 10.4103/jehp.jehp_1011_21.

eCollection 2022.

High school basic life support training: Is the trainer's experience of

cardiopulmonary resuscitation in the actual setting important? A randomized
control trial.

Sanati A(1), Jaberi AA(2), Bonabi TN(3).

Author information:
(1)Department of Medical Surgical Nursing, School of Nursing and Midwifery,
Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan,
Kerman Province, Iran.
(2)Department of Psychiatric and Mental Health Nursing, Social Determinants of
Health Research Center, School of Nursing and Midwifery, Rafsanjan University of
Medical Sciences, Rafsanjan, Kerman Province, Iran.
(3)Department of Community Health Nursing, Social Determinants of Health
Research Center, School of Nursing and Midwifery, Rafsanjan University of
Medical Science, Rafsanjan, Kerman Province, Iran.

BACKGROUND: Although basic life support (BLS) has been taught in school by a
variety of professionals, it is still unclear that, whether the instructor's
previous cardiopulmonary resuscitation (CPR) experience is an important factor.
This study aimed to compare the effect of BLS training, based on trainer
experience in actual situations, on knowledge and skills of secondary high
school students.
MATERIALS AND METHODS: In this randomized controlled trial, 150 high school
students were selected based on the inclusion criteria and then assigned into
two groups, (76 in Group A), and (74 in Group B) randomly. Both groups were
trained according to adult BLS: 2020 American Heart Association guidelines on
mannequins in three 60 min in-person training sessions. The knowledge and skill
scores were measured for both groups before, immediately, and 1 month after
intervention by a questionnaire. Data were analyzed by the SPSS software version
22, using Chi-square, Mann-Whitney U, repeated-measure ANOVA tests, and
statistically modeling at a significance level of 0.05.
RESULTS: There were no significant differences between groups regarding
demographic characteristics. The knowledge and skill scores in both groups
increased significantly compared to baseline immediately and 1 month after the
intervention (P = 0.001). However, there was no significant difference in
knowledge scores between groups (P = 0.076(. However, at the immediacy and 1
month after the intervention, the skill score in "Group A" was significantly
higher than the "Group B" (P = 0.001).
CONCLUSIONS: The trainer's experience of CPR in the actual setting in the
transfer of BLS knowledge is not important, but it improved Student's BSL skill
acquisition score.

Copyright: © 2022 Journal of Education and Health Promotion.

DOI: 10.4103/jehp.jehp_1011_21
PMCID: PMC9277763
PMID: 35847145

Conflict of interest statement: There are no conflicts of interest.

72. BMJ Open. 2017 Jan 6;7(1):e011436. doi: 10.1136/bmjopen-2016-011436.

Basic life support education in secondary schools: a cross-sectional survey in

London, UK.

Salciccioli JD(1), Marshall DC(1), Sykes M(1), Wood AD(1), Joppa SA(1), Sinha
M(1), Lim PB(2).

Author information:
(1)Imperial College London, London, UK.
(2)Department of Cardiology, Hammersmith Hospital, London UK.

OBJECTIVES: Basic life support (BLS) training in schools is associated with

improved outcomes from cardiac arrest. International consensus statements have
recommended universal BLS training for school-aged children. The current
practice of BLS training in London schools is unknown. The aim of this study was
to assess current practices of BLS training in London secondary schools.
SETTING, POPULATION AND OUTCOMES: A prospective audit of BLS training in London
secondary schools was conducted. Schools were contacted by email, and a
subsequent telephone interview was conducted with staff familiar with local
training practices. Response data were anonymised and captured electronically.
Universal training was defined as any programme which delivers BLS training to
all students in the school. Descriptive statistics were used to summarise the
results.
RESULTS: A total of 65 schools completed the survey covering an estimated
student population of 65 396 across 19 of 32 London boroughs. There were 5 (8%)
schools that provide universal training programmes for students and an
additional 31 (48%) offering training as part of an extracurricular programme or
chosen module. An automated external defibrillator (AED) was available in 18
(28%) schools, unavailable in 40 (61%) and 7 (11%) reported their AED provision
as unknown. The most common reasons for not having a universal BLS training
programme are the requirement for additional class time (28%) and that funding
is unavailable for such a programme (28%). There were 5 students who died from
sudden cardiac arrest over the period of the past 10 years.
CONCLUSIONS: BLS training rates in London secondary schools are low, and the
majority of schools do not have an AED available in case of emergency. These
data highlight an opportunity to improve BLS training and AEDs provision. Future
studies should assess programmes which are cost-effective and do not require
significant amounts of additional class time.

Published by the BMJ Publishing Group Limited. For permission to use (where not
already granted under a licence) please go to
http://www.bmj.com/company/products-services/rights-and-licensing/.

DOI: 10.1136/bmjopen-2016-011436
PMCID: PMC5223627
PMID: 28062467 [Indexed for MEDLINE]

Conflict of interest statement: Conflicts of Interest: None declared.

73. Resuscitation. 2015 Aug;93:58-62. doi: 10.1016/j.resuscitation.2015.05.028.

Epub
2015 Jun 6.

Structured training in assessment increases confidence amongst basic life

support instructors.

Thorne CJ(1), Jones CM(2), Coffin NJ(3), Hulme J(4), Owen A(2).

Author information:
(1)Resuscitation for Medical Disciplines Research Group, The Medical School,
University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom; Heart
of England NHS Foundation Trust, Bordesley Green East, Birmingham B9 5SS, United
Kingdom. Electronic address: [email protected].
(2)Resuscitation for Medical Disciplines Research Group, The Medical School,
University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom; Queen
Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation
Trust, Birmingham B15 2WB, United Kingdom.
(3)Resuscitation for Medical Disciplines Research Group, The Medical School,
University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom.
(4)Resuscitation for Medical Disciplines Research Group, The Medical School,
University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom;
Sandwell and West Birmingham Hospitals NHS Trust, Birmingham City Hospital,
Dudley Road, Birmingham B18 7QH, United Kingdom.

AIM: Assessment skills are often neglected in resuscitation training and it has
been shown that the ERC BLS/AED instructor course may be insufficient to prepare
candidates for an assessment role. We have introduced an Assessment Training
Programme (ATP) to improve assessors' decision making. In this article we
present our ATP and an observational study of candidates' confidence levels upon
completing both an ERC BLS/AED instructor course and our ATP.
METHODS: Forty-seven candidates undertook the ERC instructor course and 20
qualified ERC BLS/AED instructors undertook the ATP. Pre- and post-course
questionnaires were completed. Confidence was assessed on ten-point Visual
Analogue Scales (VAS).
RESULTS: Overall confidence on the ERC BLS/AED instructor course rose from 5.9
(SD 1.8) to 8.7 (SD 1.4) (P < 0.001). A more modest improvement was witnessed on
the ATP, rising from 8.2 (SD 1.4) to 9.6 (SD 0.5) (P < 0.001). Upon completion
of their respective courses, assessors (mean 9.6, SD 0.5) were significantly
more confident at assessing than instructors (mean 8.7, SD 0.5) (P<0.001).
Confidence in assessing individual algorithm components was similar on both
courses. On the post-course questionnaire those on the ATP remained
significantly more confident at assessing borderline candidates compared to
instructors (P < 0.001), with no difference for clear pass (P = 0.067) or clear
fail (P = 0.060) candidates.
CONCLUSION: The ATP raises the confidence of assessing BLS/AED candidates to a
level above that of the ERC instructor course alone. We advocate that
resuscitation organisations consider integrating an ATP into their existing
training structure.

Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.resuscitation.2015.05.028
PMID: 26054546 [Indexed for MEDLINE]

74. Ann Med Surg (Lond). 2022 Sep 22;82:104588. doi: 10.1016/j.amsu.2022.104588.
eCollection 2022 Oct.

Knowledge, attitude, and practice towards basic life support among graduating
class health science and medical students at Dilla University; a cross sectional
study.

Tadesse M(1), Assen Seid S(1), Getachew H(1), Ali SA(1).

Author information:
(1)Department of Anesthesiology, Dilla University,College of Medicine and Health
Science, Dilla, Ethiopia.

INTRODUCTION: Basic Life Support is a level of medical care Applied to victims

of life-threatening illnesses and injuries before professional help is provided.
This study aimed to assess the knowledge, attitude, and practice toward Basic
Life support in Graduating class of health science and medical students at Dilla
university referral hospital.
METHOD: ology: A cross-sectional study was conducted on graduating class
students of Dilla University, college of medicine and health science from
September 10/2021 to December 13/2021. A total of 167 participants were selected
by a systematic random sampling technique. A bi-variable and multi-variable
logistic regression analysis were carried out.
RESULT: Among the study participants, 95 (56.9%) and 86(51.5%) have good
knowledge and good practice towards basic life support respectively. Being
trained for basic life support and advanced life support, exposure with the
person in need of basic life support were found more knowledgeable with odd
ratio of [AOR = 13.8, 95% CI (6.3-30.1)], [AOR = 27.7, 95% CI (6.4-119)] and
[AOR = 15.7, 95% CI (6.6-37.5)]. Learning anesthesia increases knowledge about
basic life support nearly two times [AOR = 1.8, 95% CI (o.4-9.5)] when compared
to medicine.
CONCLUSION: The findings of this study suggest that nearly half of health
science students in our hospital lack adequate knowledge and skills in BLS.
Training on basic life support and advanced life support, learning in anesthesia
and medicine departments, and exposure to the person in need of basic life
support were significantly associated with high knowledge. To increase knowledge
of BLS standardized Training and assessments are recommended.

© 2022 The Authors.

DOI: 10.1016/j.amsu.2022.104588
PMCID: PMC9577529
PMID: 36268360

75. Teach Learn Med. 2001 Fall;13(4):240-6. doi: 10.1207/S15328015TLM1304_05.

First aid and basic life support skills training early in the medical
curriculum: curriculum issues, outcomes, and confidence of students.

Das M(1), Elzubeir M.

Author information:
(1)Medical Education Department, United Arab Emirates University, Al Ain, United
Arab Emirates. [email protected]

BACKGROUND: The importance of training physicians and other health care

professionals in first aid and basic life support (BLS) is now widely
recognized. The Faculty of Medicine and Health Sciences of the United Arab
Emirates University have been offering formal training in these skills to
1st-year medical students since 1989. The aim of this study was to determine the
efficacy of the program and the extent to which it provides students with
confidence to perform skills on their own after training.
DESCRIPTION: 165 of 180 male and female students comprising 3 cohorts (91.7%
response rate) completed a self-administered anonymous questionnaire. The
questionnaire contained open- ended and Likert-type questions regarding course
organization, content, strengths and weaknesses, teaching--learning approaches,
and skills development and confidence. The authors analyzed assessment outcomes
and associations between self-perceived levels of confidence and ability to
practice.
EVALUATION: Students were uniformly enthusiastic and highly motivated by the
program. Self-assessed confidence in ability to perform skills on their own
after completing the program was moderately correlated with perceived frequency
of opportunity to practice many skills. There was nevertheless a consistent
desire for more practice time.
CONCLUSIONS: The results suggest that the program provides students with sound
basic knowledge and adequate practical skills in first aid and BLS and that
adequacy of time and physical and human resources are important prerequisites to
facilitate practice and engender confidence in skills.

DOI: 10.1207/S15328015TLM1304_05
PMID: 11727390 [Indexed for MEDLINE]

76. Med Teach. 2006 Mar;28(2):e49-58. doi: 10.1080/01421590600617657.

Basic life support skills training in a first year medical curriculum: six
years' experience with two cognitive-constructivist designs.

Durak HI(1), Certuğ A, Calişkan A, van Dalen J.

Author information:
(1)Ege University Faculty of Medicine, Turkey. [email protected]

RATIONALE: Although the Basic Life Support (BLS) ability of a medical student is
a crucial competence, poor BLS training programs have been documented worldwide.
Better training designs are needed. This study aims to share detailed
descriptions and the test results of two cognitive-constructivist training
models for the BLS skills in the first year of medical curriculum.
METHOD: A BLS skills training module was implemented in the first year
curriculum in the course of 6 years (1997-2003). The content was derived from
the European Resuscitation Council Guidelines. Initially, a competence-based
model was used and was upgraded to a cognitive apprenticeship model in 2000. The
main performance-content type that was expected at the end of the course was:
competent application of BLS procedures on manikins and peers at an OSCE as well
as 60% achievement in a test consisting of 25 MCQ items. A retrospective cohort
survey design using exam results and a self-completed anonymous student ratings'
questionnaire were used in order to test models.
RESULTS: Training time for individual students varied from 21 to 29 hours. One
thousand seven hundred and sixty students were trained. Fail rates were very low
(1.0-2.2%). The students were highly satisfied with the module during the 6
years.
CONCLUSION: In the first year of the medical curriculum, a competence-based or
cognitive apprenticeship model using cognitive-constructivist designs of skills
training with 9 hours theoretical and 12-20 hours long practical sessions took
place in groups of 12-17 students; medical students reached a degree of
competence to sufficiently perform BLS skills on the manikins and their peers.
The cognitive-constructivist designs for skills training are associated with
high student satisfaction. However, the lack of controls limits the
extrapolation of this conclusion.

DOI: 10.1080/01421590600617657
PMID: 16707285 [Indexed for MEDLINE]

77. Australas Emerg Care. 2023 Dec;26(4):303-307. doi: 10.1016/j.auec.2023.03.003.

Epub 2023 Mar 22.

Factors associated with willingness to perform basic life support in the

community setting in Yogyakarta, Indonesia.

Kusumawati HI(1), Sutono(2), Alim S(2), Achmad BF(2), Putri AF(3).

Author information:
(1)Department of Nursing, Faculty of Medicine, Public Health and Nursing,
Universitas Gadjah Mada, Indonesia. Electronic address:
[email protected].
(2)Department of Nursing, Faculty of Medicine, Public Health and Nursing,
Universitas Gadjah Mada, Indonesia.
(3)Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

BACKGROUND: Cardiac arrest is one of the fatal medical emergencies which need to
be treated immediately. Poor survival rates in the community settings are common
because of limited and ineffective bystander basic life support (BLS). This
study aimed to identify factors that are associated with the willingness to
perform BLS in communities in Yogyakarta, Indonesia METHODS: A descriptive study
was conducted with a cross-sectional design. Participants (n = 251) were
enrolled from the general population consisting of teachers, security personnel,
and police officers recruited through cluster random sampling. Data were
gathered using both digital or printed questionnaires. Ordinal logistic
regression with adjusted odds ratio (AOR) was used to analyze the association
between BLS predictors and willingness to perform BLS.
RESULTS: Most participants were willing to perform BLS for all genders (55.55%).
The inability to perform BLS and fear of causing harm were the main barriers to
performing BLS accounting for 61.35% and 43.82%, respectively. Compared to other
independent predictors, ages 40-59 were found to be the highest predictors of
willingness to perform BLS (AOR:1.44) followed by experience of seeing real or
simulation of the emergency case (AOR:1.38) CONCLUSIONS: More than half of the
respondents were eager to perform BLS although some barriers were also found.
This study provides some understanding of the predictor factors associated with
BLS performance and shows respondents with some training or experience were more
likely to perform BLS. The results inform policymakers to develop a strategic
plan for increasing willingness to apply BLS in the community. WC:250.

Copyright © 2023 College of Emergency Nursing Australasia. Published by Elsevier

Ltd. All rights reserved.

DOI: 10.1016/j.auec.2023.03.003
PMID: 36964023 [Indexed for MEDLINE]

Conflict of interest statement: Conflict of Interest No competing interests

declared.

78. Cureus. 2021 Oct 20;13(10):e18932. doi: 10.7759/cureus.18932. eCollection 2021

Oct.

Evaluation of Basic Life Support First Responder Naloxone Administration

Protocol Adherence.

Mastenbrook J(1), Emrick D(2), Bauler LD(3), Markman J(4), Koedam T(1), Fales
W(1).

Author information:
(1)Emergency Medicine, Western Michigan University Homer Stryker MD School of
Medicine, Kalamazoo, USA.
(2)Student Affairs, Western Michigan University Homer Stryker MD School of
Medicine, Kalamazoo, USA.
(3)Biomedical Sciences, Western Michigan University Homer Stryker MD School of
Medicine, Kalamazoo, USA.
(4)General Surgery, Mount Carmel Graduate Medical Education, Grove City, USA.

OBJECTIVES: Opioid overdoses have become a significant problem across the United
States resulting in respiratory depression and risk of death. Basic Life Support
(BLS) first responders have had the option to treat respiratory depression using
a bag-valve-mask device, however naloxone, an opioid antagonist, has been shown
to quickly restore normal respiration. Since the introduction of naloxone and
recent mandates across many states for BLS personnel to carry and administer
naloxone, investigation into the adherence of naloxone use standing protocols is
warranted.
METHODS: This preliminary study examined 100 initial cases of BLS first
responder administration of naloxone for appropriate indications and protocol
adherence.
RESULTS: This study found that n=22/100 naloxone administrations were
inappropriate, often given to patients who were not suffering from respiratory
depression (n=11/22). Positive pressure ventilation (PPV) was not administered
prior to naloxone in n=56/100 cases, of which n=42/100 had an inadequate
respiratory effort documented. For patients with a known history of substance
use disorder, there was a significant increase in administration of naloxone
prior to PPV (60%; n=33/55) compared to patients without a known history (30%;
n=9/30).
CONCLUSION: Overall these preliminary data suggest that during BLS naloxone
administration, the majority of cases did not follow at least one component of
the standard protocol for patients with respiratory depression. This study
suggests that further education and more research are needed to better
understand the decision-making processes of prehospital providers to ensure
adherence to standard protocols.

Copyright © 2021, Mastenbrook et al.

DOI: 10.7759/cureus.18932
PMCID: PMC8604552
PMID: 34812316

Conflict of interest statement: The authors have declared that no competing

interests exist.

79. Cureus. 2022 Nov 15;14(11):e31530. doi: 10.7759/cureus.31530. eCollection 2022

Nov.

Awareness, Knowledge, and Attitudes Regarding Basic Life Support Among the
Population With Relatives Suffering From Heart Diseases in the Al-Qassim Region,
Saudi Arabia.

Alrasheedi SM(1), Alrashdi MN(1), Almutairi KF(2), Alruways AF(3), Almutairi

IN(2), Alfehaid SN(4), Alrashdi OA(5), Alkhdairi A(1), Alrashidi AS(6), Aloraini
YN(7).

Author information:
(1)Department of Medicine, Unaizah College of Medicine and Medical Sciences,
Qassim University, Unaizah, SAU.
(2)Internal Medicine, Unaizah College of Medicine and Medical Sciences, Qassim
University, Unaizah, SAU.
(3)Department of Medicine, College of Medicine, Shaqra University, Dawadmi, SAU.
(4)Internal Medicine, College of Medicine, King Saud University, Riyadh, SAU.
(5)Primary Care Center, Qassim Health Cluster, Qassim, SAU.
(6)Otolaryngology, King Salman Bin Abdulaziz Medical City, Madinah Health
Cluster, Madinah, SAU.
(7)Department of Home Health Care, Bukairyyah General Hospital, Qassim Health
Cluster, Bukairyyah, SAU.

Background and objective Basic Life Support (BLS) is critical because it keeps
patients with life-threatening illnesses or injuries alive and maintains
viability until a team of paramedics or hospital staff can provide expert care.
There are many events that can result in serious injury and cause a person to
stop breathing. BLS awareness among the population who have relatives with heart
diseases greatly increases their confidence to act quickly when necessary and
reduces their level of hesitation. In this study, we aimed to evaluate the level
of clinical competence in the population who have relatives with heart diseases
for them to recognize and respond to individuals in need of BLS in the Qassim
region of Saudi Arabia. Methodology We conducted a quantitative, observational,
and analytical cross-sectional study to achieve our objective. The targeted
population involved only Saudis. The study was conducted electronically using
social network apps in the Al-Qassim region of Saudi Arabia. The questionnaire
evaluated if the subject had a family member with heart disease. Data collected
included sociodemographic characteristics and knowledge and awareness about BLS
as related to specific objectives. Results Of the 414 participants, 58.8% were
females; 33.3% were between the ages of 40-49 years, and 30.7% were between
18-29 years old. The prevalence of participants who reported participating
in cardiopulmonary resuscitation (CPR) training was 19.8%. The main reasons for
not participating in these training were a lack of knowledge about the courses
(60.5%), being too busy (16.2%), and thinking that they did not need them
(12.3%). Being younger than 29 years in age was one of the factors associated
with participating in CPR training [odds ratio (OR): 11.85, 95% confidence
interval (CI): 1.54-91.42, p=0.017] versus those aged over 59 years. Gender was
significantly associated with the rate of participation in CPR training: females
had significantly lower rates of participation than males (15.2% vs. 25.7%, OR:
0.52, 95% CI: 0.32-0.84, p=0.008). Of note, 25.5% of the participants had
adequate knowledge regarding CPR. Having trained in CPR was significantly
associated with a higher level of knowledge among the participants (1.82-fold)
(OR: 1.82, 95% CI: 1.08-3.06, p=0.023). Conclusion Based on our findings, there
is limited awareness and training related to CPR among people with relatives
suffering from cardiac diseases in the Qassim region of Saudi Arabia. This may
be associated with higher rates of morbidity and mortality related to heart
diseases in the region.

Copyright © 2022, Alrasheedi et al.

DOI: 10.7759/cureus.31530
PMCID: PMC9753406
PMID: 36532927

Conflict of interest statement: The authors have declared that no competing

interests exist.

80. Eur J Emerg Med. 2009 Dec;16(6):336-8. doi: 10.1097/MEJ.0b013e32832d048b.

First aid and basic life support training for first year medical students.

Altintaş KH(1), Yildiz AN, Aslan D, Ozvariş SB, Bilir N.

Author information:
(1)Department of Public Health, Faculty of Medicine, Hacettepe University,
Ankara, Turkey. [email protected]

We developed 24 and 12-h programs for first aid and basic life support (FA-BLS)
training for first-year medical students and evaluated the opinions of both the
trainers and trainees on the effectiveness of the programs. The trainees were
the first-year students of academic years 2000-2001 (316 students) and 2001-2002
(366 students). The evaluations of the participants were collected from short
questionnaires created specifically for the study. For the 24-h training
program, most of the students stated that FA-BLS sessions met their expectations
(85.9%) and they were satisfied with the training (91.1%). Of the participants,
75.6% stated that they could apply FA confidently in real situations simulating
the topics they learned in the FA-BLS sessions. For the 12-h training program,
84.4% of the students felt themselves competent in FA-BLS applications. The
trainers considered both of the programs as effective.

DOI: 10.1097/MEJ.0b013e32832d048b
PMID: 19491692 [Indexed for MEDLINE]

81. Resuscitation. 2007 Oct;75(1):169-75. doi: 10.1016/j.resuscitation.2007.03.009.

Epub 2007 May 4.

Teaching basic life support to school children using medical students and
teachers in a 'peer-training' model--results of the 'ABC for life' programme.

Toner P(1), Connolly M, Laverty L, McGrath P, Connolly D, McCluskey DR.

Author information:
(1)Craigavon Area Hospital, United Kingdom.

BACKGROUND: The 'ABC for life' programme was designed to facilitate the wider
dissemination of basic life support (BLS) skills and knowledge in the
population. A previous study demonstrated that using this programme 10-12-year
olds are capable of performing and retaining these vital skills when taught by
medical students. There are approximately 25,000 year 7 school children in 900
primary schools in Northern Ireland. By using a pyramidal teaching approach
involving medical students and teachers, there is the potential to train BLS to
all of these children each year.
AIMS: To assess the effectiveness of a programme of CPR instruction using a
three-tier training model in which medical students instruct primary school
teachers who then teach school children.
SETTINGS: School children and teachers in the Western Education and Library
Board in Northern Ireland.
METHODS: A course of instruction in cardiopulmonary resuscitation (CPR)--the
'ABC for life' programme--specifically designed to teach 10-12-year-old children
basic life support skills. Medical students taught teachers from the Western
Education and Library Board area of Northern Ireland how to teach basic life
support skills to year 7 pupils in their schools. Pupils were given a 22-point
questionnaire to assess knowledge of basic life support immediately before and
after a teacher led training session.
RESULTS: Children instructed in cardiopulmonary resuscitation using this
three-tier training had a significantly improved score following training (57.2%
and 77.7%, respectively, p<0.001).
CONCLUSION: This study demonstrates that primary school teachers, previously
trained by medical students, can teach BLS effectively to 10-12-year-old
children using the 'ABC for life' programme.

DOI: 10.1016/j.resuscitation.2007.03.009
PMID: 17482334 [Indexed for MEDLINE]

82. J Family Med Prim Care. 2020 Nov 30;9(11):5601-5605. doi:

10.4103/jfmpc.jfmpc_680_20. eCollection 2020 Nov.

How much ambulance personnel know about basic life support (BLS)? A
hospital-based study from Eastern India.

Hansda U(1), Sahoo S(1), Biswas S(2), Mohanty CR(1), Barik S(1), Giri PP(3).

Author information:
(1)Department of Trauma and Emergency, All India Institute of Medical Sciences,
Bhubaneswar, Odisha, India.
(2)Seventh Semester MBBS Student, All India Institute of Medical Sciences,
Bhubaneswar, Odisha, India.
(3)Department of Community Medicine and Family Medicine, All India Institute of
Medical Sciences, Bhubaneswar, Odisha, India.

BACKGROUND: Basic life support (BLS) is an important component of emergency

medical management. Ambulance personnel play a key role in resuscitation to save
a life before reaching the hospital. We do not have any published data about the
level of knowledge on BLS among the ambulance personnel.
OBJECTIVE: This study was done with the objective to assess the level of
knowledge on BLS among the ambulance personnel.
MATERIALS AND METHODS: A cross-sectional study was done in the emergency
department (ED) of a tertiary care hospital. Universal sampling was done taking
all the personnel of ambulances over the period of one month. Data were
collected about the type of vehicle used for ambulance, the number of personnel
in an ambulance, educational qualifications, and equipment present in their
ambulances. The questionnaire to capture the level of knowledge were based on
American Heart Association 2015 guidelines.
RESULT: The total number of ambulance arrivals was 729 times. But data analysis
was done from 104 ambulances excluding the repeat arrivals and those who did not
give consent. There were 62 type-C and D ambulances, and 42 were type-B
ambulances. Total of 210 personnel were there in 104 ambulances. Seventy-nine
team leaders did not have any paramedical degrees. Fifty-eight team leaders were
trained in BLS before working in an ambulance. In spite of this, 66 (63%) team
leaders had poor performance (score of 0 to 4).
CONCLUSION: The level of knowledge on BLS was poor in more than half of the
ambulance personnel. They should be trained regularly on providing BLS.

Copyright: © 2020 Journal of Family Medicine and Primary Care.

DOI: 10.4103/jfmpc.jfmpc_680_20
PMCID: PMC7842495
PMID: 33532402

Conflict of interest statement: There are no conflicts of interest.

83. Med Educ Online. 2014 Nov 6;19:24841. doi: 10.3402/meo.v19.24841. eCollection
2014.

Retention of first aid and basic life support skills in undergraduate medical
students.

de Ruijter PA(1), Biersteker HA(2), Biert J(3), van Goor H(3), Tan EC(3).

Author information:
(1)Institute for Scientific Education and Research, Radboud University Medical
Center, Nijmegen The Netherlands; [email protected].
(2)Institute for Scientific Education and Research, Radboud University Medical
Center, Nijmegen The Netherlands.
(3)Department of Surgery - Traumasurgery, Radboud University Medical Center,
Nijmegen, The Netherlands.

BACKGROUND: Undergraduate medical students follow a compulsory first aid (FA)

and basic life support (BLS) course. Retention of BLS seems poor and only little
information is provided on the retention of FA skills. This study aims at
evaluating 1- and 2-year retention of FA and BLS training in undergraduate
medical students.
METHODS: One hundred and twenty students were randomly selected from first year
(n=349) medical students who successfully followed a compulsory FA and BLS
course. From these 120 students, 94 (78%) and 69 (58%) participated in retention
tests of FA and BLS skills after 1 and 2 years, respectively. The assessment
consisted of two FA stations and one BLS station.
RESULTS: After 1 year, only 2% passed both FA and BLS stations and 68% failed
both FA and BLS stations. After 2 years, 5% passed and 50% failed both FA and
BLS stations. Despite the high failure rate at the stations, 90% adequately
checked vital signs and started cardiopulmonary resuscitation appropriately.
CONCLUSIONS: The long-term retention of FA and BLS skills after a compulsory
course in the first year is poor. Adequate check of vital signs and commencing
cardiopulmonary resuscitation retained longer.

DOI: 10.3402/meo.v19.24841
PMCID: PMC4224704
PMID: 25382803 [Indexed for MEDLINE]

84. BMC Nurs. 2023 Oct 20;22(1):398. doi: 10.1186/s12912-023-01552-x.

The effect of a simulation-based training program in basic life support on the

knowledge of Palestinian nurses: a quasi-experimental study in governmental
hospitals.

Fahajan Y(1), Emad OJ(2), Albelbeisi AH(3)(4), Albelbeisi A(5), Shnena YA(6),
Khader A(1), Kakemam E(7).

Author information:
(1)General Directorate of Nursing, Ministry of Health, Gaza, Palestine.
(2)General Directorate of Mental Health, Ministry of Health, Gaza, Palestine.
(3)Medical Services Directorate, Gaza Strip, Palestine.
(4)College of Health Professions, Israa University, Gaza, Palestine.
(5)Health Research Unit, Ministry of Health, Gaza, Palestine.
(6)Faculty of Nursing, Midwifery Department, Islamic University of Gaza, Gaza,
Palestine.
(7)Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz
University of Medical Sciences, Tabriz, Iran. [email protected].

BACKGROUND: Basic Life Support (BLS) plays an important role in increasing the
survival rate of hospitalized heart attack patients. There are no previous
studies on the effect of BLS training among Palestinian nurses. This study aimed
to evaluate the effect of simulation-based BLS training program on nurses'
knowledge Palestinian nurses at governmental hospitals.
METHODS: A quasi-experimental, pre & post-test design was used. 700 nurses were
recruited proportionally using a simple random sampling method among 2980 nurses
from 13 public hospitals in the Gaza Strip. This study was conducted from June
to August 2022. A practical BLS test consisting of 10 multiple-choice questions
according to American Heart Association guidelines (2020) was collected and
sociodemographic characteristics. SPSS software, version 24 was used for the
statistical analysis. Descriptive statistics and weighted mean were used. T-Test
and One-way analysis of variance (ANOVA) were applied to determine differences
in means among groups.
RESULTS: Most of the participating nurses (55.7%) were male, while (44.3%) were
female. The majority of nurses (84.4%) are under 40 years of age. The weighted
mean scores in the pre-test ranged from 52.2 to 75.1% and the mean scores was
(6.16 ± 1.97). After applying conventional BLS training, the weighted mean
scores ranged from 85.6 to 97.3% and the mean scores was (9.19 ± 1.04). The
study revealed that the nurses' knowledge increased after applying
simulation-based training program. The mean of knowledge scores was
statistically significant between the pre and post-test on the basis of the
current work hospital (P-value < 0.001).
CONCLUSION: This study affords significant evidence of the positive effects of
the BLS training program in improving nurses' knowledge; we recommend advanced
BLS training for all healthcare providers, doctors, and nurses working in
hospitals and healthcare centers. Nursing managers can implement systematic
strategies to enhance nurses' knowledge and practice in BLS to target
low-scoring Governorates.

© 2023. BioMed Central Ltd., part of Springer Nature.

DOI: 10.1186/s12912-023-01552-x
PMCID: PMC10588256
PMID: 37864224
Conflict of interest statement: The authors declare no competing interests.

85. BMC Health Serv Res. 2017 Sep 22;17(1):674. doi: 10.1186/s12913-017-2621-5.

Impact of basic life-support training on the attitudes of health-care workers

toward cardiopulmonary resuscitation and defibrillation.

Abolfotouh MA(1), Alnasser MA(2), Berhanu AN(2), Al-Turaif DA(3), Alfayez AI(4).

Author information:
(1)King Abdullah International Medical Research Center, King Saud bin-Abdulaziz
University for Health Sciences (KSBAU-HS), Riyadh, Saudi Arabia.
[email protected].
(2)Postgraduate Training Center, Deanship of postgraduate Education & Academic
Affairs, KSAU-HS, Riyadh, Saudi Arabia.
(3)King Abdullah International Medical Research Center, King Saud bin-Abdulaziz
University for Health Sciences (KSBAU-HS), Riyadh, Saudi Arabia.
(4)Postgraduate Education & Academic Affairs, KSAU-HS, Riyadh, Saudi Arabia.

BACKGROUND: Cardiopulmonary resuscitation (CPR) increases the probability of

survival of a person with cardiac arrest. Repeating training helps staff retain
knowledge in CPR and in use of automated external defibrillators (AEDs).
Retention of knowledge and skills during and after training in CPR is difficult
and requires systematic training with appropriate methodology. The aim of this
study was to determine the effect of basic life-support (BLS) training on the
attitudes of health-care providers toward initiating CPR and on use of AEDs, and
to investigate the factors that influence these attitudes.
METHODS: A quasi-experimental study was conducted in two groups: health-care
providers who had just attended a BLS-AED course (post-BLS group, n = 321), and
those who had not (pre-BLS group, n = 421). All participants had previously
received BLS training. Both groups were given a validated questionnaire to
evaluate the status of life-support education and certification, attitudes
toward use of CPR and AED and concerns regarding use of CPR and AED. Multiple
linear regression analyses were applied to identify significant predictors of
the attitude and concern scores.
RESULTS: Overall positive attitudes were seen in 53.4% of pre-BLS respondents
and 64.8% of post-BLS respondents (χ2 = 9.66, p = 0.002). Positive attitude was
significantly predicted by the recent completion of BLS training (β = 5.15,
p < 0.001), the number of previous BLS training courses (β = 2.10, p = 0.008)
and previous exposure to cardiac-arrest cases (β = 3.44, p = 0.018), as well as
by low concern scores, (β = -0.09, p < 0.001). Physicians had significantly
lower concern scores than nurses (β = -10.45, p = 0.001). Concern scores
decreased as the duration of work experience increased (t = 2.19, p = 0.029).
CONCLUSIONS: Repeated educational programs can improve attitudes toward CPR
performance and the use of AEDs. Training that addressed the concerns of
health-care workers could further improve these attitudes.

DOI: 10.1186/s12913-017-2621-5
PMCID: PMC5610457
PMID: 28938914 [Indexed for MEDLINE]

Conflict of interest statement: ETHICS APPROVAL AND CONSENT TO PARTICIPATE: This

study was approved by the institutional review board of the MNG-HA in Riyadh,
Saudi Arabia (Ref. # RC12/049). Participation in this study was voluntary. HCWs
were assured that their feedback would not affect their performance evaluations,
work status or salaries. No written consent was sought, as there were no
personal identifiers on the questionnaires, and this was approved by the IRB.
Submission of responses to the questionnaire was considered to constitute
implied consent. The voluntary nature of participating in the survey was made
explicit and unambiguous in the cover letter. The investigators did not coerce
or entice anyone to complete the questionnaire. Any participant could decline to
return the questionnaire. CONSENT FOR PUBLICATION: Not applicable. COMPETING
INTERESTS: The authors declare that they have no competing interests.
PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.

86. J Gen Fam Med. 2022 Apr 19;23(4):289-290. doi: 10.1002/jgf2.538. eCollection
2022 Jul.

Combined online and offline basic life support workshop with infection
prevention and control for COVID-19.

Ikeda A(1), Tochino Y(2), Nishihata T(1), Oku S(3), Shuto T(2).

Author information:
(1)Osaka City University School of Medicine Osaka Japan.
(2)Department of Medical Education and General Practice, Osaka City University
Graduate School of Medicine Osaka Japan.
(3)Skills Simulation Center Osaka City University Hospital Osaka Japan.

The coronavirus disease 2019 outbreak has made it difficult to hold face-to-face
BLS training sessions at university. Even in this limited situation, the
effective use of combined online video course and offline training can
contribute to gaining participants' confidence in conducting BLS and improving
mindset than before.

© 2022 The Authors. Journal of General and Family Medicine published by John
Wiley & Sons Australia, Ltd on behalf of Japan Primary Care Association.

DOI: 10.1002/jgf2.538
PMCID: PMC9110984
PMID: 35600906

Conflict of interest statement: None.

87. Niger Med J. 2022 Sep 12;63(4):304-311. doi: 10.60787/NMJ-63-4-77. eCollection

2022 Jul-Aug.

Knowledge of Basic Life Support among Doctors and Nurses Attending a Refresher
Course in a Teaching Hospital in Southwest Nigeria.

Akinbodewa A(1), Gbala M(2), Ige O(3), Akinkunmi F(4), Odanye A(1).

Author information:
(1)Department of Internal Medicine, University of Medical Sciences, Ondo State,
Nigeria.
(2)Department of Obstetrics and Gynaecology, University of Medical Sciences,
Ondo State, Nigeria.
(3)Department of Orthopaedics, University of Medical Sciences, Ondo State,
Nigeria.
(4)Department of Paediatrics, University of Medical Sciences, Ondo State,
Nigeria.

BACKGROUND: Poor knowledge of Basic Life Support (BLS) can lead to hesitation in
delivering prompt intervention, thus increasing mortality in people with cardiac
arrest. We set out to determine level of knowledge of Basic Life Support among
doctors and nurses working in a teaching hospital in Nigeria.
METHODOLOGY: Self-administered questionnaires were employed in a descriptive,
cross-sectional study to assess knowledge of doctors and nurses. The overall
knowledge score and, separate scores for doctors and nurses were calculated.
Data was analyzed using IBM SPSS version 20.
RESULTS: Two hundred and fifty participants (18-59) years were evaluated. There
were more females (153, 61.2%) and more nurses (149, 59.8%). Sixty (24%) of the
participants had received at least one previous BLS training. One hundred and
one (40.4%) participants scored ≥50%. The overall average score was 43.6%. The
average score for doctors and nurses were 45.1% and 42.7% respectively.
Knowledge in some domains were very low viz: sequence in cardiopulmonary
resuscitation (2.8%), compression-to-breath ratio (2.8%) and compression rate
(32.3%). There was no significant difference in knowledge score by profession,
gender, previous exposure to BLS training, number of years post-qualified and
number of years in service.
CONCLUSION: Healthcare workers in Nigeria have poor knowledge of BLS. They
require training and re-training in BLS via creative and innovative means that
are best suited for resource poor countries.

Copyright © 2022 Nigerian Medical Association.

DOI: 10.60787/NMJ-63-4-77
PMCID: PMC11163263
PMID: 38863472

Conflict of interest statement: The authors declare no conflict of interest.

88. Resuscitation. 2007 Jul;74(1):158-65. doi: 10.1016/j.resuscitation.2006.11.017.

Epub 2007 Mar 13.

Medical students teaching basic life support to school children as a required

element of medical education: a randomised controlled study comparing three
different approaches to fifth year medical training in emergency medicine.

Breckwoldt J(1), Beetz D, Schnitzer L, Waskow C, Arntz HR, Weimann J.

