Do Longer Fins Improve Ocean Rescues? A Comprehensive Investigation into Lifeguard Performance and Physiological Impact.

Coastal environments present dynamic challenges necessitating rapid and efficient responses during aquatic emergencies. Lifeguards, as pivotal links in the intervention chain, rely on various tools, with rescue time being paramount. The choice of fins, specifically long versus short ones, plays a critical role in optimizing lifeguard performance during rescues. This randomized cross-over study explores the impact of flipper size on ocean rescues, employing a sample of 14 lifeguards. Long fins (LFs) and short fins (SFs) were compared in terms of rescue time (RT) and physiological load (PL). Tests included ocean rescues without fins (R), with LF (R-LF), and with SF (R-SF). Variables recorded encompassed swim approach time, tow-in time, overall rescue time, perceived exertion rates (RPEs), and post-rescue lactate concentration. Long fins demonstrated superior performance in swim approach and tow-in times compared to both short fins and no fins (p < 0.001). Overall rescue time favored long fins significantly (p < 0.001), indicating their efficiency in practical ocean rescue scenarios. Physiologically, long fins induced lower perceived exertion in arms (p = 0.033) compared to short fins. Lactate concentrations post-rescue revealed no significant differences (p > 0.05). This study demonstrates that long fins significantly improve lifeguard performance during ocean rescues, reducing rescue times and alleviating arm fatigue.

In-water resuscitation during a surf rescue: Time lost or breaths gained? A pilot study.

BACKGROUND: A technique called in-water resuscitation (IWR) was devised on a surfboard to ventilate persons who seemingly did not breathe upon a water rescue. Despite IWR still raises uncertainties regarding its applicability, this technique is recommended by the International Liaison Committee for Resuscitation (ILCOR). Thus, this study aimed to evaluate the feasibility of IWR with a rescue board before and during towing and, to compare rescue times and rescue-associated fatigue levels between rescues with rescue breath attempts and without (SR). METHODS: A randomized crossover pilot test was conducted: 1) IWR test with pocket mask and, 2) Conventional SR test. IWR tests were conducted using a Laerdal ResusciAnne manikin (Stavanger, Norway). Three groups of variables were recorded: a) rescue time (in s), b) effective ventilations during rescue, and c) rating of perceived effort (RPE). RESULTS: Focusing on the rescue time, the performance SR was significantly faster than IWR rescue which took 61 s longer to complete the rescue (Z = -2.805; p = 0.005). No significant differences were found between techniques for the RPE (T = -1.890; p = 0.095). In the IWR analysis, lifeguards performed an average of 27 ± 12 rescue breaths. CONCLUSION: The application of IWR on a rescue board is feasible both at the time of rescue and during towing. It shortens the reoxygenation time but delays the arrival time to shore. Both IWR and SR result in similar levels of perceived fatigue.

[Challenges in teaching first aids at schools: analysis of spanish educational legislation (LOMLOE) and curricular guidance]. / Desafíos en la enseñanza escolar de los primeros auxilios: análisis de la legislación educativa (LOMLOE) y orientación curricular.

OBJECTIVE: Teaching first aid (FA) to children and young people is a priority strategy in Public Health. The aim of this paper was to review and analyze new educational legislation within the FA curriculum framework, which is necessary for providing teachers and healthcare professionals with a practical guide that guides teaching to train first responders in different school stages. METHODS: A group of four experts with curricular experience at different educational levels, as well as in the field of FA, participated in this analysis. The methodology involved a consensus analysis approach on the content of the spanish Royal Decrees (RD) for Primary Education (RD 157/2022), Secondary Education (RD 217/2022), and Baccalaureate (RD 243/2022) that develop the curriculum of the Organic Law 3/2020 (LOMLOE). RESULTS: In the analysis of the three RD, ten general concepts were identified: accident prevention; protocol Protect, Alert, Assist (PAS); 1-1-2 protocol; recovery position (PLS); cardiopulmonary resuscitation (CPR); automated external or semi-automatic defibrillator (AED); foreign body airway obstruction (FBAO); FA; transportation of the injured; and stroke. Throughout all educational stages, in twenty-seven instances appeared content explicitly related to accident prevention or the learning of FA. CONCLUSIONS: The current curriculum provides FA content from the age of eight-nine (3rd year of Primary Education). By the end of compulsory education, all students should be able to identify cardiac arrest, alert emergency services, initiate resuscitation maneuvers, use the defibrillator, and know how to respond to choking incidents.

