Basic life support knowledge transfer from schoolchildren to family members and friends: a scoping review and...

Out-of-hospital cardiac arrest is a leading cause of death in Europe, with most events occurring at home. Early recognition and initiation of resuscitation improve survival and neurological outcomes, yet they are not consistently performed by bystanders. School-based initiatives such as "Kids Save Lives" promote basic life support (BLS) training and encourage schoolchildren to disseminate this knowledge within their families. However, evidence on how this transfer occurs and how it can be assessed remains limited.

To map how BLS knowledge transfer from schoolchildren to family members and friends has been implemented and evaluated, and to identify potential key limitations for measurement and reporting.

A scoping review was conducted following PRISMA-ScR. Searches were performed in PubMed, Scopus, and Web of Science in February 2026. Studies involving adolescents (10-19 years) trained in BLS at school who subsequently taught family members and friends were included. Evidence was synthetized descriptively, focusing on training characteristics, transfer processes, and reported outcomes.

Four quasi-experimental studies and one prospective observational study were included. Training was mainly based on self-instruction kits, and knowledge transfer was typically conducted without supervision. Outcomes focused primarily on theoretical knowledge, with limited assessment of practical skills or long-term retention. The reported multiplier effect ranged from 0.33 to 4.9, with substantial variability and inconsistent measurement.

Schoolchildren may act as transmitters of BLS knowledge to family members and friends, but current evidence is limited, heterogeneous, and largely based on indirect or self-reported outcomes. More structured and standardized approaches are needed to better understand, evaluate, and optimize this potentially relevant knowledge transfer process.