Feasibility of life-supporting first-aid (LSFA) training as a mandatory subject in primary schools

Prehospital Emergency Care: A Cross-Sectional Survey of First-Aid Preparedness Among Layperson First Responders in Northern Uganda

Background

Uganda has a high incidence of road traffic accidents and high mortality rates, yet lacks a mature prehospital emergency care system. Our study addresses this gap by assessing the experiences, training, and confidence in providing first aid (FA) among diverse layperson first responders in Northern Uganda, expanding beyond previous research, which was limited to Central Uganda and specific occupational groups.

Methods

We conducted a cross-sectional survey among layperson first responders of various occupations in Gulu City, Acholi sub-region, Uganda. Data on socio-demographics, training, experiences, knowledge, and confidence in FA were collected.

Results

We included 396 participants, of whom 81.6% (n=323) were male, 47.0.6% (n=186) were aged 21-30 years, 59.3% (n=235) had obtained a secondary level of education, 23.7% (n=94) were commercial motorcyclists, and 45.7% (n=181) had work experience of >5 years. The majority (85.4%, n=338) had witnessed acute illness/trauma. Accidents/bleeding were the most commonly witnessed cases (68.6%, n=232), followed by burn injuries (10.1%, n=34). Most participants (52.3%, n=207) had attended FA training. Only 20.5% (n=81) had obtained an above-average score (≥70%). The majority (67.9%, n=269) were confident in providing FA. Lack of knowledge and skills (61.4%, n=78), fear of taking health risks (18.9%, n=24), and legal implications (7.1%, n=9) were the major reasons for not being willing to confidently give FA. Factors associated with above-average knowledge were tertiary education and being confident in providing FA, while training in FA and prior experience in giving FA were associated with confidence in giving FA.

Conclusion

In this study, laypeople in Northern Uganda exhibited a high level of FA training. However, low confidence in providing FA is attributed to inadequate knowledge, fear of health risks, and legal concerns. Therefore, future efforts should focus on assessing FA practices in diverse regions and promoting formal FA training.

"When you're hurt and you need serious help you call 999." Educating children about emergency services and appropriate use of 999: An evaluation study of the Blue Light Hub app

OBJECTIVES

In the face of unprecedented demand, the Welsh Ambulance Services University NHS Trust developed 'Blue Light Hub': a new app to educate primary school-aged children about emergency services. Our overarching aim was to examine the effectiveness of the app.

DESIGN

Primary school-aged children from three schools in South Wales, UK, played with the app for 2 hours over 2 weeks in class time. Children completed quizzes to assess their knowledge and awareness of, and confidence in engaging with, emergency services before and after using the app.

PARTICIPANTS

Our evaluation focused on N=393 children who completed both the pre-test and post-test quizzes. On average, children were 8-9 years old (median school year, Year 4); 47.8% were male and 50.9% were female.

RESULTS

After using the app, there was a significant increase in the proportion of children who knew of appropriate actions to take in non-emergency scenarios, χ2(1) = 26.01, and could provide a question a call handler would ask them if they called 999, χ2(1) = 13.79. There was also an increase in the proportion of children who could identify an National Health Service (NHS) service that could help them if they were unwell, χ2(1) = 33.31, name different roles in the NHS, χ2(1) = 12.80 and knew how dialling 111 could help them χ2(1) = 90.05 (all p values<0.001).

CONCLUSION

To our knowledge, Blue Light Hub is the first app of its kind designed to educate primary school-aged children about emergency services. Our findings provide preliminary evidence that the app supports children's knowledge and awareness of emergency services.

Enhancing Cardiopulmonary Resuscitation Training with Mixed Reality: Improving Cardiopulmonary Resuscitation Performance and Enjoyment

Cardiac arrests stand as a leading cause of mortality worldwide. When performed timely, cardiopulmonary resuscitation (CPR) can significantly improve a person's chance of survival during a cardiac arrest. Given that the majority of cardiac arrests happen outside of hospitals, it becomes crucial to equip as many laypeople as possible with CPR skills. Recently, mixed reality has garnered attention as a potential tool for CPR training. This study, with a randomized controlled trial (RCT), tested the effectiveness of a mixed reality CPR training compared to traditional training among laypeople (N = 59). Results revealed that participants in the mixed reality training either showed similar (i.e., compressions per minute, exam scores) or better (i.e., compression depth) CPR performance compared to participants that received the traditional training. Furthermore, the mixed reality training was perceived as more enjoyable than the traditional training. Finally, across conditions, participants reported comparable levels of presence, indicating a similar sense of being in a CPR situation. Based on these findings, we conclude that mixed reality CPR training can serve as a viable alternative for traditional CPR training. Especially, the enjoyable nature of mixed reality can boost motivation and encourage more people to follow or refresh previous CPR training.

Effectiveness of an Intervention to Enhance First Aid Knowledge among Early Childhood Education Students: A Pilot Study

Empowering early childhood education students from the beginning with the necessary knowledge and skills to act swiftly in emergency situations could be crucial in saving lives in certain cases. In order to improve the first aid knowledge and skills of early childhood education students, a pre/post study was conducted with a two-week intermediate intervention involving 13 early childhood education students. Their knowledge and skills in first aid were assessed using an ad-hoc instrument before and after the intervention. The results demonstrate a statistically significant improvement in all items related to first aid general knowledge, first aid kits, and CPR maneuvers, as well as in the overall scale. These findings provide evidence that early childhood education students can be equipped through low-cost interventions to acquire and apply certain essential first aid skills, such as dialing emergency services, understanding the purpose of first aid kit items, and recognizing vital signs in individuals, that may be crucial in saving lives in the future.

A six-year teaching life supportive first aid program to eventually generate peer trainer pupils: a prospective case control study

BACKGROUND

Out of hospital cardiac arrest is a life-threatening condition. To improve the chances of survival, lay-person cardio-pulmonary-resuscitation (CPR) is a crucial factor. Many bystanders fail to react appropriately, even if life supporting first aid (LSFA) programs and campaigns including CPR tried to increase the handling of basic cardiac life support. To achieve an enhanced learning of CPR a pupil's grade after grade teaching program was established in a school with medical students.

