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BackgroundEducation 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.MethodsQualitative 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.ResultsWe 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.ConclusionOur 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.

Background: App-linked real-time feedback-devices for cardiopulmonary resuscitation (CPR) aim to improve laypersons’ resuscitation quality. Resuscitation guidelines recommend these technologies in training settings. This is the first study comparing resuscitation quality of all App-linked feedback-devices currently on market. Methods: A prospective randomised simulation study was performed. After standardised instructions, participants performed 2-minutes compression-only CPR on a manikin without feedback (baseline). Afterwards, participants performed 4 × 2 min CPR with four different feedback devices in randomised order (CorPatch® Trainer, CPRBAND AIO Training, SimCPR®ProTrainer, Relay Response™) (intervention). CPR metrics (chest compression depth (CD), chest compression rate (CR), percentage of correct CD/CR (%), correct hand position, correct chest recoil, and technical preparation-time) were assessed. Devices data were compared to the baseline group using Wilcoxon testing with IBM SPSS (primary outcome). Differences between devices were analysed with ANOVA testing (secondary outcome). Normally distributed data were described as mean ± standard deviation (SD) and non-normally distributed data as Median [Interquartile range (IQR). CPR self-confidence was measured by means of questionnaire before and after feedback devices’ use. Comparison was performed by students t-test. Results: Forty participants were involved. SimCPR®ProTrainer was the only device, which resulted in guideline-compliant chest compressions (Mean ± SD:5.37 ± 0.76) with improved chest compression depth (p

Background: Children are highly susceptible to injury and death from accidents. Appropriate intervention can limit disability and increase survival (Alshammari, 2021). In this review, we aim to assess the knowledge and attitudes of the public towards pediatric first aid in the Makkah region of Saudi Arabia. Methods: In this cross-sectional study, a self-administered questionnaire was distributed among residents of the Makkah region. Descriptive statistics were employed to express numerical variables and categorical variables. A p-value of < 0.05 was considered statistically significant. Results: The study included 397 respondents. More than half were female (60.2%). Approximately one-third of the respondents were aged > 50 years, and 28.5% were working or studying in the medical field. Most participants had heard about first aid (99.5%) and believed that training was required to provide first aid (93.7%). However, less than half of the respondents (45.1%) had attended first-aid training once. Almost half of the respondents (51.6%) had previously encountered an injury, accident, or medical emergency; of these, 77.6% had provided first aid to the individual who experienced the emergency, and the most common types of emergencies included cut wounds (38.5%), burns (37.6%), and fits (25.4%). Conclusion: First aid is an important tool for providing immediate emergency care for all people, and it is particularly important for children. Knowledge of and attitude towards first-aid tools are essential for providing first aid when needed. In contrast, training in first aid is crucial for providing appropriate first aid, particularly for children and young infants. [ABSTRACT FROM AUTHOR]

Background: The Automated External Defibrillator represents a cornerstone of life-saving interventions, essential for responding to cardiac emergencies both within hospital walls and in community settings. Nurses shoulder the responsibility of understanding the correct protocols for AED usage, as their proficiency can be pivotal in administering timely and effective interventions during instances of cardiac arrest, significantly increasing the chances of survival. Purpose: The aim of this study Assess of Sudanese nurses Competency in Automated External Defibrillator (AED) knowledge and performance: in Khartoum Sudan. Methods: A quasi-experimental study conducted in 2023 aimed to evaluate the competencies of 100 qualified nurses regarding their knowledge and performance related to Automated External Defibrillators (AEDs). Throughout the study, seminars and lectures were delivered to the nursing staff to enhance their understanding of AED usage. Nurse performance was measured by conducting an applied experiment involving a mannequin and an AED, and following the prescribed steps. Data collection was carried out using questionnaires and observation checklists, with subsequent analysis conducted using the statistical software SPSS. Result: The study findings indicate a predominant representation of female participants, comprising 65 % of the total sample, with a significant portion falling within the 18 to 30 years age bracket. Among the participants, the majority, at 56 %, held a B.Sc. degree, followed by diplomas (25 %), master's degrees (5 %), and Ph.D. qualifications (2 %). Surprisingly, 57 % of participants had not undergone prior training in AED usage. The study's pre-test mean for knowledge stood at 16 %, increasing substantially to 84 % in the post-test phase, with a statistically significant P-value of 0.000, reflecting a marked improvement in knowledge. Similarly, the pre-test mean for performance was 19.1 %, rising to 80.1 % in the post-test phase, with a corresponding P-value of 0.000, indicating a significant enhancement in performance. These findings collectively suggest a positive shift towards improved knowledge and performance in AED usage among the participants. Conclusion: Study concludes improves nurses’ knowledge and performance in Automated External Defibrillator.

A heart attack is the sudden cessation of effective heart function in a healthy-looking individual. Basic Life Support training becomes an important thing for the layman considering the many incidents of cardiac arrest outside the hospital that need a lot of time to get the help of trained health workers. The purpose of this social service is to increase knowledge and skills in the field of Basic Life Support, participants are able to practice handling code blue in accordance with the procedures and the flow of fast and precise. Specific targets to be achieved are the formation of Code Blue System at Pondok Pesantren Putra and the formation of BLS Citizen Community in Kediri. The method used in community service is by In-house training supported by lecture, demonstration and practice methods. The targets of this activity are the students who include 38 students who are given Basic Life Support training for one day, then compared the level of knowledge and attitude before and after (pre post-test design). Different test results of attitude before and after training is not different meaningful. However, it does not mean that the training process can be considered unsuccessful in improving the attitude of all participants, because the average attitudes value is still high, more than 4. This is presumably still good attitude retention from Basic Life Support training which has been given in the same population a year ago. [ABSTRACT FROM AUTHOR]

