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Kids Save Lives: ERC Position Statement on School Children Education in CPR "Hands that help - Training children is training for life"

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... Βystanders' cardiopulmonary resuscitation (CPR) rates vary among different countries [2]. The annual training of schoolchildren over the age of 12 years is recommended as a means to improve bystander CPR rate and consequently survival rate after OHCA [3,4]. Bystanders will perform CPR and use an automatic external defibrillator (AED) in the case of OHCA provided they are trained on the CPR algorithm and have confidence in their ability to perform the task. ...
... The main finding of the study is that schoolteachers and peers acting as instructors can enhance the self-efficacy level of students after hands-on training in CPR/AED in a similar way to the known gold standard, experienced healthcare professionals [11]. Despite recommendations, compulsory annual resuscitation training for all students over the age of 12 years [3,4], through sessions guided by healthcare professionals or schoolteachers may not be feasible due to limited instructors' availability. Furthermore, schoolteachers may display decreased willingness to teach a subject beyond their specialty [12,13]. ...
... In contrast to the recommendation of annual retraining [4], our study showed that self-efficacy levels decrease significantly after 6 months, suggesting that more frequent sessions might be appropriate. ...
... It is highly likely that the first person to intervene in a case of EH-CRA will not be a healthcare professional. This highlights the importance of CPR training for the general public 6 . The current sequence of steps for CPR is the BLS algorithm recommended by the European Resuscitation Council (ERC) (2015) 7 . ...
... The International Liaison Committee on Resuscitation (ILCOR) and the World Federation of Societies of Anesthesiologists (WFSA) have developed an initiative known as "Kids Save Lives." This aims to introduce CPR training for schoolage children all over the world 6 . The scheme received the backing of the WHO in 2015. ...
... It is also likely that they will go on to teach CPR to their families, pupils and teachers being important multipliers, so that the proportion of skilled individuals among the general population should increase considerably [10][11][12] . For this reason, the compulsory training of school children could have a major impact on improving CRA survival rates through the inter-ventions of passers-by, and also, become a successful mean of spreading CPR skills among the population at large 6,11 . ...
Article
Objective: This longitudinal descriptive study aimed to evaluate cognitive skills acquisition in basic Cardiopulmonary Resuscitation (bCPR) among a group of Year 5 and Year 6 primary school pupils. The study made use of online tools due to the impossibility of conventional methods during the COVID-19 lockdown. Materials and methods: Pupils received formal training in bCPR. Training was imparted uniformly by a teacher at the school (qualified in Basic Life Support -BLS- and Advanced Life Support -ALS- training by the CPR National Plan). The skills acquired (those proposed as essential for bCPR training by the European Resuscitation Council) were evaluated fifteen weeks later. Skills acquisition was evaluated by means of an online questionnaire developed specifically for the study. Results: In all the cognitive skills included in bCPR training, the acquisition level achieved was over 65%. Acquisition of knowledge of the anatomical areas at which cardiac massage must be applied and the means of emergency systems activation was high, while 25.5% of pupils knew the order in which maneuvers should be performed. Pupils' self-confidence and self-perception of their capacity to act when faced with a real CPR situation increased significantly. Conclusions: Primary school pupils learned all the cognitive skills involved in bCPR, showing high levels of skills acquisition and positive self-perception of their capacity to apply them.
... Early adopters of such programmes have some of the highest bystander CPR and survival rates internationally, indicating that educating children is a successful way to reach the entire population. 7 For example, in Denmark, the rate of bystander CPR nearly doubled 5 years after CPR training was introduced into schools, with a threefold improvement in survival following OHCA over 10 years. 8 The Australian school curriculum ...
... This statement recommends two hours of CPR training annually in schools worldwide. 7 While this recommendation specifies training should begin in children from 12 years of age, the statement also acknowledges younger children can also be successfully trained. BLS training can be provided by schools in different formatsusing self-instructive video kits, online and teacher-led BLS skills in class. ...
... Studies have shown that Australian students are supportive of learning BLS training in schools, 10 and that teachers can be taught to provide training. 7 The Australian Resuscitation Council and a number of key stakeholder organisations have worked together to formulate a strategy to help facilitate the introduction of a programme of regular BLS training into the Australian school curriculum. This Aussie KIDS SAVE LIVES position statement ( Fig. 2) represents the initial step of informing and engaging the community about this important (and lifesaving) initiative. ...
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Every year 25 000 Australians experience a cardiac arrest in our community, but only 12% survive. The faster cardiopulmonary resuscitation and defibrillation, known as basic life support (BLS), is commenced, the greater the chance of survival. Currently, only half of the Australian adults are trained in BLS. The Australian Resuscitation Council and key stakeholder organisations believe that the best way to ensure all Australians know how to save a life is by mandating BLS education and training in our schools. This ‘Aussie KIDS SAVE LIVES’ position statement outlines our strategy to help facilitate the introduction of a programme of regular BLS training into the Australian school curriculum.
... KIDS SAVE LIVES (KSL) is an international joint initiative that recommends including cardiopulmonary resuscitation (CPR) training in school curricula to increase bystander CPR rates in cases of out-of-hospital cardiac arrest (OHCA). To date, KSL has been endorsed by the World Health Organization [1], the European Resuscitation Council, the European Patient Safety Foundation, the International Liaison Committee on Resuscitation and the World Federation of Societies of Anesthesiologists [2,3]. ...
... Over the years, KSL has become a key measure to sustainably increase lay resuscitation rates. Various KSL strategies have been scientifically indicated: (1) studies have already shown that the concatenation of different community initiatives increases bystander CPR rates; one such initiative is to include CPR in school curricula [18,19]; (2) the number of CPR-trained individuals in the population gradually increases over time [19]; (3) the BLS training of the majority of the population cannot be achieved through voluntary courses [1,4]; (4) children from 5 to 18 years old are able to learn certain aspects of FA [20]; and (5) knowing how to provide BLS would be similar to riding a bike (in the sense you would never forget it) [2,3]. ...
... In Spain, although education laws are promulgated by the Spanish government, the different autonomous communities have specific competencies regarding education plans, including the capacity to design and implement part of the school curricula. To scientifically evaluate the different levels of KSL implementation in Spain, we collected data from a large number of teachers with the following four objectives: (1) to evaluate the BLS knowledge of schoolteachers, (2) to determine the attitudes of schoolteachers towards teaching BLS and its inclusion in school curricula (in both schools and universities), (3) to know if the KSL initiative is known to schoolteachers in Spain, and (4) to assess whether BLS is taught in Spanish provinces where providing FA is mandatory by law. ...
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Training schoolchildren in basic life support (BLS) is strongly recommended to effectively increase bystander cardiopulmonary resuscitation (CPR) rates. Paediatricians and other health staff members used to be involved in BLS training, but the wide dissemination of BLS skills would need additional support; as a solution, schoolteachers might have enough knowledge necessary to help to achieve this goal. The aim of this cross-sectional survey study, which involved 3423 schoolteachers, was to evaluate the knowledge related to first aid (FA) and BLS of schoolteachers in Spain. In addition, the study aimed to evaluate the content taught to the schoolchildren regarding FA and teachers’ attitudes towards teaching FA. Three-quarters of the surveyed schoolteachers reported knowing FA, and 17% reported teaching it. The emergency medical telephone number and CPR were the subjects taught most often by schoolteachers. However, the schoolteachers demonstrated a lack of knowledge in the identification of cardiac arrest and in CPR. Ninety-eight percent of the respondents agreed with including FA training in schools and as part of university degree programmes and supported the KIDS SAVE LIVES statement. Teaching FA was a positive predictor to be willing to perform CPR (OR: 1.7; 95% CI 1.32–2.31) and to use a defibrillator (OR: 1.4; 95% CI 1.10–1.67).Conclusions: Schoolteachers are willing to teach FA in schools. However, more training and specific curricula are needed to increase the quality of schoolchildren’s CPR training. The training of schoolteachers in CPR might be the foundation for the sustainable transfer of CPR-related knowledge to schoolchildren. Therefore, the inclusion of FA and BLS in university degree programmes seems to be essential. What is Known: • Bystander cardiopulmonary resuscitation rates are associated with improved survival rates. • Resuscitation training in schools increases the bystander cardiopulmonary resuscitation rate. What is New: • Schoolteachers are willing to teach basic life support, but they need more and better training. • Schoolteachers agreed with the inclusion of first aid training in schools and university degree programmes aimed at training teachers/undergraduate teaching degrees.
... A wide range of people is able to teach schoolchildren for CPR successfully (e.g. healthcare professionals, trained teachers, healthcare students, etc.) [12,13]. However, there are several limitations of the implementation of first aid and CPR education in schools (e.g. ...
... A wide range of people is able to teach schoolchildren for CPR successfully (e.g. healthcare professionals, trained teachers, healthcare students, etc.) [12]. ERC recommends that one of the best ways is if CPR training is held by the own schoolteachers of the children after the appropriate training [13]. ...
Article
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Abstract Aim Teaching Basic Life Support (BLS) in schools is a key initiative to improve the survival rates after out-of-hospital cardiac arrest. Low-cost training materials can reach a wider population. Our aim was to compare the effectiveness of using teaching cards with the traditional instructor-led and combined methods on BLS skills and attitude and to evaluate the long-term effects after two months. Methods A quasi-experimental combination design study. Two hundred sixty-three schoolchildren aged 6 to 10 years were assigned to three groups with different methods to teach BLS: teaching card group (n = 100), traditional instructor-led teaching group (n = 91), combined teaching group (n = 72). BLS skills and attitude were measured and compared before the training (T0), after the training (T1), and two months later (T2). Results BLS skills improved in every group at T1 compared to T0 (p
... Therefore, BLS education in early childhood may be key to increasing the effective number of bystanders providing cardiopulmonary resuscitation (CPR) and early defibrillation [4]. In this sense, the World Health Organization (WHO), in agreement with international organizations such as the American Heart Association [5] and the European Resuscitation Council (ERC) [6], recommend initiatives to increase basic CPR by witnesses, which should be taught to all citizens, including schoolchildren, through the so-called "Helping Hands-Training children is training for life" [7]. On the other hand, a strategy to reach the largest possible number of the school population can be to apply this training in educational centers, since their attendance is mandatory, and, in addition, schoolchildren would not only be potential rescuers but also multipliers of CPR knowledge between family and friends [8][9][10][11][12]. ...
... Two educational centers in Galicia (Spain) were invited to participate in the research during the academic year 21-22, after completing an ad hoc questionnaire on the previous training received in BLS for their 10-13-year-old students. This age is considered the target population, as indicated by the positioning of the ERC for the teaching of BLS following the recommendations of the "children save lives" proposal [7]. As inclusion criteria, only students who did not have a physical or mental disability that prevented them from learning and performing the basic CPR maneuvers and use of the AED in 5th and 6th grades of primary education could participate in this research. ...
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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.
