KIDEFIB – Can children defibrillate?

Dr Thomas Hughes MRCP FRCS MBA FCEMConsultant Emergency Medicine

Dr Peyton Davis MRCS(Eng) FCEM DICMSpecialist Registrar Emergency and Intensive Care Medicine

Mrs Lynn Pilgrim, Oxfordshire I.M.P.S. Manager

Oxford University Hospitals, Oxford, UK

• Less than 1% of population can do CPR – aim for 20%• ELS – teaching ALL children how to save a life• Joint campaign by the Resuscitation Council (UK) and

the British Heart Foundation (Launched March 2011)

• Lobbying UK Parliament to include ELS as a mandatory part of the national school curriculum.

• European Resuscitation Council• ILCOR Advisory statement

• “Secondary school students should be taught it from year 7, and their skills should be refreshed every year.

• ELS is simple, and easy to teach and learn. • It takes as little as two hours to teach, 0.2% of school year.• Teachers can include ELS in a range of different subjects.• Children of 10 years+ can learn the full range of ELS.• Teachers at primary school should be encouraged to teach…

dialing 999, calling for help and checking for danger.”

Evidence for ELS/BLS teaching in childhood

Evidence for ELS/BLS teaching in childhood

Evidence for ELS/BLS teaching in childhood

How do you educate your population?

• Passive training• Active training• Simplistic / Cartoons• Adults / Children• Context

When in England…

No knowledge

Passive Awareness

www.bbc.co.uk

Active trainingPassive Training

http://www.youtube.com/watch?feature=player_embedded&v=JR0aZX1_TD8

Active training: KIDEFIB Study

• RCTs in Educational Research rare• Mainly observational / questionnaire-based• Cluster Randomised Controlled Trial • Control versus • Passive CPR versus • Active CPR (including AED use)

June/July 2010March 2010January 2010

Stage 3 Testing

Stage 2 Selection

Stage 1 Teaching

313 Children in Primary Schools in

Oxfordshire, UK

7 schools

106 Active Participation

102 Passive Participation

2 schools 105 Controls

Teaching Programme

• Public health programme• School visit to John Radcliffe Hospital• 3-hours, including tour of ED and BLS / AED use.• Basic Life Support (BLS), and the phased introduction

Automatic External Defibrillator (AED).• Approved by the ethics committee

Where?

Results – Can they defibrillate?

• Control – 42/105 (40%)• Passive – 86/102 (84%)• Active – 99/106 (93%)

Control Passive Active0%

10%20%30%40%50%60%70%80%90%

100%

Successful Defibrillation?

ControlPassiveActive

Can they defibrillate effectively?• Mean (SD) time in seconds to defibrillation:• Control – 171 (57) seconds• Passive – 175 (40) seconds• Active – 160 (42) seconds

Control Passive Active0

10

20

30

40

50

60

Mean Time to defibrillate (secs)

Conclusions

• This study demonstrates that children aged 11 years old can use a defibrillator effectively and safely, and retain this knowledge over 4-5 months.

• Active training involving use of the AED appears to be the most effective method.

Recommendations

• If you’re from the UK… Online e-petition

www.bhf.org.uk

• http://campaigning.bhf.org.uk/ea-campaign/clientcampaign.do?ea.client.id=57&ea.campaign.id=9432&ea.tracking.id=7296e6f9

Questions

Thank you:

Dr Tom Hughes, Lynn Pilgrim, Dr Felicity Rowley, Dr Sheena Patel and I.M.P.S. team,

Oxford University Hospitals, Oxford, UK

And all 313 volunteers!