gms | German Medical Science

Background: Lay people who get trained in basic life support may be regarded to be on a low expertise level. In this context training should be as simple as possible and focus on the most effective measures on an evidence base. These are: detection of cardiac arrest, starting chest compressions and delivering high quality chest compressions. The main obstacle for lay persons to act is the fear of doing harm to the victim. Intention of this study was to observe whether course instructors succeeded in transferring this knowledge into action.

Methods: 20 randomly chosen BLS courses provided by various institutions in Berlin were observed by a participating observer who revealed himself to the instructor only at the end of the course. Instructional quality was measured by a checklist with Likert-like scales ranging from -2 (very poor) to +2 (excellent).

Results: Quality of teaching of chest compressions was rated +0.40 on average, but instructors did not underline the importance of minimising interruptions (–1.70). Average teaching quality for detection of cardiac arrest was rated –1.30, for “reducing fear of mistakes” it was –0.90. Even worse, participants were constantly pointed to supposedly fatal mistakes. Particularly instructors who also worked as ambulance personnel (n=8/20) extensively reported on cases where lay rescuers had made mistakes. Seven out of 20 instructors failed to detect a systematic mistake made by the participating observer during chest compression training (grossly incorrect hand position).

Discussion: Instructional quality of most BLS courses was insufficient. Therefore instructors should receive regular supervision and training.