By Dr Michelle Wright
Accidents and medical emergencies can happen when we least expect them. I think most adults have an idea of what to do in a scenario where first aid is needed or have undergone some first aid training at some point in their lives. But how about our children? Do they know the numbers to call in an emergency? Could they stem major bleeding? Could they give Basic Life Support, including Cardio-Pulmonary Resuscitation (CPR), to an unconscious person who is not breathing?
This topic is thought to be so important that the European Resuscitation Council (ERC), the European Patient Safety Foundation (EPSF), the International Committee on Resuscitation (ILCOR) and the World Federation of Societies of Anaesthesiologists (WFSA) issued a joint statement, “Kids Save Lives”, back in 2015.1 The statement was also endorsed by the World Health Organization (WHO).
Included in the statement was the recommendation that children from the age of 12 years in all schools worldwide receive two hours of CPR training every year.
Sudden cardiac death claims the lives of around 2000 people every day in Europe and the United States and the figures are similar for other parts of the world.1 It takes time for the emergency services to arrive on the scene. This means that bystanders can make an important difference to chances of survival if they have the knowledge and skills to provide Basic Life Support.
Including resuscitation training in the school curriculum is a logical way to save lives. It is a bit like learning to ride a bike or learning to swim. If you do it when you are young, you are unlikely to forget. Young people have enthusiasm and desire for learning. They are also likely to pass on skills learned to other members of their family and so contribute to improved resuscitation skills in lay people overall.
In countries where national initiatives to improve the management of cardiac arrest have been implemented, the statistics have been impacted. For example, in Denmark, the rate of bystander CPR almost doubled after five years. Over ten years, survival rates for out-of-hospital cardiac arrest improved threefold, and education of schoolchildren in resuscitation was thought to be a contributing factor.2
What are some of the essential skills for young people to learn?
First and foremost, what number to call in an emergency. For very little ones, the Europe-wide emergency services number 112 can be taught by counting their ‘one mouth, one nose and two eyes’. For older kids who already have a mobile phone, making sure they have the EchoSOS emergency App downloaded is essential.3 This literally allows them to have important emergency numbers at their fingertips and to transmit their location to the emergency services when they make their call.
Then, for older primary school children and teenagers, a step-by-step approach to help a person in a medical emergency can be remembered by using the mnemonic DRABC, with teaching tailored to their age:
- Your safety, as well as that of the person you are helping and any others on the scene, is paramount.
- Once you have made sure everyone is safe, check for a response.
- Shake the person’s shoulders and ask: “Are you OK? Can you hear me?”
- If they respond, don’t move the person. Find out what has happened and get help.
- If there is no response, open the person’s airway.
- With them lying on their back, use one hand on their forehead and the other hand under their chin to tilt their head back and lift their chin.
- Look, listen and feel for normal breathing.
- If the person is breathing, turn them into the Recovery Position – a safe position with them lying on their side to maintain their airway open.
- If they are not breathing, call for an ambulance. Ask another bystander to do this for you or use speaker function on your phone.
- Send for a defibrillator if available.
- Use your hands in the centre of the person’s chest to start chest compressions.
- Push hard and fast at a rate of 100-120 compressions per minute.
- If also giving breaths, provide cycles of 30 compressions and 2 breaths.
- If giving ‘hands-only’ CPR, give continuous chest compressions.
- Continue CPR until a defibrillator arrives on the scene, the person shows signs of moving, opening their eyes and breathing normally, or a healthcare professional tells you to stop.
These steps may sound scary, including to parents or teachers who may not feel they have the right skills themselves to inform their young people. Of course, appropriate training is needed for educators so that they feel comfortable and equipped to pass on their knowledge.
As an additional reassurance, in my experience of delivering first aid training for over 12 years, children in schools, youth groups, sports clubs and scout troops alike are less restrained than adults when it comes to learning resuscitation skills. They grasp concepts quickly and love a hands-on approach, particularly when using realistic manikins to bring training alive.
I firmly believe that you do not need to be an adult – kids can save lives too! Advocating for first aid and resuscitation training in schools could make a significant difference to survival rates and global statistics.
‘I really liked the First Aid course I did with my friends and Dr Michelle. It taught me how to help someone in need – and even to save someone’s life! I think all kids should learn first aid because being prepared for things going wrong, means you can go on even bigger adventures.’
- Statement Kids save lives: Training school children in cardiopulmonary resuscitation worldwide: https://kids-save-lives.net/
- 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;310:1377–84.
- EchoSOS: https://echosos.com/en/