Preservation of Basic Life Support Competencies Among Certified First Responders

Background and Objectives: Slovenia, like many other European nations, has introduced voluntary first responders to enhance survival rates in out-of-hospital cardiac arrests. In currently published research, no conclusive data exists on the optimal retraining interval, categorizing recommendations as expert opinion with limited reliability. Materials and Methods: Between 2019 and 2024, observational longitudinal research and a cross-sectional comparison was conducted in accordance with national guidelines on Slovenian newly certified (N = 342; 227 males, 112 females and three participants with missing or undetermined gender; mean age, 31.3 ± 12.2 years) and senior (N = 140; 105 males, 35 females; mean age, 38.0 ± 11.9 years) licensed first responders (LFRs) with 5-10 years of experience (median = 6.5, IQR 6-7). LFRs were reassessed for retention of skills and knowledge one year after previous certification. Additionally, each cohort was classified into groups according to the number of interventions they engaged in over the past year, and their retention of skills and knowledge was assessed. Results: During the initial year of service, no statistically significant decline in practical skills (median 53 [52-54] vs. 53 [50-54]; p = 0.059) or theoretical knowledge (median 10 [9-10] vs. 9 [9-10]; p = 0.458) was observed among newly certified LFRs. In contrast, senior LFRs demonstrated significantly lower practical skill scores prior to recertification compared with newly certified LFRs (median 51 [49-54] vs. 54 [52-55]; p < 0.001), whereas theoretical knowledge remained stable (median 9 [8.5-10] vs. 10 [9-10]; p = 0.091). Intervention frequency did not affect skill or knowledge retention among newly certified LFRs. However, senior LFRs who did not participate in any interventions during the certification period demonstrated significantly lower practical skill scores comparable to newly certified LFRs (median 49 [47-51] vs. 54 [52-55]; p < 0.001), whereas those who participated in at least one intervention showed no significantly lower scores (median 52 [50-54] vs. 54 [52-55]; p = 0.117). No significant reduction in theoretical knowledge was observed. Linear regression analysis demonstrated that participation in at least one intervention significantly predicted higher practical skill scores among senior LFRs (β = -1.11, p = 0.001), whereas no significant association was observed for theoretical knowledge retention or among newly certified LFRs. Conclusions: The initial training for Slovenian LFRs was found to be adequate. However, senior LFRs who did not participate in interventions demonstrated lower practical skill performance compared with newly certified LFRs. Further evaluation and different strategies for recertifying senior LFRs should be adopted, considering the number of interventions they have been involved in after last certification.