Violeta González-Salvado1, Emilio Rodríguez-Ruiz2, Cristian Abelairas-Gómez3, Alberto Ruano-Raviña4, Carlos Peña-Gil5, José Ramón González-Juanatey5, Antonio Rodríguez-Núñez6. 1. Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain. Electronic address: vgonzalezsalvado@gmail.com. 2. Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Servicio de Medicina Intensiva, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain. 3. Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Facultad de Ciencias de la Educación, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain. 4. Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain. 5. Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain. 6. Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Unidad de Cuidados Intensivos Pediátricos, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Escuela de Enfermería, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: Bystander assistance is decisive to enhance the outcomes of out-of-hospital cardiac arrest. Despite an increasing number of basic life support (BLS) training methods, the most effective formula remains undefined. To identify a gold standard, we performed a systematic review describing reported BLS training methods for laypeople and analyzed their effectiveness. METHODS: We reviewed the MEDLINE database from January 2006 to July 2018 using predefined inclusion and exclusion criteria, considering all studies training adult laypeople in BLS and performing practical skill assessment. Two reviewers independently extracted data and evaluated the quality of the studies using the MERSQI (Medical Education Research Study Quality Instrument) scale. RESULTS: Of the 1263 studies identified, 27 were included. Most of them were nonrandomized controlled trials and the mean quality score was 13 out of 18, with substantial agreement between reviewers. The wide heterogeneity of contents, methods and assessment tools precluded pooling of data. Nevertheless, there was an apparent advantage of instructor-led methods, with feedback-supported hands-on practice, and retraining seemed to enhance retention. Training also improved attitudinal aspects. CONCLUSIONS: While there were insufficiently consistent data to establish a gold standard, instructor-led formulas, hands-on training with feedback devices and frequent retraining seemed to yield better results. Further research on adult BLS training may need to seek standardized quality criteria and validated evaluation instruments to ensure consistency.
INTRODUCTION AND OBJECTIVES: Bystander assistance is decisive to enhance the outcomes of out-of-hospital cardiac arrest. Despite an increasing number of basic life support (BLS) training methods, the most effective formula remains undefined. To identify a gold standard, we performed a systematic review describing reported BLS training methods for laypeople and analyzed their effectiveness. METHODS: We reviewed the MEDLINE database from January 2006 to July 2018 using predefined inclusion and exclusion criteria, considering all studies training adult laypeople in BLS and performing practical skill assessment. Two reviewers independently extracted data and evaluated the quality of the studies using the MERSQI (Medical Education Research Study Quality Instrument) scale. RESULTS: Of the 1263 studies identified, 27 were included. Most of them were nonrandomized controlled trials and the mean quality score was 13 out of 18, with substantial agreement between reviewers. The wide heterogeneity of contents, methods and assessment tools precluded pooling of data. Nevertheless, there was an apparent advantage of instructor-led methods, with feedback-supported hands-on practice, and retraining seemed to enhance retention. Training also improved attitudinal aspects. CONCLUSIONS: While there were insufficiently consistent data to establish a gold standard, instructor-led formulas, hands-on training with feedback devices and frequent retraining seemed to yield better results. Further research on adult BLS training may need to seek standardized quality criteria and validated evaluation instruments to ensure consistency.
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