Be the hero: Evaluation of the quality of basic life support manoeuvres by school-age children

Abstract

Background: Out-of-Hospital Cardiac Arrest (OHCA) is the third leading cause of death in developed countries, with a survival rate less than 10%. Actually, although 70% of OHCA episodes are witnessed by laypeople only a third receive Basic Life Support (BLS). In Portugal, bystander-performed Cardiopulmonary Resuscitation (CPR) rate is still below 17%, with a survival rate of 4%. One of the most effective ways to increase bystander CPR is by training school-age children in BLS and Automated External Defibrillator (AED). Aims: Evaluate the capacity to learn and the quality of BLS maneuvers performed by school-age children. Methods: During a four-month period (interruption due to SARS-CoV-2 pandemic), BLS-AED teaching sessions were provided across schools in Oeiras, Portugal. It is considered that children older than 14 years old are able to perform quality chest compressions. Thus, classes from 14 to 18 years old were selected. Each session lasted 100 mins and was provided by nurses, with a ratio of one nurse to six students. Laerdal Medical's QCPR® software was used to measure and collect data of the quality of chest compressions. According to QCPR®, CPR is considered high quality if the final score is higher than 84%. A p-value of less than 0.05 was considered statistically significant. Results: A total of 734 young people were trained, with a median score of 97% (89–99) on the final QCPR® score. All students were able to provide chest compressions with the appropriate depth (>5 cm), 82% (44–96) provided chest compress at the recommended rate (100–120 bpm), and median compression rate of 112 (106–119) cpm. Male students performed deeper and more successful compressions but with less recoil than female students. Conclusions: School-age children aged 14–18 years old were able to learn and perform high-quality BLS maneuvers. We consider these results can have relevant public-health implications.