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Australian Health Review

Emergency response readiness for primary school children

Jeff Wilks1,4 PhD, Adjunct Professor

Harry Kanasa2 PhD, Lecturer
Donna Pendergast2 PhD, Professor and Dean
Ken Clark3 Dip TAE, Dip TDD, Operations Manager
Socio-Legal Research Centre, Griffith University, Gold Coast Campus, Parklands Drive, Southport,
Qld 4222, Australia.
School of Education and Professional Studies, Griffith University, Gold Coast Campus, Parklands Drive,
Southport, Qld 4222, Australia. Email:;
Australian Lifesaving Academy Queensland, Surf Life Saving Queensland, 18 Manning Street,
South Brisbane, Qld 4101, Australia. Email:
Corresponding author. Email:

Objective. The aim of the present study was to determine whether a 1-day basic life support (BLS) training program can
significantly increase emergency response readiness for primary school children.
Methods. One hundred and seven children aged 11–12 years completed a program led by surf lifesaving instructors.
A 50-item quiz was administered 1 week before and 1 and 8 weeks after training.
Results. Significant improvements were gained in knowledge of cardiopulmonary resuscitation (CPR; P < 0.001), the
response sequence for emergency situations (DRSABCD action plan) and various emergency scenarios, including choking
(P < 0.001) and severe bleeding (P < 0.001). Knowledge and understanding were retained at the 8-week follow-up. Students
reported increased confidence in assisting others after training, consistent with previous studies.
Conclusions. A 1-day training program can significantly increase BLS knowledge and confidence to provide
assistance in an emergency situation. Findings reinforce the value of school-based training that provides a general
foundation for emergency response readiness.

What is known about this topic? The importance and value of teaching BLS to school children is well established in the
US, UK and Europe. However, in the past 20 years there has been little or no published Australian evaluation research in
this area, despite thousands of training programs running each year around the country for children in first aid, CPR and
water safety.
What does this paper add? This paper confirms that Australian primary school children can benefit significantly from
short, targeted BLS training programs that provide the basic skills and confidence for them to respond in an emergency
What are the implications for practitioners? The paper provides a training and evaluation framework that can be used
by health educators for age-appropriate BLS programs. The study shows that making training real-world and relevant,
especially having hands-on CPR practice with manikins, can address common barriers to performing first aid and CPR
reported by young people.

Received 14 April 2015, accepted 30 July 2015, published online 14 September 2015

Introduction acquisition of knowledge and skills that can save lives, awareness
There is widespread agreement among health professionals that and mental preparation for emergency situations, increased con-
teaching first aid and cardiopulmonary resuscitation (CPR) to fidence and self-esteem and a sense of contribution to the
school children is an effective way of increasing the number of community.7
trained bystanders available in emergency situations.1–5 Indeed, Older children may be the only bystanders available to assist
the American Heart Association recommends that training in with a variety of medical emergencies, such as sudden cardiac
CPR be a mandatory subject in the secondary school curriculum.6 arrest,6 falls among the elderly,8 injuries to age cohorts and
Among the many benefits for individual students are the younger siblings in their care.9 Many emergencies occur in the

Journal compilation  AHHA 2015

B Australian Health Review J. Wilks et al.

