Elsevier

Resuscitation

Volume 72, Issue 2, February 2007, Pages 270-279
Resuscitation

Training and educational paper
The ‘ABC for life’ programme—Teaching basic life support in schools

https://doi.org/10.1016/j.resuscitation.2006.06.031Get rights and content

Summary

Background

Less than 1% of the general public know how to assess or manage someone who has collapsed. It has been estimated that if 15–20% of the population were capable of performing cardiopulmonary resuscitation (CPR), mortality of out of hospital cardiac arrest could be decreased significantly. Training basic life support (BLS) skills to school children would be the most cost effective way of achieving this goal and ensuring that a large proportion of the population acquire basic life saving skills.

Aims

To assess retention of knowledge of basic life support 6 months after a single course of instruction in cardiopulmonary resuscitation designed specifically for school children.

Setting

School pupils in a rural location in one region of the United Kingdom.

Methods

A course of instruction in cardiopulmonary resuscitation – the ‘ABC for life’ programme – specifically designed to teach 10–12-year-old school children basic life support skills.

The training session was given to school pupils in a rural location in Northern Ireland. A 22 point questionnaire was used to assess acquisition and retention of basic life support knowledge.

Results

Children instructed in cardiopulmonary resuscitation showed a highly significant increase in level of knowledge following the training session. While their level of knowledge decreased over a period of 6 months it remained significantly higher than that of a comparable group of children who had never been trained.

Conclusion

A training programme designed and taught as part of the school curriculum would have a significant impact on public health.

Introduction

Northern Ireland has one of the highest incidences of heart disease in the world.1 There are approximately 3000 sudden deaths each year with the vast majority due to myocardial infarction.2 Cardiopulmonary resuscitation (CPR) skills are not widespread and, given that 70% of arrests take place at home,3 the majority of people do not receive basic life support (BLS) prior to the arrival of the emergency services. The time between arrest and the onset of CPR is directly related to overall survival4 and ideally CPR should be initiated within 4 min of arrest to achieve conscious survival. The American Heart Association suggests that morbidity and mortality of out-of-hospital cardiac arrest could be significantly decreased if 20% of the population were able to perform CPR.5 If everyone was given CPR and early defibrillation following cardiac arrest approximately 2000 lives could be saved each year in Northern Ireland. Currently, overall survival from out-of-hospital cardiac arrest in the UK is less than 7%,6 which may reflect the lack of CPR skills in the population.

The European Resuscitation Council recommended that basic life support should be included in the school curriculum.7 This has also been supported by the International Guidelines 20008 and in the ILCOR Advisory Statement.9 Resuscitation skills have been compulsory teaching in Norway since the early 1960s10 and have been introduced in a number of other countries.11, 12, 13, 14, 15, 16

The ‘ABC for life’ programme was established to introduce BLS training into Northern Ireland primary schools. The aim is to train up to 25,000 pupils per year to perform adequate CPR with provisions made to facilitate ongoing training to improve skill retention.

This report aims to describe the design of the ‘ABC for life’ programme and the change in and retention of knowledge in a sample of school children trained using the programme.

Section snippets

Materials and methods

The ‘ABC for life’ programme was developed by medical students and the Head of the Department of Medicine at Queen's University Belfast. It uses two groups of people; medical students and school teachers, who have the ability to teach CPR, are highly motivated and have the time to impart CPR knowledge and skills to school children. Figure 1 shows the pyramidal system of teaching and knowledge transfer. Each medical student instructs small groups of teachers in BLS (ratio 1:5, respectively) who

Results

Seventy-nine pupils were included in the study; 46 received training (CPR group) and 33 were controls. Pupil characteristics are shown in Table 2. Baseline age was significantly different between groups but there was no difference in sex, positive family history of heart problems, previous CPR training or baseline BLS knowledge.

No pupil achieved full marks on the questionnaire prior to training however two pupils (4.3%) scored over 70% (16/22) correct. After training, four pupils (8.7%)

Discussion

Training a large number of the general population to perform CPR would be a major public health benefit. At present this is not happening in any region of the UK. Using the approach of training medical students to teach teachers who in turn teach school children to perform CPR means that up to 25,000 individuals/year in Northern Ireland could be trained. Over a 10-year period, approximately 20% of the population would have these life saving skills. In addition to the direct training of pupils,

Conclusions

The ‘ABC for life’ programme has the potential to introduce widespread basic life support skills in the population. This has the impact of improving knowledge of CPR and changing attitudes towards performing CPR in real life situations, and has the potential to have long-term health benefits for the population. This study demonstrates that using our training methods 10–12-year-old children acquire basic life support skills. By using a ‘peer-training’ model with medical students and teachers, a

Conflict of interest

There are no conflicts of interest.

References (26)

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    Other points deserve mention with regard to effectiveness. For Item B, other studies have observed statistically significant improvements in knowledge retention before training, immediately after, and at two and four months,11,12 as we found in univariate analysis. There is a reference in the literature to a decline in knowledge retention after six months, although assessment of this variable was not within the scope of our study.

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A Spanish translated version of the summary of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2006.06.031.

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