Background: Basic life support (BLS) delivery improves prognosis following out-of-hospital cardiac arrest and forms an integral part of undergraduate medical curricula, although limited literature has assessed student confidence in utilizing these skills. An investigation of medical students’ self-reported confidence and hypothetical willingness to perform BLS was undertaken at the University of Bristol, within its peer-led BLS training scheme (RMD Bristol). Due to the study timing including COVID-19 restrictions (2020–21), changes in student confidence during this period could also be explored. Methods: A prospective cohort study of medical students participating in BLS training during 2018–2022 (N = 1084) was undertaken. Self-reported confidence and hypothetical willingness to perform BLS was assessed using pre- and post-training questionnaires (five-point Likert scale). Data were analyzed in three groups: 1) pre-COVID (including in-person training), 2) during COVID (virtual-only training), and 3) post-COVID (including in-person training). Results: 347 medical students completed 658 questionnaire responses. All training modes significantly increased self-reported confidence and hypothetical willingness to perform BLS (p < 0.05). Self-reported confidence reduced rapidly following virtual-only training. During the pandemic, a reduction in student-perceived willingness to provide BLS in an emergency was observed in a community but not a hospital setting. Conclusion: Peer-led BLS training is effective in improving medical students’ self-reported confidence and willingness to administer BLS, regardless of delivery mode. The COVID-19 pandemic influenced both the delivery of teaching and students’ attitudes towards performing BLS. Due to the rapid confidence fade after virtual-only training, BLS teaching with an in-person component may remain the most effective model for training medical students. Abstraite Contexte: L’administration des soins immédiats en réanimation (SIR) améliore le pronostic après un arrêt cardiaque extrahospitalier et fait partie intégrante des programmes d’études médicales de premier cycle, mais peu d’études ont évalué la confiance des étudiants dans l’utilisation de ces compétences. Une étude sur la confiance déclarée des étudiants en médecine et leur volonté hypothétique de pratiquer les SIR a été entreprise à l’Université de Bristol, dans le cadre de son programme de formation SIR dirigé par des pairs (RMD Bristol). Le calendrier de l’étude incluant les restrictions du COVID-19 (2020–21), les changements dans la confiance des étudiants au cours de cette période ont également pu être explorés. Méthodes: Une étude de cohorte prospective des étudiants en médecine qui ont suivi une formation SIR entre 2018 et 2022 (N = 1084) a été entreprise. La confiance auto déclarée et la volonté hypothétique de pratiquer les SIR ont été évaluées à l’aide de questionnaires avant et après la formation (échelle de Likert en 5 points). Les données ont été analysées en trois groupes : 1) pré-COVID (y compris la formation en personne), 2) pendant COVID (formation virtuelle uniquement) et 3) post-COVID (y compris la formation en personne). Résultats: 347 étudiants en médecine ont répondu à 658 questionnaires. Tous les modes de formation ont augmenté de manière significative la confiance déclarée et la volonté hypothétique d’effectuer les SIR (p < 0,05). La confiance déclarée a diminué rapidement après une formation uniquement virtuelle. Pendant la pandémie, une réduction de la volonté perçue par les étudiants de fournir des soins d’urgence a été observée dans un contexte communautaire mais pas dans un contexte hospitalier. Conclusion: La formation SIR menée par les pairs est efficace pour améliorer la confiance déclarée des étudiants en médecine et leur volonté de fournir les SIR, quel que soit le mode de formation. La pandémie de COVID-19 a influencé à la fois l’enseignement et l’attitude des étudiants à l’égard du BLS. En raison de la perte de confiance rapide après une formation uniquement virtuelle, l’enseignement des SIR avec une composante en personne peut rester le modèle le plus efficace pour la formation des étudiants en médecine. 抽象的 背景: 基本生命支援術（BLS）的施行改善了院外心臟驟停的預後，也是大學醫學課程的重要組成部分，但有關評估學生運用這些技能的信心的文獻卻很有限。布里斯托大學在其同伴引導BLS培訓計劃（RMD Bristol）中進行了一項關於醫學生自我報告在施行BLS的信心和意願的調查。由於研究期包括了COVID-19限制的時段（2020–21），因此可以同時探討於此期間學生信心的變化。 方法: 使用了前瞻性隊列的研究方法，而研究對象是在2018年至2022年進行了BLS培訓的醫學生（N = 1084）。利用培訓前和培訓後問卷（5點李克特量表）來評估他們自我報告的信心和意願。資料分析分為三組：1）COVID之前（包括面授培訓），2）COVID期間（僅虛擬培訓），3）COVID之後（包括面授培訓） 結果: 共有347名醫學生完成了658份問卷回答。結果顯示所有培訓方式都能顯著提高施行BLS的自信心和意願（p < 0.05）。而自我報告的信心在只接受虛擬培訓後有迅速降低的現象。另觀察所得，在大流行期間，如遇上緊急情況，學生在社區環境下施行BLS的意願有所下降，但在醫院環境下並未觀察到這種情況 結論: 不論何種培訓方式，同伴引導的BLS培訓有效地提高了醫學生施行BLS的信心和意願。COVID-19大流行影響了教學的方式和學生對施行BLS的態度。由於學生的信心在僅接受虛擬培訓後迅速消退，帶有面授形式的BLS教學可能仍然是培訓醫學生最有效的模式 背景: 基本生命支持术（BLS）的进行改善了院外心脏骤停的预后，也是医学本科课程的重要组成部分，但评估学生运用这些技能的信心的文献却很有限。布里斯托大学在同伴引导BLS培训计划（RMD Bristol）中进行了一项医学生自我报告在进行BLS时的信心和意愿的调查。基于研究期间包括了COVID-19限制的时段（2020–21），因此还可以探讨在此期间学生信心的变化 方法: 使用了前瞻性队列的研究方法，而研究对象是在2018年至2022年进行了BLS培训的医学生（N = 1084）。利用培训前和培训后问卷（5点李克特量表）来评估他们自我报告的信心和意愿。信息分析分为三组：1）COVID之前（包括面授培训），2）COVID期间（仅虚拟培训），3）COVID之后（包括面授培训） 结果: 共有347名医学生完成了658份问卷回答。结果显示所有培训方式都能显著提高进行BLS的自信心和意愿（p < 0.05）。而自我报告的信心在只接受虚拟培训后有迅速降低的现象。另就观察所见，在大流行期间，如遇上紧急情况，学生在社区环境下进行BLS的意愿有所下降，但在医院环境下没有观察到这种情况 结论: 不论何种培训方式，同伴引导的BLS培训有效地提高了医学生进行BLS的信心和意愿。COVID-19大流行影响了教学的方式和学生对进行BLS的态度。基于学生的信心在仅接受虚拟培训后迅速消退，带有面授形式的BLS教学可能仍然是培训医学生最有效的模式 Mots clés: Support de base (BLS); étudiants en médecine; pair enseignement; COVID 19; étude de confiance 關鍵字: 基本生活支持 (BLS); 醫學生; 同行 教學; 新冠肺炎; 信心研究 关键字: 基本生活支持 (BLS); 医学生; 同行 教学; 新冠肺炎; 信心研究