METHODS

The learning of CPR was investigated in a prospective, case-controlled study at an international school. Pupils (12 ± 3 years old) joining our LSFA courses (n = 538, female: 243, attendance for evaluation: 476) were compared to a control group (n = 129, female: 52, attendance for evaluation: 102). Surveys and quality of CPR (QCPR%) through a computer linked "Resusci Anne" dummy were compared with Chi-squared tests, t-tests pair wisely, and by one-way ANOVA.

RESULTS

Knowledge and skills on the "Resusci Anne" were significantly better in trained grade 9 pupils compared to the control group (QCPR, 59 vs. 25%). The number of LSFA courses each grade 9 student had, correlated with improved practical performance (r² = 0.21, p < 0.001). The willingness to deliver CPR to strangers increased with improved practical performance. Attitudes towards performing CPR were high in all participating grades.

CONCLUSION

Repetitive teaching LSFA to grade 5-9 pupil's grade after grade by medical students has been successfully established. Pupils who finish the program will eventually be able to teach LSFA to younger students. This is furthermore a good way of sharing a "learning by teaching" role and it enables to have more pupils as trainers who can provide instruction to a larger number of pupils with the purpose of having a better-trained population in LSFA.

Schoolteachers Teach First Aid and Trauma Management to Young Primary School Children: An Experimental Study with Educational Intervention

OBJECTIVES

The primary objective of this pilot study was to examine the effectiveness of teaching first aid to 6-8-year-old children within their primary school setting. The study aimed to address two key research questions: (1) Can children of this age group acquire first aid and trauma management skills from their schoolteachers? (2) How long do children retain the acquired first aid knowledge?

METHODS

A pilot experimental study with an educational intervention was conducted in a single primary school in Greece. A total of 60 schoolchildren aged 6-8 years were randomly selected for participation, with 30 children assigned to the training group and 30 children assigned to the control group, which did not receive any intervention. To assess the children's understanding of first aid, a specialized questionnaire was administered to all children one day before the training, as well as to the training group one day after the training, and at two and six months following the training.

RESULTS

Prior to the training, there were no significant differences in first aid knowledge between the children in the training group and those in the control group. However, one day after the training, the trained children demonstrated significantly higher scores (p < 0.05) compared to the control group. Over time, the first aid knowledge of the trained children gradually declined at the two- and six-month follow-up assessments, although it remained higher than their pre-training level.

CONCLUSIONS

First aid training provided by their teachers improved the knowledge of 6-8-year-old primary school children in first aid and trauma management.

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.

The Role of a First Aid Training Program for Young Children: A Systematic Review

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.

RCParvulari training: A basic life support training methodology applied to 5-year-old students: Effectiveness in a cluster-randomized clinical trail

INTRODUCTION

Basic life support training in school age is a topical issue because, with adequate training, any person can help save a life.

METHODS

Cluster clinical trial with data collection through an ad hoc self-administered, semi-structured questionnaire. The target population encompassed the students aged 4-6 years enrolled in 49 educational centres. The centres were randomly allocated to the intervention or control group. The intervention group was trained with the RCParvulari® methodology, consisting of theoretical and practical training on the first link of the chain of survival. The control group only received theoretical training. We evaluated participants before and immediately after the intervention and between 3 and 12 months post intervention by means of the questionnaire. We assessed the acquisition and retention over time of the knowledge and skills covered in the training compared to previous trainings in both groups.

RESULTS

A total of 1327 schoolchildren (79% of the target population) participated. The level of knowledge acquired immediately after training and after 3-12 months compared to baseline was significantly better (P < .001) in the intervention group than in the control group, both in early recognition and contacting of emergency services (112) and in remembering the "mouth-nose-eyes" mnemonic.

CONCLUSIONS

The RCParvulari® methodology significantly contributed to an improved ability to recognize a possible medical emergency, start the chain of survival by alerting an adult and call the 112 emergency number in students in the last year of preschool education.

Pediatric first aid, trauma knowledge, and attitude among parents and general population in Aseer region, Southern Saudi Arabia

Objectives:

Around the world, accidents and injuries are the leading causes of death among children. Because mothers and family members commonly administer first aid at home and at preschools, it’s critical to learn what parents and the public think about children’s mishaps. Our objective was to assess parents’ knowledge and attitude toward pediatric first aid in the Aseer region of Saudi Arabia.

Methods:

A cross-sectional study was conducted in the Aseer region of Saudi Arabia to assess the parents’ level of knowledge and attitude about pediatric first aid and trauma with an electronic- and paper-based multiple-choice self-administered questionnaire covering different medical emergencies. The Arabic and English versions of the questionnaire were made from the information obtained from the first aid educational content of the Saudi Ministry of Health.

Results:

When the participants were asked about their knowledge of pediatric first aid, arranged in descending order from most answers, 37% (n = 135) answered it was good, 30% (n = 111) answered that it was very good, 20% (n = 74) answered that it was not enough, and 13% (n = 47) answered that it was excellent. Results of the multiple linear regression analysis showed the knowledge score to be significantly higher among participants who had higher education levels (t = 2.039, p < 0.001), who had received first aid training before (t = 2.786, p = 0.0001), those who were already healthcare providers (t = 4.336, p < 0.001), those who were from rural districts (t = 2.5, p = 0.355), and younger personnel (t = 0.821, p = 0.345) The difference was not statistically significant.

Conclusion:

Although this study shows that the level of first aid knowledge among personnel who care for children was low, it also shows that they are interested in obtaining proper training.

Stop the Bleed Training for High School Students: Guardian Attitudes and Their Association with Prior Trauma

BACKGROUND

Uncontrolled bleeding is the leading preventable cause of death after injury. Stop the Bleed (STB) is a bleeding control training with proposed expansion into schools. However, the attitudes of guardians, specifically those with past trauma/injury, towards expanding STB into schools are unknown.

METHODS

A cross-sectional survey evaluated guardian attitudes towards STB training in high schools, and compared responses between guardians based on the experience of prior trauma. Logistic regression models evaluated the association between prior trauma and guardian-reported acceptability of STB training.

