Poster Presentations / Resuscitation 84S (2013) S8–S98 S43

playing methods and than to examine the results of first aid train-ing.

Material and methods: 51 children (5 and 6 years old) visit-ing kindergarten in two places of Hungary (Muraszemenye andLetenye) were involved in the survey between September 2011.Until November 2011. The training consisted of two sessions withtheoretical and practical games about first aid. Beside the firststeps how to examine and handle an unconscious patient andhow to call an ambulance, the most frequently occurring injurieswere performed in different situations with playing. On the thirdsession children were tested about their skills and one month laterre-tested. During this period the children had the possibility topractice. The tests measured the problem solving skills and basicknowledge about different first aid requiring scenarios. The statis-tical analyses were made with SPSS 17.0 software using Chi-squaretest and T-test.

Results: On the measurement scale the maximum point of thetest was 38 points. The average point of the first test was 16.94points and the re-test score was higher (17.5 points). The differencebetween the results was significant (p < 0.05). This may be becauseof the continual training. The results showed attitudinal differencesbetween boys and girls (p < 0.05).

Conclusions: The 5 and 6 years old children of kindergarten canlearn the basic concepts (for example: the causes of the injuries),but less children can act in complex situations adequately (forexample: difficult situations, or the degrees of burns). The play-ing method of teaching first aid can motivate children for helpingaptitude.

Keywords: Basic Life Saving Activities; Kindergarten; Helpingaptitude.

http://dx.doi.org/10.1016/j.resuscitation.2013.08.113

AP086

CPR education in school of medicine—Then andnow

Aleksandar Pavlovic 1, Sladjana Trpkovic 1,∗,Nebojsa Videnovic 1, Ana Sekulic 2, OliveraMarinkovic 2

1 Medical Faculty Pristina – Kosovska Mitrovica,Kosovska Mitrovica, Serbia2 CHC Bezanijska Kosa, Belgrade, Serbia

The aim was to compare education in CPR of medical studentsat our University in 2012. Compared with the year 2000.

Methodology: The study was carried out on students in finalyears of medical studies (100 respondents) in the form of a test.The curricula at School of Medicine in 2000, as compared with 2012,was also reviewed (practical and theoretical lectures in CPR).

Results: In 2000, CPR was studied as part of the InternalMedicine class for a period of only one theoretical and one practicalclass. Students were not trained to perform endotracheal intuba-tion, without the possibility of using manikins, reference books,and videos, students who trained by the program in the year 2000,scored 56% on the CPR test. Curricula of medicine in 2012, is dif-ferent from that in 2000. CPR is taught in several classes thoughtall years of studies: First Aid with 12 h of theoretical and practicalclasses; Surgery (8 h), Internal Medicine (6 h), Anesthesiology andresuscitation (20 h) and practical classes in the sixth year of studies(10 h).

The presence of CPR in theoretical and practical classes in 2012,as compared with 2000, has increased for 28 times. A test was givento final year students 2012, in the field of BLS and ALS measuresof CPR. The success rate of the test was excellent – an average

of 96% correct answers which was statistically significant higher(p < 0.001) referred to test of the 2000.

Conclusion: Education of medical students in the field of CPR atour University is much better and more comprehensive in the lastten years due to the reorganization of the faculties curricula, theintroducing of the Bologna process and the availability of didacticmaterials and equipment for training.

Keywords: CPR; Education; Medical students.

http://dx.doi.org/10.1016/j.resuscitation.2013.08.114

AP087

Anaesthesia and emergency medicine trainees’certification status of resuscitation courses inYorkshire & Humber Deanery

Elizabeth Horncastle ∗, Selin Kabadayi

Leeds General Infirmary, Leeds, UK

Introduction: Both anaesthesia and emergency medicine (EM)trainees are frequently involved in the initial resuscitation of thecritically unwell. Adequate training in resuscitation, both theoryand practice, is vital. We set out to determine trainee’s current certi-fication status with regards to resuscitation courses in our deanery.

Methods: Online survey of all anaesthesia and EM trainees, inYorkshire & Humber Deanery, from October 2012 to March 2013(Table 1).

