Teaching basic life support: a prospective randomized study on low-cost training strategies in secondary schools.

BACKGROUND: Cardiopulmonary resuscitation (CPR) training at school is recommended. Limited school resources prevent implementation. The learning efficacy of low-cost training strategies is unknown.

OBJECTIVE: To evaluate the efficacy of different CPR learning strategies using low-cost didactic tools.

METHODS: Children (n=593, 15-16 years) were randomized to four training conditions: (1) manikin+teacher instruction (control group), (2) manikin+video instruction, (3) foam dice+plastic bag+peer training+teacher instruction, and (4) foam dice+plastic bag+peer training+video instruction. After a 50 min training, a 3 min CPR test on a manikin was performed using SkillReporting Software (Laerdal, Norway), and repeated after 6 months. The data of children without previous CPR training were analysed. Analysis of variance and the χ-test assessed differences between groups.

RESULTS: Complete data sets were available for 165 pupils. Initially, group 3 scored lower on the mean ventilation volume (P<0.05). The control group scored better than the alternative groups (P<0.05) on the mean compression rate. After 6 months, the differences disappeared. All groups scored equally on ventilation volume (P=0.12), compression depth (P=0.11), compression rate (P=0.10), correct hand position (P=0.46) and number of correct compressions (P=0.76). Ventilation volume was sufficient in 32% of the pupils, 18% had a correct compression depth and 59% had a correct compression rate.

CONCLUSION: Training efficacy with low-cost equipment was not different from training with a manikin. The outcome for all training strategies was suboptimal. The basics of CPR can be taught with alternative equipment if manikins are not available.