RESULTS

Of 750 guardians who received the survey, 484 (64.5%) responded. Most guardians (95.3%) wanted their child trained. Few (4.2%) felt this training would be harmful; 44.9% felt their child might be held responsible if something went wrong, and 28.4% reported it might be too scary for their child. In adjusted models, guardians with prior trauma were more likely to want their child trained (odds ratio [OR] = 3.50, 95% confidence interval [CI] 1.11-15.50), and identify STB as important to them (OR = 4.07, 95% CI 1.66-12.26).

CONCLUSION

Our results support STB training in high schools, and guardians with a trauma history may be more likely to want their child trained. Further work to understand the perceived potential harm, and work to design trauma-informed first-response trainings is warranted.

GP lead medical student visits to primary schools can provide a valuable learning experience for both students and pupils

Background: A key clinical skill for undergraduate medical students is communication with children, yet it is becoming increasingly difficult for medical schools to provide sufficient experience within a secondary care setting. One potential solution to this is to develop innovative ways of involving local schools.Aim: To demonstrate what was learned from a pilot school visit and show how this was developed into a successful programme.Method: As part of their GP-based Foundations of Primary Care course, medical students were allocated to local primary schools in their tutorial groups led by their GP tutors. They developed and delivered health promotion activities that were appropriate for school pupils. Review of the visit identified areas of improvement which were used to redesign the programme. Surveys were conducted after the subsequent visit to assess the response of medical students, school pupils and teachers.Learning outcomes: Medical students gained experience in communicating and interacting with school-aged children, and developed teaching and team working skills. School pupils reported change in their health-related knowledge and behaviour and the visits introduced them to the medical profession at a young age. The visits were well received by the teachers who valued the medical students' input.Conclusions: Building on the learning from the pilot school visit, a successful programme was developed that was challenging but ultimately enhanced medical student learning and brought significant benefits for the school pupils. Future developments include the potential to expand the topics taught and developing training in teaching for medical students.

First aid training in secondary schools: A comparative study and implementation considerations

INTRODUCTION

School-based first aid training has benefits for adolescents with an opportunity to increase health and safety knowledge relating to injury and cardiac arrest.

METHOD

Using a quasi-experimental design we evaluated differences among students (M_age = 13.46 years, 55% female) taught first aid through the Skills for Preventing Injury in Youth (SPIY) program (n = 1942), treatment-as-usual school-based first aid training (n = 675), and students who did not receive first aid training (n = 489).

RESULTS

Results showed significant differences in self-reported knowledge scores at twelve-month follow-up (controlling for baseline knowledge). Students in the SPIY group and the treatment-as-usual first aid group had higher total scores than the control group. Teachers and students reported positive perceptions to first aid study, in particular the interactive delivery and scenarios for contextualizing information. Practical Applications: The study provides support for the retention of first aid knowledge up to 12-months and thus the inclusion and feasibility of first aid training in secondary school curriculum.

[Can we train the chain of survival while playing? Validation of the tool «Rescube»]

PURPOSE

To validate the content and adequacy of the «Rescube» training material that includes adapted information from the chain of survival.

MATERIAL AND METHODS

The study included three steps: (i)material development by 7 experts, following Delphi method; (ii)assessment of training material by 11 experts by means of a Likert score and calculation of content validity; and (iii)pilot study in two groups of 5 to 8years-old: Rescube group (GR; n=60) and Traditional group (GT; n=60). GR was trained with Rescube and a Teddy bear, while GT was traditionally trained with a pediatric manikin. Participants were individually assessed at baseline, and one week and one month after training.

RESULTS

All content validity indexes calculated are above the recommended cut-off for analysis with more than 9 experts (≥0,80). Children's learning results were positive, with percentages equal or higher than 80% in all registered variables at the first (one week) evaluation and equal or higher than 67% when evaluated one month after training. No significant differences were detected between groups.

CONCLUSION

The Rescube training tool based on infantile pictures is valid and useful to train young schoolchildren in the chain of survival.

An educational pathway and teaching materials for first aid training of children in sub-Saharan Africa based on the best available evidence

BACKGROUND

First aid training is a cost-effective way to decrease the burden of disease and injury in low- and middle-income countries (LMIC). Since evidence from Western countries has shown that children are able to learn first aid, first aid training of children in LMIC may be a promising way forward. Hence, our project aim was to develop contextualized materials to train sub-Saharan African children in first aid, based on the best available evidence.

METHODS

Systematic literature searches were conducted to identify studies on first aid education to children up to 18 years old (research question one), and studies investigating different teaching approaches (broader than first aid) in LMIC (research question two). A multidisciplinary expert panel translated the evidence to the context of sub-Saharan Africa, and evidence and expert input were used to develop teaching materials.

RESULTS

For question one, we identified 58 studies, measuring the effect of training children in resuscitation, first aid for skin wounds, poisoning etc. For question two, two systematic reviews were included from which we selected 36 studies, revealing the effectiveness of several pedagogical methods, such as problem-solving instruction and small-group instruction. However, the certainty of the evidence was low to very low. Hence expert input was necessary to formulate training objectives and age ranges based on "good practice" whenever the quantity or quality of the evidence was limited. The experts also placed the available evidence against the African context.

CONCLUSIONS

The above approach resulted in an educational pathway (i.e. a scheme with educational goals concerning first aid for different age groups), a list of recommended educational approaches, and first aid teaching materials for children, based on the best available evidence and adapted to the African context.

The effectiveness of traditional Basic Life Support training and alternative technology-enhanced methods in high schools

Background:

Implementation of resuscitation training in school programs is a promising approach to improve rates of cardiopulmonary resuscitation use by trained bystanders. Unfortunately, theoretical cardiopulmonary resuscitation instruction alone is not sufficiently effective in developing practical skills.

Objectives:

This study aimed to investigate the effectiveness of traditional Basic Life Support training and alternative instructional methods to achieve learning objectives of Basic Life Support education.