OBJECTIVE: La enseñanza de los primeros auxilios (PPAA) a escolares y jóvenes es una estrategia prioritaria en Salud Pública. El objetivo de este trabajo fue revisar y analizar la nueva legislación educativa en el marco curricular de PPAA, lo cual es necesario para ofrecer a los docentes y sanitarios una guía práctica que oriente la enseñanza para formar a primeros intervinientes en las diferentes etapas escolares. METHODS: Un grupo de cuatro expertos con experiencia curricular en los diferentes niveles educativos, así como en el campo de los PPAA, participaron en este análisis. La metodología consistió en un enfoque de análisis de consenso sobre el contenido de los Reales Decretos (RD) de Educación Primaria (RD 157/2022), Secundaria (RD 217/2022) y Bachillerato (RD 243/2022) que desarrollan curricularmente la Ley Orgánica 3/2020 (LOMLOE). RESULTS: En el análisis de los tres RD se encontraron diez conceptos generales: prevención de accidentes; protocolo Proteger, Alertar, Socorrer (PAS); protocolo 1-1-2; posición lateral de seguridad (PLS); reanimación cardiopulmonar (RCP); desfibrilador externo automático o semiautomático (DEA/DESA); obstrucción de vía aérea por cuerpo extraño (OVACE); PPAA; traslado de accidentados; e ictus. A lo largo de todas las etapas educativas fueron veintisiete las veces en que aparecían explícitamente contenidos vinculados con la prevención de accidentes o al aprendizaje de PPAA. CONCLUSIONS: El currículo actual dota de contenido en materia de PPAA desde los ocho-nueve años (3º de Educación Primaria). Al finalizar la Enseñanza Secundaria Obligatoria, todo el alumnado debería saber identificar la parada cardíaca, alertar a los servicios de emergencias, iniciar las maniobras de reanimación, usar el desfibrilador y saber actuar ante un atragantamiento.

Is the Over-the-Head Technique an Alternative for Infant CPR Performed by a Single Rescuer? A Randomized Simulation Study with Lifeguards.

(1) Objective: The objective was to evaluate the quality of cardiopulmonary resuscitation (CPR, chest compressions and ventilations) when performed by a lone first responder on an infant victim via the over-the-head technique (OTH) with bag-mask ventilation in comparison with the standard lateral technique (LAT) position. (2) Methods: A randomized simulation crossover study in a baby manikin was conducted. A total of 28 first responders performed each of the techniques in two separate CPR tests (15:2 chest compressions:ventilations ratio), each lasting 5 min with a 15 min resting period. Quality CPR parameters were assessed using an app connected to the manikin. Those variables were related to chest compressions (CC: depth, rate, and correct CC point) and ventilation (number of effective ventilations). Additional variables included perceptions of the ease of execution of CPR. (3) Results: The median global CPR quality (integrated CC + V) was 82% with OTH and 79% with LAT (p = 0.94), whilst the CC quality was 88% with OTH and 80% with LAT (p = 0.67), and ventilation quality was 85% with OTH and 85% with LAT (p = 0.98). Correct chest release was significantly better with OTH (OTH: 92% vs. LAT: 62%, p < 0.001). There were no statistically significant differences in the remaining variables. Ease of execution perceptions favored the use of LAT over OTH. (4) Conclusions: Chest compressions and ventilations can be performed with similar quality in an infant manikin by lifeguards both with the standard recommended position (LAT) and the alternative OTH. This option could give some advantages in terms of optimal chest release between compressions. Our results should encourage the assessment of OTH in some selected cases and situations as when a lone rescuer is present and/or there are physical conditions that could impede the lateral rescue position.

Aquatic Feasibility of Limbs Application of Tourniquets (AFLAT) during a Lifeguard Water Rescue: A Simulation Pilot Study.

