A study led by scientists in Austria suggests that kids as young as 9 years old can and should learn how to use CPR (cardiopulmonary resuscitation) and other life support skills and found that even when tested four months after training they retain a good level of knowledge and skill.

The study, which was led by Dr Fritz Sterz, from the Medical University of Vienna, is published in the 31 July issue of the open access journal Critical Care.

Previous studies have questioned whether it is worth teaching schoolchildren CPR and other life saving skills because they may not be strong enough nor be able to retain the knowledge effectively.

Sterz and colleagues studied schoolchildren who underwent life support training, including CPR, and found that although the smallest may not be strong enough, they retained the knowledge well.

For the study they recruited 147 children of average age 13 years who had been through 6 hours of life support CPR training from their teachers during a standard school semester.

Four months after the children completed their CPR and life support training the researchers assessed their ability to perform CPR, check vital signs, deploy an automatic defibrillator, put a dummy casualty in the correct recovery position, and whether they had effectively notified the ambulance service.

They also noted each child’s age, gender, body mass index (BMI) and looked for patterns between these variables and the outcomes of the assessment.

The results showed that:

  • 86 per cent of the 147 students performed CPR correctly.
  • The median (mid range) depth of chest compressions was 35 mm and the median number of compressions per minute was 129.
  • 69 per cent of the children tilted the dummy (mannequin) casualty’s head enough for effective mouth to mouth resuscitation.
  • The median amount of air delivered during resuscitation was 540 ml.
  • The children scored at least 80 per cent or higher in other tests of their life support knowledge and skills.
  • Depth of chest compression was significantly linked to children’s BMI, body weight and body height, but not with age.
  • There were no significant links between other performance outcomes and gender, age, and BMI.

The authors wrote that:

“Students as young as 9 years are able to successfully and effectively learn basic life support skills including AED [automated external defibrillator] deployment, correct recovery position and emergency calling.”

“As in adults, physical strength may limit depth of chest compressions and ventilation volumes but skill retention is good,” they added.

Because BMI and not age was significantly correlated to depth of compression, it would indicate that a well-built 9 year old child would be just as capable as an older child at performing CPR.

Sterz and colleagues concluded that:

“Given the excellent performance by the students evaluated in this study, the data support the concept that CPR training can be taught and learnt by school children and that CPR education can be implemented effectively in primary schools at all levels.”

“Even if physical strength may limit CPR effectiveness, cognitive skills are not dependent on age, and with periodic retraining, children’s performance would likely improve over time,” they added.

“School children sufficiently apply life supporting first aid: a prospective investigation.”
Roman Fleischhack, Alexander Nuernberger, Fritz Sterz, Christina Schoenberg, Tania Urso, Tanja Habart, Martina Mittlboeck, and Nisha Chandra- Strobos.
Critical Care 2009, 13:R127, doi:10.1186/cc7984
Published: 31 July 2009

Additional sources: BioMed Central.

Written by: Catharine Paddock, PhD