International Journal of First Aid Education

First Aid Training in Remote Borderline Communities in Armenia

2023-02-23T21:45:44+00:00

First Aid Learning for Targeted Rural Communities in Timor-Leste

2023-02-23T22:04:46+00:00

Evaluation of a 2-day First Aid Course Including Basic Resuscitation With 1,268 Primary School Children Aged 6–13 Years – A Multicenter Intervention Study

2023-02-26T16:15:23+00:00

Background: In Germany, current school-based first aid training recommendations do not include children under 13 years. Our aim was therefore to evaluate a primary school-based first aid course for children aged 6–13 years.

Methods: Our 2-day course (4 hours per day) for primary schools in the German rural state Brandenburg included basic elements of scene safety, compression bandages, recovery position, and resuscitation. The evaluation of specific knowledge and skills took place 1-day post-course.

Results: Among the 1,268 included children (median age 9y, 49% girls) from six primary schools, 25% had previously attended first aid courses. Most children knew emergency phone number(s) pre-course. Afterward, this knowledge improved by 15% in the 6–7-year age group (reaching 80%) whereas it remained at 90% in children aged 8–13 years.

After the course, about 80% of the 8–13-year-old children (40% in 6–7-year age group) answered at least one resuscitation question correctly. In the practical skill assessments, about 80% of the 8–13-year-old children (60% in the 6–7-year age group) chose a correct or almost-correct chest compression rate during resuscitation. The correct depth of compression was achieved by about 80% (10–13 years), 60% (8–9 years), and 40% (6–7 years). Three-quarters successfully put another child in the recovery position; more than two-thirds applied a compression bandage appropriately.

Conclusions: A 2-day course in a primary school setting showed considerable improvement in first aid and resuscitation skills of children aged 6–13 years. Future studies should examine these effects’ sustainability and the appropriate timing for refresher courses.

Zusammenfassung

Hintergrund: In Deutschland umfassen die aktuellen schulbasierten Erste-Hilfe-Schulungsempfehlungen keine Kinder unter 13 Jahren. Unser Ziel war es daher, einen Erste-Hilfe-Kurs für Grundschulen zu evaluieren.

Material und Methode: Unser zweitägiger Kurs (4 Stunden pro Tag) für Grundschulen im Bundesland Brandenburg umfasste Basiselemente der eigenen Sicherheit am Unfallort, Kompressionsverbände, stabile Seitenlage und Wiederbelebung. Nach der Basiserhebung kurz vor Schulungsbeginn fand die Evaluation spezifischer Kenntnisse (mit Fragebogen) und Fertigkeiten einen Tag nach dem Kurs statt.

Ergebnisse Unter den 1.268 eingeschlossenen Kindern (Altersmedian 9 Jahre, 49% Mädchen) von sechs Grundschulen hatten 25% bereits früher an einem Erste-Hilfe-Kurs teilgenommen. Die meisten Kinder kannten vor dem Kurs bereits die Notrufnummer(n). Danach verbesserte sich dieses Wissen um 15% und erreichte 80% in der Altersgruppe der 6-7-Jährigen, während es bei älteren Kindern (8-13 Jahre) bei 90% blieb. Nach dem Kurs beantworteten 40% der 6-7-Jährigen und etwa 80% der 8-13-jährigen Kinder mindestens eine Frage zur Reanimation richtig. Bei den Bewertungen der praktischen Fertigkeiten wählten 60% der 6-7-Jährigen und etwa 80% der 8-13-jährigen Kinder während der Wiederbelebung die korrekte oder nahezu korrekte Rate der Kompression des Brustkorbs aus. Die richtige Kompressionstiefe wurde von 40% (6-7 Jahre), 60% (8-9 Jahre) und etwa 80% (10-13 Jahre) erreicht. Drei Viertel der Teilnehmenden setzten erfolgreich ein anderes Kind in die Stabile Seitenlage; mehr als zwei Drittel legten einen Kompressionsverband angemessen an.

