Schoolchildren as life savers: at what age do they become strong enough?

Objective: It is not clear when schoolchildren become enough strong to perform good quality chest compressions (CC). Our purpose was to assess CC quality in schoolchildren.

Methods: 721 children, 10-15 years old (YO) participated in 1 h hands-on training session. Subjects were tested during performing 2 min of continuous CC by means of Laerdal Resusci Anne(®) with Skillreporter(®), without feedback.

Results: Mean compression depth (MCD) increased with age, from 30.7 mm in 10YO to 42.9 mm in 15YO (p<0.05) and was related to height, weight, and BMI. Boys delivered significantly deeper CC than girls in the 10, 13, 14 and 15YO groups (p<0.001). The percentage of children who achieved the MCD goal (50-60 mm), increased with age, from 0.0% at 10 years to 26.5% at 15 years (p<0.001). Mean compression rate (MCR) ranged from 121 min(-1) in 15YO to 134 min(-1) in 12YO. The percentage of children who achieved a CC rate inside the goal (100-120 min(-1)), ranged from 20.3% in 11YO to 31.0% in 15YO. Correct CC fraction was low and ranged from 2% in the 10YO to 22% in the 15YO (p<0.05). Children older than 13YO obtained better results than younger ones for all analyzed variables (p<0.001). Performance decreased with time: 12% of children achieved >50% of correct CC fraction in first minute, while only 5% did it in second minute (p<0.001).

Conclusions: In schoolchildren, age, sex and anthropometry are significant CPR quality factors. Although quality increases with age, their global performance is poor. Thirteen years is the minimum age to be able to achieve a minimum CPR quality similar to the one adult possess. CPR performance in schoolchildren significantly deteriorates within 60 s.