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Jarosławski J, Burzyński J, Kryczka K, Michalak A, Warda W, Zieliński K, Fendler W, Chobot A. Impact of anthropometric factors on chest compression depth during CPR provided by children aged 11-14 in a community-wide study. Resusc Plus 2024; 19:100708. [PMID: 39100391 PMCID: PMC11294725 DOI: 10.1016/j.resplu.2024.100708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 08/06/2024] Open
Abstract
Objective To assess the depth of chest compressions (CC) provided by schoolchildren and their relation with providers's anthropometric characteristics. Methods We organized 1-hour hands-on training sessions for 11-14y.o. in volunteering schools. After training, willing subjects performed 2 min of recorded continuous CCs by means of Laerdal Resusci Anne® with CPRMeter2®, with visual feedback. Compression pace was given by metronome; instructors supervised the correct body position. Collected data included age, sex, as well as measured body weight and height. Results We analyzed records from N = 702 children (mean age: 12.76 ± 1.02 years, 379 (51.63%) boys) out of 761 participating in the study. Their mean median compression depth (MCD) was 46.70 ± 7.74 mm, which was below minimal effective CC depth advised by current guidelines (50 mm). This corresponded to low mean fraction of CCs ≥ 50 mm (CCF ≥ 50 mm, 42.86 ± 33.67%), and only 42.88% of children achieving at least 50% of compressions ≥ 50 mm. Boys had significantly higher mean MCD and CCF ≥ 50 mm than girls (MCD: 49.34 ± 7.05 mm vs 45.97 ± 8.07 mm, p < 0.0001; CCF ≥ 50 mm: 50.23 ± 32.90% vs 40.40 ± 34.97%, p < 0.0001). Age differentiated children who achieved at least 50% of compressions ≥50 mm from those who did not with AUC of 0.69 (for cut-off of 12.1 years: 85% sensitivity, 41% specificity), whereas weight offered an improved prediction (AUC 0.74; for cut-off 44.8 kg: 77.4% sensitivity, 61.1% specificity). Conclusions Sex, age and anthropometric factors are significant CC quality factors. Children with higher body weight are more likely to deliver CCF50%≥50 mm. Among the studied population, children ≥12 years old provided more effective chest compressions.
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Affiliation(s)
- Jarosław Jarosławski
- Student Association of Pediatrics and Critical Care, Department of Pediatrics, Institute of Medical Sciences, University of Opole, Al. W.Witosa 26, 45-052 Opole, Poland
| | - Jacek Burzyński
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Ul. Mazowiecka 15, 92-215Lodz, Poland
| | - Krzysztof Kryczka
- Student Association of Pediatrics and Critical Care, Department of Pediatrics, Institute of Medical Sciences, University of Opole, Al. W.Witosa 26, 45-052 Opole, Poland
| | - Arkadiusz Michalak
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Ul. Mazowiecka 15, 92-215Lodz, Poland
- Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Ul. Sporna 36/50, 91-738 Lodz Poland
| | - Wiktor Warda
- Student Association of Pediatrics and Critical Care, Department of Pediatrics, Institute of Medical Sciences, University of Opole, Al. W.Witosa 26, 45-052 Opole, Poland
| | - Krzysztof Zieliński
- Student Association of Pediatrics and Critical Care, Department of Pediatrics, Institute of Medical Sciences, University of Opole, Al. W.Witosa 26, 45-052 Opole, Poland
| | - Wojciech Fendler
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Ul. Mazowiecka 15, 92-215Lodz, Poland
| | - Agata Chobot
- Department of Pediatrics, Institute of Medical Sciences, University of Opole, Al. W.Witosa 26, 45-052 Opole, Poland
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McGlinchey Ford M, Rogotzke CD, Bencik SL, Billian JR, Young JL, Bencik CD, Mastenbrook JD. Teaching Cardiopulmonary Resuscitation to Later Elementary School Students. Ann Emerg Med 2024; 83:385-393. [PMID: 37966412 DOI: 10.1016/j.annemergmed.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 11/16/2023]
Abstract
STUDY OBJECTIVE Bystander cardiopulmonary resuscitation (CPR) rates remain low in the United States. Training children is a proposed method to increase this rate, but data on the compression efficacy of US elementary school-aged children are scarce. We hypothesized that fourth and fifth graders could learn how to respond to cardiac arrests and provide effective chest compressions. METHODS We conducted a nonrandomized before-and-after study with fourth- and fifth-grade elementary students. Two 2-hour CPR educational sessions were held. Two weeks later, skills were assessed using a de novo checklist, and manikin-analyzed compression effectiveness (dichotomized at 50% efficacy) was analyzed using Chi-squared tests. We used paired t tests to evaluate knowledge change on identical pre- and post-tests. Secondary analysis evaluated associations between compression effectiveness and grade, age, sex, and body mass index (BMI) using Chi-squared tests. RESULTS Three hundred fifty-six students completed the study. The mean change in test scores measuring CPR knowledge increased from 8.2 to 9.3 (1.1, 95% confidence interval [CI] 0.9 to 1.2). Self-reported adequate CPR knowledge increased from 44% to 97% (odds ratio [OR] 44.17, 95% CI 12.62 to 154.62). Seventy-two percent of students completed >7/11 predefined resuscitation steps, and 76% delivered ≥50% effective compressions. Grade was significantly associated with achieving ≥50% effective compression (OR 2.02, 95% CI, 1.19 to 3.43). Age, BMI, and sex were not significantly associated with greater compression efficacy. CONCLUSION Most students were able to learn hands-only CPR, apply their knowledge during a simulated cardiac arrest scenario, and deliver effective chest compressions. Students' confidence and willingness to perform CPR increased after the intervention.
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Affiliation(s)
- Maureen McGlinchey Ford
- Department of Emergency Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI.
| | - Cyle D Rogotzke
- Department of Emergency Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI
| | - Sherrie L Bencik
- Department of Emergency Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI
| | - Joseph R Billian
- Division of Epidemiology and Biostatistics, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI; Department of Biomedical Informatics, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI
| | - Jeffrey L Young
- Department of Biomedical Informatics, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI
| | | | - Joshua D Mastenbrook
- Department of Emergency Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI
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Schroeder DC, Finke SR, Grübl T, Jänig CW, Böttiger BW. Education of schoolchildren in cardiopulmonary resuscitation - overview of the current literature. Curr Opin Crit Care 2023; 29:616-620. [PMID: 37861212 DOI: 10.1097/mcc.0000000000001111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
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.
