Elsevier

Resuscitation

Volume 67, Supplement 1, December 2005, Pages S181-S189
Resuscitation

European Resuscitation Council Guidelines for Resuscitation 2005: Section 9. Principles of training in resuscitation

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Introduction

There are a variety of methods used for training in resuscitation. None are perfect and, in the absence of frequent practice, retention of knowledge and skills is suboptimal. The optimal interval for retraining has not been established, but repeated refresher training at intervals of less than 6 months seems to be needed for most individuals who are not undertaking resuscitation on a regular basis.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12

Section snippets

Objectives

The objective of training is to equip the learner with the ability to be able to undertake resuscitation in a real clinical situation at the level at which they would be expected to perform, be they be lay bystander, first responder in the community or hospital, a healthcare professional working in an acute area, or a member of the medical emergency or cardiac arrest response team.

Methods

Training should follow the principles of adult education and learning. Generally this will mean an established European Resuscitation Council (ERC) course with small-group (four to eight members) participation using interactive discussion and hands-on practice for skills and clinical scenarios for problem-solving and team leadership.13 The ratio of instructors to candidates should range from 1:3 to 1:6, depending on the type of course.

Core knowledge should be acquired by candidates before the

Ethos

The course should be taught by trained instructors who have undertaken the relevant specific ERC course in teaching and assessment. Teaching should be conducted by encouragement with constructive feedback on performance rather than humiliation. First names are encouraged among both faculty and candidates to reduce apprehension, and the mentor/mentee system is used to enhance feedback and support for the candidate. Stress is inevitable,20 particularly during assessment, but the aim of the

Language

Initially, the ERC courses were taught in English by an international faculty.13 As local instructors have been trained, and manuals and course materials have been translated into different languages, the courses, particularly the provider courses, are now taught increasingly in the candidates’ native language.

Instructors

A tried and tested method has evolved for identifying and training instructors.

The Basic Life Support (BLS) and Automated External Defibrillator (AED) courses

BLS and AED courses are appropriate for a wide range of providers. These may include clinical and non-clinical healthcare professionals (particularly those who are less likely to be faced with having to manage a cardiac arrest), general practitioners, dentists, medical students, first-aid workers, lifeguards, those with a duty of care for others (such as school teachers and care workers), and members of first-responder schemes, as well as members of the general public.

The Immediate Life Support (ILS) course

The ILS course is for the majority of healthcare professionals who attend cardiac arrests rarely but have the potential to be first responders or cardiac-arrest team members.21 The course teaches the healthcare professionals the skills that are most likely to result in successful resuscitation while awaiting the arrival of the resuscitation team.22 Importantly, the ILS course also includes a section on preventing cardiac arrest, and complements other short courses that focus on managing sick

The Advanced Life Support (ALS) course

The target candidates for this course are doctors and senior nurses working in emergency areas of the hospital and those who may be members of the medical emergency or cardiac arrest teams.26 The course is also suitable for senior paramedics and certain hospital technicians. The ILS course is more suitable for first-responder nurses, doctors who rarely encounter cardiac arrest in their practice, and emergency medical technicians. Up to 32 candidates can be accommodated on the course, with a

The European Paediatric Life Support (EPLS) course

The EPLS course is designed for healthcare workers who are involved in the resuscitation of a newborn, an infant or a child whether in or out of hospital The course aims at providing caregivers with the knowledge and skills for the management of the critically ill child during the first hour of illness and to prevent progression of diseases to cardiac arrest.

Competence in basic paediatric life support is a prerequisite, although a 90-min refresher course on BLS and relief of foreign-body airway

The Newborn Life Support (NLS) course

This course is designed for health workers likely to be present at the birth of a baby in the course of their job. It aims to give those who may be called upon to start resuscitation at birth the background knowledge and skills to approach the management of the newborn infant during the first 10–20 min in a competent manner. The course is suitable for midwives, nurses and doctors and, like most such courses, works best with candidates from a mixture of specialties.

The course is usually conducted

The Generic Instructor Course (GIC)

This course is for candidates who have been recommended as IP, emanating from the ALS or EPLS provider courses. In some, the MIMMS course is undertaken under the auspices of the ALSG, and IPs from that course may take the GIC to qualify as ICs for teaching that course. There should be a maximum of 24 candidates, with a ratio of at least 1 instructor to 3 candidates. Instructors must all be fully experienced ERC instructors, not ICs. A key person is the educator. Groups should not exceed six

The Educator Master Class (EMC)

This course, normally held annually, is designed for those aspiring to become medical educators for the GIC. Suitable candidates are selected by the faculty, and generally must have a background and qualification in medical education or must have demonstrated a special commitment to educational practice over a number of years. They should have experience of a provider course and a GIC, and should have studied the background reading for the course.

The instructors for the course are experienced

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