Feasibility of life-supporting first-aid (LSFA) training as a mandatory subject in primary schools
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,
References (30)
- et al.
Attitudes of trained Swedish lay rescuers toward CPR performance in an emergency. A survey of 1012 recently trained CPR rescuers
Resuscitation
(2000) - et al.
Life supporting first aid training of the public—review and recommendations
Resuscitation
(1999) - et al.
Resuscitation in Europe: a tale of five European regions
Resuscitation
(1999) - et al.
Neighborhoods matter: a population-based study of provision of cardiopulmonary resuscitation
Ann. Emerg. Med.
(1999) - et al.
The need for wider dissemination of CPR skills: are schools the answer
Resuscitation
(1994) - et al.
The teaching of cardiopulmonary resuscitation in schools in Hampshire
Resuscitation
(1997) - et al.
Four-step CPR-improving skill retention
Resuscitation
(1998) - et al.
The attitudes of cardiac arrest survivors and their family members towards CPR courses
Resuscitation
(2000) Survival from out-of-hospital cardiac arrest: a multivariate analysis
Med. Care
(1991)- et al.
Readiness to perform cardiopulmonary resuscitation: an emerging strategy against sudden cardiac death
Psychosom. Med.
(1999)
Estimating the effect of bystander-initiated cardiopulmonary resuscitation in Japan
Resuscitation
Kids learn to ‘do the right thing’—emergency training not too difficult for kids
Hosp. Case Manage.
Indicators of response to a mass media CPR campaign
Am. J. Public Health
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