Background: A flipped classroom integrating clinical simulation has been shown to be effective for basic life support (BLS) competencies in nursing students. Cardiopulmonary arrests (CPAs) in pregnant women have a low incidence but high morbidity and mortality. Current trends show an increasing incidence; however, most official university nursing training curricula do not include specific training modules for BLS in pregnant women. This study aims to know the satisfaction and self-confidence of nursing students with respect to a training intervention regarding in BLS in pregnant women. Additionally, it aims to assess the adequacy of this intervention for acquiring the necessary knowledge on the subject. Methods: A cross-sectional study was conducted at the University of Jaen in 2022. Data were collected on sociodemographic factors, previous contact with the topic, and topic knowledge in addition to the use of an SCLS questionnaire to measure satisfaction. Participants took the BLS training (a flipped classroom integrating clinical simulation on this topic) before answering the questionnaire. Results: A total of 136 students participated. The mean score on the BLS questionnaire was 9.10 out of 10 (SD = 1.01). The mean score for the SCLS questionnaire for females was 62.36 (SD = 7.70) and 56.23 (SD = 16.94) for the male group. Age showed a statistically significant association with SCLS score: the score decreased with an increase in age (p < 0.001). Conclusions: The flipped classroom, integrating simulation for BLS in pregnant women, improves self-confidence, satisfaction, and knowledge on the topic.

Background: A flipped classroom integrating clinical simulation has been shown to be effective for basic life support (BLS) competencies in nursing students. Cardiopulmonary arrests (CPAs) in pregnant women have a low incidence but high morbidity and mortality. Current trends show an increasing incidence; however, most official university nursing training curricula do not include specific training modules for BLS in pregnant women. This study aims to know the satisfaction and self-confidence of nursing students with respect to a training intervention regarding in BLS in pregnant women. Additionally, it aims to assess the adequacy of this intervention for acquiring the necessary knowledge on the subject. Methods: A cross-sectional study was conducted at the University of Jaen in 2022. Data were collected on sociodemographic factors, previous contact with the topic, and topic knowledge in addition to the use of an SCLS questionnaire to measure satisfaction. Participants took the BLS training (a flipped classroom integrating clinical simulation on this topic) before answering the questionnaire. Results: A total of 136 students participated. The mean score on the BLS questionnaire was 9.10 out of 10 (SD = 1.01). The mean score for the SCLS questionnaire for females was 62.36 (SD = 7.70) and 56.23 (SD = 16.94) for the male group. Age showed a statistically significant association with SCLS score: the score decreased with an increase in age (p < 0.001). Conclusions: The flipped classroom, integrating simulation for BLS in pregnant women, improves self-confidence, satisfaction, and knowledge on the topic. [ABSTRACT FROM AUTHOR]

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This review explores the role of smartphone applications in providing real-time guidance for cardiopulmonary resuscitation (CPR) practices and highlights their potential to improve CPR quality among laypersons. A narrative literature review was conducted on the effectiveness of mobile CPR applications for smartphones. Studies published between 2014 and 2024 were included to ensure that new technological advances were examined. Our findings revealed that guided CPR applications significantly improve most critical parameters for efficacious resuscitation. Application users demonstrated that they achieved performance comparable to or even better than CPR-certified individuals. However, these tools have limitations, mostly related to familiarity, which may result in a delay in activating the application and, therefore, in initiating CPR. While smartphone applications are promising tools for enhancing bystander CPR, their integration into emergency medical response requires careful consideration. To fully take advantage of these applications, they should be incorporated into public health campaigns and standard CPR training. This would be even more successful if the application's functionality were standardized across different regions. Our research indicates that a combination of education and technology will likely play a major role in CPR training in the future, improving the efficacy and accessibility of life-saving measures. Smartphone applications could greatly improve the chain of survival in out-of-hospital cardiac arrest (OHCA) events. The design and accessibility of these applications as well as the integration of these applications with current emergency response frameworks should be the main areas of future research., Competing Interests: 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., (Copyright © 2024, Vallianatou et al.)

Introduction: The study aimed to assess the impact of a modified paediatric basic life support (BLS) training on paediatric nurses' knowledge and skills in the main tertiary level public hospital in Rwanda. Methods: A prospective, before-and-after educational intervention study was performed. Nurses working in the paediatric department at Centre Hospitalier Universitaire de Kigali (CHUK) were enrolled after consenting to the study. A modified BLS training was administered using didactic lectures, videos, case discussions, and simulations. Knowledge and skills were assessed before, immediately and six months after the training, using the American Heart Association (AHA) multiple-choice questions test and simulation scenarios. Ethical approval from the hospital's investigational review board was obtained before the start of the study. Results: Fifty-seven nurses working in paediatric department were included in the study, most with advanced nursing degrees. At baseline, only 3.5% scored above 80% on the knowledge test and none were able to perform high-quality one-rescuer CPR. Knowledge and high-quality one-rescuer CPR skills improved significantly immediately after the training, with 63.2% scoring above 80% and 63.2% capable of performing high-quality one-rescuer CPR (p

Introduction: Out-of-hospital cardiac arrest (OHCA) is a major cause of sudden cardiac death which can be prevented by early cardiopulmonary resuscitation (CPR). International bodies recommend that basic life support (BLS) skills be taught in schools in order to increase the rate of bystander CPR and reduce mortality from OHCA. We are not aware of any BLS education program for non-healthcare students in Nigeria. This study was to assess the awareness and attitude to acquiring BLS skills among university students. Methods: We conducted a cross-sectional study among final year university undergraduates using a questionnaire that assessed students' sociodemographic characteristics, awareness of CPR, previous experiences, and attitude to basic life support (BLS). Counts and proportions were compared for the demographic characteristics using Chi-squared and Fisher's exact tests. Results: Four hundred and seventy-five students from 15 faculties participated in this study, median age was 22.8 years (interquartile range: 21.2–24.5 years). Majority (82.5%) have heard of CPR, 29.7% have undergone CPR training; 77.3% of those who had been trained were confident that they could perform CPR. Previous CPR training was significantly associated with faculty, year of study and age. Eighty-nine (18.7%) students have witnessed someone die from a trauma. Four hundred and fifty (94.7%) respondents would like to get BLS training, 440 (92.6%) think that CPR training should be included in the school curriculum. Conclusion: There is good awareness and positive attitude to the acquisition and practice of cardiopulmonary resuscitation among university students in Nigeria. Few students however, have been trained to administer bystander cardiopulmonary resuscitation. Therefore, there is a need to implement university wide BLS education in Nigeria.