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Affiliation(s)
- Daniel C Schroeder
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne
- Department of Anaesthesiology and Intensive Care, German Armed Forces Central Hospital of Koblenz, Koblenz, Germany
| | - Simon-Richard Finke
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne
| | - Tobias Grübl
- Department of Anaesthesiology and Intensive Care, German Armed Forces Central Hospital of Koblenz, Koblenz, Germany
| | - Christoph W Jänig
- Department of Anaesthesiology and Intensive Care, German Armed Forces Central Hospital of Koblenz, Koblenz, Germany
| | - Bernd W Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne
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Allan KS, Mammarella B, Visanji M, Moglica E, Sadeghlo N, O'Neil E, Chan TT, Kishibe T, Aves T. Methods to teach schoolchildren how to perform and retain cardiopulmonary resuscitation (CPR) skills: A systematic review and meta-analysis. Resusc Plus 2023; 15:100439. [PMID: 37638097 PMCID: PMC10448218 DOI: 10.1016/j.resplu.2023.100439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/11/2023] [Accepted: 07/23/2023] [Indexed: 08/29/2023] Open
Abstract
Background Worldwide, bystander CPR rates are low; one effective way to increase these rates is to train schoolchildren; however, the most effective way to train them is currently unknown. Methods This systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies, evaluated whether CPR training for schoolchildren, using innovative teaching modalities (nonpractical, self, or peer-training) versus standard instructor-led training, resulted in higher quality CPR, self-confidence and short-term (≤3 months post-training) or long-term (>3 months post-training) retention of CPR skills. Results From 9793 citations, 96 studies published between 1975 and 2022 (44 RCTs and 52 before/after studies) were included. There were 43,754 students, average age of 11.5 ± 0.9 (range 5.9-17.6) and 49.2% male. Only 13 RCTs compared practical vs. nonpractical training (n = 5), self- vs. instructor-led training (n = 7) or peer- vs. instructor-led training (n = 5). The observed statistically significant differences in mean depth and rate of compressions between children with hands-on practical training and those without were not clinically relevant. Regardless of training modality, compression depth was consistently suboptimal. No differences were observed in CPR skills immediately or ≤ 3 months post-training, between children who were self- or peer-trained vs. instructor-led. Due to lack of data, we were unable to evaluate the impact of these novel training modalities on student self-confidence. Conclusion Although innovative training modalities are equally effective to instructor-led training when teaching schoolchildren CPR, compression depth was frequently suboptimal. Recommendations on standardized training and evaluation methods are necessary to understand the best ways to train children.
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Affiliation(s)
- Katherine S. Allan
- Division of Cardiology, Unity Health Toronto - St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Bianca Mammarella
- School of Interdisciplinary Science, McMaster University, Hamilton, Ontario, Canada
- Department of Biology, McMaster University, Hamilton, Ontario, Canada
| | - Mika'il Visanji
- Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada
| | - Erinda Moglica
- Department of Chemical Engineering, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Negin Sadeghlo
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Emma O'Neil
- Division of Emergency Medicine, Unity Health Toronto - St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Tiffany T. Chan
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Teruko Kishibe
- Library Services, Unity Health Toronto, Toronto, Ontario, Canada
| | - Theresa Aves
- Division of Cardiology, Unity Health Toronto - St. Michael’s Hospital, Toronto, Ontario, Canada
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Schroeder DC, Semeraro F, Greif R, Bray J, Morley P, Parr M, Kondo Nakagawa N, Iwami T, Finke SR, Malta Hansen C, Lockey A, Del Rios M, Bhanji F, Sasson C, Schexnayder SM, Scquizzato T, Wetsch WA, Böttiger BW. Temporarily Removed. Resuscitation 2023:109772. [PMID: 37190748 DOI: 10.1016/j.resuscitation.2023.109772] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
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.
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Shaukat N, Ali DM, Jaffer M, Jarrar Z, Ashraf N, Hassan S, Daudpota AA, Qadir MA, Khowaja AH, Razzak J. Lifesaving skills training in schools - A qualitative study to explore students, teachers, and parent's perceived opportunities and challenges. BMC Public Health 2023; 23:400. [PMID: 36849931 PMCID: PMC9970688 DOI: 10.1186/s12889-023-15284-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 02/15/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE The objective of this study is to explore the perception of teachers, parents and students' regarding implementation of a school-based lifesaving skills program and help predict potential barriers and solutions. METHODS This qualitative exploratory study was conducted in Karachi, Pakistan, from December 2020- to October 2021. We included students, teachers, and parents of secondary (grades VIII, IX, and X) and higher secondary level students (grades XI and XII) in Karachi, Pakistan's public and private schools and colleges. We selected one public, two semi-private, and two private schools. We recruited students, teachers, and parents through convenience sampling. We conducted fifteen focus group discussions (FGDs) with the students, six FGDs with the teachers, and eighteen in-depth interviews (IDIs) with parents. We transcribed the data from audio recordings and translated it into the English language. Finally, we manually analyzed the data using thematic analyses. RESULTS This study found that bystanders' main barriers to performing lifesaving skills are lack of knowledge, fear of legal involvement, fear of hurting the patient by incorrect technique, lack of empathy among community stakeholders, and gender bias. However, the participants had a positive and supportive attitude toward implementing lifesaving skills training in schools. They suggested starting student training in the early teenage years, preferred medical staff as trainers, and suggested frequent small sessions in English/Urdu both or Urdu language and training via theory and practical hands-on drills. Furthermore, the training was proposed to be integrated into the school curriculum to make it sustainable. Finally, the government needs to support the program and make the legal environment more conducive for bystanders. CONCLUSION This study identified the significant barriers to performing lifesaving skills in an emergency in a low- and middle-income country (LMIC). The participants supported implementing a national lifesaving skills program in schools and colleges. However, the participants expressed that support is needed by the government for sustainability, integrating lifesaving skills into the school curriculum, providing legal support to the bystanders, and creating awareness among the general public.
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Affiliation(s)
- Natasha Shaukat
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan.
| | - Daniyal Mansoor Ali
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan
| | - Mehtab Jaffer
- School of Nursing & Midwifery, Aga Khan University, Karachi, Pakistan
| | - Zeerak Jarrar
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan
| | - Naela Ashraf
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan
| | - Sheza Hassan
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan
| | | | | | | | - Junaid Razzak
- Centre of Excellence for Trauma and Emergencies, Aga Khan University, Stadium Road, P.O. Box-3500, Karachi, 74800, Pakistan.,Department of Emergency Medicine, Weill Cornell Medicine, New York, USA
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Tse E, Plakitsi K, Voulgaris S, Alexiou GA. The Role of a First Aid Training Program for Young Children: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:431. [PMID: 36979990 PMCID: PMC10047314 DOI: 10.3390/children10030431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/26/2023] [Accepted: 02/22/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Many first aid programs have been conducted in schools, and researchers have identified that interventions improved students' knowledge, skills, and attitude. This study examines the content, practices, and assessment of first aid interventions at primary schools and evaluates their effectiveness. METHODS A systematic review was undertaken. We searched MEDLINE and Cochrane library databases from January 1990 to December 2021 using the search terms: ''first aid'' AND ''primary school children''. School-based first aid training targeting 6 to 10 years old studies in English were eligible for inclusion. RESULTS We included 11 studies that were approached by experimental (n = 6) and by observational studies (n = 5). Researchers conducted interventions in Europe (n = 9) and America (n = 2). An essential part of the teaching was hands-on practice. Most studies included in their program cardiopulmonary resuscitation (n = 8) and basic life support (n = 7). The main findings showed that trained children have significantly better knowledge of and skills in first aid than those before or without training. Children under 11 years old were not strong enough to achieve the proper depth of chest compressions. Depth of chest compressions correlates with children's age, weight, height (n = 2), and body mass index (n = 3). Conclusions The effectiveness of resuscitative or non-resuscitative first-aid training for primary school children improved students' knowledge and skills. Subsequent research could investigate children's reactions in actual first aid conditions.
