Comparison of the quality of basic life support provided by rescuers trained using the 2005 or 2010 ERC guidelines

Christopher J Thorne,Jonathan Hulme,Christopher M Jones,Andrew Owen

doi:10.1186/1757-7241-20-53

Abstract

IntroductionEffective 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.MethodsWe 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.ResultsWe 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.ConclusionsThe 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.

Highlights

Effective delivery of cardiopulmonary resuscitation (CPR) and prompt defibrillation following sudden cardiac arrest (SCA) is vital
All teachers are trained as European Resuscitation Council (ERC) basic life support (BLS)/Automated external defibrillator (AED) instructors and standardised tuition is delivered in small groups using the four-stage approach [15]
The comparability of the two groups is outlined in Table 1; the 2005 guideline group featured a marginally higher proportion of medicine and physiotherapy students than the 2010 group (75.2% and 13.0% compared with 75.0% and 11.5% respectively)

Summary

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. Recommended standards for response to SCA are routinely updated and the European Resuscitation Council (ERC) published its most recent guidelines for adult basic life support (BLS) in 2010 [11]. In comparison to their 2005 predecessor, the 2010 ERC guidelines for adult BLS advise that chest compressions are performed to a greater depth (5-6 cm compared to the previously advised depth of 4-5 cm) and within a more closely defined range of 100–120 compressions per minute (previously stipulated to be around 100 compressions per minute, but assessed on ERC BLS 2005 assessment forms as 80–120 compressions per minute) [11,12]. A paucity of research has been conducted to determine the degree to which rescuers are able to comply with guideline changes, under simulated conditions

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