Methods:

This quasi-experimental study was conducted in a secondary school in Ankara, Turkey. Eighty-three voluntary students were randomly allocated to theoretical (Group A), video-based (Group B), and mobile-assisted video-based instructions (Group C). All groups were led by the course teacher. Assessments were conducted in training and again 1 week later. Assessments were based on Basic Life Support knowledge and confidence performance scores.

Results:

Statistically significant difference was found for the groups’ Confidence Scale scores (F(2, 73) = 3.513, p = 0.035, ηp2 = 0.088); Group C (6.76 ± 1.70) scored higher than Group A. The groups’ Basic Life Support checklist scores were statistically significant (F(2, 73) = 28.050, p = 0.000, ηp2 = 0.435); Group C (32.32 ± 3.84) scored higher than the other groups. Statistically significant difference was found for the groups’ measurable Basic Life Support scores (F(2, 73) = 13.527, p = 0.000, ηp2 = 0.270); and Group C (23.76 ± 3.98) scored higher than the other groups.

Conclusion:

Our findings showed that all instruction methods led to increased Basic Life Support knowledge scores. The mobile-assisted program significantly increased knowledge scores. Same-group high-quality cardiopulmonary resuscitation parameters were more positive than the other instruction groups except for hand position. Group C students expressed higher confidence in their ability to act in an emergency when witnessing a victim collapse.

The impact of cardiopulmonary resuscitation (CPR) manikin chest stiffness on motivation and CPR performance measures in children undergoing CPR training-A prospective, randomized, single-blind, controlled trial

BACKGROUND

Cardio-pulmonary-resuscitation (CPR) training starting at the age of 12 years is recommended internationally. Training younger children is not recommended because young children lack the physical ability to perform adequate CPR and discouragement to perform CPR later is apprehended. The aim of this study was to answer the following questions: Are younger children discouraged after CPR training? Is discouragement caused by their lack in physical ability to perform adequate chest compressions on a standard manikin and would the use of manikins with a reduced resistance affect their motivation or performance?

METHODS

We investigated the motivation and CPR performance of children aged 8-13 years after CPR training on manikins of different chest stiffness in a prospective, randomized, single-blind, controlled trial. 322 children underwent randomization and received 30 minutes CPR training in small groups at school. We used two optically identical resuscitation manikins with different compression resistances of 45kg and 30kg. Motivation was assessed with a self-administered questionnaire. Performance was measured with the Resusci®Anne SkillReporter™.

FINDINGS

Motivation after the training was generally high and there was no difference between the two groups in any of the questionnaire items on motivation: Children had fun (98 vs. 99%; P = 0.32), were interested in the training (99 vs. 98%; P = 0.65), and were glad to train resuscitation again in the future (89 vs. 91%; P = 0.89). CPR performance was generally poor (median compression score (8, IQR 1-45 and 29, IQR 11-54; P<0.001) and the mean compression depth was lower in the 45kg-resistance than in the 30kg-resistance group (33±10mm vs. 41±9; P<0.001).

CONCLUSIONS

Compression resistances of manikins, though influencing CPR performance, did not discourage 8 to 13 year old children after CPR training. The findings refute the view that young children are discouraged when receiving CPR training even though they are physically not able to perform adequate CPR.

School Children Save Lives

Sudden cardiac death is one of the most common causes of preventable death in the industrialized world. In countries with organized emergency health services, it is possible to increase the rate of resuscitation performed by the public and save more lives. Increasing the rate of correct intervention by those witnessing sudden cardiac death requires an increase in the number of adults with training in CPR in society. Resuscitation training should begin in the school years to reach the whole of society within time. As school children with training in CPR increase, the proportion of individuals in society with training and the desire to help others increases, which causes a general increase in resuscitation rates. To teach children "Basic Life Support" the training models should be applied in theory, with training kits, and accompanied by educators, with a variety of figures based on video or computer based training. One of the most important steps in increasing the resuscitation rates performed by the public globally and enhancing survival is through training school children.

Advocating for Life Support Training of Children, Parents, Caregivers, School Personnel, and the Public

Pediatric cardiac arrest in the out-of-hospital setting is a traumatic event for family, friends, caregivers, classmates, and school personnel. Immediate bystander cardiopulmonary resuscitation and the use of automatic external defibrillators have been shown to improve survival in adults. There is some evidence to show improved survival in children who receive immediate bystander cardiopulmonary resuscitation. Pediatricians, in their role as advocates to improve the health of all children, are uniquely positioned to strongly encourage the training of children, parents, caregivers, school personnel, and the lay public in the provision of basic life support, including pediatric basic life support, as well as the appropriate use of automated external defibrillators.

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.

Correlation between Physical Features of Elementary School Children and Chest Compression Depth

Introduction

The height and body weight of 6th grade elementary school children may have influence on chest compression.

Materials & methods

In accordance with the 2005 American Heart Association guidelines and 2006 Korean Association of CardioPulmonary Resuscitation (CPR) guidelines, a 25-minute audiovisual presentation and practical demonstration of CPR were presented by the researchers and assistants. The assistants supervised and corrected the practical performance of the students who performed 5 cycles of CPR (2 minutes each) with the aid of the Laerdal Resusci® Anne SkillReporter™. The students then carried out another 5 cycles of CPR (2 minutes each) using the skill reporter; and a short report was printed.

Results

The correlation coefficient between body weight and chest compression was 0.467 (p=0.000), and the correlation coefficient between height and chest compression was 0.309 (p=0.009). The intercept between body weight and chest compression was 21.763 (p=0.000), and the slope was 0.324 (p=0.000). Student height showed no linear correlation with chest compression depth.

Conclusions

The body weight of 6th grade elementary school children showed moderate correlation with chest compression depth. A minimal body weight of 50 kg is required to attain a standard chest compression depth of 38 mm. With improved training, some students with body weight less than 50 kg may also achieve satisfactory performance of CPR.

Could Hong Kong Primary Schoolchildren be Taught to Perform Compression-Only CPR: A Pilot Study

Objective

To evaluate whether Hong Kong primary schoolchildren could be taught to perform compression-only CPR.

