Okul Çağındaki Çocuklara Kardiyopulmoner Resusitasyon Öğretilebilir: Çocuklar Hayat Kurtarır

Year 2024, Volume: 7 Issue: 1, 47 - 53, 31.03.2024

Emel Altıntaş , Cem Oktay , Sena Baykara Sayılı

https://doi.org/10.54996/anatolianjem.1437152

Abstract

Hastane dışı kardiyak arrest (HDKA) önemli bir halk sağlığı sorunudur. Kardiyopulmoner resusitasyon (KPR) ile ilgili bilimin gelişmesi, kılavuzların geliştirilmesi ve teknolojinin etkisi olmasına rağmen HDKA’dan sağ kalım oranları düşük kalmaktadır. Olay yerinde bulunan kişiler tarafından hemen KPR başlatılmasının hayatta kalım oranlarını iki ile dört kat artırabilir. Mevcut kanıtlar, verilen KPR eğitiminin geniş bir yaş aralığındaki çocuklarda başarılı olduğunu göstermektedir. 4 yaşından itibaren çocukların Yaşam Zincirindeki uygulamaları yapabilmeye başladıkları gösterilmiştir Bu makaledeki amacımız, kardiyak arrestte hayatta kalımı etkileyen faktörler, okul çağındaki çocuklara KPR’nin en uygun nasıl öğretilebileceği ve çocuklara KPR eğitimi yapılması için dünya çapında yürütülen girişimlerle ilgili literatürü gözden geçirmektir.

Keywords

Kardiyopulmoner resusitasyon, hastane dışı kardiyak arrest, KPR eğitimi, okul çağındaki çocuklar

Cardiopulmonary Resusitation can be Taught To Schoolchildren: Kids Save Lives

Abstract

Out-of-hospital cardiac arrest (OHCA) is a major public health concern. Despite the advancement of resuscitation science, development of guidelines and the impact of technology regarding cardiopulmonary resuscitation (CPR), survival rates from OHCA remain low. Initiation of early bystander CPR can double or quadruple survival rates. Current evidence shows that CPR training is successful in children across a wide age range. It has been shown that from the age of 4, children begin to perform procedures in the Chain of Survival. Our objective is to review the literature on factors affecting survival in cardiac arrest, how to best teach CPR to schoolchildren and the initiatives carried out worldwide to provide CPR training to children.

Keywords

Cardiopulmonary resuscitation, out-of-hospital cardiac arrest, CPR training, school children