... 3,4 Schoolchildren are particularly susceptible and motivated for learning CPR and can be easily accessed and quickly taught. [5][6][7] They serve not only as potential rescuers but also as multipliers of CPR knowledge and positive attitude towards action in cases of OHCA in their environment. 8,9 It has long been established that BLS and AED courses improve knowledge immediately after the course whereas retention of knowledge and skills is less well explored. ...
... [10][11][12] Existing studies advocate annual training. 3,7,10,13 The »Kids save lives« statement endorsed by The World Health Organization recommends 2 hours of BLS and AED training annually from the age of 12 years. 14 However, implementation of such initiatives and other solutions depend on the motivation of individual countries. ...
Article
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Courses on basic life support (BLS) and automated external defibrillator (AED) in schools lead to increase in knowledge but its retention is less well explored. We aimed to explore the long-term retention of knowledge and practical skills among schoolchildren after a BLS and AED course to be able to tailor future courses accordingly. Study was conducted in 3 parts and included 823 seventh and ninth graders from different elementary schools in Maribor, Slovenia. In Study 1 (n=611) we assessed students' baseline knowledge and immediate knowledge gain after our BLS and AED course with a validated questionnaire; in Study 2 (n=116) we assessed retention of gained knowledge and skills after 5 months with a modified Cardiff test and Little Anne QCPR manikin; in Study 3 (n=96) we assessed retention of knowledge 2 years after the course. Mean differences in knowledge before and after the course in Study 1 and between studies were analyzed using paired t-tests and independent t-tests. Differences between individual question scores at different time points were compared using Mann – Whitney U test. A two-sided P<0,05 was considered significant. Practical skills retention was presented with descriptive statistics. Knowledge gain was significant immediately after the course with 83% correct answers compared to 60% at baseline. Scores dropped significantly after 5 months (73%) and after 2 years (75%), but remained significantly better than at baseline (P<0.001). Practical skills perfomance score as per Cardiff test after 5 months was 63%. Overall BLS performance score as per QCPR app was 59%, with an overall cardio score of 77% (average compression rate: 124/min and depth: 52 mm) and ventilation score of 44%. This study showed that long term retention of theoretical knowledge was satisfying whereas poor practical skills performance after 5 months calls for a more intense practical training on repeat courses.
... Children are able to adequately perform CPR after appropriate training [11][12][13]. Consequently, since 2015, the World Health Organization has recommended the annual repetition of a two-hour-theoretical and practical CPR training session, starting at the age of 12 years [14]. Following the 'KIDS SAVE LIVES' initiative, few countries have implemented mandatory schoolchildren CPR training programs, including Italy, France, Belgium, Denmark, and Portugal [15]. ...
... Primarily, CPR training programs for schoolchildren focused on knowledge and skills education [14]. Within recent years, soft skills (i.e., attitude, self-confidence) became more important in CPR education [16]. ...
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Background: A victim's gender is a known factor that influences the willingness of adult bystanders to perform cardiopulmonary resuscitation (CPR) if an out-of-hospital cardiac arrest (OHCA) occurs. This study aims to identify whether gender characteristics of OHCA victims are also relevant to schoolchildren, who are the key target group of CPR trainings worldwide. Methods: A prospective, educative intervention study was performed in schoolchildren (5th-7th grade). Schoolchildren's willingness to perform CPR was assessed by means of questionnaires before (t0) and after (t1) standardized CPR training. Participants were asked how determined they were to perform CPR in male and female OHCA victims on a 5-point Likert scale (not being determined to being very determined). A data analysis was performed according to the gender characteristics of schoolchildren. Results: Overall, 342 schoolchildren aged 10-15 years were included, and 166 male (MG) and 176 female (FG) schoolchildren served as a comparison group. Before (t0) and after (t1) the intervention, females showed a significantly higher general willingness to perform CPR than males (t0: 97.1% vs. 89.0%; p < 0.003 and t1: 95.7% vs. 98.9%; p = 0.038). The general willingness to perform CPR after training had a stronger increase in males (8.0% vs. 2.3%; p = 0.017). In the case that the OHCA victim was female, male schoolchildren were less willing to perform CPR than females at baseline (MG: n = 101;60.8% vs. FG: n = 147;84.5%; p < 0.001) and after training (MG: n = 97;58.4% vs. FG: n = 138;79.3%; p < 0.001). At t1, CPR willingness for female victims was improved in males (MG: n = 36;21.7% vs. FG: n = 19;10.9%; p = 0.006). Conclusions: The gender characteristics of OHCA victims, as well as schoolchildren themselves, have a relevant impact on the willingness to perform CPR. Training concepts should effectively motivate male schoolchildren to reduce preexisting inhibitions, especially towards female OHCA patients. Trial registration: This study was registered at the German Clinical Trials Register (Registration number: DRKS00017707) on 2 August 2019.
... In most instances, bystander cardiopulmonary resuscitation (CPR) attempts take place in the home, but CPR is only attempted before the arrival of medical emergency teams in less than 20% of cases, 1 when early CPR is a key determinant of survival and neurologic outcome. 2 The main strategy to increase the frequency of bystander CPR is training in basic life support (BLS), and in this regard, school-based training of students may be one of the most effective approaches. 1,3 In Spain, there have been several official initiatives and projects to provide BLS training in the school setting, 4---6 but there is no evidence yet on its actual impact on bystander initiation of BLS and victim survival. On the other hand, several studies in recent years have analysed the methodology of BLS training in children, with educational strategies varying significantly in terms of the duration of training, the methods used, the instructors and the minimum age for training. ...
... 10,14,22 The Kids Save Lives statement, issued by the ERC and endorsed by the World Health Organization, has the objective of increasing survival after OHCA and promotes 10 principles, the first of which is that ''kids can save lives''. 1 In consequence, the school is considered the ideal setting for training with the aim of having a significant impact on the response to OHCA. In several European countries, BLS training in schools is mandatory and integrated in the academic curriculum 23 ; in Spain, Royal Decrees 126/2014 24 and 1105/2014, 25 which establish the primary and secondary education curricula, respectively, include training on first aid, but do not specify the contents to be taught, so that teaching of BLS and CPR is not mandatory as it is in some neighbouring countries. ...
Article
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Objective To quantitatively assess the learning capacity of school children aged between 8-12 years in basic life support (theory and practice) after a feasible school training programme. Material and methods Quasi-experimental study with a convenience sample of 567 pupils in 3rd and 5th year of Primary Education, and first year of Compulsory Secondary Education, from 3 public schools in Galicia. They received 2h (one theoretical and another practical) of basic life support training by their Physical Education teachers, as part of the school program. The children were evaluated by a theoretical test and a practical skill test that measured the quality of chest compressions, and assessed the performance of the basic life support sequence. Results The level of knowledge increased with respect to the baseline, and was higher in the higher grades (P < .001). The complete basic life support sequence was carried out by 16.5% of pupils in the 3rd year of Primary Education, 54.4% of pupils in the 5th year of Primary Education, and 28.5% of pupils in the 1st year of Secondary Education (P = .030). The following compression quality parameters improved significantly with age: continuity of compressions (P < .001), percentage of compressions performed at correct depth (P = .002), and median depth (P < .001), while the percentage of compressions with correct decompression decreased significantly (P < .001). Conclusions Although their anthropometric characteristics may not allow them to achieve the ideal quality of this manoeuvre, a 2h theoretical and practical training programme, taught by Physical Education teachers, helps to improve the ability of children younger than 13 years old to recognise the emergency, start the chain of survival, and initiate chest compressions.
... The KIDS SAVE LIVES statement recommends 2 hours of CPR training up to the age of 12 years, although it could start earlier. 11 An evidence-based educational pathway was also designed to help schoolteachers and academic institutions integrate BLS training into school curricula, 2 and different education tools were designed and validated to educate and/or assess BLS schoolchildren's knowledge/skills. 12 13 However, to the best of our knowledge, no longitudinal trials have been carried out to study different BLS training approaches in school environments in terms of methodology. ...
... 2 However, little is known about how often schoolchildren should train to maintain BLS knowledge/skills, and currently, 2 hours of training annually from the age of 12 years is recommended. 11 As the year period may be too long for skills retention and perhaps it could not be easy to integrate 2-hour sessions into current school curricula, we tested two relatively innovative, feasible and practice-oriented strategies: brief annual retraining and very brief every 4 months of rolling-refreshers. ...
Article
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Objective To compare the effectiveness of 4-month rolling-refreshers and annual retraining in basic life support (BLS) on a sample of schoolchildren. Design Prospective longitudinal trial. Setting and participants Four hundred and seventy-two schoolchildren (8–12 years old). Interventions Schoolchildren were instructed in BLS and then split into the following three groups: control group (CG), standard group (SG) and rolling-refresher group (RRG). Their BLS skills were assessed within 1 week (T1) and 2 years later (T2). Moreover, CG did not receive any additional training; SG received one 50 min retraining session 1 year later; RRG participated in very brief (5 min) rolling-refreshers that were carried out every 4 months. Primary and secondary outcomes Hands-on skills of BLS sequence and cardiopulmonary resuscitation. Results BLS sequence performance was similar in all groups at T1, but SG and RRG followed the steps of the protocol in more proportion than CG at T2. When compared at T2, RRG showed higher proficiency than SG in checking safety, checking response, opening the airway and alerting emergency medical services. In addition, although the mean resuscitation quality was low in all groups, RRG participants reached a higher percentage of global quality cardiopulmonary resuscitation (CG: 16.4±24.1; SG: 25.3±28.8; RRG: 29.9%±29.4%), with a higher percentage of correct chest compressions by depth (CG: 3.9±11.8; SG: 10.8±22.7; RRG: 15.5±26.1 mm). Conclusions In 8-to-12-year-old schoolchildren, although annual 50 min retraining sessions help to maintain BLS performance, 4-month very brief rolling-refreshers were shown to be even more effective. Thus, we recommend implementing baseline BLS training at schools, with subsequently brief rolling-refreshers.
... We found 12 Editorials [1][2][3][4][5][6][7][8][9][10][11][12], 9 'Letters to the Editor [13][14][15][16][17][18][19][20][21]', 2 'Special Reports [22][23] [39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55], which are in Table 1. Among the nine original articles, we found three randomized controlled trials (RCT), two longitudinal studies and four cross-sectional studies ( Table 2). ...
... The worldwide scientific production associated with KIDS SAVE LIVES is broad. Among editorials, letters and special reports, we found the initiative for health education among children [2,3,[5][6][7]23] endorsed by the WHO [1], the association between the KSL and the World Restart a Heart Initiative [4,8,10,12,22], and the association with the European Resuscitation Council (ERC) [11 && ,13,16], the implementation [7,14,15,[17][18][19]23] and follow-up [17,20,23] in several countries, and during the pandemic coronavirus disease 2019 (COVID-19) [20]. ...
