Certified Basic Life Support Instructors Assess Cardiopulmonary Resuscitation Skills Poorly

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Introduction: High-quality cardiopulmonary resuscitation (CPR) improves survival from cardiac arrest. During basic life support (BLS) training, instructors assess CPR skills to enhance learning outcome. Emergency department staff and senior residents have been shown to assess chest compression quality poorly. Currently no studies have evaluated CPR assessment among certified BLS instructors. The aim of this study was to investigate certified BLS instructors’ assessment of chest compressions and rescue breathing.Methods: Data were collected at BLS courses for medical students at Aarhus University, Denmark. In pairs, BLS instructors, certified by the European Resuscitation Council, evaluated each learner in an end-of-course cardiac arrest test. Instructors’ assessments were compared with CPR quality data collected from the resuscitation manikin. Correct chest compressions were defined as ≥2 out of 3 CPR cycles with 30±2 chest compressions at a depth of 50-60mm and rate of 100-120 min-1. Correct rescue breathing was defined as ≥50% efficient breaths in 3 CPR cycles with visible, but not excessive, manikin’s chest raise (for instructors) or a volume of 500-600 mL (manikin data).Results: We included data from 90 end-of-course assessments undertaken by 16 instructor pairs. Instructors identified correct chest compressions with a sensitivity of 0.96 (95% confidence interval (CI95%) 0.79-1) and a specificity of 0.05 (CI95% 0.01-0.14), and correct rescue breaths with a sensitivity of 1 (CI95% 0.40-1) and a specificity of 0.07 (CI95% 0.03-0.15). Instructors mistakenly failed one learner due to inadequate compression depth, while passing 53 (59%) learners with inadequate compression depth according to manikin data. Instructors correctly failed 6 (7%) learners due to inadequate rescue breaths. However, 80 (89%) inadequate rescue breath performances were not identified.Conclusions: Certified BLS instructors assess performance of chest compression depth and rescue breathing poorly. This emphasizes the need for educating instructors in CPR assessment. The use of feedback devices to support instructors’ assessment of CPR skills may be beneficial to ensure high-quality learning outcome.Author Disclosures: C. Hansen: None. S.E. Rasmussen: None. M.A. Nebsbjerg: None. M. Stærk: None. B. Løfgren: None.
NummerSuppl 1
Sider (fra-til)A16131
StatusUdgivet - 11 nov. 2016

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