INTRODUCTION: Control of massive hemorrhage (MH) is a life-saving intervention. The use of tourniquets has been studied in prehospital and battlefield settings but not in aquatic environments. OBJECTIVE: The aim of this research is to assess the control of MH in an aquatic environment by analyzing the usability of two tourniquet models with different adjustment mechanisms: windlass rod versus ratchet. METHODOLOGY: A pilot simulation study was conducted using a randomized crossover design to assess the control of MH resulting from an upper extremity arterial perforation in an aquatic setting. A sample of 24 trained lifeguards performed two randomized tests: one using a windlass-based Combat Application Tourniquet 7 Gen (T-CAT) and the other using a ratchet-based OMNA Marine Tourniquet (T-OMNA) specifically designed for aquatic use on a training arm for hemorrhage control. The tests were conducted after swimming an approximate distance of 100 meters and the tourniquets were applied while in the water. The following parameters were recorded: time of rescue (rescue phases and tourniquet application), perceived fatigue, and technical actions related to tourniquet skills. RESULTS: With the T-OMNA, 46% of the lifeguards successfully stopped the MH compared to 21% with the T-CAT (P = .015). The approach swim time was 135 seconds with the T-OMNA and 131 seconds with the T-CAT (P = .42). The total time (swim time plus tourniquet placement) was 174 seconds with the T-OMNA and 177 seconds with the T-CAT (P = .55). The adjustment time (from securing the Velcro to completing the manipulation of the windlass or ratchet) for the T-OMNA was faster than with the T-CAT (six seconds versus 19 seconds; P < .001; effect size [ES] = 0.83). The perceived fatigue was high, with a score of seven out of ten in both tests (P = .46). CONCLUSIONS: Lifeguards in this study demonstrated the ability to use both tourniquets during aquatic rescues under conditions of fatigue. The tourniquet with the ratcheting-fixation system controlled hemorrhage in less time than the windlass rod-based tourniquet, although achieving complete bleeding control had a low success rate.

Desafíos en la enseñanza escolar de los primeros auxilios: análisis de la legislación educativa (LOMLOE) y orientación curricular / Challenges in teaching first aids at schools: analysis of spanish educational legislation (LOMLOE) and curricular guidance

Fundamentos: la enseñanza de los primeros auxilios (ppaa) a escolares y jóvenes es una estrategia prioritaria en salud pública. El objetivo de este trabajo fue revisar y analizar la nueva legislación educativa en el marco curricular de ppaa, lo cual es necesario para ofrecer a los docentes y sanitarios una guía práctica que oriente la enseñanza para formar a primeros intervinientes en las diferentes etapas escolares. Métodos: un grupo de cuatro expertos con experiencia curricular en los diferentes niveles educativos, así como en el campo de los ppaa, participaron en este análisis. La metodología consistió en un enfoque de análisis de consenso sobre el contenido de los reales decretos (rd) de educación primaria (rd 157/2022), secundaria (rd 217/2022) y bachillerato (rd 243/2022) que desarrollan curricularmente la ley orgánica 3/2020 (lomloe). Resultados: en el análisis de los tres rd se encontraron diez conceptos generales: prevención de accidentes; protocolo proteger, alertar, socorrer (pas); protocolo 1-1-2; posición lateral de seguridad (pls); reanimación cardiopulmonar (rcp); desfibrilador externo automático o semiautomático (dea/desa); obstrucción de vía aérea por cuerpo extraño (ovace); ppaa; traslado de accidentados; e ictus. A lo largo de todas las etapas educativas fueron veintisiete las veces en que aparecían explícitamente contenidos vinculados con la prevención de accidentes o al aprendizaje de ppaa. Conclusiones: el currículo actual dota de contenido en materia de ppaa desde los ocho-nueve años (3º de educación primaria). Al finalizar la enseñanza secundaria obligatoria, todo el alumnado debería saber identificar la parada cardíaca, alertar a los servicios de emergencias, iniciar las maniobras de reanimación, usar el desfibrilador y saber actuar ante un atragantamiento.(AU)

Background: teaching first aid (fa) to children and young people is a priority strategy in public health. The aim of this paper was to review and analyze new educational legislation within the fa curriculum framework, which is necessary for providing teachers and healthcare professionals with a practical guide that guides teaching to train first responders in different school stages.methods: a group of four experts with curricular experience at different educational levels, as well as in the field of fa, partici-pated in this analysis. The methodology involved a consensus analysis approach on the content of the spanish royal decrees (rd) for primary education (rd 157/2022), secondary education (rd 217/2022), and baccalaureate (rd 243/2022) that develop the curriculum of the organic law 3/2020 (lomloe).results: in the analysis of the three rd, ten general concepts were identified: accident prevention; protocol protect, alert, assist (pas); 1-1-2 protocol; recovery position (pls); cardiopulmonary resuscitation (cpr); automated external or semi-automatic defibrillator (aed); foreign body airway obstruction (fbao); fa; transportation of the injured; and stroke. Throughout all educational stages, in twenty-seven instances appeared content explicitly related to accident prevention or the learning of fa.conclusions: the current curriculum provides fa content from the age of eight-nine (3rd year of primary education). By the end of compulsory education, all students should be able to identify cardiac arrest, alert emergency services, initiate resuscitation maneuvers, use the defibrillator, and know how to respond to choking incidents.(AU)

Nueva herramienta de comunicación para el entrenamiento de soporte vital básico: smart glasses. Un diseño cuasiexperimental / New communication tool for basic life support training: smart glasses. A quasi-experimental study