Abstract Background Traditional, instructor led, in-person training of CPR skills has become more challenging due to COVID-19 pandemic. We compared the learning outcomes of standard in-person CPR training (ST) with alternative methods of training such as hybrid or online-only training (AT) on CPR performance, quality, and knowledge among laypersons with no previous CPR training. Methods We searched PubMed and Google Scholar for relevant articles from January 1995 to May 2020. Covidence was used to review articles by two independent researchers. Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess quality of the manuscripts. Results Of the 978 articles screened, twenty met the final inclusion criteria. All included studies had an experimental design and moderate to strong global quality rating. The trainees in ST group performed better on calling 911, time to initiate chest compressions, hand placement and chest compression depth. Trainees in AT group performed better in assessing scene safety, calling for help, response time including initiating first rescue breathing, adequate ventilation volume, compression rates, shorter hands-off time, confidence, willingness to perform CPR, ability to follow CPR algorithm, and equivalent or better knowledge retention than standard teaching methodology. Conclusion AT methods of CPR training provide an effective alternative to the standard in-person CPR for large scale public training.

BackgroundSustaining 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.MethodsIn 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.ResultsThe 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.ConclusionTele-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 registrationhttps://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00025199, Trial ID: DRKS00025199.

BackgroundEye-tracking devices are an innovative tool to understand providers’ attention during stressful medical tasks. The knowledge about what gaze behaviors improve (or harm) the quality of clinical care can substantially improve medical training. The aim of this study is to identify gaze behaviors that are related to the quality of pediatric resuscitation.MethodsForty students and healthcare providers performed a simulated pediatric life support scenario, consisting of a chest compression task and a ventilation task, while wearing eye-tracking glasses. Skill Reporter software measured chest compression (CC) quality and Neo Training software measured ventilation quality. Main eye-tracking parameters were ratio [the number of participants who attended a certain area of interest (AOI)], dwell time (total amount of time a participant attended an AOI), the number of revisits (how often a participant returned his gaze to an AOI), and the number of transitions between AOIs.ResultsThe most salient AOIs were infant chest and ventilation mask (ratio = 100%). During CC task, 41% of participants also focused on ventilation bag and 59% on study nurse. During ventilation task, the ratio was 61% for ventilation bag and 36% for study nurse. Percentage of correct CC rate was positively correlated with dwell time on infant chest (p = 0.044), while the overall CC quality was negatively correlated with dwelling outside of pre-defined task-relevant AOIs (p = 0.018). Furthermore, more dwell time on infant chest predicted lower leakage (p = 0.042). The number of transitions between AOIs was unrelated to CC parameters, but correlated negatively with mask leak during ventilations (p = 0.014). Participants with high leakage shifted their gaze more often between ventilation bag, ventilation mask, and task-irrelevant environment.ConclusionInfant chest and ventilation mask are the most salient AOIs in pediatric basic life support. Especially the infant chest AOI gives beneficial information for the resuscitation provider. In contrast, attention to task-irrelevant environment and frequent gaze shifts seem to harm the quality of care.

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., Competing Interests: 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., (Copyright © 2024 Dong, Zhang, Wang and Zheng.)

The study aimed to assess the impact of a modified paediatric basic life support (BLS) training on paediatric nurses' knowledge and skills in the main tertiary level public hospital in Rwanda. A prospective, before-and-after educational intervention study was performed. Nurses working in the paediatric department at Centre Hospitalier Universitaire de Kigali (CHUK) were enrolled after consenting to the study. A modified BLS training was administered using didactic lectures, videos, case discussions, and simulations. Knowledge and skills were assessed before, immediately and six months after the training, using the American Heart Association (AHA) multiple-choice questions test and simulation scenarios. Ethical approval from the hospital's investigational review board was obtained before the start of the study. Fifty-seven nurses working in paediatric department were included in the study, most with advanced nursing degrees. At baseline, only 3.5% scored above 80% on the knowledge test and none were able to perform high-quality one-rescuer CPR. Knowledge and high-quality one-rescuer CPR skills improved significantly immediately after the training, with 63.2% scoring above 80% and 63.2% capable of performing high-quality one-rescuer CPR (p < 0.01). Six months later, only 45.6% scored above 80% and 15.8% were capable of performing high-quality one-rescuer CPR (p < 0.01). Some skills, such as delivering breaths using bag-mask device, showed better retention. In the paediatric department of the main public tertiary care hospital in Rwanda, nurses' baseline knowledge and skills in providing BLS was poor but can increase with focused BLS training. Due to the decline in knowledge and skills over six months, the use of debriefing and focused trainings following resuscitation events and improved implementation of yearly departmental refresher courses are recommended. [ABSTRACT FROM AUTHOR]

Introduction First Aid is the initial, immediate, life in curve rendered to an injured or sick person in life threatening situations by taking effective action to keep the injured or ill person alive in the best possible condition till emergency medical services and treatment can be obtained. First aid training among students is as an important capacity building component of pre-hospital care in communities. Aim: This literature review aimed to determine whether the published literature demonstrates the knowledge & skills about first aid and CPR in cases of emergency life saving skills developed by under graduate students who have learnt first aid from first aid providers. Methods An extensive search and numerous evaluation of the peer-reviewed literature was conducted for narrative review. Journal articles were retrieved from three databases (MEDLINE, CINAHL, ERIC) using the search terms 'first aid'; 'resuscitation'; 'training'; 'under graduate students'; and 'college'. Inclusion and exclusion criteria were applied and review findings organized thematically. Results The search yielded four primary studies of India & other countries under graduate students aged 18-23 years trained by professional first aid providers. Subsequent review identified emergent themes of resuscitative first aid and non-resuscitative first aid. Heterogeneity was apparent in training and evaluation methods, and study quality varied. Reported first aid knowledge retention was mixed. Conclusion There is a lack of quality evidence to guide optimal training methods and maximize first aid knowledge retention in under graduate college students. To date, research in this area has been limited. Further research is therefore recommended. Formal evaluation of first aid training providers can help guide training methods and maximize first aid knowledge retention in under graduate college students, thereby building more robust first aid capacity in the community. [ABSTRACT FROM AUTHOR]