References

• Long B, Gottlieb M. Cardiopulmonary Resuscitation: The Importance of the Basics. Emerg Med Clin North Am. 2023;41(3):509-528. doi:10.1016/j.emc.2023.03.005
• Panchal AR, Bartos JA, Cabañas JG, et al. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020;142(16_suppl_2):S366-S468. doi:10.1161/CIR.0000000000000916
• Sayre MR, Berg RA, Cave DM, et al. Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee. Circulation. 2008;117(16):2162-2167. doi:10.1161/CIRCULATIONAHA.107.189380
• Kleinman ME, Brennan EE, Goldberger ZD, et al. Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132(18 Suppl 2):S414-S435. doi:10.1161/CIR.0000000000000259
• Sayre MR, Koster RW, Botha M, et al. Part 5: Adult basic life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations [published correction appears in Circulation. 2013 Nov 5;128(19):e393]. Circulation. 2010;122(16 Suppl 2):S298-S324. doi:10.1161/CIRCULATIONAHA.110.970996
• Taniguchi D, Baernstein A, Nichol G. Cardiac arrest: a public health perspective. Emerg Med Clin North Am. 2012;30(1):1-12. doi:10.1016/j.emc.2011.09.003
• Gräsner JT, Herlitz J, Tjelmeland IBM, et al. European Resuscitation Council Guidelines 2021: Epidemiology of cardiac arrest in Europe. Resuscitation. 2021;161:61-79. doi:10.1016/j.resuscitation.2021.02.007
• Beck B, Bray J, Cameron P, et al. Regional variation in the characteristics, incidence and outcomes of out-of-hospital cardiac arrest in Australia and New Zealand: Results from the Aus-ROC Epistry. Resuscitation. 2018;126:49-57. doi:10.1016/j.resuscitation.2018.02.029
• Gräsner JT, Bossaert L. Epidemiology and management of cardiac arrest: what registries are revealing. Best Pract Res Clin Anaesthesiol. 2013;27(3):293-306. doi:10.1016/j.bpa.2013.07.008
• Holmberg M, Holmberg S, Herlitz J. Effect of bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients in Sweden. Resuscitation. 2000;47(1):59-70. doi:10.1016/s0300-9572(00)00199-4
• Herlitz J, Bång A, Gunnarsson J, et al. Factors associated with survival to hospital discharge among patients hospitalised alive after out of hospital cardiac arrest: change in outcome over 20 years in the community of Göteborg, Sweden. Heart. 2003;89(1):25-30. doi:10.1136/heart.89.1.25
• Böttiger BW, Grabner C, Bauer H, et al. Long term outcome after out-of-hospital cardiac arrest with physician staffed emergency medical services: the Utstein style applied to a midsized urban/suburban area. Heart. 1999;82(6):674-679. doi:10.1136/hrt.82.6.674
• Gräsner JT, Wnent J, Herlitz J, et al. Survival after out-of-hospital cardiac arrest in Europe - Results of the EuReCa TWO study. Resuscitation. 2020;148:218-226. doi:10.1016/j.resuscitation.2019.12.042
• Kitamura T, Kiyohara K, Nishiyama C, et al. Chest compression-only versus conventional cardiopulmonary resuscitation for bystander-witnessed out-of-hospital cardiac arrest of medical origin: A propensity score-matched cohort from 143,500 patients. Resuscitation. 2018;126:29-35. doi:10.1016/j.resuscitation.2018.02.017
• Böttiger BW, Bode C, Kern S, et al. Efficacy and safety of thrombolytic therapy after initially unsuccessful cardiopulmonary resuscitation: a prospective clinical trial. Lancet. 2001;357(9268):1583-1585. doi:10.1016/S0140-6736(00)04726-7
• Wissenberg M, Lippert FK, Folke F, et al. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA. 2013;310(13):1377-1384. doi:10.1001/jama.2013.278483
• Böttiger BW, Semeraro F, Altemeyer KH, et al. KIDS SAVE LIVES: School children education in resuscitation for Europe and the world. Eur J Anaesthesiol. 2017;34(12):792-796. doi:10.1097/EJA.0000000000000713
• Gräsner JT, Lefering R, Koster RW, et al. EuReCa ONE-27 Nations, ONE Europe, ONE Registry: A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe [published correction appears in Resuscitation. 2016 Dec;109:145-146]. Resuscitation. 2016;105:188-195. doi:10.1016/j.resuscitation.2016.06.004
• Kanstad BK, Nilsen SA, Fredriksen K. CPR knowledge and attitude to performing bystander CPR among secondary school students in Norway. Resuscitation. 2011;82(8):1053-1059. doi:10.1016/j.resuscitation.2011.03.033
• De Buck E, Van Remoortel H, Dieltjens T, et al. Evidence-based educational pathway for the integration of first aid training in school curricula. Resuscitation. 2015;94:8-22. doi:10.1016/j.resuscitation.2015.06.008
• Omi W, Taniguchi T, Kaburaki T, et al. The attitudes of Japanese high school students toward cardiopulmonary resuscitation. Resuscitation. 2008;78(3):340-345. doi:10.1016/j.resuscitation.2008.03.233
