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      Effects of first aid training in the kindergarten - a pilot study

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          Abstract

          Objective

          Children can be the only persons present in an emergency situation. Aim of the study was to evaluate the effects of a first aid course for 4-5-year-old kindergarten children given by a first aid instructor and kindergarten teachers.

          Methods

          A mixed methods approach using both quantitative and qualitative methods was used to investigate the effects of teaching first aid in the kindergarten in the present study. 10 kindergarten children at the age of 4-5 years were included in a pilot-study, 5 girls and 5 boys. Three of them were four years and seven were five years old. Two months after completion of the first aid course children were tested in a scenario where the children had to provide first aid to an unconscious victim after a cycle accident. The next seven months the children were followed by participant observation.

          Results

          The findings suggest that 4-5-year-old children are able to learn and apply basic first aid. Tested two months after course completion 70% of the children assessed consciousness correctly and knew the correct emergency telephone number; 60% showed correct assessment of breathing and 40% of the participants accomplished the other tasks (giving correct emergency call information, knowledge of correct recovery position, correct airway management) correctly. Many of the children showed their capabilities to do so in a first aid scenario although some participants showed fear of failure in the test scenario. In an informal group testing most of these children could perform first aid measures, too. Teaching first aid also lead to more active helping behaviour and increased empathy in the children.

          Conclusion

          Kindergarten children aged 4-5 years can learn basic fist aid. First aid training should start in the kindergarten.

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          Most cited references11

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          Disseminating cardiopulmonary resuscitation training by distributing 35,000 personal manikins among school children.

          Because most cardiac arrests occur at home, widespread training is needed to increase the incidence of cardiopulmonary resuscitation (CPR) by lay persons. The aim of this study was to evaluate the effect of mass distribution of CPR instructional materials among schoolchildren. We distributed 35,002 resuscitation manikins to pupils (12 to 14 years of age) at 806 primary schools. Using the enclosed 24-minute instructional DVD, they trained in CPR and subsequently used the kit to train family and friends (second tier). They completed a questionnaire on who had trained in CPR using the kit. Teachers also were asked to evaluate the project. The incidence of bystander CPR in out-of-hospital cardiac arrest in the months following the project was compared with the previous year. In total, 6947 questionnaires (19.8%) were returned. The 6947 kits had been used to train 17,140 from the second tier (mean, 2.5 persons per pupil; 95% confidence interval, 2.4 to 2.5). The teachers had used a mean of 64 minutes (95% confidence interval, 60 to 68) for preparation and a mean of 13 minutes (95% confidence interval, 11 to 15) to tidy up. Incidence of bystander CPR in the months after the project did not increase significantly compared with the previous year (25.0% versus 27.9%; P=0.16). CPR training can be disseminated in a population by distributing personal resuscitation manikins among children in primary schools. The teachers felt able to easily facilitate CPR training. The incidence of bystander CPR did not increase significantly in the months following the project.
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            Optimal refresher training intervals for AED and CPR skills: a randomised controlled trial.

            To determine the optimal refresher training interval for lay volunteer responders in the English National Defibrillator Programme who had previously undertaken a conventional 4-h initial class and a first refresher class at 6 months. Subjects were randomised to receive either two additional refresher classes at intervals of 7 and 12 months or one additional refresher class after 12 months. Greater skill loss had occurred when the second refresher class was undertaken at 12 compared with 7 months. Skill retention however, was higher in the former group, ultimately resulting in no significant difference in final skill performance. There was no significant difference in performance between subjects attending two versus three refresher classes. On completion of refresher training all subjects were able to deliver countershocks, time to first shock decreased by 17s in both groups, and the proportion of subjects able to perform most skills increased. The execution of several important interventions remained poor, regardless of the total number of classes attended or the interval between them. These included CPR skills, defibrillation pad placement, and pre-shock safety checks. Refresher classes held more frequently and at shorter intervals increased subjects' self-assessed confidence, possibly indicating greater preparedness to use an AED in a real emergency. This study shows that the ability to deliver countershocks is maintained whether the second refresher class is held at seven or 12 months after the first. To limit skill deterioration between classes, however, refresher training intervals should not exceed 7 months. The quality of instruction given should be monitored carefully. Learning and teaching strategies require review to improve skill acquisition and maintenance.
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              Life supporting first aid training of the public--review and recommendations.

              Since the introduction around 1960 of external cardiopulmonary resuscitation (CPR) basic life support (BLS) without equipment, i.e. steps A (airway control)-B (mouth-to-mouth breathing)-C (chest (cardiac) compressions), training courses by instructors have been provided, first to medical personnel and later to some but not all lay persons. At present, fewer than 30% of out-of-hospital resuscitation attempts are initiated by lay bystanders. The numbers of lives saved have remained suboptimal, in part because of a weak or absent first link in the life support chain. This review concerns education research aimed at helping more lay persons to acquire high life supporting first aid (LSFA) skill levels and to use these skills. In the 1960s, Safar and Laerdal studied and promoted self-training in LSFA, which includes: call for the ambulance (without abandoning the patient) (now also call for an automatic external defibrillator); CPR-BLS steps A-B-C; external hemorrhage control; and positioning for shock and unconsciousness (coma). LSFA steps are psychomotor skills. Organizations like the American Red Cross and the American Heart Association have produced instructor-courses of many more first aid skills, or for cardiac arrest only-not of LSFA skills needed by all suddenly comatose victims. Self-training methods might help all people acquire LSFA skills. Implementation is still lacking. Variable proportions of lay trainees evaluated, ranging from school children to elderly persons, were found capable of performing LSFA skills on manikins. Audio-tape or video-tape coached self-practice on manikins was more effective than instructor-courses. Mere viewing of demonstrations (e.g. televised films) without practice has enabled more persons to perform some skills effectively compared to untrained control groups. The quality of LSFA performance in the field and its impact on outcome of patients remain to be evaluated. Psychological factors have been associated with skill acquisition and retention, and motivational factors with application. Manikin practice proved necessary for best skill acquisition of steps B and C. Simplicity and repetition proved important. Repetitive television spots and brief internet movies for motivating and demonstrating would reach all people. LSFA should be part of basic health education. LSFA self-learning laboratories should be set up and maintained in schools and drivers' license stations. The trauma-focused steps of LSFA are important for 'buddy help' in military combat casualty care, and natural mass disasters.
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                Author and article information

                Journal
                Scand J Trauma Resusc Emerg Med
                Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
                BioMed Central
                1757-7241
                2011
                28 February 2011
                : 19
                : 13
                Affiliations
                [1 ]Department of Surgical Sciences, Haukeland University Hospital, University of Bergen, Bergen, Norway
                [2 ]Bergen Red Cross Nursing Home, 5043 Bergen, Norway
                [3 ]Hellemyren kindergarten, 5043 Bergen, Norway
                Article
                1757-7241-19-13
                10.1186/1757-7241-19-13
                3060136
                21356047
                734a095a-b419-4fa2-9337-5dddf1708c33
                Copyright ©2011 Bollig et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 November 2010
                : 28 February 2011
                Categories
                Original Research

                Emergency medicine & Trauma
                Emergency medicine & Trauma

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