Article
Purpose of review: In sudden out-of-hospital cardiac arrest, bystander cardiopulmonary resuscitation (CPR) is one of the most important elements of the chain of survival. Since 2015, international health societies and associations have recognized KIDS SAVE LIVES (KSL) as an essential initiative on CPR principles dissemination among schoolchildren. Children can be potential multipliers of the CPR competencies by teaching families, relatives, and friends. This review aimed to determine the main CPR issues raised in the KSL-associated publications. Recent findings: We found 12 Editorials, 9 Letters, 2 Special Reports, 4 Reviews, 2 Guidelines, 9 Original Articles and 17 Conference Presentations on KSL history, the schoolchildren CPR education, and KSL program implementation in several countries. In nine original studies, the main issues were instructors' and learners' CPR knowledge, skills, and retention, gender and physical aspects affecting CPR performance, types of KSL programs and new technologies to teach CPR. Summary: The KSL-associated literature is limited to support KSL benefits. However, the KSL could potentially contribute to improve out-of-hospital CPR performed by lay people at earlier age in different countries. Children are an important target group to diffuse CPR principles ('CHECK-CALL-COMPRESS'), as they are curious, motivated and enjoy teaching others.
... The ERC recommends to start teaching BLS at 12 years or even earlier. [17] Although they are not able to perform quality chest compressions due to their anthropometric characteristics, [12] they have the cognitive ability to learn, retain knowledge and reproduce learned manoeuvres. [18] We have selected this age group for being the group immediately below the recommendations stated in the guidelines. ...
... The methodology used in our study was adjusted to the teaching schedules, not exceeding 2 hours of training, and was both theoretical and practical, as suggested by the ERC. [17] Feedback devices were used as a teaching aid, with proven useful benefits, and as a system for measuring the quality of compressions and ventilations. [19,20] Our study shows that, with a brief theoretical-practical training, 11-year-old students are able to learn the steps needed for the basic life support sequence and how to activate the survival chain with results similar to previous studies. ...
Article
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Background: Cardiopulmonary resuscitation (CPR) training in schools, despite being legislated in Spain, is not established as such within the subjects that children are taught in schools. Objective: to evaluate the acquisition of CPR skills by 11-year-old children after a brief theoretical-practical teaching programme taught by nurses at school. Methods: 62 students were assessed in a quasi-experimental study on 2 cohorts (51.4% of the sample in control group [CG]). In total, 2 sessions were given, a theoretical one, and a practical training for skill development in children, in which the CG performed the CPR in 2-minute cycles and the intervention group in 1-minute cycles. The anthropometric variables recorded were weight and height, and the variables compression quality and ventilation quality were recorded using the Laerdal ResusciAnne manikin with Personal Computer/Wireless SkillReport. Results: The assessment showed better results, in terms of BLS sequence performance and use of automated external defibrillator, in the CG and after training, except for the evaluation of the 10-second breathing assessment technique. The quality of chest compressions was better in the CG after training, as was the quality of the ventilations. There were no major differences in CPR quality after training and 4 months after the 1-minute and 2-minute training cycles. Conclusions: 11-year-old children do not perform quality chest compressions or ventilations but, considering their age, they are able to perform a BLS sequence correctly.
... 11 In order to promote schoolchildren's education in CPR worldwide, the European Patient Safety Foundation (EuPSF), the ERC, the International Liaison Committee on Resuscitation (ILCOR) and the World Federation of Societies of Anesthesiologists (WFSA) developed the "Kids Save Lives" position statement on schoolchildren's education in CPR, which asserts that "teaching CPR to all schoolchildren will lead to a marked improvement in global health". 12 In 2015, this was endorsed by the World Health Organization (WHO). 13 Portugal is part of a group of countries that has legislation about CPR education (Resolução da Assembleia da República n.º 33/2013. ...
... 14,15 Additionally, there is still a lack of scientific evidence about the best way to do it, particularly in the Portuguese pediatric population. 16 Following the "Kids Save Lives" recommendations, 12 the Medical Student Nucleus of the Coimbra Academic Association (NEM/AAC) developed a project entitled A Brincar, A Brincar, with medical students teaching Basic Life Support (BLS) to schoolchildren. As part of this project, the present study aims to evaluate the outcome of a single 120-minute BLS training session on theoretical knowledge and self-efficacy related to performing BLS, immediately after the session, and 6 months later. ...
Article
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Objective: Teaching basic life support to schoolchildren is well established as one of the most effective strategies in increasing bystander CPR rates. However, there is a lack of scientific evidence concerning the Portuguese pediatric population. The present study aims to evaluate the outcome of a basic life support training session on theoretical knowledge and self-efficacy, immediately after the training and 6 months later, in a pediatric population. Methods: A total of 392 schoolchildren, aged seven to 12 years old, participated in this prospective longitudinal study, answering a questionnaire before, immediately after, and six months after receiving 120 minutes of resuscitation training from medical students. Results: There was a significant increase in the knowledge and self-efficacy after one single training session. Both decreased over a period of six months but remained significantly higher than the baseline. These results were homogeneous across classes. Conclusions: Medical students provided adequate basic life support training to a group of Portuguese schoolchildren, with effects in the knowledge and self-efficacy lasting for at least six months.
... Of note, many laypeople lack the ability to identify OHCA or act appropriately. The American Heart Association and European Resuscitation Council advocate compulsory annual CPR training for individuals aged ≥12 years [3]. Generally, students receiving formal education (ie, middle school and high school students) are aged between 12 and 18 years. ...
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Background: Cardiopulmonary resuscitation (CPR) training for adolescents is a prominent strategy to increase the number of community first responders who can recognize cardiac arrest and initiate CPR. More schools are adopting technology-based CPR training modalities to reduce class time and reliance on instructor availability and increase their capacity for wider training dissemination. However, it remains unclear whether these technology-based modalities are comparable with standard training. Objective: This study aimed to systematically review and perform meta-analyses to evaluate the effectiveness of technology-based CPR training on adolescents' CPR skills and knowledge. Methods: Searches were conducted in PubMed, Embase, Cochrane Library, Ovid MEDLINE, CINAHL, PsycINFO, Education Resources Information Center, ProQuest Dissertations and Theses Global, and Scopus from inception to June 25, 2021. Eligible randomized controlled trials (RCTs) compared technology-based training with standard training for adolescents aged 12 to 18 years. Studies were appraised using the Cochrane risk-of-bias tool. Random-effects meta-analyses were performed using Review Manager (The Cochrane Collaboration). Subgroup analyses were conducted to explore sources of heterogeneity. Overall certainty of evidence was appraised using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: Seventeen RCTs involving 5578 adolescents were included. Most of the studies had unclear risks of selection bias (9/17, 53%) and high risks of performance bias (16/17, 94%). Interventions that included instructor guidance increased the likelihood of adolescents checking the responsiveness of the person experiencing cardiac arrest (risk ratio 1.39, 95% CI 1.19-1.63) and calling the emergency medical services (risk ratio 1.11, 95% CI 1.00-1.24). Self-directed technology-based CPR training without instructor guidance was associated with poorer overall skill performance (Cohen d=-0.74, 95% CI -1.02 to -0.45). Training without hands-on practice increased mean compression rates (mean difference 9.38, 95% CI 5.75-13.01), whereas real-time feedback potentially yielded slower compression rates. Instructor-guided training with hands-on practice (Cohen d=0.45, 95% CI 0.13-0.78) and the use of computer programs or mobile apps (Cohen d=0.62, 95% CI 0.37-0.86) improved knowledge scores. However, certainty of evidence was very low. Conclusions: Instructor-guided technology-based CPR training that includes hands-on practice and real-time feedback is noninferior to standard training in CPR skills and knowledge among adolescents. Our findings supported the use of technology-based components such as videos, computer programs, or mobile apps for self-directed theoretical instruction. However, instructor guidance, hands-on practice, and real-time feedback are still necessary components of training to achieve better learning outcomes for adolescents. Such a blended learning approach may reduce class time and reliance on instructor availability. Because of the high heterogeneity of the studies reviewed, the findings from this study should be interpreted with caution. More high-quality RCTs with large sample sizes and follow-up data are needed. Finally, technology-based training can be considered a routine refresher training modality in schools for future research.
... Además, la imprescindible activación del sistema de emergencias y el correcto posicionamiento de las manos para el masaje cardíaco sí se aprende a una edad temprana de manera adecuada aunque no consigan un masaje eficaz (Jones et al., 2007). El programa del ERC llamado KIDS SAVE LIVES, respaldado por la Organización Mundial de la Salud (OMS), ratifica la importancia de introducir la formación a nivel escolar cuanto antes, tanto al profesorado como a los niños/as, incluso en las etapas escolares que están por debajo de las edades que se mencionan en este estudio, por el beneficio posterior de la reiteración y el recuerdo de la formación recibida y por el efecto de difusión que implica, llegando a mencionarse entre sus principios como propuesta, que cada niño/a como trabajo para casa debe encargarse de formar al menos a 10 personas más (Böttiger et al., 2020;Böttiger et al., 2016). ...
Article
La parada cardiorrespiratoria (PCR) es una de las principales causas de muerte en los países industrializados. La reanimación cardiopulmonar (RCP) por testigos aumenta la supervivencia pero no hay formación en RCP en España en el sistema educativo.Este trabajo analiza la implementación de un programa de formación para profesores de Educación Secundaria por parte de sanitarios y, posteriormente, la adquisición de competencias por parte del alumnado comparando según el docente que los ha formado (profesor/a o sanitario), en un instituto de Granada (España), objetivando una adquisición de competencias adecuada a todos los niveles y mejor cuando el docente es profesor/a.
... [59][60] Public education programs, such as teaching school children, have been shown to improve willingness to perform CPR when asked. 61 Bystanders who have received formal CPR training within the last five years are more likely to perform CPR, than those without or no recent training. 62 Through further regular, targeted and widespread public education campaigns, bystanders can be more prepared to perform CPR when necessary. ...
Article
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Background To maximise out-of-hospital cardiac arrest (OHCA) patients’ survival, bystanders should perform continuous, good quality cardiopulmonary resuscitation (CPR) until ambulance arrival. Objectives To identify published literature describing barriers and facilitators between callers and call-takers, which affect initiation and performance (continuation and quality) of bystander CPR (B-CPR) throughout the OHCA emergency call. Eligibility criteria Studies were included if they reported on the population (emergency callers and call-takers), concept (psychological, physical and communication barriers and facilitators impacting the initiation and performance of B-CPR) and context (studies that analysed OHCA emergency calls). Sources of evidence Medline, CINAHL, Cochrane CENTRAL, Embase, Scopus and ProQuest were searched from inception to 9 March 2022. Charting methods Study characteristics were extracted and presented in a narrative format accompanied by summary tables. Results Thirty studies identified factors that impacted B-CPR initiation or performance during the emergency call. Twenty-eight studies described barriers to the provision of CPR instructions and CPR initiation, with prominent themes being caller reluctance (psychological), physical ability (physical), and callers hanging up the phone prior to CPR instructions (communication). There was little evidence examining barriers and facilitators to ongoing CPR performance (2 studies) or CPR quality (2 studies). Conclusions This scoping review using emergency calls as the source, described barriers to the provision of B-CPR instructions and B-CPR initiation. Further research is needed to explore facilitators and barriers to B-CPR continuation and quality throughout the emergency call, and to examine the effectiveness of call-taker strategies to motivate callers to perform B-CPR.