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Affiliation(s)
- Eleana Tse
- Department of Neurosurgery, School of Medicine, University of Ioannina, 45500 Ioannina, Greece
| | - Katerina Plakitsi
- Department of Early Childhood Education, School of Education, University of Ioannina, 45500 Ioannina, Greece
| | - Spyridon Voulgaris
- Department of Neurosurgery, School of Medicine, University of Ioannina, 45500 Ioannina, Greece
| | - George A. Alexiou
- Department of Neurosurgery, School of Medicine, University of Ioannina, 45500 Ioannina, Greece
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Compression-Only Cardiopulmonary Resuscitation and Automated External Defibrillator Course for Primary School Students: A Malaysian Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010058. [PMID: 36670609 PMCID: PMC9856577 DOI: 10.3390/children10010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/01/2022] [Accepted: 11/24/2022] [Indexed: 12/29/2022]
Abstract
The Malaysian national school curriculum currently lacks resources and tools to enforce CPR education. The aim of this study was to investigate the efficacy of a compression-only cardiopulmonary resuscitation and automated external defibrillator course among primary school students to increase their knowledge and technical skills and improve their attitudes. A quasi-experimental study was conducted using a pre−post non-equivalent design involving 38 students aged 10−12. Cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) knowledge, technical skills, and attitude towards CPR were assessed in a post test with three-month follow-up. Results of the MANOVA analysis showed significant differences in the level of knowledge (F = 10.29, p < 0.001) and attitude (F = 13.87, p < 0.001) based on the students’ age group at the time of the post test. The proportion of students who passed the technical skills component differed significantly by age (χ2 = 12.12; p = 0.002) and BMI (χ2 = 6.34; p = 0.041). No significant decay was reported in the total mean scores for knowledge, technical skills, and attitude (F = 0.727, p = 0.54) at 3-month follow-up. The course helped students perform CPR and utilize AED effectively while promoting a positive attitude with up to 3 months of retention, demonstrating the feasibility of extending the course within the Malaysian primary school curriculum.
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Tse E, Plakitsi K, Voulgaris S, Alexiou GA. Teaching Cardiopulmonary Resuscitation and Defibrillation in Children. Pediatr Emerg Care 2022; 38:e1577. [PMID: 35947075 DOI: 10.1097/pec.0000000000002815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Martínez-Isasi S, García-Suárez M, De La Peña Rodríguez MA, Gómez-Salgado J, Fernández N, Méndez-Martínez C, Leon-Castelao E, Clemente-Vivancos A, Fernández-García D. Basic life support training programme in schools by school nurses: How long and how often to train? Medicine (Baltimore) 2021; 100:e24819. [PMID: 33787576 PMCID: PMC8021366 DOI: 10.1097/md.0000000000024819] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 01/28/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Cardiopulmonary resuscitation (CPR) training in schools, despite being legislated in Spain, is not established as such within the subjects that children are taught in schools. OBJECTIVE to evaluate the acquisition of CPR skills by 11-year-old children after a brief theoretical-practical teaching programme taught by nurses at school. METHODS 62 students were assessed in a quasi-experimental study on 2 cohorts (51.4% of the sample in control group [CG]). In total, 2 sessions were given, a theoretical one, and a practical training for skill development in children, in which the CG performed the CPR in 2-minute cycles and the intervention group in 1-minute cycles. The anthropometric variables recorded were weight and height, and the variables compression quality and ventilation quality were recorded using the Laerdal ResusciAnne manikin with Personal Computer/Wireless SkillReport. RESULTS The assessment showed better results, in terms of BLS sequence performance and use of automated external defibrillator, in the CG and after training, except for the evaluation of the 10-second breathing assessment technique. The quality of chest compressions was better in the CG after training, as was the quality of the ventilations. There were no major differences in CPR quality after training and 4 months after the 1-minute and 2-minute training cycles. CONCLUSIONS 11-year-old children do not perform quality chest compressions or ventilations but, considering their age, they are able to perform a BLS sequence correctly.
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Affiliation(s)
- Santiago Martínez-Isasi
- Life Support and Medical Simulation Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; CLINURSID Research Group. Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela
| | - Mario García-Suárez
- Servicio de Anestesia y Reanimación, Complejo Asistencial Universitario de León (CAULE), Gerencia Regional de Salud de Castilla y León (SACYL), Leon
| | | | - Juan Gómez-Salgado
- Department of Sociology, Faculty of Labour Sciences, Social Work and Public Health, University of Huelva, Huelva
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Nélida Fernández
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon
| | - Carlos Méndez-Martínez
- Servicio de Anestesia y Reanimación, Complejo Asistencial Universitario de León (CAULE), Gerencia Regional de Salud de Castilla y León (SACYL), Leon
| | - Esther Leon-Castelao
- Clinical Simulation Lab, School of Medicine and Healthcare Sciences, University of Barcelona
| | - Alvaro Clemente-Vivancos
- Clinical Simulation Lab, School of Medicine and Healthcare Sciences, University of Barcelona
- Escola Superior de Enfermeria Mar (ESIMar), Universitat Pompeu Fabra, Barcelona
| | - Daniel Fernández-García
- Unidad de Radiología Vascular Intervencionista, Complejo Asistencial Universitario de León (CAULE), Gerencia Regional de Salud de Castilla y León (SACYL), Leon, Spain
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Chamdawala H, Meltzer JA, Shankar V, Elachi D, Jarzynka SM, Nixon AF. Cardiopulmonary resuscitation skill training and retention in teens (CPR START): A randomized control trial in high school students. Resusc Plus 2021; 5:100079. [PMID: 34223345 PMCID: PMC8244398 DOI: 10.1016/j.resplu.2021.100079] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 11/21/2022] Open
Abstract
Aim High school students are currently the largest group of individuals in the US receiving CPR training every year. This study examines the effect of adding a real-time visual feedback device to a standard instructor-led CPR course on skill acquisition and retention in high school students. Methods All study participants underwent baseline CPR skill testing and received a standard instructor-led compression-only CPR course. We then randomized students to a ‘Feedback Group’, consisting of 2 min of CPR training using a real-time visual feedback device, or ‘Standard Group’ that continued to practice on the inflatable manikin. CPR skills for all students were tested afterwards using the feedback device and reported as a compression score (CS) derived from their chest compression depth, rate, hand position, and full chest recoil. We compared the CS at baseline, week-0 (immediately post-intervention), week-10, week-28, and week-52 between groups. Results A total of 220 students were included in the analyses (Feedback Group = 110, Standard Group = 110). Both groups showed similar CPR performance at baseline. At week-0, the Feedback Group had a significantly higher CS compared to the Standard Group (adjusted difference: 20% [95% CI: 11%–29%; p < 0.001]). This difference attenuated over time but remained significant at the week-10 and week-28 follow-up; however, by the week-52 follow-up, there was no significant difference between groups. Conclusions Using a real-time visual feedback device during CPR training significantly improves skill acquisition and retention in high school students and should be integrated into the high school CPR curriculum.
