‘Any attempt at resuscitation is better than no attempt’ .

The Australian Resuscitation Council’s motto is certainly true when examining cases of bystander assistance. In the instance of Sudden Cardiac Arrest (SCA), time is tissue: A reduction in survival rates of 10% for every passing minute with permanent damage to brain tissue beginning to occur at 3-5 minutes.

SCA remains the largest cause of death in the adult Australian population with over 33,000 Australians suffering sudden cardiac arrest every year and alarmingly, only 5% of those survive outside of a hospital environment.

Those of us trained in cardiopulmonary resuscitation (CPR) must strive for excellence in casualty care and give our best attempt at resuscitation to achieve the best possible outcome.

The chain of survival system (below) encompasses all aspects required to achieve the best possible outcome. Any break in the chain results in a decrease in survival rates. The first three links are predominantly community-based, and with an average ambulance response time between 12- 20 minutes, it is the person sitting next to you – your co-workers, friends and family – who may be able to make the life-saving difference and give paramedics the best chance of a successful outcome on arrival.



To improve survival rates, we must strengthen every link.

Many recent clinical studies have demonstrated a clear link between the quality of care delivered and the survivability of the patient: high quality CPR is directly related to a higher chance of survival. CPR provides the brain and other major organs with the oxygen rich blood they require and prolongs the duration in which a defibrillator can be successfully used.

However, a mechanical skill such as CPR is a perishable lifesaving skill: if you don’t use it, you lose it. Reduction in the quality of practical skills is relatively fast and degradation begins to occur in as little as three weeks post training. So the big question is: how do we improve retention?

Improving retention and performance

  1. ‘Hands-on’ time: Research shows that the more time spent practicing the mechanical skill, the greater the retention. The national unit of competence in CPR and first aid requires only two minutes of adult CPR and two minutes of infant CPR to be demonstrated by learners.  Training providers must raise the bar and provide significantly more hands-on practice in their courses to facilitate fault correction and increase retention rates.
  2. Theoretical understanding: Understanding the underlying anatomy and physiology of CPR is critical. Exploration of not just the ‘how’ to perform the skill, but also ‘why’ interventions are recommended. Experience tells us that this combination (when followed by rigorous practical assessment) greatly assists in consolidating skills and knowledge.
  3. Scenario-based training: Rather than a simple practical demonstration followed by assessment, training should be delivered in as lifelike as possible simulation. Scenarios should reflect the fact that every real-life situation in life comes with a different set of variables to encourage participants to think about the correct course of action.  Debriefing the learner’s performance after the scenario is an important process to consolidate learning and identify areas for improvement.

Quality training makes the difference

Workplaces must be cognisant of these factors when engaging a provider for CPR and first aid training. Unfortunately, ‘tick in the box’ training has become all too common within the Vocational Education and Training sector, with first aid training often undertaken as a mere regulatory requirement. Quality first aid training should prepare people with the lifesaving skills required to perform at a high standard in the event of an emergency, strengthening the community links in the chain of survival.

So, next time you’re on the phone with your training provider, don’t be afraid to ask them the following questions: is the training you are receiving high quality? Is there substantial hands-on practice of skills? Did the learners participate in scenario-based learning? Was the assessment rigorous, individual and delivered in a way to not only get a ‘tick in the box’ but to develop the lifesaving skills required? And if not, why?

When we strive for excellence in training, we strengthen our community links with competent and confident first aiders who contribute to a system of care where survival rates can be significantly increased.

For further information about Premium Health’s range of quality training courses and workshops visit premiumhealth.com.au or call our friendly customer service team on 1300 721 292.

Thomas Howell National Training Manager Premium Health


Thomas is an experienced remote area paramedic and military medic. As Premium Health’s
National Training Manager he leads a team of 40 passionate, highly skilled trainers committed
to sharing their expertise with as many as 40,000 Australians every year.


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