Objetivo Analizar la efectividad de una metodología de enseñanza-aprendizaje de teleformación en soporte vital básico (SVB) basada en la comunicación a través de smart glasses. Diseño Estudio piloto cuasiexperimental de no inferioridad. Participantes Un total de 60 estudiantes universitarios. Intervenciones Aleatorización de los participantes en: grupo de teleformación a través de smart glasses (SG) y de formación tradicional (C). Ambas sesiones de entrenamiento fueron muy breves (<8 minutos) e incluyeron el mismo contenido en SVB. En SG, la capacitación fue comunicándose a través de una videollamada con smart glasses. Variables de interés principales Se evaluó el protocolo del SVB, el uso de desfibrilador externo automático (DEA), la calidad de la reanimación y los tiempos de actuación. Resultados En la mayoría de las variables del protocolo del SVB, la calidad de la reanimación y los tiempos de ejecución no hubo diferencias estadísticamente significativas entre grupos. Hubo mejor actuación de SG al valorar la respiración (SG: 100%, C: 81%; p=0,013), el avisar antes de la descarga del DEA (SG: 79%, C: 52%; p=0,025) y las compresiones con buena reexpansión (SG: 85%, C: 32%; p=0,008). Conclusiones El tele-entrenamiento en SVB-DEA para legos con smart glasses podría llegar a ser, al menos, tan efectivo como un método tradicional de enseñanza. Además, las smart glasses podrían ser más ventajosas para ciertos aspectos del protocolo del SVB y la calidad de las compresiones, probablemente debido a la capacidad de visualización de imágenes en tiempo real. La enseñanza basada en la realidad aumentada debe considerarse para la capacitación en SVB, aunque se requiere tanto cautela en la extrapolación de hallazgos como estudios futuros con mayor profundidad. (AU)

Aim To analyze the effectiveness of a teaching-learning methodology for teletraining in basic life support (BLS) based on communication through smart glasses. Design Pilot quasi-experimental non-inferiority study. Participants Sixty college students. Interventions Randomization of the participants in: tele-training through smart glasses (SG) and traditional training (C) groups. Both training sessions were very brief (less than 8 minutes) and included the same BLS content. In SG, the instructor trained through a video call with smart glasses. Main variables of interest The BLS protocol, the use of AED, the quality of resuscitation and the response times were evaluated. Results In most of the BLS protocol variables, the resuscitation quality and performance times, there were no statistically significant differences between groups. There were significant differences (in favor of the SG) in the assessment of breathing (SG: 100%, CG: 81%; p=0.013), the not-to-touch warning before applying the shock (SG: 79%, CG: 52%; p=0.025) and compressions with correct recoil (SG: 85%, CG: 32%; p=0.008). Conclusions Laypeople BLS-AED brief tele-training through smart glasses could potentially be, at least, as effective as traditional training methods. In addition, smart glasses could be more advantageous than traditional teaching for certain points of the BLS protocol and chest compressions quality, probably due to the capability of real-time visualization of images which supports the BLS sequence. Augmented reality supported teaching should be considered for BLS training, although caution is required in extrapolating findings, and further in-depth studies are needed to confirm its potential role depending on concrete target populations and environments. (AU)

New communication tool for basic life support training: smart glasses. A quasi-experimental study.

AIM: To analyze the effectiveness of a teaching-learning methodology for teletraining in basic life support (BLS) based on communication through smart glasses. DESIGN: Pilot quasi-experimental non-inferiority study. PARTICIPANTS: Sixty college students. INTERVENTIONS: Randomization of the participants in: tele-training through smart glasses (SG) and traditional training (C) groups. Both training sessions were very brief (less than 8 min) and included the same BLS content. In SG, the instructor trained through a video call with smart glasses. MAIN VARIABLES OF INTEREST: The BLS protocol, the use of AED, the quality of resuscitation and the response times were evaluated. RESULTS: In most of the BLS protocol variables, the resuscitation quality and performance times, there were no statistically significant differences between groups. There were significant differences (in favor of the SG) in the assessment of breathing (SG: 100%, C: 81%; p = 0.013), the not-to-touch warning before applying the shock (SG: 79%, C: 52%; p = 0.025) and compressions with correct recoil (SG: 85%, C: 32%; p = 0.008). CONCLUSIONS: Laypeople BLS-AED brief tele-training through smart glasses could potentially be, at least, as effective as traditional training methods. In addition, smart glasses could be more advantageous than traditional teaching for certain points of the BLS protocol and chest compressions quality, probably due to the capability of real-time visualization of images which supports the BLS sequence. Augmented reality supported teaching should be considered for BLS training, although caution is required in extrapolating findings, and further in-depth studies are needed to confirm its potential role depending on concrete target populations and environments.

