Official lay basic life support courses in Germany: is delivered content up to date with the guidelines? An observational study

BACKGROUND AND OBJECTIVES Educating the lay public in basic life support (BLS) is a cornerstone to improving bystander cardiopulmonary resuscitation (CPR) rates. In Germany, the official rescue organisations deliver accredited courses based on International Liaison Committee on Resuscitation (ILCOR) guidelines to up to 1 million participants every year. However, it is unknown how these courses are delivered in reality. We hypothesised that delivered content might not follow the proposed curriculum, and miss recent guideline updates. METHODS We analysed 20 official lay BLS courses of 240 min (which in Germany are always embedded into either a 1-day or a 2-day first aid course). One expert rated all courses as a participating observer, remaining incognito throughout the course. Teaching times for specific BLS elements were recorded on a standardised checklist. Quality of content was rated by 5-point Likert scales, ranging from -2 (not mentioned) to +2 (well explained). RESULTS Median total course time was 101 min (range 48-138) for BLS courses if part of a 1-day first aid course, and 123 min (53-244) if part of a 2-day course. Median teaching time for CPR was 51 min (range 20-70) and 60 min (16-138), respectively. Teaching times for recovery position were 44 min (range 24-66) and 55 min (24-114). Quality of content was rated worst for 'agonal gasping' (-1.35) and 'minimising chest compression interruptions' (-1.70). CONCLUSIONS Observed lay BLS courses lasted only half of the assigned curricular time. Substantial teaching time was spent on non-evidence-based interventions (eg, recovery position), and several important elements of BLS were not included. The findings call for curriculum revision, improved instructor training and systematic quality management