Our Training Session
THE EVIDENCE FOR CPR TRAINING
Sudden cardiac arrest can occur in any age group at any time. Approximately 30,000 cardiac arrests occur each year in the UK, outside of a hospital environment. Survival rates currently stand at about one person in 10 (10%.)
Once the brain has been starved of oxygen for over three minutes, permanent damage can occur.
When a cardiac arrest happens in a public place, there can be a long gap between the time the heart stops and the time CPR is started; unless a bystander (a member of the public) intervenes. It is estimated that up to a third of the public still feel reluctant to provide bystander CPR. Countries such as Denmark have addressed this problem, and successful outcomes after a Cardiac Arrest outside of the hospital, have subsequently doubled.
Giving everyone – especially young people- the confidence and skill to intervene in such an important way is life-saving, and individuals who suffer cardiac arrest would have the best chance of survival if we equip and empower the public to act.
There are many reports of young people, who have died because those around them didn’t know how to help when they needed it, including the tragic story of 13-year-old Christopher Sears, who died when he had an epileptic seizure on the school bus. Christopher was sat upright in his seat, and from the report, It appears he stopped breathing and obstructed his airway. None of his fellow pupils (or the bus driver) knew how to help him.
There could not be a stronger reminder of the importance of this simple, basic training. Everyone including children – should have access to this simple knowledge.
The government added first aid in schools to the curriculum in 2020. Although lesson plans and resources have been provided; no provision to teach basic skills face-to-face has been made to our knowledge. Our Charity began in 2016 before first aid was added to the curriculum, and our four-skill model not only focuses on the most important first aid interventions but allows for practice on the manikins, which anchors the physical action of CPR and choking management to the knowledge and scenarios. We are the only organisation we know of offering this experiential learning opportunity throughout the UK, free of charge to schools.
Our training is designed to equip and empower them to feel confident in recognising when someone needs assistance, because of choking or collapse. They will be able to quickly assess a casualty whilst staying safe, and take immediate first action and summon help quickly. The training is there to empower them so they can act and not feel helpless.
There is no expectation for them to become first responders or to be summoned to attend to casualties that are not in their immediate vicinity. The training will empower them so that they have some basic skills if they are at an event – for example at home with a sibling. The choice to get involved and offer assistance to a casualty remains entirely theirs.
Rescue Breaths (mouth-to-mouth) should be performed if the rescuer is both trained AND happy to do so. We do not teach rescue breaths for the following reasons:
- They are technically difficult to perform successfully – even by trained medical professionals.
- They interrupt chest compression, and continuous chest compressions are the most important early bystander action
- Rescuers are often reluctant to perform them – especially on casualties who have vomited.
- Reluctance to perform rescue breaths has been linked to lower incidences of bystander CPR.
- The recommendations for CPR during Covid-19 from the British Heart Foundation and Resus Council UK, are to not perform rescue breaths.
We acknowledge that in paediatric cardiac arrest (especially in younger children), low oxygen levels are the most common reason for the heart to stop. However, hands-only CPR is still a valid and useful technique and increases the chance of survival over not receiving CPR at all.
We teach our child rescuers to perform a brisk “shake-and-shout” assessment to attempt to elicit a response. This removes the need to bring the rescuers face into close contact with the casualty’s face (thus reducing the risk of Covid-19 transmission) and also removes the issue of not being sure of the response.
It can be difficult to tell if a collapsed casualty is breathing at all, breathing normally, or to be able to feel a pulse; especially through clothes and in a noisy environment.
If the child-rescuer does not know if a pulse is present or if the casualty is breathing, they will not
know what to do next. This risks them stopping resuscitation altogether, which, if the casualty needs chest compressions, they will not receive. Their chances of survival then decrease significantly.
Casualties who are not breathing normally and do not have an adequate pulse will need CPR. Our simple assessment gives a clear answer – the casualty either responds (speaks, moves, gasps, moans) or they do nothing – meaning in either case- the rescuer knows what to do next.
If compressions elicit a response from the casualty we teach the rescuer to stop and to put them into the recovery position and re-check them frequently until help arrives.
Chest Compressions are very stimulating. If a casualty has fainted, they are very likely to regain consciousness at the stimulus of a chest compression and thus respond. This will trigger the rescuer to stop compressions and place the casualty into the recovery position.
There is very little evidence to show injury, or a bad outcome, for a casualty who received compressions they didn’t need. This is in contrast to those who did not receive compressions when they needed them. Resuscitation Councils globally recommend that if a casualty is unresponsive and rescuers are not sure if they are breathing or have a pulse, then they should start hands-only CPR.
Current guidance suggests that you should if you can, to reduce the risk of Covid-19 infection.
We take a very practical approach to this advice and suggest that if the casualty has a facemask it can be applied before chest compressions begin. But, unless a cover is immediately to hand, the commencement of CPR must not be delayed by looking for face covering.
We would not recommend covering the face of a casualty who is a young child; and that any face coverings used, must not be a risk to blocking off the casualty’s airway.
We make it clear in the sessions to the children that sometimes resuscitation efforts don’t work and people whose hearts have stopped can still die. It is important to understand that it is not because
the rescuers did anything wrong.
By summoning help and performing chest compressions early, the casualty has been given the very best chance of survival and that is the important thing. It’s just sometimes that the reason for their heart-stopping, or their underlying health being poor, was too severe for them to survive, even with perfect assistance. Support is offered for rescuers such as: