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 chi(2)-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. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.