Background: Traditional, instructor led, in-person training of CPR skills has become more challenging due to COVID-19 pandemic. We compared the learning outcomes of standard in-person CPR training (ST) with alternative methods of training such as hybrid or online-only training (AT) on CPR performance, quality, and knowledge among laypersons with no previous CPR training. Methods: We searched PubMed and Google Scholar for relevant articles from January 1995 to May 2020. Covidence was used to review articles by two independent researchers. Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess quality of the manuscripts. Results: Of the 978 articles screened, twenty met the final inclusion criteria. All included studies had an experimental design and moderate to strong global quality rating. The trainees in ST group performed better on calling 911, time to initiate chest compressions, hand placement and chest compression depth. Trainees in AT group performed better in assessing scene safety, calling for help, response time including initiating first rescue breathing, adequate ventilation volume, compression rates, shorter hands-off time, confidence, willingness to perform CPR, ability to follow CPR algorithm, and equivalent or better knowledge retention than standard teaching methodology. Conclusion: AT methods of CPR training provide an effective alternative to the standard in-person CPR for large scale public training. [ABSTRACT FROM AUTHOR]

Out-of-hospital cardiac arrest (OHCA) is a major cause of sudden cardiac death which can be prevented by early cardiopulmonary resuscitation (CPR). International bodies recommend that basic life support (BLS) skills be taught in schools in order to increase the rate of bystander CPR and reduce mortality from OHCA. We are not aware of any BLS education program for non-healthcare students in Nigeria. This study was to assess the awareness and attitude to acquiring BLS skills among university students. We conducted a cross-sectional study among final year university undergraduates using a questionnaire that assessed students' sociodemographic characteristics, awareness of CPR, previous experiences, and attitude to basic life support (BLS). Counts and proportions were compared for the demographic characteristics using Chi-squared and Fisher's exact tests. Four hundred and seventy-five students from 15 faculties participated in this study, median age was 22.8 years (interquartile range: 21.2–24.5 years). Majority (82.5%) have heard of CPR, 29.7% have undergone CPR training; 77.3% of those who had been trained were confident that they could perform CPR. Previous CPR training was significantly associated with faculty, year of study and age. Eighty-nine (18.7%) students have witnessed someone die from a trauma. Four hundred and fifty (94.7%) respondents would like to get BLS training, 440 (92.6%) think that CPR training should be included in the school curriculum. There is good awareness and positive attitude to the acquisition and practice of cardiopulmonary resuscitation among university students in Nigeria. Few students however, have been trained to administer bystander cardiopulmonary resuscitation. Therefore, there is a need to implement university wide BLS education in Nigeria. [ABSTRACT FROM AUTHOR]

Objective: Professional training workshops are routinely conducted by Professional Development Center (PDC) of DUHS to provide students golden opportunities in hands on practice on simulators and also has been working as training center of AHA since 2010 for the BLS, ACLS and PALS provider and instructor courses while has been conducting BLS workshops from Nov, 2005. The objective of this study was to assess the perceptions of attending audience by post course evaluation form in BLS program. Methodology: This was a retrospective survey study. Data of BLS workshops from 2017 to 2018 was collected from PDC. Two thousand and fifty six healthcare students were enrolled in BLS course from Jan 2017 till Dec 2018. The calculated sample size was about 324 at 95% confidence level. Thus the final sample size was about 350. A post workshop evaluation questionnaire was used as a tool for data collection and it was analyzed on SPSS. Results: PDC has conducted 714 BLS provider courses since 2005 in which 8529 participants are trained till now. The results of the evaluation show that this workshop received higher score on all assessed sections i.e. more than 90% candidates marked agree & strongly agree. A clear majority of participants (97.8%) agreed that, their queries and questions were satisfactorily responded The structure and content of the workshop organized intensify participants’ skills and knowledge regarding BLS. Conclusion: Overall, Participants characterized the workshop as very useful and were very satisfied with the workshop facilitators and the topics discussed. [ABSTRACT FROM AUTHOR]

Background: App-linked real-time feedback-devices for cardiopulmonary resuscitation (CPR) aim to improve laypersons' resuscitation quality. Resuscitation guidelines recommend these technologies in training settings. This is the first study comparing resuscitation quality of all App-linked feedback-devices currently on market., Methods: A prospective randomised simulation study was performed. After standardised instructions, participants performed 2-minutes compression-only CPR on a manikin without feedback (baseline). Afterwards, participants performed 4 × 2 min CPR with four different feedback devices in randomised order (CorPatch® Trainer, CPRBAND AIO Training, SimCPR®ProTrainer, Relay Response™) (intervention). CPR metrics (chest compression depth (CD), chest compression rate (CR), percentage of correct CD/CR (%), correct hand position, correct chest recoil, and technical preparation-time) were assessed. Devices data were compared to the baseline group using Wilcoxon testing with IBM SPSS (primary outcome). Differences between devices were analysed with ANOVA testing (secondary outcome). Normally distributed data were described as mean ± standard deviation (SD) and non-normally distributed data as Median [Interquartile range (IQR). CPR self-confidence was measured by means of questionnaire before and after feedback devices' use. Comparison was performed by students t -test., Results: Forty participants were involved. SimCPR®ProTrainer was the only device, which resulted in guideline-compliant chest compressions (Mean ± SD:5.37 ± 0.76) with improved chest compression depth ( p  < 0.001), and percentage of correct chest compression depth ( p  < 0.001) compared to unassisted CPR (baseline). CorPatch® Trainer as the only device with audio-visual recoil instructions resulted in improved chest recoil (Mean ± SD:72.25 ± 24.89) compared to baseline (Mean ± SD:49.00 ± 42.20; p  < 0.01), while the other three devices resulted in significantly lower chest recoil rates (CPRBAND AIO Training: 37.03 ± 39.90; p  < 0.01, SimCPR®ProTrainer: Mean ± SD:39.88 ± 36.50; p  = 0.03, Relay Response™: Mean ± SD:36.88 ± 37.73; p  = 0.02). CPR quality when using the different feedback devices differ in chest compression depth ( p  = 0.02), chest compression rate ( p  < 0.001), percentage of correct chest compression depth/rate ( p  = 0.03/ p  = 0.04), and technical preparation-time ( p  < 0.001). Feedback-devices' use increased participant's CPR self-confidence ( p  < 0.001)., Conclusion: Although, CPR feedback devices show improved CPR performance in layperson in some metrics, none of the tested CPR feedback devices supported layperson in overall adequate CPR performance. More and better technical functionality is necessary, to fully utilise the potential of CPR feedback devices and to prevent a worsening of CPR performance when layperson use this technology., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘Sabine Wingen is executive personal assistant of the executive board of the German Resuscitation Council (GRC) and receive fees for lectures and consulting from FOM Hochschule für Oekonomie & Management and L2R GmbH. Nele Großfeld works for the L2R GmbH. Jan Stock is Head of the L2R GmbH and Project Manager at the Hans Peter Esser GmbH. Bernd W. Böttiger is treasurer of the European Resuscitation Council (ERC), Founder of the ERC Research NET, Chairman of the German Resuscitation Council (GRC), Member of the „Advanced Life Support (ALS) Task Force of the International Liaison Committee on Resuscitation (ILCOR), Member of the Executive Committee of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), Founder of the “Deutsche Stiftung Wiederbelebung”, Federal Medical Advisor of the German Red Cross (DRK), Member of the Advisory Board of the “Deutsche Herzstiftung”, Co-Editor of “Resuscitation”, Editor of the Journal “Notfall + Rettungsmedizin”, Co-Editor of the Brazilian Journal of Anesthesiology. He received fees for lectures from the following companies: Forum für medizinische Fortbildung (FomF), ZOLL Medical Deutschland GmbH, C.R. Bard GmbH, Becton Dickinson GmbH. Wolfgang A. Wetsch, Niels-Benjamin Adams, and Antonia Streit have no conflicts of interest.’., (© 2024 The Author(s).)

