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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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Cons-Ferreiro M, Mecias-Calvo M, Romo-Perez V, Navarro-Patón R. Learning of Basic Life Support through the Flipped Classroom in Secondary Schoolchildren: A Quasi-Experimental Study with 12-Month Follow-Up. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1526. [PMID: 37763645 PMCID: PMC10534659 DOI: 10.3390/medicina59091526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: International institutions together with the World Health Organisation recommend the teaching of BLS in schools. Therefore, the objective of this research was to study the feasibility of teaching CPR and AED through the flipped classroom, exploring the medium- and long-term retention of knowledge and practical skills among high school students. Materials and Methods: The sample consisted of 260 secondary schoolchildren (137 in the experimental group (EG) and 123 in the control group (CG)) between 12 and 14 years old (M = 12.75 ± 1.02). Results: The data revealed that the EG obtained better post-course results in the correct position of the hands (p = 0.011), the depth of external cardiac compression (p > 0.001), and the mean time to apply an effective shock with the AED (p = 0.013). The CG obtained better results in compressions with complete chest re-expansion (p = 0.025). These differences disappeared at 6 months (p > 0.05) and 12 months (p > 0.05). Conclusions: A training program based on the flipped classroom is as effective and viable as traditional training, although more efficient since it is applied in less time, in the sequence of action in BLS, CPR skills, and the application of an effective shock with an AED.
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Affiliation(s)
- Miguel Cons-Ferreiro
- Faculty of Education and Sport Sciences, Campus a Xunqueira, s/n, Universidade de Vigo, 36005 Pontevedra, Spain; (M.C.-F.); (V.R.-P.)
- Facultad de Formación del Profesorado, Universidade de Santiago de Compostela, 27001 Lugo, Spain;
| | - Marcos Mecias-Calvo
- Facultad de Formación del Profesorado, Universidade de Santiago de Compostela, 27001 Lugo, Spain;
| | - Vicente Romo-Perez
- Faculty of Education and Sport Sciences, Campus a Xunqueira, s/n, Universidade de Vigo, 36005 Pontevedra, Spain; (M.C.-F.); (V.R.-P.)
| | - Rubén Navarro-Patón
- Facultad de Formación del Profesorado, Universidade de Santiago de Compostela, 27001 Lugo, Spain;
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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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Zenani NE, Bello B, Molekodi M, Useh U. Effectiveness of school-based CPR training among adolescents to enhance knowledge and skills in CPR: A systematic review. Curationis 2022; 45:e1-e9. [PMID: 36453813 PMCID: PMC9724146 DOI: 10.4102/curationis.v45i1.2325] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/08/2022] [Accepted: 09/02/2022] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Cardiac arrest is responsible for 5% - 10% of all deaths among children age 5-19 years; therefore, strategies to prevent poor outcomes post cardiac arrest among children are critical within schools. OBJECTIVES The purpose of this study was to systematically review the effectiveness of cardiopulmonary resuscitation (CPR) training on CPR knowledge and skills among adolescent school children. METHOD This systematic review was conducted and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The complete bibliographic databases of PubMed, Cochrane Library, CINAHL and Web of Science were searched from January 2012 to August 2021. Included studies met all the eligibility criteria. The Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies (EPHPP) and Mixed Method Appraisal tool were used to appraise the quality of the included studies. RESULTS Fourteen studies were included in the review, and 5418 participants were found in the databases. The studies were mainly conducted during the last decade, which suggests that the public's attention has been directed toward training schoolchildren in CPR. The most common interventions were taught in video simulation training courses. They also used subjective assessments to evaluate the participants' knowledge and skills. CONCLUSION Findings from this systematic review reveal that CPR training within school settings effectively promoted a change in CPR knowledge and skills among adolescents. Hence, continuous training of CPR among schoolchildren should be encouraged by policymakers, school authorities, parents and teachers to optimise the prompt usage of the skills in any cardiac event. However, a high-quality randomised controlled trial would enhance the strength of evidence in this area.
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Affiliation(s)
- Nombulelo E Zenani
- Department of Nursing Sciences, Faculty of Health Science, North-West University, Mafikeng.
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Cons-Ferreiro M, Mecías-Calvo M, Romo-Pérez V, Navarro-Patón R. The Effects of an Intervention Based on the Flipped Classroom on the Learning of Basic Life Support in Schoolchildren Aged 10–13 Years: A Quasi-Experimental Study. CHILDREN 2022; 9:children9091373. [PMID: 36138682 PMCID: PMC9497573 DOI: 10.3390/children9091373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/19/2022]
Abstract
Most out-of-hospital cardiac arrests are attended first by bystanders who are usually friends and/or relatives of the victim. Therefore, the objective of this research was to analyse the impact of a training process based on the flipped classroom on basic life support skills in primary education students. The sample consisted of 308 children (148 experimental group (EG) and 160 control group (CG)) between 10 and 13 years old (M = 10.68 ± 0.64) from 2 schools in Galicia, Spain. The data reveal that the quality parameters are obtained in the number of total compressions in 2 min (CG = 213 and EG = 217; p = 0.024) and in the percentage of correct compressions (CG = 87.23% and EG = 91.6%; p = 0.013) except for the mean depth and the percentage of correct compressions, which were not reached in any case. Regarding the application of an effective discharge with the Automated external defibrillator (AED), there were no significant differences in the time used by schoolchildren between both methods (p = 0.795), but 97.5% (n = 156) of the CG and 100% (n = 148) of the EG are able to do it in just over 1 min. Based on the results obtained, we can conclude that a training program based on the flipped classroom is as effective and viable as traditional training in psychomotricity on CPR techniques and the application of an effective discharge using an AED.
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Affiliation(s)
- Miguel Cons-Ferreiro
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005 Pontevedra, Spain
- Facultad de Formación del Profesorado, Universidade de Santiago de Compostela, 27001 Lugo, Spain
| | - Marcos Mecías-Calvo
- Facultad de Formación del Profesorado, Universidade de Santiago de Compostela, 27001 Lugo, Spain
- Correspondence: ; Tel.: +34-982-821069
| | - Vicente Romo-Pérez
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005 Pontevedra, Spain
| | - Rubén Navarro-Patón
- Facultad de Formación del Profesorado, Universidade de Santiago de Compostela, 27001 Lugo, Spain
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