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Affiliation(s)
- Haamid Chamdawala
- Department of Pediatrics, Division of Emergency Medicine, NYC Health + Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, Building 6, Room 1B25, Bronx, NY 10461, USA
- Corresponding author at: Department of Pediatrics, NYC Health + Hospitals/Jacobi Medical Center, 1400 Pelham Parkway South, Building 6, Room 1B25, Bronx, NY 10461, USA.
| | - James A. Meltzer
- Department of Pediatrics, Division of Emergency Medicine, NYC Health + Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, Building 6, Room 1B25, Bronx, NY 10461, USA
| | - Viswanathan Shankar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Block Building, Room 315, Bronx, NY 10461, USA
| | - Dina Elachi
- Department of Pediatrics, Division of Emergency Medicine, NYC Health + Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, Building 6, Room 1B25, Bronx, NY 10461, USA
| | - Shannon M. Jarzynka
- Department of Pediatrics, Division of Emergency Medicine, NYC Health + Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, Building 6, Room 1B25, Bronx, NY 10461, USA
| | - Abigail F. Nixon
- Department of Pediatrics, Division of Emergency Medicine, NYC Health + Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, Building 6, Room 1B25, Bronx, NY 10461, USA
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De Smedt L, Depuydt C, Vekeman E, De Paepe P, Monsieurs KG, Valcke M, Mpotos N. Awareness and willingness to perform CPR: a survey amongst Flemish schoolchildren, teachers and principals. Acta Clin Belg 2019; 74:297-316. [PMID: 29874976 DOI: 10.1080/17843286.2018.1482087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Training children in cardiopulmonary resuscitation (CPR) is one of the strategies to increase bystander CPR in society. Reinforcing knowledge and awareness and increasing willingness to perform bystander CPR contributes to a better outcome after cardiac arrest. We questioned schoolchildren, teachers and principals about their awareness of the importance of CPR and about their willingness to perform CPR. METHODS During a four-month period, Flemish schoolchildren aged 10-18 years, teachers and principals were invited to complete a survey consisting of three parts: (1) demographics, (2) CPR (training) experience and (3) attitude towards CPR teaching and training. RESULT In total, 390 schoolchildren, 439 teachers and 100 principals completed the survey. Previous CPR training was reported by 33% of the schoolchildren (in 82% as part of the curriculum) and by 81% teachers and 82% principals. Willingness to participate in CPR training was 77% in schoolchildren, 79% in teachers and 86% in principals with 88% of the principals convinced that schoolchildren should learn how to perform CPR. Willingness to perform CPR in a real-life situation was 68% in schoolchildren, 84% in teachers and 92% in principals. CONCLUSION Schoolchildren are well aware of the importance of CPR and are willing to acquire the related knowledge and skills. Noteworthy is the larger awareness among principals and teachers, establishing a strong base for increasing implementation of CPR training in schools. However, a majority of children indicated a lack of training opportunities, highlighting the need for a stronger implementation.
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Affiliation(s)
- Lieven De Smedt
- Faculty of Medicine and Health Sciences, Ghent University , Ghent, Belgium
| | | | - Eva Vekeman
- Department of Educational Studies, Ghent University , Ghent, Belgium
| | - Peter De Paepe
- Faculty of Medicine and Health Sciences, Ghent University , Ghent, Belgium
- Emergency Department, Antwerp University Hospital , Edegem, Belgium
| | - Koenraad G. Monsieurs
- Faculty of Medicine and Health Sciences, Ghent University , Ghent, Belgium
- Emergency Department, Antwerp University Hospital , Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp , Wilrijk, Belgium
| | - Martin Valcke
- Department of Educational Studies, Ghent University , Ghent, Belgium
| | - Nicolas Mpotos
- Faculty of Medicine and Health Sciences, Ghent University , Ghent, Belgium
- Emergency Department, St. Lucas General Hospital , Ghent, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp , Wilrijk, Belgium
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Li H, Shen X, Xu X, Wang Y, Chu L, Zhao J, Wang Y, Wang H, Xie G, Cheng B, Ye H, Sun Y, Fang X. Bystander cardiopulmonary resuscitation training in primary and secondary school children in China and the impact of neighborhood socioeconomic status: A prospective controlled trial. Medicine (Baltimore) 2018; 97:e12673. [PMID: 30290654 PMCID: PMC6200495 DOI: 10.1097/md.0000000000012673] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) has endorsed school bystander cardiopulmonary resuscitation (CPR) training programs. But related researches in China are limited. Therefore, we conducted this study to assess bystander CPR training in school children in China and the impact of neighborhood socio-economic status (SES) on. METHODS A total of 1,093 students from seven schools in Zhejiang province participated in this study. Theoretical and practical bystander CPR training were conducted in instructor-led classes. Students completed a 10-statement questionnaire before and after training, and then underwent a skills assessment during a simulated basic life support (BLS) scenario. Subgroup analyses were stratified according to neighborhood SES. RESULTS Before training, most students (72.83%) had a strong desire to learn bystander CPR and share with others. After training, bystander CPR theory was significantly improved (P < .01), and 92.64% students reached an 85-100% performance rate in a simulated BLS scenario. Students from low-SES neighborhoods had less pre-training knowledge of bystander CPR (P < .01). However, their performance was similar with students from higher-SES neighborhoods on the post-training questionnaire and the skills assessment, and better among students aged 13-14 years. CONCLUSION School children in China have a poor pre-training knowledge of bystander CPR. However, with training, there was a significant improvement in the basic theory and skills of CPR. Bystander CPR training efforts should be targeted to Chinese primary and secondary school children, especially in low-SES neighborhoods.