Author information:
(1)Department of Anaesthesiology and Perioperative Intensive Care Medicine,
Berlin, Germany. [email protected]

Comment in
Resuscitation. 2007 Sep;74(3):572-3. doi:
10.1016/j.resuscitation.2007.04.023.

OBJECTIVES: Basic life support (BLS) by doctors has been shown to be of poor
quality. To improve medical education training should be simplified, and
simultaneously the learner should be involved more actively. To combine both
ideas we trained medical students to give BLS courses and sent them to teach
school children. This was a requirement for their emergency medicine course. Our
model was compared to conventional teaching.
DESIGN: Medical students were assigned at random to one of three groups. Group 1
("university") attended a conventional university BLS/ALS course. Group 2
("EMS") accompanied a BLS vehicle of the emergency medical service (EMS) after
suitable preparation. Group 3 ("school") was instructed to teach BLS and then
sent to teach at schools.
MAIN OUTCOME MEASURES: Clinically significant BLS skills, and overall BLS
skills, each assessed by structured clinical examination (SCE). Theoretical
knowledge assessed by written (open question) test.
RESULTS: Clinically relevant mistakes were seen in 37.5% in group 1
("university"), compared to 28.8% in group 2 ("EMS"), and 11.3% in group 3
("school"). Highly significant differences were shown between "school" and "EMS"
(p=0.011), and between "school" and "university" (p<0.001). In practical testing
for overall performance the "university" group reached a median of 78.8%
(25th-75th percentile 69.2-84.6%), group "EMS" reached 76.9% (69.2-88.5%), and
group "school" 84.6% (76.9-90.0). Group "school" showed significant advantages
over "university" (p=0.015) and "EMS" (p=0.010). Written test results did not
differ statistically.
CONCLUSION: Medical students teaching BLS to school children as a compulsory
element of their own medical training showed superior practical skills as
compared to conventional teaching. Theoretical knowledge was equivalent to the
control groups, although their course contained less theoretical information.

DOI: 10.1016/j.resuscitation.2006.11.017
PMID: 17360095 [Indexed for MEDLINE]

89. Resuscitation. 2019 Jan;134:127-132. doi: 10.1016/j.resuscitation.2018.11.008.

Epub 2018 Nov 11.

Cost minimization analysis for basic life support.

Castillo J(1), Gomar C(2), Rodriguez E(3), Trapero M(4), Gallart A(5).

Author information:
(1)Universitat Internacional de Catalunya (UIC), C/ JosepTrueta s/n. 08195 St.
Cugat del Vallès, Barcelona, Spain; Hospital de Bellvitge, C/ JosepTrueta s/n.
08195 St. Cugat del Vallès, Barcelona, Spain. Electronic address:
[email protected].
(2)Universitat de Barcelona, Spain; Department Anesthesia and Intensive Care,
Hospital Clinic de Barcelona, Spain. Electronic address: [email protected].
(3)UIC and Health Sciences, C/ JosepTrueta s/n. 08195 St. Cugat del Vallès,
Barcelona, Spain. Electronic address: [email protected].
(4)Universitat Internacional de Catalunya (UIC), Research Institute for
Evaluation and Public Policies (IRAPP) at UIC, C/ Immaculada 22. 08017,
Barcelona, Spain. Electronic address: [email protected].
(5)UIC and Health Sciences, C/ JosepTrueta s/n. 08195 St. Cugat del Vallès,
Barcelona, Spain. Electronic address: [email protected].

BACKGROUND: The use of online teaching methodology for basic life support (BLS)
courses is progressively increasing.
OBJECTIVE: The objective of this study was to verify whether the
blended-learning methodology (virtual course with a short face-to-face
complement) was more efficient than a course that followed the classical or
face-to-face methodology in our university.
MATERIALS AND METHODS: A cost minimization analysis was performed for two BLS
and automatic external defibrillation (AED) courses, one of which was conducted
face-to-face (Control Group) and the second of which was conducted via
blended-learning (Experimental Group). The courses had the same duration and
content according to the European Resuscitation Council (ERC) recommendations.
In the face-to-face course, direct costs were considered those generated by the
faculty and derived from the academic activity. Other costs were those generated
by the use of classrooms and the amortization of manikins and AED training. The
perspective of the analysis was that of the provider, the academic, and a time
horizon of six months. The costs are expressed in € 2017.
RESULTS: The savings of a course in BLS-AED based on the blended-learning
methodology calculated for a total of 160 university nursing and medical
students were € 2328.8 for the first year of its implementation and € 9048.8 for
its second edition compared with the same course using a face-to-face
methodology.
CONCLUSIONS: The blended-learning methodology supposes a cost savings for
BLS-AED courses, mainly due to the reduction of expenses of the teaching staff.
The blended-learning methodology seems to be more efficient than the
face-to-face methodology.

Copyright © 2018 Elsevier B.V. All rights reserved.

DOI: 10.1016/j.resuscitation.2018.11.008
PMID: 30428308 [Indexed for MEDLINE]

90. Open Access Emerg Med. 2023 Jun 15;15:241-252. doi: 10.2147/OAEM.S405397.
eCollection 2023.

Geographical Association Between Basic Life Support Courses and Bystander

Cardiopulmonary Resuscitation and Survival from OHCA in Denmark.

Jensen TW(1)(2)(3), Ersbøll AK(3)(4), Folke F(2)(3)(5), Andersen MP(6), Blomberg

SN(1)(2)(3), Holgersen MG(2)(7), Andersen LB(1), Lippert F(2)(3), Torp-Pedersen
C(6)(8), Christensen HC(1)(2)(9).

Author information:
(1)Emergency Medical Services Region Zealand, Naestved, Denmark.
(2)Department of Clinical Medicine, University of Copenhagen, Copenhagen,
Denmark.
(3)Copenhagen Emergency Medical Services, University of Copenhagen, Copenhagen,
Denmark.
(4)National Institute of Public Health, University of Southern Denmark,
Copenhagen, Denmark.
(5)Department of Cardiology, Herlev Gentofte University Hospital, Gentofte,
Denmark.
(6)Department of Cardiology, Nordsjaellands Hospital, Hilleroed, Denmark.
(7)Paediatric Pulmonary Service, Department of Paediatrics and Adolescent
Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
(8)Aalborg University Hospital, Aalborg & Department of Clinical Medicine,
University of Copenhagen, Copenhagen, Denmark.
(9)Danish Clinical Quality Program (RKKP), National Clinical Registries &
Department of Clinical Medicine, Copenhagen, Denmark.

INTRODUCTION: Annually, approximately 4% of the entire adult population of

Denmark participate in certified basic life support (BLS) courses. It is still
unknown whether increases in BLS course participation in a geographical area
increase bystander cardiopulmonary resuscitation (CPR) or survival from
out-of-hospital cardiac arrest (OHCA). The aim of the study was to examine the
geographical association between BLS course participation, bystander CPR, and
30-day survival from OHCA.
METHODS: This nationwide register-based cohort study includes all OHCAs from the
Danish Cardiac Arrest Register. Data concerning BLS course participation were
supplied by the major Danish BLS course providers. A total of 704,234
individuals with BLS course certificates and 15,097 OHCA were included from the
period 2016-2019. Associations were examined using logistic regression and
Bayesian conditional autoregressive analyses conducted at municipality level.
RESULTS: A 5% increase in BLS course certificates at municipality level was
significantly associated with an increased likelihood of bystander CPR prior to
ambulance arrival with an adjusted odds ratio (OR) of 1.34 (credible intervals:
1.02;1.76). The same trends were observed for OHCAs in out-of-office hours
(4pm-08am) with a significant OR of 1.43 (credible intervals: 1.09;1.89). Local
clusters with low rate of BLS course participation and bystander CPR were
identified.
CONCLUSION: This study found a positive effect of mass education in BLS on
bystander CPR rates. Even a 5% increase in BLS course participation at municipal
level significantly increased the likelihood of bystander CPR. The effect was
even more profound in out-of-office hours with an increase in bystander CPR rate
at OHCA.

© 2023 Jensen et al.

DOI: 10.2147/OAEM.S405397
PMCID: PMC10278866
PMID: 37342237

Conflict of interest statement: Professor Christian Torp-Pedersen reports grants

from Novo Nordisk and grants from Bayer, outside the submitted work. The authors
report no other conflicts of interest in this work

91. J Emerg Trauma Shock. 2014 Jul;7(3):166-9. doi: 10.4103/0974-2700.136857.

Awareness about basic life support and emergency medical services and its
associated factors among students in a tertiary care hospital in South India.

Aroor AR(1), Saya RP(2), Attar NR(1), Saya GK(3), Ravinanthanan M(4).

Author information:
(1)Department of Medicine, Kawdoor Sadananda Hegde Medical Academy, Mangalore,
Karnataka, India.
(2)Department of Emergency Medicine, Jawaharlal Institute of Postgraduate
Medical Education and Research, Puducherry, Tamil Nadu, India.
(3)Department of Preventive and Social Medicine, Jawaharlal Institute of
Postgraduate Medical Education and Research, Puducherry, Tamil Nadu, India.
(4)Reader and Research Scholar, Department of Endodontics and Conservative
Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidhyapeeth
University, Puducherry, Tamil Nadu, India.

BACKGROUND: The knowledge and skills about the basic life support (BLS) and the
advanced life support are the most important determining factors of the
cardiopulmonary resuscitation (CPR) success rates.
OBJECTIVES: To determine the level of awareness on BLS and skills among
undergraduate and postgraduate students of medical and dental profession, as
well as nursing students and interns in a tertiary care hospital.
MATERIALS AND METHODS: This descriptive cross-sectional study was conducted in a
tertiary care hospital in South India. The awareness level on BLS and factors
associated which include age, sex, level of training (undergraduate, internship,
and postgraduate groups), course of study (nursing, dental, and medical groups),
and previous exposure to BLS were assessed by using a structured questionnaire.
The association of these variables with awareness level was assessed by
independent t test, analysis of variance, and linear regression analysis.
RESULTS: Among 520 study subjects, 229 were students, 171 were interns, and 120
were postgraduate students. The overall mean score of awareness was 4.16 ± 1.40
(score range: 0-10). Age, sex, level of training, course of study, and previous
exposure to BLS were significantly associated with awareness level in univariate
analysis (P < 0.05). Linear regression model also showed that all the above
variables were significantly associated with awareness level (P < 0.05). About
322 (61.9%) subjects attributed lack of awareness about BLS to lack of available
professional training. About 479 (92.1%) responded that BLS training should be a
part of medical curriculum.
CONCLUSION: Awareness level on BLS is below average indicating the importance of
professional training at all levels in a tertiary care health institution.

DOI: 10.4103/0974-2700.136857
PMCID: PMC4126115
PMID: 25114425

Conflict of interest statement: Conflict of Interest: None declared.

92. Teach Learn Med. 2010 Apr;22(2):112-5. doi: 10.1080/10401331003656538.

First aid and basic life support: a questionnaire survey of medical schools in
the Netherlands.

Tan EC(1), Hekkert KD, van Vugt AB, Biert J.

Author information:
(1)Department of Surgery-Division of Trauma Surgery, Radboud University Nijmegen
Medical Centre, Nijmegen, The Netherlands. [email protected]

PURPOSE: Adequate education in first aid and basic life support (BLS) should be
considered as an essential aspect of the medical curriculum. The objective of
this study was to investigate the current medical training in first aid and BLS
at all 8 medical schools in the Netherlands.
SUMMARY: An evaluation was made, by sending a questionnaire to all medical
schools, regarding whether the medical training was performed in accordance with
the national Dutch guidelines for medical education. The response was 100%.
Seven of the eight medical schools train their students in first aid and BLS
during the medical curriculum. An average of only 38% of the clinical pictures
and diseases and 69% of the skills were mastered at the level-defined national
Dutch guidelines.
CONCLUSION: The medical education in the Netherlands does not meet the required
objectives as stated in the national Dutch guidelines concerning first aid and
BLS.

DOI: 10.1080/10401331003656538
PMID: 20614376 [Indexed for MEDLINE]

93. Emerg Med Int. 2019 Mar 3;2019:9342892. doi: 10.1155/2019/9342892. eCollection
2019.

Knowledge and Attitude about Basic Life Support and Emergency Medical Services
amongst Healthcare Interns in University Hospitals: A Cross-Sectional Study.

Saquib SA(1), Al-Harthi HM(2), Khoshhal AA(3), Shaher AA(2), Al-Shammari AB(4),
Khan A(5), Al-Qahtani TA(2), Khalid I(5).

Author information:
(1)Assistant Professor, Department of Periodontics and Community Dental
Sciences, Research Center for Advanced Materials Sciences, King Khalid
University, College of Dentistry, Abha, Saudi Arabia.
(2)Resident, King Khalid University, College of Dentistry, Abha, Saudi Arabia.
(3)Demnstrator, Department of Endodontics, Hail University, Saudi Arabia.
(4)Demnstrator, Department of Oral and Maxillofacial Surgery, Hail University,
Saudi Arabia.
(5)Assistant professor, Department of Oral and Maxillofacial Surgery, King
Khalid University, College of Dentistry, Abha, Saudi Arabia.

BACKGROUND: Road traffic accident and sudden cardiac arrest are one of the most
leading causes of death in KSA. Basic life support (BLS) is lifesaving
intervention as a premedical facility. Adequate knowledge and awareness about
BLS and CPR are mandatory for healthcare students.
OBJECTIVE: The objective of the present study is to assess the knowledge,
awareness and attitude towards BLS among healthcare interns in different
university hospitals across Saudi Arabia. Materials and Methods. A total of 865
health interns attending the health colleges (Medicine, Dentistry, Nursing,
Pharmacy) in the University Hospitals across KSA participated in the study. A
self-explanatory questionnaire, comprising of 15 questions, was designed for the
study. All the hypotheses were formulated using two-tailed alternatives against
each null hypothesis.
RESULT: Out of 865 subjects, 698 completed the survey with a response rate of
(80.69%). The male to female sex ratio in the entire group of respondents was
1.44:1.00. Mean score about the awareness and knowledge of BLS and other
emergency services among the participants was 2.74±1.02 and 4.02±1.56
respectively. Female participants revealed significantly higher awareness score
than male (P-value<0.05). Medical interns showed higher awareness level compared
to rest of all the faculty interns (P-value<0.01). There was no significant
difference in the attitude of interns among the different faculties. 60 to 70%
of interns had recommended to include BLS training in the university curriculum.
CONCLUSION: Among the participants of the study, overall awareness score was
average, whereas the knowledge score was below average. Further, the
participants showed a positive attitude toward BLS training. An optimistic
decision should be considered on the inclusion of Basic Life Support procedures
in the university curriculum.

DOI: 10.1155/2019/9342892
PMCID: PMC6420992
PMID: 30941220

94. Turk J Pediatr. 2018;60(6):702-708. doi: 10.24953/turkjped.2018.06.011.

Evaluating the basic life support knowledge among schoolteachers: A

cross-sectional survey in Kayseri, Turkey.

Dursun A(1), Özsoylu S(1), Emeklioğlu B(2), Akyıldız BN(1).

Author information:
(1)Intensive Care Unit, Erciyes University Faculty of Medicine, Kayseri, Turkey.
(2)Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri,
Turkey.

Dursun A, Özsoylu S, Emeklioğlu B, Akyıldız BN. Evaluating the basic life

support knowledge among schoolteachers: A cross-sectional survey in Kayseri,
Turkey. Turk J Pediatr 2018; 60: 702-708. Children spend a significant
proportion of their day in school when they are not with their
families.Therefore they might experience medical emergency situations due to
injuries, complications of chronic health conditions, or unexpected major
illnesses that occur in school. In cases of emergencies, school teachers are
expected to play a key role in performing basic life support (BLS) on school
children. Very limited data are present in the literature that address the
knowledge of the schoolteacher regarding BLS. The primary objective of this
study was to asses the BLS knowledge, training status and attitude towards
pediatric BLS among schoolteachers. The study had a cross-sectional research
design and was conducted between January and March 2017. A self administered
questionnaire was used for data collection to assess the knowledge of teachers.
The questionnaires were filled in by 541 teachers (243 male and 298 women). The
median age of the study population was 39 (34-45) years. One-third of the
respondents reported having taken a BLS class in the past (33.1%). The mean for
the correct answers for the study population was 5/14 (4/14-7/14). For trained
teachers, it was 6/14 (4/14-8/14) and for untrained teachers, it was 5/14
(3/14-7/14)(P < 0.001). There were no differences between teachers who had
attended different BLS courses. Significant differences between teachers were
observed: 62% of teachers with previous BLS training felt capable of providing
cardio pulmonary resusitation (CPR) to their students compared to 48% in the
group without previous training (P =0.001). Ninety- five percent of the teachers
were eager to attend a BLS course and 92% reported that BLS training should be
mandatorily given for teacher certification. Teachers are aware of the
importance of BLS and they are willing to attend BLS training programs and
improve their knowledge. Despite the fact that the knowledge of trained teachers
was found to be better than those of untrained teachers, school teachers in
Turkey have a low level of knowledge and skills regarding BLS.

DOI: 10.24953/turkjped.2018.06.011
PMID: 31365207

95. Cureus. 2023 Nov 10;15(11):e48613. doi: 10.7759/cureus.48613. eCollection 2023

Nov.

Awareness, Knowledge, and Attitudes Regarding Basic Life Support Among the
General Population in the Al-Majma'ah Region, Saudi Arabia.

Almutairi AH(1), Alhassan SA(2), Alsuwayyid RY(2), Alaskar AA(2), Almutairi

FS(2), Alsaid AF(2), Abdulkareem Alharbi Y(2), Almazrou MA(2), Fahad K Alotaibi
K(2).

Author information:
(1)Emergency Medicine, Majmaah University, Al Majma'ah, SAU.
(2)College of Medicine, Majmaah University, Al Majma'ah, SAU.

BACKGROUND: Cardiac arrest is a critical medical emergency that can strike

individuals of any age or background, often occurring suddenly and
unpredictably. The administration of Basic Life Support (BLS) techniques by
laypersons in the first few crucial minutes following a cardiac arrest can
substantially increase the chances of survival and minimize potential
neurological damage. Despite the vital role of BLS in saving lives, there
remains a gap in public awareness, knowledge, and attitudes regarding BLS among
the general population in many regions worldwide, including Saudi Arabia. In
recent years, there has been a growing emphasis on the importance of
community-based interventions to enhance cardiac arrest survival rates. Public
involvement in the early stages of cardiac arrest management is a key component
of the chain of survival, and improving BLS awareness and knowledge among the
general population is central to this effort.
OBJECTIVE: This study aimed to assess the awareness, knowledge, and attitudes
with regard to BLS among the general population in the Al-Majma'ah region, Saudi
Arabia.
METHODS: This is a descriptive cross-sectional study adopted among the
population living in the Al-Majma'ah region of Saudi Arabia. The data was
collected by a pre-tested and self-administered questionnaire. Data was analyzed
by using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM
Corp., Armonk, New York, United States). The questions included information on
social demographic information, awareness and knowledge, and attitudes related
to BLS.
RESULTS: More than half the participants (n=352; 52.5%) understand that during
cardiac arrest, the heart is still beating and pumping blood, but the person is
not breathing normally. This is an important understanding for providing proper
care during a cardiac arrest situation. On the other hand, the study found that
384 (57.2%) had various reasons for their lack of knowledge about
cardiopulmonary resuscitation (CPR). The biggest reason was lack of interest
(n=98; 14.6%). This highlights a need for increased awareness and education
about the importance of CPR. The findings from the Pearson correlation conducted
in this study show that age has a significant influence on the level of
awareness and knowledge of cardiac arrest BLS. The p-value obtained for the test
was 0.014, indicating that there is a significant relationship between age and
awareness and knowledge of BLS. Similarly, the study findings also show that
gender has a significant influence on the attitude of cardiac arrest BLS.
CONCLUSION: The participants had a decent understanding of BLS, particularly
regarding concepts like cardiac arrest and the role of automated external
defibrillators (AEDs). However, they showed confusion or gaps in awareness,
especially concerning the correct initial steps when encountering a collapsed
person. Many participants felt uncomfortable performing Hands-Only CPR in a
real-life situation due to a lack of knowledge and skills, which acted as a
significant barrier to public CPR performance.

Copyright © 2023, Almutairi et al.

DOI: 10.7759/cureus.48613
PMCID: PMC10710765
PMID: 38084172

Conflict of interest statement: The authors have declared that no competing

interests exist.

96. J Int Soc Prev Community Dent. 2017 Jul-Aug;7(4):161-167. doi:

10.4103/jispcd.JISPCD_240_17. Epub 2017 Jul 31.

Awareness, Attitude, and Knowledge of Basic Life Support among Medical, Dental,
and Nursing Faculties and Students in the University Hospital.

Sangamesh NC(1), Vidya KC(2), Pathi J(2), Singh A(3).

Author information:
(1)Department of Oral Medicine and Radiology, Kalinga Institute of Dental
Sciences, KIIT University, Bhubaneswar, Odisha, India.
(2)Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental
Sciences, KIIT University, Bhubaneswar, Odisha, India.
(3)Department of Preventive and Community Dentistry, Kalinga Institute of Dental
Sciences, KIIT University, Bhubaneswar, Odisha, India.

OBJECTIVE: To assess the awareness, attitude, and knowledge about basic life
support (BLS) among medical, dental, and nursing students and faculties and the
proposal of BLS skills in the academic curriculum of undergraduate (UG) course.
Recognition, prevention, and effective management of life-threatening
emergencies are the responsibility of health-care professionals. These
situations can be successfully managed by proper knowledge and training of the
BLS skills. These life-saving maneuvers can be given through the structured
resuscitation programs, which are lacking in the academic curriculum.
MATERIALS AND METHODS: A questionnaire study consisting of 20 questions was
conducted among 659 participants in the Kalinga Institute of Dental Sciences,
Kalinga Institute of Medical Sciences, KIIT University. Medical junior
residents, BDS faculties, interns, nursing faculties, and 3rd-year and
final-year UG students from both medical and dental colleges were chosen. The
statistical analysis was carried out using SPSS software version 20.0 (Armonk,
NY:IBM Corp).
RESULTS: After collecting the data, the values were statistically analyzed and
tabulated. Statistical analysis was performed using Mann-Whitney U-test. The
results with P < 0.05 were considered statistically significant. Our
participants were aware of BLS, showed positive attitude toward it, whereas the
knowledge about BLS was lacking, with the statistically significant P value.
CONCLUSION: By introducing BLS regularly in the academic curriculum and by
routine hands on workshops, all the health-care providers should be well versed
with the BLS skills for effectively managing the life-threatening emergencies.

DOI: 10.4103/jispcd.JISPCD_240_17
PMCID: PMC5558248
PMID: 28852630

Conflict of interest statement: There are no conflicts of interest.

97. Emerg Med J. 2011 Sep;28(9):786-9. doi: 10.1136/emj.2010.092957. Epub 2010 Oct
14.

Lay basic life support: the current situation in a medium-sized German town.

Piepho T(1), Resch N, Heid F, Werner C, Noppens RR.

Author information:
(1)University Medical Center of the Johannes Gutenberg-University, Department of
Anaesthesiology, Langenbeckstr. 1, 55131 Mainz, Germany.

OBJECTIVE: Basic life support (BLS) by laypersons is essential for surviving

sudden cardiac death in the community. The present study investigates BLS skill
knowledge of German laypersons in a public community place and examines the
effect of the interval between the last BLS course and present skills in
cardiopulmonary resuscitation (CPR).
METHODS: Participants were randomly recruited at a public place in a
medium-sized German town. Volunteers were confronted with a fictitious cardiac
arrest situation using a BLS training manikin and were asked to help. Using a
standardised evaluation sheet, measures were documented. Participants'
demographic data were evaluated after completion of the scenario.
RESULTS: None of the participants (n=89; male=42, female=47) followed the
current BLS algorithm correctly; independent from the last CPR course was
attended. Most steps were performed in random order. 43% (n=38) of participants
checked for responsiveness, 65% (n=58) performed chest compressions, and 63%
(n=56) delivered rescue breathing. 10% (n=9) of participants were unable to name
a national emergency telephone number. Laypersons who attended a BLS course more
than 10 years ago showed a significant lack of BLS knowledge and failed more
often to deliver chest compressions and rescue breathing.
CONCLUSIONS: The present study demonstrates that current CPR guidelines for BLS
are not followed by laypersons in a medium-sized town in Germany. These data
suggest that CPR refresher courses as well as implication of BLS guidelines in
daily life are warranted.

DOI: 10.1136/emj.2010.092957
PMID: 20947914 [Indexed for MEDLINE]

98. BMC Public Health. 2020 Jan 13;20(1):50. doi: 10.1186/s12889-020-8161-7.

Implementation of Basic Life Support training in schools: a randomised
controlled trial evaluating self-regulated learning as alternative training
concept.

Süss-Havemann C(1), Kosan J(1), Seibold T(2), Dibbern NM(3), Daubmann A(4),
Kubitz JC(1), Beck S(5).

Author information:
(1)Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf,
Martini-Str. 52, 20246, Hamburg, Germany.
(2)Department of Anaesthesiology, Intensiv Care and Pain Management, Kath.
Marienkrankenhaus, Alfredstraße 9, 22087, Hamburg, Germany.
(3)Specialist Center for Anaesthesia and Pain Medicine, Schoen Clinic Hamburg
Eilbek, Dehnhaide 120, 22081, Hamburg, Germany.
(4)Department of Medical Biometry and Epidemiology, University Medical Center
Hamburg-Eppendorf, Martini-Str. 52, 20246, Hamburg, Germany.
(5)Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf,
Martini-Str. 52, 20246, Hamburg, Germany. [email protected].

BACKGROUND: The Kids save lives statement recommends annual Basic Life Support
(BLS) training for school children but the implementation is challenging.
Trainings should be easy to realise and every BLS training should be as
effective as possible to prepare learners for lifesaving actions. Preparedness
implies skills and positive beliefs in the own capability (high self-efficacy).
METHODS: This randomized controlled cluster study investigates, if
self-regulated learning promotes self-efficacy and long-term retention of
practical BLS skills. Students in the age of 12 years participated in a
practical training in BLS and a scenario testing of skills. In the control group
the practical training was instructor-led. In the intervention group the
students self-regulated their learning processes and feedback was provided by
the peer-group. The primary outcome self-efficacy for helping in cardiac arrest
after the training and 9 months later was analysed using a multilevel mixed
model. Means and pass-rates for BLS skills were secondary outcomes.
RESULTS: Contrary to the assumptions, this study could not measure a higher
self-efficacy for helping in cardiac arrest of the students participating in the
intervention (n = 307 students) compared to the control group (n = 293 students)
after training and at the follow-up (mean difference: 0.11 points, 95% CI:
- 0.26 to 0.04, P = 0.135). The odds to pass all items of the BLS exam was not
significantly different between the groups (OR 1.11, 95% CI: 0.81 to 1.52,
p = 0.533). Self-regulated learning was associated with a higher performance of
male students in the BLS exam (mean score: 7.35) compared to females of the
intervention (female: 7.05) and compared to males of the control (7.06).
CONCLUSION: This study could not resolve the question, if self-regulated
learning in peer-groups improves self-efficacy for helping in cardiac arrest.
Self-regulated learning is an effective alternative to instructor-led training
in BLS skills training and may be feasible to realise for lay-persons. For male
students self-regulated learning seems to be beneficial to support long-term
retention of skills.
TRIAL REGISTRATION: ISRCTN17334920, retrospectively registered 07.03.2019.

DOI: 10.1186/s12889-020-8161-7
PMCID: PMC6958621
PMID: 31931770 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare that they have no competing
interests.
99. Emerg Med J. 2022 May;39(5):357-362. doi: 10.1136/emermed-2021-211774. Epub
2021
Aug 16.

Commencing one-handed chest compressions while activating emergency medical

system using a handheld mobile device in lone-rescuer basic life support: a
randomised cross-over simulation study.

Park SO(#)(1), Shin DH(#)(2), Kim C(3), Lee YH(4)(5).

Author information:
(1)Emergency Medicine, Konkuk University Medical Center, Seoul, Republic of
Korea.
(2)Emergency Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
(3)Department of Preventive Medicine, Pusan National University School of
Medicine, Busan, Republic of Korea.
(4)Emergency Medicine, Soonchunhyang University Hospital Bucheon, Bucheon,
Republic of Korea [email protected].
(5)Emergency Medicine, Sacred Heart Hospital, Hallym University School of
Medicine, Anyang, Republic of Korea.
(#)Contributed equally

INTRODUCTION: In conventional basic life support (c-BLS), a lone rescuer is

recommended to start chest compressions (CCs) after activating the emergency
medical system. To initiate earlier CCs in lone-rescuer BLS, we designed a
modified BLS (m-BLS) sequence in which the lone rescuer commences one-handed CCs
while calling for help using a handheld cellular phone with the other free hand.
This study aimed to compare the quality of BLS between c-BLS and m-BLS.
METHODS: This was a simulation study performed with a randomised cross-over
controlled trial design. A total of 108 university students were finally
enrolled. After training for both c-BLS and m-BLS, participants performed a
3-minute c-BLS or m-BLS on a manikin with a SkillReporter at random cross-over
order. The paired mean difference with SE between c-BLS and m-BLS was assessed
using paired t-test.
RESULTS: The m-BLS had reduced lag time before the initiation of CCs (with a
mean estimated paired difference (SE) of -35.0 (90.4) s) (p<0.001). For CC, a
significant increase in compression fraction and a higher number of CCs with
correct depth were observed in m-BLS (with a mean estimated paired difference
(SE) of 16.2% (0.6) and 26.9% (3.3), respectively) (all p<0.001). However, no
significant paired difference was observed in the hand position, compression
rate and interruption time. For ventilation, the mean tidal volumes did not
differ. However, the number of breaths with correct tidal volume was higher in
m-BLS than in c-BLS.
CONCLUSION: In simulated lone-rescuer BLS, the m-BLS could deliver significantly
earlier CCs than the c-BLS while maintaining high-quality cardiopulmonary
resuscitation.

© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and
permissions. Published by BMJ.

DOI: 10.1136/emermed-2021-211774
PMID: 34400404 [Indexed for MEDLINE]

Conflict of interest statement: Competing interests: None declared.

100. Prehosp Emerg Care. 2019 Nov-Dec;23(6):855-861. doi:

10.1080/10903127.2019.1595235. Epub 2019 Apr 19.
Non-Auto-Injector Epinephrine Administration by Basic Life Support Providers: A
Literature Review and Consensus Process.

Lyng JW, White CC 4th, Peterson TQ, Lako-Adamson H, Goodloe JM, Dailey MW,
Clemency BM, Brown LH.

Anaphylaxis is a life-threatening condition with a known effective prehospital

intervention: parenteral epinephrine. The National Association of EMS Physicians
(NAEMSP) advocates for emergency medical services (EMS) providers to be allowed
to carry and administer epinephrine. Some states constrain epinephrine
administration by basic life support (BLS) providers to administration using
epinephrine auto-injectors (EAIs), but the cost and supply of EAIs limits the
ability of some EMS agencies to provide epinephrine for anaphylaxis. This
literature review and consensus report describes the extant literature and the
practical and policy issues related to non-EAI administration of epinephrine for
anaphylaxis, and serves as a supplementary resource document for the revised
NAEMSP position statement on the use of epinephrine in the out-of-hospital
treatment of anaphylaxis, complementing (but not replacing) prior resource
documents. The report concludes that there is some evidence that intramuscular
injection of epinephrine drawn up from a vial or ampule by appropriately trained
EMS providers-without limitation to specific certification levels-is safe,
facilitates timely treatment of patients, and reduces costs.

DOI: 10.1080/10903127.2019.1595235
PMID: 30917719 [Indexed for MEDLINE]

101. Emerg Med J. 2010 Oct;27(10):762-5. doi: 10.1136/emj.2009.077511. Epub 2010

May
13.

Basic life support skill retention by medical students: a comparison of two

teaching curricula.

Papaioannou A(1), Fraidakis O, Volakakis N, Stefanakis G, Bimpaki E, Pagkalos J,

Psarologakis C, Aggouridakis P, Askitopoulou H.

Author information:
(1)Department of Anaesthesiology, University Hospital of Heraklion, Crete,
Greece. [email protected]

AIM: In December 2005 the new guidelines for resuscitation were released and a
new curriculum for the teaching of basic life support (BLS) was adopted. The aim
of the present study was to investigate the effectiveness of the new guidelines
and teaching curriculum on the BLS skill retention of medical students 1 year
following their initial training.
METHODS: The study was conducted in two consecutive academic years and compared
BLS skill retention of two groups of medical students in their fourth year of
medicine. The first group (group A) was taught the old guidelines with the old
curriculum in the year 2005 and was re-assessed in 2006, and the second group
(group B) was taught the new guidelines with the new curriculum in the year 2006
and was re-assessed in 2007.
RESULTS: Significantly more students in group B assessed signs of life, located
the compression area correctly and performed good quality chest compressions
compared with the group taught the old guidelines with the old curriculum.
CONCLUSIONS: The most important BLS skill, good quality chest compressions, was
retained by significantly more students who were taught the new resuscitation
guidelines according to the new curriculum.
DOI: 10.1136/emj.2009.077511
PMID: 20466828 [Indexed for MEDLINE]

102. J Accid Emerg Med. 1994 Sep;11(3):165-7. doi: 10.1136/emj.11.3.165.

Cardiopulmonary resuscitation. Paper 2: A survey of basic life support training

for medical students.

Graham CA(1), Guest KA, Scollon D.

Author information:
(1)Faculty of Medicine, University of Glasgow, UK.

This paper presents the results of a survey of Basic Life Support (BLS)
training, based on experience gained by undergraduate medical students who had
just completed their first clinical year (third year) at the University of
Glasgow. Data were collected on the amount and quality of BLS training received,
along with students' own perceptions of their confidence in providing BLS in a
cardiac arrest resuscitation attempt. The results made interesting, but not
surprising, reading with only 15% of students appearing to have been adequately
taught BLS at any point during their third year. Students want more training and
98% see resuscitation as an important topic in the curriculum. Self-perceived
confidence in performing BLS in an acute resuscitation situation is low. With no
evidence to suggest that the situation is any different elsewhere in the UK, it
is recommended that undergraduate resuscitation training is improved to reflect
the importance that medical students attach to it.

DOI: 10.1136/emj.11.3.165
PMCID: PMC1342423
PMID: 7804581 [Indexed for MEDLINE]

103. Front Public Health. 2024 Jun 27;12:1390819. doi: 10.3389/fpubh.2024.1390819.

eCollection 2024.

Implementation of basic life support education for the lay public in China:
barriers, enablers, and possible solutions.

Dong X(1), Zhang L(2), Wang Z(1), Zheng ZJ(1).

Author information:
(1)Department of Global Health, School of Public Health, Peking University,
Beijing, China.
(2)School of Public Health, Shanghai Jiao Tong University, Shanghai, China.

BACKGROUND: Education for the lay public in basic life support (BLS) is critical
for increasing bystander cardiopulmonary resuscitation (CPR) rates and improving
survival from out-of-hospital cardiac arrest (OHCA). Despite years of
implementation, the BLS training rate in China has remained modest. The aim of
this study was to investigate the factors influencing the implementation of BLS
training programs in emergency medical service (EMS) centers in China and to
identify specific barriers and enablers.
METHODS: Qualitative interviews were conducted with key informants from 40 EMS
centers in Chinese cities. The participants included 11 directors/deputy
directors, 24 training department leaders, and 5 senior trainers. The interview
guide was based on the Exploration, Preparation, Implementation, Sustainment
(EPIS) framework. Thematic content analysis was used to identify themes and
patterns across the interviews.
RESULTS: We identified 16 factors influencing the implementation of BLS training
programs encompassing the outer content, inner context, innovation and bridging
factors. Some factors acted as either barriers or enablers at different EPIS
stages. The main implementation barriers included limited external leadership,
insufficient government investment, low public awareness, a shortage of
trainers, an absence of incentives, an absence of authoritative courses and
guidelines, a lack of qualification to issue certificates, limited academic
involvement, and insufficient publicity. The main enablers were found to be
supportive government leaders, strong public demand, adequate resources, program
champions, available high-quality courses of high fitness within the local
context, the involvement of diverse institutions, and effective publicity and
promotion.
CONCLUSION: Our findings emphasize the diversity of stakeholders, the complexity
of implementation, and the need for localization and co-construction when
conducting BLS training for lay public in city EMS centers. Improvements can be
made at the national level, city level, and EMS institutional level to boost
priority and awareness, promote legislation and policies, raise sustainable
resources, and enhance the technology of BLS courses.

Copyright © 2024 Dong, Zhang, Wang and Zheng.

DOI: 10.3389/fpubh.2024.1390819
PMCID: PMC11236690
PMID: 38993705 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare that the research was
conducted in the absence of any commercial or financial relationships that could
be construed as a potential conflict of interest.

104. Medicine (Baltimore). 2021 Apr 2;100(13):e24819. doi:

10.1097/MD.0000000000024819.

Basic life support training programme in schools by school nurses: How long and
how often to train?

Martínez-Isasi S(1), García-Suárez M(2), De La Peña Rodríguez MA(3),

Gómez-Salgado J(4)(5), Fernández N(6), Méndez-Martínez C(2), Leon-Castelao E(7),
Clemente-Vivancos A(7)(8), Fernández-García D(9).

Author information:
(1)Life Support and Medical Simulation Research Group, Health Research Institute
of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; CLINURSID
Research Group. Faculty of Nursing, University of Santiago de Compostela,
Santiago de Compostela.
(2)Servicio de Anestesia y Reanimación, Complejo Asistencial Universitario de
León (CAULE), Gerencia Regional de Salud de Castilla y León (SACYL), Leon.
(3)Primary Care Board Management. Guayaba Health Center, Madrid Health Service,
Madrid.
(4)Department of Sociology, Faculty of Labour Sciences, Social Work and Public
Health, University of Huelva, Huelva.
(5)Safety and Health Postgraduate Programme, Universidad Espíritu Santo,
Guayaquil, Ecuador.
(6)Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED),
University of Leon, Leon.
(7)Clinical Simulation Lab, School of Medicine and Healthcare Sciences,
University of Barcelona.
(8)Escola Superior de Enfermeria Mar (ESIMar), Universitat Pompeu Fabra,
Barcelona.
(9)Unidad de Radiología Vascular Intervencionista, Complejo Asistencial
Universitario de León (CAULE), Gerencia Regional de Salud de Castilla y León
(SACYL), Leon, Spain.

BACKGROUND: Cardiopulmonary resuscitation (CPR) training in schools, despite

being legislated in Spain, is not established as such within the subjects that
children are taught in schools.
OBJECTIVE: to evaluate the acquisition of CPR skills by 11-year-old children
after a brief theoretical-practical teaching programme taught by nurses at
school.
METHODS: 62 students were assessed in a quasi-experimental study on 2 cohorts
(51.4% of the sample in control group [CG]). In total, 2 sessions were given, a
theoretical one, and a practical training for skill development in children, in
which the CG performed the CPR in 2-minute cycles and the intervention group in
1-minute cycles. The anthropometric variables recorded were weight and height,
and the variables compression quality and ventilation quality were recorded
using the Laerdal ResusciAnne manikin with Personal Computer/Wireless
SkillReport.
RESULTS: The assessment showed better results, in terms of BLS sequence
performance and use of automated external defibrillator, in the CG and after
training, except for the evaluation of the 10-second breathing assessment
technique. The quality of chest compressions was better in the CG after
training, as was the quality of the ventilations. There were no major
differences in CPR quality after training and 4 months after the 1-minute and
2-minute training cycles.
CONCLUSIONS: 11-year-old children do not perform quality chest compressions or
ventilations but, considering their age, they are able to perform a BLS sequence
correctly.

Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

DOI: 10.1097/MD.0000000000024819
PMCID: PMC8021366
PMID: 33787576 [Indexed for MEDLINE]

Conflict of interest statement: The authors have no conflicts of interest to

disclose .

105. ScientificWorldJournal. 2021 Jan 29;2021:4878305. doi: 10.1155/2021/4878305.

eCollection 2021.

Awareness of Secondary School Students regarding Basic Life Support in Abha

City, Southern Saudi Arabia: A Cross-Sectional Survey.

Almojarthe B(1), Alqahtani S(2), AlGouzi B(2), Alluhayb W(2), Asiri N(2).

Author information:
(1)Family Medicine Department at King Khalid University, Abha, Saudi Arabia.
(2)King Khalid University, College of Medicine, Abha, Saudi Arabia.

BACKGROUND: Basic life support (BLS) is a level of medical care that is used for
individuals with life-threatening illnesses or injuries until they can be given
full medical care at a hospital. It can be provided by trained medical
personnel, including emergency medical technicians and paramedics, and by
qualified bystanders. Vital areas of adult BLS include immediate identification
of sudden cardiac arrest and activation of the emergency response system, early
performance of high-quality cardiopulmonary resuscitation (CPR), and rapid
defibrillation, when appropriate.
AIM: To assess the awareness of secondary school students regarding BLS in Abha
City, Saudi Arabia. Methodology. A descriptive cross-sectional survey was
conducted targeting all accessible secondary school students in Abha City during
the academic years 2018-2019. After explaining the objectives and importance of
the research topic, all students in the three grades were invited to complete
the study questionnaire. The questionnaire was developed by the researchers
after reviewing the literature for related topics and consulting an expert for
any additions or modifications.
RESULTS: The study included 761 students with ages ranging from 15 to 20 years
and a mean age of 17 ± 1 years old. Male students accounted for 53.6% of the
participants, and 96.7% of the participants were Saudi. Exactly 31% of the
students had had a BLS training course, among which 79.2% had had training that
lasted for only one day. Regarding awareness, 65% of the students had heard
about BLS, and 44% knew about CPR. Exactly 52% of the students indicated that
they should call the ER if there was a case with fainting. A total of 45.3% of
the students reported that airway checking was the first step in CPR, and 16.7%
reported that the chest compression to oral breathing ratio should be 30 to 2.
Conclusions and Recommendations. In conclusion, the study revealed that poor
awareness regarding BLS was present among the students. The researchers
concluded that less than one-third of the students had BLS training. BLS should
be taught, theoretically and practically (with simulations), to middle and high
school students as BLS involves relatively simple concepts and methods.

Copyright © 2021 Bandar Almojarthe et al.

DOI: 10.1155/2021/4878305
PMCID: PMC7868155
PMID: 33603571 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare that they have no conflicts
of interest.

106. Adv Med Educ Pract. 2024 Jan 6;15:25-35. doi: 10.2147/AMEP.S440437.
eCollection
2024.

Assessing the Proficiency in Basic and Advanced Life Support Among Physicians in
Ecuador: A Cross-Sectional Study.

Izquierdo-Condoy JS(1), Naranjo-Lara P(1), Arias Rodríguez FD(2), Puglla-Mendoza

AG(1), Jima-Sanmartín J(1), Andrade Casanova D(1), Duque-Sánchez EP(1), Alegría
N N(1), Rojas Cadena MG(1), Ortiz-Prado E(1).

Author information:
(1)One Health Research Group, Faculty of Medicine, Universidad de las Américas,
Quito, Ecuador.
(2)Área de Gestión de Docencia e Investigación, Hospital Pediátrico Baca Ortiz,
Quito, Ecuador.

PURPOSE: Cardiorespiratory arrest's unpredictability poses a global health

challenge, with gaps in physicians' life support knowledge potentially leading
to poor patient outcomes, a factor yet unstudied among Ecuadorian physicians.
This study aims to elucidate the state of physicians' theoretical knowledge in
Ecuador based on Basic Life Support (BLS) and Advanced Life Support (ALS)
guidelines.
PATIENTS AND METHODS: A national cross-sectional online 35-questions survey was
conducted between February and March 2023 using a self-administered,
expert-validated questionnaire. Participants' responses were obtained through
official social media groups (WhatsApp and Facebook). The survey evaluated the
theoretical knowledge of BLS and ALS, with scores based on the number of correct
answers out of a maximum of 10.0 points. For descriptive analysis, frequencies,
percentages, means, and standard deviations (SD) were used. The T-test and
one-way ANOVA were utilized to analyze the associations between knowledge levels
and demographic and academic training variables of Ecuadorian doctors. Values of
p < 0.05 were considered statistically significant for all analyses.
RESULTS: The survey garnered responses from 385 physicians, with a majority
being female (56.6%) and possessing less than 3 years of work experience
(75.1%). Of these, 71.7% and 51.9% held BLS and ALS certifications,
respectively. Knowledge scores for BLS (5.8/10 ± 1.6) surpassed those for ALS
(4.7/10 ± 1.8) (p < 0.001). Physicians with less than 3 years of work experience
exhibited higher knowledge scores in both BLS and ALS tests (p < 0.05).
CONCLUSION: This study revealed a notable deficiency in the theoretical
knowledge of BLS and ALS among surveyed Ecuadorian physicians. Factors such as
prior certification and years of work experience appeared to influence knowledge
levels. Continual training and updates in life support protocols at universities
and healthcare institutions are key to enhancing physicians' skills and patient
outcomes.

© 2024 Izquierdo-Condoy et al.

DOI: 10.2147/AMEP.S440437
PMCID: PMC10778227
PMID: 38205130

Conflict of interest statement: The authors report no conflicts of interest in

this work.

107. BMC Med Educ. 2024 May 9;24(1):488. doi: 10.1186/s12909-024-05490-3.

The effect of scenario-based training versus video training on nurse anesthesia

students' basic life support knowledge and skill of cardiopulmonary
resuscitation: a quasi-experimental comparative study.

Saidkhani V(1), Albooghobeish M(1), Rahimpour Z(2), Haghighizadeh MH(3).

Author information:
(1)Department of Anesthesiology, School of Allied Medical Sciences, Ahvaz
Jundishapur University of Medical Sciences, Ahvaz, Iran.
(2)Department of Anesthesiology, School of Allied Medical Sciences, Ahvaz
Jundishapur University of Medical Sciences, Ahvaz, Iran.
[email protected].
(3)Department of Biostatistics and Epidemiology, School of Health, Ahvaz
Jundishapur University of Medical Sciences, Ahvaz, Iran.

BACKGROUND: Performing CPR (Cardiopulmonary Resuscitation) is an extremely

intricate skill whose success depends largely on the level of knowledge and
skill of Anesthesiology students. Therefore, this research was conducted to
compare the effect of the scenario-based training method as opposed to video
training method on nurse anesthesia students' BLS (Basic Life Support) knowledge
and skills.
METHODS: This randomized quasi-experimental study involved 45 nurse anesthesia
students of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran in
2022-2023. The practical room of the university formed the research environment.
The participants were randomly divided into three groups of scenario-based
training, video training, and control. Data were collected by a knowledge
questionnaire and a BLS skill assessment checklist before and after the
intervention.
RESULTS: There was a significant difference between the students' scores of BLS
knowledge and skill before and after the educational intervention in both SG
(scenario group) (p < 0.001) and VG (video group) (p = 0.008) (p < 0.001).
However, no significant difference was observed in this regard in the CG
(control group) (p = 0.37) (p = 0.16). Also, the mean scores of BLS knowledge
and skills in the SG were higher than those in the VG (p < 0.001).
CONCLUSION: Given the beneficial impact of scenario-based education on fostering
active participation, critical thinking, utilization of intellectual abilities,
and learner creativity, it appears that this approach holds an advantage over
video training, particularly when it comes to teaching crucial subjects like
Basic Life Support.

© 2024. The Author(s).

DOI: 10.1186/s12909-024-05490-3
PMCID: PMC11080119
PMID: 38724939 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare no competing interests.

108. Yakugaku Zasshi. 2023;143(3):309-316. doi: 10.1248/yakushi.22-00194.

A Survey of Pharmacy Students' Satisfaction with a Basic Life Support Course and
an Exploration of Factors Related to Awareness Change Before and After the
Course.

Kinoshita A(1), Hashimoto K(1), Yahara M(1), Hashimoto Y(1), Fukunaga M(1),
Shimizu T(1), Urashima Y(2), Obata T(2).

Author information:
(1)School of Pharmacy, Hyogo Medical University.
(2)Faculty of Pharmaceutical Sciences, Osaka Ohtani University.

The model core curriculum for pharmacy education and professional standards for
pharmacists established by the Japan Pharmaceutical Association aim to inculcate
knowledge and skills on basic life support (BLS) and ensure that pharmacy
students are well equipped with knowledge on BLS. In this study, pharmacy
students were enrolled in the PUSH course, a BLS training course for citizens,
and a questionnaire survey was conducted before and after the course to evaluate
the change in students awareness about BLS and overall satisfaction with the
course. The participants enrolled for the course were fourth-year students from
the School of Pharmacy, Hyogo Medical University, who consented to participate
in the study. A total of ninety-nine participants were included in this study.
After the completion of the course, the participants displayed greater
confidence, preparedness, and willingness to teach BLS, and decreased anxiety
about BLS. Factor analysis revealed four factors based on the questionnaire
answers before the course, while three factors were extracted based on the
answers after the course. Lack of confidence in BLS, extracted as one of the
factors before the course was inverted and gave rise to a new factor. Some
participants displayed increased awareness about BLS after completion of the
PUSH course. Hierarchical cluster analysis before and after the course divided
respondents into three groups. The results showed that lesser number of
participants displayed anxiety over BLS after the course. The results also
indicated high levels of satisfaction among the participants after the
completion of the PUSH course.

DOI: 10.1248/yakushi.22-00194
PMID: 36858563 [Indexed for MEDLINE]

109. Mymensingh Med J. 2023 Jan;32(1):207-212.

Assessing the Effectiveness of Clinical Skills Laboratory and Traditional

Lecture in Teaching Basic Life Support and Performance Evaluation According to
Different Domains of Revised Bloom's Taxonomy.

Selina F(1), Hasan MF, Talha KA, Al-Muhaimin M, Momo FR, Debnath J, Begum S,
Ahmad J.

Author information:
(1)Dr Farhana Selina, Associate Professor, Department of Anesthesiology, Sylhet
Women's Medical College (SWMC), Sylhet, Bangladesh; E-mail:
[email protected].

Sudden cardiac arrest out-side hospital is serious global concern. If

non-medical people are taught to initiate the basic life support (BLS) training
with cardiopulmonary resuscitation (CPR) then the mortality could be reduced
significantly. This was a non-randomized controlled study to evaluate clinical
skills laboratory (CSL) as teaching tool for basic life support (BLS) training
in comparison to traditional lecture. Sample size was 68 and performed in Sylhet
Women's Medical College from July 2022 to September 2022. All the participants
were third year nursing students. They were enrolled in to two groups. Group-A
were taught BLS by clinical skills laboratory (CSL) and Group-B were taught by
traditional lecture (TL). At the end of the teaching all of them were tested by
a vetted multiple choice question (MCQ) set. The questions were set according
the 5 levels of revised Blood's taxonomy. Mean score of Group-A (CSL) were
higher the TL group (p=0.0003). Among the revised Bloom's taxonomy understand,
apply and evaluate domains were significantly better taught (p<0.05) by CSL. The
sensitivity of CSL was 0.559 in comparison to TL for BLS training. In the modern
medical education teaching and assessment should be focused on the higher levels
of learning taxonomy. Introducing CSL in medical education could boost up the
psychomotor and cognition both in the medical education.

PMID: 36594322 [Indexed for MEDLINE]

110. BMC Med Educ. 2019 Dec 4;19(1):452. doi: 10.1186/s12909-019-1881-7.

The timing of testing influences skill retention after basic life support
training: a prospective quasi-experimental study.

Kovács E(1), Jenei ZM(2), Csordás K(3), Fritúz G(4), Hauser B(4), Gyarmathy
VA(5), Zima E(6), Gál J(4).

Author information:
(1)Department of Anaesthesiology and Intensive Therapy, Semmelweis University,
P.O.B. 2, Budapest, H-1428, Hungary. [email protected].
(2)3rd Department of Internal Medicine, Semmelweis University, P.O.B. 2,
Budapest, H-1428, Hungary.
(3)National Institute of Hematology and Infectious Diseases, Central Hospital of
Southern Pest, Albert Flórián út 5-7, Budapest, H-1097, Hungary.
(4)Department of Anaesthesiology and Intensive Therapy, Semmelweis University,
P.O.B. 2, Budapest, H-1428, Hungary.
(5)Johns Hopkins University, Baltimore, MD, USA.
(6)Heart and Vascular Center, Semmelweis University, P.O.B. 2, Budapest, H-1428,
Hungary.
BACKGROUND: Proper basic life support (BLS) is key in improving the survival of
out-of-hospital cardiac arrest. BLS skills deteriorate in three to 6 months
after training. One method to improve skill retention may be using the "testing
effect" to test skills at the end of a BLS course. The aim of our study was to
investigate whether either testing or the timing of such testing after BLS
training have any influence on skill retention.
METHODS: This was a post-test only, partial coverage, prospective
quasi-experimental study designed to evaluate a BLS training course among 464
fifth year medical students at Semmelweis University in the first semester of
2013/2014. Groups were systematically but non-randomly assigned to either a
control group that took no exam or one of two experimental groups that took an
exam (N = 179, NoExam group; N = 165, EndExam group - exam at the end of the BLS
training; N = 120, 3mExam group - exam 3 months after the BLS training). The
ability to perform ten prescribed essential BLS steps was evaluated during a
skill retention assessment 2 months after the course in the NoExam, 2 months
after the course (and the exam) in the EndExam and 5 months after the course (2
months after the exam) in the 3mExam group to measure skill retention and the
effect of our intervention. Scores were calculated for each BLS step, and also
summed up as a total score. We used Kruskal-Wallis test to assess differences in
skill retention.
RESULTS: Overall, NoExam and EndExam groups showed similar skill retention. The
mean total score (and many of the sub-scores) of students was significantly
higher in the 3mExam group compared to both the NoExam and the EndExam groups,
and there was no difference in the total score (and many of the sub-scores) of
the latter two groups. The 3mExam group had less variability in total scores
(and many of the sub-scores) than the other two groups.
CONCLUSION: Our study provides evidence that testing these skills 3 months after
BLS training may be more effective than either testing immediately at the end of
the course or no testing at all.

DOI: 10.1186/s12909-019-1881-7
PMCID: PMC6894266
PMID: 31801502 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare that they have no competing
interests.

111. Resuscitation. 2019 Nov;144:33-39. doi: 10.1016/j.resuscitation.2019.08.040.

Epub 2019 Sep 7.

Basic life support training using shared mental models improves team performance
of first responders on normal wards: A randomised controlled simulation trial.

Beck S(1), Doehn C(2), Funk H(1), Kosan J(1), Issleib M(1), Daubmann A(3),
Zöllner C(1), Kubitz JC(1).

Author information:
(1)Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf,
Martini-Str. 52, 20246 Hamburg, Germany.
(2)Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf,
Martini-Str. 52, 20246 Hamburg, Germany. Electronic address: [email protected].
(3)Department of Medical Biometry and Epidemiology, University Medical Center
Hamburg-Eppendorf, Martini-Str. 52, 20246 Hamburg, Germany.

INTRODUCTION: Survival of in-hospital cardiac arrest (IHCA) depends on fast and

effective action of the first responding team. Not only technical skills, but
professional teamwork is required. Observational studies and theoretical models
suggest that shared mental models of members improve teamwork. This study
investigated if a training on shared mental models, improves team performance in
simulated in-hospital cardiac arrest.
METHODS: On the background of an introduction of mandatory Basic Life Support
(BLS) training for clinical staff a randomized controlled trial was performed to
compare two training methods. Staff from clinical departments was randomised to
receive either a conventional instructor led training (control group) or an
interventional training (intervention group). The interventional training was
based on self-directed learning of the group in order to develop shared mental
models. Primary outcome were mean scores of the team assessment scale (TAS) and
the hands-off time. Secondary outcome were mean scores for quality of BLS.
RESULTS: Performance of 75 teams of the interventional and 66 of the control
group was analysed. The hands-off time was significantly lower in the
interventional group (5.42% vs. 8.85%, p = 0.029). Scores of the TAS and the
overall BLS score were high and not significantly different between the groups.
Hands-off time correlated significantly negative with all TAS items.
CONCLUSION: BLS training for clinical staff which creates shared mental models
reduces hands-off time in a simulated cardiac arrest scenario. Training methods
establishing shared mental models of team members can be considered for
effective team trainings without adding additional training time.

Copyright © 2019 Elsevier B.V. All rights reserved.

DOI: 10.1016/j.resuscitation.2019.08.040
PMID: 31505232 [Indexed for MEDLINE]

112. JAMA Intern Med. 2015 Feb;175(2):196-204. doi:

10.1001/jamainternmed.2014.5420.

Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life

support.

Sanghavi P(1), Jena AB(2), Newhouse JP(3), Zaslavsky AM(4).

Author information:
(1)Interfaculty Initiative in Health Policy, Harvard University, Cambridge,
Massachusetts.
(2)Department of Health Care Policy, Harvard Medical School, Boston,
Massachusetts3Massachusetts General Hospital, Boston4National Bureau of Economic
Research, Cambridge, Massachusetts.
(3)Department of Health Care Policy, Harvard Medical School, Boston,
Massachusetts4National Bureau of Economic Research, Cambridge,
Massachusetts5Department of Health Policy and Management, Harvard School of
Public Health, Boston, Massachusetts6Harvard Kenne.
(4)Department of Health Care Policy, Harvard Medical School, Boston,
Massachusetts.

Comment in
JAMA Intern Med. 2015 Feb;175(2):205-6. doi:
10.1001/jamainternmed.2014.6590.
JAMA Intern Med. 2015 Aug;175(8):1421. doi: 10.1001/jamainternmed.2015.2097.
JAMA Intern Med. 2015 Aug;175(8):1421-2. doi:
10.1001/jamainternmed.2015.2103.
JAMA Intern Med. 2015 Aug;175(8):1422-3. doi:
10.1001/jamainternmed.2015.2109.
JAMA Intern Med. 2015 Aug;175(8):1423. doi: 10.1001/jamainternmed.2015.2112.

IMPORTANCE: Most out-of-hospital cardiac arrests receiving emergency medical

services in the United States are treated by ambulance service providers trained
in advanced life support (ALS), but supporting evidence for the use of ALS over
basic life support (BLS) is limited.
OBJECTIVE: To compare the effects of BLS and ALS on outcomes after
out-of-hospital cardiac arrest.
DESIGN, SETTING, AND PARTICIPANTS: Observational cohort study of a nationally
representative sample of traditional Medicare beneficiaries from nonrural
counties who experienced out-of-hospital cardiac arrest between January 1, 2009,
and October 2, 2011, and for whom ALS or BLS ambulance services were billed to
Medicare (31,292 ALS cases and 1643 BLS cases). Propensity score methods were
used to compare the effects of ALS and BLS on patient survival, neurological
performance, and medical spending after cardiac arrest.
MAIN OUTCOMES AND MEASURES: Survival to hospital discharge, to 30 days, and to
90 days; neurological performance; and incremental medical spending per
additional survivor to 1 year.
RESULTS: Survival to hospital discharge was greater among patients receiving BLS
(13.1% vs 9.2% for ALS; 4.0 [95% CI, 2.3-5.7] percentage point difference), as
was survival to 90 days (8.0% vs 5.4% for ALS; 2.6 [95% CI, 1.2-4.0] percentage
point difference). Basic life support was associated with better neurological
functioning among hospitalized patients (21.8% vs 44.8% with poor neurological
functioning for ALS; 23.0 [95% CI, 18.6-27.4] percentage point difference).
Incremental medical spending per additional survivor to 1 year for BLS relative
to ALS was $154,333.
CONCLUSIONS AND RELEVANCE: Patients with out-of-hospital cardiac arrest who
received BLS had higher survival at hospital discharge and at 90 days compared
with those who received ALS and were less likely to experience poor neurological
functioning.

DOI: 10.1001/jamainternmed.2014.5420
PMCID: PMC4314335
PMID: 25419698 [Indexed for MEDLINE]

Conflict of interest statement: Conflict of Interest Disclosures: Dr Newhouse

reported being a director of and holding equity in Aetna. No other disclosures
were reported.

113. J Sports Med Phys Fitness. 2022 Dec;62(12):1742-1747. doi:

10.23736/S0022-4707.22.13719-9. Epub 2022 May 27.

Health characteristics, knowledge, and attitude towards basic life support among
marathon runners in Thailand: a population-based survey.

Wongtanasarasin W(1), Sutham K(1), Laosuksri W(1), Wittayachamnankul B(2).

Author information:
(1)Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University,
Chiang Mai, Thailand.
(2)Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University,
Chiang Mai, Thailand - [email protected].

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is not common but associated

with a low survival rate. There is no evidence investigating the effects of
previous Basic Life Support (BLS) training among long-distance runners. The goal
of this study is to demonstrate the health characteristics, knowledge, and
attitudes towards BLS among marathon runners.
METHODS: An online cross-sectional survey was asked to all 2019 Chiang Mai
University marathon participants as a part of the running registration. Details
of health characteristic, running history, and BLS training details were
requested. The primary outcomes were knowledge and attitude towards BLS among
marathon runners.
RESULTS: Of all 10,507 questionnaires sent, the response rate was 92.9%.
One-nineth of participants were 50 years of age or above. The mean age was
36.8±9.9 years. Most were male (56.1%) and Thai (99.4%). Only a quarter (2454
out of 9761 runners) of study population had previous BLS training. Family
history of sudden cardiac death or cardiac death with unknown causes was more in
participants with previous BLS training than those without (1.1% vs. 0.6%,
P=0.01). Previous BLS training group answered the national emergency call number
correctly more than those without (90.4% vs. 73.0%, P<0.001) and previous BLS
training group were more likely to initiate CPR than those without (median
self-confidence 8 vs. 5, respectively, P<0.001).
CONCLUSIONS: Only a quarter of running participants have participated in BLS
training before entering a marathon running. Having previous BLS training is
associated with higher self-confidence to attempt CPR. Organized planning
including trained medical staff, adequate equipment, and qualified bystanders is
recommended.

DOI: 10.23736/S0022-4707.22.13719-9
PMID: 35620953 [Indexed for MEDLINE]

114. World J Emerg Med. 2019;10(2):75-80. doi: 10.5847/wjem.j.1920-

8642.2019.02.002.

Do medical students studying in the United Kingdom have an adequate factual

knowledge of basic life support?

Willmore RD(1), Veljanoski D(2), Ozdes F(3), Stephens B(4), Mooney J(5), Crumley
SG(6), Doshi A(7), Davies P(7), Badhrinarayanan S(8), Day E(9), Tattam K(10),
Wilson A(10), Crang N(11), Green L(12), Mounsey CA(13), Fu H(13), Williams
J(13), D'souza MS(14), Sebastian D(14), Mcgiveron LA(15), Percy MG(15), Cohen
J(16), John IJ(17), Lethbridge A(17), Watkins I(18), Amin O(19), Qamar MA(20),
Hanrahan JG(21), Cramond-Wong E(22).

Author information:
(1)Barts Health NHS Trust, London, United Kingdom.
(2)Barts & the London Medical School, Queen Mary University of London, E1 2AT,
United Kingdom.
(3)Norwich Medical School, University of East Anglia, NR4 7TJ, United Kingdom.
(4)Lancaster Medical School, Lancaster University, LA1 4YW, United Kingdom.
(5)School of Medicine, Dentistry and Biomedical Sciences, Queen's University
Belfast, BT7 1NN, United Kingdom.
(6)Faculty of Medicine, University of St Andrews, KY16 9AJ, United Kingdom.
(7)Faculty of Medicine, Dentistry and Health, University of Sheffield, S10 2TN,
United Kingdom.
(8)Brighton and Sussex University Hospitals NHS Trust, BN2 5BE, United Kingdom.
(9)St George's University of London, SW17 0RE, United Kingdom.
(10)University of Liverpool School of Medicine, L3 5PS, United Kingdom.
(11)University of Exeter medical school, EX4 4QJ, United Kingdom.
(12)Faculty of Medicine, University of Southampton, SO17 1BJ, United Kingdom.
(13)Medical Sciences Division, University of Oxford, OX1 3PA, United Kingdom.
(14)University of Edinburgh Medical School, EH8 9YL, United Kingdom.
(15)Faculty of Medicine, University of Warwick, CV4 7AL, United Kingdom.
(16)University College London Medical School, WC1E 6BT, United Kingdom.
(17)Cardiff University School of Medicine, CF10 3XQ, United Kingdom.
(18)College of Medical and Dental Sciences, University of Birmingham, B15 2TT,
United Kingdom.
(19)College of Medical, Veterinary and Life Sciences, University of Glasgow, G12
8QQ, United Kingdom.
(20)Guys, Kings, and St Thomas School of Medicine, King's College London, WC2R
2LS, United Kingdom.
(21)Faculty of Life Sciences & Medicine, King's College London, WC2R 2LS, United
Kingdom.
(22)Faculty of Health Sciences at the University of Nottingham, NG7 2RD, United
Kingdom.

Comment in
Med Teach. 2022 Aug;44(8):943. doi: 10.1080/0142159X.2021.1984410.

BACKGROUND: Healthcare professionals have a duty to maintain basic life support

(BLS) skills. This study aims to evaluate medical students' factual knowledge of
BLS and the training they receive.
METHODS: A cross-sectional, closed-response questionnaire was distributed to the
first- and fourth-year students studying at institutions in the United Kingdom.
The paper questionnaire sought to quantify respondent's previous BLS training,
factual knowledge of the BLS algorithm using five multiple choice questions
(MCQs), and valuate their desire for further BLS training. Students received 1
point for each correctly identified answer to the 5 MCQ's.
RESULTS: A total of 3,732 complete responses were received from 21 medical
schools. Eighty percent (n=2,999) of students completed a BLS course as part of
their undergraduate medical studies. There was a significant difference
(P<0.001) in the percentage of the fourth-year students selecting the correct
answer in all the MCQ's compared to the first-year students except in
identifying the correct depth of compressions required during CPR (P=0.095).
Overall 10.3% (95% CI 9.9% to 10.7%) of respondents correctly identified the
answer to 5 MCQ's on BLS 9% of the first-year students (n=194) and 12% of the
fourth-year students (n=190). On an institutional level the proportion of
students answering all MCQ's correctly ranged from 2% to 54% at different
universities. Eighty-one percent of students (n=3,031) wished for more BLS
training in their curriculum.
CONCLUSION: Factual knowledge of BLS is poor among medical students in the UK.
There is a disparity in standards of knowledge across institutions and
respondents indicating that they would like more training.

DOI: 10.5847/wjem.j.1920-8642.2019.02.002
PMCID: PMC6340821
PMID: 30687442

Conflict of interest statement: Conflicts of Interest: We have read and

understood the journal’s and ICJME policy on declaration of interests and
declare that we have no competing interests.

115. Am J Emerg Med. 2015 Jan;33(1):43-9. doi: 10.1016/j.ajem.2014.10.018. Epub

2014
Oct 18.

Improper bystander-performed basic life support in cardiac arrests managed with

public automated external defibrillators.

Nishi T(1), Takei Y(2), Kamikura T(3), Ohta K(4), Hashimoto M(5), Inaba H(6).

Author information:
(1)Department of Emergency Medical Science, Kanazawa University Graduate School
of Medicine, Kanazawa, Ishikawa, Japan. Electronic address:
[email protected].
(2)Department of Emergency Medical Science, Kanazawa University Graduate School
of Medicine, Kanazawa, Ishikawa, Japan; Department of Medical Science and
Technology, Hiroshima International University, Higashi-hiroshima, Hiroshima
Japan. Electronic address: [email protected].
(3)Department of Emergency Medical Science, Kanazawa University Graduate School
of Medicine, Kanazawa, Ishikawa, Japan. Electronic address:
[email protected].
(4)Emergency Medical Center, Ishikawa Prefectural Central Hospital, Kanazawa
city, Ishikawa, Japan. Electronic address: [email protected].
(5)Emergency medical Center, Noto General Hospital, Nanao city, Ishikawa, Japan.
Electronic address: [email protected].
(6)Department of Emergency Medical Science, Kanazawa University Graduate School
of Medicine, Kanazawa, Ishikawa, Japan. Electronic address:
[email protected].

AIM: The aim of the study was to determine the quality of basic life support
(BLS) in out-of-hospital cardiac arrests (OHCAs) receiving bystander
cardiopulmonary resuscitation (CPR) and public automated external defibrillator
(AED) application.
METHODS: From January 2006 to December 2012, data were prospectively collected
from OHCA) and impending cardiac arrests treated with and without public AED
before emergency medical technician (EMT) arrival. Basic life support actions
and outcomes were compared between cases with and without public AED
application. Interruptions of CPR were compared between 2 groups of AED users:
health care provider (HCP) and non-HCP.
RESULTS: Public AEDs were applied in 10 and 273 cases of impending cardiac
arrest and non-EMT-witnessed OHCAs, respectively (4.3% of 6407 non-EMT-witnessed
OHCAs). Defibrillation was delivered to 33 (13.3%) cases. Public AED application
significantly improved the rate of 1-year neurologically favorable survival in
bystander CPR-performed cases with shockable initial rhythm but not in those
with nonshockable rhythm. Emergency calls were significantly delayed compared
with other OHCAs without public AED application (median: 3 and 2 minutes,
respectively; P < .0001). Analysis of AED records obtained from 136 (54.6%) of
the 249 cases with AED application revealed significantly lower rate of
compressions delivered per minute and significantly greater proportion of CPR
pause in the non-HCP group. Time interval between power on and the first
electrocardiographic analysis widely varied in both groups and was significantly
prolonged in the non-HCP group (P = .0137).
CONCLUSIONS: Improper BLS responses were common in OHCAs treated with public
AEDs. Periodic training for proper BLS is necessary for both HCPs and non-HCPs.

Copyright © 2014 Elsevier Inc. All rights reserved.

DOI: 10.1016/j.ajem.2014.10.018
PMID: 25455048 [Indexed for MEDLINE]

116. Sultan Qaboos Univ Med J. 2017 Feb;17(1):e59-e65. doi:

10.18295/squmj.2016.17.01.011. Epub 2017 Mar 30.

Knowledge and Attitudes Towards Basic Life Support Among Health Students at a
Saudi Women's University.

Al-Mohaissen MA(1).

Author information:
(1)Department of Clinical Sciences, Princess Nourah bint Abdulrahman University,
Riyadh, Saudi Arabia.

OBJECTIVES: Awareness of basic life support (BLS) is paramount to ensure the

provision of essential life-saving medical care in emergency situations. This
study aimed to measure knowledge of BLS and attitudes towards BLS training among
female health students at a women's university in Saudi Arabia.
METHODS: This prospective cross-sectional study took place between January and
April 2016 at five health colleges of the Princess Nourah bint Abdulrahman
University, Riyadh, Saudi Arabia. All 2,955 students attending the health
colleges were invited to participate in the study. Participants were
subsequently asked to complete a validated English-language questionnaire which
included 21 items assessing knowledge of BLS and six items gauging attitudes to
BLS.
RESULTS: A total of 1,349 students completed the questionnaire (response rate:
45.7%). The mean overall knowledge score was very low (32.7 ± 13.9) and 87.9% of
the participants had very poor knowledge scores. A total of 32.5% of the
participants had never received any BLS training. Students who had previously
received BLS training had significantly higher knowledge scores (P <0.001),
although their knowledge scores remained poor. Overall, 77.0% indicated a desire
to receive additional BLS training and 78.5% supported mandatory BLS training.
CONCLUSION: Overall knowledge about BLS among the students was very poor;
however, attitudes towards BLS training were positive. These findings call for
an improvement in BLS education among Saudi female health students so as to
ensure appropriate responses in cardiac arrest or other emergency situations.

DOI: 10.18295/squmj.2016.17.01.011
PMCID: PMC5380423
PMID: 28417030 [Indexed for MEDLINE]

Conflict of interest statement: CONFLICT OF INTEREST The author declares no

conflicts of interest.

117. Resuscitation. 2016 Nov;108:1-7. doi: 10.1016/j.resuscitation.2016.08.020.

Epub
2016 Aug 27.

Teaching school children basic life support improves teaching and basic life
support skills of medical students: A randomised, controlled trial.

Beck S(1), Meier-Klages V(2), Michaelis M(2), Sehner S(3), Harendza S(4),
Zöllner C(2), Kubitz JC(2).

Author information:
(1)Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf,
Martini-Str. 52, 20246 Hamburg, Germany. Electronic address: [email protected].
(2)Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf,
Martini-Str. 52, 20246 Hamburg, Germany.
(3)Department of Medical Biometry and Epidemiology, University Medical Center
Hamburg-Eppendorf, Martini-Str. 52, 20246 Hamburg, Germany.
(4)III. Medical Clinic and Polyclinic, University Medical Center
Hamburg-Eppendorf, Martini-Str. 52, 20246 Hamburg, Germany.

BACKGROUND: The "kids save lives" joint-statement highlights the effectiveness

of training all school children worldwide in cardiopulmonary resuscitation (CPR)
to improve survival after cardiac arrest. The personnel requirement to implement
this statement is high. Until now, no randomised controlled trial investigated
if medical students benefit from their engagement in the BLS-education of school
children regarding their later roles as physicians. The objective of the present
study is to evaluate if medical students improve their teaching behaviour and
CPR-skills by teaching school children in basic life support.
METHODS: The study is a randomised, single blind, controlled trial carried out
with medical students during their final year. In total, 80 participants were
allocated alternately to either the intervention or the control group. The
intervention group participated in a CPR-instructor-course consisting of a
4h-preparatory seminar and a teaching-session in BLS for school children. The
primary endpoints were effectiveness of teaching in an objective teaching
examination and pass-rates in a simulated BLS-scenario.
RESULTS: The 28 students who completed the CPR-instructor-course had
significantly higher scores for effective teaching in five of eight dimensions
and passed the BLS-assessment significantly more often than the 25 students of
the control group (Odds Ratio (OR): 10.0; 95%-CI: 1.9-54.0; p=0.007).
CONCLUSIONS: Active teaching of BLS improves teaching behaviour and
resuscitation skills of students. Teaching school children in BLS may prepare
medical students for their future role as a clinical teacher and support the
implementation of the "kids save lives" statement on training all school
children worldwide in BLS at the same time.

Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.resuscitation.2016.08.020
PMID: 27576085 [Indexed for MEDLINE]

118. Emerg Med J. 2009 May;26(5):327-30. doi: 10.1136/emj.2008.063594.

Basic cardiac life support education for non-medical hospital employees.

Sim MS(1), Jo IJ, Song HG.

Author information:
(1)Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan
University School of Medicine, 135-710 Ilwon-Dong 50, Gangnam-Ku, Seoul, Korea.

BACKGROUND: The International Liaison Committee on Resuscitation (ILCOR)

recommends that strategies should be implemented that promote cardiopulmonary
resuscitation (CPR) training in the workplace. Non-medical employees at a
hospital were therefore trained to conduct basic life support (BLS). Subject
background information, test results and survey findings were examined and
factors affecting BLS skill acquisition were studied.
METHODS: Of 1432 non-medical employees at a hospital trained to conduct BLS, 880
agreed to participate in the survey. The training course consisted of a single
session of 3 h of lectures, practice and testing. Skill acquisition was assessed
using a 13-item skill checklist and a 5-point overall competency scale. The
effects of age, gender, type of job, educational status, a previous history of
CPR training and level of subject-perceived training difficulty were examined.
RESULTS: According to total checklist scores, subjects achieved a mean (SD)
score of 8.66 (3.57). 22.3% performed all 13 skills. Based on 5-point overall
competency ratings, 43.7% of subjects were rated as "competent", "very good" or
"outstanding". Age (<40 years and >or=40 years) was the only factor that
significantly affected skill acquisition (skill acquisition by those >or=40
years of age was poorer than by those aged <40 years).
CONCLUSION: Traditional BLS training is less effective in individuals aged
>or=40 years.

DOI: 10.1136/emj.2008.063594
PMID: 19386864 [Indexed for MEDLINE]

119. Resuscitation. 2012 Jul;83(7):894-9. doi: 10.1016/j.resuscitation.2012.01.013.

Epub 2012 Jan 26.
Peer-led training and assessment in basic life support for healthcare students:
synthesis of literature review and fifteen years practical experience.

Harvey PR(1), Higenbottam CV, Owen A, Hulme J, Bion JF.

Author information:
(1)Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham,
UK.

BACKGROUND: In 1995, the University of Birmingham, UK, School of Medicine and

Dentistry replaced lecture-based basic life support (BLS) teaching with a
peer-led, practical programme. We present our 15-yr experience of peer-led
healthcare undergraduate training and examination with a literature review.
METHODS: A literature review of healthcare undergraduate peer-led practical
skills teaching was performed though Pubmed. The development of the Birmingham
course is described, from its inception in 1995-2011. Training methods include
peer-led training and assessment by senior students who complete an European
Resuscitation Council-endorsed instructor course. Student assessors additionally
undergo training in assessment and communication skills. The course has been
developed by parallel research evaluation and peer-reviewed publication. Course
administration is by an experienced student committee with senior clinician
support. Anonymous feedback from the most recent courses and the current annual
pass rates are reported.
RESULTS: The literature review identified 369 publications of which 28 met our
criteria for inclusion. Largely descriptive, these are highly positive about
peer involvement in practical skills teaching using similar, albeit smaller,
courses to that described below. Currently approximately 600 first year
healthcare undergraduates complete the Birmingham course; participant numbers
increase annually. Successful completion is mandatory for students to proceed to
the second year of studies. First attempt pass rate is 86%, and close to 100%
(565/566 students, 99.8%) following re-assessment the same day. 97% of
participants enjoyed the course, 99% preferred peer-tutors to clinicians, 99%
perceived teaching quality as "good" or "excellent", and felt they had
sufficient practice. Course organisation was rated "good" or "excellent" by 91%.
Each year 3-4 student projects have been published or presented internationally.
The annual cost of providing the course is currently £15,594.70 (Eur 18,410), or
approximately £26 (Eur 30) per student.
CONCLUSIONS: This large scale, peer-led BLS course demonstrates that such
programmes can have excellent outcomes with outstanding participant
satisfaction. Peer-tutors and assessors are competent, more available and less
costly than clinical staff. Student instructors develop skills in teaching,
assessment and appraisal, organisation and research. Sustainability is possible
given succession-planning and consistent leadership.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.resuscitation.2012.01.013
PMID: 22285723 [Indexed for MEDLINE]

120. Indian J Crit Care Med. 2020 May;24(5):332-335. doi:

10.5005/jp-journals-10071-23442.

