"You can also save a life!": children's drawings as a non-verbal assessment of the impact of cardiopulmonary resuscitation training

Education of schoolchildren in cardiopulmonary resuscitation - overview of the current literature

PURPOSE OF REVIEW

Recognition of cardiac arrest and initiation of cardiopulmonary resuscitation (CPR) can be learned and adequately replicated by schoolchildren. Regular instruction of schoolchildren in CPR is therefore a core element to increase low bystander CPR rates. Thereby, schoolchildren CPR training evolved as own scientific field within the last decade. Aim was to describe current evidence in terms of epidemiology, teaching approaches and political aspects.

RECENT FINDINGS

Schoolchildren demonstrate a high motivation to be trained in CPR. Teaching approaches that combine theoretical and practical learning sessions guarantee a sustainable learning effect. Schoolchildren can adequately perform chest compressions and mouth-to-mouth ventilation from the age of 12 years. Use of digital media is a highly promising teaching approach. CPR training conducted by teachers from the own school is effective and guarantees continuous development of CPR skills. Integration of schoolchildren CPR training into school curricula is the foundation for a sustainable increase of lay resuscitation rates in the population. Scientific and political promotion of schoolchildren CPR training is needed to sensitize the population and move bystander CPR in the social focus.

SUMMARY

While bystander CPR rates are low in Europe comprehensive establishment of schoolchildren CPR training may sustainably increase survival after cardiac arrest.

Temporarily Removed

BACKGROUND

Basic life support education for schoolchildren has become a key initiative to increase bystander cardiopulmonary resuscitation rates. Our objective was to review the existing literature on teaching schoolchildren basic life support to identify the best practices to provide basic life support training in schoolchildren.

METHODS

After topics and subgroups were defined, a comprehensive literature search was conducted. Systematic reviews and controlled and uncontrolled prospective and retrospective studies containing data on students <20 years of age were included.

RESULTS

Schoolchildren are highly motivated to learn basic life support. The CHECK-CALL-COMPRESS algorithm is recommended for all schoolchildren. Regular training in basic life support regardless of age consolidates long-term skills. Young children from 4 years of age are able to assess the first links in the chain of survival. By 10 to 12 years of age, effective chest compression depths and ventilation volumes can be achieved on training manikins. A combination of theoretical and practical training is recommended. Schoolteachers serve as effective basic life support instructors. Schoolchildren also serve as multipliers by passing on basic life support skills to others. The use of age-appropriate social media tools for teaching is a promising approach for schoolchildren of all ages.

CONCLUSIONS

Schoolchildren basic life support training has the potential to educate whole generations to respond to cardiac arrest and to increase survival after out-of-hospital cardiac arrest. Comprehensive legislation, curricula, and scientific assessment are crucial to further develop the education of schoolchildren in basic life support.

Facilitators and barriers for the implementation of resuscitation training programmes for schoolchildren: A systematic review

BACKGROUND

Training schoolchildren in resuscitation seems to improve rates of resuscitation by bystanders. Leading medical societies recommend comprehensive resuscitation education in schools. To date, no widespread implementation within the European Union has happened.

OBJECTIVE

The study aim was to identify facilitators and barriers for the implementation of cardiopulmonary resuscitation training for schoolchildren within the European Union.

DESIGN

Systematic review.

DATA SOURCES

A literature search in PubMed was conducted between 1 January 1999 and 30 June 2020 in accordance with the PRISMA statement. The search terms 'resuscitation', 'children' and 'Europe' were combined with the Boolean Operator 'AND' and 'OR'. Medical subject heading terms were used in order to include relevant articles.

ELIGIBILITY CRITERIA

Articles were included if cardiopulmonary resuscitation training specifically tailored for schoolchildren aged 12 to 18 years was considered in countries of the European Union. Articles that fulfilled the following criteria were excluded: duplicates, training methods only for specific patient groups, articles not accessible in the English language, and articles that did not include original data. Findings were structured by an evidence-based six-level approach to examine barriers and facilitators in healthcare.

RESULTS

Thirty out of 2005 articles were identified. Large variations in cardiopulmonary resuscitation training approaches ranging from conventional to innovative training methods can be observed. Schoolteachers as resuscitation instructors act either as barrier or facilitator depending on their personal attitude and their exposure to training in resuscitation. Cardiopulmonary resuscitation training in schoolchildren is effective. The uncoordinated interplay between the generally motivated schools and the political orientation towards resuscitation training for schoolchildren serve as barrier. The lack of financial support, absent systematic organisation and standardisation of training create major barriers.

CONCLUSION

Training schoolchildren in cardiopulmonary resuscitation is effective. More financial support and political guidance is needed. Until then, local initiatives, motivated teachers, and dedicated principles combined with innovative and low-cost training methods facilitate cardiopulmonary resuscitation training in schools.

Gender aspects in cardiopulmonary resuscitation by schoolchildren: A systematic review

AIM

Bystander CPR-rates are embarrassingly low in some European countries. To increase bystander CPR-rates, many different approaches are used; one of them is training of schoolchildren in CPR. Multiple authors investigated practical and theoretical CPR performance and demonstrated gender differences related to schoolchildren CPR. The objective was to elaborate gender aspects in practical and theoretical CPR-performance from the current literature to better address female and male students.

METHODS

A systematic search in PubMed-database with different search terms was performed for controlled and uncontrolled prospective investigations. Altogether, n = 2360 articles were identified and checked for aptitude. From n = 97 appropriated articles, n = 24 met the inclusion criteria and were finally included for full review and incorporated in the manuscript.

RESULTS

Female students demonstrated higher motivation to attend CPR-training (p < 0.001), to respond to cardiac arrest (CA) (p < 0.01), scored higher in a CPR-questionnaire (p < 0.025), revealed better remembrance of the national emergency phone-number (p < 0.05) and showed a higher multiplier effect (p < 0.0001). Male students showed higher confidence in CPR-proficiency (p < 0.05), revealed deeper chest compressions (CC) (p < 0.001; p < 0.0015; p < 0.01), a higher CC-fraction (p < 0.01) and a higher arbitrary cardiac output simulated equivalent index (p < 0.05). Male gender could not be detected to be a predictor for higher tidal volume (p = 0.70; p = 0.0212).

CONCLUSION

In context of schoolchildren CPR, gender aspects are underestimated. Female students seem to be more motivated to attend CPR-training, reach more people in the role of a multiplier and need to be individually addressed in intensified practical training. Male students achieve a more sufficient chest compression depth and -fraction and could benefit from individual motivation.