Background: Cardiopulmonary resuscitation success rates depend on the knowledge and skills of Adult basic life support (BLS) and advanced life support. The objective of the study was to find the level of awareness on BLS and skills among health personnel working in different departments of a rural teaching hospital. Methods: This descriptive cross-sectional study was conducted in a tertiary care hospital of Karnali Academy of Health Sciences, Jumla, Nepal. The awareness level about BLS was assessed using a structured questionnaire. Health personnel’s previous exposure to BLS and the inclusion of BLS in their curriculum was also assessed. Results: Among 91 participants,74% (n=67) heard about BLS,64% (n=58)have seen performing, and 25%(n=23) have performed CPR. Only 8%(n=7) attended a workshop on BLS. 43% (n=39) answered 100 and 46%(n=42) answered 30 compression per minute in adult during CPR.71%(n=65) knew the ratio of chest compression to breath in adults. Only 41%(n=37) identified anatomy/area mid-chest for chest compression. Only 40%(n=36) are familiar to the Heimlich maneuver and 5.5%(n=5) were aware of the sequence of BLS which is Head tilt, chin lift, check the pulse. Seventy-eight percent (n=71) responded that BLS training should be a part of the medical curriculum. The mean awareness of general medicine is significantly lower than the other two groups (P

Abstract 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.

Background: The immediate response to cardiac arrest is regarded as the most time-critical intervention. First responders for cardiac arrests in imaging departments are often radiology staff. The study aim was to determine radiology staff members’ confidence in initiating basic life support. Objectives: The objectives of this study included determining the general confidence levels regarding identifying cardiac arrest and initiation of basic life support (BLS) amongst Radiology staff within the studied sites, as well as to identify potential areas of uncertainty. Another objective included identifying what would contribute to increasing levels of confidence and competence in identifying cardiac arrest and initiating BLS. Method: A multi-centre cross-sectional survey was conducted using peer-validated, anonymous questionnaires. Questionnaires were distributed to radiology staff working in public sector hospitals within the Cape Town Metropole West. Due to the limited subject pool, a convenience sample was collected. Data were therefore statistically analysed using only summary statistics (mean, standard deviation, proportions, and so on), and detailed comparisons were not made. Results: We disseminated 200 questionnaires, and 74 were completed (37%). There were no incomplete questionnaires or exclusions from the final sample. Using a 10-point Likert scale, the mean ability to recognise cardiac arrest was 6.45 (SD ± 2.7), securing an airway 4.86 (SD ± 2.9), and providing rescue breaths and initiating cardiac compressions 6.14 (SD ± 2.9). Only two (2.7%) of the participants had completed a basic life support course in the past year; 11 (14.8%) had never completed any basic life support course and 28 (37.8%) had never completed any life support or critical care course. Radiologists, radiology trainees and nurses had the greatest confidence in providing rescue breaths and initiating cardiac compressions from all the groups. Conclusion: The study demonstrated a substantial lack of confidence in providing basic life support in the participating hospital imaging departments’ staff. The participants indicated that regular training and improved support systems would increase confidence levels and improve skills.

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., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Al-Husinat et al.)

Introduction: The Knowledge of Basic Life Support (BLS) is very important, especially for medical students who will become future doctors. These simple life saving maneuvers can ensure the patient’s survival and reduce morbidity and mortality. Objective: The objective of this study was to determine the level of knowledge, attitude and practice of BLS among medical students of the Rawalpindi Medical University, Rawalpindi. Methods: In this descriptive cross sectional study, medical students (3rd & 4th year MBBS) of RMU (n=376) were inquired using a self-structured questionnaire of 20 questions regarding the knowledge, attitude and practice of BLS. After excluding the incomplete response forms, the data were analyzed using SPSS v. 22.0. Results: Twenty five percent students had good, 65.7% had average and 9.3% had poor knowledge of BLS. Out of 376, 12.76% respondents were satisfied with their present knowledge. The Majority (93.08%) had a positive attitude towards learning BLS. Only 6.6% had practiced BLS and 65.69% were unable to perform CPR independently. Conclusion: Majority had an average knowledge and a positive attitude towards BLS but very few could perform it independently. This demands that the practice should go hand in hand along with its knowledge.

Background: The immediate response to cardiac arrest is regarded as the most time-critical intervention. First responders for cardiac arrests in imaging departments are often radiology staff. The study aim was to determine radiology staff members' confidence in initiating basic life support. Objectives: The objectives of this study included determining the general confidence levels regarding identifying cardiac arrest and initiation of basic life support (BLS) amongst Radiology staff within the studied sites, as well as to identify potential areas of uncertainty. Another objective included identifying what would contribute to increasing levels of confidence and competence in identifying cardiac arrest and initiating BLS. Method: A multi-centre cross-sectional survey was conducted using peer-validated, anonymous questionnaires. Questionnaires were distributed to radiology staff working in public sector hospitals within the Cape Town Metropole West. Due to the limited subject pool, a convenience sample was collected. Data were therefore statistically analysed using only summary statistics (mean, standard deviation, proportions, and so on), and detailed comparisons were not made. Results: We disseminated 200 questionnaires, and 74 were completed (37%). There were no incomplete questionnaires or exclusions from the final sample. Using a 10-point Likert scale, the mean ability to recognise cardiac arrest was 6.45 (SD ± 2.7), securing an airway 4.86 (SD ± 2.9), and providing rescue breaths and initiating cardiac compressions 6.14 (SD ± 2.9). Only two (2.7%) of the participants had completed a basic life support course in the past year; 11 (14.8%) had never completed any basic life support course and 28 (37.8%) had never completed any life support or critical care course. Radiologists, radiology trainees and nurses had the greatest confidence in providing rescue breaths and initiating cardiac compressions from all the groups. Conclusion: The study demonstrated a substantial lack of confidence in providing basic life support in the participating hospital imaging departments' staff. The participants indicated that regular training and improved support systems would increase confidence levels and improve skills. [ABSTRACT FROM AUTHOR]

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., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Almutairi et al.)

