The school Lifesavers study-A randomised controlled trial comparing the impact of Lifesaver only, face-to-face training only, and Lifesaver with face-to-face training on CPR knowledge, skills and attitudes in UK school children.

BACKGROUND: Lifesaver (www.life-saver.org.uk) is an immersive, interactive game that can be used for basic life support training. Users 'resuscitate' a victim of cardiac arrest in a filmed scenario and move their device up and down to simulate cardiac compressions.
METHODS: Randomised controlled trial of 3 UK schools (81 students) comparing Lifesaver, face-to-face (F2F) training, and a combination of both. Primary outcomes: mean chest compression rate and depth. SECONDARY OUTCOMES: flow fraction, CPR performance, and attitude survey. Outcomes measured immediately, 3 and 6 months.
RESULTS: Primary outcomes: Mean chest compression depth was suboptimal in all groups due to body size. F2F performed better than Lifesaver initially (-11.676; 95% CI -18.34 to -5.01; p=0.0001) but no difference at 3 months (p=0.493) and 6 months (p=0.809). No difference in mean compression rates for Lifesaver vs F2F (-11.89; 95% CI -30.39 to -6.61; p=0.280) and combined vs Lifesaver (0.25; 95% CI -17.4 to -17.9; p=0.999). SECONDARY OUTCOMES: all groups had flow fraction >60% after training. Combined group performed better for skills assessment than Lifesaver (4.02; 95% CI 2.81-5.22; p=0.001) and F2F (1.76; 95 CI 0.51-3; p=0.003); and the same at 6 months (1.92; 95% CI 0.19-3.64; p=0.026 and 1.96; 95% CI 0.17-3.75; p=0.029).
CONCLUSIONS: Use of Lifesaver by school children, compared to F2F training alone, can lead to comparable learning outcomes for several key elements of successful CPR. Its use can be considered where resources or time do not permit formal F2F training sessions. The true benefits of Lifesaver can be realised if paired with F2F training.