Dataset_Delphi 1st round Summary 2nd round Instructions

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Summary for the 1st round 
Based on the 1st round results: 
1) No items reached consensus for exclusion (i.e. received the rating of ≤3 points from ≥75% of 
experts). 
2) 57 items reached consensus for inclusion (i.e. received the rating of ≥7 points from ≥75% of 
experts). Since the expert group consensus was achieved, these items were subjected to the 2nd 
round unchanged even though some suggestions for modification were made occasionally. 
3) 15 items did not reach consensus for inclusion or exclusion and were subjected to the 2nd round. 
Of these, 9 items were modified according to experts’ comments (when experts provided clear 
directions for how to modify an item). 
4) Based on experts’ suggestions, 7 new items were added to the checklist (when experts provided 
clear directions for how to formulate an item). 
Unchanged, modified and new items are marked in the new questionnaire as U, M and N, respectively. 
For modified items, changes are highlighted with dark red colour. 
You can review a summary of General comments from the 1st round on page 2 below. 
 
Instructions for the 2nd round 
For each (unchanged, modified and new) item please do the following: 
(a) review the summary of comments from the expert group in column C (these comments are 
provided for your information and should not be taken by you as a directive); 
(b) review the quantitative expert group results (median, lowest and highest ratings) in column D; 
(c) review your own rating from the 1st round in column E; 
(d) give your new rating in column F by answering the following question: 
How much do you agree that this item should be utilised as part of the checklist for evaluating 
conformance of an adult BLS educational resource with resuscitation guidelines? 
You are welcome to add free-text comments and suggestions for modifying each checklist item in 
respective Comment (optional) fields. Please use a General Comment field at the end of the form if you 
have any other considerations. 
All your responses and comments will be kept anonymous. 
IMPORTANT 
(!) Please use a computer (not a mobile device) to complete the form in order not to lose its 
functionality. 
(!) Please remember: by rating an item you show how much do you agree that this item should be 
utilised as part of the checklist. In particular, when rating the item “Does the resource instruct to 
perform any superfluous actions that are noncompliant with current guidelines on BLS?” please think 
how much do you agree that this item should be included into the checklist to assess educational 
resources (in this example, as a criterion of negative assessment of a resource). 
(!) Your new rating can be the same as in previous round or different if you changed your opinion, it’s 
completely up to you.
Summary of General comments from the 1st round 
• Although the checklist has many questions I think that they are necessary. The comments in some items 
refer to the instructions. 
• can we add that a discussion is needed - if no help is delivers victim is dead - thefore any help is better 
than nothing and it is kind of citizens socila contribution to society 
• consider adding questions around the use of pocket mask/face shields/BVM. 
• Covid-19 should not be part of a standard BLS educational program. Such information should be 
distibuted to the public via other communication channels during a pandemic only. 
• does the material provide a link to participate in a first responder system locally? 
• does the resource instruct to use precautions if available (barrier for pathogens), ventilation pocket mask, 
gloves, other things to add - switch of rescuer every 2 min if available to avoid rescuer exhaustion. 
• here a consideration for what additional topic/situations should be addressed in BLS. I don't believe there 
is a large consensus on this but should there be? 
• I believe that CPR for drowning and e.g. children is forgotten here.. 
• I believe that, especially after COVID-19 pandemic, BLS training should focus more on chest compressions 
and defibrillations rather than ventilations. 
• I miss a statement about the newly comercially availible chocking devices. 
• I see there are questions on choking, which I believe is standard in most BLS courses, but should we 
consider things like drowning or opioid overdose. Or special populations like pregnancy, morbid obesity, 
children or infants. 
• In 'call for help', perhaps we should add the number to be called, 112 for almost all EU member states, + 
option to adapt to the local EMS number is different. 
• in 'chest compressions' is there a mention of 2 minute cycles and when to reassess for response 
(particularly if no AED immediately available to help keep time). 
• In 'recognition of cardiac arrest' would it be worth adding a point for 'look - listen - feel' to tie it all 
together? 
• in the present form of the list, I think we will arrive at something like a 'ceilling effect' as almost all of the 
points mentioned should be addressed in some way. The question is more about HOW the points are 
addressed (weighing the importance against cognitive load, or potential for prducing confusion). 
• q 62-67 about COVID 19 should be added and we generalize it in case of pandemic follow the national 
protocols as it might have defferences between regions. I agree these items shou;d be as educatinal 
material or list but in practice we should emphazise on high quality CPR and the feedback tech available. 
• Rather than prohibiting blind finger sweep only, procedures should instruct to open mouth and visually 
inspect for material which may be blocking the airway (food, vomit, saliva, expectorate, dental fixtures 
i.e.) and recommend that blockages that are visible be removed. 
• Recovery position is a very delicate issue, as it might be a potent distractor from performing effective CPR. 
• Sugest you do not use strange terms such as “RATHER YES” and “RATHER NO” 
• The scope of "standard" BLS should probably be pretty consistant across the world. 
• the topics continuation of CPR, recovery position, choking might be a bit too extensive for a BLS device 
and might increase the cost of the device; for instance how to assess the quality of abdominal thrusts, 
back thrusts...; 
• These shared thoughts are set towards formal BLS teaching (BLS Courses which are designed to qualify 
providors who need to the knowledge and skills professionally), not necessarily for awareness sessions for 
lay responders (such as audience for outreach campaigns such as World Restart A Hheart activities) who 
will need much less information.