... [16]. Dafür benötigt es ein landesweites Programm von Politik, Kultus-und Schulministerien für die Ausgestaltung und Implementierung des Wiederbelebungstrainings [17]. ...
Article
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Zusammenfassung Die Wiederbelebung durch Laien ist eine der wichtigsten Maßnahmen, um die Überlebensrate von Patientinnen und Patienten nach außerklinischem Herz-Kreislauf-Stillstand zu erhöhen. Während in anderen europäischen Ländern, vor allem in Skandinavien, Laienreanimationsquoten von über 80 % erreicht werden, liegt die Quote in Deutschland nur bei rund 40 %. Die vom European Resuscitation Council aktualisierten Reanimationsleitlinien 2021 messen den lebensrettenden Systemen eine zentrale Bedeutung bei und legen dabei einen Fokus auf die Wiederbelebung durch Laien. Die lebensrettenden Systeme betonen das Zusammenspiel zwischen allen an der Überlebenskette beteiligten Akteurinnen und Akteuren. So wird auch die Verbindung von Rettungsdienst und der Allgemeinbevölkerung konkretisiert. Angelehnt an die BIG-FIVE -Überlebensstrategien nach Herz-Kreislauf-Stillstand werden 5 zentrale Strategien erläutert, mit denen die größte Verbesserung des Überlebens erreicht werden kann. Darunter fallen 1) die Erhöhung der Laienreanimationsquote durch Kampagnen und die schulische Ausbildung in Wiederbelebung KIDS SAVE LIVES , 2) die Implementierung der Telefonreanimation in Leitstellen, 3) Ersthelfersysteme, 4) die flächendeckende Advanced-Life-Support-Versorgung und 5) spezialisierte Kliniken, sogenannte Cardiac Arrest Centers, nach Herz-Kreislauf-Stillstand.
... L'OMS et les sociétés savantes, en s'appuyant sur les données de la littérature, émettent un certain nombre de recommandations: la formation des enfants est utile et efficace (Böttiger et al., 2016;De Buck et al., 2015), et deux heures de formation annuelles suffisent (Lukas et al., 2016). La formation annuelle des écoliers devrait commencer dès l'âge de 12 ans ou même avant (Bohn et al., 2012). ...
Thesis
L’amélioration de la survie des patients victimes d’un arrêt cardiaque est un enjeu de santé publique. Parmi les nombreux leviers qui pourraient contribuer à améliorer le taux de survie, celui de la formation du grand public aux gestes de secourisme est essentiel. La faible proportion de la population française formée et à jour de la formation traduit la faible efficacité des politiques actuelles pour parvenir à généraliser ces formations. Conséquence de cette situation, seulement 30% des témoins d’un arrêt cardiaque débutent un massage cardiaque.A partir des résultats de nos recherches au cours de la phase exploratoire de ce travail, nous émettons l’hypothèse que, compte tenu de la difficulté à prendre une décision en situation de stress, les formations longues de secourisme actuellement dispensées auprès du grand public ne sont pas plus efficaces qu’une initiation, ciblée à condition que le témoin bénéficie, conformément aux recommandations, d’une assistance par un professionnel du centre d’appels d’urgence.Afin de valider notre hypothèse, nous nous sommes appuyé sur la réalisation d’une étude expérimentale, sur mannequin de simulation, comparant l’efficacité de quatre modalités pédagogiques chacune appliquée à une cohorte d’étudiants en santé (formation diplômante PSC1/initiation de deux heures/initiation de deux fois une heure/cohorte non formée).Le critère d'évaluation principal était la proportion de volontaires effectuant un massage cardiaque efficace. Aucune différence statistique n’a été mise en évidence entre le groupe diplômé et le groupe non formé ni avec les groupes ayant bénéficié de l’initiation. Parmi les étudiants qui n’ont pas pu bénéficier d’une assistance (oubli d’appeler les secours), aucun n’a réalisé un massage cardiaque efficace. Une formation d’au moins deux heures consécutives confère cependant un avantage sur la rapidité de mise en œuvre des gestes par rapport à l’absence de formation.Les formations de secourisme ne semblent pas dimensionnées pour apporter une compétence, tout au plus un « savoir-faire ». La stratégie actuelle, en ne favorisant pas les réactualisations des connaissances, ne permet pas l’acquisition d’un savoir durable. Même si les apprenants bénéficient d’une expérimentation sur mannequin et d’une interaction avec le formateur, ils leur est difficile d’accéder à la conceptualisation par inférences qui permettrait d’ancrer durablement les savoirs.Nos travaux, qui s’appuient sur une analyse des facteurs humains notamment en situation de stress et sur une progression pédagogique, mettent en évidence l’intérêt de développer, auprès du grand public, des formations courtes, plus facilement généralisables et répétables. Ces formations courtes, au contenu épuré, doivent pouvoir être délivrées par un panel élargi de formateurs. A l’échelle de la population française, l’acquisition et le maintien d’un socle de connaissances sur les notions de secourisme ne passera que par une modernisation de la stratégie d’enseignement prenant en compte les facteurs humains et les stratégies d’apprentissage en lien avec la politique de santé publique et de prévention.
... [12][13][14] Such training is easy and cost-effective, especially if training is part of compulsory school activities, and is encouraged worldwide. 15 Schoolchildren are particularly susceptible and motivated for learning CPR, they can be easily and quickly taught, [16][17][18] and even performed better and learned faster than adults in a study by Baldi et al 19 They serve as potential multipliers of CPR knowledge and positive attitude towards CPR in their environment. 20 Hence, understanding human behavior is important as human action is guided by attitude and subjective norms 21 which consist of various theoretical behavioral constructs. ...
Article
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As knowledge and attitude towards performing basic life support and using an automated external defibrillator (BLS and AED) contribute equally to improving survival after out-of-hospital cardiac arrest, we aimed to develop a measuring instrument for a validated assessment of schoolchildrens' attitude towards BLS and AED. The objective was to identify, measure, and address pertinent attitude dimensions that influence the intention to actually perform BLS and AED. We conducted a BLS and AED course for seventh and ninth grade students. Students fulfilled pre- and post-course questionnaires on attitude and intention to perform BLS and AED. The measuring instrument was developed with the use of exploratory factor analysis with application of principal component analysis and confirmatory factor analysis with application of structural equation modeling. Measurement invariance across different groups (gender, grades, previous courses) was tested with Wilcoxon signed ranks test and Mann–Whitney U test. Differences in attitude pre- and post-course were evaluated by application of Mann–Whitney U test. The final attitude model consisted of 3 behavioral constructs (self-confidence, positive motivation, and amotivation). Self-confidence was the major construct directly affecting the intention to act. Positive motivation had a negligible direct effect on intention but correlated strongly with self-confidence. The effect of attitude on the intention to help is therefore less complicated than was expected, which relieves the non-professional educators of having to know the specifics of the different behavioral constructs.
... The responder may be located on a different floor in the same high-rise building, but would still be able to respond swiftly [38]. This concept of training members of the public and utilising them as prehospital manpower is a promising approach, and is practised in a similar fashion in London with the GoodSAM application [39] and also echoed by the European Resuscitation Council in their statement on teaching CPR to children in schools [40]. ...
Article
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Out-of-hospital cardiac arrests (OHCAs) occurring in high-rise buildings are a challenge to Emergency Medical Services (EMS). Contemporary EMS guidelines lack specific recommendations for systems and practitioners regarding the approach to these patients. This scoping review aimed to map the body of literature pertaining to OHCAs in high-rise settings in order to clarify concepts and understanding and to identify knowledge gaps. Databases were searched from inception through to 6 May 2021 including OVID Medline, PubMed, Embase, CINAHL, and Scopus. Twenty-three articles were reviewed, comprising 8 manikin trials, 14 observational studies, and 1 mathematical modelling study. High-rise settings commonly have lower availability of bystanders and automatic external defibrillators (AEDs), while height constraints often lead to delays in EMS interventions and suboptimal cardiopulmonary resuscitation (CPR), scene access, and extrication. Four studies found return of spontaneous circulation (ROSC) rates to be significantly poorer, while seven studies found rates of survival-to-hospital discharge (n = 3) and neurologically favourable survival (n = 4) to be significantly lower in multistorey settings. Mechanical chest compression devices, transfer sheets, and strategic defibrillator placement were suggested as approaches to high-rise OHCA management. A shift to maximising on-scene treatment time, along with bundling novel prehospital interventions, could ameliorate some of these difficulties and improve clinical outcomes for patients.
... Znanje i veštine iz KPR-a mogu se dalje širiti tako što će se od dece tražiti da podučavaju svoju porodicu i prijatelje. Novo iskustvo ukazuje na to da su čak i deca u vrtiću i od navršene četiri godine starosti u stanju da uspešno prepoznaju srčani zastoj i pozovu službu hitne medicinske pomoći 43,44 . Do danas je obrazovanje dece školskog uzrasta u resuscitaciji po zakonu obavezno u šest zemalja Evrope i preporuka je u još 24 zemlje. ...
Article
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The European Resuscitation Council (ERC) has produced these Systems Saving Lives guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include chain of survival, measuring performance of resuscitation, social media and smartphones apps for engaging community, European Restart a Heart Day, World Restart a Heart, KIDS SAVE LIVES campaign, early warning scores, rapid response systems, and medical emergency team, cardiac arrest centres and role of dispatcher. The Systems Saving Lives chapter describes numerous and important factors that can globally improve the management of cardiac arrest patients not as a single intervention but as a system-level approach. The aim of this paper is to provide evidence-informed best practice guidance, about interventions which can be implemented by healthcare systems to improve outcomes of out-of-hospital and/or in-hospital cardiac arrest (OHCA and IHCA). The intended audience of the paper are governments, managers of health and education systems, healthcare professionals, teachers, students and laypeople.
... Following the World Health Organization endorsement of the Kids Save Lives statement [13], initiatives to include BLS training in primary and secondary schools have been implemented in the hope of increasing rates of bystander CPR [14][15][16]. Early findings demonstrate that when schoolchildren were educated in BLS, bystander rates of CPR have doubled [17]. Proponents of educating schoolchildren in BLS can do so using interactive digital technologies, including mobile learning (m-learning) [18,19] with gamification features (GFs) [20,21]. ...
