Abstract:

Objective To comprehensively evaluate the current evidence on the effectiveness of cardiopulmonary resuscitation（CPR） training for first responders in cases of out-of-hospital cardiac arrest（OHCA） through an overview of systematic reviews，thereby providing a reference for optimizing training strategies. Methods Cochrane Library，PubMed，Web of Science，Embase，Wiley，CNKI，and Wanfang Database were searched to identify systematic reviews related to CPR educational strategies for first responders. The search period spanned from the inception to January 2025. The methodological quality was assessed using AMSTAR 2（Assessment of Multiple Systematic Reviews 2），and the quality of evidence was evaluated using the GRADE（Grading of Recommendations Assessment Development and Evaluation） system. Results 14 systematic reviews were included，10 were of high quality，3 were of moderate quality，and one was of low quality. Outcomes for training effectiveness were categorized into four aspects - CPR skill performance，CPR-related knowledge and overall performance，learner attitudes and perceptions and real-world event outcomes. The evidence quality assessment involved 63 evidence bodies，2 of high-quality，7 of moderate-quality，26 of low-quality，and 28 of very low-quality. Conclusion Current CPR training methods could enhance the knowledge，skills，and awareness of first responders. However，the overall quality of the evidence remains low，and there is still a notable lack of long-term effectiveness data and real-world outcome reports. Future researches should incorporate the characteristics of first responders and localized settings to more rigorously evaluate the efficacy of different training approaches through higher-quality studies，standardize the evaluation system for training effectiveness，and strengthen the reporting of real-world outcomes.

Key words: Out-of-hospital Cardiac Arrest, First Responder, Cardiopulmonary Resuscitation, Training, Overview of Systematic Review