Do Water Safety Lessons Improve Water Safety Knowledge?

A person, usually a child or young adult, dies by drowning every 90 seconds around the planet. Most drowning prevention initiatives do not assess the efficacy of the intervention. In this study, thirteen- to fourteen-year-olds had their level of water safety knowledge (covering cold shock, rips and tides) assessed before, just after, and 3-6 months after one, 25-minute water safety lesson on these topics. We evaluated the knowledge gained and retained on water safety “awareness” (i.e., knowledge of risks) and “confidence” in terms of knowing what to do in an emergency. The results demonstrated that the lesson significantly increased water safety awareness and confidence in pupils, and these benefits were retained for at least six months. We accept our hypothesis that theoretical, classroom-based instruction in water safety can improve the water safety awareness and confidence of children and may represent a “lesson for life.” Given the large numbers who drown around the globe annually, a lesson on water safety should be part of every national curriculum

Psychomotor development disorders in apparently healthy children and considerations of family evaluation

Difficulties that paediatricians find when evaluating psychomotor development at an early age result in the possibility that, at the school stage, seemingly healthy children can conceal development disorders, thereby complicating their detection, even within their own family environment. This study aimed to assess the prevalence of developmental disorders in children without a prior diagnosis and the consistency between family perception and the real state of development. 187 pupils (51.3% boys) with an average age of 4.3 years (DT = 1.2) took part in the study. The real state of psychomotor development was evaluated using the Battelle-2 Inventory, while family perception was assessed using the Age and Stages Questionnaires. Results revealed an average prevalence of 10% for impaired developmental, while 13.3% displayed delayed motor development. Regarding family perception, families attributed the above-average performance to their children in all aspects. Therefore, the level of correlation between family perception and real development was light in all the dimensions analysed. The results of this study emphasize the excessive number of children with developmental disorders that have gone undetected, as well as the limitations of evaluation tools for parents when used for children with no apparent risk

Influence of a physical education plan on psychomotor development profiles of preschool children

This study aimed to investigate the influence of structured physical education on the psychomotor development of 3 to 5 year-old preschool children. The sample consisted of 324 students of both sexes (3 to 5 year-old) from 9 public kindergarten classes in Porto, Portugal. A battery of psychomotor tests (pre-test) was used to assess the students’ psychomotor development profiles. The sample was divided in 2 groups: an experimental group (162 students) and a control group (162 students). Physical Education (PE) teachers used a structured 24-week PE plan in the experimental group. After the plan completion, the same battery of tests (post-test) was run on both groups. The outcome was that both groups grew their psychomotor profiles; however this growth was always statistically higher in the experimental group (at all ages and in all variables analysed p 0.05). Structured physical education is important for preschool children’s psychomotor development. Physical activity impact on children’s interaction with the outside world was proved, through their overall development motivated by the structured physical education lessons

CPR quality reduced due to physical fatigue after a water rescue in a swimming pool

Objective. This study aimed to analyse the influence of physical fatigue, resulting from a simulated aquatic rescue, at a swimming pool, on the quality of cardiopulmonary resuscitation (CPR) delivered by the rescuer. Design, setting and participants. An intragroup design with 27 lifeguards was used in this study. The quality of CPR delivery was evaluated for two minutes for all subjects while they were at rest (test 1), as well as after a simulated aquatic rescue at a swimming pool (test 2). A Resusci Anne® SkillReporter™ (Laerdal Medical Limited, Norway) manikin was used to retrieve reports on CPR delivery, compliant with the most recent international guidelines (30:2, chest compression: ventilation ratio). Results. Rescue-related physical fatigue had a significant influence on the total number of chest compressions as well as on the ratio of correct chest compressions. Physical fatigue triggered by a swimming pool water rescue negatively influenced CPR delivery quality. These results show that the detrimental effects of physical fatigue on CPR delivery remain important, even in a swimming pool environment. Conclusions. Training programs should reflect this finding, and focus on enabling lifeguards to deliver proper CPR, even while exhausted and for long periods of time