[Prevención del ahogamiento desde la educación para la salud escolar. Evaluación del proyecto piloto SOS 112.] / Drowning prevention through school health education. Evaluation of the SOS 112 pilot project.

OBJECTIVE: Drowning represents one of the main causes of child mortality. Water-related incidents are preventable and should be addressed through health education. The aim of this study was to evaluate an educational program for eight-year-old students based on a song with content on drowning prevention. METHODS: A feasibility pilot study was conducted, including forty-six children enrolled in a public school in Santiago de Compostela (A Coruña, Spain). The study was developed in three phases. In the first step, a group of experts and musicians created the educational content and the song. Secondly, the evaluation tool was developed, and finally, the program was implemented based on flag recognition, how to help in a drowning situation, safe swimming attitudes, and information about the emergency phone number 112. The percentage of correct responses by children before and after the educational intervention were compared using the McNemar test. RESULTS: Approximately half of the children were unaware of the meaning of the flags. After listening to the song, all students identified the meaning of the red flag, and over 90% recognized the green and yellow flags (p<0.001). Before the intervention, children correctly identified, on average, 75.3% of the safe water attitude pictograms. This perception of safe attitudes significantly increased post-intervention (p<0.001), with recognition of 86.4% of the correct behaviours. The overall water safety score also significantly improved by 22.7% after the intervention (p<0.001). CONCLUSIONS: The educational song is a resource to promote the learning of signals and concepts related to child drowning prevention.

OBJETIVO: El ahogamiento representa una de las principales causas de mortalidad infantil. Los incidentes acuáticos son prevenibles y deben ser abordados desde la educación para la salud. El objetivo de este estudio fue evaluar un programa educativo en alumnado de ocho años basado en una canción con contenido para la prevención del ahogamiento. METODOS: Se realizó un estudio piloto de viabilidad que incluyó a cuarenta y seis niños/as escolarizados en un centro público de Santiago de Compostela (A Coruña, España), siendo desarrollado en tres fases. En el primer paso, un grupo de expertos y músicos crearon el contenido educativo y la canción. En segundo lugar, se elaboró la herramienta de evaluación y, finalmente, se implementó el programa basado en el reconocimiento de las banderas, en cómo ayudar en un ahogamiento, en las actitudes seguras para el baño y en información sobre el teléfono de emergencias 112. El porcentaje de respuestas correctas antes y después de la intervención educativa se compararon utilizando la prueba de McNemar. RESULTADOS: Aproximadamente la mitad de los niños/as desconocía el significado de las banderas. Después de la audición de la canción, todos los escolares identificaron el significado de la bandera roja y más del 90% reconoció la bandera verde y amarilla (p<0,001). Antes de la intervención, los niños identificaron correctamente, en promedio, el 75,3% de los pictogramas de actitudes acuáticas seguras. Esta percepción de actitudes seguras aumentó significativamente postintervención (p<0,001), reconociendo el 86,4% de las conductas correctas. La puntuación general de seguridad del agua también mejoró significativamente después de la intervención un 22,7% (p<0,001). CONCLUSIONES: La canción educativa es un medio para favorecer el aprendizaje de las señales y conceptos sobre la prevención del ahogamiento infantil.

School children brief training to save foreign body airway obstruction.

Foreign body airway obstruction (FBAO) is a relatively common emergency and a potential cause of sudden death both in children and older people; bystander immediate action will determine the victim's outcome. Although many school children's basic life support (BLS) training programs have been implemented in recent years, references to specific training on FBAO are lacking. Therefore, the aim was to assess FBAO-solving knowledge acquisition in 10-13-year-old school children. A quasi-experimental non-controlled simulation study was carried out on 564 ten-to-thirteen-year-old children from 5 schools in Galicia (Spain). Participants received a 60-min training led by their physical education teachers (5 min theory, 15 min demonstration by the teacher, and 30 min hands-on training) on how to help to solve an FBAO event. After the training session, the school children's skills were assessed in a standardized adult's progressive FBAO simulation scenario. The assessment was carried out by proficient researchers utilizing a comprehensive checklist specifically designed to address the variables involved in resolving a FBAO event according with current international guidelines. The assessment of school children's acquired knowledge during the simulated mild FBAO revealed that 62.2% of participants successfully identified the event and promptly encouraged the simulated patient to cough actively. When the obstruction progressed, its severity was recognized by 86.2% and back blows were administered, followed by abdominal thrusts by 90.4%. When the simulated victim became unconscious, 77.1% of children identified the situation and immediately called the emergency medical service and 81.1% initiated chest compressions. No significant differences in performance were detected according to participants' age.  Conclusion: A brief focused training contributes to prepare 10-13-year-old school children to perform the recommended FBAO steps in a standardized simulated patient. We consider that FBAO should be included in BLS training programs for school children. What is Known: • Kids Save Lives strategy states that school children should learn basic life support (BLS) skills because of their potential role as first responders. • This BLS training does not include content for resolving a foreign body airway obstruction (FBAO). What is New: • Following a 60-min theoretical-practical training led by physical education teachers, 10-13-year-old school children are able to solve a simulated FBAO situation. • The inclusion of FBAO content in BLS training in schools should be considered.