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Affiliation(s)
- Hui Li
- Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou
| | - Xu Shen
- Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou
- Department of Anesthesiology, Jiaxing First Hospital of Zhejiang Province, Jiaxing
| | - Xia Xu
- Department of Anesthesiology, Lihuili Hospital, Ningbo Medical center, Ningbo
| | - Yan Wang
- Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou
| | - Lihua Chu
- Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou
| | - Jialian Zhao
- Department of Anesthesiology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang
| | - Ya Wang
- Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou
| | - Haihong Wang
- Department of Anesthesiology, Sir Run Run Shaw Hospital Affiliated to Medical College of Zhejiang University, Hangzhou, China
| | - Guohao Xie
- Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou
| | - Baoli Cheng
- Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou
| | - Hui Ye
- Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou
| | - Yaqi Sun
- Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou
| | - Xiangming Fang
- Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou
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Wilks J, Kanasa H, Pendergast D, Clark K. Emergency response readiness for primary school children. AUST HEALTH REV 2018; 40:357-363. [PMID: 26363643 DOI: 10.1071/ah15072] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 07/30/2015] [Indexed: 11/23/2022]
Abstract
Objective The aim of the present study was to determine whether a 1-day basic life support (BLS) training program can significantly increase emergency response readiness for primary school children. Methods One hundred and seven children aged 11-12 years completed a program led by surf lifesaving instructors. A 50-item quiz was administered 1 week before and 1 and 8 weeks after training. Results Significant improvements were gained in knowledge of cardiopulmonary resuscitation (CPR; P<0.001), the response sequence for emergency situations (DRSABCD action plan) and various emergency scenarios, including choking (P<0.001) and severe bleeding (P<0.001). Knowledge and understanding were retained at the 8-week follow-up. Students reported increased confidence in assisting others after training, consistent with previous studies. Conclusions A 1-day training program can significantly increase BLS knowledge and confidence to provide assistance in an emergency situation. Findings reinforce the value of school-based training that provides a general foundation for emergency response readiness. What is known about this topic? The importance and value of teaching BLS to school children is well established in the US, UK and Europe. However, in the past 20 years there has been little or no published Australian evaluation research in this area, despite thousands of training programs running each year around the country for children in first aid, CPR and water safety. What does this paper add? This paper confirms that Australian primary school children can benefit significantly from short, targeted BLS training programs that provide the basic skills and confidence for them to respond in an emergency situation. What are the implications for practitioners? The paper provides a training and evaluation framework that can be used by health educators for age-appropriate BLS programs. The study shows that making training real-world and relevant, especially having hands-on CPR practice with manikins, can address common barriers to performing first aid and CPR reported by young people.
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Affiliation(s)
- Jeff Wilks
- Socio-Legal Research Centre, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Qld 4222, Australia
| | - Harry Kanasa
- School of Education and Professional Studies, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Qld 4222, Australia.
| | - Donna Pendergast
- School of Education and Professional Studies, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Qld 4222, Australia.
| | - Ken Clark
- Australian Lifesaving Academy Queensland, Surf Life Saving Queensland, 18 Manning Street, South Brisbane, Qld 4101, Australia. Email
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Ma A, Wong K, Tou A, Vyas L, Wilks J. CPR Knowledge and Attitudes among High School Students Aged 15-16 in Hong Kong. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791502200101] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Sudden cardiac arrest is a serious public health problem in Hong Kong, with up to 85% of victims not surviving to hospital admission. International research findings show that teaching cardiopulmonary resuscitation (CPR) to lay bystanders can significantly improve out-of-hospital survival rates. A particular target group for CPR training and education is high school students. Since the commonest site of sudden cardiac deaths in Hong Kong occur at home, school-age adolescents are likely to be the only available bystanders in many emergent situations. Design Questionnaire survey. Methods This study investigated CPR knowledge and attitudes of 383 students aged 15-16 years across 18 schools in Hong Kong to understand barriers and facilitators for CPR delivery. A questionnaire pilot tested and validated by a panel of health professionals was distributed to students, using a convenience sampling methodology. Results Most students (87%) had not received CPR training, with common reasons for not attending being lack of time, lack of interest and not sure where to attend a course. Results of Mann Whitney U tests indicated that students who had received training scored significantly (p<0.05) higher on factual knowledge and also attitudes toward CPR training than those without training. There were no gender differences. Most students reported that they would attempt to perform CPR in a cardiac arrest situation, even if they had not received training, because they believed that CPR could increase the survival rate and it was morally the right thing to do. Conclusions Teaching CPR to Hong Kong school students is an effective way to develop the next generation of emergency first responders. (Hong Kong j.emerg.med. 2015;22:3-13)
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Affiliation(s)
- Awwma Ma
- Hong Kong Institute of Education, Department of Health and Physical Education, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong
| | - Kl Wong
- ELCHK Kin Ming Nursery School, G/F, Wing B & C, Ming Sing House, Kin Ming Estate, Tseung Kwan O, New Territories, Hong Kong
| | - Ayl Tou
- Vocational Training Council, Youth College (Kwai Chung), 13-19 San Kwai Street, Kwai Chung, New Territories, Hong Kong
| | - L Vyas
- Hong Kong Institute of Education, Department of Health and Physical Education, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong
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Dîrzu DS, Hagău N, Boț T, Fărcaș L, Copotoiu SM. Training in cardiopulmonary resuscitation provided by medical students, residents and specialists: A non-inferiority trial. HONG KONG J EMERG ME 2017. [DOI: 10.1177/1024907917742877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: No definitive answer has been given to the question ‘who should teach cardiopulmonary resuscitation?’ Healthcare professionals and high school teachers are mostly the trainers, but medical students are increasingly being used for this purpose. Methods: We divided 296 high school students in three groups based on trainer professional level. Medical students, anaesthesia and intensive care residents, and anaesthesia and intensive care specialists provided basic life support training. We tested their theoretical knowledge with the help of a multiple-choice question questionnaire and practical abilities with the help of a medical simulator, recording chest compression frequency as the primary outcome parameter. Results: The study shows comparable results in all groups, with the exception of the chest compression frequency which was higher in the students’ and residents’ groups (students: 134.7/min ± 14.1; residents: 137.9/min ± 15.9; specialists: 126.3/min ± 19.3). Increased rates were not associated with lower depths (39.0 mm ± 8.2, 40.5 mm ± 9.7, and 38.1 mm ± 8.2), so the quality of compressions provided may be seen as equivalent in all the study groups. Conclusion: Our data suggest that medical students may be as effective as anaesthesia and intensive care specialists and residents in cardiopulmonary resuscitation training.
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Affiliation(s)
- Dan Sebastian Dîrzu
- Department of Anesthesia and Intensive Care, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Anesthesia and Intensive Care, University of Medicine and Pharmacy Târgu Mureș, Mureș, Romania
| | - Natalia Hagău
- Department of Anesthesia and Intensive Care, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Theodor Boț
- Department of Anesthesia and Intensive Care, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Loredana Fărcaș
- Department of Anesthesia and Intensive Care, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sanda Maria Copotoiu
- Department of Anesthesia and Intensive Care, University of Medicine and Pharmacy Târgu Mureș, Mureș, Romania
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Mpotos N, Iserbyt P. Children saving lives: Training towards CPR excellence levels in chest compression based on age and physical characteristics. Resuscitation 2017; 121:135-140. [PMID: 29107674 DOI: 10.1016/j.resuscitation.2017.10.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 10/12/2017] [Accepted: 10/28/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND The World Health Organization's endorsement of the "Kids save lives" statement fosters the implementation of cardiopulmonary resuscitation (CPR) training for school children worldwide. However, not every child achieves and maintains the recommended chest compression depth of 5-6cm. PURPOSE To investigate the variability in compression depth for three age groups (grade 1: 12-14; grade 2: 14-16; grade 3: 16-18 years) as a function of physical characteristics and to define minimal compression excellence levels for training. METHODS Compression depth of 265 subjects (111 girls, 154 boys) aged 12-18 years from one secondary school was individually assessed and reported in percentiles per age group. Pearson correlations between physical characteristics and CPR variables were calculated. Excellence level was defined as the percentage compressions with depth 5-6cm. RESULTS In grade 1 (12-14 years), achieved excellence levels were 1% for girls and 23% for boys at the 75th percentile. In grade 2 (14-16 years), it increased to 24% for girls and 80% for boys. In grade 3 (16-18 years) finally, it was 59% for girls and 87% for boys. Significant positive correlations were found between CPR and physical variables (p<0.05), especially weight >50kg (p<0.01). CONCLUSION A minimal excellence level of 25% is achievable by boys 12-14year and girls 14-16year and can be gradually improved to 60% and 90% according to age and gender. This might necessitate more exertion and training for some younger children, especially girls, and will probably be more easily achieved for children weighing >50kg.
