Elsevier

Resuscitation

Volume 59, Issue 2, November 2003, Pages 211-220
Resuscitation

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

https://doi.org/10.1016/S0300-9572(03)00233-8Get rights and content

Abstract

Background: Life-supporting first-aid (LFSA) training in primary schools might prove a useful means of increasing cardiac arrest survival rates. We thus studied the feasibility of introducing first-aid training to 6–7-year old primary school children. Methods and results: During 1 week medical students and emergency physicians provided LSFA training to 47 first- and second-year pupils, including semi-automatic defibrillation. A course assessment was made using cartoon-style questionnaires for the pupils, video tapes of the training and telephone interviews with the children's parents. Prior to training, only eight pupils (17%) were able to place in the correct sequence a series of pictures illustrating the various stages of the procedure of semi-automatic defibrillation. After training that figure rose to 24 (51%). Using a semi-automatic defibrillator, excellent performances were recorded by video camera in eight pupils. Post-training telephone interviews were conducted with 34 parents (79%), 28 (82%) of whom now considered their children capable of reacting properly in an emergency situation. The children had been given stickers displaying the European Emergency Call Number 112 together with a set of brochures. In 25 cases (74%), the children applied the stickers to their parents phones at home. Conclusions: LSFA training is a feasible proposition for 6–7-year olds who might well be in a position to save the lives of cardiac-arrest victims. Future training sessions should determine the impact of repeat courses and the findings should be used to convince politicians and administrators of the need of LSFA training as a mandatory subject in schools.

Sumàrio

Contexto: O treino em Primeiros Soccorros e Suporte de Vida (LFSA) nas escolas primárias pode ser um meio útil para aumentar as taxas de sobrevida da paragem cardı́aca. Estudamos a possibilidade de introduzir o treino em primeiros socorros a crianças da escola primária com 6-7 anos de idade. Métodos e resultados: Durante uma semana, médicos emergencistas e estudantes de medicina fizeram formação em LFSA a 47 alunos do primeiro e segundo anos, incluindo desfibrilhação semi-automática. Fez-se a avaliação do curso utilizando questionários em banda desenhada para os alunos, vı́deo para o treino e entrevistas telefónicas para os pais das crianças. Antes da formação, apenas 8 crianças (17%) eram capazes de ordenar na sequência correcta a série de desenhos que ilustrava os vários estadios dos procedimentos de desfibrilhação semi-automática. Depois da formação, o número subiu para 24 (51%). Foram gravadas em vı́deo excelentes utilizações do desfibrilhador semi-automático em 8 alunos. Foram feitas entrevistas telefónicas após a formação a 34 pais (79%), dos quais 28 (82%) consideravam que os seus filhos estavam agora aptos a reagir adequadamente numa situação de emergência. Foram dados ás crianças autocolantes com o Número Europeu de Emergência 112, juntamente com um conjunto de brochuras. Em 25 (74%) casos as crianças colocaram os autocolantes no telefone dos pais em casa. Conclusões: A formação em LSFA é uma proposta realizável para crianças de 6–8 anos de idade que podem estar em situação de salvar vı́timas de paragem cardı́aca. Futuras sessões de treino deverão determinar o impacto de cursos repetidos e os resultados deverão ser utilizados para convencer os polı́ticos e administradores da necessidade do ensino de LSFA como disciplina obrigatória.

Resumen

Antecedentes: El entrenamiento en primeros auxilios de soporte vital en colegios primarios puede resultar ser un medio útil de aumentar las tasas de sobrevida del paro cardı́aco. Estudiamos la factibilidad de introducir entrenamiento en primeros auxilios a niños de 6-7 años de escuela primaria. Métodos y resultados: Estudiantes de medicina y médicos de emergencias proporcionaron entrenamiento en LCFA durante una semana a 47 alumnos de primer y segundo grado de primaria, incluyendo desfibrilación semi automática. Se hizo una evaluación del curso usando un cuestionario estilo caricatura para los pupilos, usando cintas de video de los entrenamientos y entrevistas telefónicas con los padres de los niños. Antes del entrenamiento, solo 8 niños (17%) eran capaces de ubicar en la secuencia correcta una serie de dibujos que ilustraban varias etapas del proceso de desfibrilación semiautomática. Después del entrenamiento esa cifra subió a 24 (51%). En el uso de un desfibrilador semiautomático, se registraron con cámara de video desempeños excelentes en 8 pupilos. Se condujeron entrevistas post entrenamiento con 34 padres (79%), 28 (82%) de los cuales hoy consideraban a sus hijos capaces de reaccionar adecuadamente en una situación de emergencia. Se les dio a los niños autoadhesivos que mostraban el numero Europeo de emergencias 112 junto con un grupo de folletos. En 25 casos (74%), los niños pegaron los autoadhesivos en los teléfonos de sus padres en casa. Conclusiones: El entrenamiento en LSFA es una proposición factible para niños de 6-7 años de edad que bien podrı́an estar en posición de salvar las vidas de vı́ctimas de paro cardı́aco. Futuras sesiones de entrenamiento deberı́an determinar el impacto de repetir los cursos y los hallazgos deben ser usados para convencer a los polı́ticos y administradores de la necesidad de entrenamiento en LSFA como un tema mandatorio.