Schlussfolgerungen Ein zweitägiger Kurs in der Grundschule führte in allen Altersgruppen von 6-13 Jahren zu einer deutlichen Verbesserung ihrer Kenntnisse in Erster-Hilfe und Fähigkeiten bei der Wiederbelebung. Zukünftige Studien sollten die Nachhaltigkeit dieser Effekte und den geeigneten Zeitpunkt für Auffrischungskurse untersuchen.

Streszczenie

Tło Obecne zalecenia dotyczące szkolenia z pierwszej pomocy w niemieckich szkołach nie obejmują dzieci poniżej 13 roku życia. Naszym celem było zatem ocenienie kursu pierwszej pomocy dla dzieci w wieku od 6 do 13 lat prowadzonego w szkole podstawowej.

Metody Nasz dwudniowy kurs (4 godziny dziennie) dla szkół podstawowych na obszarach wiejskich w niemieckim kraju związkowym Brandenburgia obejmował podstawowe elementy bezpieczeństwa w miejscu zdarzenia, bandażowanie uciskowe, pozycję bezpieczną i resuscytację. Ocena konkretnych umiejętności i wiedzy odbyła się dzień po zakończeniu kursu.

Wyniki Wśród 1268 uwzględnionych dzieci (średni wiek 9 lat, 49% dziewczyn) z sześciu szkół podstawowych, 25% uczestniczyło wcześniej w kursach pierwszej pomocy. Większość dzieci przed kursem znała już numer(y) alarmowy. Po kursie wiedza ta poprawiła się o 15% w grupie wiekowej 6-7 lat (osiągając 80%), podczas gdy w grupie wiekowej 8-13 lat pozostała na poziomie 90%. Po kursie około 80% dzieci w wieku od 8 do 13 lat (40% w grupie wiekowej 6-7 lat) poprawnie odpowiedziało na co najmniej jedno pytanie dotyczące resuscytacji. W ocenach praktycznych umiejętności, około 80% dzieci w wieku od 8 do 13 lat (60% w grupie wiekowej 6-7 lat) wybrało właściwe lub prawie właściwe tempo ucisków klatki piersiowej podczas resuscytacji. Prawidłowa głębokość ucisków była osiągana przez około 80% (w wieku od 10 do 13 lat), 60% (w wieku od 8 do 9 lat) i 40% (w wieku od 6 do 7 lat). Trzy czwarte dzieci skutecznie ułożyło inne dziecko w pozycji bezpiecznej, a ponad dwie trzecie odpowiednio zastosowało bandaż uciskowy.

Wnioski Dwudniowy kurs przeprowadzony w szkole podstawowej wykazał znaczną poprawę umiejętności pierwszej pomocy i resuscytacji u dzieci w wieku od 6 do 13 lat. W przyszłych badaniach należy zbadać trwałość tych efektów oraz odpowiedni czas na odświeżenie wiedzy pozyskanej na kursach.

Schlüsselwörter: Grundschule, Erste Hilfe, Wiederbelebung, Laienschulung, Schulkinder, Schüler, Basisreanimation, Klassenzimmer, Blutungsstillung, Kompressionsverband, Stabile Seitenlage, Wiederbelebung, Laien-Wiederbelebung

Słowa kluczowe: szkoła podstawowa, pierwsza pomoc, resuscytacja, szkolenie dla laików, dzieci szkolne, uczniowie

Perspective of Need for First Aid Education in Bulgarian Schools

2023-03-17T00:16:11+00:00

Background: First aid and disaster response training for school teachers is not mandatory in many countries, including the Republic of Bulgaria, despite its importance for protecting lives and reducing long-term negative effects of injuries to students on school premises.

Methods: A sample of 419 teachers from 26 public and private schools in different cities, towns, and villages in all the six NUTS 2 level regions in Bulgaria filled in questionnaires in order to examine their current level of first aid and disaster response training and motivation for improving it. Chi-square, Cramér‘s V, and p-values were calculated in order to explore possible factors influencing teachers’ motivations for learning first aid.

