Kids save lives: Who should train schoolchildren in resuscitation? A systematic review.

AIM

CPR training for schoolchildren to increase bystander CPR-rates is widely applied. HCPs are regarded as the instructor gold standard, but using non-HCP instructors (e.g., peer-tutors, schoolteachers, medical students) challenges that. This systematic review assesses whether cardiopulmonary resuscitation (CPR) training for children led by peer-tutors, schoolteachers, or medical students results in different learning outcomes to training by health-care professionals (HCPs).

METHODS

We searched studies that compared CPR training for schoolchildren delivered by peer-tutors, schoolteachers, or medical students with training led by HCPs assessing student knowledge, skills, willingness and/or confidence to perform CPR . We included randomized and non-randomized controlled trials Medline, Embase, Psychinfo, Cinahl, Cochrane, Scopus, Web of Science, and Eric were searched from inception until December 23rd, 2023 . Two independent reviewers performed title, abstract, full text screening, bias assessment, and grading of certainty of evidence. We followed the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) guidelines, and registered the review with PROSPERO.

RESULTS

Of 9'092 studies identified, 14 were included. Comparison of intervention groups to HCP-led training showed similar overall results (knowledge, skills, self-confidence). Superior results for HCP training were only reported for 'ventilation volume', while schoolteachers and medical students achieved superior knowledge transfer. A meta-analysis was possible for 'compression depth' between peer-tutors and HCPs showing no significant differences. Certainty of evidence was 'low' to 'very low'.

CONCLUSION

This systematic review of CPR training for school children revealed that peer-tutors, schoolteachers and medical students achieve similar educational outcomes compared to those of HCPs. Non-HCPs training schoolchildren is an appropriate cost-efficient alternative and easy to implement in school curricula.