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Notfall + Rettungsmedizin

, Volume 12, Issue 5, pp 347–353 | Cite as

Reanimationsunterricht in Schulen

Ein Weg zur Verbesserung der Reanimationsergebnisse?
  • J. Breckwoldt
Leitthema

Zusammenfassung

Hintergrund

Ergebnisse von Reanimationen außerhalb von Krankenhäusern sind überwiegend ungünstig und hängen sehr stark von der Häufigkeit und Qualität von Ersthelfermaßnahmen durch Augenzeugen ab. Zur Verbesserung der Situation sind umfangreiche Ausbildungsanstrengungen der gesamten Gesellschaft nötig. Besonders geeignet ist dafür die Schulzeit, weil dort frühzeitig im Verlauf des lebenslangen Lernens die Wiederbelebung als Kulturfertigkeit verankert werden kann. Im deutschen Sprachraum existieren viele unterschiedliche Einzelprojekte, die allerdings weder organisatorisch noch inhaltlich untereinander vernetzt sind. In diesem Artikel soll der Versuch unternommen werden, Erfahrungen aus international publizierten Projekten zusammenzuführen und daraus Grundprinzipien für eine Umsetzung im deutschsprachigen Bereich abzuleiten.

Methoden

Vor dem Hintergrund der international zugänglichen Literatur werden Überlegungen zu notwendigen Inhalten, möglichen Ausbildungszeitpunkten, Unterrichtsformaten und Umsetzungsmöglichkeiten angestellt.

Ergebnisse

Als wichtigste Inhalte, insbesondere für kürzere Unterrichtsformate, werden festgehalten: Erkennen des Kreislaufstillstandes, Alarmierung des Rettungsdienstes und Thoraxkompressionen. Auch die Anwendung eines automatisierten externen Defibrillators (AED) hat einen wichtigen Stellenwert. Beatmung und stabile Seitenlage hingegen spielen eine untergeordnete Rolle und sollten in kompakte Unterrichtsformate aus Gründen der Klarheit nicht einbezogen werden. Ein besonderes Problem ist die geringe Verfügbarkeit von qualifizierten Ausbildern. Insofern müssen regional jeweils unterschiedliche Wege beschritten werden. Inhaltlich hat sich das German Resuscitation Council (GRC) das Ziel gesetzt, ein modellhaftes Curriculum zu erarbeiten.

Schlüsselwörter

Reanimation Ersthelfermaßnahmen Kreislaufstillstand Thoraxkompression Automatisierter externer Defibrillator 

Resuscitation training in schools

A way to improve resuscitation results?

Abstract

Background

Outcome from out-of-hospital cardiac arrest is generally unfavorable and greatly depends on the frequency and quality of bystander CPR. In order to improve the situation extensive educational efforts are necessary to teach CPR to society. The school period is particularly suitable because at this time resuscitation can be anchored as a cultural skill early in the course of a life long learning. In the German-speaking area many different individual projects exist, however, they are not linked together organizationally or in content. This article attempts to bring together experiences from published projects and to derive basic principles for implementation in the German-speaking area.

Methods

Against the background of literature, considerations are made on learning objectives, timepoints for training, training formats and implementation.

Results

The most important contents especially for shorter training formats are: recognition of cardiac arrest, recruiting helpers and emergency medical service and chest compressions. Also, the use of an automated external defibrillator (AED) is of value. In contrast ventilation and recovery position play a subordinate role and should not be included in compact training formats for reasons of clarity. A special problem is the low availability of qualified teachers and regional solutions must be found. At present, the German Resuscitation Council is developing a standard national curriculum for school.

Keywords

Resuscitation Education Cardiac arrest Chest compressions Automated external defibrillator 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Danksagung

Zu Danken ist der Unterstützung des German Resuscitation Council – Deutscher Rat für Wiederbelebung, der BINZ-Stiftung und den Mitgliedern der Arbeitsgruppe „German Resuscitation Council school project“ (Altemeyer, Breckwoldt, Dirks, Goldschmidt, Huth, Lange, Markus, Osche, Salger).