Results:• 144 responses: 109 (75.7%) anaesthesia trainees; 35 (24.3%)

emergency medicine (EM) trainees.• Grade of trainees ranged: CT1 22 (15.3%); CT2 20 (13.9%);

CT2+/CT3 12 (8.3%); ST3 24 (16.7%); ST4 9 (6.3%); ST5(+) 57(39.6%).

Discussion: For ALS, all trainees had current or previously heldcertification with the two specialties being very similar (82% cur-rent versus 17% lapsed). With regards to ATLS, a much higherproportion of EM trainees were currently certified (85.7%) com-pared to anaesthetists (59.6%). The numbers for lapsed certificationand not attempting ATLS were much higher in the anaesthesiagroup. This was also true for APLS: 39.5% of anaesthetists versus74.2% of EM trainees holding a current certificate. The College ofEmergency Medicine states ‘trainees must have successfully com-pleted ALS (Advanced Life Support), APLS (Advanced Paediatric LifeSupport) and ATLS (Advanced Trauma Life Support) before entryinto ST4’.1 Although more flexible, the Royal College of Anaes-thetists states anaesthetists should be ‘appropriately trained andassessed’ in advanced life support to a level of the ALS course orequivalent.2 At some point, anaesthesia trainees will be expectedto attend both trauma and paediatric resuscitation calls. Perhapsthese numbers are a reflection of the clearly defined EM curriculum.The question therefore needs to be asked, should these courses be

Table 1number (%) of trainees certified currently/previously or not attempted each course.Percentages shown are of trainees of each specialty (An, anaesthetist; EM, emer-gency medicine).

Total Currently certified Certificate lapsed Not attempted

ALSAn 109 90 (82.6%) 19 (17.4%) 0EM 35 29 (82.8%) 6 (17.2%) 0

ATLSAn 109 65 (59.6%) 27 (24.8%) 17 (15.6%)EM 35 30 (85.7%) 2 (5.7%) 3 (8.6%)

APLSAn 96 38 (39.5%) 12 (12.5%) 46 (47.9%)EM 31 23 (74.2%) 0 9 (29%)

S44 Poster Presentations / Resuscitation 84S (2013) S8–S98

mandatory for anaesthetists too? We acknowledge the low num-ber of EM trainees that responded to the survey and, would liketo assess trainees’ perspectives on the courses usefulness and rel-evance to practice.

References

1. College of Emergency Medicine. ACCS training – an overview [online]. Available athttp://www.collemergencymed.ac.uk/Training-Exams/EMTA/ACCS/default.asp[accessed 18.05.13].

2. Royal College of Anaesthetists. Clinical Standards FAQs [online]. Available athttp://www.rcoa.ac.uk/clinical-standards-and-quality/faqs [accessed 18.05.13].

http://dx.doi.org/10.1016/j.resuscitation.2013.08.115

AP088

Teaching basic life support to citizens: Choosingthe most efficient target population

Miguel Angel Díaz Castellanos 1,∗, AlbertoFernández Carmona 2, Aida Díaz Redondo 3,Raimundo García del Moral 1, Antonio CárdenasCruz 4

1 Hospital Santa Ana, Motril, Spain2 Hospital Virgen de las Nieves, Granada, Spain3 Hospital San Cecilio, Granada, Spain4 Hospital de Poniente, El Ejido, Spain

Purpose: The aim of this study is to analyze the efficiency ofBLS courses in an andalusian rural population, after a massive BLStraining program (Plan Salvavidas).

Materials and methods: From January 2003 to September2009 we have trained 3493 persons in BLS. Four hours instructor-led training courses were undertaken according to the SpanishNational Plan of CPR (ERC supported). In 2010, we carried out atelephonic survey, asking pupils about out of hospital emergency(OHE) situations witnessed. Statistical analysis included bivariateand successive backward steps multivariate analysis.