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.

Objective: This study aims to address the knowledge gap in first aid and basic life support (BLS) among teachers, expand the targeted schools to elementary and intermediate schools for boys and girls, and develop clear, focused recommendations. Furthermore, to assess the knowledge, skills, and attitude of BLS among schoolteachers in Qassim, Saudi Arabia., Methods: This cross-sectional study was conducted in the school year of 2022 to 2023. In Buraidah city and the Uyun AlJiwa and Asyah governorates of Qassim, there are a total of 906 elementary and intermediate schools employing 12,057 teachers (5447 males and 6610 females). A stratified random sampling method was used with a self-administered Arabic questionnaire. This questionnaire included multiple parts (sociodemographic data, previous training status, knowledge and skill of BLS, and assessment of the following: attitude to learn and practice CPR; barriers to performing CPR; the presence or lack of previous resuscitation experience in BLS). Data were analyzed using SPSS Statistics version 25 (IBM Corp., Armonk, NY, USA). Categorical variables were described by frequency and percentage, while continuous variables were described by mean ± SD. A normality test showed that the total knowledge and skills scale was not normally distributed. The Mann-Whitney and Kruskal-Wallis tests were used to compare the mean knowledge and skills scale across variables. The accepted level of significance was below 0.05 (p <0.05)., Results: Our study included 482 participants. Only 19.5% (94) had previous CPR training, and 80.9% (76) were trained more than two years prior to this study's data collection. The main reason for participants' fears of applying BLS was the lack of proper knowledge and skills (48.1%). The majority of the teachers, i.e., 71.0% (342), wanted more training in CPR, and 41.1% (198) thought CPR training should be mandatory at school. We found no statistical relationship between attitude toward training and the city or differences in knowledge and skills scores due to the difference in sociodemographic characteristics. Also, we found no statistical relationship between the question  'Did you observe CPR on a collapsed patient?'  and the city, meaning that the observation of CPR on collapsed patients is independent of the respondent's school location. Significant differences in skills scores were found between those who had CPR observation and those who did not (p = 0.014), in knowledge scores between those who had previous CPR training and those who did not (p = 0.034), and in skills scores between those who had previous CPR training and those who did not (p <0.001). We found no significant differences in knowledge and skills scores according to the place of previous CPR training (p = 0.163 and p = 0.695, respectively)., Conclusion: This study reveals that knowledge and skills in BLS among schoolteachers need to be improved. For this reason, we emphasize the inclusion of International Liaison Committee on Resuscitation (ILCOR) recommendations in the curriculum and that they are made periodic and mandatory for teachers. Especially as we found teachers to have a positive attitude and were willing to train and help., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alahmed et al.)

Cardiac arrest is a life-threatening emergency situation. The outcome depends on timely and effective cardio-pulmonary resuscitation (CPR). Successful CPR attempts in hospitals require well-equipped emergency trolleys and properly functioning equipment, as well as staffmembers skilled in performing CPR. The study aimed to determine whether the emergency trolleys in Botswana’s hospitals’ wards or units met the expected standards. The contents of the emergency trolleys in 20 wards or units of two referral government hospitals in Botswanawere audited by using a standardised checklist. No hospital ward or unit had all the expected equipment or drugs on its emergency trolley, some units failed to check their emergency trolleys’ contents daily. All 20 hospital wards or units that participated in this study, needed to improve the contents and maintenance of their emergency trolleys, otherwise in-hospital CPR efforts in Botswana might be doomed to failure, losing lives that could have been saved if emergency trolleys’ equipment and supplies had been up to standard.

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. [ABSTRACT FROM AUTHOR]

Background: Within cardiopulmonary resuscitation external chest compressions (ECC) are of outstanding importance. Frequent training in Basic Life Support (BLS) may improve the performance, but the perfect method or environment is still a matter of research. The objective of this study was to evaluate whether practical performance and retention of skills in resuscitation training may be influenced by the gender composition in learning groups. Methods: Participants were allocated to three groups for standardized BLS-training: Female group (F): only female participants; Male group (M): only male participants; Standard group (S): male and female participants. All groups were trained with the standardized 4-step-approach method. Assessment of participants' performance was done before training (t1), after one week (t2) and eight months later (t3) on a manikin in the same cardiac arrest single-rescuer -scenario. Participants were 251 Laypersons (mean age 21; SD 4; range 18-42 years; females 63%) without previous medical knowledge. Endpoints: compression rate 90-110/min; mean compression depth 38-51 mm. Standardized questionnaires were used for the evaluation of attitude and learning environment. Results: After one week group F performed significantly better with respect to the achievement of the correct mean compression depth (F: 63% vs. S: 43%; p = 0.02). Moreover, groups F and S were the only groups which were able to improve their performance concerning the mean compression rate (t1: 35%; t3: 52%; p = 0.04). Female participants felt more comfortable in the female-only environment. Conclusions: Resuscitation training in gender-segregated groups has an effect on individual performance with superior ECC skills in the female-only learning groups. Female participants could improve their skills by a more suitable learning environment, while male participants in the standard group felt less distracted by their peers than male participants in the male-only group. [ABSTRACT FROM AUTHOR]

Introduction: Effective delivery of cardiopulmonary resuscitation (CPR) and prompt defibrillation following sudden cardiac arrest (SCA) is vital. Updated guidelines for adult basic life support (BLS) were published in 2010 by the European Resuscitation Council (ERC) in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines. Methods: We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course. Results: We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p < 0.05), reflecting a significantly greater proportion of lay-rescuers performing chest compressions at too fast a rate when trained and assessed with the 2010 rather than 2005 guidelines (6.04% vs. 2.67%; p < 0.05). Error rates for other skills did not differ between guideline groups. Conclusions: The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate. [ABSTRACT FROM AUTHOR]

ACADEMIC EMERGENCY MEDICINE 2010; 17:979–986 © 2010 by the Society for Academic Emergency Medicine 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. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to evaluate the retention of basic life support (BLS) knowledge of third year nursing and fourth year chiropractic students at Royal Melbourne Institute of Technology (RMIT) in Victoria. Study participants include 87 third year undergraduate nursing and 43 fourth year undergraduate chiropractic students. It revealed that chiropractic students have some difficulties in identifying correct compression rate compared to the nursing group.

