Letter to the Editor

KIDS SAVE LIVES implementation in Europe: A survey through the ERC Research NET

Basic life support education for schoolchildren has become a key initiative to increase bystander cardiopulmonary resuscitation rates. Our objective was to review the existing literature on teaching schoolchildren basic life support to identify the best practices to provide basic life support training in schoolchildren.

After topics and subgroups were defined, a comprehensive literature search was conducted. Systematic reviews and controlled and uncontrolled prospective and retrospective studies containing data on students <20 years of age were included.

Schoolchildren are highly motivated to learn basic life support. The CHECK-CALL-COMPRESS algorithm is recommended for all schoolchildren. Regular training in basic life support regardless of age consolidates long-term skills. Young children from 4 years of age are able to assess the first links in the chain of survival. By 10 to 12 years of age, effective chest compression depths and ventilation volumes can be achieved on training manikins. A combination of theoretical and practical training is recommended. Schoolteachers serve as effective basic life support instructors. Schoolchildren also serve as multipliers by passing on basic life support skills to others. The use of age-appropriate social media tools for teaching is a promising approach for schoolchildren of all ages.

Schoolchildren basic life support training has the potential to educate whole generations to respond to cardiac arrest and to increase survival after out-of-hospital cardiac arrest. Comprehensive legislation, curricula, and scientific assessment are crucial to further develop the education of schoolchildren in basic life support.

Valorar cuantitativamente la capacidad de aprendizaje en soporte vital básico (teórica y práctica) de escolares de 8-12 años con un programa de formación adaptado a las escuelas.

Estudio cuasiexperimental con una muestra de conveniencia de 567 alumnos de 3° y 5° de Educación Primaria y 1° de Educación Secundaria Obligatoria, de 3 colegios concertados de Galicia, que recibieron 2 h (una teórica y otra práctica) de formación en soporte vital básico por parte de sus profesores de Educación Física integrada en el programa escolar. Los niños fueron evaluados mediante un test teórico y una prueba práctica que midió la calidad de las compresiones torácicas y valoró la secuencia de soporte vital básico.

El nivel de conocimientos aumentó respecto al basal y fue mayor en los alumnos de cursos superiores (p < 0,001). La secuencia completa de soporte vital básico fue realizada por el 16,5% de los escolares de 3° de Educación Primaria, el 54,4% de los de 5° de Educación Primaria y el 28,5% de los de 1° de Educación Secundaria Obligatoria (p = 0,030). Los siguientes parámetros de calidad de las compresiones mejoraron de forma significativa con la edad: continuidad de las compresiones (p < 0,001), porcentaje de compresiones realizadas con una profundidad correcta (p = 0,002) y mediana de profundidad (p < 0,001), mientras que el porcentaje de compresiones con descompresión correcta descendió significativamente (p < 0,001).

Un programa formativo teórico-práctico de 2 h, impartido por los profesores de Educación Física, contribuye a mejorar la capacidad de los niños menores de 13 años para reconocer la emergencia, poner en marcha la cadena de supervivencia e iniciar las compresiones torácicas, aunque posiblemente sus características antropométricas no les permitan alcanzar la calidad ideal establecida para esta maniobra.

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.

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 2 h (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.

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).

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.

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.

La formation en réanimation cardiorespiratoire (RCR) et défibrillateurs externes automatisés (DEA) est obligatoire dans le cadre du programme d’études secondaires des écoles de l’Ontario. Nous avons entrepris une enquête dans les écoles pour comprendre la portée de cette formation, notamment ses obstacles et ses facilitateurs. Nous avons procédé au recrutement dans 120 (58,5 %) écoles élémentaires, 25 (12,2 %) écoles intermédiaires et 60 (29,3 %) écoles secondaires. Presque 60 % (120 sur 200) des écoles secondaires offraient la formation en RCR au personnel, mais seulement 56 % (27 sur 48) formaient les élèves. Les principaux obstacles étaient le manque de financement, de temps et de formateurs. Bien que le gouvernement ait rendu obligatoire la formation en RCR et DEA dans le cadre du programme d’études secondaires, seulement 56 % des écoles offrent la formation. D’autres études sont nécessaires pour comprendre les obstacles à la mise en œuvre de cette formation qui permet de sauver des vies.

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.