Elsevier

Resuscitation

Volume 64, Issue 3, March 2005, Pages 303-307
Resuscitation

How to become an under 11 rescuer: a practical method to teach first aid to primary schoolchildren

https://doi.org/10.1016/j.resuscitation.2004.09.004Get rights and content

Abstract

It has been calculated that, on average, 20% of the population should be trained to provide first aid, if a significant reduction of mortality is to be achieved. However, wide dissemination of the principles of emergency care poses a series of difficulties. As a partial solution, we have designed a first aid training course for children aged 8–11 years in their last three courses at primary school. According to the Italian school system, classes in primary school are indicated as I through V, from start to ending. The course addresses three issues: the broken tooth, nose bleeding and paediatric basic life support (PBLS). The course is divided into 17 didactic modules: each module contains a theoretical lecture, a practical demonstration by the trainer and a session for the trainees to practice under supervision. The aim of the study was to evaluate the benefit of teaching emergency procedures including practical sessions for pupils in primary schools. Four hundred and sixty-nine children were enrolled: the evaluation consisted of a 13 question multiple-choice written test taken at the end of the theoretical session and a semi-structured test at one month. Two hundred and seventy-one children attended to the theoretical lesson only, without going through the practical session (Group A), while the remaining 189 children completed the practical training (Group B). The outcome of the evaluation demonstrates that older children (in their V school class) score better than those in their IV and III class (p < 0.001). However, when comparing Group A and Group B in each class, the children that had also been exposed to the practical training (Group B) scored significantly better (VB versus VA p < 0.001; IVB versus IVA p < 0.001; IIIB versus IIIA p < 0.01).

In conclusion, this proposed method of teaching emergency first aid could be successful in training primary school children. The permanent integration of the subject into the core curriculum of primary schools, and extended to higher school levels, could help in disseminating the culture of emergency care in the general population.

Introduction

In most emergency situations, first aid needs to be administered by a layperson [1]. Even in the most favourable situations, it takes time for trained health care personnel to arrive at the scene [2]. The interval between, for example, a cardiac arrest and the start of cardiopulmonary resuscitation, is critical to the survival of the patient [3], [4].

The number of laypeople who deliver first aid, after witnessing an accident is still too small [5]. Most of these occasional rescuers have never taken part in a basic life support (BLS) course. Surveys have shown that occasional witnesses attempt resuscitation in less than 30% of cases, so that the number of lives saved is still sub-optimal [6].

In the 1980s, the American Heart Association suggested that morbidity and mortality from cardiac arrest could be significantly reduced if at least 20% of the population were trained to act appropriately in an emergency [7].

Those involved in spreading the culture of how to act in an emergency, face two problems—attitude and learning.

The first problem concerns the need to spread the concept of correct behaviour and basic resuscitation skills to larger section of the population. Consequently, there is a requirement for a teaching method that is applicable on a large scale for people with widely different levels of education. For large-scale training an adequate number of instructors is required. The cost is seldom supported by public institutions and more often weighs on individual citizens or volunteers.

The second problem pertains to reinforce the skills learned to ensure that the behavioural changes induced by the training programme are retained [8]. It also means that the trainees become aware of the social benefit of their knowledge of basic resuscitation skills and the need for frequent refresher training.

In common with other authors [2], [9] and the European Resuscitation Council [10], we believe that the most appropriate way to address both problems is to include BLS courses within the school syllabus.

We report on how we have designed a Paediatric Basic Life Support (PBLS) course for primary school children and the results we have achieved using different methods to induce long term learning.

Section snippets

Course preparation

The course on emergencies for primary school children, involves the combined efforts of paediatricians dealing with emergencies, schoolteachers, psychologists and a designer. It has been named ‘becoming an under 11 rescuer’. The core of the course addresses three issues: ‘the bleeding nose’, ‘the broken tooth’ and ‘paediatric basic life support’ (Fig. 1). The first two issues have been selected because they made possible to introduce the methodology of the course through two kinds of conditions

Results

Table 2 shows the results in the multiple-choice evaluation test achieved by study Groups (A or B) and school class.

Group B scored significantly better than Group A in any class (VB versus VA p < 0.001; IVB versus IVA p < 0.001; IIIB versus IIIA p < 0.01). Both in Group B and in Group A, the number of correct answers by children in school class V was significantly higher than in school classes IV and III (p < 0.001).

In both Group B and Group A the number of correct answers by children in school class

Discussion

The aim was to design a course for teaching primary school children to ensure adequate behaviour in an emergency. Of the three core issues in the course, PBLS was prepared according to current guidelines, adapted to the mental development of an average 8–11-year-old child.

The course method recognises that the ability to retain knowledge is based on the concomitant involvement of several senses. Students retain 10% of what they read, 20% of what they listen to, 30% of what they watch, 50% of

Acknowledgment

This project was made possible by a grant by nuovArmonia ONLUS association.

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  • Preliminary results of teaching first aid to 5–6 year old children – a longitudinal study

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    Citation Excerpt :

    The experiences we acquired during our test showed that first aid can be successfully taught to young children. Many other studies prove that teaching in younger age can be useful [26–28], but only a few deal with the first aid training for preschool children [29]. In Austria, six and seven year old children were able to learn and use first aid activities, for example, call an ambulance, CPR, AED, recovery position, minimise bleeding and burns [26].

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A Spanish and Portuguese translated version of the Abstract and Keywords of this article appears at 10.1016/j.resuscitation.2004.09.004.

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