Background: Eye-tracking devices are an innovative tool to understand providers' attention during stressful medical tasks. The knowledge about what gaze behaviors improve (or harm) the quality of clinical care can substantially improve medical training. The aim of this study is to identify gaze behaviors that are related to the quality of pediatric resuscitation., Methods: Forty students and healthcare providers performed a simulated pediatric life support scenario, consisting of a chest compression task and a ventilation task, while wearing eye-tracking glasses. Skill Reporter software measured chest compression (CC) quality and Neo Training software measured ventilation quality. Main eye-tracking parameters were ratio [the number of participants who attended a certain area of interest (AOI)], dwell time (total amount of time a participant attended an AOI), the number of revisits (how often a participant returned his gaze to an AOI), and the number of transitions between AOIs., Results: The most salient AOIs were infant chest and ventilation mask (ratio = 100%). During CC task, 41% of participants also focused on ventilation bag and 59% on study nurse. During ventilation task, the ratio was 61% for ventilation bag and 36% for study nurse. Percentage of correct CC rate was positively correlated with dwell time on infant chest ( p = 0.044), while the overall CC quality was negatively correlated with dwelling outside of pre-defined task-relevant AOIs ( p = 0.018). Furthermore, more dwell time on infant chest predicted lower leakage ( p = 0.042). The number of transitions between AOIs was unrelated to CC parameters, but correlated negatively with mask leak during ventilations ( p = 0.014). Participants with high leakage shifted their gaze more often between ventilation bag, ventilation mask, and task-irrelevant environment., Conclusion: Infant chest and ventilation mask are the most salient AOIs in pediatric basic life support. Especially the infant chest AOI gives beneficial information for the resuscitation provider. In contrast, attention to task-irrelevant environment and frequent gaze shifts seem to harm the quality of care., Competing Interests: 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., (Copyright © 2022 Gröpel, Wagner, Bibl, Schwarz, Eibensteiner, Berger and Cardona.)

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&#95;web/navigate.do?navigationId=trial.HTML&TRIAL&#95;ID=DRKS00025199, Trial ID: DRKS00025199., Competing Interests: 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., (Copyright © 2022 Schauwinhold, Schmidt, Rudolph, Klasen, Lambert, Krusch, Vogt and Sopka.)

Abstract Objective The quality of external chest compressions (ECC) is of primary importance within basic life support (BLS). Recent guidelines delineate the so-called 4“-step approach” for teaching practical skills within resuscitation training guided by a certified instructor. The objective of this study was to evaluate whether a “media-supported 4-step approach” for BLS training leads to equal practical performance compared to the standard 4-step approach. Materials and methods After baseline testing, 220 laypersons were either trained using the widely accepted method for resuscitation training (4-step approach) or using a newly created “media-supported 4-step approach”, both of equal duration. In this approach, steps 1 and 2 were ensured via a standardised self-produced podcast, which included all of the information regarding the BLS algorithm and resuscitation skills. Participants were tested on manikins in the same mock cardiac arrest single-rescuer scenario prior to intervention, after one week and after six months with respect to ECC-performance, and participants were surveyed about the approach. Results Participants (age 23 ± 11, 69% female) reached comparable practical ECC performances in both groups, with no statistical difference. Even after six months, there was no difference detected in the quality of the initial assessment algorithm or delay concerning initiation of CPR. Overall, at least 99% of the intervention group (n = 99; mean 1.5 ± 0.8; 6-point Likert scale: 1 = completely agree, 6 = completely disagree) agreed that the video provided an adequate introduction to BLS skills. Conclusions The “media-supported 4-step approach” leads to comparable practical ECC-performance compared to standard teaching, even with respect to retention of skills. Therefore, this approach could be useful in special educational settings where, for example, instructors’ resources are sparse or large-group sessions have to be prepared.

Abstract Background Good quality basic life support (BLS) improves outcome following cardiac arrest. As BLS performance deteriorates over time we performed a parallel group, superiority study to investigate the effect of feedback on quality of chest compression with the hypothesis that feedback delays deterioration of quality of compressions. Methods Participants attending a national one-day conference on cardiac arrest and CPR in Denmark were randomized to perform single-rescuer BLS with (n = 26) or without verbal and visual feedback (n = 28) on a manikin using a ZOLL AED plus. Data were analyzed using Rescuenet Code Review. Blinding of participants was not possible, but allocation concealment was performed. Primary outcome was the proportion of delivered compressions within target depth compared over a 2-minute period within the groups and between the groups. Secondary outcome was the proportion of delivered compressions within target rate compared over a 2-minute period within the groups and between the groups. Performance variables for 30-second intervals were analyzed and compared. Results 24 (92%) and 23 (82%) had CPR experience in the group with and without feedback respectively. 14 (54%) were CPR instructors in the feedback group and 18 (64%) in the group without feedback. Data from 26 and 28 participants were analyzed respectively. Although median values for proportion of delivered compressions within target depth were higher in the feedback group (0-30 s: 54.0%; 30-60 s: 88.0%; 60-90 s: 72.6%; 90-120 s: 87.0%), no significant difference was found when compared to without feedback (0-30 s: 19.6%; 30-60 s: 33.1%; 60-90 s: 44.5%; 90-120 s: 32.7%) and no significant deteriorations over time were found within the groups. In the feedback group a significant improvement was found in the proportion of delivered compressions below target depth when the subsequent intervals were compared to the first 30 seconds (0-30 s: 3.9%; 30-60 s: 0.0%; 60-90 s: 0.0%; 90-120 s: 0.0%). Significant differences were not found in secondary outcome and in other performance variables between the groups and over time Conclusions Quality of CPR was maintained during 2 minutes of continuous compressions regardless of feedback in a group of trained rescuers.