Abstract 240: Teaching Basic Life Support: Controlled Study with a 2-Stage Versus the Standard 4-Stage Approach

Abstract

Introduction Quality of external chest compressions (ECC) is of paramount relevance within Basic Life Support (BLS). Recent guidelines describe the so called 4-Stage-Approach for teaching practical skills within resuscitation training. However, this methodology was questioned in recent studies when used for simple skills teaching. Hypothesis To observe whether a structured 2-Stage-Approach leads to sufficient practical performance in BLS-Training compared to the standard 4-Stage-Approach. Methods Overall 270 Laypersons were trained in BLS after randomization either to the standard method group using a 4-Stage-Approach (4S) or a modified 2-Stage-Approach-group (2S) lasting the same course duration. All participants were tested on a manikin (Skillreporter ResusciAnne® with PC SkillReporting Software (Version 1.3.0), Laerdal, Stavanger, Norway) in the same cardiac arrest mock scenario prior to the BLS-course and after one week with each time 2 min of continuous ECC each. Practical Endpoints: mean compression rate; mean compression depth. Results Data from 255 subjects (4S: n=127; 2S: n=128) was analyzed. The standard group (4S) as well as the intervention group (2S) improved significantly compared to baseline testing after one week concerning compression depth (4S: 47.8±10.4 mm to 52.4±7.6 mm, p<0.0001; 2S: 47.7±10.7 mm to 55.8±5.4 mm; p<0.0001) and compression rate (4S: 116.1±23.4 min-1 to 118.7±16.0 min-1, p<0.0001; 2S: 114.1±22.8 min-1 to 119.6±13.8 min-1; p<0.0001). The participants trained with the 2-Stage-Approach showed superior performance one week after training in respect of the mean compression depth (4S: 52.4±7.6 mm vs. 2S: 55.8±5.4 mm; p<0.0001). Conclusions Teaching ECC within BLS is sufficiently accomplished with a structured 2-Stage-Approach. Compared to the standard 4-Stage-Approach this methodology leads to comparable skill performance with significantly improved compression depth. Therefore this approach should be further evaluated and offers the option to standardize instructors performance more easily.