Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 152 No. 0910 (2022)

Basic life support knowledge among Swiss conscripts: a national multicentre survey

  • Dimitri Durr
  • Pierre-Nicolas Carron
  • François-Xavier Ageron
  • Zeno Stanga
  • Antoine Schneider
  • Ludovic Maudet
  • Nicolas Beysard
Cite this as:
Swiss Med Wkly. 2022;152:w30147


BACKGROUND: Basic life support (BLS) is the first link in the chain of survival and should be performed by every lay rescuer. Although international studies have suggested that BLS knowledge was poor among the overall population, Swiss data are scarce. Our objective in this study was to evaluate BLS knowledge among Swiss conscripts, a semi-representative sample of Swiss young adults, during the recruitment process and to identify potential characteristics related to performance.

METHODS: A short online voluntary anonymous survey was proposed to Swiss conscripts called to duty in the six national recruiting centres of the Swiss Armed Forces during an 8-month period (2 February 2019 to 27 September 2019). The survey was available in three official languages (French, German, and Italian). Considered outcome was BLS knowledge evaluated on a Likert scale from 1 (very bad) to 6 (excellent). Univariate and multivariate ordinal logistic regression analyses were performed to assess the relationship between BLS knowledge and participants’ characteristics.

RESULTS: Among the 19,247 conscripts called to service during the study period, 737 replied to the survey. Among them, 735 were included in the analyses (mean age 19.8 years [± 2.1]). Of these, 144 (20%) had never received any BLS training. The BLS knowledge survey was completely answered by 670 participants (91%). 157 participants (23%) reached a BLS knowledge score ≥5. Out of 695 answers, 142 (20%) did not know the Swiss emergency phone number. Out of 670 answers, 364 (54%) believed that CPR could worsen the health status of a person in cardiac arrest, whereas 413 (62%) agreed that BLS training should be mandatory in secondary school. German as native language (odds ratio [OR] 1.3, 95% confidence interval [CI] 1.0–.8)], receipt of BLS training (OR  3.1, 95% CI 2.0–4.8), and female gender were associated with a higher BLS knowledge score. Time since the last BLS training of ≥3 years (OR 0.5, 95% CI 0.4–0.7) and unemployment (OR 0.3, 95% CI 0.1–0.9) were associated with a lower BLS knowledge score. We found substantial agreement between conscripts’ scores and their self-assessments (weighted kappa with 74% agreement).

DISCUSSION AND CONCLUSION: Knowledge of the emergency phone number and BLS principles was poor among Swiss conscripts participating in the study. However, their awareness and motivation is high. The effect of training during boot camp should be evaluated in further studies. Focusing on BLS training is essential and should be promoted in educational and professional contexts.