Results: Approximately 59% of respondents state their willingness to undergo further first aid and disaster response training. Analyzed data showed negligible relationships between teachers’ desire to improve the level of their first aid and disaster response training and the type of school they teach in. A stronger relationship between the desire of teachers to improve their first aid training and having witnessed a situation requiring first aid exists but the effect size is weak. The analysis shows the discrepancies between the confidence and decisiveness of teachers reported during the survey and the level of their first aid training.

Conclusion: The majority of teachers that participated in the research wished to improve their first aid skills. This requires further research on the appropriate forms, duration, and means for organizing such training so that in the short term the general level of first aid training of teachers in the country would increase. The results of the conducted survey do not clearly show the factors influencing the lack of motivation of the rest of the teachers. Further research in this aspect could present possibilities for improving the level of first-aid training of teachers.

Ðåçþìå

Предистория: Обучението за оказване на първа помощ и реагиране при бедствия има важно значение за опазване на живота и намаляване на дългосрочните негативни последствия от нараняване на учениците в следствие на инциденти в училище. Въпреки това, в много държави, включително Република България, то няма задължителен характер.

Методи: Формирана е извадка от 419 учители от 26 частни, държавни и общински училища в шестте планови икономически района в България. Участниците в проучването попълниха анкетни карти с оглед изследване на тяхното настоящо ниво на подготовка за оказване на първа помощ и реагиране при бедствия и мотивацията им за повишаването му в бъдеще. Изчислени са χ², коефициент на Крамер и р стойността с оглед изследване потенциалното влияние на различни фактори върху мотивацията на учителите.

Резултати: Приблизително 59% от респондентите изразяват желание да бъдат допълнително обучени за оказване на първа помощ и реагиране при бедствия. Анализираните данни показва липсата на съществена връзка между желанието на учителите да подобрят нивото си на подготовка и вида училище, в който преподават. По-силна връзка съществува между това им желание и факта, че са били свидетели на ситуация, която е изисквала оказването на помощ. Въпреки това тази връзка е слаба. Анализът показва, че съществува несъответствие между изразената по време на анкетата увереност и решителност от учителите да окажат помощ и реалната им подготовка за това.

Заключение: Преобладаващата част от учителите, участвали в изследването, биха искали да подобрят уменията си за оказване на първа помощ. Това предполага провеждането на допълнително изследване на подходящите форми, продължителност и средства за организиране на такава обучение. Резултатите от проведеното проучване не показват ясно факторите, които обуславят липсата на мотивация сред останалите учители, което може да бъде обект на следващо изследване.

Resumen

Antecedentes: La capacitación en primeros auxilios y respuesta a desastres para maestros de escuela no es obligatoria en muchos países, incluida la República de Bulgaria, a pesar de su importancia para proteger vidas y reducir los efectos negativos a largo plazo de las lesiones de los estudiantes en las instalaciones escolares.

Métodos: Una muestra de 419 docentes de 26 escuelas públicas y privadas en diferentes ciudades, pueblos y aldeas de Bulgaria en las seis regiones de nivel NUTS 2 completaron cuestionarios para examinar su nivel de capacitación en primeros auxilios y respuesta a desastres y su motivación para mejorarlo. Se calcularon los valores de Chi-cuadrado, V de Cramér y P-Valor para explorar los posibles factores que influyen en las motivaciones de los maestros para aprender primeros auxilios.

Resultados: Aproximadamente el 59% de los encuestados afirman estar dispuestos a recibir capacitación adicional en primeros auxilios y respuesta a desastres. Los datos analizados mostraron relaciones insignificantes entre el deseo de los docentes de mejorar el nivel de su capacitación en primeros auxilios y respuesta a desastres y el tipo de escuela en la que enseñan. Existe una relación más fuerte entre el deseo de los docentes de mejorar su capacitación en primeros auxilios y haber presenciado una situación que requería los primeros auxilios, pero la dimensión del efecto es débil. El análisis muestra discrepancias entre la confianza y la firmeza que reportan los docentes durante la encuesta y el nivel de su formación en primeros auxilios.