family home, especially sudden cardiac arrests.4,10 For Australian by Lubrano et al.,17 who used a broken tooth and bleeding nose
children aged 10–14 years, falls are the leading cause of hospi- as common or familiar issues to contextualise paediatric basic
talisation. Pointer 9 notes that this age group is characterised by life support training for Italian primary school students. The
greater risk-taking behaviour and increasing access, often unsu- present study also used surf lifesaving instructors in patrol uni-
pervised, to a broader range of settings, such as schools, sporting forms as role models, because surf lifesavers are recognised as
environments, streets and neighbourhoods. Up to 20% of all an Australian icon24 and are highly respected in the community.25
Australian hospitalisations for this age group involve a head During the 2013–14 patrol season, lifesavers and lifeguards
injury. Children having the knowledge and confidence to call made 11 711 rescues and provided 31 893 first aid treatments.26
for help and commence CPR if it is required can save lives. Following Australian Resuscitation Council guidelines,21 the
Age is an important consideration in teaching basic emergency learning objectives for the present training included recognition
lifesaving skills (BELS). Bernardo et al.2 recommend that ma- of an emergency, ability to call an emergency response number,
terial is taught in a manner appropriate to the child’s develop- competence in chest compressions, rescue breathing and emo-
mental level. In their BELS framework, Bernardo et al.2 suggest tional preparation for the capability to act in an emergency.
that, beginning at 6 years of age, children should be taught the
skill ‘Get Help’, including recognising an emergency, staying Methods
safe and telling an adult. By 11–13 years of age, the skills All Year 6 students at a south-east Queensland private school
introduced and acquired will expand to supporting the airway, participated in the study as part of a larger junior leadership
breathing and circulation and administering chest compressions. program. Ethics approval was obtained from a local university
Although much of the literature has focused on knowledge, and parents or guardians received a full briefing about the
attitudes and training for secondary school students,4–6,11–13 program, along with an option for their children not to participate,
there is growing evidence that upper primary children aged without penalty. In all, 107 students (51 boys, 56 girls) completed
11–12 years are an appropriate and receptive target group for the pre-program measure (Q1). Because of absenteeism, 105
life-supporting first aid.3,14,15 responses were gathered after training (Q2) and 105 students
In Australia, students aged 11–12 years are in Year 6, the completed the quiz 8 weeks after training (Q3). The mean ( s.d.)
last year of primary school. These young people are entering age of students was 11.4  0.5 years. Most students (73%) were
a developmental peak associated with puberty, which translates infrequent visitors to the beach (fewer than once or twice
to heightened learning potential, along with enhanced social, a month) and 50% had none or very little experience with surf
emotional and intellectual development and awareness. They lifesaving before the program.
are also at their most vulnerable in terms of disengaging from
their educational journey and hence a focus on learning that Training program
contributes to the development of identity, is authentic and The 1-day first aid, CPR and beach safety training program was
applies to real life provides the kind of learning context that is led by nine surf lifesaving instructors specialising in the field of
most likely to appeal.16 community education. The program was held in a large school
European and Northern Ireland researchers confirm that chil- hall and commenced with a lecture on beach safety, including
dren 11–12 years of age can learn first aid and CPR,3,17,18 recognition of beach flags and signage, how to identify lifesavers
demonstrating retention of knowledge and skills in test–retest and their role in maintaining a safe environment at the beach,
assessments.19,20 This view is supported by the Australian Re- how to recognise rip currents and what to do if you get into
suscitation Council,21 which notes ‘. . .primary school age chil- trouble while swimming at the beach. Students interacted with
dren are able to perform age appropriate Basic Life Support instructors by holding up flags, putting on lifesaver patrol uni-
skills effectively when attention is given to the context in which forms and acting out a mock rescue. The second part of the
these skills are introduced and how the skills are taught.’ morning involved leadership and team bonding exercises, such
The context of the present study is one of water safety, as the Human Knot, On the Square and Hoop Relay.27 The
recognising that childhood drowning remains a serious public afternoon program included discussion of first aid topics such
health problem in Australia.22 It is well established that knowl- as sprains, bleeding, choking, recognition of a heart attack and
edge of swimming and water safety can reduce a child’s drowning allergic reactions, all within the framework of important stages
risk and provide them with skills that may one day save a life. in responding to an emergency situation (DRSABCD (Danger,
However, concerns have been raised that many Australian stu- Response, Send for help, Airway, Breathing, CPR, Defibrillation)
dents completing primary education still lack the ability to action plan).28 Students then practised CPR skills in small
recognise potential aquatic risks, cope with emergencies or assist groups on 30 manikins (Laerdal Little Anne; Laerdal Pty Ltd,
someone else in danger. For example, Birch and Matthews23 Vic., Australia) under instructor supervision. Throughout the
report that teachers in Victoria estimate that 39% of Year 6 day students were guided by a specially designed 16-page
students lack adequate water safety knowledge. This translates workbook that required them to fill in answers aligned with the
to over 25 000 Victorian students leaving primary school training.
each year without sufficient knowledge to avoid getting into
dangerous situations in and around water. Assessment
The present study used beach safety as a core focus, then One week before the training day students completed an anon-
expanded how skills were taught to include first aid across a ymous 50-item quiz (Q1) during a class period. They were told
variety of emergency scenarios and familiarisation of CPR with the quiz was to get them thinking about the training day and that it
practice on manikins. This is an approach similar to that adopted was not an examination. Students answered only those questions
Emergency response readiness Australian Health Review C