• Lester C, Donnelly P, Weston C, et al. Teaching schoolchildren cardiopulmonary resuscitation. Resuscitation. 1996;31(1):33-38. doi:10.1016/0300-9572(95)00912-4
• Parnell MM, Pearson J, Galletly DC, et al. Knowledge of and attitudes towards resuscitation in New Zealand high-school students. Emerg Med J. 2006;23(12):899-902. doi:10.1136/emj.2006.041160
• Nord A, Hult H, Kreitz-Sandberg S, et al. Effect of two additional interventions, test and reflection, added to standard cardiopulmonary resuscitation training on seventh grade students' practical skills and willingness to act: a cluster randomised trial. BMJ Open. 2017;7(6):e014230. Published 2017 Jun 23. doi:10.1136/bmjopen-2016-014230
• Hubble MW, Bachman M, Price R, et al. Willingness of high school students to perform cardiopulmonary resuscitation and automated external defibrillation. Prehosp Emerg Care. 2003;7(2):219-224. doi:10.1080/10903120390936815
• Naim MY, Burke RV, McNally BF, et al. Association of Bystander Cardiopulmonary Resuscitation With Overall and Neurologically Favorable Survival After Pediatric Out-of-Hospital Cardiac Arrest in the United States: A Report From the Cardiac Arrest Registry to Enhance Survival Surveillance Registry. JAMA Pediatr. 2017;171(2):133-141. doi:10.1001/jamapediatrics.2016.3643
• Swor RA, Jackson RE, Cynar M, et al. Bystander CPR, ventricular fibrillation, and survival in witnessed, unmonitored out-of-hospital cardiac arrest. Ann Emerg Med. 1995;25(6):780-784. doi:10.1016/s0196-0644(95)70207-5
• McCarthy JJ, Carr B, Sasson C, et al. Out-of-Hospital Cardiac Arrest Resuscitation Systems of Care: A Scientific Statement From the American Heart Association. Circulation. 2018;137(21):e645-e660. doi:10.1161/CIR.0000000000000557
• Zeleke BG, Biswas ES, Biswas M. Teaching Cardiopulmonary Resuscitation to Young Children (<12 Years Old). Am J Cardiol. 2019;123(10):1626-1627. doi:10.1016/j.amjcard.2019.02.011
• Schmid KM, García RQ, Fernandez MM, et al. Teaching Hands-Only CPR in Schools: A Program Evaluation in San José, Costa Rica. Ann Glob Health. 2018;84(4):612-617. Published 2018 Nov 5. doi:10.9204/aogh.2367
• Li H, Shen X, Xu X, et al. Bystander cardiopulmonary resuscitation training in primary and secondary school children in China and the impact of neighborhood socioeconomic status: A prospective controlled trial. Medicine (Baltimore). 2018;97(40):e12673. doi:10.1097/MD.0000000000012673
• Paglino M, Contri E, Baggiani M, et al. A video-based training to effectively teach CPR with long-term retention: the ScuolaSalvaVita.it ("SchoolSavesLives.it") project. Intern Emerg Med. 2019;14(2):275-279. doi:10.1007/s11739-018-1946-3
• Magid KH, Heard D, Sasson C. Addressing Gaps in Cardiopulmonary Resuscitation Education: Training Middle School Students in Hands-Only Cardiopulmonary Resuscitation. J Sch Health. 2018;88(7):524-530. doi:10.1111/josh.12634
• Aloush S, Tubaishat A, ALBashtawy M, et al. Effectiveness of Basic Life Support Training for Middle School Students. J Sch Nurs. 2019;35(4):262-267. doi:10.1177/1059840517753879
• Gabriel IO, Aluko JO. Theoretical knowledge and psychomotor skill acquisition of basic life support training programme among secondary school students. World J Emerg Med. 2019;10(2):81-87. doi:10.5847/wjem.j.1920-8642.2019.02.003
• Brown LE, Carroll T, Lynes C, et al. CPR skill retention in 795 high school students following a 45-minute course with psychomotor practice. Am J Emerg Med. 2018;36(6):1110-1112. doi:10.1016/j.ajem.2017.10.026
• Malta Hansen C, Zinckernagel L, Ersbøll AK, et al. Cardiopulmonary Resuscitation Training in Schools Following 8 Years of Mandating Legislation in Denmark: A Nationwide Survey. J Am Heart Assoc. 2017;6(3):e004128. Published 2017 Mar 14. doi:10.1161/JAHA.116.004128
• Kragholm K, Wissenberg M, Mortensen RN, et al. Bystander Efforts and 1-Year Outcomes in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2017;376(18):1737-1747. doi:10.1056/NEJMoa1601891
• Riva G, Ringh M, Jonsson M, et al. Survival in Out-of-Hospital Cardiac Arrest After Standard Cardiopulmonary Resuscitation or Chest Compressions Only Before Arrival of Emergency Medical Services: Nationwide Study During Three Guideline Periods. Circulation. 2019;139(23):2600-2609. doi:10.1161/CIRCULATIONAHA.118.038179
