title: A systematic review of basic life support training targeted to family members of high-risk cardiac patients.
abstract: Targeting basic life support (BLS) training to bystanders who are most likely to witness an out of hospital cardiac arrest (OHCA) is an important public health intervention. We performed a systematic review examining the evidence of the effectiveness of providing BLS training to family members of high-risk cardiac patients.
  
  
  
  A search of Ovid MEDLINE, CINAL, EMBASE, Informit, Cochrane Library, Web of Science, Scopus, ERIC and ProQuest Dissertations and Theses Global was conducted. We included all studies training adult family members of high-risk cardiac patients regardless of methods used for cardiopulmonary resuscitation (CPR) or BLS training. Two reviewers independently extracted data and evaluated the quality of evidence using GRADE (Grades of Recommendation, Assessment, Development and Evaluation).
  
  
  
  We included 26 of the 1172 studies identified. The majority of studies were non-randomised controlled trials (n=18), of very low to moderate quality. Currently, there is insufficient evidence to indicate a benefit of this intervention for patients; largely because of low numbers of OHCA events and high loss to follow-up. However, the majority of trained individuals were able to competently perform BLS skills, reported a willingness to use these skills and experienced lower anxiety.
  
  
  
  Whilst there is no current evidence for improvement in patient outcomes from targeted BLS training for family members, this group are willing and capable to learn these skills. Future research may need to examine longer periods of follow-up using alternate methods (e.g. cardiac arrest registries), and examine the effectiveness of training in the modern era.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Alfred Hospital, Melbourne, Australia. Electronic address: susie.cartledge@monash.edu.
authors.forename: Susie
authors.initials: S
authors.lastname: Cartledge
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Alfred Hospital, Melbourne, Australia; School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Bray
authors.affiliation: Centre for Resuscitation Science, University of Pennsylvania, USA.
authors.forename: Marion
authors.initials: M
authors.lastname: Leary
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Alfred Hospital, Melbourne, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Western Health, Melbourne, Australia.
authors.forename: Dion
authors.initials: D
authors.lastname: Stub
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia.
authors.forename: Judith
authors.initials: J
authors.lastname: Finn
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000401:mortality; D002318:Cardiovascular Diseases / Q000628:therapy; D005190:Family; D006801:Humans; D015337:Multicenter Studies as Topic; D065228:Non-Randomized Controlled Trials as Topic; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic
keywords: Basic life support; Cardiopulmonary resuscitation; Out of hospital cardiac arrest; Systematic review; Training