Basic Life Support: Need of the Hour-A Study on the Knowledge of Basic Life
Support among Young Doctors in India.

Chandran KV(1), Abraham SV(2).

Author information:
(1)Department of Emergency Medicine, Aster MIMS, Calicut, Kerala, India.
(2)Department of Emergency Medicine, Jubilee Mission Medical College and
Research Institute, Thrissur, Kerala, India.

INTRODUCTION: Knowledge about basic life support (BLS) is mandatory for

healthcare professionals. This study aims to evaluate the knowledge among
medical students who have completed their MBBS course and have enrolled for
internship.
MATERIALS AND METHODS: A questionnaire pertaining to BLS before and after the
BLS workshop (pretest and posttest 1) was distributed among the 50 participants
consented for the study. The questionnaire was again given to the same
participants at the end of their 1 year of internship (posttest 2) and were
analyzed.
RESULTS: Among the participants, 96% of students had attended nonstructured BLS
classes in the past but the knowledge and skill in BLS and ability to recognize
arrest were very low. Knowledge about the essential components of effective
cardiopulmonary resuscitation (CPR) was poor among students, which improved to
near 100% in posttest 1. Awareness about cervical spine stabilization, log
rolling, and management of choking was poor among the students, which improved
after the class. Although attrition had occurred, the knowledge in posttest 2
was significantly better than pretest (p value < 0.05).
CONCLUSION: The BLS knowledge among young doctors in India is very low as
evidenced by poor performance in the pretest. Regular BLS courses are necessary
to improve the knowledge among them and to prepare them to respond to a medical
emergency.
CLINICAL SIGNIFICANCE: Knowledge and skills pertaining to BLS are not usually
taught in medical schools in India. This study indicates the lack of knowledge
among medical students about BLS and the need for improvement and regular
update. This study can serve as a guide for policymakers to consider inculcating
BLS knowledge into the medical school curriculum in the near future.
HOW TO CITE THIS ARTICLE: Vineeth Chandran K, Abraham SV. Basic Life Support:
Need of the Hour-A Study on the Knowledge of Basic Life Support among Young
Doctors in India. Indian J Crit Care Med 2020;24(5):332-335.

Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.

DOI: 10.5005/jp-journals-10071-23442
PMCID: PMC7358858
PMID: 32728324

Conflict of interest statement: Source of support: Nil Conflict of interest:

None

121. World J Emerg Med. 2020;11(3):133-139. doi:

10.5847/wjem.j.1920-8642.2020.03.001.

Availability of basic life support courses for the general populations in India,
Nigeria and the United Kingdom: An internet-based analysis.

Birkun A(1), Trunkwala F(1), Gautam A(1), Okoroanyanwu M(1), Oyewumi A(1).

Author information:
(1)Department of Anaesthesiology, Resuscitation and Emergency Medicine, Medical
Academy named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal
University; 295051, Lenin Blvd, 5/7, Simferopol, Russian Federation.

BACKGROUND: The number of lay people willing to attempt cardiopulmonary

resuscitation (CPR) in real life is increased by effective education in basic
life support (BLS). However, little is known about access of general public to
BLS training across the globe. This study aimed to investigate availability and
key features of BLS courses proposed for lay people in India, Nigeria and the
United Kingdom (UK).
METHODS: A Google search was done in December 2018, using English keywords
relevant for community resuscitation training. Ongoing courses addressing BLS
and suitable for any adult layperson were included in the analysis. On-site
training courses were limited to those provided within the country's territory.
RESULTS: A total of 53, 29 and 208 eligible courses were found for India,
Nigeria and the UK, respectively. In the UK, the number of courses per 10
million population (31.5) is 79 and 21 times higher than that in India (0.4) and
Nigeria (1.5). Course geography is limited to 28% states and one union territory
in India, 30% states and the Federal Capital Territory in Nigeria. In the UK,
the training is offered in all constituent countries, with the highest
prevalence in England. Courses are predominantly classroom-based, highly
variable in duration, group size and instructors' qualifications. For India and
Nigeria, mean cost of participation is exceeding the monthly minimum wage.
CONCLUSION: In contrast to the UK, the availability and accessibility of BLS
courses are critically limited in India and Nigeria, necessitating immediate
interventions to optimize community CPR training and improve bystander CPR
rates.

Copyright: © World Journal of Emergency Medicine.

DOI: 10.5847/wjem.j.1920-8642.2020.03.001
PMCID: PMC7183922
PMID: 32351644

Conflict of interest statement: Conflicts of interests: The authors declare that

they have no competing interests.

122. Scand J Trauma Resusc Emerg Med. 2015 Jun 21;23:48. doi:
10.1186/s13049-015-0123-1.

Quality of basic life support when using different commercially available public
access defibrillators.

Müller MP(1), Poenicke C(2), Kurth M(3), Richter T(4), Koch T(5), Eisold C(6),
Pfältzer A(7), Heller AR(8).

Author information:
(1)Department of Anaesthesiology and Intensive Care Medicine, University
Hospital, Technische Universität Dresden, Dresden, Germany.
[email protected].
(2)Department of Anaesthesiology and Intensive Care Medicine, University
Hospital, Technische Universität Dresden, Dresden, Germany.
[email protected].
(3)Department of Anaesthesiology and Intensive Care Medicine, University
Hospital, Technische Universität Dresden, Dresden, Germany. [email protected].
(4)Department of Anaesthesiology and Intensive Care Medicine, University
Hospital, Technische Universität Dresden, Dresden, Germany.
[email protected].
(5)Department of Anaesthesiology and Intensive Care Medicine, University
Hospital, Technische Universität Dresden, Dresden, Germany.
[email protected].
(6)Department of Anaesthesiology and Intensive Care Medicine, University
Hospital, Technische Universität Dresden, Dresden, Germany.
[email protected].
(7)Department of Anaesthesiology and Intensive Care Medicine, University
Hospital, Technische Universität Dresden, Dresden, Germany.
[email protected].
(8)Department of Anaesthesiology and Intensive Care Medicine, University
Hospital, Technische Universität Dresden, Dresden, Germany.
[email protected].

BACKGROUND: Basic life support (BLS) guidelines focus on chest compressions with
a minimal no-flow fraction (NFF), early defibrillation, and a short perishock
pause. By using an automated external defibrillator (AED) lay persons are guided
through the process of attaching electrodes and initiating defibrillation. It is
unclear, however, to what extent the voice instructions given by the AED might
influence the quality of initial resuscitation.
METHODS: Using a patient simulator, 8 different commercially available AEDs were
evaluated within two different BLS scenarios (ventricular fibrillation vs.
asystole). A BLS certified instructor acted according to the current European
Resuscitation Council 2010 Guidelines and followed all of the AED voice prompts.
In a second set of scenarios, the rescuer anticipated the appropriate actions
and started already before the AED stopped speaking. A BLS scenario without AED
served as the control. All scenarios were run three times.
RESULTS: The time until the first chest compression was 25 ± 2 seconds without
the AED and ranged from 50 ± 3 to 148 ± 13 seconds with the AED depending on the
model used. The NFF was .26 ± .01 without the AED and between .37 ± .01 and
.72 ± .01 when an AED was used. The perishock pause ranged from 12 ± 0 to 46 ± 0
seconds. The optimized sequence of actions reduced the NFF, which ranged now
from .32 ± .01 to .41 ± .01, and the perishock pause ranging from 1 ± 1 to
19 ± 1 seconds.
CONCLUSIONS: Voice prompts given by commercially available AED merely meet the
requirements of current evidence in basic life support. Furthermore, there is a
significant difference between devices with regard to time until the first chest
compression, perishock pause, no-flow fraction and other objective measures of
the quality of BLS. However, the BLS quality may be improved with optimized
handling of the AED. Thus, rescuers should be trained on the respective AED
devices, and manufacturers should expend more effort in improving user guidance
to shorten the NFF and perishock pause.

DOI: 10.1186/s13049-015-0123-1
PMCID: PMC4475613
PMID: 26094032 [Indexed for MEDLINE]

123. Natl J Maxillofac Surg. 2014 Jan;5(1):19-22. doi: 10.4103/0975-5950.140159.

Awareness of basic life support among dental practitioners.

Baduni N(1), Prakash P(2), Srivastava D(3), Sanwal MK(4), Singh BP(1).

Author information:
(1)Department of Anaesthesiology, ESIC Dental College and Hospital, Rohini, New
Delhi, India.
(2)Department of General Surgery, ESIC Dental College and Hospital, Rohini, New
Delhi, India.
(3)Department of Oral and Maxillofacial Surgery, ESIC Dental College and
Hospital, Rohini, New Delhi, India.
(4)Department of Anaesthesiology, GB Pant Hospital, JLN Marg, New Delhi, India.

BACKGROUND: It is important that every member of our community should be trained

in effective BLS technique to save lives. At least doctors including dental
practitioners, and medical and paramedical staff should be trained in high
quality CPR, as it is a basic medical skill which can save many lives if
implemented timely.
AIM: Our aim was to study the awareness of Basic Life Support (BLS) among dental
students and practitioners in New Delhi.
MATERIALS AND METHODS: This cross sectional study was conducted by assessing
responses to 20 selected questions pertaining to BLS among dental students,
resident doctors/tutors, faculty members and private practitioners in New Delhi.
All participants were given a printed questionnaire where they had to mention
their qualifications and clinical experience, apart from answering 20 questions.
STATISTICAL ANALYSIS: Data was collected and evaluated using commercially
available statistical package for social sciences (SPSS version 12).
RESULTS: One hundred and four responders were included. Sadly, none of our
responders had complete knowledge about BLS. The maximum mean score (9.19 ±
1.23) was obtained by dentists with clinical experience between 1-5 years.
CONCLUSION: To ensure better and safer healthcare, it is essential for all
dental practitioners to be well versed with BLS.

DOI: 10.4103/0975-5950.140159
PMCID: PMC4178349
PMID: 25298712

Conflict of interest statement: Conflict of Interest: None declared.

124. Ir Med J. 2017 May 10;110(5):572.

Life After the Event: A Review of Basic Life Support Training for Parents
Following Apparent Life-Threatening Events and Their Experience and Practices
Following Discharge.

Macken WL(1), Clarke N(1), Nadeem M(1), Coghlan D(1).

Author information:
(1)Department of General Paediatrics, National Children's Hospital, Tallaght,
Dublin.

Apparent Life-Threatening Events (ALTEs) are a common presentation to paediatric

hospitals and represent a significant cause of parental anxiety. Basic Life
Support (BLS) training is recommended for all caregivers following ALTEs. This
study aimed to assess the rate of caregiver BLS training and reviewed parents
experience following discharge. Parents were interviewed by phone following
discharge. Over the study period 25 children attended the Emergency Department
with ALTE, 17/25 (68%) were trained and 13/17 (76%) were contactable for
interview. All parents found training decreased their anxiety level and were
interested in attending for re-training. BLS resuscitation was subsequently
required by 2/13 (15%) of children. Non-medical grade monitors were in use by
10/13 (77%) of caregivers following discharge. Caregivers are eager to engage in
BLS training and it effectively reduces their caregiver anxiety. We recommend an
increase in instructor staff and use of group re-training post discharge.

PMID: 28737312 [Indexed for MEDLINE]

125. BMC Med Educ. 2024 Sep 5;24(1):971. doi: 10.1186/s12909-024-05922-0.

Knowledge and Skill Retention in First-Year MBBS Students After Basic Life
Support Training: A One-Year Longitudinal Study.
Kochhar S(1), Samagh N(2), Sharma J(3), Kaur A(4), Verma M(5).

Author information:
(1)Department of Physiology, All India Institute Of Medical Sciences, Bathinda,
Punjab, 151001, India.
(2)Department of Anesthesiology and Critical Care, All India Institute Of
Medical Sciences, 1st Floor, IPD Block, Bathinda, Punjab, 151001, India.
[email protected].
(3)Department of Anesthesiology and Critical Care, All India Institute Of
Medical Sciences, 1st Floor, IPD Block, Bathinda, Punjab, 151001, India.
(4)Department of General Medicine, All India Institute Of Medical Sciences,
Bathinda, Punjab, 151001, India.
(5)Department of Community and Family Medicine, All India Institute Of Medical
Sciences, Bathinda, Punjab, 151001, India.

BACKGROUND: The Indian National Medical Council has incorporated the Basic Life
Support (BLS) course in the foundation course of the undergraduate (MBBS)
medical curriculum. However, medical teachers raise concerns about how training
would affect the retention of Basic Life Support (BLS) abilities in the longer
run. So, the current study assesses the knowledge and retention of BLS skills
among first-year MBBS students over one year.
METHODS: We included one hundred first-year MBBS students in our study who were
trained for BLS, including theory, demonstrations and hands-on training using
mannequins. Theoretical knowledge was assessed using pre-test and post-test
questionnaires. At the same time, the skills were evaluated using Directly
Observed Procedural Skills (DOPS) scores before, just after the training
session, and again after one month, six months, and one year. Course feedback
was also taken from the students after completing the sessions.
RESULTS: There was a statistically significant difference between pre-and
post-test knowledge scores, indicating that training improved their knowledge.
(p < 0.001) There was also a statistically significant difference between
pre-and post-test skills using DOPS (p < 0.001). There was no significant
difference in the score when DOPS was conducted at one month, but a significant
decrease in their skills was seen at six months and one year when compared with
the Post Skill Score. (P < 0.001) CONCLUSIONS: The first-year medical students'
knowledge and skills were enhanced by BLS training coupled with practical
sessions. Such waning skills necessitate repeating the training at periodic
intervals to reinform retention of skills acquired during BLS training.

© 2024. The Author(s).

DOI: 10.1186/s12909-024-05922-0
PMCID: PMC11378406
PMID: 39238013 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare no competing interests.

126. Resuscitation. 1996 Jul;32(1):63-75. doi: 10.1016/0300-9572(95)00935-3.

Future directions for resuscitation research. II. External cardiopulmonary

resuscitation basic life support.

Bircher N(1), Otto C, Babbs C, Braslow A, Idris A, Keil JP, Kaye W, Lane J,
Morioka T, Roese W, Wik L.

Author information:
(1)Safar Center for Resuscitation Research, University of Pittsburgh, PA, USA.
In sudden cardiac deaths outside hospitals, the present performance of external
cardiopulmonary resuscitation-basic life support (CPR-BLS), as a bridge to
advanced life support (ALS) attempts for restoration of spontaneous circulation
(ROSC), still yields suboptimal results. Therefore, future education research
should develop more effective, simpler and quicker ways to enable everyone to
acquire the necessary BLS skills. Individualized self-training by lay persons is
being revived. Although airway control and direct mouth-to-mouth ventilation
skills are difficult to acquire, they must continue to be taught to the lay
public and health professionals, primarily for use on relatives and friends
where infection risk is not a problem. In children and trauma victims, steps A
and B alone may be lifesavers. The best way to ventilate and oxygenate during
the initiation of brief external CPR-BLS should be re-evaluated. There is a
great difference between animals and humans in the behavior of the airway and
thorax during coma, and thus in the need for added positive pressure
ventilation. During chest compressions in humans, steps A and B are needed.
Details deserve re-evaluation. The low perfusion pressures (borderline blood
flows) produced by standard external CPR remain the most serious limitation of
this method. In spite of extensive efforts so far, novel laboratory research to
remedy this limitation is important for the development of more effective
emergency artificial circulation. The results of such studies are greatly
influenced by different details in animal models. Active
compression-decompression (ACD) external CPR, also called 'push-pull' CPR, with
a plunger-type device used by hand or a machine, and intermittent abdominal
compression (IAC) external CPR are both promising modifications of standard
external CPR. Both need further experimental and clinical clarification. For
BLS, developing a more effective purely manual CPR-BLS method for help in rapid
ROSC should be given high priority. Portable external CPR machines need
improvements. They will serve for bridging ROSC-resistant cases through
transport and ALS attempts, primarily by freeing the hands of health
professionals for more effective sophisticated ALS measures.

DOI: 10.1016/0300-9572(95)00935-3
PMID: 8809921 [Indexed for MEDLINE]

127. Glob Heart. 2024 Nov 13;19(1):86. doi: 10.5334/gh.1368. eCollection 2024.

Knowledge, Attitude, and Practice of the Lebanese University Medical Students

and Junior Doctors on Basic Life Support Practices.

El Assaad H(1)(2), Osman B(1)(3), Honeine MO(1), Abi-Hanna P(1), Chahine

MN(1)(4)(5).

Author information:
(1)Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon.
(2)Leipzig University Hospital, Department of Orthopedics, Trauma Surgery and
Plastic Surgery, Leipzig, Germany.
(3)Hotel Dieu de France Hospital, Saint Joseph University, Department of
Digestive and Endocrine Surgery, Beirut, Lebanon.
(4)Basic Sciences Department, Faculty of Medical Sciences, Lebanese University,
Hadath, Lebanon.
(5)Foundation-Medical Research Institutes (F-MRI®), Beirut, Lebanon.

BACKGROUND: Basic life support (BLS) is the recognition of sudden cardiac arrest
and activation of emergency response system, followed by cardiopulmonary
resuscitation (CPR), and rapid defibrillation.
AIM: Our study aimed to determine the level of awareness of the Lebanese
University medical students and trainees on BLS, by assessing the association
between knowledge, attitude, and practice on BLS, and between the demographic
variables and KAP scores.
METHODS: This was a cross-sectional study including 330 medical students
enrolled at Lebanese University, from year four of general medicine till year
five of residency. An online survey was used to collect data about demographic
characteristics, knowledge (K), attitudes (A), and practice (P) about BLS. Data
was analyzed using SPSS version 25.
RESULTS: Participants were 52.7% females, 47.3% males, and their mean age was 24
± 2 years. Of the 330 participants, 38.8% received formal training regarding
BLS. Medical students had low knowledge (90%), moderate to good attitudes
(71.5%), and low practice (93%) regarding BLS. Multiple linear regression showed
that knowledge was positively associated with age (p = 0.001), knowledge and
information regarding BLS (p = 0.016), and any formal training/workshop
regarding BLS (p = 0.021). Attitude was positively associated with academic year
(p = 0.002) and knowledge (p = 0.003). Practice was positively associated with
age (p < 0.001) and knowledge (p < 0.001).
CONCLUSION: Most Lebanese University medical students showed low knowledge,
moderate to good attitudes, and low practice regarding BLS. We recommend that
CPR/BLS should be a core competency across all health care professional
programs.

Copyright: © 2024 The Author(s).

DOI: 10.5334/gh.1368
PMCID: PMC11568803
PMID: 39552940 [Indexed for MEDLINE]

Conflict of interest statement: The authors have no competing interests to

declare.

128. Belitung Nurs J. 2024 Jun 28;10(3):261-271. doi: 10.33546/bnj.3328.

eCollection
2024.

Enriching nursing knowledge and practice in Jordanian government hospitals

through basic life support simulation training: A randomized controlled trial.

Abu-Wardeh Y(1)(2), Ahmad WMAW(3), Che Hamzah MSS(4), Najjar YW(5), Hassan
II(1).

Author information:
(1)School of Health Sciences, Health Campus, Universiti Sains Malaysia, 16150
Kubang Kerian, Kelantan, Malaysia.
(2)Nursing Department, Prince Faisal Hospital, Ministry of Health, AMMAN,
Jordan.
(3)Department of Biostatistics, School of Dental Sciences, Health Campus,
Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
(4)Department of Emergency Medicine, School of Medical Science, Health Campus,
Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
(5)Zarqa University College, Al-Balqa Applied University, Zarqa, Jordan.

BACKGROUND: Healthcare providers must possess the necessary knowledge and skills
to perform effective cardiopulmonary resuscitation (CPR). In the event of
cardiopulmonary arrest, basic life support (BLS) is the initial step in the
life-saving process before the advanced CPR team arrives. BLS simulation
training using manikins has become an essential teaching methodology in nursing
education, enhancing newly employed nurses' knowledge and skills and empowering
them to provide adequate resuscitation.
OBJECTIVE: This study aimed to evaluate the potential effect of BLS simulation
training on knowledge and practice scores among newly employed nurses in
Jordanian government hospitals.
METHODS: A total of 102 newly employed nurses were randomly assigned to two
groups: the control group (n = 51) received standard training, and the
experimental group (n = 51) received one full day of BLS simulation training.
The training program used the American Heart Association (AHA)-BLS-2020
guidelines and integrated theoretical models such as Miller's Pyramid and Kolb's
Cycle. Both groups were homogeneous in inclusion characteristics and pretest
results. Knowledge and practice scores were assessed using 23 multiple-choice
questions (MCQs). Data were analyzed using one-way repeated measures ANOVA.
RESULTS: The results indicated significant differences in knowledge scores, F(2,
182) = 58.514, p <0.001, and practice scores, F(2, 182) = 20.134, p <0.001,
between the control and experimental groups at all measurement times: pretest,
posttest 1, and posttest 2. Moreover, Cohen's d reflected the effectiveness of
BLS simulation training as an educational module, showing a large effect
(Cohen's d = 1.568) on participants' knowledge levels and a medium effect
(Cohen's d = 0.749) on participants' practice levels.
CONCLUSION: The study concludes that BLS simulation training using the
AHA-BLS-2020 guidelines and integrating theoretical models such as Miller's
Pyramid and Kolb's Cycle significantly improves knowledge and practice scores
among newly employed nurses, proving highly effective in enhancing their
competencies in performing CPR. Implementing BLS simulation training in nursing
education programs can significantly elevate the proficiency of newly employed
nurses, ultimately improving patient outcomes during cardiopulmonary arrest
situations. This training approach should be integrated into standard nursing
curricula to ensure nurses are well-prepared for real-life emergencies.
TRIAL REGISTRY NUMBER: NCT06001879.

© The Author(s) 2024.

DOI: 10.33546/bnj.3328
PMCID: PMC11211748
PMID: 38947304

Conflict of interest statement: The authors declared that they have no known
competing financial interests or personal relationships that could have appeared
to influence the work reported in this paper.

129. BMC Health Serv Res. 2019 Nov 21;19(1):865. doi: 10.1186/s12913-019-4676-y.

Current state of knowledge of basic life support in health professionals of the

largest city in Pakistan: a cross-sectional study.

Irfan B(1), Zahid I(2), Khan MS(3), Khan OAA(4), Zaidi S(4), Awan S(5), Bilal
S(6), Irfan O(7).

Author information:
(1)Jinnah Postgraduate Medical Center, Karachi, Pakistan.
(2)Dow University of Health Sciences, Karachi, Pakistan.
[email protected].
(3)Altamash Institute of Dental Medicine, Karachi, Pakistan.
(4)Jinnah Sindh Medical University, Karachi, Pakistan.
(5)Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
(6)Faculty School of Dentistry, Lead IMU-Quit Smoking Service, International
Medical University, Kuala Lumpur, Malaysia.
(7)Peter Gilgan Center of Research and Learning, Hospital for Sick Children,
Toronto, Canada.
BACKGROUND: Basic Life Support (BLS) is the recognition of sudden cardiac arrest
and activation of the emergency response system, followed by resuscitation, and
rapid defibrillation. According to WHO, Pakistan has one of the highest
mortality rates from accidental deaths therefore assessment and comparison of
BLS knowledge in health professionals is crucial. We thereby aim to assess and
compare the knowledge of BLS in doctors, dentists and nurses.
METHODS: A multi-centric cross-sectional survey was conducted in Karachi at
different institutions belonging to the private as well as government sector
from January to March 2018. We used a structured questionnaire which was adapted
from pretested questionnaires that have been used previously in similar studies.
Descriptive statistics were analyzed using SPSS v22.0, where adequate knowledge
was taken as a score of at least 50%. P < 0.05 was considered as significant.
Logistic regression was used to identify the factors affecting the knowledge
regarding BLS in health care professionals.
RESULTS: The responders consisted of 140 doctors, nurses and dentists each. Only
one individual (dentist) received a full score of 100%. In total, 58.3% of the
population had inadequate knowledge. Average scores of doctors, dentists and
nurses were 53.5, 43.3 and 38.4% respectively. Doctors, participants with prior
training in BLS and those with 6 to 10 years after graduation were found to be a
significant predictor of adequate knowledge, on multivariate analysis.
CONCLUSION: Even though knowledge of BLS in doctors is better than that of
dentists and nurses, overall knowledge of health care professionals is extremely
poor. Present study highlights the need for a structured training of BLS for
health care workers.

DOI: 10.1186/s12913-019-4676-y
PMCID: PMC6868838
PMID: 31752855 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare that they have no competing
interests.

130. JMIR Serious Games. 2020 Nov 25;8(4):e24166. doi: 10.2196/24166.

Comparing Basic Life Support Serious Gaming Scores With Hands-on Training
Platform Performance Scores: Pilot Simulation Study for Basic Life Support
Training.

Aksoy ME(#)(1).

Author information:
(1)Acibadem Mehmet Ali Aydınlar University, Department Biomedical Device
Technology, CASE (Center of Advanced Simulation and Education), Istanbul,
Turkey.
(#)Contributed equally

BACKGROUND: Serious games enrich simulation-based health care trainings and

improve knowledge, skills, and self-confidence of learners while entertaining
them.
OBJECTIVE: A platform which can combine performance data from a basic life
support (BLS) serious game app and hands-on data based on the same scoring
system is not available in the market. The aim of this study was to create such
a platform and investigate whether performance evaluation of BLS trainings would
be more objective compared to conventional Objective Structured Clinical
Examination (OSCE) examinations if these evaluations were carried out with the
platform which combines OSCE scoring criteria with sensor data retrieved from
the simulator's sensors.
METHODS: Participants were 25 volunteers (11 men [44.0%] and 14 [56.0] women)
among Acıbadem Mehmet Ali Aydınlar University students without prior knowledge
of the BLS protocol. A serious game module has been created for teaching
learners the European Resuscitation Council Basic Life Support 2015 protocol. A
second module called the hands-on module was designed for educators. This module
includes a checklist used for BLS OSCE examinations and can retrieve sensor data
such as compression depth, compression frequency, and ventilation volume from
the manikin (CPR Lilly; 3B Scientific GmbH) via Bluetooth. Data retrieved from
the sensors of the manikin enable educators to evaluate learners in a more
objective way. Performance data retrieved from the serious gaming module have
been combined with the results of the hands-on module. Data acquired from the
hands-on module have also been compared with the results of conventional OSCE
scores of the participants, which were obtained by watching the videos of the
same trainings.
RESULTS: Participants were considered successful in the game if they scored
80/100 or above. Overall, participants scored 80 or above in an average of 1.4
(SD 0.65) trials. The average BLS serious game score was 88.3/100 (SD 5.17) and
hands-on average score was 70.7/100 (SD 17.3), whereas the OSCE average score
was 84.4/100 (SD 12.9). There was no statistically significant correlation
between success on trials (score ≥80/100), serious game, hands-on training app,
and OSCE scores (Spearman rho test, P>.05). The mean BLS serious game score of
the participants was 88.3/100 (SD 5.17), whereas their mean hands-on training
app score was 70.7/100 (SD 17.3) and OSCE score was 84.4/100 (SD 12.9).
CONCLUSIONS: Although scoring criteria for OSCE and hands-on training app were
identical, OSCE scores were 17% higher than hands-on training app scores. After
analyzing the difference of scores between hands-on training app and OSCE, it
has been revealed that these differences originate from scoring parameters such
as compression depth, compression frequency, and ventilation volume. These data
suggest that evaluation of BLS trainings would be more objective if these
evaluations were carried out with the modality, which combines visual OSCE
scoring criteria with sensor data retrieved from the simulator's sensors.
TRIAL REGISTRATION: ClinicalTrials.gov NCT04533893;
https://clinicaltrials.gov/ct2/show/NCT04533893.

©Mehmet Emin Aksoy. Originally published in JMIR Serious Games

(http://games.jmir.org), 25.11.2020.

DOI: 10.2196/24166
PMCID: PMC7725648
PMID: 33237035

Conflict of interest statement: Conflicts of Interest: None declared.

131. Resuscitation. 2003 Aug;58(2):187-92. doi: 10.1016/s0300-9572(03)00126-6.

Knowledge of basic life support: a pilot study of the Turkish population by

Baskent University in Ankara.

Akpek EA(1), Kayhan Z.

Author information:
(1)Department of Anesthesiology, Baskent University Faculty of Medicine, 06490
Ankara, Turkey. [email protected]

Erratum in
Resuscitation. 2004 May;61(2):245. Elif, Akpek A [corrected to Akpek, Elif
A]; Zeynep, Kayhan [corrected to Kayhan, Zeynep].

A total of 494 participants who were scheduled to take Baskent University's

basic life support (BLS) training programme in 2001-02 were asked to complete a
25-item questionnaire prior to the course. The questionnaire investigated the
demographic characteristics of the subjects, their knowledge of the theoretical
and practical aspects of BLS, and personal experience and attitudes related to
BLS. The 'non-medical group' included 179 laypersons, and the 'medical group'
was composed of medical students (n=220), residents (n=69) and clinical nurses
(n=26). One-hundred and twenty-six (25.5%) of the participants had an encounter
with some form of medical emergency event in their past and 207 (41.9%) had
taken a BLS course previously. The most commonly cited anxiety about performing
BLS was the fear of further harming the victim (56.9%). Nine of the participants
said they would not perform mouth-to-mouth ventilation (1.8%). Compared to the
other participants, individuals with previous emergency experience, and those
who had previous BLS training answered significantly more of the theoretical
questions correctly. However, neither of these groups performed significantly
better than the other participants in the practical questions (P>0.05 for both
comparisons). Based on our findings, we recommend that BLS training for medical
undergraduates, other medical personnel and laypersons be improved and
standardized throughout Turkey.

DOI: 10.1016/s0300-9572(03)00126-6
PMID: 12909381 [Indexed for MEDLINE]

132. Med Teach. 2006 Mar;28(2):189-92. doi: 10.1080/01421590500312847.

First aid and basic life support of junior doctors: A prospective study in
Nijmegen, the Netherlands.

Tan EC(1), Severien I, Metz JC, Berden HJ, Biert J.

Author information:
(1)Department of General Surgery--Traumatology, Radboud University Nijmegen
Medical Centre, The Netherlands. [email protected]

According to the Dutch medical education guidelines junior doctors are expected
to be able to perform first aid and basic life support. A prospective study was
undertaken to assess the level of first aid and basic life support (BLS)
competence of junior doctors at the Radboud University Nijmegen Medical Centre
(RUNMC), the Netherlands. Fifty-four junior doctors (18%), of the medical
students in their final years, were submitted to a theoretical test, composed of
multiple-choice questions concerning first aid and basic life support. This test
was followed by a practical test consisting of two out-of-hospital first aid and
basic life support scenarios including cardiopulmonary resuscitation (CPR). In
total, 19% of the junior doctors passed the theoretical test. The first scenario
was performed correctly in 11%. The CPR situation was correctly performed by 30%
of the students as observed by the examiners but when assessed by the checklists
of Berden only 6% of the students performed correct CPR. It is concluded that
the level of first aid and basic life support of the junior doctors at the RUNMC
is low and does not meet the required level as stated in the guidelines for
practice of medical education in the Netherlands.

DOI: 10.1080/01421590500312847
PMID: 16707305 [Indexed for MEDLINE]

133. Circulation. 2015 Oct 20;132(16 Suppl 1):S51-83. doi:

10.1161/CIR.0000000000000272.

Part 3: Adult Basic Life Support and Automated External Defibrillation: 2015
International Consensus on Cardiopulmonary Resuscitation and Emergency
Cardiovascular Care Science With Treatment Recommendations.

Travers AH, Perkins GD, Berg RA, Castren M, Considine J, Escalante R, Gazmuri
RJ, Koster RW, Lim SH, Nation KJ, Olasveengen TM, Sakamoto T, Sayre MR, Sierra
A, Smyth MA, Stanton D, Vaillancourt C; Basic Life Support Chapter
Collaborators.

Collaborators: Bierens JJ, Bourdon E, Brugger H, Buick JE, Charette ML, Chung
SP, Couper K, Daya MR, Drennan IR, Gräsner JT, Idris AH, Lerner EB, Lockhat H,
Løfgren B, McQueen C, Monsieurs KG, Mpotos N, Orkin AM, Quan L, Raffay V,
Reynolds JC, Ristagno G, Scapigliati A, Vadeboncoeur TF, Wenzel V, Yeung J.

This review comprises the most extensive literature search and evidence
evaluation to date on the most important international BLS interventions,
diagnostics, and prognostic factors for cardiac arrest victims. It reemphasizes
that the critical lifesaving steps of BLS are (1) prevention, (2) immediate
recognition and activation of the emergency response system, (3) early
high-quality CPR, and (4) rapid defibrillation for shockable rhythms. Highlights
in prevention indicate the rational and judicious deployment of
search-and-rescue operations in drowning victims and the importance of education
on opioid-associated emergencies. Other 2015 highlights in recognition and
activation include the critical role of dispatcher recognition and
dispatch-assisted chest compressions, which has been demonstrated in multiple
international jurisdictions with consistent improvements in cardiac arrest
survival. Similar to the 2010 ILCOR BLS treatment recommendations, the
importance of high quality was reemphasized across all measures of CPR quality:
rate, depth, recoil, and minimal chest compression pauses, with a universal
understanding that we all should be providing chest compressions to all victims
of cardiac arrest. This review continued to focus on the interface of BLS
sequencing and ensuring high-quality CPR with other important BLS interventions,
such as ventilation and defibrillation. In addition, this consensus statement
highlights the importance of EMS systems, which employ bundles of care focusing
on providing high-quality chest compressions while extricating the patient from
the scene to the next level of care. Highlights in defibrillation indicate the
global importance of increasing the number of sites with public-access
defibrillation programs. Whereas the 2010 ILCOR Consensus on Science provided
important direction for the “what” in resuscitation (ie, what to do), the 2015
consensus has begun with the GRADE methodology to provide direction for the
quality of resuscitation. We hope that resuscitation councils and other
stakeholders will be able to translate this body of knowledge of international
consensus statements to build their own effective resuscitation guidelines.

DOI: 10.1161/CIR.0000000000000272
PMID: 26472859 [Indexed for MEDLINE]

134. Adv Biomed Res. 2023 Apr 28;12:112. doi: 10.4103/abr.abr_232_21. eCollection
2023.

Self-Training Video Module versus Instructor Taught Pediatric Basic Life Support
According to Peyton Model: Report of an Experience.

Ghanbaryan M(1), Saeidi M(1).

Author information:
(1)Department of Pediatrics, Imam Hossein Children Hospital, Isfahan University
of Medical Sciences, Isfahan, Iran.
BACKGROUND: Bystander cardiopulmonary resuscitation is an important predictor of
out-of-hospital arrest prognosis in the pediatric population. The purpose of
this study was to assess the effectiveness of two educational methods, a video
module and Peyton model with manikin, in parent's education.
MATERIALS AND METHODS: We enrolled 140 subjects, 70 in each group. We assess
their knowledge, attitude, and practice about pediatric basic life support (BLS)
before and after two different types of educational interventions.
RESULTS: Mean attitude, knowledge, and practice score were significantly higher
after educational intervention in both groups. Knowledge and total practice
score were significantly higher in the Peyton group compared with DVD group (P =
0.02 and 0.000, respectively). The rate of totally correct chest compression was
53% in Peyton/manikin group versus 24% in DVD/lecture group and the difference
was meaningful statistically (P = 0.0003).
CONCLUSION: Any educational intervention has a significant effect on the Iranian
parent's knowledge and practice about child BLS, but education through manikin
can increase this impact.

Copyright: © 2023 Advanced Biomedical Research.

DOI: 10.4103/abr.abr_232_21
PMCID: PMC10241626
PMID: 37288035

Conflict of interest statement: There are no conflicts of interest.

135. JMIR Serious Games. 2024 Apr 5;12:e56037. doi: 10.2196/56037.

Effects of a Serious Smartphone Game on Nursing Students' Theoretical Knowledge

and Practical Skills in Adult Basic Life Support: Randomized Wait
List-Controlled Trial.

Fijačko N(#)(1)(2), Masterson Creber R(#)(3), Metličar Š(#)(1)(4), Strnad

M(#)(2)(5)(6), Greif R(#)(7)(8)(9), Štiglic G(#)(1)(10), Skok P(#)(2).

Author information:
(1)Faculty of Health Sciences, University of Maribor, Maribor, Slovenia.
(2)Maribor University Medical Centre, Maribor, Slovenia.
(3)School of Nursing, Columbia University, New York, NY, United States.
(4)Medical Dispatch Centre Maribor, University Clinical Centre Ljubljana,
Ljubljana, Slovenia.
(5)Faculty of Medicine, University of Maribor, Maribor, Slovenia.
(6)Community Healthcare Center Dr Adolfa Drolca Maribor, Maribor, Slovenia.
(7)European Resuscitation Council Research Net, Niels, Belgium.
(8)University of Bern, Bern, Switzerland.
(9)School of Medicine, Sigmund Freud University Vienna, Vienna, Austria.
(10)Faculty of Electrical Engineering and Computer Science, University of
Maribor, Maribor, Slovenia.
(#)Contributed equally

BACKGROUND: Retention of adult basic life support (BLS) knowledge and skills
after professional training declines over time. To combat this, the European
Resuscitation Council and the American Heart Association recommend shorter, more
frequent BLS sessions. Emphasizing technology-enhanced learning, such as mobile
learning, aims to increase out-of-hospital cardiac arrest (OHCA) survival and is
becoming more integral in nursing education.
OBJECTIVE: The aim of this study was to investigate whether playing a serious
smartphone game called MOBICPR at home can improve and retain nursing students'
theoretical knowledge of and practical skills in adult BLS.
METHODS: This study used a randomized wait list-controlled design. Nursing
students were randomly assigned in a 1:1 ratio to either a MOBICPR intervention
group (MOBICPR-IG) or a wait-list control group (WL-CG), where the latter
received the MOBICPR game 2 weeks after the MOBICPR-IG. The aim of the MOBICPR
game is to engage participants in using smartphone gestures (eg, tapping) and
actions (eg, talking) to perform evidence-based adult BLS on a virtual patient
with OHCA. The participants' theoretical knowledge of adult BLS was assessed
using a questionnaire, while their practical skills were evaluated on
cardiopulmonary resuscitation quality parameters using a manikin and a
checklist.
RESULTS: In total, 43 nursing students participated in the study, 22 (51%) in
MOBICPR-IG and 21 (49%) in WL-CG. There were differences between the MOBICPR-IG
and the WL-CG in theoretical knowledge (P=.04) but not in practical skills
(P=.45) after MOBICPR game playing at home. No difference was noted in the
retention of participants' theoretical knowledge and practical skills of adult
BLS after a 2-week break from playing the MOBICPR game (P=.13). Key observations
included challenges in response checks with a face-down manikin and a general
neglect of safety protocols when using an automated external defibrillator.
CONCLUSIONS: Playing the MOBICPR game at home has the greatest impact on
improving the theoretical knowledge of adult BLS in nursing students but not
their practical skills. Our findings underscore the importance of integrating
diverse scenarios into adult BLS training.
TRIAL REGISTRATION: ClinicalTrials.gov (NCT05784675);
https://clinicaltrials.gov/study/NCT05784675.

