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Martínez-Isasi S, Carballo-Fazanes A, Jorge-Soto C, Otero-Agra M, Fernández-Méndez F, Barcala-Furelos R, Izquierdo V, García-Martínez M, Rodríguez-Núñez A. School children brief training to save foreign body airway obstruction. Eur J Pediatr 2023; 182:5483-5491. [PMID: 37777603 PMCID: PMC10746610 DOI: 10.1007/s00431-023-05202-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/31/2023] [Accepted: 09/09/2023] [Indexed: 10/02/2023]
Abstract
Foreign body airway obstruction (FBAO) is a relatively common emergency and a potential cause of sudden death both in children and older people; bystander immediate action will determine the victim's outcome. Although many school children's basic life support (BLS) training programs have been implemented in recent years, references to specific training on FBAO are lacking. Therefore, the aim was to assess FBAO-solving knowledge acquisition in 10-13-year-old school children. A quasi-experimental non-controlled simulation study was carried out on 564 ten-to-thirteen-year-old children from 5 schools in Galicia (Spain). Participants received a 60-min training led by their physical education teachers (5 min theory, 15 min demonstration by the teacher, and 30 min hands-on training) on how to help to solve an FBAO event. After the training session, the school children's skills were assessed in a standardized adult's progressive FBAO simulation scenario. The assessment was carried out by proficient researchers utilizing a comprehensive checklist specifically designed to address the variables involved in resolving a FBAO event according with current international guidelines. The assessment of school children's acquired knowledge during the simulated mild FBAO revealed that 62.2% of participants successfully identified the event and promptly encouraged the simulated patient to cough actively. When the obstruction progressed, its severity was recognized by 86.2% and back blows were administered, followed by abdominal thrusts by 90.4%. When the simulated victim became unconscious, 77.1% of children identified the situation and immediately called the emergency medical service and 81.1% initiated chest compressions. No significant differences in performance were detected according to participants' age. Conclusion: A brief focused training contributes to prepare 10-13-year-old school children to perform the recommended FBAO steps in a standardized simulated patient. We consider that FBAO should be included in BLS training programs for school children. What is Known: • Kids Save Lives strategy states that school children should learn basic life support (BLS) skills because of their potential role as first responders. • This BLS training does not include content for resolving a foreign body airway obstruction (FBAO). What is New: • Following a 60-min theoretical-practical training led by physical education teachers, 10-13-year-old school children are able to solve a simulated FBAO situation. • The inclusion of FBAO content in BLS training in schools should be considered.
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Affiliation(s)
- Santiago Martínez-Isasi
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Simulation, Life Support, and Intensive Care Research Unit, (SICRUS) of the Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Faculty of Nursing, Universidade de Santiago de Compostela, Av/Xoan XXIII, S/N, 15782, Santiago de Compostela, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), Instituto de Salud Carlos III, RD21/0012/0025, Madrid, Spain
| | - Aida Carballo-Fazanes
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
- Simulation, Life Support, and Intensive Care Research Unit, (SICRUS) of the Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
- Faculty of Nursing, Universidade de Santiago de Compostela, Av/Xoan XXIII, S/N, 15782, Santiago de Compostela, Spain.
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), Instituto de Salud Carlos III, RD21/0012/0025, Madrid, Spain.
| | - Cristina Jorge-Soto
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Simulation, Life Support, and Intensive Care Research Unit, (SICRUS) of the Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Faculty of Nursing, Universidade de Santiago de Compostela, Av/Xoan XXIII, S/N, 15782, Santiago de Compostela, Spain
| | - Martín Otero-Agra
- REMOSS Research Group, Faculty of Education and Sport Sciences, Universidade de Vigo, Pontevedra, Spain
- Escuela de Enfermería de Pontevedra, Universidade de Vigo, Pontevedra, Spain
| | - Felipe Fernández-Méndez
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- REMOSS Research Group, Faculty of Education and Sport Sciences, Universidade de Vigo, Pontevedra, Spain
- Escuela de Enfermería de Pontevedra, Universidade de Vigo, Pontevedra, Spain
| | - Roberto Barcala-Furelos
- REMOSS Research Group, Faculty of Education and Sport Sciences, Universidade de Vigo, Pontevedra, Spain
| | - Verónica Izquierdo
- Simulation, Life Support, and Intensive Care Research Unit, (SICRUS) of the Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), Instituto de Salud Carlos III, RD21/0012/0025, Madrid, Spain
| | | | - Antonio Rodríguez-Núñez
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Simulation, Life Support, and Intensive Care Research Unit, (SICRUS) of the Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Faculty of Nursing, Universidade de Santiago de Compostela, Av/Xoan XXIII, S/N, 15782, Santiago de Compostela, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), Instituto de Salud Carlos III, RD21/0012/0025, Madrid, Spain
- Pediatric Critical, Intermediate and Palliative Care Section, Pediatric Area, Santiago de Compostela's University Clinic Hospital, Santiago de Compostela, Spain
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Calvo-Francés F, Cilleros-Pino L, Barraza-Illanes PA, Díaz-Hernández M, Hernández-Rodríguez JE. Validation of the knowledge evaluation questionnaire of the cardiopulmonary resuscitation training program in high school students. Medicine (Baltimore) 2023; 102:e34609. [PMID: 37861498 PMCID: PMC10589594 DOI: 10.1097/md.0000000000034609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/14/2023] [Indexed: 10/21/2023] Open
Abstract
There is an urgent need for generalized training in cardiopulmonary resuscitation (CPR) techniques, starting with secondary education. Validated instruments for assessing the efficacy of such interventions are not yet available. This study aimed to validate an evaluation questionnaire of a CPR training program for high school students, to analyze the levels of readability, difficulty, reliability, and content validity, as well as the fit the purpose for which they were designed, the trait they are intended to measure. An instrumental study was conducted in 2 phases. In the first phase, an inter-judge validation was carried out with 11 experts in CPR accredited instructors of basic and advanced CPR by the American Heart Association. In the second phase, the psychometric properties were evaluated from the perspective of Item Response Theory. During May of the 2017/18 and 2018/19 academic years, 259 4th-year secondary school students from a high school in the southeastern area of the island of Gran Canaria (mean age: 15.78 years; 50.60% male) were surveyed anonymously using the questionnaire to be validated. The questionnaire was easily readable (74.12 Flesch-Szigriszt Index); the difficulty level (Easy/Very Easy) in the context of this secondary school level of education and the ability level of the respondents overlapped sufficiently and there was no gender bias. The questionnaire was able to discriminate between respondents of slightly more than 7 levels of expertise, from low knowledge of CPR to high knowledge of CPR (Separation Index 7.53). The model fit was excellent (infit = 1/outfit = 1.01). The content validity index was adequate. The separation index and reliability exceeded what was considered adequate for guaranteed use. The level of difficulty of the items and the level of ability of the respondents is in line with the educational level of the students. The questionnaire did not produce a gender bias in response probability. The questionnaire is easily understandable and can discriminate between different levels of ability without differential gender bias, and its reliability is outstanding, as it exceeds the minimum criteria.