Conclusión: La mayoría de los docentes que participaron en la investigación deseaban mejorar sus habilidades en primeros auxilios. Esto requiere más investigación sobre la forma, la duración y los medios apropiados para organizar dicha capacitación de modo que, a corto plazo, aumente el nivel general de capacitación en primeros auxilios de los maestros en el país. Los resultados de la encuesta realizada no muestran claramente los factores que influyen en la falta de motivación del resto del profesorado. Una investigación adicional en este aspecto podría ofrecer posibilidades para mejorar el nivel de formación en primeros auxilios de los profesores.

Palabras Clave: formación en primeros auxilios; escuelas; profesores; Bulgaria

Exploring Medical Students’ Self-Reported Confidence and Willingness Administering Basic Life Support (BLS) Following Peer-Led Training in the Context of COVID-19

2023-07-28T12:50:30+00:00

Background: Basic life support (BLS) delivery improves prognosis following out-of-hospital cardiac arrest and forms an integral part of undergraduate medical curricula, although limited literature has assessed student confidence in utilizing these skills. An investigation of medical students’ self-reported confidence and hypothetical willingness to perform BLS was undertaken at the University of Bristol, within its peer-led BLS training scheme (RMD Bristol). Due to the study timing including COVID-19 restrictions (2020–21), changes in student confidence during this period could also be explored.

Methods: A prospective cohort study of medical students participating in BLS training during 2018–2022 (N = 1084) was undertaken. Self-reported confidence and hypothetical willingness to perform BLS was assessed using pre- and post-training questionnaires (five-point Likert scale). Data were analyzed in three groups: 1) pre-COVID (including in-person training), 2) during COVID (virtual-only training), and 3) post-COVID (including in-person training).

Results: 347 medical students completed 658 questionnaire responses. All training modes significantly increased self-reported confidence and hypothetical willingness to perform BLS (p < 0.05). Self-reported confidence reduced rapidly following virtual-only training. During the pandemic, a reduction in student-perceived willingness to provide BLS in an emergency was observed in a community but not a hospital setting.

Conclusion: Peer-led BLS training is effective in improving medical students’ self-reported confidence and willingness to administer BLS, regardless of delivery mode. The COVID-19 pandemic influenced both the delivery of teaching and students’ attitudes towards performing BLS. Due to the rapid confidence fade after virtual-only training, BLS teaching with an in-person component may remain the most effective model for training medical students.

Abstraite

Contexte: L’administration des soins immédiats en réanimation (SIR) améliore le pronostic après un arrêt cardiaque extrahospitalier et fait partie intégrante des programmes d’études médicales de premier cycle, mais peu d’études ont évalué la confiance des étudiants dans l’utilisation de ces compétences. Une étude sur la confiance déclarée des étudiants en médecine et leur volonté hypothétique de pratiquer les SIR a été entreprise à l’Université de Bristol, dans le cadre de son programme de formation SIR dirigé par des pairs (RMD Bristol). Le calendrier de l’étude incluant les restrictions du COVID-19 (2020–21), les changements dans la confiance des étudiants au cours de cette période ont également pu être explorés.

Méthodes: Une étude de cohorte prospective des étudiants en médecine qui ont suivi une formation SIR entre 2018 et 2022 (N = 1084) a été entreprise. La confiance auto déclarée et la volonté hypothétique de pratiquer les SIR ont été évaluées à l’aide de questionnaires avant et après la formation (échelle de Likert en 5 points). Les données ont été analysées en trois groupes : 1) pré-COVID (y compris la formation en personne), 2) pendant COVID (formation virtuelle uniquement) et 3) post-COVID (y compris la formation en personne).

Résultats: 347 étudiants en médecine ont répondu à 658 questionnaires. Tous les modes de formation ont augmenté de manière significative la confiance déclarée et la volonté hypothétique d’effectuer les SIR (p < 0,05). La confiance déclarée a diminué rapidement après une formation uniquement virtuelle. Pendant la pandémie, une réduction de la volonté perçue par les étudiants de fournir des soins d’urgence a été observée dans un contexte communautaire mais pas dans un contexte hospitalier.