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Affiliation(s)
- Nicolas Mpotos
- Emergency Department, St. Lucas General Hospital, Groenebriel 1, B-9000 Ghent, Belgium; Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk, Belgium.
| | - Peter Iserbyt
- Physical Activity, Sports & Health Research Group, KU Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
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Müller AS, Comploi M, Hötzel J, Lintner L, Rammlmair G, Weiß C, Kreimeier U. Praktische Fertigkeiten von Schulkindern nach videogestütztem Reanimationstraining. Notf Rett Med 2016. [DOI: 10.1007/s10049-016-0174-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kitamura T, Nishiyama C, Murakami Y, Yonezawa T, Nakai S, Hamanishi M, Marukawa S, Sakamoto T, Iwami T. Compression-only CPR training in elementary schools and student attitude toward CPR. Pediatr Int 2016; 58:698-704. [PMID: 26663150 DOI: 10.1111/ped.12881] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 11/24/2015] [Accepted: 12/07/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Little is known about the effectiveness of systematic cardiopulmonary resuscitation (CPR) training for elementary school children. METHODS We introduced systematic training of chest compression-only CPR and automated external defibrillator (AED) use to elementary school students aged 10-12 years at 17 schools. The questionnaire compared student attitudes towards CPR and their knowledge about it before and after CPR training. We also evaluated parent and teacher views about CPR training in school education. The primary outcome was positive attitude, defined as "yes" and "maybe yes" on a 5 point Likert-type scale of student attitudes towards CPR.1 RESULTS: A total of 2047 elementary school students received CPR training. Of them, 1899 (92.8%) responded to the questionnaire regarding their attitude towards CPR before and after the training. Before training, 50.2% answered "yes" and 30.3% answered "maybe yes", to the question: "If someone suddenly collapses in front of you, can you do something such as check response or call emergency?" After training, their answers changed to 75.6% and 18.3% for "yes" and "maybe yes", respectively. Many of the students (72.3%, 271/370) who did not have a positive attitude before CPR training had a positive attitude after the training (P < 0.001). Most students understood how to perform CPR (97.7%) and use an AED (98.5%). Parents (96.2%, 1173/1220) and teachers (98.3%, 56/57) answered that it was "good" and "maybe good" for children to receive the training at elementary schools. CONCLUSION Systematic chest compression-only CPR training helped elementary school students to improve their attitude towards CPR.
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Affiliation(s)
- Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Chika Nishiyama
- Department of Critical Care Nursing, Kyoto University Graduate School of Human Health Science, Kyoto, Japan
| | | | | | | | | | | | - Tetsuya Sakamoto
- Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Taku Iwami
- Kyoto University Health Service, Kyoto, Japan
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Fonseca del Pozo FJ, Valle Alonso J, Canales Velis NB, Andrade Barahona MM, Siggers A, Lopera E. Basic life support knowledge of secondary school students in cardiopulmonary resuscitation training using a song. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2016; 7:237-241. [PMID: 27442599 PMCID: PMC4958348 DOI: 10.5116/ijme.5780.a207] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 07/09/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To examine the effectiveness of a "cardiopulmonary resuscitation song" in improving the basic life support skills of secondary school students. METHODS This pre-test/post-test control design study enrolled secondary school students from two middle schools randomly chosen in Córdoba, Andalucia, Spain. The study included 608 teenagers. A random sample of 87 students in the intervention group and 35 in the control group, aged 12-14 years were selected. The intervention included a cardiopulmonary resuscitation song and video. A questionnaire was conducted at three-time points: pre-intervention, one month and eight months post-intervention. RESULTS On global knowledge of cardiopulmonary resuscitation, there were no significant differences between the intervention group and the control group in the trial pre-intervention and at the month post-intervention. However, at 8 months there were significant differences with a p-value = 0.000 (intervention group, 95% CI: 6.39 to 7.13 vs. control group, 95% CI: 4.75 to 5.92), F(1,120)=16.644, p=0.000). In addition, significant differences about students' basic life support knowledge about chest compressions at eight months post-intervention (F(1,120)=15.561, p=0.000) were found. CONCLUSIONS Our study showed that incorporating the song component in the cardiopulmonary resuscitation teaching increased its effectiveness and the ability to remember the cardiopulmonary resuscitation algorithm. Our study highlights the need for different methods in the cardiopulmonary resuscitation teaching to facilitate knowledge retention and increase the number of positive outcomes after sudden cardiac arrest.
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Affiliation(s)
| | - Joaquin Valle Alonso
- Department of Emergency Medicine, Royal Bournemouth and Christchurch NHS Foundation Trust, UK
| | | | | | - Aidan Siggers
- Department of Emergency Medicine, Royal Bournemouth and Christchurch NHS Foundation Trust, UK
| | - Elisa Lopera
- Department of Emergency Medicine, Hospital Comarcal Valle de Los Pedroches. Pozoblanco (Córdoba), Spain
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Cardiopulmonary Resuscitation Training in Schools: A Comparison of Trainee Satisfaction among Different Age Groups. Keio J Med 2016; 65:49-56. [PMID: 27319976 DOI: 10.2302/kjm.2015-0009-oa] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cardiopulmonary resuscitation (CPR) has recently been added to the school curriculum worldwide and is currently taught to students between the ages of 10 and 16 years. The effect of the age of trainees on their satisfaction with CPR training has yet been elucidated. The aim of this study was to compare the satisfaction of trainees of different ages who participated in CPR training in schools in Japan. In total, 392 primary school students (10-11 years old), 1798 junior high school students (12-13 years old), and 4162 high schools students (15-16 years old) underwent the same 3-h course of CPR training, according to the guidelines of 2000 for Emergency Cardiovascular Care and CPR. The course was evaluated by a questionnaire completed by the participants. Primary school students responded most positively to all questions, including those reflecting enjoyment and the confidence of participants to apply CPR (Jonckheere-Terpstra test: P < 0.01). Exploratory factor analysis defined three latent variables (reaction, concentration, and naïveté) based on the seven variables addressed in the questionnaire. In the causal relationships analyzed by structural equation modeling (SEM), naïveté (which is related to age) directly affected the other latent variables. The current model suggested that the students' satisfaction with CPR training was strongly related to their age. Primary school students enjoyed CPR training more and were more confident in their ability to perform CPR than junior high and high school students were. Therefore, children aged 10-11 years may be the most appropriate candidates for the introduction of CPR training in schools.