they could. The same quiz was administered unannounced in followed by the patient (10%) and finally bystanders (4%).
class 1 week after the training day (Q2) and again 8 weeks after A Chi-squared test for independence revealed this change to be
training (Q3).The quiz was developed drawing on the profes- significant (c2 (1 d.f., n = 317) = 83.17, P < 0.001, phi = 0.51),
sional literature,2–6,29 lifesaving programs30–32 and extensive with a large effect size.33
discussions with first aid providers. Drafts of the quiz were
reviewed by 10 members of Surf Life Saving Queensland Help from emergency services
and changes made to the content and wording before the study Students were asked to list three types of emergency services
commenced. The quiz booklets contained colourful cartoons, they could call for assistance. Ambulance, fire brigade, police
drawings and photographs designed to make the assessment and State Emergency Service (SES) were accepted as a correct
interesting and engaging, as well as age-appropriate.21 response, with a maximum score of 3 for this item. Analysis of
variance (ANOVA) showed students were able to recall a
greater number of emergency services in Q3 (P = 0.005) com-
Although the complete quiz assessed students’ beach safety pared with Q1, with no differences between Q1 and Q2
knowledge, emergency services and life-supporting first aid, only (P = 0.113) and Q2 and Q3 (P = 0.485; Table 1).
results related to knowledge of emergency services and life-
supporting first aid are presented herein. Emergency telephone number

Most important person in any emergency situation Students were asked ‘what is the three-digit number that we use
to phone for help?’. The correct response in Australia is Triple
Given three options of ‘bystanders’, ‘you’ and ‘patient’, students Zero (000). There were no significant differences in responses
were asked to nominate who is the most important person in any to this question among Q1, Q2 and Q3; student knowledge of
emergency situation. Figure 1 shows the percentage of respon- the correct emergency phone number was high in Q1 (88%) and
dents indicating each choice. Most students (58%) in Q1 indicated remained high in Q3 (92%).
that the patient was the most important person in an emergency,
followed by themselves (34%) and finally bystanders (5%). After Stages in responding to an emergency: DRSABCD
training (Q2), these proportions changed so that 79% of respon-
Students were asked: ‘Surf lifesavers and other first aid providers
dents indicated that they were the most important person,
use DRSABCD to remind them of the important stages in
responding to an emergency. Write in the word that goes with
each first letter, and what each stage means.’ A complete answer,
for example, would be: ‘D = Danger; make sure that there is no
80 danger to yourself and no further danger to the patient(s) or
bystanders’.28 Table 2 shows that only 17 students attempted
% Respondents

Quiz 1 58
60 an answer before training and the highest correct response was
Quiz 2
50 Quiz 3
for CPR (four students). After training, 91 students provided
40 34
answers, with 76 correctly identifying Danger and 74 identifying
CPR. Eight weeks after training, 80 students provided answers,
with 63 correctly identifying Danger and 58 identifying CPR.
20 13 13
10 Students in Q2 and Q3 recalled a significantly greater number
10 5 4
of words than in Q1 (P < 0.001 for both). There was a significant
0 decay between Q2 and Q3 (P = 0.016; Table 1). Further analyses
You Bystander Patient
for the word and meaning of DRSABCD revealed that students
Fig. 1. Responses to the question ‘Who is the most important person in an in Q2 and Q3 recalled a significantly greater number of meanings
emergency situation?’ before (Quiz 1) and 1 (Quiz 2) and 8 weeks (Quiz 3) than in Q1 (P < 0.001 for both). There was no significant differ-
after a 1-day basic life support training program. ence between Q2 and Q3 (P = 0.071).

Table 1. Inferential and descriptive statistics for measures of participant knowledge of emergency services and basic first aid
Unless indicated otherwise, data are given as the mean  s.d. scores for each question on the quiz, administered before (Quiz 1) and 1 (Quiz 2) and 8 weeks
(Quiz 3) after a 1-day basic life support training program. CPR, cardiopulmonary resuscitation