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Affiliation(s)
- Fernando Calvo-Francés
- Nursing Department, Faculty of Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Lucía Cilleros-Pino
- Nursing Department, Faculty of Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Paula Andrea Barraza-Illanes
- Fernando Pessoa Canarias University, Department of Clinical Psychology and Neuropsychology, Santa María de Guía, Spain
| | - Maximino Díaz-Hernández
- Nursing Department, Faculty of Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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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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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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CPR Quality Assessment in Schoolchildren Training. J Cardiovasc Dev Dis 2022; 9:jcdd9110398. [DOI: 10.3390/jcdd9110398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 11/18/2022] Open
Abstract
Whilst CPR training is widely recommended, quality of performance is infrequently explored. We evaluated whether a checklist can be an adequate tool for chest compression quality assessment in schoolchildren, compared with a real-time software. This observational study (March 2019–2020) included 104 schoolchildren with no previous CPR training (11–17 years old, 66 girls, 84 primary schoolchildren, 20 high schoolchildren). Simultaneous evaluations of CPR quality were performed using an observational checklist and real-time software. High-quality CPR was determined as a combination of 70% correct maneuvers in compression rate (100–120/min), depth (5–6 cm), and complete release, using a real-time software and three positive performance in skills using a checklist. We adjusted a multivariate logistic regression model for age, sex, and BMI. We found moderate to high agreement percentages in quality of CPR performance (rate: 68.3%, depth: 79.8%, and complete release: 91.3%) between a checklist and real-time software. Only 38.5% of schoolchildren (~14 years-old, ~54.4 kg, and ~22.1 kg/m2) showed high-quality CPR. High-quality CPR was more often performed by older schoolchildren (OR = 1.43, 95% IC:1.09–1.86), and sex was not an independent factor (OR = 1.26, 95%IC:0.52–3.07). For high-quality CPR in schoolchildren, a checklist showed moderate to high agreement with real-time software. Better performance was associated with age regardless of sex and BMI.
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Sanati A, Jaberi AA, Bonabi TN. High school basic life support training: Is the trainer's experience of cardiopulmonary resuscitation in the actual setting important? A randomized control trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:165. [PMID: 35847145 PMCID: PMC9277763 DOI: 10.4103/jehp.jehp_1011_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 08/27/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although basic life support (BLS) has been taught in school by a variety of professionals, it is still unclear that, whether the instructor's previous cardiopulmonary resuscitation (CPR) experience is an important factor. This study aimed to compare the effect of BLS training, based on trainer experience in actual situations, on knowledge and skills of secondary high school students. MATERIALS AND METHODS In this randomized controlled trial, 150 high school students were selected based on the inclusion criteria and then assigned into two groups, (76 in Group A), and (74 in Group B) randomly. Both groups were trained according to adult BLS: 2020 American Heart Association guidelines on mannequins in three 60 min in-person training sessions. The knowledge and skill scores were measured for both groups before, immediately, and 1 month after intervention by a questionnaire. Data were analyzed by the SPSS software version 22, using Chi-square, Mann-Whitney U, repeated-measure ANOVA tests, and statistically modeling at a significance level of 0.05. RESULTS There were no significant differences between groups regarding demographic characteristics. The knowledge and skill scores in both groups increased significantly compared to baseline immediately and 1 month after the intervention (P = 0.001). However, there was no significant difference in knowledge scores between groups (P = 0.076(. However, at the immediacy and 1 month after the intervention, the skill score in "Group A" was significantly higher than the "Group B" (P = 0.001). CONCLUSIONS The trainer's experience of CPR in the actual setting in the transfer of BLS knowledge is not important, but it improved Student's BSL skill acquisition score.
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Affiliation(s)
- Ali Sanati
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Kerman Province, Iran
| | - Ali Ansari Jaberi
- Department of Psychiatric and Mental Health Nursing, Social Determinants of Health Research Center, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Kerman Province, Iran
| | - Tayebeh Negahban Bonabi
- Department of Community Health Nursing, Social Determinants of Health Research Center, School of Nursing and Midwifery, Rafsanjan University of Medical Science, Rafsanjan, Kerman Province, Iran
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