Design

Prospective experimental trial

Subjects

Primary schoolchildren of age 9-12 years old from different Cub Scout packs attended a 2 hour voluntary compression-only CPR training session between late 2014 and mid-2015.

Main outcome measures

Cardiopulmonary resuscitation (CPR) knowledge in the format of pre- and post-test multiple choices questions (MCQ). Psychomotor skills assessment including correct hand position, compression depth, compression rate and chest wall recoil between each compression.

Results

A total of 112 primary schoolchildren attended the training session, in them 72% were boys. Pretest score and post-test score was 2.81/5 and 4.82/5, respectively. The difference was statistically significant (p<0.05). About 96% of subjects had correct hand position at all time during CPR. Mean compression rate was 119/minute. Mean compression depth was 3 cm. About 47% of subjects had 100% complete recoil of chest wall following compression.

Conclusion

Primary schoolchildren above 9 years old are able to acquire essential knowledge and skills in compression-only CPR. Their physical strength may limit their ability to perform effective chest compression; it is still worthwhile to advocate CO-CPR education in primary schoolchildren in Hong Kong in order to raise their interest in this life saving skills and to equip them with essential cognitive skills in emergency situations. To achieve optimal cost-effectiveness and a compression depth of at least 4 cm, body weight of 53 kg or above should be considered as a selection criterion.

["Kids Save Lives"-resuscitation training for schoolchildren : Systematic review]

BACKGROUND

Even in western developed countries, the probability of survival after out-of-hospital cardiac arrest (OHCA) is only 6-10%. In order to improve survival after OHCA, early initiation of cardiopulmonary resuscitation (CPR) by laypersons is essential. Introduction of CPR training in schoolchildren seems to be effective to increase lay-CPR rates.

OBJECTIVE

The objective of the present investigation was to elucidate educational aspects of teaching schoolchildren in CPR and to summarize campaigns related to a comprehensive establishment of lay-CPR worldwide.

MATERIALS AND METHODS

A literature research in PubMed was performed, the cutoff date was 27 February 2017. Overall, 192 abstracts were analyzed; 51 articles were considered relevant and included in the manuscript. An additional keyword research in Google revealed >230,000 entries, and 20 of those were included in the present manuscript.

RESULTS

A minimum age of 12-13 years is required to achieve a comparable quality of CPR to adult basic life support (BLS). Key issues are (i) the correct detection of a cardiac arrest, (ii) a correctly performed call for help, (iii) thoracic compressions and (iv) if applicable, the initiation of adequate mouth-to-mouth ventilation. Practical training showed a significantly higher CPR quality compared to theoretical training only or to the use of instruction or online videos only. Worldwide implementation of a 2-h BLS training per year in children from the age of 12 or younger is recommended by the "Kids Save Lives"- statement since 2015. In Germany, implementation at the level of the federal states has progressed to different degrees.

'The year of first aid': effectiveness of a 3-day first aid programme for 7-14-year-old primary school children

Aim of the study

Bystanders can play an important role in the event of sudden injury or illness. Our aim was to evaluate the effects of a 3-day first aid course for all primary school age groups (7–14 years old).

Methods

582 school children were involved in the study. Training consisted of three sessions with transfer of theoretical knowledge and practical skills about first aid. The following most urgent situations were addressed in our study: adult basic life support (BLS), using an automated external defibrillator (AED), handling an unconscious patient, managing bleeding and calling the ambulance. Data collection was made with a questionnaire developed for the study and observation. Students were tested before, immediately after and 4 months after training. Results were considered significant in case of p<0.05.

Results

Prior to training there was a low level of knowledge and skills on BLS, management of the unconscious patient, use of an AED and management of bleeding. Knowledge and skills improved significantly in all of these categories (p<0.01) and remained significantly higher than the pre-test level at 4 months after training (p<0.01). Younger children overall performed less well than older children, but significantly improved over the pre-test level both immediately and 4 months after training (p<0.01). Prior first aid training was associated with knowledge of the correct ambulance number (p=0.015) and management of bleeding (p=0.041). Prior to training, age was associated with pre-test knowledge and skills of all topics (p<0.01); after training, it was only associated with AED use (p<0.001). There was a significant correlation between the depth of chest compression and children’s age, weight, height and body mass index (p<0.001). Ventilation depended on the same factors (p<0.001).

Conclusion

Children aged 7–14 years are able to perform basic life-saving skills. Knowledge retention after 4 months is good for skills, but thinking in algorithms is difficult for these children.

A qualitative study to identify barriers to deployment and student training in the use of automated external defibrillators in schools

BACKGROUND

Student training in use of automated external defibrillators and deployment of such defibrillators in schools is recommended to increase survival after out-of-hospital cardiac arrest. Low implementation rates have been observed, and even at schools with a defibrillator, challenges such as delayed access have been reported. The purpose of this study was to identify barriers to the implementation of defibrillator training of students and deployment of defibrillators in schools.

METHODS

A qualitative study based on semi-structured individual interviews and focus groups with a total of 25 participants, nine school leaders, and 16 teachers at eight different secondary schools in Denmark (2012-2013). Thematic analysis was used to identify regular patterns of meaning using the technology acceptance model and focusing on the concepts of perceived usefulness and perceived ease of use.

RESULTS

School leaders and teachers are concerned that automated external defibrillators are potentially dangerous, overly technical, and difficult to use, which was related to their limited familiarity with them. They were ambiguous about whether or not students are the right target group or which grade is suitable for defibrillator training. They were also ambiguous about deployment of defibrillators at schools. Those only accounting for the risk of students, considering their schools to be small, and that time for professional help was limited, found the relevance to be low. Due to safety concerns, some recommended that defibrillators at schools should be inaccessible to students. They lacked knowledge about how they work and are operated, and about the defibrillators already placed at their campuses (e.g., how to access them). Prior training and even a little knowledge about defibrillators were crucial to their perception of student training but not for their considerations on the relevance of their placement at schools.