Conclusion: La formation SIR menée par les pairs est efficace pour améliorer la confiance déclarée des étudiants en médecine et leur volonté de fournir les SIR, quel que soit le mode de formation. La pandémie de COVID-19 a influencé à la fois l’enseignement et l’attitude des étudiants à l’égard du BLS. En raison de la perte de confiance rapide après une formation uniquement virtuelle, l’enseignement des SIR avec une composante en personne peut rester le modèle le plus efficace pour la formation des étudiants en médecine.

抽象的

背景: 基本生命支援術（BLS）的施行改善了院外心臟驟停的預後，也是大學醫學課程的重要組成部分，但有關評估學生運用這些技能的信心的文獻卻很有限。布里斯托大學在其同伴引導BLS培訓計劃（RMD Bristol）中進行了一項關於醫學生自我報告在施行BLS的信心和意願的調查。由於研究期包括了COVID-19限制的時段（2020–21），因此可以同時探討於此期間學生信心的變化。

方法: 使用了前瞻性隊列的研究方法，而研究對象是在2018年至2022年進行了BLS培訓的醫學生（N = 1084）。利用培訓前和培訓後問卷（5點李克特量表）來評估他們自我報告的信心和意願。資料分析分為三組：1）COVID之前（包括面授培訓），2）COVID期間（僅虛擬培訓），3）COVID之後（包括面授培訓）

結果: 共有347名醫學生完成了658份問卷回答。結果顯示所有培訓方式都能顯著提高施行BLS的自信心和意願（p < 0.05）。而自我報告的信心在只接受虛擬培訓後有迅速降低的現象。另觀察所得，在大流行期間，如遇上緊急情況，學生在社區環境下施行BLS的意願有所下降，但在醫院環境下並未觀察到這種情況

結論: 不論何種培訓方式，同伴引導的BLS培訓有效地提高了醫學生施行BLS的信心和意願。COVID-19大流行影響了教學的方式和學生對施行BLS的態度。由於學生的信心在僅接受虛擬培訓後迅速消退，帶有面授形式的BLS教學可能仍然是培訓醫學生最有效的模式

背景: 基本生命支持术（BLS）的进行改善了院外心脏骤停的预后，也是医学本科课程的重要组成部分，但评估学生运用这些技能的信心的文献却很有限。布里斯托大学在同伴引导BLS培训计划（RMD Bristol）中进行了一项医学生自我报告在进行BLS时的信心和意愿的调查。基于研究期间包括了COVID-19限制的时段（2020–21），因此还可以探讨在此期间学生信心的变化

方法: 使用了前瞻性队列的研究方法，而研究对象是在2018年至2022年进行了BLS培训的医学生（N = 1084）。利用培训前和培训后问卷（5点李克特量表）来评估他们自我报告的信心和意愿。信息分析分为三组：1）COVID之前（包括面授培训），2）COVID期间（仅虚拟培训），3）COVID之后（包括面授培训）

结果: 共有347名医学生完成了658份问卷回答。结果显示所有培训方式都能显著提高进行BLS的自信心和意愿（p < 0.05）。而自我报告的信心在只接受虚拟培训后有迅速降低的现象。另就观察所见，在大流行期间，如遇上紧急情况，学生在社区环境下进行BLS的意愿有所下降，但在医院环境下没有观察到这种情况

结论: 不论何种培训方式，同伴引导的BLS培训有效地提高了医学生进行BLS的信心和意愿。COVID-19大流行影响了教学的方式和学生对进行BLS的态度。基于学生的信心在仅接受虚拟培训后迅速消退，带有面授形式的BLS教学可能仍然是培训医学生最有效的模式

Mots clés: Support de base (BLS); étudiants en médecine; pair enseignement; COVID 19; étude de confiance

關鍵字: 基本生活支持 (BLS); 醫學生; 同行教學; 新冠肺炎; 信心研究

关键字: 基本生活支持 (BLS); 医学生; 同行教学; 新冠肺炎; 信心研究

Development of an Evidence-Based First Aid Guideline for First Responders in Sub-Saharan Africa

2023-03-16T18:47:04+00:00

Background: Many Sub-Saharan African countries lack effective emergency medical services. In response, Red Cross and Red Crescent National Societies, amongst other organizations implement first responder training programs across Africa. The current paper describes the development of an advanced manual for first responders (FAFR) in Sub-Saharan Africa.