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Disparities in Survival with Bystander CPR following Cardiopulmonary Arrest Based on Neighborhood Characteristics. Emerg Med Int 2016; 2016:6983750. [PMID: 27379186 PMCID: PMC4917693 DOI: 10.1155/2016/6983750] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 04/05/2016] [Indexed: 11/17/2022] Open
Abstract
The American Heart Association reports the annual incidence of out-of-hospital cardiopulmonary arrests (OHCA) is greater than 300,000 with a survival rate of 9.5%. Bystander cardiopulmonary resuscitation (CPR) saves one life for every 30, with a 10% decrease in survival associated with every minute of delay in CPR initiation. Bystander CPR and training vary widely by region. We conducted a retrospective study of 320 persons who suffered OHCA in South Florida over 25 months. Increased survival, overall and with bystander CPR, was seen with increasing income (p = 0.05), with a stronger disparity between low- and high-income neighborhoods (p = 0.01 and p = 0.03, resp.). Survival with bystander CPR was statistically greater in white- versus black-predominant neighborhoods (p = 0.04). Increased survival, overall and with bystander CPR, was seen with high- versus low-education neighborhoods (p = 0.03). Neighborhoods with more high school age persons displayed the lowest survival. We discovered a significant disparity in OHCA survival within neighborhoods of low-income, black-predominance, and low-education. Reduced survival was seen in neighborhoods with larger populations of high school students. This group is a potential target for training, and instruction can conceivably change survival outcomes in these neighborhoods, closing the gap, thus improving survival for all.
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Hart D, Flores-Medrano O, Brooks S, Buick JE, Morrison LJ. Cardiopulmonary resuscitation and automatic external defibrillator training in schools: "is anyone learning how to save a life?". CAN J EMERG MED 2015; 15:270-8. [PMID: 23972132 DOI: 10.2310/8000.2013.130898] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Bystander resuscitation efforts, such as cardiopulmonary resuscitation (CPR) and use of an automatic external defibrillator (AED), save lives in cardiac arrest cases. School training in CPR and AED use may increase the currently low community rates of bystander resuscitation. The study objective was to determine the rates of CPR and AED training in Toronto secondary schools and to identify barriers to training and training techniques. METHODS This prospective study consisted of telephone interviews conducted with key school staff knowledgeable about CPR and AED teaching. An encrypted Web-based tool with prespecified variables and built-in logic was employed to standardize data collection. RESULTS Of 268 schools contacted, 93% were available for interview and 83% consented to participate. Students and staff were trained in CPR in 51% and 80% of schools, respectively. Private schools had the lowest training rate (39%). Six percent of schools provided AED training to students and 47% provided AED training to staff. Forty-eight percent of schools had at least one AED installed, but 25% were unaware if their AED was registered with emergency services dispatch. Cost (17%), perceived need (11%), and school population size (10%) were common barriers to student training. Frequently employed training techniques were interactive (32%), didactic instruction (30%) and printed material (16%). CONCLUSIONS CPR training rates for staff and students were moderate overall and lowest in private schools, whereas training rates in AED use were poor in all schools. Identified barriers to training include cost and student population size (perceived to be too small to be cost-effective or too large to be implemented). Future studies should assess the application of convenient and cost-effective teaching alternatives not presently in use.
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Choi SS, Yun SW, Lee BK, Jeung KW, Song KH, Lee CH, Park JS, Jeong JY, Shin SY. Effectiveness and feasibility of assistant push on improvement of chest compression quality: a crossover study. Am J Emerg Med 2015; 33:373-7. [PMID: 25636519 DOI: 10.1016/j.ajem.2014.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/03/2014] [Accepted: 12/09/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To improve the quality of chest compression (CC), we developed the assistant-push method, whereby the second rescuer pushes the back of the chest compressor during CC. We investigated the effectiveness and feasibility of assistant push in achieving and maintaining the CC quality. METHODS This was a randomized crossover trial in which 41 subjects randomly performed both of standard CC (single-rescuer group) and CC with instructor-driven assistant push (assistant-push group) in different order. Each session of CC was performed for 2 minutes using a manikin. Subjects were also assigned to both roles of chest compressor and assistant and together performed CC with subject-driven assistant push. Depth of CC, compression to recoil ratio, duty cycle, and rate of incomplete recoil were quantified. RESULTS The mean depth of CC (57.0 [56.0-59.0] vs 55.0 [49.5-57.5], P < .001) was significantly deeper, and the compression force (33.8 [29.3-36.4] vs 23.3 [20.4-25.3], P < .001) was stronger in the assistant-push group. The ratio of compression to recoil, duty cycle, and rate of incomplete chest recoil were comparable between the 2 groups. The CC depth in the single-rescuer group decreased significantly every 30 seconds, whereas in the assistant-push group, it was comparable at 60- and 90-second time points (P = .004). The subject assistant-push group performed CCs at a depth comparable with that of the instructor assistant-push group. CONCLUSION The assistant-push method improved the depth of CC and attenuated its decline, eventually helping maintain adequate CC depth over time. Subjects were able to feasibly learn assistant push and performed effectively.
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Affiliation(s)
- Sung Soo Choi
- Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea
| | - Seong-Woo Yun
- Department of Emergency Medical Technology, Namseoul University, 91 Daehak-ro, Sebuk-gu, Cheonan, Republic of Korea
| | - Byung Kook Lee
- Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea.
| | - Kyung Woon Jeung
- Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea
| | - Kyoung Hwan Song
- Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea
| | - Chang-Hee Lee
- Department of Emergency Medical Technology, Namseoul University, 91 Daehak-ro, Sebuk-gu, Cheonan, Republic of Korea
| | - Jung Soo Park
- Department of Emegency Medicine, College of Medicine, Chungbuk National University, 52 Naesudong-ro, Seowon-gu, Cheongju, Republic of Korea
| | - Ji Yeon Jeong
- Department of Emergency Medical Service. Howon University, 64 Howondae 3gil, Gunsan, Jeollabuk-do, Republic of Korea
| | - Sang Yeol Shin
- Department of Emergency Medical Service. Howon University, 64 Howondae 3gil, Gunsan, Jeollabuk-do, Republic of Korea
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Rahman NHN, Keng Sheng C, Kamauzaman THT, Md Noh AY, Wahab SFA, Zaini IZ, Fauzi MH, Ab Rahman A, Dzulkifli NS. A multicenter controlled trial on knowledge and attitude about cardiopulmonary resuscitation among secondary school children in Malaysia. Int J Emerg Med 2013; 6:37. [PMID: 24135122 PMCID: PMC3833308 DOI: 10.1186/1865-1380-6-37] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 09/16/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We performed a multicenter controlled trial to assess the knowledge and attitude (KA) about cardiopulmonary resuscitation (CPR) among secondary school children in a district in Malaysia. METHODS This was a prospective intervention study. The primary endpoint of the study was to determine the level of KA about resuscitation after CPR training. The six schools and classes from selected schools were chosen by randomization among the form three and four classes using sealed envelopes. A fully validated questionnaire consisting of three sections (sociodemographic, knowledge and attitude) was given to the pupils before and 2 weeks after the intervention. The intervention group was given a lecture, video show, pamphlet and 1-h practical session on CPR training. The control group received a placebo in order to overcome the learning effect. The maximum scores for the knowledge and attitude sections were 72 and 28, respectively. Repeated measures ANOVA analysis was used for specific objectives to determine the changes in knowledge and attitude level pre- and post-intervention for both study groups. P-values less than 0.05 were taken as significant at 95% confidence intervals. RESULTS The mean (SD) total knowledge scores for the intervention (n = 216) and control (n = 252) groups were 62.43 (13.68) and 62.29 (12.11), respectively (maximum score 72) (p > 0.05). On the other hand, the mean (SD) total attitude scores for the intervention and the control groups were 19.33 (4.51) and 17.85 (4.52), respectively (maximum score 28) (p < 0.001). There were significant differences in mean knowledge and attitude scores between the intervention and control groups with regard to time (pre- and post-intervention). The mean difference in knowledge and attitude scores between both study groups was 8.31 (p < 0.001) and 2.39 (p < 0.001), respectively. CONCLUSIONS The level of knowledge and attitudes of secondary school children was shown to be acceptable prior to the intervention. Furthermore, a brief CPR training program improved their level of knowledge and attitudes significantly as compared to those who had never been trained.