©Nino Fijačko, Ruth Masterson Creber, Špela Metličar, Matej Strnad, Robert
Greif, Gregor Štiglic, Pavel Skok. Originally published in JMIR Serious Games
(https://games.jmir.org), 05.04.2024.

DOI: 10.2196/56037
PMCID: PMC11031703
PMID: 38578690

Conflict of interest statement: Conflicts of Interest: NF is a member of the

European Resuscitation Council (ERC) basic life support (BLS) Science and
Education Committee. RG is the ERC director of guidelines and the International
Liaison Committee on Resuscitation (ILCOR) and chair of the ILCOR Education,
Implementation, and Teams Task Force. Other authors declare no conflicts of
interest.

136. BMC Med Educ. 2014 Sep 6;14:185. doi: 10.1186/1472-6920-14-185.

Basic life support is effectively taught in groups of three, five and eight
medical students: a prospective, randomized study.

Mahling M, Münch A, Schenk S, Volkert S, Rein A, Teichner U, Piontek P, Haffner

L, Heine D, Manger A, Reutershan J, Rosenberger P, Herrmann-Werner A(1), Zipfel
S, Celebi N.

Author information:
(1)Department of Internal Medicine VI, Psychosomatic Medicine, University
Hospital of Tübingen, Osianderstraße 5, Tübingen 72076, Germany.
[email protected].

BACKGROUND: Resuscitation is a life-saving measure usually instructed in

simulation sessions. Small-group teaching is effective. However, feasible group
sizes for resuscitation classes are unknown. We investigated the impact of
different group sizes on the outcome of resuscitation training.
METHODS: Medical students (n = 74) were randomized to courses with three, five
or eight participants per tutor. The course duration was adjusted according to
the group size, so that there was a time slot of 6 minutes hands-on time for
every student. All participants performed an objective structured clinical
examination before and after training. The teaching sessions were videotaped and
resuscitation quality was scored using a checklist while we measured the chest
compression parameters with a manikin. In addition, we recorded hands-on-time,
questions to the tutor and unrelated conversation.
RESULTS: Results are displayed as median (IQR). Checklist pass rates and scores
were comparable between the groups of three, five and eight students per tutor
in the post-test (93%, 100% and 100%). Groups of eight students asked fewer
questions (0.5 (0.0 - 1.0) vs. 3.0 (2.0 - 4.0), p < .001), had less hands-on
time (2:16 min (1:15 - 4:55 min) vs. 4:07 min (2:54 - 5:52 min), p = .02),
conducted more unrelated conversations (17.0 ± 5.1 and 2.9 ± 1.7, p < 0.001) and
had lower self-assessments than groups of three students per tutor (7.0 (6.1 -
9.0) and 8.2 (7.2 - 9.0), p = .03).
CONCLUSIONS: Resuscitation checklist scores and pass rates after training were
comparable in groups of three, five or eight medical students, although smaller
groups had advantages in teaching interventions and hands-on time. Our results
suggest that teaching BLS skills is effective in groups up to eight medical
students, but smaller groups yielded more intense teaching conditions, which
might be crucial for more complex skills or less advanced students.

DOI: 10.1186/1472-6920-14-185
PMCID: PMC4168208
PMID: 25194168 [Indexed for MEDLINE]

137. PLoS One. 2018 Jun 12;13(6):e0198918. doi: 10.1371/journal.pone.0198918.

eCollection 2018.

Gender and age-specific aspects of awareness and knowledge in basic life

support.

Krammel M(1)(2)(3), Schnaubelt S(3)(4), Weidenauer D(3)(5), Winnisch M(3)(6),

Steininger M(3)(5), Eichelter J(1)(3), Hamp T(2)(3), van Tulder R(3)(7),
Sulzgruber P(3)(4).

Author information:
(1)Department of Anesthesiology, Intensive Care and Pain Medicine, Medical
University of Vienna, Vienna, Austria.
(2)Emergency Medical Service Vienna, Vienna, Austria.
(3)Austrian Cardiac Arrest Awareness Association - PULS, Vienna, Austria.
(4)Department of Emergency Medicine, Medical University of Vienna, Vienna,
Austria.
(5)Department of Medicine II, Division of Cardiology, Medical University of
Vienna, Vienna, Austria.
(6)Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria.
(7)Department of Internal Medicine I, Division of Cardiology, Karl Landsteiner
University of Health Sciences, Krems, Austria.

BACKGROUND: The 'chain of survival'-including early call for help, early

cardiopulmonary resuscitation (CPR) and early defibrillation-represents the most
beneficial approach for favourable patient outcome after out-of-hospital cardiac
arrest (OHCA). Despite increasing numbers of publicly accessible automated
external defibrillators (AED) and interventions to increase public awareness for
basic life support (BLS), the number of their use in real-life emergency
situations remains low.
METHODS: In this prospective population-based cross-sectional study, a total of
501 registered inhabitants of Vienna (Austria) were randomly approached via
telephone calls between 08/2014 and 09/2014 and invited to answer a standardized
questionnaire in order to identify public knowledge and awareness of BLS and
AED-use.
RESULTS: We found that more than 52 percent of participants would presume OHCA
correctly and would properly initiate BLS attempts. Of alarming importance, only
33 percent reported that they would be willing to perform CPR and 50 percent
would use an AED device. There was a significantly lower willingness to initiate
BLS attempts (male: 40% vs. female: 25%; OR: 2.03 [95%CI: 1.39-2.98]; p<0.001)
and to use an AED device (male: 58% vs. female: 44%; OR: 1.76 [95%CI:
1.26-2.53]; p = 0.002) in questioned female individuals compared to their male
counterparts. Interestingly, we observed a strongly decreasing level of
knowledge and willingness for BLS attempts (-14%; OR: 0.72 [95%CI: 0.57-0.92]; p
= 0.027) and AED-use (-19%; OR: 0.68 [95%CI: 0.54-0.85]; p = 0.001) with
increasing age.
CONCLUSION: We found an overall poor knowledge and awareness concerning BLS and
the use of AEDs among the Viennese population. Both female and elderly
participants reported the lowest willingness to perform BLS and use an AED in
case of OHCA. Specially tailored programs to increase awareness and willingness
among both the female and elderly community need to be considered for future
educational interventions.

DOI: 10.1371/journal.pone.0198918
PMCID: PMC5997304
PMID: 29894491 [Indexed for MEDLINE]

Conflict of interest statement: The authors have declared that no competing

interests exist.

138. Prehosp Disaster Med. 2019 Jun;34(3):322-329. doi: 10.1017/S1049023X19004357.

Epub 2019 May 28.

Paramedic Disaster Health Management Competencies: A Scoping Review.

Horrocks P(1), Hobbs L(1), Tippett V(1), Aitken P(1).

Author information:
(1)Queensland University of Technology,Kelvin Grove, Queensland,Australia.

INTRODUCTION: Paramedics are tasked with providing 24/7 prehospital emergency

care to the community. As part of this role, they are also responsible for
providing emergency care in the event of a major incident or disaster. They play
a major role in the response stage of such events, both domestic and
international. Despite this, specific standardized training in disaster
management appears to be variable and inconsistent throughout the profession. A
suggested method of building disaster response capacities is through
competency-based education (CBE). Core competencies can provide the fundamental
basis of collective learning and help ensure consistent application and
translation of knowledge into practice. These competencies are often organized
into domains, or categories of learning outcomes, as defined by Blooms taxonomy
of learning domains. It is these domains of competency, as they relate to
paramedic disaster response, that are the subject of this review.
METHODS: The methodology for this paper to identify existing paramedic disaster
response competency domains was adapted from the guidance for the development of
systematic scoping reviews, using a methodology developed by members of the
Joanna Briggs Institute (JBI; Adelaide, South Australia) and members of five
Joanna Briggs Collaborating Centres.
RESULTS: The literature search identified six articles for review that reported
on paramedic disaster response competency domains. The results were divided into
two groups: (1) General Core Competency Domains, which are suitable for all
paramedics (both Advanced Life Support [ALS] and Basic Life Support [BLS]) who
respond to any disaster or major incident; and (2) Specialist Core Competencies,
which are deemed necessary competencies to enable a response to certain types of
disaster. Further review then showed that three separate and discrete types of
competency domains exits in the literature: (1) Core Competencies, (2)
Technical/Clinical Competencies, and (3) Specialist Technical/Clinical
Competencies.
CONCLUSIONS: The most common domains of core competencies for paramedic first
responders to manage major incidents and disasters described in the literature
were identified. If it's accepted that training paramedics in disaster response
is an essential part of preparedness within the disaster management cycle, then
by including these competency domains into the curriculum development of
localized disaster training programs, it will better prepare the paramedic
workforce's competence and ability to effectively respond to disasters and major
incidents.

DOI: 10.1017/S1049023X19004357
PMID: 31134873 [Indexed for MEDLINE]

139. Simul Healthc. 2019 Oct;14(5):281-286. doi: 10.1097/SIH.0000000000000386.

Certified Basic Life Support Instructors Identify Improper Cardiopulmonary

Resuscitation Skills Poorly: Instructor Assessments Versus Resuscitation Manikin
Data.

Hansen C(1), Bang C, Stærk M, Krogh K, Løfgren B.

Author information:
(1)From the Research Center for Emergency Medicine, Aarhus University Hospital,
Aarhus (C.H., C.B., M.S., B.L.); Department of Internal Medicine, Randers
Regional Hospital, Randers (C.H., C.B., M.S., B.L.), and Clinical Research Unit,
Randers Regional Hospital, Randers (C.H., C.B., M.S.); Department of Anesthesia
and Intensive Care, Aarhus University Hospital (K.K.); Centre for Health
Sciences Education, Aarhus University, Aarhus, (K.K.), Department of Clinical
Medicine, Aarhus University, Aarhus (B.L.), and Department of Cardiology, Aarhus
University Hospital, Aarhus, Denmark (B.L.).

INTRODUCTION: During basic life support (BLS) training, instructors assess

learners' cardiopulmonary resuscitation (CPR) skills and correct errors to
ensure high-quality performance. This study aimed to investigate certified BLS
instructors' assessments of CPR skills.
METHODS: Data were collected at BLS courses for medical students at Aarhus
University, Aarhus, Denmark. Two certified BLS instructors evaluated each
learner with a cardiac arrest test scenario, where learners demonstrated CPR on
a resuscitation manikin for 3.5 minutes. Instructors' assessments were compared
with manikin data as reference for correct performance. The first 3 CPR cycles
were analyzed. Correct chest compressions were defined as 2 or more of 3 CPR
cycles with 30 ± 2 chest compressions, 50 to 60 mm depth, and 100 to 120 min
rate. Correct rescue breaths were defined as 50% or more efficient breaths with
visible, but not excessive manikin chest inflation (for instructors) or 500 to
600mL air (manikin data).
RESULTS: Overall, 90 CPR assessments were performed by 16 instructor pairs.
Instructors passed 81 (90%) learners, whereas manikin pass rate was 2%.
Instructors identified correct chest compressions with a sensitivity of 0.96
[95% confidence interval (CI) = 0.79-1) and a specificity of 0.05 (95% CI =
0.01-0.14), as well as correct rescue breaths with a sensitivity of 1 (95% CI =
0.40-1) and a specificity of 0.07 (95% CI = 0.03-0.15). Instructors mistakenly
failed 1 learner with adequate chest compression depth, while passing 53 (59%)
learners with improper depth. Moreover, 80 (89%) improper rescue breath
performances were not identified.
CONCLUSIONS: Certified BLS instructors assess CPR skills poorly. Particularly,
improper chest compression depth and rescue breaths are not identified.

DOI: 10.1097/SIH.0000000000000386
PMID: 31490866 [Indexed for MEDLINE]

140. Cureus. 2024 Jun 19;16(6):e62719. doi: 10.7759/cureus.62719. eCollection 2024

Jun.

Use of High-Fidelity Simulation as an Adjunct to Basic Life Support Training To

Promote Team-Based Resuscitation Skills: A Mixed-Methods Pilot Study.

Berger DJ(1), Lum L(2), Shercliffe R(2), Sinz E(3).

Author information:
(1)Emergency & Internal Medicine, Virginia Commonwealth University Health
System, Richmond, USA.
(2)Resuscitation Sciences Training Center, Penn State Health Milton S. Hershey
Medical Center, Hershey, USA.
(3)Anesthesiology and Critical Care, West Virginia University, Morgantown, USA.

Introduction The 2020 American Heart Association's (AHA) Basic Life Support
(BLS) curriculum focuses on cardiac arrest resuscitation with one or two
rescuers, providing only limited opportunities to develop higher-level skills
such as leadership, communication, and debriefing. This mixed-methods pilot
study evaluated whether supplementing the traditional Heartcode BLS course with
a high-fidelity teamwork simulation session improved mastery of these
higher-level skills. Methods Twenty-four first-year medical students completed
the pilot training during sessions offered in February and May of 2023. The
program included the traditional AHA Heartcode BLS course, which ranges from two
to four hours, and includes both online and in-person skills components. This
was followed by a 90-minute high-fidelity simulation session consisting of two
simulated resuscitations separated by a student-led plus/delta debriefing.
Facilitators then debriefed the entire activity. Students completed an anonymous
online survey that used a 0-10 slider scale to attribute their perceived
proficiency for specific skills to the initial BLS course or the teamwork
simulations and provided qualitative feedback. Results Twenty-one students
(87.5%) completed the follow-up survey. Students credited their proficiency in
technical skills (e.g., "Chest Compressions") to both sessions equally, but
proficiency in higher-level skills, such as leadership, communication, and
teamwork, was predominantly credited to the simulation. Additionally, students
reported that the teamwork simulation promoted realism and increased
self-efficacy. Conclusion Team-based resuscitation simulations using
high-fidelity equipment augmented the AHA BLS course by promoting perceived
competence in team dynamics domains and increasing students' self-efficacy for
participating in real hospital-based resuscitations. Studies with larger sample
sizes and objective data should be performed, and the use of similar
resuscitation simulations or the development of a formal team-based BLS
certification course should be considered.

Copyright © 2024, Berger et al.

DOI: 10.7759/cureus.62719
PMCID: PMC11259406
PMID: 39036194

Conflict of interest statement: Human subjects: Consent was obtained or waived

by all participants in this study. Pennsylvania State University Institutional
Review Board issued approval STUDY00022019. Animal subjects: All authors have
confirmed that this study did not involve animal subjects or tissue. Conflicts
of interest: In compliance with the ICMJE uniform disclosure form, all authors
declare the following: Payment/services info: The project described was
supported by the National Center for Advancing Translational Sciences, National
Institutes of Health, through Grant UL1 TR002014 and Grant UL1 TR00045. The
content is solely the responsibility of the authors and does not necessarily
represent the official views of the NIH. The use of the Penn State College of
Medicine Clinical Simulation Center & Resuscitation Science Training Center
equipment, staff, and space was provided free of charge for this project. Gift
cards were self-funded by the authors. Financial relationships: Elizabeth Sinz
declare(s) personal fees and Travel from Sinz Healthcare Education Solutions,
LLC. Sinz Healthcare Education Solutions, LLC is owned by Elizabeth Sinz to
facilitate her work for the American Heart Association as an editor, updating
educational materials when the guidelines are updated. Other relationships: All
authors have declared that there are no other relationships or activities that
could appear to have influenced the submitted work.

141. Emerg Med J. 2019 Apr;36(4):239-244. doi: 10.1136/emermed-2018-207923. Epub

2019
Feb 16.

Impact of instructor professional background and interim retesting on knowledge

and self-confidence of schoolchildren after basic life support training: a
cluster randomised longitudinal study.

Haseneder R(1), Skrzypczak M(1), Haller B(2), Beckers SK(3), Holch J(4), Wank
C(4), Kochs E(1), Schulz CM(1).

Author information:
(1)Department of Anaesthesiology and Intensive Care, Klinikum rechts der Isar
der Technischen Universität München, Munich, Germany.
(2)Institute of Medical Informatics, Statistics and Epidemiology, Klinikum
rechts der Isar der Technischen Universität München, Munich, Germany.
(3)Department of Anaesthesiology, University Hospital Aachen, RWTH Aachen
University, Aachen, Germany.
(4)Girls' Boarding School Max-Josef-Stift, Munich, Germany.

INTRODUCTION: To increase the rate of bystander resuscitation, basic life

support (BLS) training for schoolchildren is now recommended on a broad level.
However, debate continues about the optimal teaching methods. In this study, we
investigated the effects of a 90 min BLS training on female pupils' BLS
knowledge and self-confidence and whether learning outcomes were influenced by
the instructors' professional backgrounds or test-enhanced learning.
METHODS: We conducted a cluster randomised, longitudinal trial in a girls'
grammar school in Germany from 2013 to 2014. Pupils aged 10-17 years were
randomised to receive BLS training conducted by either emergency physicians or
medical students. Using a multiple-choice questionnaire and a Likert-type scale,
BLS knowledge and self-confidence were investigated before training (t0), 1 week
(t1) and 9 months after training (t2). To investigate whether test-enhanced
learning influenced learning outcomes, the questionnaire was administered
6 months after the training in half of the classrooms. The data were analysed
using linear mixed-effects models.
RESULTS: The study included 460 schoolchildren. BLS knowledge (mean number of
correct answers) increased from 5.86 at t0 to 9.24 at t1 (p<0.001) and
self-confidence (mean score on the Likert-type scale) increased from 8.70 at t0
to 11.29 at t1 (p<0.001). After 9 months, knowledge retention was good (8.94 at
t2; p=0.080 vs t1), but self-confidence significantly declined from t1 to 9.73
at t2 (p<0.001). Pupils trained by medical students showed a slight but
statistically significant greater increase in the knowledge at both t1 and t2,
whereas instructors' background did not influence gain or retention of
self-confidence. Retesting resulted in a marginally, non-significantly better
retention of knowledge.
CONCLUSIONS: BLS training led to short-term gains in knowledge and
self-confidence. Although knowledge was retained at 9 months after the training
session, self-confidence significantly decreased. Interim testing did not appear
to impact retention of knowledge or self-confidence. Medical students should be
considered as instructors for these courses given their favourable learning
outcomes and greater availability.

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and
permissions. Published by BMJ.

DOI: 10.1136/emermed-2018-207923
PMID: 30772830 [Indexed for MEDLINE]

Conflict of interest statement: Competing interests: None declared.

142. Resuscitation. 2015 Jan;86:1-5. doi: 10.1016/j.resuscitation.2014.10.007. Epub

2014 Oct 18.

A novel approach to life support training using "action-linked phrases".

Hunt EA(1), Cruz-Eng H(2), Bradshaw JH(3), Hodge M(4), Bortner T(5), Mulvey
CL(6), McMillan KN(7), Galvan H(5), Duval-Arnould JM(8), Jones K(9), Shilkofski
NA(10), Rodgers DL(5), Sinz EH(11).

Author information:
(1)Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns
Hopkins University School of Medicine Department of Anesthesiology and Critical
Care Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of
Medicine Department of Pediatrics, Baltimore, Maryland, USA; Johns Hopkins
University School of Medicine Division of Health Sciences Informatics,
Baltimore, Maryland, USA; Johns Hopkins Medicine Simulation Center, Baltimore,
Maryland, USA.
(2)Penn State Hershey Medical Center Department of Anesthesiology, Hershey,
Pennsylvania, USA.
(3)Uniformed Services of the Health Sciences, Bethesda, Maryland, USA.
(4)Penn State University College of Medicine, Hershey, Pennsylvania, USA.
(5)Penn State Hershey Clinical Simulation Center, Hershey, Pennsylvania, USA.
(6)Penn State Hershey Medical Center Department of Anesthesiology, Hershey,
Pennsylvania, USA; Penn State Hershey Clinical Simulation Center, Hershey,
Pennsylvania, USA.
(7)Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns
Hopkins University School of Medicine Department of Anesthesiology and Critical
Care Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of
Medicine Department of Pediatrics, Baltimore, Maryland, USA; Johns Hopkins
Medicine Simulation Center, Baltimore, Maryland, USA.
(8)Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns
Hopkins University School of Medicine Department of Anesthesiology and Critical
Care Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of
Medicine Division of Health Sciences Informatics, Baltimore, Maryland, USA;
Johns Hopkins Medicine Simulation Center, Baltimore, Maryland, USA.
(9)Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns
Hopkins University School of Medicine Department of Anesthesiology and Critical
Care Medicine, Baltimore, Maryland, USA; Johns Hopkins Medicine Simulation
Center, Baltimore, Maryland, USA.
(10)Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns
Hopkins University School of Medicine Department of Anesthesiology and Critical
Care Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of
Medicine Department of Pediatrics, Baltimore, Maryland, USA; Johns Hopkins
Medicine Simulation Center, Baltimore, Maryland, USA; Perdana University
Graduate School of Medicine, Kuala Lumpur, Malaysia.
(11)Penn State Hershey Medical Center Department of Anesthesiology, Hershey,
Pennsylvania, USA; Penn State University College of Medicine, Hershey,
Pennsylvania, USA; Penn State Hershey Clinical Simulation Center, Hershey,
Pennsylvania, USA; Penn State Hershey Medical Center Department of Neurosurgery,
Hershey, Pennsylvania, USA. Electronic address: [email protected].

BACKGROUND: Observations of cardiopulmonary arrests (CPAs) reveal concerning

patterns when clinicians identify a problem, (e.g. loss of pulse) but do not
immediately initiate appropriate therapy (e.g. compressions) resulting in delays
in life saving therapy.
METHODS: We hypothesized that when individuals utilized specific, short,
easy-to-state action phrases stating an observation followed by an associated
intervention, there would be a higher likelihood that appropriate action would
immediately occur. Phase I: A retrospective analysis of residents in simulated
CPAs measured what proportion verbalized "There's no pulse", statements and/or
actions that followed and whether "Action-Linked Phrases" were associated with
faster initiation of compressions. Phase II: Two prospective, quasi-experimental
studies evaluated if teaching three Action-Linked Phrases for Basic Life Support
(BLS) courses or six Action-Linked Phrases for Advanced Cardiovascular Life
Support (ACLS) courses was associated with increased use of these phrases.
RESULTS: Phase I: 62% (42/68) of residents verbalized "there's no pulse" during
initial assessment of a pulseless patient, and only 16/42 (38%) followed that by
stating "start compressions". Residents verbalizing this Action-Linked Phrase
started compressions sooner than others: (30s [IQR:19-42] vs. 150 [IQR:51-242],
p < 0.001). Phase II: In BLS courses, the three Action-Linked Phrases were used
more frequently in the intervention group: (226/270 [84%] vs. 14/195 [7%]; p <
0.001). In ACLS courses, the six Action-Linked Phrases were uttered more often
in the intervention group: (43% [157/368] vs. 23% [46/201], p < 0.001).
CONCLUSIONS: Action-Linked Phrases innately used by residents in simulated CPAs
were associated with faster initiation of compressions. Action-Linked Phrases
were verbalized more frequently if taught as part of a regular BLS or ACLS
course. This simple, easy to teach, and easy to implement technique holds
promise for impacting cardiac arrest teams' performance of key actions.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.resuscitation.2014.10.007
PMID: 25457379 [Indexed for MEDLINE]

143. PLoS One. 2017 May 22;12(5):e0178210. doi: 10.1371/journal.pone.0178210.

eCollection 2017.

Influence of learning styles on the practical performance after the four-step

basic life support training approach - An observational cohort study.

Schröder H(1)(2), Henke A(3), Stieger L(2), Beckers S(1)(2), Biermann H(4),
Rossaint R(1), Sopka S(1)(2).
Author information:
(1)Department of Anaesthesiology, University Hospital RWTH Aachen University,
Aachen, North Rhine-Westphalia, Germany.
(2)Aachen Interdisciplinary Training Centre for Medical Education, Medical
Faculty RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany.
(3)Department of Internal Medicine, Hermann-Josef-Hospital, Erkelenz, North
Rhine-Westphalia, Germany.
(4)Department of Internal Medicine, Agaplesion Elisabethenstift, Darmstadt,
Hesse, Germany.

BACKGROUND: Learning and training basic life support (BLS)-especially external

chest compressions (ECC) within the BLS-algorithm-are essential resuscitation
training for laypersons as well as for health care professionals. The objective
of this study was to evaluate the influence of learning styles on the
performance of BLS and to identify whether all types of learners are
sufficiently addressed by Peyton's four-step approach for BLS training.
METHODS: A study group of first-year medical students (n = 334) without previous
medical knowledge was categorized according to learning styles using the German
Lernstilinventar questionnaire based on Kolb's Learning Styles Inventory.
Students' BLS performances were assessed before and after a four-step BLS
training approach lasting 4 hours. Standardized BLS training was provided by an
educational staff consisting of European Resuscitation Council-certified
advanced life support providers and instructors. Pre- and post-intervention BLS
performance was evaluated using a single-rescuer-scenario and standardized
questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely
disagree). The recorded points of measurement were the time to start, depth, and
frequency of ECC.
RESULTS: The study population was categorized according to learning styles:
diverging (5%, n = 16), assimilating (36%, n = 121), converging (41%, n = 138),
and accommodating (18%, n = 59). Independent of learning styles, both male and
female participants showed significant improvement in cardiopulmonary
resuscitation (CPR) performance. Based on the Kolb learning styles, no
significant differences between the four groups were observed in compression
depth, frequency, time to start CPR, or the checklist-based assessment within
the baseline assessment. A significant sex effect on the difference between pre-
and post-interventional assessment points was observed for mean compression
depth and mean compression frequency.
CONCLUSIONS: The findings of this work show that the four-step-approach for BLS
training addresses all types of learners independent of their learning styles
and does not lead to significant differences in the performance of CPR.

DOI: 10.1371/journal.pone.0178210
PMCID: PMC5439953
PMID: 28542636 [Indexed for MEDLINE]

Conflict of interest statement: Competing Interests: The authors have declared

that no competing interests exist.

144. Resuscitation. 2010 Jun;81(6):691-4. doi: 10.1016/j.resuscitation.2010.02.021.

Epub 2010 Mar 26.

The effect of basic life support education on laypersons' willingness in

performing bystander hands only cardiopulmonary resuscitation.

Cho GC(1), Sohn YD, Kang KH, Lee WW, Lim KS, Kim W, Oh BJ, Choi DH, Yeom SR, Lim
H.
Author information:
(1)Department of Emergency Medicine, Hallym University, School of Medicine,
Seoul, South Korea. [email protected]

Comment in
Resuscitation. 2010 Jun;81(6):639-40. doi:
10.1016/j.resuscitation.2010.04.001.

BACKGROUND: Recently, hands only CPR (cardiopulmonary resuscitation) has been

proposed as an alternative to standard CPR for bystanders. The present study was
performed to identify the effect of basic life support (BLS) training on
laypersons' willingness in performing standard CPR and hands only CPR.
METHODS: The participants for this study were non-medical personnel who applied
for BLS training program that took place in 7 university hospitals in and around
Korea for 6 months. Before and after BLS training, all the participants were
given questionnaires for bystander CPR, and 890 respondents were included in the
final analyses.
RESULTS: Self-assessed confidence score for bystander CPR, using a visual
analogue scale from 0 to 100, increased from 51.5+/-30.0 before BLS training to
87.0+/-13.7 after the training with statistical significance (p 0.001). Before
the training, 19% of respondents reported willingness to perform standard CPR on
a stranger, and 30.1% to perform hands only CPR. After the training, this
increased to 56.7% of respondents reporting willingness to perform standard CPR,
and 71.9%, hands only CPR, on strangers. Before and after BLS training, the odds
ratio of willingness to perform hands only CPR versus standard CPR were 1.8 (95%
CI 1.5-2.3) and 2.0 (95% CI 1.7-2.6) for a stranger, respectively. Most of the
respondents, who reported they would decline to perform standard CPR, stated
that fear of liability and fear of disease transmission were deciding factors
after the BLS training.
CONCLUSIONS: The BLS training increases laypersons' confidence and willingness
to perform bystander CPR on a stranger. However, laypersons are more willing to
perform hands only CPR rather than to perform standard CPR on a stranger
regardless of the BLS training.

Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.resuscitation.2010.02.021
PMID: 20347208 [Indexed for MEDLINE]

145. Simul Healthc. 2018 Feb;13(1):27-32. doi: 10.1097/SIH.0000000000000286.

Comparison of Cardiopulmonary Resuscitation Quality Between Standard Versus

Telephone-Basic Life Support Training Program in Middle-Aged and Elderly
Housewives: A Randomized Simulation Study.

Kim TH(1), Lee YJ, Lee EJ, Ro YS, Lee K, Lee H, Jang DB, Song KJ, Shin SD,
Myklebust H, Birkenes TS.

Author information:
(1)From the Department of Emergency Medicine (T.H.K.), Seoul Metropolitan
Government Seoul National University Boramae Medical Center, Seoul National
University College of Medicine, Seoul; Department of Emergency Medicine
(Y.J.L.), Inha University Hospital, Incheon; Department of Emergency Medicine
(E.J.L.), Korea University Anam Hospital; Laboratory of Emergency Medical
Services (Y.S.R., H.L., D.B.J.), Seoul National University Hospital Biomedical
Research Institute; Department of Emergency Medicine (K.W.L.), Inje University
College of Medicine and Seoul Paik Hospital; Department of Emergency Medicine
(K.J.S., S.D.S.), Seoul National University College of Medicine, Seoul, Korea;
and Laerdal Medical (H.M., T.S.B.), Stavanger, Norway.

INTRODUCTION: For cardiac arrests witnessed at home, the witness is usually a

middle-aged or older housewife. We compared the quality of cardiopulmonary
resuscitation (CPR) performance of bystanders trained with the newly developed
telephone-basic life support (T-BLS) program and those trained with standard BLS
(S-BLS) training programs.
METHODS: Twenty-four middle-aged and older housewives without previous CPR
education were enrolled and randomized into two groups of BLS training programs.
The T-BLS training program included concepts and current instruction protocols
for telephone-assisted CPR, whereas the S-BLS training program provided training
for BLS. After each training course, the participants simulated CPR and were
assisted by a dispatcher via telephone. Cardiopulmonary resuscitation quality
was measured and recorded using a mannequin simulator. The primary outcome was
total no-flow time (>1.5 seconds without chest compression) during simulation.
RESULTS: Among 24 participants, two (8.3%) who experienced mechanical failure of
simulation mannequin and one (4.2%) who violated simulation protocols were
excluded at initial simulation, and two (8.3%) refused follow-up after 6 months.
The median (interquartile range) total no-flow time during initial simulation
was 79.6 (66.4-96.9) seconds for the T-BLS training group and 147.6
(122.5-184.0) seconds for the S-BLS training group (P < 0.01). Median cumulative
interruption time and median number of interruption events during BLS at initial
simulation and 6-month follow-up simulation were significantly shorter in the
T-BLS than in the S-BLS group (1.0 vs. 9.5, P < 0.01, and 1.0 vs. 10.5, P =
0.02, respectively).
CONCLUSIONS: Participants trained with the T-BLS training program showed shorter
no-flow time and fewer interruptions during bystander CPR simulation assisted by
a dispatcher.

DOI: 10.1097/SIH.0000000000000286
PMID: 29369963 [Indexed for MEDLINE]

146. Acta Cardiol. 2020 Dec;75(8):760-766. doi: 10.1080/00015385.2019.1677374. Epub

2019 Oct 16.

Mastery versus self-directed blended learning in basic life support: a

randomised controlled trial.

Madou T(1)(2), Iserbyt P(2).

Author information:
(1)Vives University College, Torhout, Belgium.
(2)Department of Kinesiology, Physical Activity, Sport and Health Research
Group, KU Leuven, Leuven, Belgium.

Background: Blended learning combines online learning with face-to-face

learning. Research investigating the effect of different blended learning models
to teach basic life support (BLS) is lacking.Objectives: To investigate the
effect of a mastery learning (ML) versus a self-directed learning (SDL) blend on
students' BLS performance. In ML, students learn BLS as a linear sequence
meaning each step should be 'mastered' prior to advancing to the next. In SDL,
students' autonomy is increased for his or her learning trajectory leading to
non-linear, user driven learning paths.Methods: A randomised controlled trial.
Four conditions were created by combining two learning models (SDL and ML) in
two learning phases (online and face to face). Bachelor students (n = 145) were
randomised over these four conditions. In all blends, an online learning module
was available for one week prior to a face-to-face learning component of which
the duration was 45 minutes. All learners' BLS performance was assessed
individually and unannounced one week following blended learning. An individual
BLS score was calculated combining cardiopulmonary resuscitation (CPR) variables
reported by a Laerdal ResusciAnne Manikin and qualitative observations by two
trained researchers.Results: Students' CPR performance adhered to international
2015 guidelines for all groups. Median BLS-performance was 83.0% (interquartile
range 13.2%). No statistical differences between groups were found for BLS
performance or CPR variables.Conclusions: All blended learning models were
highly time-effective since the face-to-face component only took 45 minutes and
learning outcomes adhered to guidelines.

DOI: 10.1080/00015385.2019.1677374
PMID: 31617447 [Indexed for MEDLINE]

147. BMC Med Educ. 2016 Oct 7;16(1):263. doi: 10.1186/s12909-016-0788-9.

Analyses of inter-rater reliability between professionals, medical students and

trained school children as assessors of basic life support skills.

Beck S(1), Ruhnke B(2), Issleib M(3), Daubmann A(4), Harendza S(5), Zöllner
C(3).

Author information:
(1)Department of Anaesthesiology, University Hospital Hamburg-Eppendorf,
Martinistr. 52, 20246, Hamburg, Germany. [email protected].
(2)The Medical Faculty of the University Hamburg, Martinistr. 52, 20246,
Hamburg, Germany.
(3)Department of Anaesthesiology, University Hospital Hamburg-Eppendorf,
Martinistr. 52, 20246, Hamburg, Germany.
(4)Department of Medical Biometry and Epidemiology, University Medical Center
Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
(5)Department of Internal Medicine, University Medical Center Hamburg-Eppendorf,
Martinistr. 52, 20246, Hamburg, Germany.

BACKGROUND: Training of lay-rescuers is essential to improve survival-rates

after cardiac arrest. Multiple campaigns emphasise the importance of basic life
support (BLS) training for school children. Trainings require a valid assessment
to give feedback to school children and to compare the outcomes of different
training formats. Considering these requirements, we developed an assessment of
BLS skills using MiniAnne and tested the inter-rater reliability between
professionals, medical students and trained school children as assessors.
METHODS: Fifteen professional assessors, 10 medical students and 111-trained
school children (peers) assessed 1087 school children at the end of a
CPR-training event using the new assessment format. Analyses of inter-rater
reliability (intraclass correlation coefficient; ICC) were performed.
RESULTS: Overall inter-rater reliability of the summative assessment was high
(ICC = 0.84, 95 %-CI: 0.84 to 0.86, n = 889). The number of comparisons between
peer-peer assessors (n = 303), peer-professional assessors (n = 339), and
peer-student assessors (n = 191) was adequate to demonstrate high inter-rater
reliability between peer- and professional-assessors (ICC: 0.76), peer- and
student-assessors (ICC: 0.88) and peer- and other peer-assessors (ICC: 0.91).
Systematic variation in rating of specific items was observed for three items
between professional- and peer-assessors.
CONCLUSION: Using this assessment and integrating peers and medical students as
assessors gives the opportunity to assess hands-on skills of school children
with high reliability.

DOI: 10.1186/s12909-016-0788-9
PMCID: PMC5054623
PMID: 27717352 [Indexed for MEDLINE]

148. Emerg Med J. 2012 Oct;29(10):833-7. doi: 10.1136/emermed-2011-200633. Epub

2011
Nov 1.

Basic life support skill retention of medical interns and the effect of clinical
experience of cardiopulmonary resuscitation.

Na JU(1), Sim MS, Jo IJ, Song HG, Song KJ.

Author information:
(1)Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan
University School of Medicine, Seoul, Korea.

OBJECTIVE: To investigate the level of basic life support (BLS) skill retention
of medical interns 6 and 12 months after BLS education and analyse the
correlation between clinical experience of cardiopulmonary resuscitation (CPR)
and BLS skill retention.
MATERIALS AND METHODS: The baseline performance of BLS skills in medical doctors
during their internship was tested immediately after the BLS provider course.
The subjects were divided into two groups, which were tested using the same
method after 6 months or after 12 months. Data on the subjects' CPR experience
were collected through CPR records--specifically, the number of CPR experiences
and the feedback given by the CPR team leaders. To evaluate BLS skill retention,
baseline BLS skill performance was compared with the skill performances measured
after 6 or 12 months.
RESULTS: Fifty-six subjects were enrolled in the 6 month group and 36 in the 12
month group. For non-compression skills, the points for skills declined from 12
to 6 points in the 6 month group and from 12 to 6 points in the 12 month group
and the declines in both groups were statistically significant. For compression
skills, in the 12 month group, the hands-off time improved from 9.9 s to 8.7 s,
with statistical significance. In the multivariate linear regression test, the
number of times feedback was given had a statistical relationship with
improvement in hands-off time in the 12 month group (coefficient 0.58, 95% CI
0.12 to 1.05).
CONCLUSIONS: In medical doctors, the compression skills were well preserved, but
the retention of non-compression skills was poor.

DOI: 10.1136/emermed-2011-200633
PMID: 22045605 [Indexed for MEDLINE]

149. BMC Med Educ. 2023 Jan 25;23(1):62. doi: 10.1186/s12909-022-03951-1.

Comparison of real-time feedback and debriefing by video recording on basic life

support skill in nursing students.

Ghaderi MS(1)(2), Malekzadeh J(3), Mazloum S(3), Pourghaznein T(4).

Author information:
(1)Department of Nursing, Torbat Jam Faculty of Medical Sciences, Torbat Jam,
Razavi Khorasan Province, Iran.
(2)Clinical Research Development Unit, Sajjadieh Hospital, Torbat Jam Faculty of
Medical Sciences, Torbat Jam, Razavi Khorasan Province, Iran.
(3)Nursing and Midwifery Care Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran.
(4)Nursing and Midwifery Care Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran. [email protected].

BACKGROUND: Cardiopulmonary resuscitation skill have a direct impact on its

success rate. Choosing the right method to acquire this skill can lead to
effective performance. This investigation was conducted to compare the effect of
Real-time feedback and debriefing by video recording on basic life support skill
in nursing students.
METHODS: This quasi-experimental study was performed on 67 first year nursing
students. First, a theoretical basic life support (BLS) training session was
held for the all participants, at the end of session the pre-test was taken.
Students were randomly assigned to two groups. A 4-hour practical BLS training
session was conducted in the real - time feedback group as well as the
debriefing by video recording group, and at the end of the training, a post-test
was taken from each group. Each group received a post-test. Data were analyzed
using SPSS 25 software.
RESULTS: Results showed a significant difference between mean (SD) of debriefing
by video recording group in pre-test and post-test (p < 0.001) and in the
real-time feedback group there was a significant difference between mean (SD) in
pre-test and post-test (p < 0.001), respectively. In addition, there was no
significant difference between the mean score of basic life support skill in
real-time feedback and debriefing by video recording.
CONCLUSIONS: Both real-time feedback and debriefing by video recording were
effective on basic life support skill.