Quiz 1 Quiz 2 Quiz 3 F P-value Effect

(n = 107) (n = 105) (n = 105) sizeA
List three types of emergency services that may assist you in an emergency 1.60 ± 1.35 1.96 ± 1.37 2.17 ± 1.24 5.11 0.007 0.03
What is the three-digit number that we use to phone for help? 0.88 ± 0.33 0.95 ± 0.21 0.92 ± 0.27 1.96 0.142 –
What does ‘DRSABCD’ stand for? 0.13 ± 0.55 3.72 ± 2.64 2.90 ± 2.55 82.61 <0.001 0.34
What does ‘DRSABCD’ stand for and what does it mean? 0.09 ± 0.40 2.87 ± 2.90 2.18 ± 2.58 43.92 <0.001 0.22
What does ‘CPR’ stand for? 0.00 ± 0.00 0.33 ± 0.47 0.29 ± 0.45 24.24 <0.001 0.13
Compressions : breaths ratio 0.03 ± 0.17 0.90 ± 0.31 0.82 ± 0.39 271.77 <0.001 0.63
First aid scenarios 5.43 ± 2.30 7.34 ± 2.04 7.06 ± 2.07 24.32 <0.001 0.13
Cohen33 classifies an Eta-squared value of 0.01 as a small effect, 0.06 as a medium effect and 0.14 as a large effect.
D Australian Health Review J. Wilks et al.

CPR First aid scenarios

For knowledge of the meaning of ‘CPR’, students were scored 1 Four situations were described where students had to decide a first
mark for each correct element (i.e. C = cardio, P = pulmonary, aid response in an emergency situation. Each scenario had a
R = resuscitation) with a maximum score of 3. Students per- colour image depicting the emergency. The number and propor-
formed better in Q2 (P = 0.001) and Q3 (P < 0.001) than in Q1, tion of students giving each response, by quiz, are given in
whereas there was no significant difference between Q2 and Q3 Table 3. Findings were analysed using a Chi-squared test for
(P = 0.632). Overall, students did not perform well on this ques- independence.
tion and the Discussion considers spelling and embarrassment as The first scenario was: ‘You’re having lunch with a friend and
possible reasons for this. he begins to choke on some food. He can’t speak, breathe or cough
In assessing students’ knowledge of the correct compressions it up. How can you help?’. There was a significant association
to breaths ratio (i.e. 30 : 2), both numbers in the correct order between quiz and item response (c2 (6 d.f., 317) = 94.267,
were required. No part marks were awarded. Students P < 0.001, phi = 0.545). Table 3 shows a significant shift from
performed significantly better in Q2 (P < 0.001) and Q3 Answer B (‘Wrap your arms around him and squeeze hard’) in
(P < 0.001) than in Q1. There was no difference between Q2 Q1 (62%) to Answer C (‘Give up to five back blows between
and Q3 (P = 0.159). his shoulder blades’) in Q2 (81%) and Q3 (77%) as a result of
the training and instructors explaining that back blows are
Table 2. Number of correct responses for the DRSABCD action plan easier and more effective for children to deliver than the
before (Quiz 1) and 1 (Quiz 2) and 8 weeks (Quiz 3) after a 1-day basic life Heimlich Manoeuvre (Answer B) they may have seen on
support training program television.
CPR, cardiopulmonary resuscitation The second scenario was: ‘A man is complaining of breath-
lessness and a tight pain in the chest. You suspect a heart attack.
Quiz 1 (n = 17) Quiz 2 (n = 91) Quiz 3 (n = 80)
What should you do?’. There was no association between quiz
D – Danger 3 76 63 and item response (c2 (6 d.f., 317) = 3.694, P = 0.718, phi =
R – Response 3 54 35 0.108). Most students were able to identify the correct response
S – Send for help 0 51 43 (Answer C; ‘Call Triple Zero (000) and sit him in a comfortable
A – Airway 1 50 38 position’) in Q1 (77%), and this was maintained in Q2 (87%)
B – Breathing 2 45 30
and Q3 (81%; Table 3).
C – CPR 4 74 58
D – Defibrillation 1 41 38
Scenario three asked: ‘One of your friends has cut her arm
and is bleeding severely. How do you treat her injury?’. There

Table 3. Participant responses to first aid scenarios before (Quiz 1) and 1 (Quiz 2) and 8 weeks (Quiz 3) after a 1-day basic life support
training program
Unless indicated otherwise, data are presented as n (%). Correct answers are bolded