Methods: This FAFR manual was developed according to the principles of Evidence-Based Practice accounting for scientific evidence, expert opinion, and preferences of the target audience (i.e., Sub-Saharan African first responders). The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach was used to assess the certainty of evidence. A geographically balanced expert panel of African field and academic experts set the scope and defined the research questions. The best available evidence was systematically collected and presented to independent and dedicated content writers, drafting the manual. The expert panel discussed these draft recommendations during a two-day meeting and validated the final version of the manual.

Results: The systematic literature addressed 87 research questions. Of these, 52 could be supported by scientific evidence, in thirteen cases by a Cochrane systematic review. We determined the GRADE certainty of the evidence as low (38%) or very low (53%). Where no evidence was found, good practice points were formulated based on expert opinion.

Conclusions: The FAFR manual is used by Red Cross and Red Crescent National Societies across Africa and will be updated every five years by the Belgian Red Cross. The manual is freely available to anyone interested (https://www.rodekruis.be/en/what-do-we-do/first-aid-and-support/first-aid-for-first-responders/).

Résumé

Contexte: De nombreux pays de l’Afrique subsaharienne ne bénéficient pas d’aide médicale d’urgence efficace. Pour y remédier, les Sociétés Nationales de la Croix-Rouge et du Croissant-Rouge, entre autres, ont mis en place des programmes de formation pour les premiers répondants en Afrique. Ce document décrit la création d’un manuel avancé pour les premiers répondants (FAFR) en Afrique subsaharienne.

Méthodes: Ce manuel FAFR intègre les principes des pratiques fondées sur des données probantes tenant compte de preuves scientifiques, de l’avis d’experts et des préférences d’un groupe cible (ici, les premiers répondants d’Afrique subsaharienne). L’approche GRADE (Grading of Recommendations Assessment, Development, and Evaluation) a été utilisée pour évaluer la certitude des preuves. Un panel géographique équilibré d’experts africains de terrain et universitaires ont défini les objectifs et les questions de l’étude. Les meilleures preuves disponibles étaient systématiquement collectées et présentées aux rédacteurs de contenus indépendants chargés de rédiger la première version du manuel. Le panel d’experts a examiné les recommandations lors d’une réunion de deux jours et a validé la version finale du manuel.

Résultats: La revue systématique de la littérature s’est basée sur 87 questions de recherche. Parmi elles, 52 ont pu être appuyées par des preuves scientifiques, et dans treize cas par une revue systématique Cochrane. Nous avons déterminé une certitude GRADE de la preuve comme étant faible (38 %) ou très faible (53 %). Si aucune preuve n’était trouvée, des points de bonne pratique étaient formulés basés sur l’avis des experts.

Conclusions: Ce manuel FAFR a été utilisé par les Sociétés Nationales de la Croix-Rouge et du Croissant-Rouge en Afrique et sera mis à jour tous les cinq ans par la Croix-Rouge de Belgique - Communauté flamande. Ce manuel est disponible en libre accès à toute personne intéressée (https://www.rodekruis.be/en/what-do-we-do/first-aid-and-support/first-aid-for-first-responders/).

[Translation by:

Aurélia Feyssaguet

Voluntary translator for the Global First Aid Reference Centre]

Resumo

Enquadramento: Muitos países da África Subsariana carecem de serviços médicos de emergência eficazes. Em resposta, as Sociedades Nacionais da Cruz Vermelha e do Crescente Vermelho, entre outras organizações, implementam programas de formação de primeiros socorros em toda a África. O presente artigo descreve o desenvolvimento de um manual avançado para socorristas (FAFR) na África Subsariana.