Literatur

  1. 1.
    ACT – Advanced Coronary Treatment Foundation. High school CPR. URL: http://www.actfoundation.caGoogle Scholar
  2. 2.
    Andresen D, Arntz HR, Gräfling W (2008) Public access resuscitation program including defibrillator training for lay persons: a randomized trial to evaluate the impact of training course duration. Resuscitation 76:419–424PubMedCrossRefGoogle Scholar
  3. 3.
    Bång A, Herlitz J, Martinell S (2003) Interaction between emergency medical dispatcher and caller in suspected out-of-hospital cardiac arrest calls with focus on agonal breathing. A review of 100 tape recordings of true cardiac arrest cases. Resuscitation 56:25–34PubMedCrossRefGoogle Scholar
  4. 4.
    Breckwoldt J, Beetz D, Schnitzer L et al (2007) Medical students teaching basic life support to school children as a required element of medical education: A randomised controlled study comparing three different approaches to fifth year medical training in emergency medicine. Resuscitation 74:158–165PubMedCrossRefGoogle Scholar
  5. 5.
    Breckwoldt J, Schloesser S, Arntz HR (2009) Perceptions of bystanders of out-of-hospital cardiac arrest. Resuscitation accepted for publication 01.07.2009Google Scholar
  6. 6.
    Burghofer K, Schlechtriemen T (2005) Konsequenzen aus der Altruismusforschung für die Ausbildung in Erster Hilfe. Notfall Rettungsmed 8:408–411CrossRefGoogle Scholar
  7. 7.
    Chamberlain DA, Hazinski MF (2003) Education in Resuscitation – ILCOR advisory statement. Resuscitation 59:11–43PubMedCrossRefGoogle Scholar
  8. 8.
    Corne L, Rydant L, Lauwaert D, Bruynseels P (1984) Teaching cardiopulmonary resuscitation basic life support to school-children. Acta Anaesthesiol Belg 35:107–113PubMedGoogle Scholar
  9. 9.
    Eisenberg MS (2006) Incidence and significance of gasping or agonal breathing in cardiac arrest patients. Curr Opin Crit Care 12:204–206PubMedCrossRefGoogle Scholar
  10. 10.
    Eisenburger P, Safar P (1999) Life supporting first aid training of the public – review and recommendations. Resuscitation 41:3–18PubMedCrossRefGoogle Scholar
  11. 11.
    Fabry G (2008) Medizindidaktik. Huber, BernGoogle Scholar
  12. 12.
    German Resuscitation Council (GRC) – Deutscher Rat für Wiederbelebung, URL: http://www.grc-org.deGoogle Scholar
  13. 13.
    Gundry JW, Comess KA, DeRook FA et al (1999) Comparison of naive sixth-grade children with trained professionals in the use of an automated external defibrillator. Circulation 100(16):1703–1707PubMedGoogle Scholar
  14. 14.
    Hauff SR, Rea TD, Culley LL et al (2003) Factors impeding dispatcher-assisted telephone cardiopulmonary resuscitation. Ann Emerg Med 42:731–737PubMedCrossRefGoogle Scholar
  15. 15.
    Herlitz J, Engdahl J, Svensson L et al (2005) Factors associated with an increased chance of survival among patients suffering from an out-of-hospital cardiac arrest in a national perspective in Sweden. Am Heart J 149:61–66PubMedCrossRefGoogle Scholar
  16. 16.
    Hill K, Mohan C, Stevenson M, McCluskey D (2009) Objective assessment of CPR skills of 10–11-year-old schoolchildren using two different external compression to ventilation ratios. Resuscitation 80:96–99PubMedCrossRefGoogle Scholar
  17. 17.
    Hollenberg J, Herlitz J, Lindqvist J et al (2008) Improved survival after out-of-hospital cardiac arrest is associated with an increase in proportion of emergency crew-witnessed cases and bystander cardiopulmonary resuscitation. Circulation 118:389–396PubMedCrossRefGoogle Scholar
  18. 18.
    Isbye DL, Meyhoff CS, Lipert FK, Rasmussen LS (2007) Skill retention in adults and in children 3 months after BLS training using a simple personal resuscitation manikin. Resuscitation 74:396–402CrossRefGoogle Scholar
  19. 19.
    Jugendrotkreuz, URL: http://www.jrk-berlin.deGoogle Scholar
  20. 20.
    Jones I, Whitfield R, Colquhoun M et al (2007) At what age can school children provide effective chest compressions? An observational study from the Heartstart UK schools training programme. BMJ 334:1201–1203PubMedCrossRefGoogle Scholar
  21. 21.
    Kaye W, Rallis SF, Mancini ME et al (1991) The problem of poor retention of CPR skills may lie with the instructor, not the learner or the curriculum. Resuscitation 21:67–87PubMedCrossRefGoogle Scholar
  22. 22.
    Kellum MJ (2007) Compression-only CPR for bystanders and first responders. Curr Opin Crit Care 13:268–272PubMedCrossRefGoogle Scholar