Basic life support training for people with disabilities. A scoping review.

Background: The integration of populations with various types of disabilities into basic life support (BLS) training programs could contribute to a potential increase in trained laypersons with BLS knowledge and, consequently, in survival rates. The objective of this study was to analyze the distinct educational methods which exist today on BLS for people with some type of specific disability, and to evaluate their impact on the quality of BLS maneuvers. Methods: A scoping review in which the different training strategies in BLS for people with distinctive disabilities were analyzed was carried out. Previous studies were sought and researched in MEDLINE, EMBASE, and the Cochrane Library from the beginning up to 4 August 2023. Results: A total of 14 studies were thoroughly analyzed. The BLS training strategies for people with disabilities were classified according to the following criteria: objective (training, content validation or analysis of learning barriers), target population (visual, hearing, physical disabilities or Down syndrome), training resources (training with/without adaptation), contents (BLS and use of the automated external defibrillator) and evaluation instrument (i.e., the simulation test and knowledge questionnaire). The variety of BLS training programs for such population is limited. Likewise, people with different disabilities are able to effectively learn BLS maneuvers, although with mixed results, mainly in those regarding the CPR quality. Conclusion: People with visual, hearing disabilities or Down syndrome are able to effectively learn BLS maneuvers.

Trained Lifeguards Performing Pediatric Cardiopulmonary Resuscitation While Running: A Pilot Simulation Study.

The aim of this study was to compare the quality of standard infant CPR with CPR in motion (i.e., walking and running) via performing maneuvers and evacuating the infant from a beach. Thirteen trained lifeguards participated in a randomized crossover study. Each rescuer individually performed three tests of 2 min each. Five rescue breaths and cycles of 30 chest compressions followed by two breaths were performed. Mouth-to-mouth-and-nose ventilation was carried out, and chest compressions were performed using the two-fingers technique. The manikin was carried on the rescuer's forearm with the head in the distal position. The analysis variables included compression, ventilation, and CPR quality variables, as well as physiological and effort parameters. Significantly lower compression quality values were obtained in running CPR versus standard CPR (53% ± 14% versus 63% ± 15%; p = 0.045). No significant differences were observed in ventilation or CPR quality. In conclusion, lifeguards in good physical condition can perform simulated infant CPR of a similar quality to that of CPR carried out on a victim who is lying down in a fixed position.

A systematic review of interventions for resuscitation following drowning.

Objectives: The International Liaison Committee on Resuscitation, in collaboration with drowning researchers from around the world, aimed to review the evidence addressing seven key resuscitation interventions: 1) immediate versus delayed resuscitation; (2) compression first versus ventilation first strategy; (3) compression-only CPR versus standard CPR (compressions and ventilations); (4) ventilation with and without equipment; (5) oxygen administration prior to hospital arrival; (6) automated external defibrillation first versus cardiopulmonary resuscitation first strategy; (7) public access defibrillation programmes. Methods: The review included studies relating to adults and children who had sustained a cardiac arrest following drowning with control groups and reported patient outcomes. Searches were run from database inception through to April 2023. The following databases were searched Ovid MEDLINE, Pre-Medline, Embase, Cochrane Central Register of Controlled Trials. Risk of bias was assessed using the ROBINS-I tool and the certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. The findings are reported as a narrative synthesis. Results: Three studies were included for two of the seven interventions (2,451 patients). No randomised controlled trials were identified. A retrospective observational study reported in-water resuscitation with rescue breaths improved patient outcomes compared to delayed resuscitation on land (n = 46 patients, very low certainty of evidence). The two observational studies (n = 2,405 patients), comparing compression-only with standard resuscitation, reported no difference for most outcomes. A statistically higher rate of survival to hospital discharge was reported for the standard resuscitation group in one of these studies (29.7% versus 18.1%, adjusted odds ratio 1.54 (95% confidence interval 1.01-2.36) (very low certainty of evidence). Conclusion: The key finding of this systematic review is the paucity of evidence, with control groups, to inform treatment guidelines for resuscitation in drowning.

