The missing link: basic life support at school

Abstract

Out-of-hospital cardiac arrest (OHCA) is one of the main causes of death in the world. The increase in the survival rate to this sudden event is influenced by the chain of survival (CoS) procedures. The school is the opportune institution to promote the education of citizens in basic life support (BLS), increasing the number of bystanders trained for effective action in the first two links of the CoS. This study aims to understand students' perceptions about acquiring BLS skills and identify their motivation to intervene in an emergency. This is a descriptive, cross-sectional, and analytical study, of the survey type, with a sample of 1215 students attending in the 10th grade in Portugal. The results show that 42.8% of the students consider that they have acquired enough skills to intervene and, of these, 7.9% consider themselves to be very well prepared. The greatest competence, which does not exceed 58.2%, is in terms of ensuring the safety of the rescuer and the patient, followed by the practice of the lateral safety position (57.6%). Among the 22 training areas, 59% assume values lower than 50%, i.e., they do not translate the training of students to intervene. In the context of pediatric BLS, preparation is even more incipient. Students' motivation to intervene has a median of 7 and mode of 8, on a scale between 1 (very weakly motivated) and 10 (highly motivated). The difference in motivation between the sexes is not significant. There are several constraints that tend to prevent students from acting in an emergency, in addition to their perceptions of training: the possibility that the patient has a contagious disease (27.5%), the fact that they are facing an appalling traumatic accident, with other injuries (24.3%) and the victim being a family member (8.8%). It is concluded that students, despite being motivated, do not feel able to intervene in an OHCA. It seems, therefore, essential to develop didactic approaches different from the current ones, which enable the effective training of senior students in basic education in BLS, to increase the survival rate in the face of a sudden event of this nature. This study underlines the need to develop observational studies, which rely on direct observation techniques, in groups of schools, with a view to in-depth knowledge of the contexts and the construction of evidence that underlies successful practices in the teaching and learning of BLS.