  1. American Heart Association. HIGHLIGHTS of the 2015 American Heart Association Guidelines Update for CPR and ECC. 2015.
  2. Khalid U, Juma AA. Paradigm shift: ‘ABC’ to ‘CAB’ for cardiac arrests. Scand J Trauma Resusc Emerg Med. 2010 Nov;18(1):59.
  3. Déroulement et dates des écoles de recrues [Internet]. [cité 25 févr 2018]. Disponible sur:
  4. TCS suisse, ASS alliance suisse des samaritains. Test premiers secours - TCS Suisse [Internet]. [cité 26 nov 2017]. Disponible sur:
  5. Rasmus A, Czekajlo MS. A national survey of the Polish population’s cardiopulmonary resuscitation knowledge. Eur J Emerg Med. 2000 Mar;7(1):39–43.
  6. Chen M, Wang Y, Li X, Hou L, Wang Y, Liu J, et al. Public Knowledge and Attitudes towards Bystander Cardiopulmonary Resuscitation in China. BioMed Res Int. 2017;2017.
  7. Siebenpfund P, Kaufmann G, Roman B, Ummenhofer W. La réanimation par des secouristes volontaires. BMS. 2015;33(96):1124–6.
  8. Lukas RP, Van Aken H, Mölhoff T, Weber T, Rammert M, Wild E, et al. Kids save lives: a six-year longitudinal study of schoolchildren learning cardiopulmonary resuscitation: Who should do the teaching and will the effects last? Resuscitation. 2016 Apr;101:35–40.
  9. Kanstad BK, Nilsen SA, Fredriksen K. CPR knowledge and attitude to performing bystander CPR among secondary school students in Norway. Resuscitation. 2011 Aug;82(8):1053–9.
  10. Ghuysen A, Collas D, Stipulante S, Donneau AF, Hartstein G, Hosmans T, et al. Dispatcher-assisted telephone cardiopulmonary resuscitation using a French-language compression-only protocol in volunteers with or without prior life support training: A randomized trial. Resuscitation. 2011 Jan;82(1):57–63.
  11. Fondation Suisse de Cardiologie. Arrêt cardio-circulatoire - Fondation Suisse de Cardiologie [Internet]. [cited 2021 juill 21]. Disponible sur:
  12. Gräsner JT, Herlitz J, Tjelmeland IB, Wnent J, Masterson S, Lilja G, et al. European Resuscitation Council Guidelines 2021: epidemiology of cardiac arrest in Europe. Resuscitation. 2021 Apr;161:61–79.
  13. Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, et al.; Adult basic life support and automated external defibrillation section Collaborators. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015 Oct;95:81–99.
  14. Plant N, Taylor K. How best to teach CPR to schoolchildren: a systematic review. Resuscitation. 2013 Apr;84(4):415–21.
  15. de Ruijter PA, Biersteker HA, Biert J, van Goor H, Tan EC. Retention of first aid and basic life support skills in undergraduate medical students. Med Educ Online. 2014 Nov;19(1):24841.
  16. Binkhorst M, Coopmans M, Draaisma JM, Bot P, Hogeveen M. Retention of knowledge and skills in pediatric basic life support amongst pediatricians. Eur J Pediatr. 2018 Jul;177(7):1089–99.
  17. Confédération Suisse. Loi fédérale sur l’armée et l’administration militaire. Sect. Titre deuxième, Chap 1, Art. 3 févr 3, 1995.
  18. Finke SR, Schroeder DC, Ecker H, Wingen S, Hinkelbein J, Wetsch WA, et al. Gender aspects in cardiopulmonary resuscitation by schoolchildren: A systematic review. Resuscitation. 2018 Apr;125:70–8.
  19. Lester C, Donnelly P, Weston C. Is peer tutoring beneficial in the context of school resuscitation training? Health Educ Res. 1997 Sep;12(3):347–54.
  20. Papalexopoulou K, Chalkias A, Dontas I, Pliatsika P, Giannakakos C, Papapanagiotou P, et al. Education and age affect skill acquisition and retention in lay rescuers after a European Resuscitation Council CPR/AED course. Heart Lung. 2014 Jan-Feb;43(1):66–71.
  21. Fischer H, Strunk G, Neuhold S, Kiblböck D, Trimmel H, Baubin M, et al. The effectiveness of ERC advanced life support (ALS) provider courses for the retention of ALS knowledge. Resuscitation. 2012 Feb;83(2):227–31.
  22. Bühler G, Bütikofer S, Craviolini J, Hermann M, Krähenbühl D, Eliane M, et al. Was tun im Notfall? Befragung zum Verhalten und den Kompetenzen in Erster Hilfe in der Schweiz. Zürich: Sotomo, Schweizerisches Rotes Kreuz. Helsana. 2020;(août):43.
  23. Clark MJ, Enraght-Moony E, Balanda KP, Lynch M, Tighe T, FitzGerald G. Knowledge of the national emergency telephone number and prevalence and characteristics of those trained in CPR in Queensland: baseline information for targeted training interventions. Resuscitation. 2002 Apr;53(1):63–9.
  24. Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, Perrier L. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA. 2006 Sep;296(9):1094–102.