Article
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Background: Globally, 3.7 million people die of sudden cardiac death annually. Following the World Health Organization endorsement of the Kids Save Lives statements, initiatives to train school-age children in basic life support (BLS) have been widespread. Mobile phone apps, combined with gamification, represent an opportunity for including mobile learning (m-learning) in teaching schoolchildren BLS as an additional teaching method; however, the quality of these apps is questionable. Objective: This study aims to systematically evaluate the quality, usability, evidence-based content, and gamification features (GFs) of commercially available m-learning apps for teaching guideline-directed BLS knowledge and skills to school-aged children. Methods: We searched the Google Play Store and Apple iOS App Store using multiple terms (eg, cardiopulmonary resuscitation [CPR] or BLS). Apps meeting the inclusion criteria were evaluated by 15 emergency health care professionals using the user version of the Mobile Application Rating Scale and System Usability Scale. We modified a five-finger mnemonic for teaching schoolchildren BLS and reviewed the apps' BLS content using standardized criteria based on three CPR guidelines. GFs in the apps were evaluated using a gamification taxonomy. Results: Of the 1207 potentially relevant apps, only 6 (0.49%) met the inclusion criteria. Most apps were excluded because the content was not related to teaching schoolchildren BLS. The mean total scores for the user version of the Mobile Application Rating Scale and System Usability Scale score were 3.2/5 points (95% CI 3.0-3.4) and 47.1/100 points (95% CI 42.1-52.1), respectively. Half of the apps taught hands-only CPR, whereas the other half also included ventilation. All the apps indicated when to start chest compressions, and only 1 app taught BLS using an automated external defibrillator. Gamification was well integrated into the m-learning apps for teaching schoolchildren BLS, whereas the personal and fictional, educational, and performance gamification groups represented most GFs. Conclusions: Improving the quality and usability of BLS content in apps and combining them with GFs can offer educators novel m-learning tools to teach schoolchildren BLS skills.
... In this way, many people can be reached at the same time. 14 The method that the students help each other and learn by teaching is called the "peer education model." In a previous study, high school teachers trained as instructors; this model was found to be successful for high school BLS education. ...
Article
Background and Objectives The aim of the study was to test the effectiveness of the peer education method on the learning and application of Basic Life Support (BLS) in high school students and to test the effectiveness of the peer education model on the BLS instructor training. Methods High school grade one students were included in the study. Students were divided in two groups (Group A and Group B). Peer instructors who were trained by health professionals trained students in Group A. Peer instructors who were trained by their peers trained students in Group B. Pre- and post-training awareness and knowledge tests were applied to measure the awareness and knowledge of all students. Students’ success in applying BLS steps was evaluated by a practical exam that was coordinated by physicians using a checklist. Results Result of the pre-post training awareness questionnaire, pre-post training knowledge tests, and practical exam indicated that instructors trained by their peers were as effective as the instructors trained by medical physicians in terms of giving BLS training to high school students. In the 16-step BLS application competence evaluation, the students in Group A applied BLS with a success rate of 90.2% and in Group B with a success rate of 93.4%. Conclusion In the current study, it was shown that the peer education model is effective in BLS training and BLS instructor training in high school students. This novel method of peer education gives an opportunity to overcome the stated shortage in the budget and in trained instructors.
... Das vom ERC initiierte Programm KIDS SAVE LIVES hat das strategische Ziel, möglichst viele Kinder weltweit, vor allem in den Schulen, in CPR auszubilden [28,29]. Die CPR-Kompetenzen sollen an das Alter der Schüler angepasst werden (Vorschule bis zur Hochschulbildung) basierend auf den unterschiedlichen Voraussetzungen, um die Fertigkeitenzuerwerbenund die dahinterliegende Theorie zu verstehen [30][31][32][33][34]. Schullehrer unterstützen solche BLS-Schulungen sehr, verfügen jedoch häufig nicht über ausreichende inhaltliche CPR-Kenntnisse [35,36]. ...
Article
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Diese Leitlinien des European Resuscitation Council basieren auf dem internationalen wissenschaftlichen Konsens 2020 zur kardiopulmonalen Reanimation mit Behandlungsempfehlungen (International Liaison Committee on Resuscitation 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations [ILCOR] 2020 CoSTR). Dieser Abschnitt bietet Bürgern und Angehörigen der Gesundheitsberufe Anleitungen zum Lehren und Lernen der Kenntnisse, der Fertigkeiten und der Einstellungen zur Reanimation mit dem Ziel, das Überleben von Patienten nach Kreislaufstillstand zu verbessern. = These European Resuscitation Council education guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidance to citizens and healthcare professionals with regard to teaching and learning the knowledge, skills and attitudes of resuscitation with the ultimate aim of improving patient survival after cardiac arrest.
... Various campaigns or events (Kids Save Lives and World Restart a Heart by the European Resuscitation Council, American Heart Association's CPR awareness week) help to spread the awareness of cardiac arrest and the importance of CPR to the public. 8,9 CPR training requires instructors and appropriate facilities and equipment, as well as quality assessment of the training results. To disseminate CPR training, the national and local communities need a system and legislations for recruiting appropriate resources for CPR training and systematically implementing CPR education. ...
... Lediglich 8 % der Patientinnen und Patienten werden danach lebend aus dem Krankenhaus entlassen, wobei Studien zeigen, dass die Überlebensrate der Betroffenen durch den unmittelbaren Beginn von Reanimationsmaßnahmen durch Laien verdoppelt bis verdreifacht werden kann [14,15,20]. Die systematische Wiederbelebungsausbildung im Schulunterricht wird daher bereits seit Jahren auch international als "KIDS SAVE LIVES"-Initiative von der Weltgesundheitsorganisation (WHO) unterstützt [5,7]. Experten gehen von mehr als 10.000 Menschenleben aus, die sich durch eine höhere Laienreanimationsquote pro Jahr allein in Deutschland zusätzlich retten ließen [13]. ...
Article
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AimIntegration of resuscitation training in schools worldwide is intended to improve the willingness of societies to resuscitate people with an out-of-hospital cardiac arrest. The aim of the present study was to examine how teachers, as qualified multipliers, independently implement cardiopulmonary resuscitation training (CPR) in their schools.Method In cooperation with the German Resuscitation Council, the University Hospital of Cologne qualified teachers from secondary schools in a specially developed teach-the-teacher course. From July–November 2019, evaluation of this teacher multiplication concept was conducted via a web-based survey.ResultsA total of 23 of 26 schools took part in the survey (88%). In sum, 96% (n = 22) of all responding schools have implemented CPR training. A total of 229 teachers were qualified, who trained 8612 pupils during the 2‑year observation period. On average, a qualified teacher trained 38 pupils in CPR. The multiplication factors (number of pupils trained per teacher) varied from school to school (minimum/maximum: 10/1747). The project responsible teachers indicated that they felt very confident in carrying out the CPR training independently.Conclusion Specially qualified teachers reliably introduce CPR training at their schools. To reach even more pupils with the training, multiplication factors must be further increased through targeted support services.
... Por ello, debemos indicar que el profesorado participante en este estudio, inicialmente no poseía los suficientes conocimientos en SVB. Este hecho podría dificultar que el profesorado implementase este tipo de contenidos en sus clases, según los currículos educativos actuales (en aquellas materias que así estuviese estipulado), y de este modo contribuir a la formación de escolares de acuerdo con organismos internacionales como la ERC (Böttiger, et al., 2016;Lukas, Van Aken, Mölhoff, Weber, Rammert, Wid, & Bohn, 2016;Semeraro, et al., 2017). ...
Article
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El objetivo de esta investigación fue evaluar los conocimientos en Reanimación Cardiopulmonar (RCP) solo manos y utilización del Desfibrilador Externo Automatizado (DEA) del profesorado gallego de Educación Infantil, Primaria y Secundaria tras un proceso de video-formación, comparando el grado del olvido que se produce tras una semana (G1), al mes (G2) y a los dos meses (G3). Participaron 126 profesores de entre 25-64 años (M = 44,23 DE = 7,74), de los cuales 100 (79,4%) eran mujeres y 26 (20,6%) hombres. Los resultados muestran diferencias estadísticamente significativas en la media de respuestas correctas entre el cuestionario inicial y final en todas las dimensiones estudiadas [i.e. Global (p < .001); RCP en adulto (p < .001) y DEA y teléfono de emergencias (p < .001)], entre los grupos (G1, G2 y G3), de manera global (p = .001) y conocimiento de parámetros de la RCP (p < .001). Se encontraron diferencias significativas en la profundidad media en la RCP en adulto (hombres vs mujeres; p = .046). Respecto a los tiempos de empleo del DEA existen diferencias en aplicar una descarga eficaz entre los grupos G2 y G3 (p = .028), siendo menor el tiempo en el G2. Tras la aplicación de un programa de vídeo-formación se produce un aumento de conocimientos teóricos en el profesorado y se mantiene, al menos, hasta pasados 2 meses con una leve disminución. En cuanto al aprendizaje de las habilidades en RCP sólo manos y aplicación del DEA, se mantienen de igual manera en el tiempo, al menos, hasta los 2 meses. Abstract. The aim of this research was to evaluate knowledge of hands-only Cardiopulmonary Resuscitation (CPR) and the use of the Automated External Defibrillator (AED) in Galician schoolteachers of childhood, primary and secondary education, after video-training process, comparing the degree of forgetfulness after one week (G1), one month (G2) and two months (G3). 126 teachers aged 25-64 years (M = 44.23 SD = 7.74) participated, of whom 100 (79.4%) were women and 26 (20.6%) men. The results show statistically significant differences in the mean number of correct answers between the initial and final questionnaire in all the dimensions studied [i.e. Global (p < .001); Adult CPR (p < .001) and AED and emergency telephone (p < .001)], between the groups (G1, G2 and G3), globally (p = .001) and knowledge of CPR parameters (p < .001). Significant differences were found in the mean depth of only-hands CPR in adults (men vs. women; p = .046). With respect to the time of use of the AED, there are differences in applying an effective discharge between groups G2 and G3 (p = .028), with less time in G2. After the application of a training programme there is an increase in theoretical knowledge in the teaching staff and this is maintained at least until after 2 months with a slight decrease. As for the learning of skills in only-hands CPR and the application of the AED, they are maintained in the same way over time, at least up to two months.
... 1,2 With prompt bystander cardiopulmonary resuscitation (CPR) and early defibrillation by automated external defibrillators (AEDs), survival rates can reach as high as 70%. 3 In Ontario, only 40% of bystanders who witness persons having SCAs provide CPR, and even fewer know what an AED is or where to find one. 1 Teaching school-age children how to perform CPR and use AEDs is a reliable and sustainable method for increasing rates of bystander CPR and survival from SCA. 4 Worldwide, 6 European countries and 40 US states have legislated CPR and AED training in schools; 5,6 however, no such legislation exists in Canada. In the 1990s, the Province of Ontario mandated the inclusion of CPR and AED training in the Grade 9 Physical Health and Education Curriculum, following successful pilot studies. ...
Article
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Cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) training in schools are mandated in the Ontario high school curriculum. We surveyed schools to understand the scope of this training, including its barriers and facilitators. We recruited 120 (58.5%) elementary, 25 (12.2%) middle, and 60 (29.3%) high schools. Almost 60% (120 of 200) provided staff with CPR training, but only 56% (27 of 48) of high schools trained students. Major barriers included lack of funding, time, and trainers. Despite government-mandated curriculum, only 56% of high schools offer CPR and AED training. More research is needed to understand the barriers to implementing this lifesaving training.