Quiz 1 Quiz 2 Quiz 3 c2 d.f. P-value

First aid scenario: choking
Answer A: Put your fingers down his throat to try to remove the obstruction 2 (2%) 5 (5%) 6 (6%)
Answer B: Wrap your arms around him and squeeze hard 66 (62%) 12 (11%) 13 (12%)
Answer C: Give up to five back blows between his shoulder blades 31 (29%) 85 (81%) 81 (77%) 94.267 6 <0.001
First aid scenario: chest painB
Answer A: Get him to lay down flat 3 (3%) 2 (2%) 3 (3%)
Answer B: Call Triple Zero (000) and encourage him to stand 15 (14%) 8 (8%) 12 (11%)
up and move around slowly
Answer C: Call Triple Zero (000) and sit him in a comfortable position 82 (77%) 91 (87%) 85 (81%) 3.694 6 0.718
First aid scenario: severe bleedingC
Answer A: Put the injured limb in some cold water 20 (19%) 2 (2%) 4 (4%)
Answer B: Apply direct pressure over the wound 74 (69%) 94 (90%) 93 (82%)
Answer C: Give her an aspirin 4 (4%) 4 (4%) 2 (2%) 27.297 6 <0.001
First aid scenario: unconscious patientD
Answer A: Leave her to wake up by herself 0 (0%) 1 (1%) 2 (2%)
Answer B: Begin CPR 10 (9%) 17 (16%) 19 (18%)
Answer C: Check her airway is clear 24 (22%) 18 (17%) 23 (22%)
Answer D: Send for help 63 (59%) 64 (61%) 54 (51%) 8.550 8 0.382
The choking scenario was described as follows: You’re having lunch with a friend and he begins to choke on some food. He can’t speak, breathe
or cough it up. How can you help?
The chest pain scenario was described as follows: A man is complaining of breathlessness and a tight pain in the chest. You suspect a heart attack.
What should you do?
The severe bleeding scenario was described as follows: One of your friends has cut her arm and is bleeding severely. How do you treat her injury?
The unconscious patient scenario was described as follows: In the school playground you see one of your friends lying on the ground. You ask
her if she’s all right but she doesn’t respond. What should you do next?
Emergency response readiness Australian Health Review E

was a significant association between quiz and item response beginning of the project, it proved valuable for guiding the
(c2 (6 d.f., 317) = 27.297, P < 0.001, phi = 0.293). Only 69% of training and for scaffolding the assessment measures.
students were able to identify the correct response (Answer B; Eight weeks after training students had significantly improved
‘Apply direct pressure over the wound’) in Q1; after training in their knowledge of the DRSABCD words and meanings, and
the proportion increased to 90% in Q2, but decreased to 82% had a greater appreciation of the specialist services they could
in Q3. access in an emergency situation.
The final scenario was: ‘In the school playground you see Prior to training, most of the Year 6 students thought the
one of your friends lying on the ground. You ask her if she’s all most important person in any emergency situation was the
right but she doesn’t respond. What should you do next?’. There patient, followed by themselves, then bystanders. After training
was no association between quiz and item response (c2 (8 d.f., there was a significant shift in understanding with the correct
317) = 8.550, P = 0.382, phi = 0.164). Although the majority of order of ‘you’, ‘bystander’ and then ‘patient’, reflecting the need
students chose the correct Answer D (‘Send for help’) before for an individual to take responsibility for controlling any emer-
(Q1; 59%) and after (Q2; 61%) training, there was some decay gency scene, ensuring no one else is exposed to danger, assessing
8 weeks after training (Q3; 51%). The Discussion considers the the patient and calling for help.28
effect of training on students’ expectations that they should take A critical element in the first stage of the chain of survival is
personal control of an emergency situation rather than immedi- sending for help, including access and activation of the emer-
ately send for help. gency medical system.34 Like European studies of school chil-
dren,12,13,35 there was a high level of knowledge about the correct
Confidence in giving first aid emergency services number among our Year 6 students before
training. An unexpected finding was that 5% of students before
Students rated their confidence in providing first aid to ‘a family training gave the emergency number as 911 (the number in the US
member’, ‘a friend’, ‘someone you don’t know who is your age’ and Canada) instead of 000, the Australian number. This probably
(same age stranger) and ‘someone you don’t know who is an reflects the influence of American movies and television. Instruc-
adult’ (adult stranger). Ratings were made on a five-point Likert- tors addressed this error during training and thereafter the 911
type scale ranging from 1 (‘not at all confident’) to 5 (‘very number was not mentioned. Interestingly, if the 911 number is
confident’). Figure 2 shows the percentage of respondents indi- dialled in Australia the call automatically transfers to the Triple
cating they were ‘very confident’ in administering first aid Zero operator. This is not always the case in other jurisdictions, so
according to familiarity with the person and by quiz. A consistent education programs for children must be very clear about the
pattern across all three quizzes was that students were more correct emergency number in their locale and address any con-
confident in administering first aid to family members, followed fusion stemming from other international influences.
by friends and finally strangers, regardless of age. A common finding in studies of first aid and CPR with children
is a substantial improvement in knowledge immediately after
Discussion training, then a decline at follow-up.3,36–38 This natural decay is a
Following the Australian Resuscitation Council guidelines for strong reason for providing refresher programs.6 However, even
basic life support training,21 the present study focused on recog- single training programs can produce significant gains.20 Before
nition of an emergency situation and ability to respond appro- training, few Year 6 students knew much about CPR. Following
priately. The emergency DRSABCD action plan– was used as a training, most could identify CPR as a stage in the emergency
framework and although it was not familiar to students at the action plan, correctly recall the compressions to breaths ratio and
determine when it would be appropriate to discontinue CPR in an
emergency situation. An unexpected finding was the poor per-
Family member Friend formance on the question ‘What does CPR stand for?’, where only
100 Same age stranger Adult stranger 34 students attempted a response after training. Follow-up dis-
90 cussions with students revealed that concerns about correct
80 spelling and related embarrassment form an unnecessary barrier
with this age group. We suggest that if students know what CPR
% Respondents