Introduction

Surviving cardiac arrest depends on several different factors [1]. Immediate action and cardiopulmonary resuscitation (CPR) performed by laypersons are fundamental to the success. Survival rates correlate proportionally to the time taken to administer CPR. Few are able to help or willing to act decisively in an emergency on the street or at home [2], [3], [4], [5], [6], [7].

Victims of a cardiac arrest require appropriate resuscitation prior to the arrival of the emergency team. Survival rates will only improve, if the time without basic life support (BSL) is kept to an absolute minimum. On average, it takes some 8–13 min for the EMS to arrive on the scene. Only then, in many cases, is CPR administered. The first 3–5 min are vital to avoiding irreversible organ damage in normothermic patients [8]. The optimal management is to have first responder CPR. Knowing how to react in an emergency can make all the difference between life and death for the victim [9]. A member of the general public is generally the first responder; their knowledge of LSFA is key to the patient's survival.

The effectiveness of CPR administered by lay persons has been the subject of considerable research [10]. To increase the number of cases where CPR is initiated by a lay person, it is obviously desirable to train a large proportion of the general public. The American Heart Association has suggested that morbidity and mortality in out-of-hospital cardiac arrests could be reduced significantly, if 20% of the adult population were appropriately trained [11]. The Austrian Red Cross and other organisations offer training amenities, yet the public at large is not inclined to invest time and money in such courses. Nobody is willing to pay for the additional stress involved, let alone spend valuable leisure time in regular LSFA training programmes after work or at weekends. The Austrian Red Cross (Jugendrotkreuz) has started LSFA training for children aged eight and older.

In Austria, the opportunities open to adults wishing to acquire the requisite knowledge and receive practical training are limited. Driving school courses, CPR training during military service and similar courses are often inadequate and of dubious quality. They are directed towards small groups and may not reach the ‘masses’. Austria still lacks other possibilities of publicising LSFA on a national scale. As a result there is reluctance to administer LSFA for fear of doing something wrong. In the ultimate analysis this leads to little resuscitation being administered by lay persons. Given this situation, another approach has to be found to increase the level of knowledge of BLS and de-mystifying LSFA.

Section snippets

Material and methods

Our analysis focused first on the international literature and official information available from different national and international bodies and emergency medical service organisations. After that we investigated the present situation in Austria and then designed and evaluated an LSFA teaching programme for primary schools. In an advanced elective course extending over two semesters (winter semester 2001 and summer semester2002), 17 undergraduates (nine male aged 22–36 and eight female aged

Results

The findings of the three undergraduate working groups are presented below.

Discussion

Our findings show that at the age of six or seven, schoolchildren are quite capable of comprehending and practising first aid. For them, using something an AED was as simple as using a TV remote control. The young schoolchildren showed themselves to be receptive to first-aid training and clearly derived benefit from it. The simplicity of teaching and ease of learning were as impressive as their display of the knowledge acquired during the course. Furthermore, the international literature search

Conclusions

LSFA training is a feasible proposition for 6–7-year olds. Future training should evaluate the impact of repeated courses and be used to alert politicians and administrators to the need to include this kind of training as a mandatory component in the primary school curriculum. The pupils of today are the performers of CPR tomorrow.

Acknowledgements

The University of Vienna, Austria has awarded the project the Bank Austria Foundation Prize ‘Interdisziplinäre Lehrveranstaltungen’ Innovation in Teaching (€ 4000) http://www.univie.ac.at/intiovation. Many thanks to Marcus Müllner for the provision of statistical advice. For the generous support they lent our project we wish to thank: Austrian Heart Foundation, General Hospital–University Clinics Vienna, Laerdal Medical, OEAMTC, Philips, Point of View, RORACO and the Vienna Ambulance Service,

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