CONCLUSIONS

It is crucial for implementation of automated external defibrillators in schools to inform staff about how they work and are operated and that students are an appropriate target group for defibrillator training. Furthermore, it is important to provide schools with a basis for decision making about when to install defibrillators, and to ensure that school staff and students are informed about their placement.

Teaching Life-Saving Manoeuvres in Primary School

Introduction. In the event of sudden cardiac arrest (SCA) early intervention provided by a layperson can be life-saving. Teaching first aid in primary school may increase the lifelong ability and motivation of young people to take action in an emergency. Objective. The aim of this article is to report a training experience on BLSD (Basic Life Support and Defibrillation) designed for a group of pupils in an Italian primary school, with assessment of its effectiveness at a distance. Methods. The assessment was carried out using a multiple choice questionnaire on a sample of 130 pupils aged 11-12, 62 trained in BLSD and 68 as a control group. The trained group also performed an emergency simulation to assess their learning of practical skills. Results. Using the t test, significant differences emerged in the questionnaire scores between the case-control group. The results of the skill test were positive, even for the most difficult manoeuvres such as opening airways, assessing breathing, or using an AED (Automated External Defibrillator). Conclusion. Although there are still some open questions regarding the ability to retain these skills in the medium/long term, the study shows that life-saving manoeuvres can be effectively taught to primary school pupils.

Basic life support knowledge of secondary school students in cardiopulmonary resuscitation training using a song

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.

Automated external defibrillation skills by naive schoolchildren

AIM

Early defibrillation should achieve the highest survival rates when applied within the first minutes after the collapse. Public access defibrillation programs have increased the population awareness of the importance of defibrillation. Schoolchildren should be trained in basic life support (BLS) skills and some countries have included BLS in their school syllabus. However, little is known of the current knowledge and ability of schoolchildren to use an automated external defibrillator (AED).

METHODS

A multicentric descriptive study, 1295 children from 6 to 16 years of age without previous BLS or AED training. Subjects performed a simulation with an AED and a manikin with no training or feedback and were evaluated by means of a checklist.

RESULTS

A total of 258 participants (19.9%) were able to simulate an effective and safe defibrillation in less than 3min and 52 (20.1% of this group) performed it successfully. A significant correlation between objective and age group was observed (G=0.172) (p<0.001). The average time to deliver a shock was 83.3±26.4s; that time decreased significantly with age [6 YO (108.3±40.4) vs. 16 YO (64.7±18.6)s] (p<0.001).

CONCLUSIONS

Around 20% of schoolchildren without prior training are able to use an AED correctly in less than 3min following the device's acoustic and visual instructions. However, only one-fifth of those who showed success managed to complete the procedure satisfactorily. These facts should be considered in order to provide a more accurate definition and effective implementation of BLS/AED teaching and training at schools.

Cardiopulmonary Resuscitation Training in Schools: A Comparison of Trainee Satisfaction among Different Age Groups

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.

School-Based First Aid Training Programs: A Systematic Review

BACKGROUND

This review examines the breadth of first aid training delivered to school students and the components that are age appropriate to adolescents.

METHOD

Eligible studies included school-based first aid interventions targeting students aged between 10 and 18 years. Online databases were searched, for peer-reviewed publications available as at August 2014.

RESULTS

A total of 20 journal articles were relevant to the review. Research supported programs with longer durations (3 hours or more). Most programs taught resuscitation alone and few included content that was context-specific and relevant to the target group. The training experience of the facilitator did not appear to impact on student outcomes. Incorporating both practical and didactic components was found to be an important factor in delivering material and facilitating the retention of knowledge. Educational resources and facilitator training were found to be common features of effective programs.

CONCLUSIONS

The review supports first aid in school curriculum and provides details of key components pertinent to design of school-based first aid programs. The findings suggest that first aid training may have benefits wider than the uptake and retention of knowledge and skills. There is a need for future research, particularly randomized controlled trials to aid in identifying best practice approaches.

'Kids save lives': why schoolchildren should train in cardiopulmonary resuscitation

PURPOSE OF REVIEW

Quick initiation of basic life support (BLS) by laypersons is one of the most successful strategies in the fight against sudden cardiac death. In developed countries, cardiac arrest is still a major contributor to avoidable death, and despite the fact that more than 50% of all cardiac arrests are witnessed, layperson BLS is performed in less than 20%. To improve this situation, BLS training in schools has been established.

RECENT FINDINGS

Cardiopulmonary resuscitation (CPR) instruction including the use of automatic external defibrillators (AEDs) has shown to be feasible even for young schoolchildren, and there is an indication that respective programmes are effective to enhance patient outcome on a population basis. Earlier training may even lead to more sustainable results; however, it is reasonable to implement adjusted curricula for different child ages. The programme 'Kids Save Lives' recently endorsed by the WHO will help promoting school-based BLS training worldwide demanding education on CPR for all pupils starting at least at age 12.

SUMMARY

Resuscitation training in schools can help to increase the amount of BLS-trained population. Social skills of pupils can be improved and training can be successfully implemented independently of the pupils' age and physique.

Evidence-based educational pathway for the integration of first aid training in school curricula

BACKGROUND

"Calling for help, performing first aid and providing Cardiopulmonary Resuscitation (CPR)" is part of the educational goals in secondary schools in Belgium (Flanders). However, for teachers it is not always clear at what age children can be taught which aspects of first aid. In addition, it is not clear what constitutes "performing first aid" and we strongly advocate that the first aid curriculum is broader than CPR training alone.

OBJECTIVES

To develop an evidence-based educational pathway to enable the integration of first aid into the school curriculum by defining the goals to be achieved for knowledge, skills and attitudes, for different age groups.

METHODS

Studies were identified through electronic databases research (The Cochrane Library, MEDLINE, Embase). We included studies on first aid education for children and adolescents up to 18 years old. A multidisciplinary expert panel formulated their practice experience and expert opinion and discussed the available evidence.

RESULTS

We identified 5822 references and finally retained 30 studies (13 experimental and 17 observational studies), including studies concerning emergency call (7 studies), cardiopulmonary resuscitation (18 studies), AED (Automated External Defibrillator) use (6 studies), recovery position (5 studies), choking (2 studies), injuries (5 studies), and poisoning (2 studies). Recommendations (educational goals) were derived after carefully discussing the currently available evidence in the literature and balancing the skills and attitudes of children of different ages.