70 63
58 is, and how and when to do it, then the correct spelling of
51 ‘cardiopulmonary resuscitation’ is probably not essential.
The opportunity to practice CPR on manikins on the
training day, especially with an instructor calling out the timing
30 26
24 25 for 30 compressions to two rescue breaths over the public
20 address system for four successive cycles with each student,
7 8 9
10 strongly reinforced the correct ratio. Before training, only 2%
7 8 8 of the class answered 30 : 2 correctly. This jumped to 90% after
Quiz 1 Quiz 2 Quiz 3 training and remained at 82% at the 8-week follow-up quiz. The
Fig. 2. Percentage of respondents indicating they would be ‘very confident’ improvement in knowledge of the CPR ratio was the most
in administering first aid before (Quiz 1) and 1 (Quiz 2) and 8 weeks (Quiz 3) significant in the present study.
after a 1-day basic life support training program to a family member, a friend, There were also substantial gains in knowledge and under-
someone they don’t know who is their age (same age stranger) and someone standing across the emergency first aid scenarios. For choking
they don’t know who is an adult (adult stranger). there was a significant shift from choosing the Heimlich
F Australian Health Review J. Wilks et al.

manoeuvre, which children may have seen at the movies or on ensure students have the hands-on ability to save a life in an
television, to the five back blows after training. Given the relative emergency situation.
size of some children in this age bracket, the back blows are
likely to be easier and more effective, especially with an adult Conclusions
patient.28 For the chest pains and suspected heart attack scenario,
most students recognised the correct response of calling Triple A 1-day first aid, CPR and beach safety program for primary
Zero and assisting the patient to sit comfortably. school children significantly increased their basic life support
In the severe bleeding scenario there was a significant im- knowledge and confidence to provide assistance in an emergency
provement in the number of children choosing direct pressure situation. Training delivered by surf lifesaving instructors offered
over the wound after training. This is very practical knowledge an opportunity for role models to engage older children at an
because open wounds account for 12% of the injuries requiring important time in their social, emotional and intellectual devel-
hospitalisation among 10–14-year-old Australian children.9 For opment. We join others3,20,36 in recommending that basic life
the unconscious victim, most students chose ‘send for help’, but support training be made widely available in the final year of
interestingly up to 20% after training still chose the other options primary school, with routine refresher programs delivered
of ‘check her airway is clear’ or ‘start CPR’. Both these responses through existing curriculum structures to sustain knowledge at
are at later stages of the emergency DRSABCD action plan and secondary education levels.
may reflect the enthusiasm of some students to actively assist
‘a friend’ in this case, especially having just received some Competing interests
training in first aid and CPR.13 The authors have no competing interests to declare.
Related to the previous point, familiarity with the patient
strongly determines whether and to what extent bystanders are Acknowledgements
willing to offer assistance in an emergency situation.39 Chung
et al.14 found that Korean students were most willing to perform The authors thank the instructors from Surf Life Saving Queensland who led
CPR on a family member, then a friend and less so for a stranger. the training program and Joy Reynolds from Griffith University, Graeme
Kirkpatrick, Ben Campbell and the Year 6 students from Coomera Anglican
Our Year 6 students reported the same pattern, being ‘very
College for their participation in the study.
confident’ to administer first aid to family members, followed
by friends and finally strangers, regardless of age. Confidence
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