Methods to teach schoolchildren how to perform and retain cardiopulmonary resuscitation (CPR) skills: A systematic review and meta-analysis.

Background: Worldwide, bystander CPR rates are low; one effective way to increase these rates is to train schoolchildren; however, the most effective way to train them is currently unknown. Methods: This systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies, evaluated whether CPR training for schoolchildren, using innovative teaching modalities (nonpractical, self, or peer-training) versus standard instructor-led training, resulted in higher quality CPR, self-confidence and short-term (≤3 months post-training) or long-term (>3 months post-training) retention of CPR skills. Results: From 9793 citations, 96 studies published between 1975 and 2022 (44 RCTs and 52 before/after studies) were included. There were 43,754 students, average age of 11.5 ±â€¯0.9 (range 5.9-17.6) and 49.2% male. Only 13 RCTs compared practical vs. nonpractical training (n = 5), self- vs. instructor-led training (n = 7) or peer- vs. instructor-led training (n = 5). The observed statistically significant differences in mean depth and rate of compressions between children with hands-on practical training and those without were not clinically relevant. Regardless of training modality, compression depth was consistently suboptimal. No differences were observed in CPR skills immediately or ≤ 3 months post-training, between children who were self- or peer-trained vs. instructor-led. Due to lack of data, we were unable to evaluate the impact of these novel training modalities on student self-confidence. Conclusion: Although innovative training modalities are equally effective to instructor-led training when teaching schoolchildren CPR, compression depth was frequently suboptimal. Recommendations on standardized training and evaluation methods are necessary to understand the best ways to train children.

Responding to Cardiac Arrest in the Community in the Digital Age.

Sudden cardiac arrest (SCA) is a common event, affecting almost 400,000 individuals annually in North America. Initiation of cardiopulmonary resuscitation (CPR) and early defibrillation using an automated external defibrillator (AED) are critical for survival, yet many bystanders are reluctant to intervene. Digital technologies, including mobile devices, social media, and crowdsourcing might help play a role to improve survival from SCA. In this article we review the current digital tools and strategies available to increase rates of bystander recognition of SCA, prompt immediate activation of emergency medical services (EMS), initiate high-quality CPR, and to locate, retrieve, and operate AEDs. Smartphones can help to educate and connect bystanders with EMS dispatchers, through text messaging or video calling, to encourage the initiation of CPR and retrieval of the closest AED. Wearable devices and household smart speakers could play a future role in continuous vital signs monitoring in individuals at risk of lethal arrhythmias and send an alert to either chosen contacts or EMS. Machine learning algorithms and mathematical modelling might aid EMS dispatchers with better recognition of SCA as well as policymakers with where to best place AEDs for optimal accessibility. There are challenges with the use of digital tech, including the need for government regulation and issues with data ownership, accessibility, and interoperability. Future research will include smart cities, e-linkages, new technologies, and using social media for mass education. Together or in combination, these emerging digital technologies might represent the next leap forward in SCA survival.

Mandating Training Is Not Enough: The State of Cardiopulmonary Resuscitation and Automated External Defibrillator Training in Ontario Schools.

Cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) training in schools are mandated in the Ontario high school curriculum. We surveyed schools to understand the scope of this training, including its barriers and facilitators. We recruited 120 (58.5%) elementary, 25 (12.2%) middle, and 60 (29.3%) high schools. Almost 60% (120 of 200) provided staff with CPR training, but only 56% (27 of 48) of high schools trained students. Major barriers included lack of funding, time, and trainers. Despite government-mandated curriculum, only 56% of high schools offer CPR and AED training. More research is needed to understand the barriers to implementing this lifesaving training.

La formation en réanimation cardiorespiratoire (RCR) et défibrillateurs externes automatisés (DEA) est obligatoire dans le cadre du programme d'études secondaires des écoles de l'Ontario. Nous avons entrepris une enquête dans les écoles pour comprendre la portée de cette formation, notamment ses obstacles et ses facilitateurs. Nous avons procédé au recrutement dans 120 (58,5 %) écoles élémentaires, 25 (12,2 %) écoles intermédiaires et 60 (29,3 %) écoles secondaires. Presque 60 % (120 sur 200) des écoles secondaires offraient la formation en RCR au personnel, mais seulement 56 % (27 sur 48) formaient les élèves. Les principaux obstacles étaient le manque de financement, de temps et de formateurs. Bien que le gouvernement ait rendu obligatoire la formation en RCR et DEA dans le cadre du programme d'études secondaires, seulement 56 % des écoles offrent la formation. D'autres études sont nécessaires pour comprendre les obstacles à la mise en œuvre de cette formation qui permet de sauver des vies.