Bystander performance using the 2010 vs 2015 ERC guidelines: A post-hoc analysis of two randomised simulation trials

Resusc Plus. 2021 May 14;6:100123. doi: 10.1016/j.resplu.2021.100123. eCollection 2021 Jun.

Abstract

Background: The European Resuscitation Council (ERC) basic life support (BLS) 2015 guidelines were simplified compared to the 2010 guidelines. We aimed to compare BLS/automated external defibrillator (AED) skill performance and skill retention following training with the 2010 or 2015 BLS/AED guidelines.

Methods: Post-hoc analysis of two randomised simulation trials including videorecordings of laypersons skill-tested after ERC BLS/AED training using either the 2010 (n = 70) or 2015 (n = 70) BLS guidelines. Outcomes: (a) correct sequence of the BLS/AED algorithm, (b) correct sequence of the BLS/AED algorithm with all skills performed correctly, and (c) time to EMS call, first chest compression and shock delivery immediately after training and three months later. Groups were compared using multivariate logistic regression.

Results: Mean age (±standard deviation) was 40 (±11) vs. 44 (±11) years and 70% vs. 50% were females for the 2010 and 2015 groups, respectively. Correct sequence of the BLS/AED algorithm for the 2010 vs. 2015 group was 84% vs. 91%, P = 0.08 immediately after training and 16% vs. 41%, adjusted odds ratio (aOR): 5.6 (95% CI: 2.3-14.0, P < 0.001) after three months. Correct sequence with all skills performed correctly was 56% vs. 47%, P = 0.31 immediately after training and 5% vs. 16%, aOR: 4.8 (95% CI: 1.2-19.2), P = 0.03 after three months. Time to EMS call was shorter in the 2015 group immediately after training (P = 0.008) but all other time points did not differ.

Conclusion: The simplified 2015 BLS guidelines was associated with better adherence to the sequence of the BLS/AED algorithm when compared to the 2010 BLS guidelines three months after training in a simulated cardiac arrest scenario, without significantly improving skill performance immediately after training.

Keywords: Basic life support; Cardiopulmonary resuscitation; Cardiopulmonary resuscitation/standards; Education; Out-of-hospital cardiac arrest; Quality of health care/standards.