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Feasibility of adapted basic life support training in adults with intellectual disabilities in Italy: a prospective
Luca Gregorio Giaccari1,2, Gaetano Tammaro3, Michele Massaro4
1Service of Anesthesia and Intensive Care, "Vito Fazzi" Hospital, Piazzetta Muratore, 73100, Lecce, Italy. lucagregorio.giaccari@gmail.com.
Introduction:
Out-of-hospital cardiac arrest (OHCA) remains a major public health challenge, with survival depending on rapid bystander intervention. Individuals with intellectual disabilities are frequently excluded from adult Basic Life Support (BLS) training, despite their potential role as lay rescuers. The main objective was to evaluate the feasibility and preliminary educational impact of adapted BLS training in adults with mild to moderate intellectual disabilities.
Methods:
A prospective pilot feasibility study was conducted with 18 adults recruited through a community disability organization. Participants were classified using the extended Clinical Dementia Rating Scale (CDR). Training followed the Italian Resuscitation Council methodology and was adapted to participants' cognitive needs through simplified language, repeated demonstrations, visual reinforcement, and small-group hands-on practice. Knowledge was assessed before (T0) and after training (T1) using multiple-choice tests, while practical skills were evaluated through repeated in-session assessments conducted during the course. Practical skills included cardiac arrest recognition, chest compressions, defibrillation, and airway obstruction management, each scored on a standardized 0-2 scale.
Results:
Participants (mean age 44.7 years; 56% women) were classified as CDR 0 (39%), CDR 0.5 (28%), and CDR 1 (33%). Knowledge improved across all CDR groups, with the proportion of correct answers increasing substantially after training; in CDR 0 participants, correct answers rose from 31% to 71% (p < 0.001). Early-session practical assessments showed high recognition of cardiac arrest (75%) and airway obstruction (100%), although execution of chest compressions and defibrillation was initially limited (12.5%). Repeated in-session practical assessments showed progressive improvement in chest compressions, defibrillation, and airway obstruction management, with final-session performance reaching 82-92% of participants achieving sufficient or higher skill levels. Satisfaction was high, with all participants reporting positive feedback.
Conclusion:
Adapted BLS training is feasible and potentially effective in individuals with intellectual disabilities, supporting the feasibility of their inclusion in resuscitation education programs and suggesting a potential contribution to community preparedness.
Trial Registration:
Protocol no. 14/2018, approval date 15 January 2018.