• Böttiger BW, Van Aken H. Kids save lives--Training school children in cardiopulmonary resuscitation worldwide is now endorsed by the World Health Organization (WHO). Resuscitation. 2015;94:A5-A7. doi:10.1016/j.resuscitation.2015.07.005
• Kitamura T, Kiyohara K, Sakai T, et al. Public-Access Defibrillation and Out-of-Hospital Cardiac Arrest in Japan. N Engl J Med. 2016;375(17):1649-1659. doi:10.1056/NEJMsa1600011
• Semeraro F, Greif R, Böttiger BW, et al. European Resuscitation Council Guidelines 2021: Systems saving lives. Resuscitation. 2021;161:80-97. doi:10.1016/j.resuscitation.2021.02.008
• Böttiger BW, Van Aken H. Training children in cardiopulmonary resuscitation worldwide. Lancet. 2015;385(9985):2353. doi:10.1016/S0140-6736(15)61099-6
• Böttiger BW, Lockey A, Aickin R, et al. “All citizens of the world can save a life” - The World Restart a Heart (WRAH) initiative starts in 2018. Resuscitation. 2018;128:188-190. doi:10.1016/j.resuscitation.2018.04.015
• Böttiger BW, Lockey A. World Restart a Heart initiative: all citizens of the world can save a life. Lancet. 2018;392(10155):1305. doi:10.1016/S0140-6736(18)31774-4
• Schroeder DC, Semeraro F, Greif R, et al. KIDS SAVE LIVES: Basic Life Support Education for Schoolchildren: A Narrative Review and Scientific Statement From the International Liaison Committee on Resuscitation [published correction appears in Circulation. 2023 Jul 4;148(1):e1]. Circulation. 2023;147(24):1854-1868. doi:10.1161/CIR.0000000000001128
• Bollig G, Wahl HA, Svendsen MV. Primary school children are able to perform basic life-saving first aid measures. Resuscitation. 2009;80(6):689-692. doi:10.1016/j.resuscitation.2009.03.012.
• Bollig G, Myklebust AG, Østringen K. Effects of first aid training in the kindergarten--a pilot study. Scand J Trauma Resusc Emerg Med. 2011;19:13. Published 2011 Feb 28. doi:10.1186/1757-7241-19-13
• Naqvi S, Siddiqi R, Hussain SA, et al. School children training for basic life support. J Coll Physicians Surg Pak. 2011;21(10):611-615. doi:10.2011/JCPSP.611615
• Huber JF, Davis S, Phan J, et al. Children's Ability to Call 911 in an Emergency: A Simulation Study. Pediatrics. 2021;147(4):e2020010520. doi:10.1542/peds.2020-010520
• Plant N, Taylor K. How best to teach CPR to schoolchildren: a systematic review. Resuscitation. 2013;84(4):415-421. doi:10.1016/j.resuscitation.2012.12.008
• Otero-Agra M, Rodríguez-Núñez A, Rey E, et al. What biomechanical factors are more important in compression depth for children lifesavers? A randomized crossover study. Am J Emerg Med. 2019;37(1):100-108. doi:10.1016/j.ajem.2018.05.003
• Abelairas-Gómez C, Martinez-Isasi S, Barcala-Furelos R, et al. Training frequency for educating schoolchildren in basic life support: very brief 4-month rolling-refreshers versus annual retraining-a 2-year prospective longitudinal trial. BMJ Open. 2021;11(11):e052478. Published 2021 Nov 30. doi:10.1136/bmjopen-2021-052478
• Uhm T, Oh J, Park J, et al. Correlation between Physical Features of Elementary School Children and Chest Compression Depth. Hong Kong J Emerg Med. 2010;17(3):218-223. doi:10.1177/102490791001700303
• Lorem T, Palm A, Wik L. Impact of a self-instruction CPR kit on 7th graders' and adults' skills and CPR performance. Resuscitation. 2008;79(1):103-108. doi:10.1016/j.resuscitation.2008.04.030
• Chamdawala H, Meltzer JA, Shankar V, et al. Cardiopulmonary resuscitation skill training and retention in teens (CPR START): A randomized control trial in high school students. Resusc Plus. 2021;5:100079. Published 2021 Feb 6. doi:10.1016/j.resplu.2021.100079
• Berthelot S, Plourde M, Bertrand I, et al. Push hard, push fast: quasi-experimental study on the capacity of elementary schoolchildren to perform cardiopulmonary resuscitation. Scand J Trauma Resusc Emerg Med. 2013;21:41. Published 2013 May 21. doi:10.1186/1757-7241-21-41
• Doucet L, Lammens R, Hendrickx S, et al. App-based learning as an alternative for instructors in teaching basic life support to school children: a randomized control trial. Acta Clin Belg. 2019;74(5):317-325. doi:10.1080/17843286.2018.1500766
• Bohn A, Van Aken HK, Möllhoff T, et al. Teaching resuscitation in schools: annual tuition by trained teachers is effective starting at age 10. A four-year prospective cohort study. Resuscitation. 2012;83(5):619-625. doi:10.1016/j.resuscitation.2012.01.020
• Lind B. Teaching mouth-to-mouth resuscitation in primary schools. Acta Anaesthesiol Scand Suppl. 1961;Suppl 9:63-81.
