Push hard, push fast: quasi-experimental study on the capacity of elementary schoolchildren to perform cardiopulmonary resuscitation

Abstract

BackgroundThe optimal age to begin CPR training is a matter of debate. This study aims to determine if elementary schoolchildren have the capacity to administer CPR efficiently.MethodsThis quasi-experimental study took place in a Quebec City school. Eighty-two children 10 to 12 years old received a 6-hour CPR course based on the American Heart Association (AHA) Guidelines. A comparison group of 20 adults who had taken the same CPR course was recruited. After training, participants’ performance was evaluated using a Skillreporter manikin. The primary outcome was depth of compressions. The secondary outcomes were compression rate, insufflation volume and adherence to the CPR sequence. Children’s performance was primarily evaluated based on the 2005 AHA standards and secondarily compared to the adults’ performance.ResultsSchoolchildren did not reach the lower thresholds for depth (28.1 +/− 5.9 vs 38 mm; one-sided p = 1.0). The volume of the recorded insufflations was sufficient (558.6 +/222.8 vs 500 ml; one-sided p = 0.02), but there were a significant number of unsuccessful insufflation attempts not captured by the Skillreporter. The children reached the minimal threshold for rate (113.9 +/−18.3 vs 90/min; one-sided p < 0.001). They did not perform as well as the adults regarding compression depth (p < 0.001), but were comparable for insufflation volume (p = 0.83) and CPR sequence.ConclusionsIn this study, schoolchildren aged 10–12 years old did not achieve the standards for compression depth, but achieved adequate compression rate and CPR sequence. When attempts were successful at generating airflow in the Skillreporter, insufflation volume was also adequate.

To strengthen self-confidence as a step in improving prehospital youth laymen basic life support

“…This increase is a small improvement of the youths' self-confidence in performing mouth to mouth ventilation. In real life events, there is a possibility for a high psychological barrier of youth to initiate mouth-to-mouth ventilation [27] resulting in en poorly performed ventilation of the patient [28]. Schroeder et al [29], therefore, argues that, due to the decreasing importance of mouth-to-mouth ventilation in lay resuscitation in favor of chest compressions, specially adapted CPR-algorithms for school children could be discussed [29].…”

To enhance the quality of CPR performed by youth layman

“…There is a risk that the air instead goes down into the ventricle of the patient [21]. Another reason why the patient is not ventilated may be the high psychological barrier of youth to initiate mouth-to-mouth ventilation as described by Berthelot et al [22]. The participants who did not want to ventilate the patient, using mouth to mouth, did not make a serious attempt to ventilate mouth to mouth.…”

Children saving lives: Training towards CPR excellence levels in chest compression based on age and physical characteristics

“…This finding is in line with other authors and underpins the fact that children's physical characteristics play a role in the quality of chest compressions. [9][10][11][12][13] According to the literature the influence of gender on the compression depth in children is yet not clear. 10,14 Our data provide insight on the gender dependent evolution of the skills proficiency throughout the three different age groups (i.e., grades).…”

“…6,7,8 Achieving adequate compression depth is age-, height-and weight dependent and therefore children's physical characteristics play a role in the quality of chest compressions. [9][10][11][12][13] The influence of gender on the compression depth in children is yet not clear, but most likely related to body weight. 10,14 Moreover, the influence of rescuer fatigue, especially in younger children will also impact on compression depth over time.…”