© 2023. The Author(s).

DOI: 10.1186/s12909-022-03951-1
PMCID: PMC9878936
PMID: 36698121 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare that they have no competing
interests.

150. Resuscitation. 2013 Jan;84(1):72-7. doi: 10.1016/j.resuscitation.2012.08.320.

Epub 2012 Aug 23.

Retraining basic life support skills using video, voice feedback or both: a
randomised controlled trial.

Mpotos N(1), Yde L, Calle P, Deschepper E, Valcke M, Peersman W, Herregods L,

Monsieurs K.

Author information:
(1)Emergency Department, Ghent University Hospital, De Pintelaan 185, B-9000
Ghent, Belgium. [email protected]

Comment in
Resuscitation. 2013 Jan;84(1):11-2. doi:
10.1016/j.resuscitation.2012.10.003.

INTRODUCTION: The optimal strategy to retrain basic life support (BLS) skills on
a manikin is unknown. We analysed the differential impact of a video (video
group, VG), voice feedback (VFG), or a serial combination of both (combined
group, CG) on BLS skills in a self-learning (SL) environment.
METHODS: Two hundred and thirteen medicine students were randomly assigned to a
VG, a VFG and a CG. The VG refreshed the skills with a practice-while-watching
video (abbreviated Mini Anne™ video, Laerdal, Norway) and a manikin, the VFG
with a computer-guided manikin (Resusci Anne Skills Station™, Laerdal, Norway)
and the CG with a serial combination of both. Each student performed two
sequences of 60 compressions, 12 ventilations and three complete cycles of BLS
(30:2). The proportions of students achieving adequate skills were analysed
using generalised estimating equations analysis, taking into account pre-test
results and training strategy.
RESULTS: Complete datasets were obtained from 192 students (60 VG, 69 VFG and 63
CG). Before and after training, ≥70% of compressions with depth ≥50 mm were
achieved by 14/60 (23%) vs. 16/60 (27%) VG, 24/69 (35%) vs. 50/69 (73%) VFG and
19/63 (30%) vs. 41/63 (65%) CG (P<0.001). Compression rate 100-120/min was
present in 27/60 (45%) vs. 52/60 (87%) VG, 28/69 (41%) vs. 44/69 (64%) VFG and
27/63 (43%) vs. 42/63 (67%) CG (P=0.05). Achievement of ≥70% ventilations with a
volume 400-1000 ml was present in 29/60 (49%) vs. 32/60 (53%) VG, 32/69 (46%)
vs. 52/69 (75%) VFG and 25/63 (40%) vs. 51/63 (81%) CG (P=0.001). There was no
between-groups difference for complete release.
CONCLUSIONS: Voice feedback and a sequential combination of video and voice
feedback are both effective strategies to refresh BLS skills in a SL station.
Video training alone only improved compression rate. None of the three
strategies resulted in an improvement of complete release.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.resuscitation.2012.08.320
PMID: 22922073 [Indexed for MEDLINE]

151. Front Neurosci. 2019 Dec 12;13:1336. doi: 10.3389/fnins.2019.01336.

eCollection
2019.

Performance Monitoring via Functional Near Infrared Spectroscopy for Virtual

Reality Based Basic Life Support Training.

Aksoy E(1)(2), Izzetoglu K(3), Baysoy E(1), Agrali A(1), Kitapcioglu D(2),
Onaral B(3).

Author information:
(1)Department of Biomedical Device Technology, Acıbadem Mehmet Ali Aydınlar
University, Istanbul, Turkey.
(2)Center of Advanced Simulation and Education, Acıbadem Mehmet Ali Aydınlar
University, Istanbul, Turkey.
(3)School of Biomedical Engineering, Science and Health Systems, Drexel
University, Philadelphia, PA, United States.

The use of serious game tools in training of medical professions is steadily

growing. However, there is a lack of reliable performance assessment methods to
evaluate learner's outcome. The aim of this study is to determine whether
functional near infrared spectroscopy (fNIRS) can be used as an additional tool
for assessing the learning outcome of virtual reality (VR) based learning
modules. The hypothesis is that together with an improvement in learning outcome
there would be a decrease in the participants' cerebral oxygenation levels
measured from the prefrontal cortex (PFC) region and an increase of
participants' serious gaming results. To test this hypothesis, the subjects were
recruited and divided into four groups with different combinations of prior
virtual reality experience and prior Basic Life Support (BLS) knowledge levels.
A VR based serious gaming module for teaching BLS and 16-Channel fNIRS system
were used to collect data from the participants. Results of the participants'
scores acquired from the serious gaming module were compared with fNIRS measures
on the initial and final training sessions. Kruskal Wallis test was run to
determine any significant statistical difference between the groups and
Mann-Whitney U test was utilized to obtain pairwise comparisons. BLS training
scores of the participants acquired from VR based serious game's the learning
management system and fNIRS measurements revealed decrease in use of resources
from the PFC, but increase in behavioral performance. Importantly, brain-based
measures can provide an additional quantitative metric for trainee's expertise
development and can assist the medical simulation instructors.

Copyright © 2019 Aksoy, Izzetoglu, Baysoy, Agrali, Kitapcioglu and Onaral.

DOI: 10.3389/fnins.2019.01336
PMCID: PMC6920174
PMID: 31920503

152. Cureus. 2024 Oct 10;16(10):e71214. doi: 10.7759/cureus.71214. eCollection 2024

Oct.

Evaluation of Awareness, Knowledge, and Attitude Toward Basic Life Support Among
the General Population in Saudi Arabia: A Nationwide Survey.

Alghamdi B(1), Alshehri FF(2), Alsharif BM(2), Habib SK(2), AlSugayer MK(2),
Juaythin NA(2), Aldrebi WA(2).

Author information:
(1)Department of Emergency Medicine, Prince Sultan Military Medical City,
Riyadh, SAU.
(2)College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU),
Riyadh, SAU.

Background Basic life support (BLS) is the key component in changing the outcome
from death to survival when cardiac arrest occurs. It involves providing
cardiopulmonary resuscitation (CPR) and utilizing an automated external
defibrillator (AED) to help restore the normal cardiac rhythm. By equipping more
individuals with BLS training, it will enhance community preparedness and public
health. Aim This study aimed to evaluate the general population's awareness,
knowledge, and attitude toward BLS in Saudi Arabia. Subject and methods This
cross-sectional study was conducted among the Saudi general population covering
all five main regions in Saudi Arabia (Central, Eastern, Western, Southern, and
Northern). A self-administered questionnaire was sent through volunteer data
collectors in every area in which they live to the population using a Google
(Google, Inc., Mountain View, CA) survey. The questionnaire includes
socio-demographic characteristics (i.e., age, gender, region of residence, etc.)
to assess the awareness, knowledge, and attitude toward BLS using a 20-item
questionnaire based on the American Heart Association (AHA). Results Of the 992
participants, 615 (62%) were females, and 325 were aged between 26 and 35 years
(32.8%). Four hundred eleven participants (41.4%) attended training related to
BLS. The most common source of training information was a resuscitation society
course (51.8%), followed by the university curriculum (24.6%) and school
(10.7%). The overall mean knowledge score was 9.64 (SD 2.92) out of 20 points.
Among them, 487 (49.1%) had moderate knowledge levels, 466 (47%) were poor, and
only 39 (3.9%) had good knowledge. Factors associated with increased knowledge
include younger age, living outside Central Region, better education, being a
healthcare worker, knowing how to give a cardiac massage, previous participation
in BLS training, and witnessed of sudden death. The biggest barrier that would
prevent participants from providing a cardiac massage is fear of making a
mistake (63.1%). Conclusion The general population's knowledge of BLS was found
to be inadequate. However, younger participants who had a better education and
worked in a healthcare institution tended to be more knowledgeable about BLS
than the rest of the groups. The gaps in the knowledge are evidently seen in
this study. Hence, appropriate measures are needed to bridge knowledge gaps.
Healthcare authorities should devise a program to deliver necessary information
about the basic facts of BLS throughout the community.

Copyright © 2024, Alghamdi et al.

DOI: 10.7759/cureus.71214
PMCID: PMC11550098
PMID: 39525172

Conflict of interest statement: Human subjects: Consent was obtained or waived

by all participants in this study. Deanship of Scientific Research of King
Faisal University issued approval KFU-REC-2023-SEP-ETHICS1202. Having reviewed
the details submitted by the applicant regarding the abovenamed research
project, the Research Ethics Committee at King Faisal University grants its
ethical approval to the protocol. Projects may be subject to an audit or any
other form of monitoring by the committee at any time. The committee may request
a regular report on the progress of the project to ensure that researchers are
committed to the highest ethical standards. Researchers are held accountable for
the storage, retention, and security of original data obtained from projects.
Any substantial alterations to the project or emerging events or matters that
may affect the ethical acceptability of the project must be reported immediately
to the committee via email ([email protected]) or phone (0096615899773).
Animal subjects: All authors have confirmed that this study did not involve
animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE
uniform disclosure form, all authors declare the following: Payment/services
info: All authors have declared that no financial support was received from any
organization for the submitted work. Financial relationships: All authors have
declared that they have no financial relationships at present or within the
previous three years with any organizations that might have an interest in the
submitted work. Other relationships: All authors have declared that there are no
other relationships or activities that could appear to have influenced the
submitted work.

153. Tohoku J Exp Med. 2005 Feb;205(2):157-69. doi: 10.1620/tjem.205.157.

The evaluation of first aid and basic life support training for the first year
university students.

Altintaş KH(1), Aslan D, Yildiz AN, Subaşi N, Elçin M, Odabaşi O, Bilir N, Sayek
I.

Author information:
(1)Department of Public Health, Faculty of Medicine, Hacettepe University,
Ankara, Turkey. [email protected]

In Turkey, the first aiders are few in quantity and yet they are required in
many settings, such as earthquakes. It was thought that training first year
university students in first aid and basic life support (FA-BLS) techniques
would serve to increase the number of first aiders. It was also thought that
another problem, the lack of first aid trainers, might be addressed by training
medical students to perform this function. A project aimed at training first
year university students in FA-BLS was conducted at Hacettepe University. In the
first phase, medical student first aid trainers (MeSFAT) were trained in FA-BLS
training techniques by academic trainers and in the second phase, first year
university students were trained in FA-BLS techniques by these peer trainers
under the academic trainers' supervision. The purpose of this study was to
assess the participants' evaluation of this project and to propose a new program
to increase the number of first aiders in the country. In total, 31 medical
students were certified as MeSFATs and 12 of these trained 40 first year
university students in FA-BLS. Various questionnaires were applied to the
participants to determine their evaluation of the training program. Most of the
participants and the authors considered the program to be successful and
effective. This method may be used to increase the number of first aid trainers
and first aiders in the community.

DOI: 10.1620/tjem.205.157
PMID: 15673974 [Indexed for MEDLINE]

154. Curriculum Development in Medical Simulation.

Ladkany D(1), Pastorino A(2).

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025

Jan–.
2023 May 1.

Author information:
(1)Georgetown University Hospital/MedStar
(2)OhioHealth Doctors Hospital, OU HCOM

Simulation training, initially developed in the 18th century, has become a

mainstay of medical education. The medical profession strives to provide safe
and high-quality care to patients. Both evidence-based medicine and procedural
competency are important in attaining this goal. Simulation, which spans from
procedural training to case-based scenarios and beyond, has been implemented for
all levels of learners. While Cardiopulmonary Resuscitation (CPR) and Basic Life
Support (BLS) training are some of the most common simulation scenarios people
will encounter, simulation training can be much more advanced, complex, and
interprofessional. Simulation activities do not occur in isolation. Appropriate
pre-simulation education is necessary, and it should occur in conjunction with
adequate debriefing. Therefore, the development of a robust curriculum using
simulation must be deliberate to ensure that it is a valuable experience for all
participants.

Copyright © 2025, StatPearls Publishing LLC.

PMID: 32119378

Conflict of interest statement: Disclosure: Diana Ladkany declares no relevant

financial relationships with ineligible companies. Disclosure: Alyssa Pastorino
declares no relevant financial relationships with ineligible companies.

155. Clin Exp Hypertens. 2022 Oct 3;44(7):634-640. doi:

10.1080/10641963.2022.2103145. Epub 2022 Aug 3.

Knowledge, attitude and preparedness of healthcare students toward basic life

support at King Khalid University, Abha, Kingdom of Saudi Arabia.

Shaik Alavudeen S(1), Basharat V(2), Khaled Bahamdan A(3), Easwaran V(1), Khaled
Bahamdan G(4), Akhtar MS(1), Alshahrani S(1), Alqahtani A(5), Venkatesan K(6).

Author information:
(1)Department of Clinical Pharmacy, College of Pharmacy, King Khalid University,
Abha, KSA.
(2)Department of Internal Medicine, College of Medicine, King Khalid University,
Abha, KSA.
(3)Pharmacist, King Khalid University Medical City, Abha, KSA.
(4)Department of Periodontics and Community Dental Sciences, College of
Dentistry, King Khalid University, Abha, KSA.
(5)Department of Pharmaceutics, College of Pharmacy, King Khalid University,
Abha, KSA.
(6)Department of Pharmacology, College of Pharmacy, King Khalid University,
Abha, KSA.

BACKGROUND: Worldwide, millions of people die of sudden cardiac arrest every

year. A well-timed cardiopulmonary resuscitation (CPR) increases the possibility
of survival by two- to fourfolds. This study aimed to assess the knowledge,
attitude, and preparedness of health care students toward basic life support
(BLS) at King Khalid University.
METHODS: A cross-sectional study was conducted among the health care students of
King Khalid University from August to October 2020. Data were collected using a
pretested, semi-structured questionnaire and the data were analyzed using
Statistical Package for the Social Sciences.
RESULRS: The total number of participants was 346. Overall, the participant's
knowledge regarding the BLS was inadequate. Majority of the participants were
not aware of the acronyms used in BLS. The level of education has a significant
impact on the knowledge, whereas gender has no significant impact on the
knowledge. The answers to the attitude and the preparedness items were also not
satisfying. Lack of knowledge is one of the common reasons for not performing
BLS. Periodical training program and refresher courses were the most recommended
methods to increase the knowledge toward the BLS.
CONCLUSION: It is evident from the current study that there is a lack of
knowledge and preparedness toward BLS among most health care students. It is
recommended to incorporate more BLS training and refresher courses in the health
care college curricula.

DOI: 10.1080/10641963.2022.2103145
PMID: 35922057 [Indexed for MEDLINE]

156. JBI Evid Implement. 2024 Jun 10. doi: 10.1097/XEB.0000000000000434. Online
ahead
of print.

Basic life support training for intensive care unit nurses at a general hospital
in Tabriz, Iran: a best practice implementation project.

Kabiri N(1), Hajebrahimi S(1)(2), Soleimanpour M(1), Ardebili RA(3), Kashgsaray

NH(4), Soleimanpour H(5).

Author information:
(1)Research Center for Evidence-based Medicine, Iranian EBM Centre: A JBI Centre
of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences,
Tabriz, Iran.
(2)Urology Department, Helsinki University, Helsinki, Finland.
(3)Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine,
Tabriz University of Medical Sciences, Tabriz, Iran.
(4)Emergency and Trauma Care Research Center, Tabriz University of Medical
Sciences, Tabriz, Iran.
(5)Medical Philosophy and History Research Center, Tabriz University of Medical
Sciences, Tabriz, Iran.

INTRODUCTION AND OBJECTIVES: Basic life support (BLS) is foundational to the

care delivered to cardiac arrest victims. This study evaluated current practices
and implemented best practices related to BLS training for intensive care unit
(ICU) nurses in a general hospital in Tabriz, Iran.
METHODS: This interventional before-after study was informed by the JBI Evidence
Implementation Framework. An audit, feedback, and re-audit strategy was used to
measure baseline compliance with best practices, develop an implementation
strategy to address gaps in compliance, and undertake a final evaluation to
measure changes in compliance. The JBI Practical Application of Clinical
Evidence System (JBI PACES) and situational analysis Getting Research into
Practice (GRiP) tool were used to support data collection and implementation
planning. There were 13 evidence-based criteria and a sample of 9 ICU nurses.
RESULTS: The baseline audit revealed gaps between current practice and best
practice in 9 of the 13 criteria. Barriers included insufficient education tools
and programs, insufficient supervision, lack of skills laboratories, and a lack
of continuous BLS education. Improvement strategies included providing a human
stimulator manikin, developing an education program for nurses, as well as
establishing a cardiopulmonary-cerebral resuscitation department, a skills
laboratory, and continuous BLS education based on the American Heart Association
guidelines. The follow-up audit revealed improvement of 100% across all
criteria.
CONCLUSIONS: This project indicates that a clinical audit is effective for
assessing evidence-based BLS education for ICU nurses, thereby improving
resuscitation performance and patient outcomes.
SPANISH ABSTRACT: http://links.lww.com/IJEBH/A213.

Copyright © 2024 JBI. Unauthorized reproduction of this article is prohibited.

DOI: 10.1097/XEB.0000000000000434
PMID: 38847103

Conflict of interest statement: The authors declare no conflicts of interest

157. Br J Nurs. 2007 Jun 14-27;16(11):664-6. doi: 10.12968/bjon.2007.16.11.23685.

Confidence vs competence: basic life support skills of health professionals.

Castle N(1), Garton H, Kenward G.

Author information:
(1)Frimley Park Foundation Trust, Camberley, and Durban Institute of Technology,
RSA.

The provision of prompt effective resuscitation is fundamental in ensuring

successful outcomes following cardiac arrest but historically nurses and doctors
have lacked competence in performing basic life support (BLS), despite being
confident in their abilities. The object of this study was to assess BLS
confidence as assessed against competence of doctors' in-training, qualified
nurses and healthcare assistants (HCAs) following the development of structured
resuscitation training. This study has highlighted that the introduction of a
structured resuscitation training programme has resulted in a noticeable
improvement in BLS skills, particularly with regard to doctors. Registered
nurses have improved with regular training compared with previously published
data but HCAs tend to perform poorly and are under-confident. There remains a
mismatch between confidence and competence, with only doctors demonstrating both
confidence and competency and therefore changes to training programmes may be
required to address this mismatch.

DOI: 10.12968/bjon.2007.16.11.23685
PMID: 17577185 [Indexed for MEDLINE]

158. BMC Med Educ. 2012 Jul 23;12:58. doi: 10.1186/1472-6920-12-58.

Assessing basic life support skills without an instructor: is it possible?

Mpotos N(1), De Wever B, Valcke MA, Monsieurs KG.

Author information:
(1)Emergency Department, Ghent University Hospital, De Pintelaan 185, Ghent,
B-9000, Belgium. [email protected]

BACKGROUND: Current methods to assess Basic Life Support skills (BLS; chest
compressions and ventilations) require the presence of an instructor. This is
time-consuming and comports instructor bias. Since BLS skills testing is a
routine activity, it is potentially suitable for automation. We developed a
fully automated BLS testing station without instructor by using innovative
software linked to a training manikin. The goal of our study was to investigate
the feasibility of adequate testing (effectiveness) within the shortest period
of time (efficiency).
METHODS: As part of a randomised controlled trial investigating different
compression depth training strategies, 184 medicine students received an
individual appointment for a retention test six months after training. An
interactive FlashTM (Adobe Systems Inc., USA) user interface was developed, to
guide the students through the testing procedure after login, while Skills
StationTM software (Laerdal Medical, Norway) automatically recorded compressions
and ventilations and their duration ("time on task"). In a subgroup of 29
students the room entrance and exit time was registered to assess efficiency. To
obtain a qualitative insight of the effectiveness, student's perceptions about
the instructional organisation and about the usability of the fully automated
testing station were surveyed.
RESULTS: During testing there was incomplete data registration in two students
and one student performed compressions only. The average time on task for the
remaining 181 students was three minutes (SD 0.5). In the subgroup, the average
overall time spent in the testing station was 7.5 minutes (SD 1.4). Mean scores
were 5.3/6 (SD 0.5, range 4.0-6.0) for instructional organisation and 5.0/6 (SD
0.61, range 3.1-6.0) for usability. Students highly appreciated the automated
testing procedure.
CONCLUSIONS: Our automated testing station was an effective and efficient method
to assess BLS skills in medicine students. Instructional organisation and
usability were judged to be very good. This method enables future formative
assessment and certification procedures to be carried out without instructor
involvement.
TRIAL REGISTRATION: B67020097543.

DOI: 10.1186/1472-6920-12-58
PMCID: PMC3461425
PMID: 22824338 [Indexed for MEDLINE]

159. Resuscitation. 2000 Nov;47(3):321-3. doi: 10.1016/s0300-9572(00)00308-7.

A survey of basic life support training in various undergraduate health care

professions.

Jordan T(1), Bradley P.

Author information:
(1)Clinical Skills Resource Centre, The Infirmary Building, 70 Pembroke Place,
Liverpool L69 3GF, UK.

Basic life support (BLS) is a core skill in which all healthcare professionals
should be proficient. It is logical to provide BLS training during undergraduate
years ensuring basic competence in all graduating healthcare students. Previous
surveys of medical and dental schools have highlighted deficiencies in BLS
training. This survey sought to assess the level of BLS training provided for
students across a broad range of disciplines in the North West region of the UK.
This included courses leading to an entry qualification into medicine,
dentistry, nursing, midwifery or a profession allied to medicine (PAM).
Information was collected by self-administered postal questionnaire with a
response rate of 87%. The survey highlighted major variations in BLS training
provided at undergraduate level across disciplines.

DOI: 10.1016/s0300-9572(00)00308-7
PMID: 11114464 [Indexed for MEDLINE]

160. Scand J Trauma Resusc Emerg Med. 2018 Nov 16;26(1):96. doi:
10.1186/s13049-018-0564-4.

The role of a checklist for assessing the quality of basic life support
performance: an observational cohort study.

van Dawen J(1), Vogt L(2)(3), Schröder H(4)(5), Rossaint R(2), Henze L(3),
Beckers SK(2)(6), Sopka S(2)(3).

Author information:
(1)St. Augustinus Hospital, Renkerstraße 45, 52355, Düren, Germany.
(2)Department of Anaesthesiology, University Hospital Aachen, Medical Faculty,
RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
(3)Interdisciplinary Training Centre for Medical Education and Patient Safety -
AIXTRA, Medical Faculty, RWTH Aachen University, Wendlingweg 2, 52074, Aachen,
Germany.
(4)Department of Anaesthesiology, University Hospital Aachen, Medical Faculty,
RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
[email protected].
(5)Interdisciplinary Training Centre for Medical Education and Patient Safety -
AIXTRA, Medical Faculty, RWTH Aachen University, Wendlingweg 2, 52074, Aachen,
Germany. [email protected].
(6)Emergency Medical Service, Fire Department Aachen, Stolberger Str. 155,
52060, Aachen, Germany.

BACKGROUND: Training lay rescuers in Basic Life Support (BLS) is essential to

improve bystander cardiopulmonary resuscitation (CPR) rates; in addition, simple
methods are needed to provide feedback on CPR performance. This study evaluated
whether a simple observational checklist can be used by BLS instructors to
adequately measure the quality of BLS performance as an alternative to other
feedback devices.
METHODS: The BLS performances of 152 first-year medical students (aged
21.4 ± 3.9 years) were recorded on video, and objective data regarding the
quality of the BLS were documented using Laerdal PC SkillReporting software. The
performances were categorized according to quality. Ten BLS instructors observed
the videos and completed a ten-point checklist based on the Cardiff Test of BLS
(version 3.1) to assess the performances. The validity of the checklist was
reviewed using interrater reliability as well as by comparing the
checklist-based results with objective performance data.
RESULTS: Matching the checklist-based evaluation with the objective performance
data revealed high levels of agreement for very good (82%) and overall
insufficient (75%) performances. Regarding the checklist-based evaluation,
interrater reliability depended on the checklist item; thus, some items were
more easily identified correctly than others. The highest and lowest levels of
agreement were observed for the items "undressed torso" and "complete release
between compressions" (mean joint-probability 95 and 67%, respectively).
CONCLUSIONS: The observational checklist adequately distinguished sufficient
from insufficient BLS performances and offered an assessment of items not
incorporated by SkillReporting software such as the initial assessment or
undressing the chest. Although its usefulness was reduced for scaling
intermediate performance groups, the checklist may be overall a useful rating
tool in BLS-training if objective feedback devices are not available, for
example, due to large groups of participants or limited training time.

DOI: 10.1186/s13049-018-0564-4
PMCID: PMC6240285
PMID: 30445986 [Indexed for MEDLINE]

Conflict of interest statement: ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The

study was approved by the local ethics committee of the medical faculty at RWTH
Aachen University (No. EK- 100/12). All participants and raters provided written
consent to contribute to this study. CONSENT FOR PUBLICATION: Not applicable.
COMPETING INTERESTS: The authors declare that they have no competing interests.
PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.

161. Resuscitation. 2016 Nov;108:8-19. doi: 10.1016/j.resuscitation.2016.08.021.

Epub
2016 Aug 28.

Comparing the effect of self-instruction with that of traditional instruction in

basic life support courses-A systematic review.

Hsieh MJ(1), Bhanji F(2), Chiang WC(3), Yang CW(4), Chien KL(5), Ma MH(6).

Author information:
(1)Department of Emergency Medicine, National Taiwan University Hospital,
Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, National
Taiwan University, Taipei, Taiwan.
(2)Centre for Medical Education, McGill University, Montreal, Canada.
(3)Department of Emergency Medicine, National Taiwan University Hospital,
Taipei, Taiwan.
(4)Department of Emergency Medicine, National Taiwan University Hospital,
Taipei, Taiwan; Department of Medical Education, National Taiwan University
Hospital, Taipei, Taiwan.
(5)Institute of Epidemiology and Preventive Medicine, National Taiwan
University, Taipei, Taiwan.
(6)Department of Emergency Medicine, National Taiwan University, Taiwan;
Department of Emergency Medicine, National Taiwan University Hospital, Yun-Lin
Branch, Taiwan. Electronic address: [email protected].

AIM: The efficacy of learning basic life support (BLS) through self-instruction
is not clearly understood. The aim of our review was to compare the effect of
self-instruction with that of traditional instruction on learners taking BLS
courses.
METHODS: We searched the Cochrane Central Register of Controlled Trials,
MEDLINE, EMBASE, CINAHL, PsycInfo and SCI-EXPANDED databases for randomized
control trials (RCTs) or randomized cluster-controlled trials published from
January 1, 1966 to April 25, 2015 which compared self-instruction with
traditional instruction in BLS courses. Characteristics, participants, design
and outcomes of included studies were extracted.
RESULTS: The search yielded 2119 unique articles, of which 19 RCTs and 3
randomized cluster-controlled trials were included. The learners were different
across studies, including laypersons, parents and caretakers of children,
university or high school students, medical, pharmacy and nursing students, and
practicing nurses. Self-instructional material included DVD, videotapes, on-line
learning or interactive computer programs accompanied with synchronous or
asynchronous hands-on practice. There were no studies comparing clinical
outcomes between the different instructional methods. In evaluating skill
performance, there was variability among studies in the skill assessment tools
utilized and time of assessment. Nevertheless, the most frequent conclusion of
these studies was that self-instruction had similar performance compared with
traditional courses. Four studies which measured cognitive knowledge outcomes
all demonstrated similar outcomes between the two methods.
CONCLUSION: Although it remains inconclusive about which is superior between the
two methods, considering the potential to train many more rescuers and to reduce
resource utilization, well-designed self-instruction with hands-on practice may
be an alternative to traditional BLS courses.

Copyright © 2016. Published by Elsevier Ireland Ltd.

DOI: 10.1016/j.resuscitation.2016.08.021
PMID: 27581252 [Indexed for MEDLINE]

162. Eur J Emerg Med. 2013 Jun;20(3):193-6. doi: 10.1097/MEJ.0b013e328355fd59.

Self-perception of knowledge and confidence in performing basic life support

among medical students.

Freund Y(1), Duchateau FX, Baker EC, Goulet H, Carreira S, Schmidt M, Riou B,
Rouby JJ, Duguet A.

Author information:
(1)Emergency Department, Pitié - Salpêtrière Hospital. [email protected]

AIM: Before implementing new workshops and teaching in our faculty for
performing basic life support (BLS), we aimed to determine the level of
self-confidence of medical students with regard to the management of cardiac
arrest (CA).
METHODS: We conducted a preinterventional study. A questionnaire was sent to
third-year to sixth-year medical students. We recorded sex, year of training,
and personal witnessing of CA. We asked them about their theoretical knowledge
on 10 main items of BLS and their self-perception of qualification to conduct a
CA situation. We tested the respective influence of sex, year of training, and
personal witnessing of CA.
RESULTS: In total, 592 (37%) students completed the questionnaire, 42% of them
were men. Less than a third of the students (30%) thought of themselves as being
sufficiently qualified to conduct BLS. After the third year, the level of study
did not influence their theoretical knowledge or their self-perception of
qualification. Male sex and the number of CAs witnessed were the only factors
positively associated with better self-confidence regarding qualification.
CONCLUSION: Self-perception of qualification in BLS is poor in our faculty. In
our study, personal witnessing of CA greatly influenced confidence, whereas
level of study did not.

DOI: 10.1097/MEJ.0b013e328355fd59
PMID: 22735507 [Indexed for MEDLINE]

163. World J Emerg Med. 2015;6(2):118-22. doi: 10.5847/wjem.j.1920-

8642.2015.02.006.

Assessment of knowledge and attitude about basic life support among dental
interns and postgraduate students in Bangalore city, India.

Narayan DP(1), Biradar SV(1), Reddy MT(1), Bk S(1).

Author information:
(1)Department of Public Health Dentistry, Vydehi Institute of Dental Sciences
and Research Center, Bangalore, India.

BACKGROUND: Life-threatening emergencies can occur at anytime, at anywhere and

in anyone. Effective management of an emergency situation in the dental office
is ultimately the dentist's responsibility. The lack of training and inability
to cope with medical emergencies can lead to tragic consequences and sometimes
legal complications. Therefore, health professionals including dentists must be
well prepared to deal with medical emergencies. This study was undertaken to
assess the knowledge about and attitude towards basic life support (BLS) among
dental interns and postgraduate students in Bangalore city, India.
METHODS: A cross sectional survey was conducted among dental interns and
postgraduate students from May 2014 to June 2014 since few studies have been
conducted in Bangalore city. A questionnaire with 17 questions regarding the
knowledge about and attitude towards BLS was distributed to 202 study
participants.
RESULTS: The data analyzed using the Chi-square test showed that dental interns
and postgraduate students had average knowledge about BLS. In the 201
participants, 121 (59.9%) had a positive attitude and 81 (40.1%) had a negative
attitude towards BLS.
CONCLUSIONS: Cardiopulmonary resuscitation should be considered as part of the
dental curriculum. Workshops on a regular basis should be focused on skills of
cardiopulmonary resuscitation for dental students.

DOI: 10.5847/wjem.j.1920-8642.2015.02.006
PMCID: PMC4458471
PMID: 26056542

Conflict of interest statement: Conflicts of interest: The authors declare that

no competing interest and no personal relationships with other people or
organizations that could inappropriately influence their work.

164. World J Emerg Med. 2017;8(2):131-135. doi: 10.5847/wjem.j.1920-

8642.2017.02.009.

Knowledge, attitude and anxiety pertaining to basic life support and medical
emergencies among dental interns in Mangalore City, India.

Somaraj V(1), Shenoy RP(2), Panchmal GS(2), Jodalli PS(2), Sonde L(2), Karkal
R(3).

Author information:
(1)Department of Public Health Dentistry, Rajas Dental College & Hospital,
Tirunelveli, Tamil Nadu, India.
(2)Department of Public Health Dentistry, Yenepoya Dental College, Mangalore,
Karnataka, India.
(3)Department of Psychiatry, Yenepoya Medical College, Mangalore, Karnataka
575018, India.

BACKGROUND: This cross-sectional study aimed to assess the knowledge, attitude

and anxiety pertaining to basic life support (BLS) and medical emergencies among
interns in dental colleges of Mangalore city, Karnataka, India.
METHODS: The study subjects comprised of interns who volunteered from the four
dental colleges. The knowledge and attitude of interns were assessed using a
30-item questionnaire prepared based on the Basic Life Support Manual from
American Heart Association and the anxiety of interns pertaining to BLS and
medical emergencies were assessed using a State-Trait Anxiety Inventory (STAI)
Questionnaire. Chi-square test was performed on SPSS 21.0 (IBM Statistics, 2012)
to determine statistically significant differences (P<0.05) between assessed
knowledge and anxiety.
RESULTS: Out of 183 interns, 39.89% had below average knowledge. A total of 123
(67.21%) reported unavailability of professional training. The majority (180,
98.36%) felt the urgent need of training in basic life support procedures.
Assessment of stress showed a total of 27.1% participants to be above
high-stress level. Comparison of assessed knowledge and stress was found to be
insignificant (P=0.983).
CONCLUSION: There was an evident lack of knowledge pertaining to the management
of medical emergencies among the interns. As oral health care providers moving
out to the society, a focus should be placed on the training of dental interns
with respect to Basic Life Support procedures.

DOI: 10.5847/wjem.j.1920-8642.2017.02.009
PMCID: PMC5409234
PMID: 28458758

Conflict of interest statement: Conflicts of interest: The authors declare that

no competing interest and no personal relationships with other people or
organizations that could inappropriately influence their work.

165. Indian J Anaesth. 2016 Nov;60(11):821-826. doi: 10.4103/0019-5049.193669.

Students' satisfaction to hybrid problem-based learning format for basic life

support/advanced cardiac life support teaching.

Chilkoti G(1), Mohta M(1), Wadhwa R(1), Saxena AK(1), Sharma CS(1), Shankar
N(2).

Author information:
(1)Department of Anaesthesiology and Critical Care, University College of
Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India.
(2)Department of Physiology, University College of Medical Sciences, New Delhi,
India.

BACKGROUND AND AIMS: Students are exposed to basic life support (BLS) and
advanced cardiac life support (ACLS) training in the first semester in some
medical colleges. The aim of this study was to compare students' satisfaction
between lecture-based traditional method and hybrid problem-based learning (PBL)
in BLS/ACLS teaching to undergraduate medical students.
METHODS: We conducted a questionnaire-based, cross-sectional survey among 118
1st-year medical students from a university medical college in the city of New
Delhi, India. We aimed to assess the students' satisfaction between
lecture-based and hybrid-PBL method in BLS/ACLS teaching. Likert 5-point scale
was used to assess students' satisfaction levels between the two teaching
methods. Data were collected and scores regarding the students' satisfaction
levels between these two teaching methods were analysed using a two-sided paired
t-test.
RESULTS: Most students preferred hybrid-PBL format over traditional
lecture-based method in the following four aspects; learning and understanding,
interest and motivation, training of personal abilities and being confident and
satisfied with the teaching method (P < 0.05).
CONCLUSION: Implementation of hybrid-PBL format along with the lecture-based
method in BLS/ACLS teaching provided high satisfaction among undergraduate
medical students.

DOI: 10.4103/0019-5049.193669
PMCID: PMC5125185
PMID: 27942055

Conflict of interest statement: There are no conflicts of interest.

166. Resuscitation. 2006 Jan;68(1):93-100. doi:

10.1016/j.resuscitation.2005.05.014.
Epub 2005 Oct 10.

Attitudes to basic life support among medical students following the 2003 SARS
outbreak in Hong Kong.

Caves ND(1), Irwin MG.

Author information:
(1)Department of Anaesthesiology, The University of Hong Kong, Queen Mary
Hospital, Room 424, Block K, Pokfulam Road, Hong Kong. [email protected]

BACKGROUND: In 2003 severe acute respiratory syndrome (SARS) affected 1,755

people in Hong Kong, including 386 health care professionals, some of whom were
infected during resuscitation attempts of affected patients. This study seeks to
explore whether this epidemic has altered the willingness of Hong Kong medical
students to perform basic life support and mouth-to-mouth ventilation during an
out-of-hospital cardiac arrest.
METHODS: A questionnaire was used to survey Year 4 medical students at the end
of their undergraduate anaesthesia attachment, during which basic life support
(BLS) skills were taught. The survey was conducted during July and August 2003,
approximately two months after Hong Kong was removed from the World Health
Organisation SARS Infected Areas list, and was designed to examine student
confidence in BLS skills, their perceptions of the risks associated with
performing BLS and their willingness to perform BLS in varying situations.
RESULTS: The response rate was over 60% (35 from a possible 54). Students were
positive regarding the adequacy of their BLS training. They were concerned about
disease transmission during resuscitation but were less positive regarding
whether the risks had increased due to SARS. In all situations they were
significantly more likely to perform mouth-to-mouth ventilation for a family
member compared with a stranger (p < 0.001) and to withhold mouth-to-mouth
ventilation if either vomit or blood were present in the victim's mouth.
CONCLUSIONS: Hong Kong medical students feel able to perform BLS if required.
They are concerned about the risk of disease transmission, including SARS,
during resuscitation, but would be more likely to withhold mouth-to-mouth
resuscitation in the presence of vomit or blood than due to a fear of
contracting SARS.

DOI: 10.1016/j.resuscitation.2005.05.014
PMCID: PMC7116926
PMID: 16219408 [Indexed for MEDLINE]
167. Pediatr Int. 2017 Mar;59(3):352-356. doi: 10.1111/ped.13155. Epub 2016 Nov 21.

Quality of basic life support education and automated external defibrillator

setting in schools in Ishikawa, Japan.

Takamura A(1)(2)(3)(4), Ito S(5), Maruyama K(5), Ryo Y(5), Saito M(5), Fujimura
S(5), Ishiura Y(3), Hori A(1).

Author information:
(1)Department of Medical Education, Kanazawa Medical University, Uchinada,
Japan.
(2)Department of Community Medicine, Kanazawa Medical University, Uchinada,
Japan.
(3)Clinical Simulation Centre, Kanazawa Medical University, Uchinada, Japan.
(4)Department of Family Medicine, Mie University Graduate School of Medicine,
Tsu, Japan.
(5)Faculty of Medicine, Kanazawa Medical University, Uchinada, Japan.

BACKGROUND: Automated external defibrillators (AED) have been installed in

schools in Japan since 2004, and the government strongly recommends teaching
basic life support (BLS). We therefore examined the quality of BLS education and
AED installation in schools.
METHODS: We conducted a prefecture-wide questionnaire survey of all primary and
junior high schools in 2016, to assess BLS education and AED installation
against the recommendations of the Japan Circulation Society. The results were
analyzed using descriptive statistics and chi-squared test.
RESULTS: In total, 195 schools out of 315 (62%) responded, of which 38% have
introduced BLS education for children. BLS training was held in a smaller
proportion of primary schools (18%) than junior high schools (86%). More than
90% of primary school staff had undergone BLS training in the previous 2 years.
The most common locations of AED were the gymnasium (32%) followed by entrance
hall (28%), staffroom (25%), and infirmary (12%). The reasons given for location
were that it was obvious (34%), convenient for staff (32%), could be used out of
hours (17%), and the most likely location for a heart attack (15%).
Approximately 18% of schools reported that it takes >5 min to reach the AED from
the furthest point.
CONCLUSION: BLS training, AED location, and understanding of both are not
sufficient to save children's lives efficiently. Authorities should make
recommendations about the correct number of AED, and their location, and provide
more information to improve the quality of BLS training in schools.