• Sherif C, Erdös J, Sohm M, et al. Effectiveness of mouth-to-mouth resuscitation performed by young adolescents on a mannequin. Am J Emerg Med. 2005;23(1):51-54. doi:10.1016/j.ajem.2004.09.022
• Younas S, Raynes A, Morton S, et al. An evaluation of the effectiveness of the Opportunities for Resuscitation and Citizen Safety (ORCS) defibrillator training programme designed for older school children. Resuscitation. 2006;71(2):222-228. doi:10.1016/j.resuscitation.2006.03.014
• Uray T, Lunzer A, Ochsenhofer A, et al. Feasibility of life-supporting first-aid (LSFA) training as a mandatory subject in primary schools. Resuscitation. 2003;59(2):211-220. doi:10.1016/s0300-9572(03)00233-8
• Jorge-Soto C, Abelairas-Gómez C, Barcala-Furelos R, et al. Automated external defibrillation skills by naive schoolchildren. Resuscitation. 2016;106:37-41. doi:10.1016/j.resuscitation.2016.06.007
• Dieltjens T, De Buck E, Verstraeten H, et al. Evidence-based recommendations on automated external defibrillator training for children and young people in Flanders-Belgium. Resuscitation. 2013;84(10):1304-1309. doi:10.1016/j.resuscitation.2013.03.025.
• De Smedt L, Depuydt C, Vekeman E, et al. Awareness and willingness to perform CPR: a survey amongst Flemish schoolchildren, teachers and principals. Acta Clin Belg. 2019;74(5):297-316. doi:10.1080/17843286.2018.1482087
• Chen ZQ, Zhao Y, Lu ZH, et al. Awareness and attitudes of Chinese students towards cardiopulmonary resuscitation. Emerg Med J. 2010;27(12):907-910. doi:10.1136/emj.2009.079558
• Luria JW, Smith GA, Chapman JI. An evaluation of a safety education program for kindergarten and elementary school children. Arch Pediatr Adolesc Med. 2000;154(3):227-231. doi:10.1001/archpedi.154.3.227
• Beck S, Issleib M, Daubmann A, et al. Peer education for BLS-training in schools? Results of a randomized-controlled, noninferiority trial. Resuscitation. 2015;94:85-90. doi:10.1016/j.resuscitation.2015.06.026
• Beck S, Meier-Klages V, Michaelis M, et al. Teaching school children basic life support improves teaching and basic life support skills of medical students: A randomised, controlled trial. Resuscitation. 2016;108:1-7. doi:10.1016/j.resuscitation.2016.08.020
• Jiménez-Fábrega X, Escalada-Roig X, Miró O, et al. Comparison between exclusively school teacher-based and mixed school teacher and healthcare provider-based programme on basic cardiopulmonary resuscitation for secondary schools. Emerg Med J. 2009;26(9):648-652. doi:10.1136/emj.2008.062992
• Abelairas-Gómez C, Rodríguez-Núñez A, Casillas-Cabana M, et al. Schoolchildren as life savers: at what age do they become strong enough?. Resuscitation. 2014;85(6):814-819. doi:10.1016/j.resuscitation.2014.03.001
• Banfai B, Pandur A, Schiszler B, et al. ‘Kids save lives’ in Hungary-Implementation, opportunities, programmes, opinions, barriers. Resuscitation. 2018;130:e3-e4. doi:10.1016/j.resuscitation.2018.06.033
• Böttiger BW, Lockey A, Georgiou M, et al. KIDS SAVE LIVES: ERC Position statement on schoolteachers' education and qualification in resuscitation. Resuscitation. 2020;151:87-90. doi:10.1016/j.resuscitation.2020.04.021
• Lukas RP, Engel P, Wecker S, et al. Cardiopulmonary resuscitation guidance improves medical students' adherence to guidelines in simulated cardiac arrest: a randomised cross-over study. Eur J Anaesthesiol. 2013;30(12):752-757. doi:10.1097/EJA.0b013e328362147f
• Cheng A, Magid DJ, Auerbach M, et al. Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020;142(16_suppl_2):S551-S579. doi:10.1161/CIR.0000000000000903
• Semeraro F, Monesi A, Gordini G, et al. Kids Save Lives: A blended learning approach to improve engagement of schoolchildren. Resuscitation. 2023;182:109675. doi:10.1016/j.resuscitation.2022.109675
• Lim XMA, Liao WA, Wang W, et al. The Effectiveness of Technology-Based Cardiopulmonary Resuscitation Training on the Skills and Knowledge of Adolescents: Systematic Review and Meta-analysis. J Med Internet Res. 2022;24(12):e36423. Published 2022 Dec 15. doi:10.2196/36423
• Horriar L, Rott N, Semeraro F, et al. A narrative review of European public awareness initiatives for cardiac arrest. Resusc Plus. 2023;14:100390. Published 2023 Apr 19. doi:10.1016/j.resplu.2023.100390
• Nakagawa NK, Silva LM, Carvalho-Oliveira R, et al. KIDS SAVE LIVES BRAZIL: A successful pilot program to implement CPR at primary and high schools in Brazil resulting in a state law for a training CPR week. Resuscitation. 2019;140:81-83. doi:10.1016/j.resuscitation.2019.05.009.