Metodologia: Este manual do FAFR foi desenvolvido de acordo com os princípios da Prática Baseada em Evidência, contabilizando evidências científicas, opinião de especialistas e preferências do público-alvo (ou seja, socorristas da África Subsaariana). A abordagem GRADE (Grading of Recommendations Assessment, Development, and Evaluation) foi utilizada para avaliar o nível de evidência. Um painel de especialistas geograficamente equilibrado de especialistas africanos e académicos definiu o âmbito e definiu as questões de investigação. As melhores provas disponíveis foram sistematicamente recolhidas e apresentadas a redatores de conteúdos independentes e dedicados, elaborando o manual. O painel de peritos debateu essas recomendações preliminares durante uma reunião de dois dias e validou a versão final do manual.

Resultados: A literatura sistemática abordou 87 questões de pesquisa. Destas, 52 poderiam ser apoiados por evidências científicas, em treze casos por uma revisão sistemática Cochrane. Determinou-se que a o nível de evidência GRADE era reduzida (38%) ou muito reduzia (53%). Nos casos em que não foram encontrados elementos de prova, foram formulados pontos de boas práticas com base no parecer de peritos.

Conclusões: O manual do FAFR é utilizado pelas Sociedades Nacionais da Cruz Vermelha e do Crescente Vermelho em toda a África e será atualizado de cinco em cinco anos pela Cruz Vermelha Belga. O manual está disponível gratuitamente para qualquer pessoa interessada (https://www.rodekruis.be/en/what-do-we-do/first-aid-and-support/first-aid-for-first-responders/).

[Translation by:

Fábio Oliveira

Centro Hospitalar do Tâmega e Sousa

Porto, Portugal

https://orcid.org/0000-0002-6545-3364]

Providing First Aid to People Experiencing Mental Health Problems: Development of Evidence-Based Guidance Materials for Laypeople

2023-02-22T19:27:22+00:00

Background: Family and friends are particularly well placed to recognize early signs of mental health problems, provide initial support, and refer to professional help if needed. This project aimed to develop evidence-based guidance materials for laypeople on how to provide help to people experiencing mental health problems, adapted to the context of Flanders, Belgium.

Methods: We performed a systematic literature review for 12 different mental health topics, focusing on communicative support interventions feasible to be performed by laypeople. Systematic literature searches were conducted in MEDLINE, Embase, and PsycNET (October 2018). One reviewer per topic conducted data extraction and methodological quality assessment using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology. The evidence was used to develop a draft manual, which was presented to a multidisciplinary expert panel involving both content experts (n = 10) and mental health peer workers in training (all people with lived experience) (n = 6).

Results: Included studies involved 15 experimental and 75 observational studies, leading to 58 evidence conclusions on communicative interventions, risk factors or protective factors, and their relationship to mental health outcomes. The certainty of the evidence was very low for the majority of the evidence conclusions (84.5%), highlighting the need for expert and stakeholder input to inform practical recommendations. Scientific evidence and expert input were used to formulate 33 individual actions on how to provide first aid to people experiencing mental health problems. The recommendations were made available to laypeople via a guidance manual and a mobile application.

Conclusions: Input from the scientific literature and the expert panel were essential to obtain evidence-based guidance materials that were meaningful for practice in a Flemish context.

Effects of Physical Fatigue on Cardiopulmonary Resuscitation Quality by Lifeguards: A Systematic Review and Meta-analysis

2023-06-15T16:00:17+00:00

Background: Lifeguards actively contribute to the safeguarding of human lives in aquatic environments. When attending to victims of cardiac arrest in the water, lifeguards must perform basic life support after intense physical exertion that may involve running, swimming, and towing. The purpose of this review is to assess the magnitude of the effects caused by physical fatigue on the quality of subsequent cardiopulmonary resuscitation, under simulated conditions.

Methods: A systematic literature search was conducted following PRISMA guidelines, covering the databases: PubMed, Web of Science, ScienceDirect, and Academic Search Complete, using the keywords: (lifeguard) AND ("cardiopulmonary" OR "cardiorespiratory" OR "basic life support" OR "resusc*"). Articles published until 25 May 2023 were considered for inclusion. The methodological quality of the included studies was assessed using the JBI Critical Appraisal Tool. The pooled data analysis was conducted using a random-effects model, with heterogeneity assessed using I².