... 21 The KIDS SAVE LIVES programme initiated by the ERC has a key strategic aim to target as many children as possible worldwide with CPR education in schools. 27,28 The CPR competencies should be adapted to the age of the students from preschool to university level due to their differing abilities to perform the skill and understand the underpinning theory. 29À33 Teachers are very supportive about BLS training, but often lack proper content knowledge. ...
Article
Full-text available
These European Resuscitation Council education guidelines, are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidance to citizens and healthcare professionals with regard to teaching and learning the knowledge, skills and attitudes of resuscitation with the ultimate aim of improving patient survival after cardiac arrest. Keywords: Basic and advanced life support; Education, Simulation; Faculty development; Resuscitation; Technology enhanced learning.
... 103 It has been clearly demonstrated in different studies that healthcare professionals, teachers trained to teach CPR, students, peers and others can successfully teach schoolchildren, and all can serve as multipliers. 104 CPR knowledge and skills can be spread further by asking children to teach their family and friends. 102 Evolving experience indicates that even children in the kindergarten and from the age of four years are able to successfully recognise a cardiac arrest and call the EMS. ...
Article
The European Resuscitation Council (ERC) has produced these Systems Saving Lives guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include chain of survival, measuring performance of resuscitation, social media and smartphones apps for engaging community, European Restart a Heart Day, World Restart a Heart, KIDS SAVE LIVES campaign, lower-resource setting, European Resuscitation Academy and Global Resuscitation Alliance, early warning scores, rapid response systems, and medical emergency team, cardiac arrest centres and role of dispatcher.
... Several countries have implemented CPR training at schools, including students as young as 12 years old [19]. Therefore, it is highly recommended to promote and provide CPR training to young people from an early age [20]. ...
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Training in basic life support (BLS) using clinical simulation improves compression rates and the development of cardiopulmonary resuscitation (CPR) skills. This study analyzed the learning outcomes of undergraduate nursing students taking a BLS clinical simulation course. A total of 479 nursing students participated. A pre-test and post-test were carried out to evaluate theoretical knowledge of BLS through questions about anatomical physiology, cardiac arrest, the chain of survival, and CPR. A checklist was used in the simulation to evaluate practical skills of basic CPR. The learning outcomes showed statistically significant differences in the total score of the pre-test and after completing the BLS clinical simulation course (pre-test: 12.61 (2.30), post-test: 15.60 (2.06), p < 0.001). A significant increase in the mean scores was observed after completing the course in each of the four parts of the assessment protocol (p < 0.001). The increase in scores in the cardiac arrest and CPR sections were relevant (Rosenthal’s r: −0.72). The students who had prior knowledge of BLS scored higher on both the pre-test and the post-test. The BLS simulation course was an effective method of teaching and learning BLS skills.
... In 2018, we implemented the worldwide "KIDS SAVE LIVES" (KSL) [2] campaign in Hungary called "KIDS SAVE LIVES in Hungary" (KSLH) [3]. Our aim was to increase the awareness on CPR education in childhood. ...
... En la mayoría de las ocasiones, el intento de reanimación cardiopulmonar (RCP) por testigos se produce en el domicilio, pero es realizado antes de la llegada de los servicios de emergencia médicos en menos del 20% de los casos 1 , siendo la RCP precoz un factor determinante para la supervivencia y el pronóstico neurológico 2 . El pilar básico para aumentar el porcentaje de RCP por testigos es la formación en soporte vital básico (SVB), y en este sentido, la formación de escolares puede ser una de las estrategias más efectivas 1,3 . ...
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Objective To quantitatively assess the learning capacity of school children aged between 8-12 years in basic life support (theory and practice) after a feasible school training programme. Material and methods Quasi-experimental study with a convenience sample of 567 pupils in 3rd, 5th and 1st year of Primary Education, and Compulsory Secondary Education, respectively, from 3 public schools in Galicia. They received 2h (one theoretical and another practical) of basic life support training by their Physical Education teachers, as part of the school program. The children were evaluated by a theoretical test and a practical skill test that measured the quality of chest compressions, and assessed the performance of the basic life support sequence. Results The level of knowledge increased with respect to the baseline, and was higher in the higher grades (P<.001). The complete basic life support sequence was carried out by 16.5% of pupils in the 3rd year of Primary Education, 54.4% of pupils in the 5th year of Primary Education, and 28.5% of pupils in the 1st year of Secondary Education (P=.030). The following compression quality parameters improved significantly with age: continuity of compressions (P<.001), percentage of compressions performed at correct depth (P=.002), and median depth (P<.001), while the percentage of compressions with correct decompression decreased significantly (P<.001). Conclusions Although their anthropometric characteristics may not allow them to achieve the ideal quality of this manoeuvre, a 2-h theoretical and practical training programme, taught by Physical Education teachers, helps to improve the ability of children younger than 13 years-old to recognise the emergency, start the chain of survival, and initiate chest compressions.
... As a result, legislative and funding mandates have been recognized as the frontline requirements to systematically initiate school-based training [5]. Promising initiatives, such as the "KIDS SAVE LIVES" program, which has been endorsed by the World Health Organization [75], have led the charge in training schoolchildren in CPR, encouraging mandatory worldwide training as a means to improve the provision of bystander CPR [76][77][78]. Although before such mandates can be established, further outcomes-based research on the impact of CPR/AED training in young individuals is required. ...
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Purpose of review: Although rare, sudden cardiac death (SCD) in the young is a tragic event, having a dramatic impact upon all involved. The psychosocial burden associated with SCD can leave friends, families, and entire communities bereft. With only limited evidence to describe the volatile emotional reactions associated with a young SCD, there is an urgent need for care providers to better understand the psychological complexities and impacts faced by both at-risk individuals and those directly affected by these tragic events. Recent findings: Current knowledge of the psychosocial implications associated with SCD in the young has recently generated interest in the cardiovascular community, with the goal of addressing prevention strategies (screening), family bereavement, and the psychological impact of at-risk or surviving individuals. With the emergence of novel strategies aimed at reducing the public health impact of SCD in the young, further discussion regarding the psychosocial impact of SCD, encompassing prevention, survivorship, and the downstream communal effects of a young death is required. Support systems and intervention could assist in the management of the associated psychosocial burden, yet there is a lack of clinical guidelines to direct this form of care. Conclusions: There is an important need for multidisciplinary collaboration across subspecialties to provide support to grieving individuals and manage patient well-being throughout the screening process for SCD. This collaborative approach requires the integration of cardiovascular and psychological expertise where relevant.
... (Hands that help-Training children is training for life). Incluso recomiendan que los niños sean formados para entrenar a su familia y amigos en las 2 semanas siguientes al curso (15)(16)(17) para así, tratar de aumentar el porcentaje de RCP por testigo en la población adulta. ...
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RESUMEN El objetivo del estudio fue analizar la viabilidad de enseñar RCP en actividades deportivas con apoyo musical y evaluar si este nuevo enfoque iguala los resultados de un curso tradicional de reanimación cardiopulmonar (RCP). Participaron 84 estudiantes universitarias sin conocimientos de RCP distribuidas en dos grupos de forma aleatoria. El primero recibió formación de RCP sólo manos integradas en una clase de aeróbic y el otro recibió un curso de RCP de manera convencional. Los resultados en la clase coreografiada comparados con el curso tradicional fueron: Profundidad media de compresiones (41,64 vs 42,92;
Article
Resumen: Introducción: la parada cardiorrespiratoria es una de las principales causas de muerte en los países industrializados. La reanimación cardiopulmonar (RCP) por testigos aumenta la supervivencia. En España el nivel de conocimientos al respecto es bajo, suponiendo un exceso de mortalidad. Es urgente formar a la población en general en RCP. Material y métodos: analizamos el impacto de la implementación de un programa de formación en soporte vital para los profesores y los estudiantes de educación secundaria, realizando un estudio observacional, descriptivo y transversal, con una muestra de 649 estudiantes, a los que se aleatorizó en 2 grupos para ser formados por un profesor de educación secundaria previamente instruido en soporte vital o por un sanitario. Posteriormente se analizó la adquisición de competencias y la diferencia según la edad y el sexo de los estudiantes. Resultados: objetivamos una adecuada adquisición de competencias a nivel global, y una diferencia estadísticamente significativa a favor de los estudiantes formados por su profesor en comparación con los que fueron formados por sanitarios. Conclusión: la adquisición de competencias en RCP por parte de los profesores y los estudiantes de educación secundaria presenta un nivel elevado y adecuado como para garantizar la participación de los mismos en los programas formativos, y la aplicabilidad de lo aprendido en situaciones reales. Consideramos que debe sistematizarse la formación en soporte vital a nivel de la educación secundaria obligatoria, por parte de los profesores. Abstract: Introduction: Cardiorespiratory arrest is one of the leading causes of death in industrialized countries. Bystander cardiopulmonary resuscitation (CPR) increases survival. However, there is a low level of general knowledge about this issue in Spain which entails a greater mortality rate in CA cases. It is urgent to train the general population in CPR. Material and methods: The impact of implementing a life support training program for secondary school teachers and students was analyzed. An observational, descriptive, and cross-sectional study was carried out, with a sample of 649 students, who were randomized into two groups to be trained by a secondary school teacher previously instructed in life support or by a health worker. Subsequently, the acquisition of skills and the difference according to the age and sex of the students were analyzed. Results: An adequate acquisition of skills at a global level was observed, and a statistically significant difference in favor of the students trained by their teacher compared to those who were trained by health professionals. Conclusion: Skills acquisition in basic CPR by secondary school students and teachers presents a high and adequate level to guarantee the participation in training programs and the applicability of what is learned in real situations, both for teachers and students. Life support training should be systematized at secondary education level by secondary school teachers.
Article
Resumen Introducción La formación en soporte vital básico en edad escolar es un tema de actualidad, ya que, con una formación adecuada, todo individuo puede ayudar a salvar una vida. Métodos Ensayo clínico por conglomerados basado en un cuestionario ad hoc, autoadministrable y semiestructurado. La población diana fueron alumnos de entre cuatro y seis años de 49 centros educativos. Los centros se aleatorizaron en grupo intervención y control. El grupo intervención recibió la metodología RCParvulari®, consistente en una formación teórico-práctica sobre el primer anillo de la cadena de supervivencia. El grupo control solo recibió una formación teórica. Los sujetos de estudio fueron evaluados preintervención, postintervención y entre tres y 12 meses después mediante un cuestionario. Se valoró adquisición y retención a lo largo del tiempo de la información recibida, en comparación con la formación previa en ambos grupos. Resultados Participaron un total de 1.327 escolares (79% de la población diana). El nivel de conocimientos adquiridos inmediatamente después de la formación y pasados tres a 12 meses aumentó más respecto al basal en el grupo intervención que en el grupo control con diferencias significativas (p < 0,001), tanto al reconocer y llamar al número de emergencias 112, como al recordar la mnemotecnia «boca-nariz-ojos». Conclusiones La metodología RCParvulari® contribuyó de forma significativa a mejorar la capacidad del alumnado de quinto curso de educación infantil para reconocer una eventual emergencia médica, poner en marcha la cadena de la supervivencia alertando a un adulto y llamando al número de emergencias 112.