CONCLUSIONS

An evidence-based educational pathway with educational goals concerning learning first aid for each age group was developed. This educational pathway can be used for the integration of first aid training in school curricula.

Are schoolteachers able to teach first aid to children younger than 6 years? A comparative study

OBJECTIVES

This study was designed to assess the knowledge acquired by very young children (<6 years) trained by their own teachers at nursery school. This comparative study assessed the effect of training before the age of 6 years compared with a group of age-matched untrained children.

SETTING

Some schoolteachers were trained by emergency medical teams to perform basic first aid.

PARTICIPANTS

Eighteen classes comprising 315 pupils were randomly selected: nine classes of trained pupils (cohort C1) and nine classes of untrained pupils (cohort C2).

PRIMARY AND SECONDARY OUTCOME MEASURES

The test involved observing and describing three pictures and using the phone to call the medical emergency centre. Assessment of each child was based on nine criteria, and was performed by the teacher 2 months after completion of first aid training.

RESULTS

This study concerned 285 pupils: 140 trained and 145 untrained. The majority of trained pupils gave the expected answers for all criteria and reacted appropriately by assessing the situation and alerting emergency services (55.7-89.3% according to the questions). Comparison of the two groups revealed a significantly greater ability of trained pupils to describe an emergency situation (p<0.005) and raise the alert (p<0.0001).

CONCLUSIONS

This study shows the ability of very young children to assimilate basic skills as taught by their own schoolteachers.

Schoolchildren as lifesavers in Europe - training in cardiopulmonary resuscitation for children

Sudden cardiac arrest is a major contributor to avoidable deaths in Europe. Immediate initiation of basic life support (BLS) by lay bystanders is among the most successful strategies in its treatment. Despite the fact that more than half of all cardiac arrests are witnessed in a number of European countries, layperson resuscitation is initiated in only one-fifth of all cases. One strategy to promote bystander BLS is to establish cardiac resuscitation training in schools. BLS instructions for schoolchildren - including the use of automatic external defibrillators (AEDs) - have been shown to be feasible independently of the children's age or physical ability. Nonetheless, it appears reasonable to implement age-adjusted curricula. The earlier in the course of life-long learning BLS instruction begins, the more sustainable training may be.

Push hard, push fast: quasi-experimental study on the capacity of elementary schoolchildren to perform cardiopulmonary resuscitation

BACKGROUND

The optimal age to begin CPR training is a matter of debate. This study aims to determine if elementary schoolchildren have the capacity to administer CPR efficiently.

METHODS

This quasi-experimental study took place in a Quebec City school. Eighty-two children 10 to 12 years old received a 6-hour CPR course based on the American Heart Association (AHA) Guidelines. A comparison group of 20 adults who had taken the same CPR course was recruited. After training, participants' performance was evaluated using a Skillreporter manikin. The primary outcome was depth of compressions. The secondary outcomes were compression rate, insufflation volume and adherence to the CPR sequence. Children's performance was primarily evaluated based on the 2005 AHA standards and secondarily compared to the adults' performance.

RESULTS

Schoolchildren did not reach the lower thresholds for depth (28.1 +/- 5.9 vs 38 mm; one-sided p = 1.0). The volume of the recorded insufflations was sufficient (558.6 +/222.8 vs 500 ml; one-sided p = 0.02), but there were a significant number of unsuccessful insufflation attempts not captured by the Skillreporter. The children reached the minimal threshold for rate (113.9 +/-18.3 vs 90/min; one-sided p < 0.001). They did not perform as well as the adults regarding compression depth (p < 0.001), but were comparable for insufflation volume (p = 0.83) and CPR sequence.

CONCLUSIONS

In this study, schoolchildren aged 10-12 years old did not achieve the standards for compression depth, but achieved adequate compression rate and CPR sequence. When attempts were successful at generating airflow in the Skillreporter, insufflation volume was also adequate.

How best to teach CPR to schoolchildren: a systematic review

BACKGROUND

Training schoolchildren to perform cardiopulmonary resuscitation is one possible method of increasing bystander CPR rates. We reviewed available literature to identify what methods of training children have been successful.

OBJECTIVES AND METHODS

This review sought to evaluate evidence addressing the following PICO question: (P) In schoolchildren, (I) what types of CPR, AED and first aid training (C) when compared to no training and to each other (O) lead to ability to perform life saving measures? Searches were conducted in Ovid MEDLINE (1946 - August 2012), Ovid EMBASE (1974 - August 2012) and Ebscohost Cinahl (1981 - August 2012). Database specific subject headings in all three databases (MeSH in MEDLINE, Emtree in EMBASE, Cinahl Headings) were selected for the concepts of cardiopulmonary resuscitation (CPR) and education. The combined results were then limited by age to include all school aged children. The search yielded 2620 articles. From titles, abstract and key words, 208 articles described CPR, AED and/or first aid training in schoolchildren and were eligible for review. These were obtained in full, were unavailable or not published in English. We reviewed articles for publication type and relevance. 48 studies were identified. One additional study was included as an extension of a study retrieved within the search.

RESULTS

The studies found by the search were heterogeneous for study and training methodology. Findings regarding schoolchild age and physical factors, the role of practical training, use of self-instruction kits, use of computer based learning, reduced training time, trainer type, AED training are presented.

CONCLUSIONS

Evidence shows that cardiopulmonary training, delivered in various ways, is successful in a wide age range of children. While older children perform more successfully on testing, younger children are able to perform basic tasks well, including use of AEDs. Chest compression depth correlates with physical factors such as increasing weight, BMI and height. Instruction must include hands on practice to enable children to perform physical tasks. Repeated training improves performance and retention but the format and frequency of repeated training is yet to be fully determined. Types of training that may reduce the main obstacles to implementation of such training in schools include use of self-instruction kits, computer based learning and use of teacher and peer tutor trainers, but again, need further exploration. As starting points we recommend legislative and funded mandates to provide such training to schoolchildren, and production and use of a framework which will delineate longitudinal delivery of training over the school career. Further research should have some uniformity in terms of assessment methodology, look at longer outcomes, and ideally will evaluate areas that are currently poorly defined.

