Roshan Mathew, Ankit Kumar Sahu, Nirmal Thakur, Aaditya Katyal, Sanjeev Bhoi, Praveen Aggarwal

Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India

Keywords: Cardiopulmonary resuscitation, children, bystander, school


BACKGROUND AND AIM: Up to 70% of out-of-hospital cardiac arrests are witnessed by family members, friends, and other bystanders. These bystanders can play a vital role in delivering help, before professional help arrives. Mandatory nationwide training of schoolchildren has shown the highest impact in improving the bystander cardiopulmonary resuscitation (CPR) rate. In our study, we compared the competency of different classes of schoolchildren from middle school onward in learning hands-only CPR.

MATERIALS AND METHODS: This study was conducted in four schools. Schoolchildren were divided into three groups as middle school (6th to 8th standard) (MS), secondary school (9th and 10th standard) (SC), and senior secondary school (11th and 12th standard) (SN). Training module consisted of slide presentation on “hands-only CPR” of 1 h, video demonstration of 30 min, and hands-on session of 2.5 h. Students were then individually assessed for the skills.

RESULTS: A total of 810 children were enrolled and trained. Initial approach was performed correctly by 68% of MS, 79.3% of SC, and 82.4% of SN school children, whereas 49.4% of MS, 61.3% of SC, and 72.5% of SN correctly performed chest compression in terms of rate, depth, and duration. Median compression depth and maximum duration of CPR achieved were significantly different across class groups (P < 0.001) Compression depth and duration of chest compression were positively correlated with children's age, height, weight, and body mass index (P < 0.001).

CONCLUSION: Theoretical training on hands-only CPR can be started at the middle school level, and practical training can be incorporated in school curricula from secondary school.

Ethics Committee Approval

Ethical Board or Institutional Review Board Approval was taken from the All India Institute of Medical Sciences Ethics Committee on March 2019 (IEC/284/3/2019).

Author Contributions

RM, AK, and SB conceived the study and designed the trial. RM, AKS, AK, and NT undertook recruitment of participating centers and patients and managed the data, including quality control. AKS and RM provided statistical advice on study design and analyzed the data; PA chaired the data oversight committee. RM drafted the manuscript, and all the authors contributed substantially to its revision. RM takes responsibility for the study as a whole.

Conflict of Interest

None Declared.

Financial Disclosure

None Declared.


We acknowledge the Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India, for providing the necessary logistic support to complete this project.