Results: In total, 8 studies (297 lifeguards) were included. Results indicate that physical fatigue jeopardizes the quality of compressions (ES: -0.90) and ventilations (ES: -1.10).

Conclusions: In general, lifeguards perform cardiopulmonary resuscitation poorly, especially when physically fatigued. Hence, this underscores the importance of keeping these professionals prepared to perform basic life support.

Resumo

Introdução: Os nadadores-salvadores contribuem ativamente na salvaguarda da vida humana em espaços aquáticos. Quando procuram dar resposta a vítimas de ataque cardíaco na água, estes profissionais devem realizar suporte básico de vida após atividade física intensa, que pode incluir correr, nadar e rebocar. O propósito desta revisão é averiguar a magnitude do efeito causado pela fadiga física na ressuscitação cardiopulmonar subsequente, sob condições simuladas.

Métodos: Uma pesquisa sistemática da literatura foi realizada seguindo as normas PRISMA, cobrindo as bases de dados: PubMed, Web of Science, ScienceDirect, and Academic Search Complete, usando as palavras-chave: (lifeguard) AND ("cardiopulmonary" OR "cardiorespiratory" OR "basic life support" OR "resusc*"). Os artigos publicados até 25 de maio de 2023 foram considerados para inclusão. A qualidade metodológica dos estudos incluídos foi avaliada com recurso à JBI Critical Appraisal Tool. A análise de dados foi conduzida utilizando random-effects model, com a heterogeneidade avaliada usando o teste I².

Resultados: No total, 8 estudos foram incluídos (297 participantes). Os resultados indicam que a fadiga física compromete a qualidade das compressões (ES: -0.90) e das ventilações (ES: -1.10)

Conclusões: De modo geral, os nadadores-salvadores realizam ressuscitação cardiopulmonar com má qualidade, especialmente sob fadiga. Assim, estes resultados ilustram a importância de manter nadadores-salvadores devidamente preparados para realizar suporte básico de vida.

Résumé

Effets de la fatigue physique sur la qualité de la réanimation cardio-pulmonaire par les sauveteurs : Une revue systématique et une méta-analyse

Contexte : Les sauveteurs contribuent activement à la sauvegarde des vies humaines dans les milieux aquatiques. Lorsqu'ils s'occupent de victimes d'arrêts cardiaques dans l'eau, les sauveteurs doivent effectuer une réanimation de base après un effort physique intense qui peut impliquer la course, la natation et le remorquage. L'objectif de cette étude est d'évaluer l'ampleur des effets de la fatigue physique sur la qualité de la réanimation cardio-pulmonaire subséquente, dans des conditions simulées.

Méthodes : Une recherche documentaire systématique a été effectuée conformément aux lignes directrices PRISMA, couvrant les bases de données : PubMed, Web of Science, ScienceDirect, et Academic Search Complete, en utilisant les mots clés en anglais : (lifeguard) et ("cardiopulmonary" ou "cardiorespiratory" ou "basic life support" OU "resusc*"). Les articles publiés jusqu'au 25 mai 2023 ont été pris en compte. La qualité méthodologique des études incluses a été évaluée à l'aide du JBI Critical Appraisal Tool. L'analyse des données regroupées a été réalisée à l'aide d'un modèle à effets aléatoires, l'hétérogénéité étant évaluée à l'aide de I2.

Résultats : Au total, 8 études (297 sauveteurs) ont été incluses. Les résultats indiquent que la fatigue physique compromet la qualité des compressions (ES : -0,90) et des ventilations (ES : -1,10).

Conclusion : En général, les sauveteurs font mal la réanimation cardio-pulmonaire, surtout lorsqu'ils sont physiquement fatigués. Cela souligne donc l'importance de maintenir ces professionnels préparés à effectuer les soins de base.

Letter from the Editors

2023-03-22T22:57:49+00:00