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Original Research

Open Access

Assessment of the implementation of step-by-step adult basic life support sequence by emergency medical technicians and drivers during regular annual training


1Emergency Medical Services, Belgrade, Serbia

2University of Belgrade, Faculty of Organizational Sciences, Belgrade, Serbia

DOI: 10.22514/SV151.042019.1 Vol.15,Issue 1,April 2019 pp.14-21

Published: 23 April 2019

*Corresponding Author(s): SLADJANA ANDJELIĆ E-mail:


Objective. Evaluation of the efficiency of practicing step-by-step (SBS) BLS/AED (basic life support/automatic external defi-brillator) sequence by emergency medical technicians (EMT) and ambulance drivers (AD) working in medical transport teams. Methods. A prospective two-month study was conducted in which EMTs and ADs working in medical transport teams per-formed their regular 4-hour annual train-ing (1 h of lectures, 1.5 h of practical train-ing and 1.5 h of testing). Each participant performed SBS of BLS/AED sequences in front of a three-member team of instruc-tors. The implementation of BLS/AED se-quence was evaluated by scoring from 0 to 2 (0 – not, 1 – partially, 2 – properly), sepa-rately for EMTs, ADs and in total. The final analysis compared a properly implement-ed SBS sequence (S1-S36) of actions: IA - initial assessment (S1-S10), BLS (S11-S18), AED (S19-S25), RP - recovery position (S26-S32) and FBAO - foreign body airway obstruction (S33-S36) for use by the BLS/AED between EMTs and ADs. The crite-rion for a completed regular training was at least 47 (65.0%) of the total number of points won for properly implemented pro-cedures.

Results. The study involved 31 EMTs and 63 Ads, regardless of gender and average age, with EMTs having slightly longer work experience (p>0.05). The results of our study show that EMTs are more skilled at IA, cardiopulmonary resuscitation (CPR) and AED, whereas ADs were better at im-plementing RP and performing the Heim-lich maneuver (p<0.001).

Conclusion. Although EMTs and ADs implement SBS BLS/AED procedures correctly and satisfactorily in more than 65.0%, future research should focus on finding more efficient, shorter and cheaper BLS/AED trainings.


basic life support, step-by-step, sequence, emergency medical technicians, ambulance drivers

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SLADJANA ANDJELIĆ,ZORAN RADOJICIC,SRDJAN STOJANOVIC,VLADA TAMBURKOVSKI. Assessment of the implementation of step-by-step adult basic life support sequence by emergency medical technicians and drivers during regular annual training. Signa Vitae. 2019. 15(1);14-21.


1. Taniguchi D, Baernstein A, Nichol G. Cardiac arrest: a public health perspective. Emerg Med Clin North Am 2012;30:1-12.

2. Kleinman ME, Brennan EE, Goldberger ZD, Swor RA, Terry M, Bobrow BJ, et al. Part 5: Adult basic life support and cardiopulmo-nary resuscitation quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132(18 Suppl 2):S414-S35.

3. Soreide E, Morrison L, Hillman K, Monsieurs K, Sunde K, Zideman D, et al. The formula for survival in resuscitation. Resuscitation 2013;84:1487-93.

4. Greif R, Lockey AS, Conaghan P, Lippert A, De Vries W, Monsieurs KG, on behalf of the Education and implementation of resuscita-tion section Collaborators. European Resuscitation Council Guidelines for Resuscitation 2015:Section 10. Education and implemen-tation of resuscitation. Resuscitation 2015;95:288–301.

5. Perkins G, Handley A, Koster R, Castrén M, Smyth M, Olasveengen T, et al. European Resuscitation Council Guidelines for Resus-citation 2015: Section 2. Adult basic life support and automated external defibrillation. 2015;95:85-8.

6. Chan TK, Wan KA, Chan JCK, Lam HKC, Wrong YT, Kan PG. New era of CPR: application of i-technology in resuscitation. Hong Kong J Em Med 2012;19:305-11.

7. Hendry JM. Poor Quality CPR Often Performed by Trained Medical Professionals. Available from: cfm?searched=/clinical/cardiac/PoorQualityCPR.cfm. Accessed: November 18, 2006

8. Miotto HC, Goulart EMA, Amaral CF, Moreira MCV. Influência do subsídio financeiro e do local da realização do Curso de Suporte Avançado de Vida em Cardiologia, no aprendizado da emergência cardiovascular. Arq Bras Cardiol 2008; 90(3):191-4.

9. Batcheller AM, Brennan RT, Braslow A, Urrutia A, Kaye W. Cardiopulmonary resuscitation performance of subjects over forty is bet-ter following half-hour video self-instruction compared to traditional four-hour classroom training. Resuscitation 2000;43(2):101-10.

10. Toner P, Connoly M, Laverty L, McGrath P, Connoly D, McCluskey DR. Teaching basic life support to school children using medical students and teachers in a “peer-training“ model-results of the “ABC for life“ programme. Resuscitation 2007;75:169-75.

11. Garcia Vega FJ, Montero Perez FJ, Encinas Puente RM. Editorial: Schools: a community setting to target for training in car-diopulmonary resuscitation. Emergencias 2008;20:223-5.

12. Sutton RM, Niles D, Meaney PA, Aplenc R, French B, Abella BS, et al. Low-dose, high-frequency CPR training improves skill reten-tion of in-hospital pediatric providers. Pediatrics 2011;128:e145–51.

13. Niles D, Sutton RM, Donoghue A, Kalsi MR, Robertset K, Boyle L, et al. "Rolling Refreshers": a novel approach to maintain CPR psychomotor skill competence. Resuscitation 2009;80:909-12.

14. Willcox M, Harrison H, Asiedu A, Nelson A, Gomez P, LeFevre A. Incremental cost and cost-effectiveness of low-dose, high-fre-quency training in basic emergency obstetric and newborn care as compared to status quo: part of a cluster-randomized training intervention evaluation in Ghana. Global Health 2017;13(1):88. doi: 10.1186/s12992-017-0313-x.

15. Monsieurs KG, De Regge M, Schelfout S, D`Hondt F, Mpotos N, Valcke M, et al. Efficacy of a self-learning station for basic life sup-port refresher training in a hospital: a randomized controlled trial. Eur J Emerg Med 2012;19(4):214-9.

16. Chung CH, Siu AY, Po LL, Lam CY, Wong PC. Comparing the effectiveness of video self-instruction versus traditional classroom instruction targeted at cardiopulmonary resuscitation skills for laypersons: a prospective randomised controlled trial. Hong Kong Med J 2010;16:165-70.

17. Wick L, Kramer-Johansen J, Myklebust H, Sorebo H, Svensson L, Fellows B, et al. Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA 2005;293(3):299-304.

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