Dispatcher-assisted BLS for lay bystanders: A pilot study comparing video streaming via smart glasses and telephone instructions.

OBJECTIVE: To determine whether dispatcher assistance via smart glasses improves bystander basic life support (BLS) performance compared with standard telephone assistance in a simulated out-of-hospital cardiac arrest (OHCA) scenario. METHODS: Pilot study in which 28 lay people randomly assigned to a smart glasses-video assistance (SG-VA) intervention group or a smartphone-audio assistance (SP-AA) control group received dispatcher guidance from a dispatcher to provide BLS in an OHCA simulation. SG-VA rescuers received assistance via a video call with smart glasses (Vuzix, Blade) connected to a wireless network, while SP-AA rescuers received instructions over a smartphone with the speaker function activated. BLS protocol steps, quality of chest compressions, and performance times were compared. RESULTS: Nine of the 14 SG-VA rescuers correctly completed the BLS protocol compared with none of the SP-AA rescuers (p = 0.01). A significantly higher number of SG-VA rescuers successfully opened the airway (13 vs. 5, p = 0.002), checked breathing (13 vs. 8, p = 0.03), correctly positioned the automatic external defibrillator pads (14 vs.6, p = 0.001), and warned bystanders to stay clear before delivering the shock (12 vs. 0, p < 0.001). No significant differences were observed for performance times or chest compression quality. The mean compression rate was 104 compressions per minute in the SG-VA group and 98 compressions per minute in the SP-AA group (p = 0.46); mean depth of compression was 4.5 cm and 4.4 cm (p = 0.49), respectively. CONCLUSIONS: Smart glasses could significantly improve dispatcher-assisted bystander performance in an OHCA event. Their potential in real-life situations should be evaluated.

Prevención del ahogamiento desde la educación para la salud escolar. Evaluación del proyecto piloto SOS 112 / Drowning prevention through school health education. Evaluation of the SOS 112 pilot project

FUNDAMENTOS: El ahogamiento representa una de las principales causas de mortalidad infantil. Los incidentes acuáticos sonprevenibles y deben ser abordados desde la educación para la salud. El objetivo de este estudio fue evaluar un programa educativoen alumnado de ocho años basado en una canción con contenido para la prevención del ahogamiento. MÉTODOS: Se realizó un estudio piloto de viabilidad que incluyó a cuarenta y seis niños/as escolarizados en un centro público deSantiago de Compostela (A Coruña, España), siendo desarrollado en tres fases. En el primer paso, un grupo de expertos y músicoscrearon el contenido educativo y la canción. En segundo lugar, se elaboró la herramienta de evaluación y, finalmente, se implementóel programa basado en el reconocimiento de las banderas, en cómo ayudar en un ahogamiento, en las actitudes seguras para elbaño y en información sobre el teléfono de emergencias 112. El porcentaje de respuestas correctas antes y después de la intervencióneducativa se compararon utilizando la prueba de McNemar. RESULTADOS: Aproximadamente la mitad de los niños/as desconocía el significado de las banderas. Después de la audición dela canción, todos los escolares identificaron el significado de la bandera roja y más del 90% reconoció la bandera verde y amarilla(p<0,001). Antes de la intervención, los niños identificaron correctamente, en promedio, el 75,3% de los pictogramas de actitudesacuáticas seguras. Esta percepción de actitudes seguras aumentó significativamente postintervención (p<0,001), reconociendo el86,4% de las conductas correctas. La puntuación general de seguridad del agua también mejoró significativamente después de laintervención un 22,7% (p<0,001). CONCLUSIONES: La canción educativa es un medio para favorecer el aprendizaje de las señales y conceptos sobre la prevencióndel ahogamiento infantil.(AU)

BACKGROUND: Drowning represents one of the main causes of child mortality. Water-related incidents are preventable and shouldbe addressed through health education. The aim of this study was to evaluate an educational program for eight-year-old studentsbased on a song with content on drowning prevention. METHODS: A feasibility pilot study was conducted, including forty-six children enrolled in a public school in Santiago de Compostela(A Coruña, Spain). The study was developed in three phases. In the first step, a group of experts and musicians created the educationalcontent and the song. Secondly, the evaluation tool was developed, and finally, the program was implemented based on flag recognition,how to help in a drowning situation, safe swimming attitudes, and information about the emergency phone number 112. The percentageof correct responses by children before and after the educational intervention were compared using the McNemar test. RESULTS: Approximately half of the children were unaware of the meaning of the flags. After listening to the song, all studentsidentified the meaning of the red flag, and over 90% recognized the green and yellow flags (p<0.001). Before the intervention, childrencorrectly identified, on average, 75.3% of the safe water attitude pictograms. This perception of safe attitudes significantly increasedpost-intervention (p<0.001), with recognition of 86.4% of the correct behaviours. The overall water safety score also significantlyimproved by 22.7% after the intervention (p<0.001). CONCLUSIONS: The educational song is a resource to promote the learning of signals and concepts related to child drowningprevention.(AU)