Article
This study aimed to analyze the characteristics of out-of-hospital acute cardiac arrest patients collected from the Korea Centers for Disease Control and Prevention to identify the current status and provide basic data to increase the recovery rate of out-hospital acute cardiac arrest patients. As a result of the study, the number of acute cardiac arrest patients in Korea in 2019 was 30,279, of whom 1,505 (64.4%) were men and 10,774 (35.6%) were women. Of the total patients, 1,056 (51.7%) showed good neurological outcomes when paramedics performed defibrillation at the pre-hospital stage ( p = 0.001). In the initial review of electrocardiographic rhythm performed by paramedics, 1,025 patients (52.8%) showed ventricular fibrillation and pulseless ventricular tachycardia, which indicated good neurological outcomes ( p = 0.001).
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Background: The present meta-analysis of clinical and simulation trials aimed to compare video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (V-DACPR) with conventional audio-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (C-DACPR). Methods: We searched PubMed, Embase, Web of Science, Cochrane Collaboration databases and Scopus from inception until June 10, 2021. The primary outcomes were the prehospital return of spontaneous circulation (ROSC), survival to hospital discharge, and survival to hospital discharge with a good neurological outcome for clinical trials, and chest compression quality for simulation trials. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) indicated the pooled effect. The analyses were performed with the RevMan 5.4 and STATA 14 software. Results: Overall, 2 clinical and 8 simulation trials were included in this meta-analysis. In clinical trials, C-DACPR and V-DACPR were characterised by, respectively, 11.8% vs. 24.3% of prehospital ROSC (OR 1⁄4 0.46; 95% CI: 0.30, 0.69; I2 1⁄4 66%; p < .001), 10.7% vs. 22.3% of survival to hospital discharge (OR 1⁄4 0.46; 95% CI: 0.30, 0.70; I2 1⁄4 69%; p < .001), and 6.3% vs. 16.0% of survival to hospital discharge with a good neurological outcome (OR 1⁄4 0.39; 95% CI: 0.23, 0.67; I2 1⁄4 73%; p<.001). In simulation trials, chest compression rate per minute equalled 91.3±22.6 for C- DACPR and 107.8 ± 12.6 for V-DACPR (MD 1⁄4 �13.40; 95% CI: �21.86, �4.95; I2 1⁄4 97%; p 1⁄4 .002). The respective values for chest compression depth were 38.7±14.3 and 41.8±12.5mm (MD 1⁄4 �2.67; 95% CI: �8.35, 3.01; I2 1⁄4 98%; p 1⁄4 .36). Conclusions: As compared with C-DACPR, V-DACPR significantly increased prehospital ROSC and survival to hospital discharge. Under simulated resuscitation conditions, V-DACPR exhibited a higher rate of adequate chest compressions than C-DACPR.
Article
Objective: We aimed to compare traditional basic life support (BLS) education with specific and innovative educative didactic material that has been previously designed and validated. Methods: Fifteen classes of schoolchildren aged 5 to 8 years (n = 237) were randomly assigned to 4 groups in which different didactic and complementary materials were used: (1) the Rescube tool with a cuddly toy (n = 61), (2) the Endless Book tool with a cuddly toy (n = 74), (3) traditional teaching with a cuddly toy (n = 46), and (4) traditional teaching with a manikin (n = 55). The BLS sequence was assessed at baseline (T0). After that, children took part in a one-hour theory and practice session in their assigned training modality. BLS sequence was assessed again within one week (T1) and after one month (T2). Results: The 4 modalities were successful in improving children's skills when comparing T0 with both T1 and T2 (P < .05). At T2, more schoolchildren remembered the complete BLS sequence after using the Rescube (75%) compared with the number of schoolchildren who remember the complete BLS sequence after using the Endless Book (53%), a manikin (42%), or a cuddly toy (13%) (P < .05). A higher proportion of participants who used the Rescube correctly performed all the BLS steps analyzed compared with those who used only the manikin or a cuddly toy during the learning phase. The Endless Book was also more effective except for learning to check consciousness and breathing. Conclusion: Better BLS learning and knowledge retention outcomes were achieved by using our specific and adapted didactic materials (Rescube and Endless Book). These new educational tools have the potential to substantially support BLS school education programs.
Article
The European Resuscitation Council (ERC) has produced these Systems Saving Lives guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The following topics are covered: chain of survival, measuring performance of resuscitation, social media and smartphones apps for engaging the community, European Restart a Heart Day, World Restart a Heart, KIDS SAVE LIVES campaign, lower-resource setting, European Resuscitation Academy and Global Resuscitation Alliance, early warning scores, rapid response systems, and medical emergency team, cardiac arrest centres and role of dispatchers.
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Objective: Out-of-hospital cardiac arrests (OHCA) in schools and universities are uncommon. However, these institutions must plan and prepare for such events to ensure the best outcomes. To evaluate their preparedness we assessed baseline characteristics, survival outcomes and 12-year trends for OHCA in schools/universities compared to other public locations. Methods: We conducted a retrospective analysis of OHCA in schools/universities and public locations between 2008 and 2019 using Victorian Ambulance Cardiac Arrest Registry data. Results: We included 9,037 EMS attended cases, 131 occurred in schools/universities and 8,906 in public locations. Compared to public locations, a significantly higher proportion of EMS treated cases in schools/universities received bystander cardiopulmonary resuscitation (CPR) (95.5% vs. 78.5%, p < 0.001), public access defibrillation (PAD) (26.1% vs. 9.9%, p < 0.001) and presented in shockable rhythms (69.4% vs. 50.9%, p < 0.001). Unadjusted survival to hospital discharge rates were also significantly higher in schools/universities (39.6% vs. 24.2%, p < 0.001). The long-term unadjusted trends for bystander CPR in schools/universities increased from 91.7% (2008-10) to 100% (2017-19) (p-trend =0.025), for PAD from 4.2% (2008-10) to 47.5% (2017-19) (p-trend <0.001) and for survival to hospital discharge from 16.7% (2008-10) to 57.5% (2017-19) (p-trend =0.004). However, after adjustment for favorable cardiac arrest factors, such as younger age, bystander CPR and PAD, survival was similar between schools/universities and public locations. Conclusion – The majority of OHCA in schools and universities were witnessed and received bystander CPR, however less than half received PAD. Developing site-specific cardiac emergency response plans and providing age appropriate CPR training to primary, secondary and university students would help improve PAD rates.
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El objetivo del presente estudio consiste en realizar una revisión sistemática de la literatura científica centrándose en el análisis de los materiales utilizados en programas escolares para la formación en primeros auxilios. Se consideraron susceptibles de ser incluidos, aquellos artículos de investigación originales que contenían programas de enseñanza o intervenciones desarrolladas en el ámbito escolar, dirigidas a alumnos entre 6 y 18 años, en los que se trabajaba cualquier aspecto relacionado con los primeros auxilios. Fueron exploradas las principales bases de datos en inglés y español correspondientes a los ámbitos de la educación y la salud en sus versiones disponibles en línea en abril de 2018. Un total de 27 artículos fueron finalmente objeto de la revisión y se procedió a la síntesis de la información que contenían. Los materiales empleados en los diferentes programas formativos fueron muy variados. la mayoría de los programas optan por una combinación de materiales didácticos generales y específicos, siendo la opción más habitual la mezcla de material audiovisual con material no fungible, móvil, complementario y de medición. En conclusión, existe una enorme variedad de materiales a disposición de los maestros en educación física para llevar a cabo la enseñanza de los primeros auxilios, por lo que, a la hora de diseñar un programa formativo eficaz, deberían emplearse criterios didácticos para seleccionar y combinar los materiales a emplear.
Article
Cardiovascular events are the third cause of death in the world. It is generally accepted by all the main health organisations dedicated to this topic that increasing the number of potential members of the public who could intervene if necessary will lead to an increase in the survival rate in the case of cardiac arrest. To achieve this goal, offering effective training courses to as many individuals as possible, on a large scale and at a low cost, is recommended. Schools are by nature one of the ideal places for implementing this type of large-scale training programme. With this study the authors aim to measure how open students and teachers are to basic life-support training in their school and how this can improve their confidence levels in performing basic life-support if needed.
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We describe a conceptual framework that teachers can utilize when embedding immersive virtual reality with HMDs in their classroom for educational purposes. The concept is based on an ongoing research project where an immersive virtual reality application is being produced and will be used in K-12 education for learning first aid. By using virtual reality, we redefine the way students learn first aid by exposing them to real-life scenarios in an immersive virtual environment where they feel a sense of presence, that otherwise would not have been possible due to resources, risks and ethical reasons. The conceptual framework we have developed is an attempt to close a gap between the focus on the benefits of this promising learning technology and the practical considerations and guidelines from a teacher's perspective in an educational con-text. We believe that there is immense value in providing teachers with a framework they can use when embedding immersive virtual reality in the dynamic environment of classrooms.
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Aim of the study Comprehensive training of the population in Basic Life Support (BLS) increases the chance of survival in cardiac arrest. To implement BLS trainings at schools a high number of instructors will be needed. This non-inferiority study investigated, if online education is effective to prepare instructors to teach BLS compared to face-to-face education. Methods A cluster randomised, controlled, single blinded study was performed in 2018 in Hamburg, Germany. A mixed group of potential instructors were allocated alternately to either the intervention or control group and participated in a four-hour instructor training. The instructor training of the control group was realised by trained educators. The intervention group participated in a self-regulated online training with hands-on training supported by peers. Instructors provided BLS training for high school students. The primary endpoint was a mean score in the BLS skills assessment of the students. The secondary endpoint was teaching effectiveness of the instructors. Results BLS assessments of 808 students of 46 classes, who were taught by 74 instructors could be analysed. The students trained by interventional instructors achieved 0.14 points less (95%-CI: -0.27 to 0.56) compared to students trained by control instructors (9.34 vs. 9.48). The non-inferiority could not be confirmed. The teaching performance in the intervention group was better in some aspects compared to the control group. Conclusion Integrating all results of this study, online education may be an effective alternative to prepare potential BLS instructors. Using free online courses, motivated persons can independently acquire necessary skills to become instructors and autonomously realise low cost BLS trainings at schools.
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Aims: This prospective longitudinal study over 6 years compared schoolteachers and emergency physicians as resuscitation trainers for schoolchildren. It also investigated whether pupils who were trained annually for 3 years retain their resuscitation skills after the end of this study. Methods: A total of 261 pupils (fifth grade) at two german grammar schools received resuscitation training by trained teachers or by emergency physicians. The annual training events stopped after 3 years in one group and continued for 6 years in a second group. We measured Knowledge about resuscitation (questionnaire), chest compression rate (cc/min), chest compression depth (mm), ventilation rate (1-min), ventilation volume (mL), self-efficacy (questionnaire). Their performance was evaluated after 1, 3 and 6 years. Results: The training events increased the pupils' knowledge and practical skills. When trained by teachers, the pupils achieved better results for knowledge (92.86%±8.38 vs. 90.10%±8.63, P=0.04) and ventilation rate (4.84/min±4.05 vs. 3.76/min±2.37, P=0.04) than when they were trained by emergency physicians. There were no differences with regard to chest compression rate, depth, ventilation volume, or self-efficacy at the end of the study. Knowledge and skills after 6 years were equivalent in the group with 6 years training compared with 3 years training. Conclusions: Trained teachers can provide adequate resuscitation training in schools. Health-care professionals are not mandatory for CPR training (easier for schools to implement resuscitation training). The final evaluation after 6 years showed that resuscitation skills are retained even when training is interrupted for 3 years.
