Last reviewed 15 December 2015
In the grand scale of medical emergencies, a cardiac arrest must top the lot. When a heart stops pumping blood around the body and normal breathing suddenly stops, every second can make the difference between life and death. It only takes a few minutes for irreversible brain damage to occur.
According to the British Heart Foundation (BHF), there are around 60,000 out-of-hospital cardiac arrest in the UK each year and around half of these are treated by emergency medical services. This places ordinary men, women and children in the position of having to cope with the remaining 30,000 emergencies.
Eighty per cent of these out-of-hospital emergencies happen in the home and chances of survival are not good. Much will obviously depend on where the cardiac arrest takes place and if there is someone close at hand who knows what to do, but survival rates are rarely better than between 2% and 12%.
In the UK, the target time for an ambulance to arrive following a 999 call is eight minutes. Generally speaking, this target is met 75% of the time, but every minute counts for someone who has suffered a cardiac arrest. In the period between the incident and the arrival of professional help, people who have been trained in emergency life support (ELS) can buy vital time for the casualty. Clearly if more people had ELS skills, survival would improve.
The BHF estimates that only one in seven secondary age pupils in England receives training that could help them to potentially save a life. With this in mind, the BHF, St John Ambulance and the British Red Cross have joined forces to launch Every Child a Lifesaver. The aim is to persuade Parliament to enact the Emergency First Aid Education Bill that would make first aid a compulsory subject in all state-funded secondary schools before the next General Election in 2020. The Bill is due for its second reading in Parliament on 20 November 2015.
Currently, according to the British Red Cross, although 84% of secondary school teachers and 97% of 11-to 16-year-olds think that first aid should be part of the school curriculum, less than one in four secondary schools actually teach first aid.
Fifty seven per cent of teachers believe that the only way for schools to take first aid seriously is to make it compulsory.
First aid, of course, is not just about cardiac arrest. Every year in the UK, there are tens of thousands of medical emergencies that result in deaths, injuries and disabilities. Although cardiac arrest is the main attention grabber, young people are probably more likely to be faced with accidents in the home. The Royal Society for the Prevention of Accidents (RoSPA) reports that more than two million children under the age of 15 are taken to hospital each year following home accidents.
Home accidents result in approximately 6000 deaths every year and not surprisingly the most vulnerable groups are the under-fives and over-sixty fives. Burns and scalds account for some 175,000 attendances at A&E, with over 8000 young children being injured as a result of falls in and around the home.
Far too many people simple do not know what to do when they are faced with an emergency. A survey by the British Red Cross found that only one in 13 UK people felt confident enough to carry out emergency first aid. This compares with around 80% in Germany and Scandinavia.
It is accepted that children are more likely to suffer major injuries than adults. Children are often present at the scene of an accident and emergency, but a survey by St John Ambulance found that 69% of children would not know how to treat an injury when faced with the situation. If they have been properly trained children can be just as effective as adults in administering ELS, helping to prevent disability and saving lives.
Children aged 10 and above can learn the full range of ELS skills including cardiopulmonary resuscitation (CPR). Younger children are also able to confidently use many ELS skills, although they may not be strong enough to compress a chest. However, they are still able to learn the technique and this can be effectively used as they physically develop.
Research has shown that skill retention among young children is very good and there are many instances where quite young children have been able to use these skills most effectively in an emergency.
In English and Welsh schools, any first aid teaching has tended to be squeezed into the safety element of personal, social, health and economic education (PSHE), but since PSHE is not a National Curriculum subject, first aid often finds itself fighting a losing battle. This is in contrast to schools in countries such as France, Denmark and Norway where ELS is a mandatory part of the school curriculum.
In Denmark, for instance, 6 to 8 year-olds are taught the basic first aid principles while 8- to 11-year-olds learn how to deal with bleeding and 12- to 15-year-olds progress to more advanced ELS skills and CPR. A similar system applies in Norway, where in some areas, such as Stavanger, survival from a shockable cardiac arrest is as high as 52%.
This apparent lack of interest in UK schools cannot be blamed on lack of teaching resources.
St John Ambulance has a long tradition of running first aid training in schools and provides a range of free training resources. There is also a network of trainers that schools can call upon.
The British Red Cross also provide a range of free interactive learning resources. There are lesson plan templates with curriculum links and activities for different age groups, abilities and settings, and much more.
Apps are becoming popular. The British Red Cross, for instance, has a mobile app that might be of particular use to a young babysitter since it deals with what to do if a small child chokes or suffers some kind of accident. The BHF has one that covers CPR.
For the under-11s, the BHF produces a little book called Artie Beat’s Lifesavers that is aimed at teaching what to do if someone:
is bleeding a lot
has chest pains
The BHF has also recently launched its Call Push Rescue Training. Taking the CPR initials the BHF identifies them as:
push hard and fast on the centre of the chest 30 times
give two rescue breaths.
The 30-minute course is free to all secondary schools, sixth forms and colleges in both maintained and independent sectors, as well as being available to community groups working with young people over the age of 12.
It comes with inflatable manikins and a range of resources and lesson frameworks suitable for groups of 35 pupils. It covers how and when to perform CPR on an adult or child, how to put someone in the recovery position and how to use a public access defibrillator. No instructor is needed because all the techniques are taught using the educational DVD.
In England alone, there are around three million 11- to 19- year-olds in state funded secondary education. It is not difficult to imagine the difference it might make to survival rates if they all received some emergency life support training and spent just 30 minutes learning CPR.