  25. Lynn DJ, Holzer C, O’Neill P. Relationships between self-assessment skills, test performance, and demographic variables in psychiatry residents. Adv Health Sci Educ Theory Pract. 2006 Feb;11(1):51–60.
  26. Lund-Kordahl I, Mathiassen M, Melau J, Olasveengen TM, Sunde K, Fredriksen K. Relationship between level of CPR training, self-reported skills, and actual manikin test performance-an observational study. Int J Emerg Med. 2019 Jan;12(1):2.
  27. Seli P, Wammes JD, Risko EF, Smilek D. On the relation between motivation and retention in educational contexts: the role of intentional and unintentional mind wandering. Psychon Bull Rev. 2016 Aug;23(4):1280–7.
  28. Boland LL, Satterlee PA, Hokanson JS, Strauss CE, Yost D. Chest Compression Injuries Detected via Routine Post-arrest Care in Patients Who Survive to Admission after Out-of-hospital Cardiac Arrest. Prehosp Emerg Care. 2015 Jan-Mar;19(1):23–30.
  29. Krischer JP, Fine EG, Davis JH, Nagel EL. Complications of cardiac resuscitation. Chest. 1987 Aug;92(2):287–91.
  30. Carron PN, Dami F, Niquille M, Frei O, Valloton L, Yersin B. Médecine d’urgence préhospitalière. Éditions médecine & hygiène; 2013. 637 p.
  31. SRC - Swiss Resuscitation Council. Directives de cours 2015 Guide pour l’obtention du label SRC pour les cours Basic Life Support - version 2.0. 2015.
  32. . American Academy of Pediatrics Committee on School Health. Basic life support training school. Pediatrics. 1993 Jan;91(1):158–9.
  33. Vetter VL, Haley DM. Secondary prevention of sudden cardiac death: does it work in children? Curr Opin Cardiol. 2014 Jan;29(1):68–75.
  34. Bohn A, Lukas RP, Breckwoldt J, Böttiger BW, Van Aken H. ‘Kids save lives’: why schoolchildren should train in cardiopulmonary resuscitation. Curr Opin Crit Care. 2015 Jun;21(3):220–5.
  35. Song KJ, Shin SD, Park CB, Kim JY, Kim DK, Kim CH, et al. Dispatcher-assisted bystander cardiopulmonary resuscitation in a metropolitan city: a before-after population-based study. Resuscitation. 2014 Jan;85(1):34–41.
  36. Mathiesen WT, Bjørshol CA, Høyland S, Braut GS, Søreide E. Exploring How Lay Rescuers Overcome Barriers to Provide Cardiopulmonary Resuscitation: A Qualitative Study. Prehosp Disaster Med. 2017 Feb;32(1):27–32.
  37. Reder S, Cummings P, Quan L. Comparison of three instructional methods for teaching cardiopulmonary resuscitation and use of an automatic external defibrillator to high school students. Resuscitation. 2006 Jun;69(3):443–53.
  38. Semeraro F, Frisoli A, Loconsole C, Mastronicola N, Stroppa F, Ristagno G, et al. Kids (learn how to) save lives in the school with the serious game Relive. Resuscitation. 2017 Jul;116:27–32.
  39. Cuijpers P, Kicken W, Gorgels A. Effectiveness of a blended learning approach for CPR training in secondary schools for different education level groups. Resuscitation. 2012 Oct;83:e112.
  40. Langlais BT, Panczyk M, Sutter J, Fukushima H, Wu Z, Iwami T, et al. Barriers to patient positioning for telephone cardiopulmonary resuscitation in out-of-hospital cardiac arrest. Resuscitation. 2017 Jun;115:163–8.
  41. Hsieh MJ, Bhanji F, Chiang WC, Yang CW, Chien KL, Ma MH. Comparing the effect of self-instruction with that of traditional instruction in basic life support courses-A systematic review. Resuscitation. 2016 Nov;108:8–19.
  42. Meissner TM, Kloppe C, Hanefeld C. Basic life support skills of high school students before and after cardiopulmonary resuscitation training: a longitudinal investigation. Scand J Trauma Resusc Emerg Med. 2012 Apr;20(1):31.
  43. Böttiger BW, Van Aken H. Kids save lives—training school children in cardiopulmonary resuscitation worldwide is now endorsed by the World Health Organization (WHO). Resuscitation. 2015 Sep;94:A5–7.
  44. Bouland AJ, Risko N, Lawner BJ, Seaman KG, Godar CM, Levy MJ. The Price of a Helping Hand: Modeling the Outcomes and Costs of Bystander CPR. Prehosp Emerg Care. 2015;19(4):524–34.
  45. Friesen J, Patterson D, Munjal K. Cardiopulmonary Resuscitation in Resource-limited Health Systems-Considerations for Training and Delivery. Prehosp Disaster Med. 2015 Feb;30(1):97–101.
  46. Nichol G, Huszti E, Birnbaum A, Mahoney B, Weisfeldt M, Travers A, et al. Cost-effectiveness of lay responder defibrillation for out-of-hospital cardiac arrest. Ann Emerg Med. août 2009;54(2):226-235.e1-2.
  47. Burkart R, Regener H. Stratégie nationale de survie relative aux arrêts circulatoires. Bull Médecins Suisses. 2019 Nov;100(48):1615–7.

Most read articles by the same author(s)

1 2 > >>