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"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. 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. 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. 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. 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. Copyright © 2015. Published by Elsevier Ireland Ltd.
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To test the effect of a physician staffed advanced cardiac life support (ALS) system on patient outcome following out-of-hospital cardiac arrest. Observational study. Two tier basic life support (BLS) and physician staffed ALS services in the midsized urban/suburban area of Heidelberg, Germany. All patients suffering out-of-hospital cardiac arrest of cardiac aetiology between January 1992 and December 1994 and who were covered by ALS services. Physician staffed ALS services. Return of spontaneous circulation, hospital discharge, and one year survival, according to the Utstein style. Of 330 000 inhabitants, 755 suffered from cardiac arrest covered by the Heidelberg ALS services. In 512 patients, cardiopulmonary resuscitation had been initiated. Of 338 patients with cardiac aetiology, return of spontaneous circulation was achieved in 164 patients (49%), 48 (14%) were discharged alive, and 40 (12%) were alive one year later; most of these patients showed good neurological outcome. Thus, 4.85 patients with cardiac aetiology were saved by the ALS services and discharged alive per 100 000 inhabitants a year. Ventricular fibrillation or tachycardia was detected in 106 patients (31%), other cardiac rhythms in 40 (12%), and asystole in 192 (57%). Hospital discharge rates (and one year survival) in these subgroups were 34.0% (29.2%), 12.5% (7.5%), and 3.6% (3.1%), respectively. Discharge rates increased if cardiac arrest was witnessed (bystander, 20.0%; BLS/ALS personnel, 21.4%; non-witnessed arrest, 3.3%; p < 0.01), and if the time period between the alarm and the arrival of the ALS unit was four minutes or less (</= 4 minutes, 30.6%; 4-8 minutes, 10.4%; > 8 minutes, 8. 1%; p < 0.001). In 69 patients with bystander witnessed cardiac arrest with ventricular fibrillation, the discharge rate was 37.7%; 21 patients were alive after one year. A two tier BLS and physician staffed ALS system is associated with good long term outcome of patients suffering from out-of-hospital cardiac arrest of cardiac aetiology in a midsized urban/suburban area. Further studies, however, are required to assess whether having a physician in the ALS unit is an independent determinant for improved long term outcome.
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This executive summary provides the essential treatment algorithms for the resuscitation of children and adults and highlights the main guideline changes since 2010. Detailed guidance is provided in each of the ten sections, which are published as individual papers within this issue of Resuscitation. The sections of the ERC Guidelines 2015 are:
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-Data on long-term function of out-of-hospital cardiac arrest survivors are sparse. We examined return to work as proxy of preserved function without major neurological deficits in survivors. -In Denmark, out-of-hospital cardiac arrests are systematically reported to the Danish Cardiac Arrest Register since 2001. During 2001-2011, we identified 4,354 patients employed before arrest among 12,332 working age patients (18-65 years), of which 796 survived to day 30. Among 796 survivors (median age 53 years [Q1-Q3 46-59]; 81.5% men), 610 (76.6%) returned to work in a median time of 4 months [Q1-Q3 1-19] with a median time of 3 years spent back at work, of which 74.6% (N=455) remained employed without sick leaves during the first six months after return to work. This latter proportion of survivors returning to work increased over time (66.1% in 2001-2005 versus 78.1% in 2006-2011, P=0.002). In multivariable Cox regression analysis, factors associated with return to work with ≥6 months of sustainable employment were 1] arrest during 2006-2011 versus 2001-2005, HR 1.38 (95% CI, 1.05-1.82); 2] male gender, HR 1.48 (CI 95%, 1.06-2.07); 3] age of 18-49 versus 50-65 years, HR 1.32 (95% CI, 1.02-1.68); 4] bystander-witnessed arrest, HR 1.79 (95% CI, 1.17-2.76); and 5] bystander cardiopulmonary resuscitation, HR 1.38 (95% CI, 1.02-1.87). -Of 30-day survivors employed before arrest, 76.6% returned to work. The percentage of survivors returning to work increased significantly along with improved survival during 2001-2011 suggesting an increase in proportions of survivors with preserved function over time.
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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. 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. 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.
Article
Importance: Out-of-hospital cardiac arrest is a major health problem associated with poor outcomes. Early recognition and intervention are critical for patient survival. Bystander cardiopulmonary resuscitation (CPR) is one factor among many associated with improved survival. Objective: To examine temporal changes in bystander resuscitation attempts and survival during a 10-year period in which several national initiatives were taken to increase rates of bystander resuscitation and improve advanced care. Design, setting, and participants: Patients with out-of-hospital cardiac arrest for which resuscitation was attempted were identified between 2001 and 2010 in the nationwide Danish Cardiac Arrest Registry. Of 29,111 patients with cardiac arrest, we excluded those with presumed noncardiac cause of arrest (n = 7390) and those with cardiac arrests witnessed by emergency medical services personnel (n = 2253), leaving a study population of 19,468 patients. Main outcomes and measures: Temporal trends in bystander CPR, bystander defibrillation, 30-day survival, and 1-year survival. Results: The median age of patients was 72 years; 67.4% were men. Bystander CPR increased significantly during the study period, from 21.1% (95% CI, 18.8%-23.4%) in 2001 to 44.9% (95% CI, 42.6%-47.1%) in 2010 (P < .001), whereas use of defibrillation by bystanders remained low (1.1% [95% CI, 0.6%-1.9%] in 2001 to 2.2% [95% CI, 1.5%-2.9%] in 2010; P = .003). More patients achieved survival on hospital arrival (7.9% [95% CI, 6.4%-9.5%] in 2001 to 21.8% [95% CI, 19.8%-23.8%] in 2010; P < .001). Also, 30-day survival improved (3.5% [95% CI, 2.5%-4.5%] in 2001 to 10.8% [95% CI, 9.4%-12.2%] in 2010; P < .001), as did 1-year survival (2.9% [95% CI, 2.0%-3.9%] in 2001 to 10.2% [95% CI, 8.9%-11.6%] in 2010; P < .001). Despite a decrease in the incidence of out-of-hospital cardiac arrests during the study period (40.4 to 34.4 per 100,000 persons in 2001 and 2010, respectively; P = .002), the number of survivors per 100,000 persons increased significantly (P < .001). For the entire study period, bystander CPR was positively associated with 30-day survival, regardless of witnessed status (30-day survival for nonwitnessed cardiac arrest, 4.3% [95% CI, 3.4%-5.2%] with bystander CPR and 1.0% [95% CI, 0.8%-1.3%] without; odds ratio, 4.38 [95% CI, 3.17-6.06]). For witnessed arrest the corresponding values were 19.4% (95% CI, 18.1%-20.7%) vs 6.1% (95% CI, 5.4%-6.7%); odds ratio, 3.74 (95% CI, 3.26-4.28). Conclusions and relevance: In Denmark between 2001 and 2010, an increase in survival following out-of-hospital cardiac arrest was significantly associated with a concomitant increase in bystander CPR. Because of the co-occurrence of other related initiatives, a causal relationship remains uncertain.
Article
Major European institutions report cardiovascular disease (CVD) as the first cause of death in adults, with cardiac arrest and sudden death due to coronary ischaemia as the primary single cause. Global incidence of CVD is decreasing in most European countries, due to prevention, lifestyle and treatment. Mortality of acute coronary events inside the hospital decreases more rapidly than outside the hospital. To improve the mortality of cardiac arrest outside the hospital, reliable epidemiological and process figures are essential: "we can only manage what we can measure". Europe is a patchwork of 47 countries (total population of 830 million), with a 10-fold difference in incidence of coronary heart disease between North and South, East and West, and a 5-fold difference in number of EMS-treated cardiac arrest (range 17-53/1000,000/year). Epidemiology of cardiac arrest should not be calculated as a European average, but it is appropriate to describe the incidence of cardiac arrest, the resuscitation process, and the outcome in each of the European regions, for benchmarking and quality management. Epidemiological reports of cardiac arrest should specify definitions, nominator (number of cases) and denominator (study population). Recently some regional registries in North America, Japan and Europe fulfilled these conditions. The European Registry of Cardiac Arrest (EuReCa) has the potential to achieve these objectives on a pan-European scale. For operational applications, the Utstein definition of "Cardiac arrest" is used which includes the potential of survival. For application in community health, the WHO definition of "sudden death" is frequently used, describing the mode of death. There is considerable overlap between both definitions. But this explains that no single method can provide all information. Integrating data from multiple sources (local, national, multinational registries and surveys, death certificates, post-mortem reports, community statistics, medical records) may create a holistic picture of cardiac arrest in the community.
Article
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.
Article
This article reviews out-of-hospital cardiac arrest from a public health perspective. Case definitions are discussed. Incidence, outcome, and fixed and modifiable risk factors for cardiac arrest are described. There is a large variation in survival between communities that is not explained by patient or community factors. Study of variation in outcome in other related conditions suggest that this is due to differences in organizational culture rather than processes of care. A public health approach to improving outcomes is recommended that includes ongoing monitoring and improvement of processes and outcome of care.
Article
An important predictor of outcomes from out-of-hospital cardiac arrest (OOHCA) is bystander resuscitation, but in industrialised nations this is undertaken only in 15-50%. To explore reasons for this low response rate we analysed bystander perceptions during the victim's collapse, and methods used to assess cardiac arrest. Over a 12-month period we prospectively investigated all dispatches for witnessed cardiac arrest of two physician-staffed emergency medical service (EMS) units within a western European metropolitan area (Berlin, Germany). On scene the bystander was identified by the EMS physician and approached to have a semi-structured interview in the following days. Out of 201 eligible responses, 138 bystanders could be interviewed (68.7%). 63 (45.3%) of these bystanders did not detect cardiac arrest. 36 bystanders (25.9%) spontaneously reported a "bluish colour" of the patient's head or body which occurred "unexpectedly". 39 persons (28.1%) reported abnormal breathing. Assessment of breathing was not undertaken in 27.0%, nor of circulation in 29.0%. If circulation was assessed pulse check was performed in 93.4%. In this sample of interviewed bystanders of OOHCA, almost half of the arrests were not detected. This might be a reason for the low rate of bystander resuscitation. Common bystander perceptions of arrest presence included "bluish skin colour" and abnormal breathing of the victim. These findings indicate that improvement of perception capabilities should be incorporated as a major learning objective into lay basic life support training. In addition, information regarding skin colour may be of value in dispatch protocols.