Department of Anesthesiology and Pain Medicine, Hospital for Sick Children, Toronto, Canada.
Resuscitation. 2013 Apr;84(4):415-21. doi: 10.1016/j.resuscitation.2012.12.008. Epub 2012 Dec 11.
Training schoolchildren to perform cardiopulmonary resuscitation is one possible method of increasing bystander CPR rates. We reviewed available literature to identify what methods of training children have been successful.
This review sought to evaluate evidence addressing the following PICO question: (P) In schoolchildren, (I) what types of CPR, AED and first aid training (C) when compared to no training and to each other (O) lead to ability to perform life saving measures? Searches were conducted in Ovid MEDLINE (1946 - August 2012), Ovid EMBASE (1974 - August 2012) and Ebscohost Cinahl (1981 - August 2012). Database specific subject headings in all three databases (MeSH in MEDLINE, Emtree in EMBASE, Cinahl Headings) were selected for the concepts of cardiopulmonary resuscitation (CPR) and education. The combined results were then limited by age to include all school aged children. The search yielded 2620 articles. From titles, abstract and key words, 208 articles described CPR, AED and/or first aid training in schoolchildren and were eligible for review. These were obtained in full, were unavailable or not published in English. We reviewed articles for publication type and relevance. 48 studies were identified. One additional study was included as an extension of a study retrieved within the search.
The studies found by the search were heterogeneous for study and training methodology. Findings regarding schoolchild age and physical factors, the role of practical training, use of self-instruction kits, use of computer based learning, reduced training time, trainer type, AED training are presented.
Evidence shows that cardiopulmonary training, delivered in various ways, is successful in a wide age range of children. While older children perform more successfully on testing, younger children are able to perform basic tasks well, including use of AEDs. Chest compression depth correlates with physical factors such as increasing weight, BMI and height. Instruction must include hands on practice to enable children to perform physical tasks. Repeated training improves performance and retention but the format and frequency of repeated training is yet to be fully determined. Types of training that may reduce the main obstacles to implementation of such training in schools include use of self-instruction kits, computer based learning and use of teacher and peer tutor trainers, but again, need further exploration. As starting points we recommend legislative and funded mandates to provide such training to schoolchildren, and production and use of a framework which will delineate longitudinal delivery of training over the school career. Further research should have some uniformity in terms of assessment methodology, look at longer outcomes, and ideally will evaluate areas that are currently poorly defined.
培训学童进行心肺复苏术是提高旁观者心肺复苏术（CPR）率的一种可能方法。我们回顾了现有文献，以确定对儿童进行了哪些成功的培训方法。
本综述旨在评估以下 PICO 问题的证据：（P）在学童中，（I）与无培训和相互比较，（C）哪种类型的 CPR、AED 和急救培训（O）导致能够进行救生措施？在 Ovid MEDLINE（1946 年至 2012 年 8 月）、Ovid EMBASE（1974 年至 2012 年 8 月）和 Ebscohost Cinahl（1981 年至 2012 年 8 月）中进行了搜索。在这三个数据库中的所有数据库（MEDLINE 中的 MeSH、EMBASE 中的 Emtree、Cinahl Headings）中都选择了心肺复苏术（CPR）和教育的特定主题标题。然后将合并结果按年龄限制为包括所有学龄儿童。搜索结果产生了 2620 篇文章。从标题、摘要和关键词来看，有 208 篇文章描述了对学童进行的 CPR、AED 和/或急救培训，符合审查条件。这些文章都全文获得，无法获得或未以英文发表。我们对出版类型和相关性进行了评论。确定了 48 项研究。另外一项研究作为检索范围内检索到的一项研究的延伸而被纳入。
搜索发现的研究在研究和培训方法上存在异质性。介绍了与学童年龄和身体因素、实践培训的作用、自我指导工具包的使用、基于计算机的学习、培训时间缩短、培训师类型、AED 培训相关的发现。
证据表明，以各种方式进行的心肺复苏培训在广泛的儿童年龄范围内是成功的。虽然年龄较大的儿童在测试中表现更好，但年龄较小的儿童能够很好地完成基本任务，包括使用 AED。胸部按压深度与体重、BMI 和身高等身体因素相关。指导必须包括实践操作，使儿童能够执行身体任务。重复培训可以提高表现和保留率，但重复培训的格式和频率尚未完全确定。可能减少在学校实施此类培训的主要障碍的培训类型包括使用自我指导工具包、基于计算机的学习和使用教师和同伴导师培训师，但仍需要进一步探索。作为起点，我们建议立法和提供资金来为学童提供此类培训，并制定一个框架，将培训贯穿整个学校生涯。进一步的研究应该在评估方法方面具有一定的统一性，着眼于更长的结果，并希望评估目前定义不明确的领域。