© 2016 Japan Pediatric Society.

DOI: 10.1111/ped.13155
PMID: 27589486 [Indexed for MEDLINE]

168. BMC Med Educ. 2024 Jul 19;24(1):779. doi: 10.1186/s12909-024-05763-x.

Comparative study on the impact of 'Infographic versus video feedback' on

enhancing students' clinical skills in basic life support.

Miri K(1), Yaghoubi A(2), Kholousi S(2), Yousofzadeh M(2), Zanganeh A(2),
Gharayi M(2), Namazinia M(3).

Author information:
(1)Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh
University of Medical Sciences, Torbat Heydariyeh, Iran. [email protected].
(2)Student Research Committee, Torbat Heydariyeh University of Medical Sciences,
Torbat Heydariyeh, Iran.
(3)Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh
University of Medical Sciences, Torbat Heydariyeh, Iran. [email protected].

BACKGROUND: Effective cardiopulmonary resuscitation (CPR) training for nursing

students is crucial for improving patient outcomes in cardiac arrest scenarios.
This study assesses the impact of infographic versus video feedback on enhancing
nursing students' clinical skills in Basic Life Support (BLS).
METHODS: In a randomized controlled setting, 76 nursing students at Torbat
Heydariyeh University of Medical Sciences were divided into two groups: one
received infographic-based education and the other video feedback training. Pre-
and post-intervention assessments measured knowledge and skill retention using
validated questionnaires.
RESULTS: Post-training, the infographic group showed significantly higher
knowledge scores, while the video feedback group exhibited greater improvement
in CPR skill performance. No significant differences were noted in pre-training
assessment scores between the groups.
CONCLUSION: Infographic-based education enhances BLS knowledge retention, and
video feedback improves practical CPR skills. This suggests potential benefits
of a combined infographic and video feedback approach for optimizing CPR
training outcomes, addressing a critical need in medical education.

© 2024. The Author(s).

DOI: 10.1186/s12909-024-05763-x
PMCID: PMC11264920
PMID: 39030534 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare no competing interests. The

authors declare that there is no conflict of interest in the publication of this
article.

169. Ulus Travma Acil Cerrahi Derg. 2006 Apr;12(2):87-94.

[Prehospital life support in trauma patients: basic or advanced trauma life

support].

[Article in Turkish]

Ozdoğan M(1), Ağalar F, Eryilmaz M, Ozel G, Taviloğlu K.

Author information:
(1)Department of General Surgery Atatürk Training and Research Hospital, Ankara,
and Department of General Surgery Medicine Faculty of Kirikkale University,
Turkey. [email protected]

The controversy between Advanced Trauma Life Support (ATLS) and Basic Life
Support (BLS) in the prehospital care of trauma patients has not been resolved
yet. The purpose of this study was to examine the literature with respect to the
type of prehospital care applied to the trauma patients. A total of 76 papers on
ATLS and/or BLS for trauma were reviewed regarding the variables such as
intravenous catheter application, prehospital fluid resuscitation, transport
time, intubation and mortality. As a conclusion, the data in the literature do
not support the routine use of on-field ATLS in trauma patients. Prospective
randomized trials comparing ATLS and BLS in prehospital management of trauma
patients are needed to clarify this issue.
PMID: 16676246 [Indexed for MEDLINE]

170. Biomed Res Int. 2016;2016:2420568. doi: 10.1155/2016/2420568. Epub 2016 Jul
27.

The Effect of the Duration of Basic Life Support Training on the Learners'
Cardiopulmonary and Automated External Defibrillator Skills.

Lee JH(1), Cho Y(1), Kang KH(1), Cho GC(1), Song KJ(2), Lee CH(3).

Author information:
(1)Department of Emergency Medicine, Hallym University School of Medicine, Seoul
24252, Republic of Korea.
(2)Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan
University School of Medicine, Seoul 06351, Republic of Korea.
(3)Department of Emergency Medical Service, Namseoul University, Cheonan,
Chungnam 331-707, Republic of Korea.

Background. Basic life support (BLS) training with hands-on practice can improve
performance during simulated cardiac arrest, although the optimal duration for
BLS training is unknown. This study aimed to assess the effectiveness of various
BLS training durations for acquiring cardiopulmonary resuscitation (CPR) and
automated external defibrillator (AED) skills. Methods. We randomised 485 South
Korean nonmedical college students into four levels of BLS training: level 1
(40 min), level 2 (80 min), level 3 (120 min), and level 4 (180 min). Before and
after each level, the participants completed questionnaires regarding their
willingness to perform CPR and use AEDs, and their psychomotor skills for CPR
and AED use were assessed using a manikin with Skill-Reporter™ software.
Results. There were no significant differences between levels 1 and 2, although
levels 3 and 4 exhibited significant differences in the proportion of overall
adequate chest compressions (p < 0.001) and average chest compression depth (p =
0.003). All levels exhibited a greater posttest willingness to perform CPR and
use AEDs (all, p < 0.001). Conclusions. Brief BLS training provided a moderate
level of skill for performing CPR and using AEDs. However, high-quality skills
for CPR required longer and hands-on training, particularly hands-on training
with AEDs.

DOI: 10.1155/2016/2420568
PMCID: PMC4978818
PMID: 27529066 [Indexed for MEDLINE]

171. World J Emerg Med. 2015;6(3):179-85. doi: 10.5847/wjem.j.1920-

8642.2015.03.003.

Performance of cardiopulmonary resuscitation during prolonged basic life support

in military medical university students: A manikin study.

Wang J(1), Zhuo CN(2), Zhang L(3), Gong YS(4), Yin CL(3), Li YQ(4).

Author information:
(1)Department of Emergency Medicine, Southwest Hospital, Third Military Medical
University, Chongqing, China ; Medical Training Center, Southwest Hospital,
Third Military Medical University, Chongqing, China.
(2)College of Bioengineering, Chongqing University, Chongqing, China.
(3)Department of Emergency Medicine, Southwest Hospital, Third Military Medical
University, Chongqing, China.
(4)School of Biomedical Engineering, Third Military Medical University,
Chongqing, China.

BACKGROUND: The quality of chest compressions can be significantly improved

after training of rescuers according to the latest national guidelines of China.
However, rescuers may be unable to maintain adequate compression or ventilation
throughout a response of average emergency medical services because of increased
rescuer fatigue. In the present study, we evaluated the performance of
cardiopulmonary resuscitation (CPR) in training of military medical university
students during a prolonged basic life support (BLS).
METHODS: A 3-hour BLS training was given to 120 military medical university
students. Six months after the training, 115 students performed single rescuer
BLS on a manikin for 8 minutes. The qualities of chest compressions as well as
ventilations were assessed.
RESULTS: The average compression depth and rate were 53.7±5.3 mm and 135.1±15.7
compressions per minute respectively. The proportion of chest compressions with
appropriate depth was 71.7%±28.4%. The average ventilation volume was
847.2±260.4 mL and the proportion of students with adequate ventilation was
63.5%. Compared with male students, significantly lower compression depth
(46.7±4.8 vs. 54.6±4.8 mm, P<0.001) and adequate compression rate (35.5%±26.5%
vs. 76.1%±25.1%, P<0.001) were observed in female students.
CONCLUSIONS: CPR was found to be related to gender, body weight, and body mass
index of students in this study. The quality of chest compressions was well
maintained in male students during 8 minutes of conventional CPR but declined
rapidly in female students after 2 minutes according to the latest national
guidelines. Physical fitness and rescuer fatigue did not affect the quality of
ventilation.

DOI: 10.5847/wjem.j.1920-8642.2015.03.003
PMCID: PMC4566006
PMID: 26401177

Conflict of interest statement: Conflicts of interest: The authors declare that

there are no conflicts of interest related to the publication of this paper.

172. Int J Med Sci. 2020 Oct 22;17(18):3082-3090. doi: 10.7150/ijms.47343.

eCollection 2020.

Changes of knowledge and practical skills before and after retraining for basic
life support: Focused on students of Dental School.

Kim SY(1), Shin D(2), Kim HJ(3), Karm MH(4).

Author information:
(1)Department of Dental Anesthesiology, School of Dentistry, Seoul National
University, Seoul, Republic of Korea.
(2)Department of Emergency Medical Service, Korea National University of
Transportation, Chungcheongbuk-do, Republic of Korea.
(3)Department of Dental Anesthesiology and Dental Research Institute, School of
Dentistry, Seoul National University, Seoul, Republic of Korea.
(4)Department of Dental Anesthesiology, Seoul National University Dental
Hospital, Seoul, Republic of Korea.

Background: Considering the increasing possibility of emergency situations in

dental clinics over time, we conducted this study to evaluate the changes in the
knowledge and practical skills of students of dental school before and after
retraining for 2 years after the initial education on basic life support (BLS)
of the American Heart Association (AHA). Methods: All third-year students of
dental school who had received the same education on BLS provider training of
the AHA 2 years earlier were included in this study. Among them, 98 students
were asked to answer a questionnaire about BLS knowledge and conduct a practical
skills assessment of high-quality cardiopulmonary resuscitation using Little
Anne QCPR before and after retraining. Results: After retraining, the level of
BLS knowledge increased in all 7 categories, and BLS performance increased in
all 19 subcategories. Comparison of the QCPR numerical data items before and
after retraining showed that all items after retraining met the criteria
recommended by the AHA. Conclusion: Students of dental school had low levels of
knowledge and practical skills of BLS before retraining after 2 years from the
initial education and had high levels after retraining. Therefore, BLS training
must be updated periodically, and more effective education methods are required
to maintain BLS knowledge and practical skills.

© The author(s).

DOI: 10.7150/ijms.47343
PMCID: PMC7646099
PMID: 33173429 [Indexed for MEDLINE]

Conflict of interest statement: Competing Interests: The authors have declared

that no competing interest exists.

173. Circulation. 2010 Nov 2;122(18 Suppl 3):S685-705. doi:

10.1161/CIRCULATIONAHA.110.970939.

Part 5: adult basic life support: 2010 American Heart Association Guidelines for
Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Berg RA, Hemphill R, Abella BS, Aufderheide TP, Cave DM, Hazinski MF, Lerner EB,
Rea TD, Sayre MR, Swor RA.

Erratum in
Circulation. 2011 Oct 11;124(15):e402.

The critical lifesaving steps of BLS are ● Immediate Recognition and Activation
of the emergency response system ● Early CPR and ● Rapid Defibrillation for VF.
When an adult suddenly collapses, whoever is nearby should activate the
emergency system and begin chest compressions (regardless of training). Trained
lay rescuers who are able and healthcare providers should provide compressions
and ventilations. Contrary to the belief of too many in this situation, CPR is
not harmful. Inaction is harmful and CPR can be lifesaving. However, the quality
of CPR is critical. Chest compressions should be delivered by pushing hard and
fast in the center of the chest (ie, chest compressions should be of adequate
rate and depth). Rescuers should allow complete chest recoil after each
compression and minimize interruptions in chest compressions. They should also
avoid excessive ventilation. If and when available, an AED should be applied and
used without delaying chest compressions. With prompt and effective provision of
these actions, lives are saved every day.

DOI: 10.1161/CIRCULATIONAHA.110.970939
PMID: 20956221 [Indexed for MEDLINE]

174. BMC Med Educ. 2024 Dec 30;24(1):1554. doi: 10.1186/s12909-024-06519-3.

A five-finger mnemonic for teaching schoolchildren the theoretical components of

adult basic life support: a modified reactive Delphi-guided development and
memorability pilot test with schoolchildren.

Fijačko N(1)(2), Greif R(3)(4), Metličar Š(5)(6), Štiglic G(5)(7)(8), Abella

BS(9), Strnad M(10)(11)(12); Delphi study investigators.

Author information:
(1)Faculty of Health Sciences, University of Maribor, Maribor, Slovenia.
[email protected].
(2)Emergency Department, Maribor University Medical Centre, Maribor, Slovenia.
[email protected].
(3)University of Bern, Bern, Switzerland.
(4)Department of Surgical Science, University of Torino, Torino, Italy.
(5)Faculty of Health Sciences, University of Maribor, Maribor, Slovenia.
(6)Medical Dispatch Centre Maribor, University Clinical Centre Ljubljana,
Ljubljana, Slovenia.
(7)Faculty of Electrical Engineering and Computer Science, University of
Maribor, Maribor, Slovenia.
(8)Usher Institute, University of Edinburgh, Edinburgh, UK.
(9)Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
(10)Emergency Department, Maribor University Medical Centre, Maribor, Slovenia.
(11)Faculty of Medicine, University of Maribor, Maribor, Slovenia.
(12), Community Healthcare Center Dr. Adolfa Drolca Maribor, Maribor, Slovenia.

BACKGROUND: A mnemonic is a cognitive aid frequently used in health-related

education. The main goal of this study was to develop and test a 5-finger
mnemonic for teaching schoolchildren the theoretical aspects of adult Basic Life
Support (BLS) steps, a process rarely described in the context of instructing
laypersons.
METHODS: Experts from the European Resuscitation Council's Basic Life Support
Science and Education Committee (ERC BLS SEC), specializing in teaching adult
BLS, participated in the first phase of the pilot study. This phase employed the
modified reactive Delphi to develop a 5-finger mnemonic for teaching
schoolchildren the theoretical aspects of adult BLS steps, in accordance with
the 2021 ERC BLS guidelines. The mnemonic underwent revision rounds based on
expert suggestions and was evaluated using a 9-point Likert scale. The process
was repeated until there was unanimous approval. In the second phase, a pilot
test was conducted with schoolchildren at a summer camp to assess their recall
of the 5-finger mnemonic. Following their training in adult BLS steps utilizing
the 5-finger mnemonic, schoolchildren were tasked with arranging cards depicting
images from the mnemonic both before and after the training.
RESULTS: From March to October 2022, a four-round modified reactive Delphi
engaged four experts from the ERC BLS SEC. Initial expert consensus was
moderate, 6.0 (IQR = 4.5-7.5, min = 1, max = 9), on a scale 1 ("totally
disagree") to 9 ("totally agree"). The experts consensus improved over
subsequent rounds, resulting in two final versions of the 5-finger mnemonic.
Both versions concentrate on the comprehensive adult BLS, differing only in
their approach to cardiopulmonary resuscitation (CPR): one employs a method of
30 chest compressions followed by two rescue breaths, while the other utilizes
compression-only CPR. In August 2023, a recall pilot test involved mostly female
schoolchildren (12/13, 92.3%). Pre-training, no cards with 5-finger mnemonic
content were arranged correctly, but post-training, progress improvement was
observed, especially in older schoolchildren (Z = -2.727, p = 0.006).
CONCLUSIONS: The pilot study highlights the potential of using tailored
educational tools, such as mnemonics, to teach important lifesaving skills to
different age groups. This suggests that the 5-finger mnemonic effectively
improved schoolchildren's understanding of the theoretical aspects of adult BLS
steps.

© 2024. The Author(s).

DOI: 10.1186/s12909-024-06519-3
PMCID: PMC11684042
PMID: 39736674 [Indexed for MEDLINE]

Conflict of interest statement: Declarations. Ethics approval and consent to

participate: Ethical approval was obtained from the National Ethics Committee
(0120–157/2018) and from schoolchildren parents or guardians with all
participators signing informed consent. Consent for publication: Not applicable.
Competing interests: The authors declare no competing interests.

175. J Intensive Care. 2014 Apr 24;2(1):28. doi: 10.1186/2052-0492-2-28.

eCollection
2014.

Basic life support training for single rescuers efficiently augments their
willingness to make early emergency calls with no available help: a cross-over
questionnaire survey.

Hirose K(1), Enami M(1), Matsubara H(1), Kamikura T(1), Takei Y(2), Inaba H(1).

Author information:
(1)Department of Emergency Medical Science, Kanazawa University Graduate School
of Medicine, 13-1 Takaramachi, Kanazawa, 920-8641 Japan.
(2)Department of Medical Science and Technology, Hiroshima International
University, Hiroshima, Japan.

BACKGROUND: The aim of this study was to investigate effects of basic life
support (BLS) training on willingness of single rescuers to make emergency calls
during out-of-hospital cardiac arrests (OHCAs) with no available help from
others.
METHODS: A cross-over questionnaire survey was conducted with two
questionnaires. Questionnaires were administered before and after two BLS
courses in fire departments. One questionnaire included two scenarios which
simulate OHCAs occurring in situations where help from other rescuers is
available (Scenario-M) and not available (Scenario-S). The conventional BLS
course was designed for multiple rescuers (Course-M), and the other was designed
for single rescuers (Course-S).
RESULTS: Of 2,312 respondents, 2,218 (95.9%) answered all questions and were
included in the analysis. Although both Course-M and Course-S significantly
augmented willingness to make early emergency calls not only in Scenario-M but
also in Scenario-S, the willingness for Scenario-M after training course was
significantly higher in respondents of Course-S than in those of Course-M (odds
ratio 1.706, 95% confidential interval 1.301-2.237). Multiple logistic
regression analysis for Scenario-M disclosed that post training (adjusted odds
ratio 11.6, 95% confidence interval 7.84-18.0), age (0.99, 0.98-0.99), male
gender (1.77, 1.39-2.24), prior BLS experience of at least three times (1.46,
1.25-2.59), and time passed since most recent training during 3 years or less
(1.80, 1.25-2.59) were independently associated with willingness to make early
emergency calls and that type of BLS course was not independently associated
with willingness. Therefore, both Course-M and Course-S similarly augmented
willingness in Scenario-M. However, in multiple logistic regression analyses for
Scenario-S, Course-S was independently associated with willingness to make early
emergency calls in Scenario-S (1.26, 1.00-1.57), indicating that Course-S more
efficiently augmented willingness. Moreover, post training (2.30, 1.86-2.83) and
male gender (1.26, 1.02-1.57) were other independent factors associated with
willingness in Scenario-S.
CONCLUSIONS: BLS courses designed for single rescuers with no help available
from others are likely to augment willingness to make early emergency calls more
efficiently than conventional BLS courses designed for multiple rescuers.

DOI: 10.1186/2052-0492-2-28
PMCID: PMC4267597
PMID: 25520840

176. Resusc Plus. 2021 May 15;6:100137. doi: 10.1016/j.resplu.2021.100137.

eCollection 2021 Jun.

Deliberate practice and mastery learning in resuscitation education: A scoping

review.

Donoghue A(1), Navarro K(2), Diederich E(3), Auerbach M(4), Cheng A(5).

Author information:
(1)Divisions of Critical Care Medicine and Emergency Medicine, Departments of
Anesthesia and Critical Care Medicine and Pediatrics, Perelman School of
Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
(2)Division of EMS, Department of Emergency Medicine, University of Texas
Southwestern Medical Center, Dallas, TX, USA.
(3)Division of Pulmonary, Critical Care, and Sleep Medicine, Department of
Medicine, University of Kansas School of Medicine, Kansas City, KS, USA.
(4)Departments of Pediatrics and Emergency Medicine, Yale University, New Haven,
CT, USA.
(5)Departments of Pediatrics and Emergency Medicine, University of Calgary,
Calgary, Canada.

STUDY AIM: To summarize the current state of knowledge of deliberate practice

and mastery learning (DP and/or ML) as teaching methods for resuscitation
education.
METHODS: A scoping review of PubMed, Scopus, and Embase was conducted through
March 1, 2021. Studies examining the effect of the incorporation of either
deliberate practice and/or mastery learning during resuscitation education were
eligible for inclusion. Included studies were dichotomized into studies
comparing deliberate practice and/or mastery learning to other training methods
(randomized controlled trials) and studies examining before and after impact of
deliberate practice and/or mastery learning alone (observational studies).
Studies and findings were tabulated and summarized using the scoping review
methodology published by Arksey and O'Malley.
RESULTS: 63 published studies were screened; sixteen studies met all inclusion
criteria (4 randomized controlled trials and 12 observational studies). One
randomized controlled trial and eleven observational studies demonstrated
improvement in skill and/or knowledge following educational interventions using
deliberate practice and/or mastery learning. Significant variability between
studies with regard to research designs, learner groups, comparators, and
outcomes of interest made quantitative summarization of findings difficult.
CONCLUSIONS: The incorporation of deliberate practice and/or mastery learning in
resuscitation education may be associated with improved educational outcomes and
less skill decay than other educational methods. Current literature on DP and ML
suffers from a lack of consistency in research methodology, subjects, and
outcomes. Future research should employ uniform definitions for deliberate
practice and mastery learning, follow research design that isolates its effect,
and examine generalizable and translatable outcomes.

© 2021 The Authors.

DOI: 10.1016/j.resplu.2021.100137
PMCID: PMC8244416
PMID: 34223392

177. Healthcare (Basel). 2020 Oct 1;8(4):379. doi: 10.3390/healthcare8040379.

Learning Assessment from a Lecture about Fundamentals on Basic Life Support

among Undergraduate Students of Health Sciences.

Tavares LFB(1), Raimundo RD(1), Leone C(1), Castanha CSC(1), Gonçalves de

Oliveira A(1), Daboin BEG(1), Mendes JET(1), Abreu LC(1)(2).

Author information:
(1)Laboratory of Study Design and Scientific Writing, Centro Universitário Saúde
ABC, São Paulo 09060-650, Brazil.
(2)Graduate Program in Medical Sciences, Universidade de São Paulo, São Paulo
05508-060, Brazil.

Introduction: Cardiac arrest is one of the leading public health problems

worldwide and in Brazil. A victim of cardiorespiratory arrest needs prompt basic
life support (BLS) to increase survival. Objective: To evaluate the performance
of a synthesis lecture on BLS given to university students in Health Sciences.
Methods: A total of 422 undergraduate students in Nursing, Physiotherapy, and
Medicine participated in this study. Data were collected by applying a pre-test
through a BLS questionnaire based on the American Heart Association guidelines.
Results: Students obtained a minimum grade of 40% of the pre-test questions. The
score increased to 75% in the post-test; the students with the best performance
in the pre-test maintained a higher total number of correct answers in the
post-test. There was also better performance in those with previous training in
BLS. The students from the first year of medical school were the ones who
benefited the most from the lecture. Conclusion: Regardless of the grade course,
the Health Science students showed a significant improvement in their level of
knowledge after attending the synthesis lecture, indicating its adequacy to
promote initial learning about BLS.

DOI: 10.3390/healthcare8040379
PMCID: PMC7711553
PMID: 33019578

Conflict of interest statement: The authors declare no conflict of interest.

178. Inquiry. 2022 Jan-Dec;59:469580221098755. doi: 10.1177/00469580221098755.

Retention of Knowledge and Skills After a Basic Life Support Course for
Schoolchildren: A Prospective Study.

Borovnik Lesjak V(1), Šorgo A(2)(3), Strnad M(1)(4)(5).

Author information:
(1)Emergency Medical Services Unit, 123929Zdravstveni Dom Dr Adolfa Drolca
Maribor, Slovenia.
(2)Faculty of Natural Sciences and Mathematics, University of Maribor, Slovenia.
(3)Faculty of Electrical Engineering and Computer Science, University of
Maribor, Slovenia.
(4)Faculty of Medicine, University of Maribor, Slovenia.
(5)Emergency Department, 112806Univerzitetni Klinicni Center Maribor, Slovenia.

Courses on basic life support (BLS) and automated external defibrillator (AED)
in schools lead to increase in knowledge but its retention is less well
explored. We aimed to explore the long-term retention of knowledge and practical
skills among schoolchildren after a BLS and AED course to be able to tailor
future courses accordingly. Study was conducted in 3 parts and included 823
seventh and ninth graders from different elementary schools in Maribor,
Slovenia. In Study 1 (n=611) we assessed students' baseline knowledge and
immediate knowledge gain after our BLS and AED course with a validated
questionnaire; in Study 2 (n=116) we assessed retention of gained knowledge and
skills after 5 months with a modified Cardiff test and Little Anne QCPR manikin;
in Study 3 (n=96) we assessed retention of knowledge 2 years after the course.
Mean differences in knowledge before and after the course in Study 1 and between
studies were analyzed using paired t-tests and independent t-tests. Differences
between individual question scores at different time points were compared using
Mann - Whitney U test. A two-sided P<0,05 was considered significant. Practical
skills retention was presented with descriptive statistics. Knowledge gain was
significant immediately after the course with 83% correct answers compared to
60% at baseline. Scores dropped significantly after 5 months (73%) and after
2 years (75%), but remained significantly better than at baseline (P<0.001).
Practical skills perfomance score as per Cardiff test after 5 months was 63%.
Overall BLS performance score as per QCPR app was 59%, with an overall cardio
score of 77% (average compression rate: 124/min and depth: 52 mm) and
ventilation score of 44%. This study showed that long term retention of
theoretical knowledge was satisfying whereas poor practical skills performance
after 5 months calls for a more intense practical training on repeat courses.

DOI: 10.1177/00469580221098755
PMCID: PMC9168916
PMID: 35652386 [Indexed for MEDLINE]

Conflict of interest statement: Declaration of conflicting interests: The

author(s) declared no potential conflicts of interest with respect to the
research, authorship, and/or publication of this article.

179. Int J Crit Illn Inj Sci. 2016 Apr-Jun;6(2):61-4. doi: 10.4103/2229-
5151.183018.

Comparison of effectiveness of class lecture versus workshop-based teaching of

basic life support on acquiring practice skills among the health care providers.

Karim HM(1), Yunus M(2), Bhattacharyya P(1), Ahmed G(3).

Author information:
(1)Department of Anaesthesiology and Critical Care, North Eastern Indira Gandhi
Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.
(2)Department of Anaesthesiology and Critical Care, North Eastern Indira Gandhi
Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India;
Department of Emergency Medicine and Traumatology, North Eastern Indira Gandhi
Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.
(3)Department of Community Medicine, All India Institute of Hygiene and Public
Health, Kolkata, West Bengal, India.

BACKGROUND: Basic life support (BLS) is an integral part of emergency medical

care. Studies have shown poor knowledge of it among health care providers who
are usually taught BLS by lecture-based teachings in classes.
OBJECTIVES: This study is designed to assess the effectiveness of class lecture
versus workshop-based teaching of BLS on acquiring the practice skills on
mannequin.
METHODS: After ethical approval and informed consent from the participants, the
present study was conducted among the health care providers. Participants were
grouped in lecture-based class teaching and workshop-based teaching. They were
then asked to practice BLS on mannequin (Resusci Anne with QCPR) and evaluated
as per performance parameters based on American Heart Association BLS.
Statistical analyses are done by Fisher's exact t-test using GraphPad INSTAT
software and P < 0.05 is taken as significant.
RESULTS: There were 55 participants in lecture-based teaching and 50 in
workshop-based teaching group. There is no statistical difference in recognition
of arrest, checking pulse, and starting chest compression (P > 0.05). Though
more than 83% of lecture-based teaching group has started chest compression as
compared 96% of workshop group; only 49% of the participants of lecture-based
group performed quality chest compression as compared to 82% of other group (P =
0.0005). The workshop group also performed better bag mask ventilation and
defibrillation (P < 0.0001).
CONCLUSION: Workshop-based BLS teaching is more effective and lecture-based
class teaching better is replaced in medical education curriculum.

DOI: 10.4103/2229-5151.183018
PMCID: PMC4901828
PMID: 27308252

180. Rev Col Bras Cir. 2012 Jul-Aug;39(4):335-9. doi:

10.1590/s0100-69912012000400015.

Analysis of the YouTube videos on basic life support and cardiopulmonary

resuscitation.

[Article in English, Portuguese]

Tourinho FS(1), de Medeiros KS, Salvador PT, Castro GL, Santos VE.

Author information:
(1)Department of Nursing– UFRN. [email protected]

OBJECTIVE: To analyze the videos on the YouTube video sharing site, noting which
points addressed in the videos related to CPR and BLS, based on the 2010
Guidelines for the American Heart Association (AHA).
METHODS: This was an exploratory, quantitative and qualitative research
performed in the YouTube sharing site, using as keywords the expressions in
Portuguese equivalent to the Medical Subject Headings (MeSH) "Cardiopulmonary
Resuscitation" and "Basic Life Support" for videos that focused on the basic
life support.
RESULTS: The research totaled 260 videos over the two searches. Following the
exclusion criteria, 61 videos remained. These mostly are posted by individuals
and belong to the category Education. Moreover, most of the videos, despite
being added to the site after the publication of the 2010 AHA Guidelines, were
under the older 2005 guidelines.
CONCLUSION: Although the video-sharing site YouTube is widely used today, it
lacks videos about CPR and BLS that comply to the most recent AHA
recommendations, which may negatively influence the population that uses it.

DOI: 10.1590/s0100-69912012000400015
PMID: 22936234 [Indexed for MEDLINE]

181. Prehosp Emerg Care. 2001 Oct-Dec;5(4):360-5. doi: 10.1080/10903120190939517.

Can basic life support personnel safely determine that advanced life support is
not needed?

Cone DC(1), Wydro GC.

Author information:
(1)Department of Surgery, Yale University School of Medicine, New Haven,
Connecticut, USA. [email protected]

OBJECTIVE: To determine whether firefighter/emergency medical technicians-basic

(FF/EMT-Bs) staffing basic life support (BLS) ambulances in a two-tiered
emergency medical services (EMS) system can safely determine when advanced life
support (ALS) is not needed.
METHODS: This was a prospective, observational study conducted in two academic
emergency departments (EDs) receiving patients from a large urban fire-based EMS
system. Runs were studied to which ALS and BLS ambulances were simultaneously
dispatched, with the patient transported by the BLS unit. Prospectively
established criteria for potential need for ALS were used to determine whether
the FF/EMT-B's decision to cancel the ALS unit was safe, and simple outcomes
(admission rate, length of stay, mortality) were examined. In the system
studied, BLS crews may cancel responding ALS units at their discretion; there
are no protocols or medical criteria for cancellation.
RESULTS: A convenience sample of 69 cases was collected. In 52 cases (75%), the
BLS providers indicated that they cancelled the responding ALS unit because they
did not feel ALS was needed. Of these, 40 (77%) met study criteria for ALS: 39
had potentially serious chief complaints, nine had abnormal vital signs, and ten
had physical exam findings that warranted ALS. Forty-five (87%) received an
intervention immediately upon ED arrival that could have been provided in the
field by an ALS unit, and 16 (31%) were admitted, with a median length of stay
of 3.3 days (range 1.1-73.4 days). One patient died.
CONCLUSION: Firefighter/EMT-Bs, working without protocols or medical criteria,
cannot always safely determine which patients may require ALS intervention.

DOI: 10.1080/10903120190939517
PMID: 11642585 [Indexed for MEDLINE]

182. An Pediatr (Barc). 2006 Sep;65(3):241-51. doi: 10.1016/s1695-4033(06)70187-4.

[Basic life support in pediatrics].

[Article in Spanish]

Calvo Macías A(1), Manrique Martínez I, Rodríguez Núñez A, López-Herce Cid J.

Author information:
(1)Servicio de Críticos y Urgencias Pediátricas. Hospital Materno-Infantil de
Málaga. España.

Basic life support (BLS) is the combination of maneuvers that identifies the
child in cardiopulmonary arrest and initiates the substitution of respiratory
and circulatory function, without the use of technical adjuncts, until the child
can receive more advanced treatment. BLS includes a sequence of steps or
maneuvers that should be performed sequentially: ensuring the safety of rescuer
and child, assessing unconsciousness, calling for help, positioning the victim,
opening the airway, assessing breathing, ventilating, assessing signs of
circulation and/or central arterial pulse, performing chest compressions,
activating the emergency medical service system, and checking the results of
resuscitation. The most important changes in the new guidelines are the
compression: ventilation ratio and the algorithm for relieving foreign body
airway obstruction. A compression/ ventilation ratio of 30:2 will be recommended
for lay rescuers of infants, children and adults. Health professionals will use
a compression: ventilation ratio of 15:2 for infants and children. If the health
professional is alone, he/she may also use a ratio of 30:2 to avoid fatigue. In
the algorithm for relieving foreign body airway obstruction, when the child
becomes unconscious, the maneuvers will be similar to the BLS sequence with
chest compressions (functioning as a deobstruction procedure) and ventilation,
with reassessment of the mouth every 2 min to check for a foreign body, and
evaluation of breathing and the presence of vital signs. BLS maneuvers are easy
to learn and can be performed by anyone with adequate training. Therefore, BLS
should be taught to all citizens.

DOI: 10.1016/s1695-4033(06)70187-4
PMID: 17094208 [Indexed for MEDLINE]

183. Resuscitation. 2011 Jun;82(6):743-8. doi: 10.1016/j.resuscitation.2011.01.031.

Epub 2011 Mar 12.

The analysis of self and tutor assessment in the skill of basic life support
(BLS) and endotracheal intubation: focused on the discrepancy in assessment.

Kim SJ(1), Choi SH, Lee SW, Hong YS, Cho H.

Author information:
(1)Department of Emergency Medicine, Korea University College of Medicine,
Seoul, Republic of Korea.

INTRODUCTION: This paper reports the results of a study of fourth year medical
students that assessed whether assessments of basic life support (BLS) and
intubation performance differ when assessed by the students themselves or by
tutors. This information should be helpful for designing the contents of a
complementary education core.
METHODS: Tutor assessments and student-assessments were conducted using a
checklist and a fivepoint rating scale, and then compared. For the two skill
performance tests, Resusci(®) Anne SkillGuide™ and Laerdal(®) Airway Management
Trainer (Laerdal, Norway) devices were used. The check-lists used to evaluate
students were based on International Liasion Committee on Resuscitation (ILCOR)
guidelines and Korean Emergency Airway Management Society (KEAMS) tutor
guidelines.
RESULTS: A total of 83 medical students participated in the study, intra-class
correlation coefficient between tutor and student assessment were 0.542 (95% CI
0.371-0.678) in BLS and 0.693 (0.538-0.802). There were also no significant
differences between self-assessments and tutor assessments based on the
five-point. In BLS skill session, we found out that "maintenance of airway" and
"palpating a carotid pulse" were the mostly missed parts. In the intubation
skill, omitting the parts of 'securing the airway' while preparing for
intubation, proper positioning of blade tip in the valleculae, and appropriate
insertion of endotracheal tube were demonstrated.
CONCLUSION: We observed correlations between student self-assessments and tutor
assessments for both BLS and intubation. Analyzing the discrepancies between
self-assessment and tutor assessment will be helpful in focusing training on the
steps that were omitted by students or during which students demonstrated
incompetence.

Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.resuscitation.2011.01.031
PMID: 21402434 [Indexed for MEDLINE]
184. Arch Acad Emerg Med. 2024 Feb 28;12(1):e32. doi: 10.22037/aaem.v12i1.2223.
eCollection 2024.

Knowledge, Attitude and Perceptions of Healthcare Workers in Arab Countries

Regarding Basic Life Support; a Systematic Review and Meta-Analysis.

Alsabri MAH(1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12), Elsayed SM(2)(3), Elshanbary

AA(4), Zaazouee MS(5), Alqeeq BF(6), Zehra SA(7), Al-Sayaghi KM(8), Alkubati
SA(8)(10), Alrubaiee GG(11)(12).

Author information:
(1)Emergency Department, Al-thawra Modern General Hospital, Yemen.
(2)Pediatrics Department, National Heart Institute, Giza, Egypt.
(3)Faculty of Medicine, October 6 University, Giza, Egypt.
(4)Faculty of Medicine, Alexandria University, Alexandria, Egypt.
(5)Faculty of Medicine, Al-Azhar university, Assiut, Egypt.
(6)Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine.
(7)Dow Medical College, Karachi, Pakistan.
(8)Critical Care and Emergency Nursing Department, atTaibah University, Medina,
Saudi Arabia.
(9)Department of Medical Surgical Nursing, College of Nursing, University of
Hail, Hail, Saudi Arabia.
(10)Department of Nursing, Faculty of Medicine and Health Sciences, Hodeida
University, Hodeida, Yemen.
(11)College of Nursing, University of Hail, Hail, Saudi Arabia.
(12)Department of Community Health and Nutrition, Al-Razi University, Hail,
Saudi Arabia.

INTRODUCTION: Effective Basic Life Support (BLS) interventions, including

cardiopulmonary resuscitation (CPR), are essential for enhancing survival rates.
This review aimed to evaluate the knowledge, attitudes, and perceptions (KAP) of
healthcare professionals regarding BLS in Arab countries.
METHODS: We conducted a systematic search on PubMed, Cochrane, Scopus, Web of
Science, and EMBASE, to identify relevant studies. We included studies performed
in Arab countries that included healthcare workers' KAP assessment towards BLS.
The meta-analysis was carried out utilizing the OpenMeta Analyst Software, and a
subgroup analysis was performed for Nursing staff category. The quality of the
included cross-sectional studies was assessed through Newcastle-Ottawa quality
assessment scale.
RESULTS: A total of 18 studies were included in our study, and eight of them
entered the analysis. The study showed that 61.3% (95% confidence interval (CI):
48.9%, 73.7%, p<0.001) of health care workers were knowledgeable about the
correct CPR ratio, and 62.1% (95% CI: 51.7%, 72.5%, p<0.001) answered the
location of chest compression correctly. While, only 36.5% (95% CI: 23.5%,
49.6%, p<0.001) had correct answers regarding the compression rate, 48.1% (95%
CI: 38.1%, 58.0%, p<0.001) were aware of the compression depth, and 34.8% (95%
CI: 22.9%, 46.7%, p<0.001) answered the sequence correctly.
CONCLUSION: The study revealed a gap regarding the BLS KAP of healthcare workers
in different Arab countries, which crucially requires taking actions, in terms
of frequent certified training sessions, assessments, and clear protocols.

DOI: 10.22037/aaem.v12i1.2223
PMCID: PMC11077391
PMID: 38721445

Conflict of interest statement: The authors declare that they have no conflict
of interest.
185. Resuscitation. 2005 Oct;67(1):45-50. doi: 10.1016/j.resuscitation.2005.04.012.

Improved basic life support performance by ward nurses using the CAREvent Public
Access Resuscitator (PAR) in a simulated setting.

Monsieurs KG(1), De Regge M, Vogels C, Calle PA.

