Attila Pandur

‘The year of first aid’: effectiveness of a 3-day first aid programme for 7-14-year-old primary school children

Aim of the study Bystanders can play an important role in the event of sudden injury or illness. Our aim was to evaluate the effects of a 3-day first aid course for all primary school age groups (7–14 years old). Methods 582 school children were involved in the study. Training consisted of three sessions with transfer of theoretical knowledge and practical skills about first aid. The following most urgent situations were addressed in our study: adult basic life support (BLS), using an automated external defibrillator (AED), handling an unconscious patient, managing bleeding and calling the ambulance. Data collection was made with a questionnaire developed for the study and observation. Students were tested before, immediately after and 4 months after training. Results were considered significant in case of p<0.05. Results Prior to training there was a low level of knowledge and skills on BLS, management of the unconscious patient, use of an AED and management of bleeding. Knowledge and skills improved significantly in all of these categories (p<0.01) and remained significantly higher than the pre-test level at 4 months after training (p<0.01). Younger children overall performed less well than older children, but significantly improved over the pre-test level both immediately and 4 months after training (p<0.01). Prior first aid training was associated with knowledge of the correct ambulance number (p=0.015) and management of bleeding (p=0.041). Prior to training, age was associated with pre-test knowledge and skills of all topics (p<0.01); after training, it was only associated with AED use (p<0.001). There was a significant correlation between the depth of chest compression and children’s age, weight, height and body mass index (p<0.001). Ventilation depended on the same factors (p<0.001). Conclusion Children aged 7–14 years are able to perform basic life-saving skills. Knowledge retention after 4 months is good for skills, but thinking in algorithms is difficult for these children.

Knowledge about basic life support in European students

INTRODUCTION Better knowledge and skills of basic life support can save millions of lives each year in Europe. AIM The aim of this study was to measure the knowledge about basic life support in European students. METHOD From 13 European countries 1527 volunteer participated in the survey. The questionnaire consisted of socio-demographic questions and knowledge regarding basic life support. The maximum possible score was 18. RESULTS Those participants who had basic life support training earned 11.91 points, while those who had not participated in lifesaving education had 9.6 points (p<0.001). Participants from former socialist Eastern European countries reached 10.13 points, while Western Europeans had average 10.85 points (p<0.001). The best results were detected among the Swedish students, and the worst among the Belgians. CONCLUSIONS Based on the results, there are significant differences in the knowledge about basic life support between students from different European countries. Western European youth, and those who were trained had better performance.

A PET/CT szerepe a sugárkezelésre kerülő betegek N és M klinikai stagingjében, a terápia meghatározásában. Intézeti tapasztalatok

INTRODUCTION AND AIM: The aim of our study was to investigate changes in clinical staging N (lymph node) and M (distant metastasis) in patients who receive PET/CT-based 3D radiotherapy within complex oncological treatment, and compare to conventional cross-sectional imaging staging technique. We also investigated the presence of PET/CT-detected second tumors and the effect of PET/CT on therapeutic decisions. METHOD: From the 1st of January 2015 to the 30th of November 2016, 192 patients (n = 192) were treated with PET/CT-based radiation (109 head, 44 lung, 28 rectum and 11 cervical localization) in the Oncoradiology Institute of the Health Center of the University of Kaposvar. All patients received conventional cross-sectional and PET/CT imaging in accordance with the valid investigation protocol. The average time interval between the two cross-sectional investigations was 5.2 weeks. Clinical N and M staging was performed on the basis of the classification of the American Joint Committee on Cancer (AJCC) and the Union of International Cancer Control (UICC). RESULTS: By analyzing the clinical stages N and M separately, based on the results of the PET/CT studies, the N stage was changed in 77 cases and the M stage changed in 31 cases. Overall, the PET/CT study resulted in higher clinical stages in 68 (35.4%) patients and lower clinical stages in 14 (7.3%) patients. The treatment plan was changed in 9% of the patients (n = 18) (definitive versus palliative treatment) and the extension of radiotherapy treatment target volume (PTV) was indicated in 20% of the patients (n = 39) due to the change in clinical lymph node status. PET/CT also detected secondary tumors in 15 (8%) patients. CONCLUSION: Based on our results, the addition of PET/CT to conventional cross-sectional staging imaging permits a more accurate clinical classification of N and M stages and significantly influences therapeutic decisions. PET/CT imaging also provides a great help in detecting occult second tumors. The results of our Institute harmonize with the international data available in the literature. Orv Hetil. 2018; 159(39): 1593-1601.

