Enhancing the quality of CPR performed by laypeople

Kerstin Lerjestam, Anna Willman, Ingrid Andersson, Anna Abelsson



The prognosis of survival for a person suffering from cardiac arrest increases when a layperson performs cardiopulmonary resuscitation (CPR) on-site. In Sweden, providing CPR training to people working in public places is considered a social benefit.


The aim of this study was to investigate the effect of a 3-hour CPR intervention for electricians.


Data were collected through an intervention by means of simulation and consisted of a pre- and post-assessment of the participants’ CPR performance.


The results show a statistically significant improvement in ventilation (41%) and quality of compression (36%).


With short rehearsal training, the layperson can significantly improve the quality of CPR given. In a situation of cardiac arrest, this can be crucial for the patient’s survival and continued quality of life.


CPR; intervention; layperson; simulation

Full Text:



Herlitz J. National Register for Cardiac Arrest. Annual Report 2011. (In Swedish). Gothenburg: Association of Management Officers in Swedish Ambulance Care (FLISA) and Swedish Council for Cardiovascular Rescue (CPR Council), 2012.

Herlitz J, Svensson L, Holmberg S, et al. Efficacy of bystander CPR: intervention by lay people and by health care professionals. Resuscitation 2005;66:291–5.

Aune S, Eldh M, Engdahl J, et al. Improvement in the hospital organisation of CPR training and outcome after cardiac arrest in Sweden during a 10-year period. Ibid. 2011;82:431–5.

Hoyme DB, Atkins DL. Implementing cardiopulmonary resuscitation training programs in high schools: Iowa’s experience. J Pediatr 2017;181:172–6.

Ethical Guidelines for CPR (2013). (In Swedish). Swedish Medical Association, Swedish Nursing Association, Swedish council for cardiovascular rescue. Available at: www.sls.se/globalassets/sls/etik/dokument/riktlinjer20maj-2.pdf [Assessed 15 August 2017].

Monsieurs GK, Nolan JP, Bossaert LL, et al. European Resuscitation Council Guidelines for Resuscitation. Section 1. Executive summary. Resuscitation 2015;95:1–80.

Bedell S, Delbanco T. Choices about cardiopulmonary resuscitation in the hospital. When do physicians talk with their patients? N Engl J Med 1984;310:1089–93.

AML (4:10). Work environment law. (In Swedish). Arbetsmiljölagen. Work Environment Authority, Stockholm.

Truhlar A, Deakin CD, Soar J, et al. European Resuscitation Council Guidelines for Resuscitation. Section 4. Cardiac arrest in special circumstances. Resuscitation 2015;95:148–201.

Smart JR, Kranz K, Carmona F, et al. Does real-time objective feedback and competition improve performance and quality in manikin CPR training – a prospective observational study from several European EMS. Scand J Trauma Resusc Emerg Med 2015;23:79.

Stiell IG, Brown SP, Christenson J, et al. What is the role of chest compression depth during out-of-hospital cardiac arrest resuscitation? Crit Care Med 2012;40:1192–8.

Bhanji F, Donoghue AJ, Wolff MS, et al. Part 14: Education. 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132:561–73.

Greif R, Lockey AS, Conaghan P, et al. European Resuscitation Council Guidelines for Resuscitation. Section 10. Education and implementation of resuscitation. Resuscitation 2015;95:288–301.

World Medical Association. Declaration of Helsinki. Ethical principles for medical research involving human subjects. JAMA 2013;310:2191–4.

SFS 2008:192. Act amending the Act (2003: 460) concerning the ethical review of research involving humans. (In Swedish) Stockholm: Swedish Parliament.

Abella BS. The importance of cardiopulmonary resuscitation quality. Curr Opin Crit Care 2013;19:175–80.

Nishiyama C, Iwami T, Murakami Y, et al. Effectiveness of simplified 15-min refresher BLS training program: a randomized controlled trial. Resuscitation 2015;24;90:56–60.

Oermann, MH, Kardong-Edgren, SE, Odom-Maryon T. Effects of monthly practice on nursing students’ CPR psychomotor skill performance. ibid. 2011;82:447–53.

Smith KK, Gilcreast D, Pierce K. Evaluation of staff’s retention of ACLS and BLS skills. ibid. 2008;78:59–65.

Beskind DL, Stolz U, Thiede R, et al. Viewing an ultra-brief chest compression only video improves some measures of bystander CPR performance and responsiveness at a mass gathering event. ibid. 2017;16;118:96–100.

Navarro-Patón R, Freire-Tellado M, Pavón-Prieto MD, et al. Dispatcher assisted CPR: Is it still important to continue teaching lay bystander CPR? Am J Emerg Med 2017;35:569–73.

Park YM, Shin SD, Lee YJ, et al. Cardiopulmonary resuscitation by trained responders versus lay persons and outcomes of out-of-hospital cardiac arrest: a community observational study. Resuscitation 2017;28;118:55–62.

Mathiesen WT, Bjørshol CA, Høyland S, et al. Exploring how lay rescuers overcome barriers to provide cardiopulmonary resuscitation: a qualitative study. Prehosp Disaster Med 2017;32:27–32.

Axelsson A, Herlitz J, Karlsson T, et al. Factors surrounding cardiopulmonary resuscitation influencing bystanders’ psychological reactions. Resuscitation 1998;37:13–20.

Axelsson A, Herlitz J, Fridlund B. How bystanders perceive their cardiopulmonary resuscitation intervention; a qualitative study. Ibid. 2000;47:71–81.

Mathiesen WT, Bjørshol CA, Braut GS, et al. Reactions and coping strategies in lay rescuers who have provided CPR to out-of-hospital cardiac arrest victims: a qualitative study. BMJ Open 2016;6:010671.

DOI: http://dx.doi.org/10.33151/ajp.15.4.594


  • There are currently no refbacks.

The Official Journal of Paramedics Australasia © 2019                           ISSN: 2202-7270


Crossref Member Badge