Pediatric first aid knowledge and attitudes among staff in the preschools of Shanghai, China

Background

Unintentional injury remains the leading cause of morbidity and mortality among children worldwide. The aims of this study were to assess a baseline level of first aid knowledge and overall attitudes regarding first aid among staff members in Shanghai preschools.

Methods

A cross-sectional study was carried out among the staff members at selected preschools. A stratified random sampling method was first used to identify suitable subjects. Data were obtained using a multiple-choice questionnaire. A standardized collection of demographics was performed and participants were given the aforementioned questionnaire to indicate knowledge of and attitudes toward first aid.

Results

1067 subjects completed the questionnaire. None of the surveyed employees answered all questions correctly; only 39 individuals (3.7%) achieved passing scores. The relative number of correct answers to specific questions ranged from 16.5% to 90.2%. In particular, subjects lacked knowledge regarding first aid for convulsive seizures (only 16.5% answered correctly), chemical injuries to the eye (23%), inhaled poison (27.6%), and choking and coughing (30.1%). A multiple linear regression analysis showed scores were significantly higher among staff members with more education, those who had received first aid training before or were already healthcare providers, younger employees, and staff members from rural districts. Most employees agreed that giving first aid was helpful; the vast majority felt that it was important and useful for them to learn pediatric first aid.

Conclusions

The level of first-aid knowledge among preschool staffs in Shanghai was low. There is an urgent need to educate staff members regarding first aid practices and the various risk factors relating to specific injuries.

Effects of first aid training in the kindergarten--a pilot study

Objective

Children can be the only persons present in an emergency situation. Aim of the study was to evaluate the effects of a first aid course for 4-5-year-old kindergarten children given by a first aid instructor and kindergarten teachers.

Methods

A mixed methods approach using both quantitative and qualitative methods was used to investigate the effects of teaching first aid in the kindergarten in the present study. 10 kindergarten children at the age of 4-5 years were included in a pilot-study, 5 girls and 5 boys. Three of them were four years and seven were five years old. Two months after completion of the first aid course children were tested in a scenario where the children had to provide first aid to an unconscious victim after a cycle accident. The next seven months the children were followed by participant observation.

Results

The findings suggest that 4-5-year-old children are able to learn and apply basic first aid. Tested two months after course completion 70% of the children assessed consciousness correctly and knew the correct emergency telephone number; 60% showed correct assessment of breathing and 40% of the participants accomplished the other tasks (giving correct emergency call information, knowledge of correct recovery position, correct airway management) correctly. Many of the children showed their capabilities to do so in a first aid scenario although some participants showed fear of failure in the test scenario. In an informal group testing most of these children could perform first aid measures, too. Teaching first aid also lead to more active helping behaviour and increased empathy in the children.

Conclusion

Kindergarten children aged 4-5 years can learn basic fist aid. First aid training should start in the kindergarten.

Evaluation of Greek high school teachers' knowledge in basic life support, automated external defibrillation, and foreign body airway obstruction: implications for nursing interventions

INTRODUCTION

The aim of this study was to evaluate the theoretic knowledge of high school teachers regarding cardiopulmonary resuscitation, automated external defibrillation, and foreign body airway obstruction.

METHODS

Three hundred ten respondents were tested prospectively by use of a scoring system. Data were obtained by use of a questionnaire that included 24 questions. Data were collected between April 9 and June 16, 2009.

RESULTS

Only 21.03% of the teachers had ever participated in life support courses, and most of them did not possess adequate theoretic knowledge in the management of adult cardiac arrest or foreign body airway obstruction. As the age of the teachers increases, the ratio of correct answers decreases. Life support course attendance has a positive effect on their theoretic knowledge. The majority of the teachers would welcome an emergency nurse to educate them and their students on basic life support and foreign body airway obstruction.

DISCUSSION

This study shows that most of the respondents had a mediocre level of knowledge in basic life support, automated external defibrillation, and foreign body airway obstruction. Given that emergency nurses regularly practice resuscitation in the emergency department in which they are working, they have the motivation to be kept updated with the current guidelines on resuscitation, because guidelines on resuscitation are revised every 5 years. Teachers, on the other hand, are less motivated to be kept updated; thus emergency nurses may be the key component in educating teachers and school students. Therefore we believe that emergency nurses should take on the responsibility and act as school educators regarding cardiopulmonary resuscitation.

School children sufficiently apply life supporting first aid: a prospective investigation

Introduction

The usefulness of CPR training in schools has been questioned because young students may not have the physical and cognitive skills needed to correctly perform such complex tasks correctly.

Methods

In pupils, who received six hours of CPR training from their teachers during a standard school semester at four months post training the following outcome parameters were assessed: CPR effectiveness, AED deployment, accuracy in checking vital signs, correctness of recovery position, and whether the ambulance service was effectively notified. Possible correlations of age, gender, body mass index (BMI), and outcome parameters were calculated.

Results

Of 147 students (mean age 13 ± 2 years), 86% performed CPR correctly. Median depth of chest compressions was 35 mm (inter quartile range (IQR) 31 to 41), and the median number of compressions per minute was 129 bpm (IQR 108 to 143). Sixty nine percent of the students tilted the mannequin head sufficiently for mouth to mouth resuscitation, and the median air volume delivered was 540 ml (IQR 0 to 750). Scores on other life supporting techniques were at least 80% or higher. Depth of chest compressions showed a correlation with BMI (r = 0.35; P < 0.0001), body weight (r = 0.38; P < 0.0001), and body height (r = 0.31; P = 0.0002) but not with age. All other outcomes were found to be unrelated to gender, age, or BMI.

Conclusions

Students as young as 9 years are able to successfully and effectively learn basic life support skills including AED deployment, correct recovery position and emergency calling. As in adults, physical strength may limit depth of chest compressions and ventilation volumes but skill retention is good.