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Iserbyt P, Byra M. The design of instructional tools affects secondary school students' learning of cardiopulmonary resuscitation (CPR) in reciprocal peer learning: a randomized controlled trial. Resuscitation 2013; 84:1591-5. [PMID: 23831502 DOI: 10.1016/j.resuscitation.2013.06.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 06/11/2013] [Accepted: 06/20/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Research investigating design effects of instructional tools for learning Basic Life Support (BLS) is almost non-existent. AIM To demonstrate the design of instructional tools matter. The effect of spatial contiguity, a design principle stating that people learn more deeply when words and corresponding pictures are placed close (i.e., integrated) rather than far from each other on a page was investigated on task cards for learning Cardiopulmonary Resuscitation (CPR) during reciprocal peer learning. METHODS A randomized controlled trial. A total of 111 students (mean age: 13 years) constituting six intact classes learned BLS through reciprocal learning with task cards. Task cards combine a picture of the skill with written instructions about how to perform it. In each class, students were randomly assigned to the experimental group or the control. In the control, written instructions were placed under the picture on the task cards. In the experimental group, written instructions were placed close to the corresponding part of the picture on the task cards reflecting application of the spatial contiguity principle. RESULTS One-way analysis of variance found significantly better performances in the experimental group for ventilation volumes (P=.03, ηp2=.10) and flow rates (P=.02, ηp2=.10). For chest compression depth, compression frequency, compressions with correct hand placement, and duty cycles no significant differences were found. CONCLUSION This study shows that the design of instructional tools (i.e., task cards) affects student learning. Research-based design of learning tools can enhance BLS and CPR education.
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Affiliation(s)
- Peter Iserbyt
- Research Group for Physical Activity, Sports & Health, KU Leuven, Tervuursevest 101, BE-3001 Leuven, Belgium.
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Mpotos N, Vekeman E, Monsieurs K, Derese A, Valcke M. Knowledge and willingness to teach cardiopulmonary resuscitation: a survey amongst 4273 teachers. Resuscitation 2013; 84:496-500. [PMID: 23376584 DOI: 10.1016/j.resuscitation.2013.01.023] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 01/21/2013] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Schoolteachers are expected to play a role in teaching cardiopulmonary resuscitation (CPR) to schoolchildren, but little is known about their attitudes, actual knowledge and willingness to do so. We conducted a survey about CPR knowledge, preparedness to perform and teach CPR as well as attitude towards an alternative self-learning strategy amongst Flemish teachers. METHODS A questionnaire was developed consisting of four distinct parts: (1) Demographics; (2) CPR knowledge and skills level; (3) Attitude towards training and (4) Resuscitation experience. Content experts screened the questionnaire in view of content validity. One hundred and seventy-one students in Educational Sciences were each asked to interview 25 different teachers. RESULTS A total of 4273 teachers participated in the study (primary school n=856; secondary school n=2562; higher education n=855). Of all respondents, 59% (2539/4273) had received previous CPR training with the highest proportion observed in primary schoolteachers (69%) and in the age group 21-30 years (68%). Mandatory CPR training at school was supported by 41% (1751/4273) of the teachers and only 36% was aware that CPR is now formally included in the secondary education curriculum. Sixty-one percent (2621/4273) did not feel capable and was not willing to teach CPR, mainly because of a perceived lack of knowledge in 50% (2151/2621). In addition 69% (2927/4273) felt incompetent to perform correct CPR and 73% (3137/4273) wished more training. Feeling incompetent and not willing to teach was related to the absence of previous training. Primary schoolteachers and the age group 21-30 years were most willing to teach CPR. CONCLUSIONS Although many teachers mentioned previous CPR training, only a minority of mostly young and primary schoolteachers felt competent in CPR and was willing to teach it to their students.
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Affiliation(s)
- Nicolas Mpotos
- Emergency Department, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium.
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Colquhoun M. Learning CPR at school--everyone should do it. Resuscitation 2012; 83:543-4. [PMID: 22425813 DOI: 10.1016/j.resuscitation.2012.03.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 03/08/2012] [Indexed: 12/01/2022]
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A popular song improves CPR compression rate and skill retention by schoolchildren: A manikin trial. Resuscitation 2011; 82:499-500. [DOI: 10.1016/j.resuscitation.2011.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Revised: 01/03/2011] [Accepted: 01/05/2011] [Indexed: 11/30/2022]
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Koster RW, Sayre MR, Botha M, Cave DM, Cudnik MT, Handley AJ, Hatanaka T, Hazinski MF, Jacobs I, Monsieurs K, Morley PT, Nolan JP, Travers AH. Part 5: Adult basic life support: 2010 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Resuscitation 2011; 81 Suppl 1:e48-70. [PMID: 20956035 DOI: 10.1016/j.resuscitation.2010.08.005] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Rudolph W Koster
- Department of Cardiology, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands.
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Cave DM, Aufderheide TP, Beeson J, Ellison A, Gregory A, Hazinski MF, Hiratzka LF, Lurie KG, Morrison LJ, Mosesso VN, Nadkarni V, Potts J, Samson RA, Sayre MR, Schexnayder SM. Importance and implementation of training in cardiopulmonary resuscitation and automated external defibrillation in schools: a science advisory from the American Heart Association. Circulation 2011; 123:691-706. [PMID: 21220728 DOI: 10.1161/cir.0b013e31820b5328] [Citation(s) in RCA: 169] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sayre MR, Koster RW, Botha M, Cave DM, Cudnik MT, Handley AJ, Hatanaka T, Hazinski MF, Jacobs I, Monsieurs K, Morley PT, Nolan JP, Travers AH. Part 5: Adult basic life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2010; 122:S298-324. [PMID: 20956253 DOI: 10.1161/circulationaha.110.970996] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Starting at school. Notf Rett Med 2009. [DOI: 10.1007/s10049-009-1209-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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