  23. 23.
    Lackner CK, Kanz KG, Rothenberger S, Ruppert M (2001) AED-Anwenderperformanz von Laien- und Ersthelfern. Notfall Rettungsmed 4:572–584CrossRefGoogle Scholar
  24. 24.
    Lafferty C, Larsen PD, Galletly D (2003) Resuscitation training in New Zealand schools. N Z Med J 116(1181):U582PubMedGoogle Scholar
  25. 25.
    Lester CA, Weston CF, Donnelly PD et al (1994) The need of wider dissemination of CPR: are the schools the answer? Resuscitation 28:233–237PubMedCrossRefGoogle Scholar
  26. 26.
    Lester CA, Donnelly P, Weston CF, Morgan M (1996) Teaching school children CPR. Resuscitation 31:33–38PubMedCrossRefGoogle Scholar
  27. 27.
    Lewis RM, Fulstow R, Smith GB (1997) The teaching of cardiopulmonary resuscitation in schools in Hampshire. Resuscitation 35:27–31PubMedCrossRefGoogle Scholar
  28. 28.
    Lind B (1961) Teaching mouth-to-mouth resuscitation in primary schools. Acta Anaesthesiol Scand 9:63–69Google Scholar
  29. 29.
    Markus P (2008) Malteser-Dokumentation: GRC-BLS Modul Grundschule persönl. MitteilungGoogle Scholar
  30. 30.
    Miró O, Jiménez-Fábrega X, Espigol G et al (2006) Teaching BLS to 12–16 year olds in Barcelona schools: view of head teachers. Resuscitation 70:107–116PubMedCrossRefGoogle Scholar
  31. 31.
    Nolan JP, Baskett P (2005) European resuscitation council guidelines for resuscitation 2005. Resuscitation 67(2–3):1–314Google Scholar
  32. 32.
    Osche S (2004) Defibrillation durch Ersthelfer. Notfall Rettungsmed 7:32–33CrossRefGoogle Scholar
  33. 33.
    Phillips PS, Nolan JP (2001) Training in basic and advanced life support in UK medical schools: a questionnaire survey. BMJ 323(7303):22–23PubMedCrossRefGoogle Scholar
  34. 34.
    Reder S, Quan L (2003) Cardiopulmonary resuscitation training in Washington state public high schools. Resuscitation 56:283–288PubMedCrossRefGoogle Scholar
  35. 35.
    Riegel B, Nafziger SD, McBurnie MA et al (2006) How well are cardiopulmonary resuscitation and automated external defibrillator skills retained over time? Results from the PAD trial. Acad Emerg Med 13:254–263PubMedCrossRefGoogle Scholar
  36. 36.
    Ropollo LP, Pepe PE, Cimon N et al (2005) Modified cardiopulmonary resuscitation instruction protocols for emergency medical dispatchers: rationale and recommendations. Resuscitation 65:203–210CrossRefGoogle Scholar
  37. 37.
    Schlechtriemen T, Wannemacher A, Kettel W, Altemeyer KH (2004) Erste-Hilfe-Ausbildung in der Grundschule. Notfall Rettungsmed 7:174–180Google Scholar
  38. 38.
    Sellin S, Breckwoldt J, Baumann A (2008) What influence does protocol based dispatch have on emergency calls related to cardiac arrest? Resuscitation 77S:83 (Abstr)Google Scholar
  39. 39.
    SOS-KANTO study group (2007) Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study. Lancet 369:920–926CrossRefGoogle Scholar
  40. 40.
    Stiell I, Nichol G, Wells G et al (2003) Health-related quality of life is better for cardiac arrest survivors who received citizen cardiopulmonary resuscitation. Circulation 108:1939–1944PubMedCrossRefGoogle Scholar
  41. 41.
    Sue E, Schmidt TA, Mann NC, Zechnich AD (2000) A randomised controlled trial to assess decay in acquired knowledge among paramedics completing a pediatric resuscitation course. Acad Emerg Med 7:779–786CrossRefGoogle Scholar
  42. 42.
    Toner P, Connolly M, Laverty L et al (2007) Teaching basic life support to school children using medical students and teachers in a peer-training model – results of the ABC for life programme. Resuscitation 75:169–175PubMedCrossRefGoogle Scholar
  43. 43.
    Uray T, Lunzer A, Ochsenhofer A et al (2003) Feasibility of life-supporting first aid training as a mandatory subject in primary schools. Resuscitation 59(2):211–220PubMedCrossRefGoogle Scholar
  44. 44.
    Van Kerschaver E, Delooz HH, Moens GF (1989) The effectiveness of repeated CPR training in a school population. Resuscitation 17:211–222CrossRefGoogle Scholar
  45. 45.
    Wik L, Steen PA, Bircher NG (1994) Quality of bystander cardiopulmonary resuscitation influences outcome after prehospital cardiac arrest. Resuscitation 27:195–203CrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag 2009

Authors and Affiliations

  1. 1.Klinik für Anästhesiologie mit Schwerpunkt operative IntensivmedizinCharité – Universitätsmedizin Berlin, Campus Benjamin FranklinBerlinDeutschland

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