Abstract 214: Basic Life Support Instructors Overestimate Their Own Ability to Perform Cardiopulmonary Resuscitation

Abstract

Introduction: High-quality cardiopulmonary resuscitation (CPR) increases survival from cardiac arrest. Laypeople attend basic life support (BLS) courses to learn CPR, but unfortunately, skill quality and retention are often poor. BLS instructors teach by demonstrating CPR skills. However, BLS instructors’ ability to correctly demonstrate CPR remains to be investigated. Aim: To determine BLS instructors’ competence in demonstrating CPR skills. Methods: Certified BLS instructors were asked to demonstrate CPR on a resuscitation manikin (AMBU ® Man, AMBU) in a simulated teaching setting but without verbal explanations. Data on CPR quality was collected from the manikin and the first three cycles of CPR were analyzed. Correct CPR was defined according to the European Resuscitation Council 2015 Guidelines: chest compression (CC) depth of 50-60 mm, CC rate of 100-120 min -1 , and rescue breath volume of 500-600 mL. Instructors were asked to rate their own ability to perform CPR on a 5-point Likert scale before the demonstration and after receiving a performance report thereof. Results: Data from 125 certified instructors were analyzed. Median instructor age was 45 years (Q1;Q3: 30;56), 72% were male, and instructor experience was 8 years (3;14) with a median of 14 courses/year (6;44)). Mean CC depth was 64 mm (SD: 7.3). In total, 22% of chest compressions were performed within guideline recommendations (72% were too deep and 5% were too shallow). Mean CC rate was 115 min -1 (10.8). Full recoil was achieved in 86% of CCs. Of all attempted rescue breaths, 94% resulted in any amount of air registered (mean volume: 499 mL (291)). Only 11% of rescue breaths were within guideline recommendations (52% were too shallow and 37% were excessive). Instructors rated their ability to perform CCs lower after receiving a performance report (p=0.02). Similarly, ratings of rescue breathing ability were lower after receiving a performance report (p=0.01). Conclusion: Certified and experienced BLS instructors performed CC with excessive depth, but with acceptable CC rate and recoil. Instructors were unable to correctly demonstrate rescue breathing. Instructors overrated their ability to demonstrate correct CPR even when provided with their own CPR performance report.