Can high school students teach their peers high quality cardiopulmonary resuscitation (CPR)?

Daniel Amundsen Damvall; Tonje Søraas Birkenes; Kjetil Nilsen; Solveig Haukås Haaland; Helge Myklebust; Trond Nordseth

doi:10.1016/j.resplu.2022.100250

Can high school students teach their peers high quality cardiopulmonary resuscitation (CPR)?

Resusc Plus. 2022 May 24:10:100250. doi: 10.1016/j.resplu.2022.100250. eCollection 2022 Jun.

Authors

Daniel Amundsen Damvall¹, Tonje Søraas Birkenes², Kjetil Nilsen³, Solveig Haukås Haaland², Helge Myklebust², Trond Nordseth^{4

5}

Affiliations

¹ Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway.
² Laerdal Medical AS, NO-4002 Stavanger, Norway.
³ Nordland Hospital Trust, NO-8092 Bodø, Norway.
⁴ Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway.
⁵ Department of Anesthesia and Intensive Care Medicine, St. Olav Hospital, NO-7006 Trondheim, Norway.

Abstract

Background: If adolescents can teach each other cardiopulmonary resuscitation (CPR) during school hours, this may be a cost-effective approach to CPR training. The aim of this study was to evaluate CPR quality among students trained by student instructors in CPR.

Material and methods: Three high schools participated. Recruited student instructors (SIs) were given a two-day course by professional instructors. Theoretic knowledge was acquired through an e-learning program. The SIs then trained fellow students in a 90-minute practical CPR session during physical education classes. All participants performed a 4-minutes test of CPR performance. Data was collected using Little Anne QCPR manikins with QCPR classroom software (Laerdal Medical Inc, Norway). Statistical equivalence in CPR performance was assessed applying the two one-sided tests (TOST)-procedure.

Results: Eight professional instructors trained 76 SIs who trained approximately 2650 students in CPR. The number of available tests for analysis of student performance was 982. The compression rates were within guideline recommendations for SIs (mean 110.6, SD 5.4) and students (mean 118.6, SD 8.6). The corresponding numbers for mean compression depth were 7.2 cm (SD 0.7) and 7 cm (SD 1.0). Students demonstrated greater variation in mouth-to-mouth (MTM) skills, with only 41% performing at least 15 successful ventilations during the test. Except for the total number of MTM ventilations (mean difference -5.6), CPR performance was deemed statistically equivalent between professional instructors, SIs and students.

Conclusions: High school students can be trained as CPR instructors and teach fellow students CPR with good quality, with some variation in MTM-ventilation skills.

Keywords: CPR training; Cardiac arrest; Cardiopulmonary resuscitation.