Results: We have called 3493 pupils of BLS courses. 1131answered correctly our survey. Mean age was 26.7 years, 59% werewomen. OHE witness rate was 10.43% (118 pupils). Life supporttechniques were applied in 87.5% of cases, including: call EMS 49%,mouth to mouth 42%, chest compressions 49%, airway obstructiontreatment 24%, recovery position 19%. Location of OHE were: publicenclosures 27.3%, street 23.9%, home 20.5%, work place 13.6%, road11.1%. The time delayed between BLS course date and first emer-gency witness was less than one year in 20.3% of cases, two yearsin 39.8% and higher in 39.9%.

If we assume a cost of course of 1000 Euros for 20 pupils. Accord-ing to the rate of intervention of every 20 pupils trained 2.1 aregoing to attend an OHE. Therefore the cost for intervention is 476.2Euros. If we apply this cost to the interventions in the first two yearsafter the course it rises up to 2.220 Euros.

Conclusions: The results of the efficiency analysis revealed thatthe cost per intervention performed in our environment was nothigh. However, many people would have to be trained to producea measurable impact on the overall statistics for interventions bywitnesses.

http://dx.doi.org/10.1016/j.resuscitation.2013.08.116

AP089

Debriefing after in-hospital cardiopulmonaryresuscitation—Does it work? A literature review

Anne Mette Kristiansen 1,∗, Jette R. Svanholm 1,Klas Karlgren 2

1 Department of Cardiology, Aarhus UniversityHospital, Aarhus, Denmark2 Department of Learning, Informatics, Managementand Ethics (LIME), Karolinska Institutet, Stockholm,Sweden

Purpose: Debriefing could be one of several initiatives toimprove cardiopulmonary resuscitation (CPR) performance.1 How-ever, resuscitation is rarely addressed as a learning opportunity.The purpose of this study was to review existing models or meth-ods of debriefing after in-hospital resuscitation and the argumentsand evidence put forth for these.

Methods: A structured literature search2 was conducted in 10educational and medical databases. Nine articles met the inclu-sion criteria and were critically reviewed by two authors. Results:Debriefing primarily aims at either ‘improving knowledge and per-formance’ or ‘dealing with stress and emotions’. Debriefing aiming at‘improving knowledge and performance’ is usually weekly, includesinvolved an uninvolved staff, and can last up to 60 min. This modelhas shown that debriefing resulted in improved CPR and return ofspontaneous circulation. Debriefing ‘dealing with stress and emo-tions’ typically takes place shortly after an event, with involved anduninvolved staff, and can last up till 90 min. This model has shownlimited effectiveness. Debriefings aiming at ‘improving knowledgeand performance’ did not attend to emotions. Not all elements of thedebriefings were reported. Studies implicitly referred to the impor-tance of reflection but without describing the process or stating thetheoretical frame.

Conclusions: Debriefings aiming at ‘improving knowledge andperformance’ were associated with improved CPR processes. Allcharacteristics of the debriefing process were not reported in depth,lacked consistency and leaving some elements of the debrief-ing process unanswered or only partly answered. Future researchshould aim at clearly describing all characteristics of effective mod-els of debriefing including clarifications of how and why they work.

References

1. Seethala RR, et al. Approaches to improving cardiac arrest resuscitation perfor-mance. Curr Opin Crit Care 2010;16:196–202.

2. Polit DF, et al. Nursing research: generating and assessing evidence for nursingpractice. Lippincott Williams & Wilkins 2008.

http://dx.doi.org/10.1016/j.resuscitation.2013.08.117

AP090

How can we improve resuscitation skillstraining in anaesthesia and emergencymedicine: The trainees’ perspective?

Elizabeth Horncastle ∗, Selin Kabadayi

Leeds General Infirmary, Leeds, UK

Introduction: We have previously surveyed both anaesthe-sia and emergency medicine (EM) trainees in our deanery ontheir current certification status of ALS (Advanced Life Support),ATLS (Advanced Trauma Life Support) & APLS (Advanced PaediatricLife Support) and, reasons for not re-certifying/attempting eachcourse.1 Trainees felt there were a number of barriers to attend-ing these courses, time and money, for example, and also some felt