Author information:
(1)Emergency Department, Ghent University Hospital, De Pintelaan 185, B-9000
Ghent, Belgium. [email protected]

INTRODUCTION: The CAREvent Public Access Resuscitator (PAR, O-Two Medical

Technologies, Ontario, Canada) is a new oxygen-driven device alternating two
ventilations with 15 prompts for chest compressions. The PAR is designed for use
with a standard resuscitation face mask and is equipped with mask leakage and
obstruction alarms. The purpose of this study was to assess the quality of basic
life support (BLS) by hospital nurses and to evaluate if BLS with the PAR is
better than BLS using the mouth-to-mask technique.
METHODS: The study group consisted of 352 nurses from Ghent University Hospital
working outside the critical care and emergency departments. BLS skills were
measured using a Laerdal Skillreporter manikin (Laerdal, Norway) connected to a
Laerdal PC Skillreporting system. To assess base line skills, 200 nurses were
tested without previous notice in single rescuer BLS using a pocket mask (PM,
Laerdal, Norway) or a bag-valve mask device (Laerdal, Norway) over a period of 2
min. A separate consecutive sample of 152 nurses was randomised to the PM or PAR
groups after a standard BLS refresher course. The PAR group received a short
period of training in PAR use. Immediately after training, both groups performed
the 2 min single rescuer BLS test.
RESULTS: Unprepared nurses achieved only 26 compressions and 3 ventilations/min.
Immediately after training, nurses using the PAR delivered 54 compressions/min
as opposed to 35 for the PM group (p<0.0001). PAR users ventilated six times/min
compared to five times for PM users (p<0.0001).
CONCLUSION: Immediately after training, the use of the PAR improved BLS
performance by ward nurses significantly, bringing the number of ventilations
and compressions per minute close to the theoretical maximum achievable within
the current guidelines. Retention tests after 6 and 12 months will show if the
effect is sustained.

DOI: 10.1016/j.resuscitation.2005.04.012
PMID: 16129540 [Indexed for MEDLINE]

186. Clinics (Sao Paulo). 2024 Nov 8;79:100518. doi: 10.1016/j.clinsp.2024.100518.

eCollection 2024.

Willingness and skills among students from non-health academic fields in

providing efficient basic life support.

Sugimoto PN(1), Gouvêa GB(1), Salles IC(1), de Carvalho HB(2), Aikawa P(3), Azi
LMTA(4), da Silva LFF(5), Macchione M(5), Semeraro F(6), Lockey A(7), Greif
R(8), Carmona MJC(9), Böttiger BW(10), Nakagawa NK(11).

Author information:
(1)Education, Assessment and Intervention in Cardiovascular Group, Faculdade de
Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
(2)Education, Assessment and Intervention in Cardiovascular Group, Faculdade de
Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil; Preventive
Department, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São
Paulo, SP, Brazil.
(3)Education, Assessment and Intervention in Cardiovascular Group, Faculdade de
Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil; Institute
of Biological Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rio
Grande do Sul, RS, Brazil.
(4)Education, Assessment and Intervention in Cardiovascular Group, Faculdade de
Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil; Federal
University of Bahia, Bahia, BA, Brazil.
(5)Education, Assessment and Intervention in Cardiovascular Group, Faculdade de
Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil; Department
of Pathology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São
Paulo, SP, Brazil.
(6)Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore
Hospital Carlo Alberto Pizzardi, Bologna, Italy.
(7)Calderdale and Huddersfield NHS Trust, Halifax, United Kingdom.
(8)School of Medicine, Sigmund Freud University Vienna, Vienna, Austria;
University of Bern, Bern, Switzerland.
(9)Education, Assessment and Intervention in Cardiovascular Group, Faculdade de
Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil;
Anesthesiology Discipline, Faculdade de Medicina da Universidade de São Paulo
(FMUSP), São Paulo, SP, Brazil.
(10)University of Cologne, Department of Anaesthesiology and Intensive Care
Medicine, University Hospital, Medical Faculty, Germany.
(11)Education, Assessment and Intervention in Cardiovascular Group, Faculdade de
Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil. Electronic
address: [email protected].

Education in basic life support is widely proposed to increase survival in

out-of-hospital sudden cardiac arrest. The authors aimed to assess knowledge,
skills, and attitudes, including willingness to help, regarding myocardial
infarction and sudden cardiac arrest among university students of all fields of
knowledge.
METHODS: An Ethical Research Committee approved this cross-sectional study. An
electronic survey "KIDS SAVE LIVES BRAZIL" was sent to 58,862 students of 82
disciplines in three universities, aged ≥ 18 years. The survey covered three
categories: knowledge, skills, and attitude. Each category was graded between 0
and 10 points (the highest).
RESULTS: Among students, 4,803 undergraduates (8.2 %) answered the survey, and
were divided into three groups of disciplines: medicine (219, ∼21.7 years, 38 %
male), other-healthcare (n = 1,058; ∼22.9 years; 36 % male), and non-health-care
(n = 3,526; ∼22.9 years; 35 % male). All three groups showed significant
differences between them (p < 0.001). The non-health-care compared with medicine
and other healthcare groups showed, respectively, the lowest median scores (25
%‒75 %) in knowledge (4.0 [0.0‒9.3], 4.0 [4.0‒8.0], and 4.0 [4.0‒4.7]), skills
(2.4 [1.2‒3.3], 6.4 [4.0‒8.3], 4.0 [2.4‒6.2]), and attitude (5.9 [5.9‒6.8], 7.3
[5.9‒7.3], and 7.3 [5.9‒7.3]).
CONCLUSION: University students who answered the e-survey have the willingness
to help victims suffering from myocardial infarction or sustaining sudden
cardiac arrest. However, non healthcare students markedly lack the knowledge and
skills to perform cardiopulmonary resuscitation and automated external
defibrillation. These findings reveal a stark difference in basic life support
competencies between students in related healthcare fields and those in
non-health fields, emphasizing the need for universal basic life support
training.

Copyright © 2024 HCFMUSP. Published by Elsevier España, S.L.U. All rights

reserved.
DOI: 10.1016/j.clinsp.2024.100518
PMCID: PMC11583723
PMID: 39520800 [Indexed for MEDLINE]

Conflict of interest statement: Conflicts of interest Federico Semeraro is

Chair-Elect of the European Resuscitation Council and an Emeritus Member of the
ILCOR BLS Task Force. Maria José C. Carmona receives fees from Cristália Pharma
Ind., Medtronic PLC, and União Química Pharma S.A. Editor of the Brazilian
Journal of Anaesthesiology. Andrew Lockey is the President of the Resuscitation
Council UK, Bernd W. Böttiger is the treasurer of the European Resuscitation
Council (ERC); Chairman of the German Resuscitation Council (GRC); Federal
Medical Advisor of the German Red Cross (DRK); Member of the Advanced Life
Support (ALS) Task Force of the International Liaison Committee on Resuscitation
(ILCOR); Member of the Board of the German Interdisciplinary Association for
Intensive Care and Emergency Medicine (DIVI), Founder of the ERC Research NET
and the German Resuscitation Foundation, Co-Editor of “Resuscitation”; Editor of
the Journal “Notfall + Rettungsmedizin”, Co-Editor of the Brazilian Journal of
Anaesthesiology. He received fees for lectures from the following companies:
Forum für medizinische Fortbildung (FomF), Baxalta Deutschland GmbH, ZOLL
Medical Deutschland GmbH, C.R. Bard GmbH, GS Elektromedizinische Geräte G.
Stemple GmbH, Novartis Pharma GmbH, Philips GmbH Market DACH, Bioscience
Valuation BSV GmbH. Naomi K. Nakagawa is the Brazilian Coordinator of Kids Save
Lives Brazil, a Member of the Science and Education Basic Life Support Committee
of the European Resuscitation Council, and Co-Editor of Clinics.

187. Prehosp Disaster Med. 2010 Mar-Apr;25(2):159-63. doi:

10.1017/s1049023x00007901.

Paramedic intercepts with basic life support ambulance services in rural

Minnesota.

Myers LA(1), Russi CS, Schultz JL.

Author information:
(1)Medical Transport, Mayo Clinic, Rochester, Minnesota 55901, USA.
[email protected]

INTRODUCTION: In rural Minnesota, it is common for paramedics providing advanced

life support (ALS) to rendezvous with ambulances providing only basic life
support (BLS). These "intercepts" presumably allow for a higher level of care
when patients have certain problems or need ALS interventions. The aim of this
study was to review and understand the frequency of paramedic intercepts with
regard to the actual care rendered and transport urgency (lights and sirens vs.
none).
METHODS: All paramedic intercepts occurring between January 2003 and December
2007 for one multi-site emergency medical services (EMS) provider were reviewed
for ALS interventions and treatments provided. In addition, the urgency of
responses to the dispatch call or "intercept" and transport to a receiving
facility were analyzed.
RESULTS: During the study period, 1,675 paramedic intercepts occurred and were
reviewed. The ALS ambulances responded to the dispatch emergently (lights and
sirens) in 97.5% of intercepts (1,633), but emergently transported only 24.2% of
the patients (405). Paramedics performed no interventions above BLS levels in
11.6% (194) of the cases. Of the remaining 1,481 patients who received ALS
interventions, 955 (64.4%) received no treatment or diagnostic testing other
than electrocardiographic monitoring, intravenous access, or both.
CONCLUSIONS: A significant discrepancy between emergent responses and actual ALS
care rendered during intercept calls was demonstrated. Given the significant
rate of EMS worker fatalities and transferable patient care costs, further study
is needed to determine whether costs and safety are potentially improved by
decreasing emergent responses. Future directions include developing or emulating
Medical Priority Dispatch System triage protocols for advanced services
providing intercepts. In addition, further study of patient outcomes between
intercept and non-intercept cases is necessary.

DOI: 10.1017/s1049023x00007901
PMID: 20467996 [Indexed for MEDLINE]

188. BMJ Open. 2023 Sep 4;13(9):e073369. doi: 10.1136/bmjopen-2023-073369.

Factors affecting knowledge and attitude of healthcare workers towards basic

life support in Khyber Teaching Hospital, Peshawar, Pakistan: a cross-sectional
analysis.

Hasnain S(1), Hussan J(2), Khan L(3), Muhammad S(3), Kamal K(3), Sawaira(3),
Hayat U(3), Abbasi A(3), Akhlaq M(3), Ahmad A(3), Ahmad K(3).

Author information:
(1)Student, Khyber Medical College, Peshawar, Pakistan [email protected].
(2)Community Medicine, Khyber Medical College, Peshawar, Pakistan.
(3)Student, Khyber Medical College, Peshawar, Pakistan.

OBJECTIVE: This study was conducted to assess the knowledge and attitude of
healthcare workers towards basic life support (BLS) in Khyber Teaching Hospital,
Peshawar, and to investigate the factors affecting them.
DESIGN: Cross-sectional study.
SETTING: This study was carried out in a tertiary care hospital in Peshawar,
Pakistan.
PARTICIPANTS: 201 healthcare professionals were recruited for this study through
simple convenience sampling which included house officers (HOs), trained medical
officers, postgraduate residents, professors, specialty registrars and nurses.
Healthcare professionals who were reluctant to give consent were excluded from
the study.
RESULTS: Among the chosen participants, only 16.4% had good knowledge whereas
63% had a good attitude towards BLS. Knowledge of participants was found to be
positively associated with less time elapsed between the training sessions
(p=0.041). On the other hand, factors such as age(p=0.004), designation
(p=0.05), number of BLS sessions attended (p=0.012) and the time elapsed since
the last BLS session attended (p=0.015), were positively associated with the
attitude of healthcare professionals.
CONCLUSION: The level of knowledge and attitude towards BLS by healthcare
professionals was suboptimal. Those individuals who had attended BLS training
sessions frequently had better knowledge and attitude as compared with their
counterparts.

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No

commercial re-use. See rights and permissions. Published by BMJ.

DOI: 10.1136/bmjopen-2023-073369
PMCID: PMC10481732
PMID: 37666556 [Indexed for MEDLINE]

Conflict of interest statement: Competing interests: None declared.

189. Resusc Plus. 2023 Mar 8;14:100369. doi: 10.1016/j.resplu.2023.100369.

eCollection 2023 Jun.

Overconfidence effects and learning motivation refreshing BLS: An observational

questionnaire study.

Bushuven S(1)(2)(3)(4), Bansbach J(1), Bentele M(5)(4), Trifunovic-Koenig

M(3)(4), Bentele S(6)(4), Gerber B(5), Hagen F(7), Friess C(7), Fischer MR(2).

Author information:
(1)Department of Anesthesiology and Critical Care, Medical Center - University
of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
(2)Institute for Medical Education, University Hospital, LMU Munich, Munich,
Germany.
(3)Institute for Infection Control and Infection Prevention, Hegau-Jugendwerk
Gailingen, Health Care Association District of Constance, Germany.
(4)Training Center for Emergency Medicine (NOTIS e.V), Engen, Germany.
(5)Institute for Anesthesiology, Intensive Care, Emergency Medicine and Pain
Therapy, Hegau-Bodensee Hospital Singen, Germany.
(6)Department for Emergency Medicine, University-Hospital Augsburg, University
of Augsburg, Augsburg, Germany.
(7)Department of Emergency Medicine and Paramedic and Fire Academy, Munich,
Germany.

AIM OF THE STUDY: Regular refresher skill courses are necessary to maintain
competence in basic life support. The utilization of these training programs
strongly depends on the motivation to learn. Learning motivation may be affected
by overconfidence and clinical tribalism, as they both imply a higher competence
compared to others, and therefore, a lower demand for training. This study aimed
to assess how overconfidence in basic life support competencies affects learning
motivation.
METHODS: We conducted a cross-sectional, observational, multicenter, anonymous
online questionnaire survey using validated psychometric tests for healthcare
professionals in Germany. Further, we tested participants' knowledge and
attitude regarding international basic life support guidelines. The study was
conducted between March and April 2022, and healthcare providers from 22 German
emergency medical services and hospitals at all levels were assessed.
RESULTS: Of 2,000 healthcare professionals assessed, 407 completed the
assessment (response rate, 20.4%). We confirmed the presence of overconfidence
and clinical tribalism (identity differentiation between social groups) among
the 407 physicians, nurses, and emergency medical service providers who
completed the survey. Three different learning-motivation groups emerged from
cluster analysis: "experts" (confident and motivated), "recruitables"
(overconfident and motivated), and "unawares" (overconfident and unmotivated).
The three groups were present in all professional groups, independent of the
frequency of exposure to cardiac arrest and educational level.
CONCLUSIONS: These findings showed the presence of overconfidence effects and
different learning motivation types in individuals learning basic life support,
even in instructors.

© 2023 The Authors.

DOI: 10.1016/j.resplu.2023.100369
PMCID: PMC10020094
PMID: 36935817

Conflict of interest statement: The authors declare that they have no known
competing financial interests or personal relationships that could have appeared
to influence the work reported in this paper.
190. Acad Emerg Med. 2010 Sep;17(9):979-86. doi: 10.1111/j.1553-2712.2010.00849.x.

Comparison of outcomes of two skills-teaching methods on lay-rescuers'

acquisition of infant basic life support skills.

Shavit I(1), Peled S, Steiner IP, Harley DD, Ross S, Tal-Or E, Lemire A.

Author information:
(1)Emergency Department, Meyer Children's Hospital, Haifa, Israel.

OBJECTIVES: The objective was to determine if lay-rescuers' acquisition of

infant basic life support (BLS) skills would be better when skills teaching
consisted of videotaping practice and providing feedback on performances,
compared to conventional skills-teaching and feedback methods.
METHODS: This pilot-exploratory, single-blind, prospective, controlled,
randomized study was conducted on November 12, 2007, at the Rappaport Faculty of
Medicine, Technion-Israel Institute of Technology, Haifa, Israel. The population
under study consisted of all first-year medical students enrolled in the
2007-2008 year. BLS training is part of their mandatory introductory course in
emergency medicine. Twenty-three students with previous BLS training were
excluded. The remaining 71 were randomized into four and then two groups, with
final allocation to an intervention and control group of 18 and 16 students,
respectively. All the students participated in infant BLS classroom teaching.
Those in the intervention group practiced skills acquisition independently, and
four were videotaped while practicing. Tapes were reviewed by the group and
feedback was provided. Controls practiced using conventional teaching and
feedback methods. After 3 hours, all subjects were videotaped performing an
unassisted, lone-rescuer, infant BLS resuscitation scenario. A skills assessment
tool was developed. It consisted of 25 checklist items, grouped into four
sections: 6 points for "categories" (with specific actions in six categories),
14 points for "scoring" (of accuracy of performance of each action), 4 points
for "sequence" (of actions within a category), and 1 point for "order" of
resuscitation (complete and well-sequenced categories). Two blinded expert
raters were given a workshop on the use of the scoring tool. They further
refined it to increase scoring consistency. The main outcome of the study was
defined as evidence of better skills acquisition in overall skills in the four
sections and in the specific skills sets for actions in any individual category.
Data analysis consisted of descriptive statistics.
RESULTS: Means and mean percentages were greater in the intervention group in
all four sections compared to controls: categories (5.72 [95.33%] and 4.69
[92.66%]), scoring (10.57 [75.50%] and 7.41 [43.59%]), sequence (2.28 [57.00%]
and 1.66 [41.50%]), and order of resuscitation (0.96 [96.00%] and 0.19
[19.00%]). The means and mean percentages of the actions (skill sets) in the
intervention group were also larger than those of controls in five out of six
categories: assessing responsiveness (1.69 [84.50%] and 1.13 [56.50%]),
breathing technique (1.69 [93.00%] and 1.13 [47.20%]), chest compression
technique (3.19 [77.50%] and 1.84 [46.00%]), activating emergency medical
services (EMS) (3.00 [100.00%] and 2.81 [84.50%]), and resuming cardiopulmonary
resuscitation (0.97 [97.00%] and 0.47 [47.00%]). These results demonstrate
better performance in the intervention group.
CONCLUSIONS: The use of videotaped practice and feedback for the acquisition of
overall infant BLS skills and of specific skill sets is effective. Observation
and participation in the feedback and assessment of nonexperts attempting infant
BLS skills appeared to improve the ability of this group of students to perform
the task.

2010 by the Society for Academic Emergency Medicine

DOI: 10.1111/j.1553-2712.2010.00849.x
PMID: 20836779 [Indexed for MEDLINE]

191. J Pak Med Assoc. 2011 Jun;61(6):613-6.

Knowledge of first aid and basic life support amongst medical students: a
comparison between trained and un-trained students.

Abbas A(1), Bukhari SI, Ahmad F.

Author information:
(1)Department of Community Health Sciences, Ziauddin University, Karachi,
Pakistan.

OBJECTIVE: To compare the level of knowledge of medical students trained in

first aid with those with no training.
METHODOLOGY: This study was conducted on a convenience sample of 250 (125
trained and 125 untrained) medical students. A pre-tested self administered
questionnaire was used for data collection. The questionnaire covered all the
major topics of FA-BLS.
RESULTS: Amongst the trained students 99 (79.2%) had been trained at their
respective medical colleges. The correct responses by the trained students were
significantly better than untrained students regarding CPR, Recovery position,
Asthma and Bleeding. The mean number of correct answers for trained students was
6.13 +/- 2.1 while 4.94 +/- 2.06 out of the total 13 questions for untrained
students.
CONCLUSION: Although the knowledge of trained students was found to be better
than those of untrained students yet the mean of trained students was less than
50% which is not satisfactory. In order to improve the knowledge of medical
students on first aid, their knowledge should be reinforced every year.

PMID: 22204227 [Indexed for MEDLINE]

192. Nurse Educ Pract. 2011 Nov;11(6):365-9. doi: 10.1016/j.nepr.2011.03.010. Epub

2011 Apr 6.

Evaluation of nurses' and doctors' knowledge of basic & advanced life support
resuscitation guidelines.

Passali C(1), Pantazopoulos I, Dontas I, Patsaki A, Barouxis D, Troupis G,

Xanthos T.

Author information:
(1)Catheterization Laboratory, Thriassion Hospital, Athens, Greece.
[email protected]

Lack of resuscitation skills of nurses and doctors in basic life support (BLS)
and advanced life support (ALS) has been identified as a contributing factor to
poor outcomes of cardiac arrest victims. Our hypothesis was that nurses' and
doctors' knowledge of cardiopulmonary resuscitation guidelines would be related
to their professional background as well as their resuscitation training. A
secondary aim of this study was to assess and compare the theoretical knowledge
on BLS and ALS in nurses and doctors. A total of 82 nurses and 134 doctors
agreed to respond to a questionnaire containing demographic questions,
resuscitation experience questions and 15 theoretical knowledge questions. Our
study demonstrated that nurses and doctors working in Greece have knowledge gaps
in current BLS and ALS guidelines. However, resuscitation training had a
positive effect on theoretical CPR knowledge. Furthermore, nurses and doctors
who worked in high-risk areas for cardiac arrest, scored significantly higher
than those who worked in low-risk areas. Those who had encountered more than 5
cardiac arrests the previous year, scored significantly better. Finally the
percentage of nurses who had attended the ALS course was quite low thus ALS
training should be incorporated into the nursing curriculum.

Copyright © 2011 Elsevier Ltd. All rights reserved.

DOI: 10.1016/j.nepr.2011.03.010
PMID: 21474382 [Indexed for MEDLINE]

193. Emerg Med J. 2015 Jul;32(7):547-52. doi: 10.1136/emermed-2014-203736. Epub

2014
Aug 22.

Official lay basic life support courses in Germany: is delivered content up to

date with the guidelines? An observational study.

Wagner P(1), Lingemann C(1), Arntz HR(2), Breckwoldt J(3).

Author information:
(1)Department of Anaesthesiology and Perioperative Intensive Care Medicine,
Benjamin Franklin Medical Centre, Charité-Medical University of Berlin, Berlin,
Germany.
(2)Department of Internal Medicine II (Cardiology and Pulmology), Benjamin
Franklin Medical Centre, Charité-Medical University of Berlin, Berlin, Germany.
(3)Department of Anaesthesiology and Perioperative Intensive Care Medicine,
Benjamin Franklin Medical Centre, Charité-Medical University of Berlin, Berlin,
Germany, Vice Deanery of Education, Faculty of Medicine, University of Zurich,
Zurich, Switzerland.

BACKGROUND AND OBJECTIVES: Educating the lay public in basic life support (BLS)
is a cornerstone to improving bystander cardiopulmonary resuscitation (CPR)
rates. In Germany, the official rescue organisations deliver accredited courses
based on International Liaison Committee on Resuscitation (ILCOR) guidelines to
up to 1 million participants every year. However, it is unknown how these
courses are delivered in reality. We hypothesised that delivered content might
not follow the proposed curriculum, and miss recent guideline updates.
METHODS: We analysed 20 official lay BLS courses of 240 min (which in Germany
are always embedded into either a 1-day or a 2-day first aid course). One expert
rated all courses as a participating observer, remaining incognito throughout
the course. Teaching times for specific BLS elements were recorded on a
standardised checklist. Quality of content was rated by 5-point Likert scales,
ranging from -2 (not mentioned) to +2 (well explained).
RESULTS: Median total course time was 101 min (range 48-138) for BLS courses if
part of a 1-day first aid course, and 123 min (53-244) if part of a 2-day
course. Median teaching time for CPR was 51 min (range 20-70) and 60 min
(16-138), respectively. Teaching times for recovery position were 44 min (range
24-66) and 55 min (24-114). Quality of content was rated worst for 'agonal
gasping' (-1.35) and 'minimising chest compression interruptions' (-1.70).
CONCLUSIONS: Observed lay BLS courses lasted only half of the assigned
curricular time. Substantial teaching time was spent on non-evidence-based
interventions (eg, recovery position), and several important elements of BLS
were not included. The findings call for curriculum revision, improved
instructor training and systematic quality management.

Published by the BMJ Publishing Group Limited. For permission to use (where not
already granted under a licence) please go to
http://group.bmj.com/group/rights-licensing/permissions.

DOI: 10.1136/emermed-2014-203736
PMID: 25150197 [Indexed for MEDLINE]

194. Resuscitation. 2009 Dec;80(12):1394-8. doi:

10.1016/j.resuscitation.2009.07.006.
Epub 2009 Nov 8.

Peer evaluation in reciprocal learning with task cards for acquiring Basic Life
Support (BLS).

Iserbyt P(1), Elen J, Behets D.

Author information:
(1)Research Centre for Movement Education and Sport Pedagogy, Katholieke
Universiteit Leuven, Tervuursevest 101, BE-3001 Leuven, Belgium.
[email protected]

BACKGROUND: Research emphasises the need for instructional methods and tools
which can improve Basic Life Support (BLS) performance or reduce instructional
time.
AIM: To investigate the effect of peer evaluation to improve reciprocal learning
with task cards as instructional tools for acquiring BLS.
METHODS: A total of 78 kinesiology students from a Belgian university were
paired and randomised across two groups to learn BLS in 20min with task cards.
In the control group, students worked together in a defined doer-helper
relationship and switched roles every 5min. In the peer evaluation group,
students followed the same co-operation procedure as in the control group. In
addition, 1min before every switching of roles, the helper evaluated the doer's
performance. All BLS skills were individually assessed on a Laerdal AED Resusci
Anne mannequin (Laerdal Medical, Vilvoorde, Belgium) using the Laerdal PC-Skill
reporting system. A total BLS score was calculated and performance was measured
before training (baseline), immediately after training (intervention) and 2
weeks later (retention).
RESULTS: Significantly more students from the evaluation group remembered and
consequently performed all BLS skills at intervention (P=0.03). No significant
differences were found between groups for main cardiopulmonary resuscitation
(CPR) variables and total BLS scores at baseline, intervention and retention.
Both groups achieved more than 70% of the maximum BLS score at intervention and
retention.
CONCLUSIONS: This study demonstrated that 20min reciprocal-learning setting with
task cards is an effective method to learn BLS. The implementation of peer
evaluation in this setting has an immediate, however small, positive impact on
BLS skill learning.

DOI: 10.1016/j.resuscitation.2009.07.006
PMID: 19900743 [Indexed for MEDLINE]

195. BMC Med Educ. 2016 Jul 4;16:167. doi: 10.1186/s12909-016-0682-5.

The effect of peer-group size on the delivery of feedback in basic life support
refresher training: a cluster randomized controlled trial.

Cho Y(1), Je S(2), Yoon YS(3), Roh HR(4), Chang C(5)(6), Kang H(7), Lim T(7).
Author information:
(1)Department of Emergency Medicine, Hallym University Kangdong Sacred Heart
Hospital, Seoul, Republic of Korea.
(2)Department of Emergency Medicine, Cha University Bundang Medical Center, 59
Yatap-ro, Bundang-gu, Seongnam-si, 463-712, Gyeonggi-do, South Korea.
[email protected].
(3)Department of Emergency Medicine, Inje University College of Medicine, Busan,
Republic of Korea.
(4)Department of Medical Education, Inje University College of Medicine, Busan,
Republic of Korea.
(5)Department of Anesthesiology and Pain Medicine, Yonsei University College of
Medicine, Seoul, Republic of Korea.
(6)Anesthesia and Pain Research Institute, Yonsei University College of
Medicine, Seoul, Republic of Korea.
(7)Department of Emergency Medicine, Hanyang University College of Medicine,
Seoul, Republic of Korea.

BACKGROUND: Students are largely providing feedback to one another when

instructor facilitates peer feedback rather than teaching in group training. The
number of students in a group affect the learning of students in the group
training. We aimed to investigate whether a larger group size increases
students' test scores on a post-training test with peer feedback facilitated by
instructor after video-guided basic life support (BLS) refresher training.
Students' one-rescuer adult BLS skills were assessed by a 2-min checklist-based
test 1 year after the initial training.
METHODS: A cluster randomized controlled trial was conducted to evaluate the
effect of student number in a group on BLS refresher training. Participants
included 115 final-year medical students undergoing their emergency medicine
clerkship. The median number of students was 8 in the large groups and 4 in the
standard group. The primary outcome was to examine group differences in
post-training test scores after video-guided BLS training. Secondary outcomes
included the feedback time, number of feedback topics, and results of
end-of-training evaluation questionnaires.
RESULTS: Scores on the post-training test increased over three consecutive tests
with instructor-led peer feedback, but not differ between large and standard
groups. The feedback time was longer and number of feedback topics generated by
students were higher in standard groups compared to large groups on the first
and second tests. The end-of-training questionnaire revealed that the students
in large groups preferred the smaller group size compared to their actual group
size.
CONCLUSIONS: In this BLS refresher training, the instructor-led group feedback
increased the test score after tutorial video-guided BLS learning, irrespective
of the group size. A smaller group size allowed more participations in peer
feedback.

DOI: 10.1186/s12909-016-0682-5
PMCID: PMC4932763
PMID: 27378162 [Indexed for MEDLINE]

196. Resuscitation. 2014 Jul;85(7):874-8. doi: 10.1016/j.resuscitation.2014.03.046.

Epub 2014 Mar 28.

Effects of a mandatory basic life support training programme on the no-flow

fraction during in-hospital cardiac resuscitation: an observational study.

Müller MP(1), Richter T(2), Papkalla N(2), Poenicke C(2), Herkner C(3), Osmers
A(2), Brenner S(2), Koch T(3), Schwanebeck U(4), Heller AR(3).
Author information:
(1)ResQer (Resuscitation - Quality in Education and Research), Department of
Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav
Carus, TU Dresden, Dresden, Germany; Interdisciplinary Medical Simulation Centre
(ISIMED), University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.
Electronic address: [email protected].
(2)ResQer (Resuscitation - Quality in Education and Research), Department of
Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav
Carus, TU Dresden, Dresden, Germany; Interdisciplinary Medical Simulation Centre
(ISIMED), University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.
(3)ResQer (Resuscitation - Quality in Education and Research), Department of
Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav
Carus, TU Dresden, Dresden, Germany.
(4)Coordination Centre for Clinical Trials, University Hospital Carl Gustav
Carus, TU Dresden, Dresden, Germany.

AIM OF THE STUDY: Many hospitals have basic life support (BLS) training
programmes, but the effects on the quality of chest compressions are unclear.
This study aimed to evaluate the no-flow fraction (NFF) during BLS provided by
standard care nursing teams over a five-year observation period during which
annual participation in the BLS training was mandatory.
METHODS: All healthcare professionals working at Dresden University Hospital
were instructed in BLS and automated external defibrillator (AED) use according
to the current European Resuscitation Council guidelines on an annual basis.
After each cardiac arrest occurring on a standard care ward, AED data were
analyzed. The time without chest compressions during the period without
spontaneous circulation (i.e., the no-flow fraction) was calculated using
thoracic impedance data.
RESULTS: For each year of the study period (2008-2012), a total of 1454, 1466,
1487, 1432, and 1388 health care professionals, respectively, participated in
the training. The median no-flow fraction decreased significantly from 0.55
[0.42; 0.57] (median [25‰; 75‰]) in 2008 to 0.3 [0.28; 0.35] in 2012. Following
revision of the BLS curriculum after publication of the 2010 guidelines, cardiac
arrest was associated with a higher proportion of patients achieving ROSC (72%
vs. 48%, P=0.025) but not a higher survival rate to hospital discharge (35% vs.
19%, P=0.073).
CONCLUSION: The NFF during in-hospital cardiac resuscitation decreased after
establishment of a mandatory annual BLS training for healthcare professionals.
Following publication of the 2010 guidelines, more patients achieved ROSC after
in-hospital cardiac arrest.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

DOI: 10.1016/j.resuscitation.2014.03.046
PMID: 24686020 [Indexed for MEDLINE]

197. Front Public Health. 2018 Jan 29;6:4. doi: 10.3389/fpubh.2018.00004.

eCollection
2018.

Implementation of a Sustainable Training System for Emergency in Vietnam.

Kang S(1), Seo H(2), Ho BD(3), Nguyen PTA(3).

Author information:
(1)Department of Nursing, Cheju Halla University, Jeju City, South Korea.
(2)Halla-Stony Brook Emergency Medicine Education Center, Cheju Halla
University, Jeju City, South Korea.
(3)Hue University of Medicine and Pharmacy, Hue, Vietnam.

PURPOSE: This study analyzed the project outcomes to share lessons regarding the
development of an emergency medicine education system in Vietnam.
METHODS: Retrospective evaluation was implemented using project outcome
indicators.
RESULTS: A total of 13 training courses were administered, with the
collaboration of international experts in Korea and Vietnam. A total of 23 kinds
of emergency medicine education equipment were purchased, and a basic life
support (BLS) and two advanced cardiac life support labs were remodeled to
provide appropriate simulation training. Throughout the 2 years of the project,
nine Vietnamese BLS instructors were approved by the Korea Association of
Cardiopulmonary Resuscitation under American Heart Association. Results of
evaluation by Korean international development experts were based on five
criteria, provided by the Development Assistance Committee of the Organization
for Economic Co-operation and Development, were excellent. Success factors were
identified as partnership, ownership, commitment, government support, and global
networking.
CONCLUSION: Project indicators were all accomplished and received an excellent
evaluation by external experts. For sustainable success, healthcare policy and
legal regulation to promote high quality and safe service to the Vietnamese
people are recommended.

DOI: 10.3389/fpubh.2018.00004
PMCID: PMC5797645
PMID: 29441344

198. Resuscitation. 2004 Jan;60(1):39-44. doi: 10.1016/S0300-9572(03)00247-8.

The use of basic life support skills by hospital staff; what skills should be
taught?

Buck-Barrett I(1), Squire I.

Author information:
(1)University Hospitals of Leicester NHS Trust, Clinical Skills Centre, The
Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK.
[email protected]

OBJECTIVES: To assess the frequency of use of basic life support (BLS) skills
among hospital staff of all disciplines.
DESIGN: Postal survey of 9600 teaching hospital staff.
PARTICIPANTS: 3807 respondents from all disciplines.
MAIN OUTCOME MEASURES: Frequency of attendance, and the use of BLS skills, at
patients with cardiopulmonary arrest.
RESULTS: Most respondents reported having attended BLS training previously:
27.9% in the prior 6 months; 24.5% 6-12 months previously; 17.1% over 1 year
ago; and 11.5% over 2 years ago. 17.1% reported never having received BLS
training. 1.9% gave no valid response. Nearly half of all respondents had never
attended a cardiopulmonary arrest. Among those most likely to have attended,
i.e. qualified nursing and medical staff, the median frequency of attendance was
less than once per year. Ventilation delivered using a pocket mask or
bag-valve-mask was reported by 9.4 and 29.2% of respondents, respectively. Less
than 7% reported the use of mouth-to-mouth ventilation. Only among qualified
nursing (8.8%) and medical (24.7%) staff did this proportion exceed 5%. The vast
majority of non-qualified nursing staff (84.9%), allied health professionals
(86%) and administrative and clerical staff (98%) had used neither chest
compressions nor mouth-to-mouth ventilation.
CONCLUSIONS: Some skills taught during BLS training are used infrequently in the
in-hospital situation. The likelihood of attendance at arrest events and of the
use of BLS skills is extremely low among some identified professional groups.
BLS skills teaching should be targeted at those groups most likely to actually
use them in order to make best use of the resources available.

DOI: 10.1016/S0300-9572(03)00247-8
PMID: 14987782 [Indexed for MEDLINE]

199. J Emerg Med. 2012 Sep;43(3):472-7. doi: 10.1016/j.jemermed.2011.09.011. Epub

2012 Jan 17.

Mobile phone-assisted basic life support augmented with a metronome.

Paal P(1), Pircher I, Baur T, Gruber E, Strasak AM, Herff H, Brugger H, Wenzel
V, Mitterlechner T.

Author information:
(1)Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical
University, Innsbruck, Austria.

BACKGROUND: Basic life support (BLS) performed by lay rescuers is poor. We

developed software for mobile phones augmented with a metronome to improve BLS.
STUDY OBJECTIVES: To assess BLS in lay rescuers with or without software
assistance.
METHODS: Medically untrained volunteers were randomized to run through a cardiac
arrest scenario with ("assisted BLS") or without ("non-assisted BLS") the aid of
a BLS software program installed on a mobile phone.
RESULTS: Sixty-four lay rescuers were enrolled in the "assisted BLS" and 77 in
the "non-assisted BLS" group. The "assisted BLS" when compared to the
"non-assisted BLS" group, achieved a higher overall score (19.2 ± 7.5 vs. 12.9 ±
5.7 credits; p < 0.001). Moreover, the "assisted BLS" when compared to the
"non-assisted" group checked (64% vs. 27%) and protected themselves more often
from environmental risks (70% vs. 39%); this group also called more often for
help (56% vs. 27%), opened the upper airway (78% vs. 16%), and had more correct
chest compressions rates (44% ± 38% vs. 14% ± 28%; all p < 0.001). However, the
"assisted BLS" when compared to the "non-assisted BLS" group, was slower in
calling the dispatch center (113.6 ± 86.4 vs. 54.1 ± 45.1 s; p < 0.001) and
starting chest compressions (165.3 ± 93.3 vs. 87.1 ± 53.2 s; p < 0.001).
CONCLUSIONS: "Assisted BLS" augmented by a metronome resulted in a higher
overall score and a better chest compression rate when compared to "non-assisted
BLS." However, in the "assisted BLS" group, time to call the dispatch center and
to start chest compressions was longer. In both groups, lay persons did not
ventilate satisfactorily during this cardiac arrest scenario.

Copyright © 2012 Elsevier Inc. All rights reserved.

DOI: 10.1016/j.jemermed.2011.09.011
PMID: 22257600 [Indexed for MEDLINE]

200. Resuscitation. 1999 Jun;41(1):3-18. doi: 10.1016/s0300-9572(99)00034-9.

Life supporting first aid training of the public--review and recommendations.

Eisenburger P(1), Safar P.

Author information:
(1)Department of Emergency Medicine, Allgemeines Krankenhaus, Vienna, Austria.

Since the introduction around 1960 of external cardiopulmonary resuscitation

(CPR) basic life support (BLS) without equipment, i.e. steps A (airway
control)-B (mouth-to-mouth breathing)-C (chest (cardiac) compressions), training
courses by instructors have been provided, first to medical personnel and later
to some but not all lay persons. At present, fewer than 30% of out-of-hospital
resuscitation attempts are initiated by lay bystanders. The numbers of lives
saved have remained suboptimal, in part because of a weak or absent first link
in the life support chain. This review concerns education research aimed at
helping more lay persons to acquire high life supporting first aid (LSFA) skill
levels and to use these skills. In the 1960s, Safar and Laerdal studied and
promoted self-training in LSFA, which includes: call for the ambulance (without
abandoning the patient) (now also call for an automatic external defibrillator);
CPR-BLS steps A-B-C; external hemorrhage control; and positioning for shock and
unconsciousness (coma). LSFA steps are psychomotor skills. Organizations like
the American Red Cross and the American Heart Association have produced
instructor-courses of many more first aid skills, or for cardiac arrest only-not
of LSFA skills needed by all suddenly comatose victims. Self-training methods
might help all people acquire LSFA skills. Implementation is still lacking.
Variable proportions of lay trainees evaluated, ranging from school children to
elderly persons, were found capable of performing LSFA skills on manikins.
Audio-tape or video-tape coached self-practice on manikins was more effective
than instructor-courses. Mere viewing of demonstrations (e.g. televised films)
without practice has enabled more persons to perform some skills effectively
compared to untrained control groups. The quality of LSFA performance in the
field and its impact on outcome of patients remain to be evaluated.
Psychological factors have been associated with skill acquisition and retention,
and motivational factors with application. Manikin practice proved necessary for
best skill acquisition of steps B and C. Simplicity and repetition proved
important. Repetitive television spots and brief internet movies for motivating
and demonstrating would reach all people. LSFA should be part of basic health
education. LSFA self-learning laboratories should be set up and maintained in
schools and drivers' license stations. The trauma-focused steps of LSFA are
important for 'buddy help' in military combat casualty care, and natural mass
disasters.

DOI: 10.1016/s0300-9572(99)00034-9
PMID: 10459587 [Indexed for MEDLINE]