Abstract 262: Teaching Laypersons BLS and AED Using a Two-stage Teaching Technique is Non-inferior to Four-stage Teaching Technique: A Randomized Controlled Study

Abstract

Introduction: Laypersons performing bystander basic life support (BLS) and using automated external defibrillation (AED) increase survival from cardiac arrest. Laypersons often hesitate to perform BLS and use an AED due to self-perceived lack of knowledge and skills. Training may reduce the barrier to intervene. Reducing training costs can allow more laypersons to be trained at the same expense. Reducing the classic four-stage technique to a two-stage technique can shorten course duration and thereby reduce costs. Hypothesis: Teaching laypersons BLS and AED, a two-stage teaching technique is non-inferior to the classic four-stage teaching technique. Methods: Laypersons (exclusion: health care professionals/students) were randomized to courses using either the two-stage (3 hours and 15 minutes) or the four-stage (4 hours) teaching technique. Immediately after training, the laypersons were tested in a simulated cardiac arrest scenario to assess their BLS and AED skills. Tests were video recorded and reviewed by two independent observers blinded to training technique. Skills were assessed using the European Resuscitation Council BLS/AED assessment form. Chest compression and rescue breathing quality data were collected electronically from the manikin. The primary endpoint was passing the test. A non-inferiority margin of 20% was pre-specified. Result: The two-stage teaching technique was non-inferior to the four-stage technique (difference -1.6%; 95%CI -17.9%; 14.6%). Pass rates were 57% among laypersons trained with the two-stage technique (n=72) and 59% among those trained with the four-stage technique (n=70). There were no significant differences between the two groups regarding number of chest compressions delivered per compression cycle (30.0±0.6 vs 30.0±0.7), chest compression rate (114±12 vs 115±14 minute -1 ), chest compression depth (47.2±9.3 vs 47.6±8.8 mm), number of effective rescue breaths between compression cycles (1.7±0.5 vs 1.6±0.7) and tidal volume (0.5±0.3 vs 0.5±0.3 L). In both groups, all participants felt that their training improved their skills. Conclusion: Teaching laypersons BLS and AED using a two-stage teaching technique is non-inferior to the classic four-stage teaching technique.