Across the board, there is no universal standard for CPR certification length. Some training providers, such as the American Red Cross, require annual recertification, while other providers require certification every two years. Although some decision-makers consider two-year recertification program more economical, is there a point at which someone is no longer prepared to respond effectively in an emergency? How long after testing does skill retention last?

 Many studies have tried to determine how often CPR recertification should occur, based on how well people who are certified in CPR perform at consecutive time intervals after their training. The results of these studies, although not optimistic, are consistent: across the board, from physicians to lay people, CPR skills steadily deteriorate shortly after certification.

In fact, CPR skill retention begins to decline as early as two weeks after a participant is trained, and progressively decreases for about a year. Less than half of participants can pass a skills test one year after training. Skill deterioration seems to plateau between year one and two, but it is inadequate at year one. The American Red Cross reviewed 24 studies, and overall, there is no evidence to support the claim that CPR skills are retained for two years.

In order to combat this lack of retention, experts recommend scheduling refresher courses every six months so that people can continue to practice the CPR techniques they have learned. In fact, the Occupational Safety and Health Administration (OSHA) released a document, "Best Practices Guide: Fundamentals of a Workplace First Aid Program," that encourages employers to lead a skills review and practice session for CPR and AED every six months, and recommends that staff be retrained annually.

Several methods, short of a complete course, can boost retention until the next retraining. Examples include reviewing course materials, practicing on a manikin, conducting drills, viewing a short video of CPR skillls, and posting CPR guidelines on the door of a bathroom stall. These simple strategies act as constant "reminders" of skills that are otherwise quickly forgotten.

The Red Cross has already taken steps toward improving CPR skill retention by requiring recerticication every year, unlike most other providers. The Red Cross encourages people to get trained in CPR, participate in annual recertification and stay certified for a lifetime. With every class, participants will become more comfortable with the lifesaving skills they learn, retain those skills for a longer period of time and gain the confidence they need to respond in an emergency.

¹Moser and Coleman, 1992; Sternbach and Kiskaddon, Fossel and Eliastam, 1984. Literature Reviews

²Occupational Safety and Administration (OSHA), "Best Practicies Guide: Fundamentals of a Workplace First Aid Program," http://www.osha.gove/Publications?OSHA3317first-aid.pdf