Implementation of high-performance CPR by basic life support (BLS) personnel: a pilot study in Thailand.
Resuscitation Plus · 2025-11-18 · Quasi-experimental
Abstract
BACKGROUND: High-performance cardiopulmonary resuscitation (HP-CPR) is a structured, pit-crew-style resuscitation model that has been shown to improve performance in advanced life support (ALS) systems. However, its applicability in volunteer-based basic life support (BLS) settings remains uncertain. This study aimed to describe the implementation of HP-CPR training for BLS personnel in Bangkok, Thailand, and to evaluate its impact on BLS performance using video-based process indicators, as well as to report patient- and system-level characteristics before and after the intervention. METHODS: We conducted a single-centre, before-and-after study of adults with non-traumatic out-of-hospital cardiac arrest (OHCA) managed by the Siriraj EMS Centre between July 2022 and January 2025. HP-CPR training for BLS personnel was delivered over a fivemonth period. The primary outcome was BLS performance, assessed through predefined process indicators using video review. Secondary outcomes included system-level characteristics and clinical outcomes. RESULTS: Of 423 patients screened, 214 met the inclusion criteria (110 pre-intervention; 104 post-intervention). Video recordings were available for 39 cases. Post-training, significant improvements were observed in two performance indicators: "counting during CPR" (0.0 % vs. 66.7 %, p < 0.01) and the "hover technique" (0.0 % vs. 62.5 %, p < 0.01). Other indicators, including uninterrupted CPR, assisted ventilation, AED use, and data handover, improved but did not reach statistical significance. Secondary outcomes-including AED use, CPR initiation by BLS, prehospital return of spontaneous circulation (ROSC), and survival outcomes-showed no significant differences between phases. CONCLUSION: Following HP-CPR training, improvements were observed in selected BLS process indicators. However, further research is needed with larger sample sizes to assess the long-term impact of HP-CPR training in volunteer-based EMS systems.
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Tags
Automated external defibrillator · CPR feedback devices · Implementation · Mechanical CPR
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