KIDS SAVE LIVES in schools: cross-sectional survey of schoolteachers

Training schoolchildren in basic life support (BLS) is strongly recommended to effectively increase bystander cardiopulmonary resuscitation (CPR) rates. Paediatricians and other health staff members used to be involved in BLS training, but the wide dissemination of BLS skills would need additional support; as a solution, schoolteachers might have enough knowledge necessary to help to achieve this goal. The aim of this cross-sectional survey study, which involved 3423 schoolteachers, was to evaluate the knowledge related to first aid (FA) and BLS of schoolteachers in Spain. In addition, the study aimed to evaluate the content taught to the schoolchildren regarding FA and teachers' attitudes towards teaching FA. Three-quarters of the surveyed schoolteachers reported knowing FA, and 17% reported teaching it. The emergency medical telephone number and CPR were the subjects taught most often by schoolteachers. However, the schoolteachers demonstrated a lack of knowledge in the identification of cardiac arrest and in CPR. Ninety-eight percent of the respondents agreed with including FA training in schools and as part of university degree programmes and supported the KIDS SAVE LIVES statement. Teaching FA was a positive predictor to be willing to perform CPR (OR: 1.7; 95% CI 1.32-2.31) and to use a defibrillator (OR: 1.4; 95% CI 1.10-1.67). Conclusions: Schoolteachers are willing to teach FA in schools. However, more training and specific curricula are needed to increase the quality of schoolchildren's CPR training. The training of schoolteachers in CPR might be the foundation for the sustainable transfer of CPR-related knowledge to schoolchildren. Therefore, the inclusion of FA and BLS in university degree programmes seems to be essential. What is Known: Bystander cardiopulmonary resuscitation rates are associated with improved survival rates. Resuscitation training in schools increases the bystander cardiopulmonary resuscitation rate. What is New: Schoolteachers are willing to teach basic life support, but they need more and better training. Schoolteachers agreed with the inclusion of first aid training in schools and university degree programmes aimed at training teachers/undergraduate teaching degrees

Comparison of the new flexible tip bougie catheter and standard bougie stylet for tracheal intubation by anesthesiologists in different difficult airway scenarios: a randomized crossover trial

BACKGROUND: Incidence of difficult endotracheal intubation ranges between 3 and 10%. Bougies have been recommended as an airway adjunct for difficult intubation, but reported success rates are variable. A new generation flexible tip bougie appears promising but was not investigated so far. We therefore compared the new flexible tip with a standard bougie in simulated normal and difficult airway scenarios, and used by experienced anesthesiologists. METHODS: We conducted a observational, randomized, cross-over simulation study. Following standardized training, experienced anesthesiologists performed endotracheal intubation using a Macintosh blade and one of the bougies in six different airway scenarios in a randomized sequence: normal airway, tongue edema, pharyngeal obstruction, manual cervical inline stabilization, cervical collar stabilization, cervical collar stabilization and pharyngeal obstruction. Overall success rate with a maximum of 3 intubation attempts was the primary endpoint. Secondary endpoints included number of intubation attempts, time to intubation and dental compression. RESULTS: Thirty-two anesthesiologist participated in this study between January 2019 and May 2019. Overall success rate was similar for the flexible tip bougie and the standard bougie. The flexible tip bougie tended to need less intubation attempts in more difficult airway scenarios. Time to intubation was less if using the flexible tip bougie compared to the standard bougie. Reduced severity of dental compression was noted for the flexible tip bougie in difficult airway scenarios except cervical collar stabilization. CONCLUSION: In this simulation study of normal and difficult airways scenarios, overall success rate was similar for the flexible tip and standard bougie. Especially in more difficult airway scenarios, less intubation attempts, and less optimization maneuvers were needed if using the flexible tip bougie

A systematic review of interventions for resuscitation following drowning

Objectives: The International Liaison Committee on Resuscitation, in collaboration with drowning researchers from around the world, aimed to review the evidence addressing seven key resuscitation interventions: 1) immediate versus delayed resuscitation; (2) compression first versus ventilation first strategy; (3) compression-only CPR versus standard CPR (compressions and ventilations); (4) ventilation with and without equipment; (5) oxygen administration prior to hospital arrival; (6) automated external defibrillation first versus cardiopulmonary resuscitation first strategy; (7) public access defibrillation programmes. Methods: The review included studies relating to adults and children who had sustained a cardiac arrest following drowning with control groups and reported patient outcomes. Searches were run from database inception through to April 2023. The following databases were searched Ovid MEDLINE, Pre-Medline, Embase, Cochrane Central Register of Controlled Trials. Risk of bias was assessed using the ROBINS-I tool and the certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. The findings are reported as a narrative synthesis. Results: Three studies were included for two of the seven interventions (2,451 patients). No randomised controlled trials were identified. A retrospective observational study reported in-water resuscitation with rescue breaths improved patient outcomes compared to delayed resuscitation on land (n = 46 patients, very low certainty of evidence). The two observational studies (n = 2,405 patients), comparing compression-only with standard resuscitation, reported no difference for most outcomes. A statistically higher rate of survival to hospital discharge was reported for the standard resuscitation group in one of these studies (29.7% versus 18.1%, adjusted odds ratio 1.54 (95% confidence interval 1.01–2.36) (very low certainty of evidence). Conclusion: The key finding of this systematic review is the paucity of evidence, with control groups, to inform treatment guidelines for resuscitation in drowning