Augmented reality training in basic life support with the help of smart glasses. A pilot study.

Introduction: Laypeople should be trained in basic life support and traditional and innovative methodologies may help to obtain this goal. However, there is a knowledge gap about the ideal basic life support training methods. Smart glasses could have a role facilitating laypeople learning of basic life support. Aim: To analyze the potential impact on basic life support learning of a very brief training supported by smart glasses video communication. Methods: Twelve laypeople were basic life support tele-trained by means of smart glasses by an instructor in this pilot study. During training (assisted trough smart glasses) and after the training (unassisted) participants' performance and quality of basic life support and automated external defibrillation procedure were assessed on a standardized simulated scenario. Results: After the training all participants were able to deliver good quality basic life support, with results comparable to those obtained when real time remotely guided by the instructor through the smart glasses. Mean chest compression rate was significantly higher when not guided (113 /min vs. 103 /min, p = 0.001). When not assisted, the participants spent less time delivering the sequential basic life support steps than when assisted while training. Conclusions: A very brief remote training supported by instructor and smart glasses seems to be an effective educational method that could facilitate basic life support learning by laypeople. This technology could be considered in cases where instructors are not locally available or in general in remote areas, providing basic internet connection is available. Smart glasses could also be useful for laypeople rolling-refreshers.

Surfers as aquatics rescuers in Portugal and Spain: Characteristics of rescues and resuscitation knowledge.

The aim of this study was to analyze the rescues carried out by surfers from Portugal and Spain, their knowledge of rescue and resuscitation and their perception and risk behavior while surfing. An online survey was conducted in 2048 surfers from Portugal and Spain, with questions regarding the demographic characteristics, experience, perception and risk behavior of the surfers; rescues attended by the surfers and surfer's knowledge and experience in rescue and resuscitation. Concerning the number of rescues carried out by surfers, 78.5% of the participants had to carry out at least one rescue in their lifetime. A significant association was found between the years of surfing experience, the surfing level and the number of rescues carried out (p < 0.05). Thirty-five-point eight percent of the surfers never attended a cardiopulmonary resuscitation (CPR) course and 76.2% had no work experience as a lifeguard. Correspondingly, the vast majority of the surfers analyzed did not have the essential knowledge about rescue and resuscitation. This study provides evidence of the important role that surfers play in saving lives on Portuguese and Spanish beaches. The results suggest that the number of rescues conducted by surfers each year in Portugal and Spain is relevant to reducing the number of fatalities that occur along coasts.

Assessment of over-the-head resuscitation method in an inflatable rescue boat sailing at full speed. A non-inferiority pilot study.

INTRODUCTION: Drowning is a public health problem. Interrupting the drowning process as soon as possible and starting cardiopulmonary resuscitation (CPR) can improve survival rates. Inflatable rescue boats (IRBs) are widely used worldwide to rescue drowning victims. Performing CPR in special circumstances requires adjusting the position based on the environment and space available. The aim of this study was to assess the quality of over-the-head resuscitation performed by rescuers aboard an IRB in comparison to standard CPR. METHODS: A quasi-experimental, quantitative, cross-sectional pilot study was conducted. Ten professional rescuers performed 1 min of simulated CPR on a QCPR Resuscy Anne manikin (Laerdal, Norway) sailing at 20 knots using two different techniques: 1) standard CPR (S-CPR) and 2) over-the-head CPR (OTH-CPR). Data were recorded through the APP QCPR Training (Laerdal, Norway). RESULTS: The quality of CPR was similar between S-CPR (61%) and OTH-CPR (66%), with no statistically significant differences (p = 0.585). Both the percentage of compressions and the percentage of correct ventilations did not show significant differences (p > 0.05) between the techniques. CONCLUSION: The rescuers can perform CPR maneuvers with acceptable quality in the IRB. The OTH-CPR technique did not show inferiority compared to S-CPR, making it a viable alternative when boat space or rescue conditions do not allow the conventional technique to be performed.