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Introduction During basic life support (BLS) training, instructors assess learners' cardiopulmonary resuscitation (CPR) skills and correct errors to ensure high-quality performance. This study aimed to investigate certified BLS instructors' assessments of CPR skills. Methods Data were collected at BLS courses for medical students at Aarhus University, Aarhus, Denmark. Two certified BLS instructors evaluated each learner with a cardiac arrest test scenario, where learners demonstrated CPR on a resuscitation manikin for 3.5 minutes. Instructors' assessments were compared with manikin data as reference for correct performance. The first 3 CPR cycles were analyzed. Correct chest compressions were defined as 2 or more of 3 CPR cycles with 30 ± 2 chest compressions, 50 to 60 mm depth, and 100 to 120 min−1 rate. Correct rescue breaths were defined as 50% or more efficient breaths with visible, but not excessive manikin chest inflation (for instructors) or 500 to 600mL air (manikin data). Results Overall, 90 CPR assessments were performed by 16 instructor pairs. Instructors passed 81 (90%) learners, whereas manikin pass rate was 2%. Instructors identified correct chest compressions with a sensitivity of 0.96 [95% confidence interval (CI) = 0.79–1) and a specificity of 0.05 (95% CI = 0.01–0.14), as well as correct rescue breaths with a sensitivity of 1 (95% CI = 0.40–1) and a specificity of 0.07 (95% CI = 0.03–0.15). Instructors mistakenly failed 1 learner with adequate chest compression depth, while passing 53 (59%) learners with improper depth. Moreover, 80 (89%) improper rescue breath performances were not identified. Conclusions Certified BLS instructors assess CPR skills poorly. Particularly, improper chest compression depth and rescue breaths are not identified.

Purpose: Using a supraglottic airway (SGA) may provide more effective ventilations compared with a mouth-to-pocket-mask for drowning victims. SGAs are widely used by nurse anesthetists but it is unknown whether surf lifeguards can use SGAs effectively. We aimed to compare the use of SGA by surf lifeguards and experienced nurse anesthetists. Materials and Methods: Surf lifeguards inserted a SGA (i-gel O 2 , size 4) in a resuscitation manikin during cardiopulmonary resuscitation (CPR) and nurse anesthetists inserted a SGA in a resuscitation manikin placed on a bed, and performed ventilations. Outcome measures: time to first ventilation, tidal volume, proportion of ventilations with visible manikin chest rise, and ventilations within the recommended tidal volume (0.5-0.6 L). Results: Overall, 30 surf lifeguards and 30 nurse anesthetists participated. Median (Q1-Q3) time to first ventilation was 20 s (15-22) for surf lifeguards and 17 s (15-21) for nurse anesthetists (p=0.31). Mean (SD) tidal volume was 0.55 L (0.21) for surf lifeguards and 0.31 L (0.10) for nurse anesthetists (p<0.0001). Surf lifeguards and nurse anesthetists delivered 100% and 95% ventilations with visible manikin chest rise (p=0.004) and 19% and 5% ventilations within the recommended tidal volume, respectively (p<0.0001). Conclusion:In a simulated setting, there was no significant difference between surf lifeguards and experienced nurse anesthetists in time to first ventilation when using a SGA. Surf lifeguards delivered a higher tidal volume, and a higher proportion of ventilations within guideline recommendations, but generally ventilations caused visible manikin chest rise for both groups.