Little lifesavers: Can we start first aid education in kindergarten? – A longitudinal cohort study:

Objectives: First aid programmes should include not only the transfer of knowledge and skills but also improve participants’ helping attitudes. The aim of this study was to evalute the immediate and long-term effects of a 3-day first aid programme for kindergarten children. Methods: One hundred and eighteen kindergarten children (5–7 years old) from an inner-city kindergarten located in Pécs, Hungary, were involved in this study between January 2016 and June 2017. Training consisted of three 45-minute sessions involving the transfer of theoretical knowledge and practical skills about first aid. Knowledge, skills and attitudes were assessed by means of a questionnaire developed for the study and through observation. Participants were tested before and immediately after the programme and at 4 and 15 months. Results: The majority of children had no prior knowledge in first aid. Knowledge and skills significantly improved immediately after training and remained significantly higher at 4 and 15 months when compared to baseline – calling the ambulance (p < 0.01), performing cardiopulmonary resuscitation (CPR; p < .01), using an automated external defibrillator (AED; p < .01), handling an unconscious patient (p < .01) and managing bleeding (p < .01). Attitudes towards first aid improved significantly after the programme (p < .01) and remained improved after 4 and 15 months when compared to baseline (p < .01). Conclusion: Beginning first aid education in kindergarten can be useful. Children cannot become professional bystanders immediately following training, but the programme can offer an introduction of first aid. However, the results decreased substantially after 15 months so regular refreshing training should be recommended.

41 Is it necessary? – opinions and experiences about first aid education in childhood – pilot study

Aim Starting first aid education in early childhood can be an effective method of knowledge transfer. Our aim was to examine first aid education related opinions of kindergarten- and primary school children, educators, and parents. Method Eight-hundred seventy-one people (700 kindergarten- and primary school children, 29 educators, 142 parents) were involved in our study. Opinions were measured with self-edited questionnaires, containing mainly open questions. Results Based on the answers, the majority of children (90%) enjoyed our programme, they would like to participate further first aid programmes in the future. General opinions of parents and educators about first aid education in childhood were mainly positive, but they also gave negative ones. The majority of participants (>90%) had a positive opinion about our completed programme.1 Based on the opinions of parents and educators first aid education is recommended by health care professionals. Opinions were independent from gender (p=0.302), age (p=0.512), time of working with children (p=0.251). Conclusion Children’s opinion about the first aid programme were mainly positive. General opinions of parents and educators were different, but were positive related our programme. Based on this results opinions can change with concrete activities and can make first aid education more popular/acceptable by laypeople. Reference . Banfai B, Pek E, Pandur A, Csonka H, Betlehem J. ‘The year of first aid’: Effectiveness of a 3-day first aid programme for 7–14-year-old primary school children. Emerg Med J2017;34:526–32. Conflict of interest None Funding None

40 The long term effects of a 3-day first aid programme for 7–14 years old primary school children

Aim Bystanders can play an important role in the event of sudden injury or illness. Our aim was to evaluate the long term effects of a 3 day first aid programme for all primary school age groups (7–14 years old). Method This study was a 15 months follow-up of our previous investigation.1 Five-hundred twenty-four primary school children were involved in this study (288 girls and 236 boys). Measurements were made in the following topics: adult basic life support, using an automated external defibrillator, handling an unconscious patient, managing bleeding and calling the ambulance. Data collection was made with a self-made questionnaire and observation. Results Knowledge and skills after 15 months were significantly higher in the majority of the measured topics than before the programme (p<0.01). However, results were significantly worse than immediately and 4 months after programme (p<0.01). Younger children overall remembered less well than older children (p<0.01). Approximately three-third of children could use an AED, know the emergency phone number and the half of them could perform correct recovery position at 15 months. Correct assessment of breathing was similar than in baseline. Conclusion This study was the most comprehensive longitudinal study so far conducted on the effects of first aid (not only resuscitation) programme among primary school children. Participants could remember some aspects of first aid long term. However, forgetting after 15 months was significant so refreshing trainings would be mandatory annually Reference . Banfai B, Pek E, Pandur A, Csonka H, Betlehem J. ‘The year of first aid’: Effectiveness of a 3-day first aid programme for 7–14-year-old primary school children. Emerg Med J2017;34:526–32. Conflict of interest None Funding None