- Email: [email protected]
Training children in cardiopulmonary resuscitation worldwide
Correspondence
We declare no competing interests.
*Mats Brännström, Cesar Diaz-Garcia, Liza Johannesson, Pernilla Dahm-Kähler, Hans Bokström [email protected] Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden (MB, CD-G, LJ, PD-K, HB); and Stockholm IVF, Stockholm, Sweden (MB) 1
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7
Brännström M, Johannesson L, Bokström H, et al. Livebirth after uterus transplantation. Lancet 2015; 385: 607–16. Oppelt P, Renner SP, Kellermann A, et al. Clinical aspects of Mayer-Rokitansky-KuesterHauser syndrome: recommendations for clinical diagnosis and staging. Hum Reprod 2006; 21: 792–97. Heinonen PK. Gestational hypertension and preeclampsia associated with unilateral agenesis in women with uterine malformations. Eur J Obstet Gynecol Reprod Biol 2004; 114: 39–43. Reisaeter AV, Roislien J, Henriksen T, Irgens LM, Hartmann A. Pregnancy and birth after kidney donation: the Norwegian experience. Am J Transplant 2009; 9: 820–24. Christensen M, Kronborg CJ, Knudsen UB. Preeclampsia and arterial stiffness—a 10-year follow up of previous preeclamptic women. Pregnancy Hypertens 2015; 5: 72–73. Balayla J, Edwards M, Lefkowitz A. Uterine artery as an arterial conduit for coronary bypass graft (CABG) surgery in women: a role for the estrogen-receptor alpha (ER-a) in the prevention of post-CABG accelerated atherosclerosis and graft disease. Med Hypotheses 2013; 80: 162–66. Brännström M, Johannesson L, Dahm-Kähler P, et al. First clinical uterus transplantation trial: a six-month report. Fertil Steril 2014; 101: 1228–36.
Training children in cardiopulmonary resuscitation worldwide In Europe and the USA, 700 000 people die after out-of-hospital cardiac arrest and unsuccessful cardiopulmonary resuscitation (CPR) every year,1 about 2000 deaths per day. These estimates apply to many other parts of the world. This cause of death is probably the third most common cause of death in www.thelancet.com Vol 385 June 13, 2015
developed countries, after all cancers combined and other cardiovascular causes.1 When professional emergency medical services arrive after cardiac arrest—which can be after 8–12 min or more—the brain has already started to die. Thus, a time window for lay resuscitation exists.2 In 60–80% of cases, a lay bystander witnesses the cardiac arrest, and 60–70% of cases occur at home.3 Lay resuscitation can fill the gap between cardiac arrest and arrival of emergency medical services in most cases. In fact, initiation of resuscitation by a lay bystander is associated with a two to four times increase in neurologically intact survival.3 Perhaps more than 100 000 deaths per year could be prevented if members of the public, beginning with school children, were educated about how to do CPR.4,5 In countries where educating school children in CPR is mandatory, lay resuscitation is done in 60–75% of cases, and survival after out-ofhospital cardiac arrest can be tripled.2 Inspired by, and on the basis of this information, the European Patient Safety Foundation, the European Resuscitation Council, the International Liaison Committee on Resuscitation, and the World Federation of Societies of Anesthesiologists developed their joint “Kids Save Lives” statement for training of school children worldwide in CPR. We asked WHO to lend support to this statement. On Jan 13, 2015, we received a letter from WHO stating that “…approval has been granted for the WHO to endorse the statement on Kids Save Lives”. We recommend in this statement that school children be educated in CPR from the age of 12 years or younger for 2 hours per year. This endorsement will help to save thousands of lives worldwide, thanks to many individuals, colleagues, organisations, initiatives, and the WHO. We declare no competing interests.
*Bernd W Böttiger, Hugo Van Aken [email protected]
Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany (BWB); Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Münster, Germany (HVA) 1
2
3
4
5
Taniguchi D, Baernstein A, Nichol G. Cardiac arrest: a public health perspective. Emerg Med Clin North Am 2012; 30: 1–12. Wissenberg M, Lippert FK, Folke F, et al. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA 2013; 310: 1377–84. Böttiger BW, Bode C, Kern S, et al. Efficacy and safety of thrombolytic therapy after initially unsuccessful cardiopulmonary resuscitation: a prospective clinical trial. Lancet 2001; 357: 1583–85. Plant N, Taylor K. How best to teach CPR to schoolchildren: a systematic review. Resuscitation 2013; 84: 415–21. Bohn A, Van Aken H, Lukas RP, Weber T, Breckwoldt J. Schoolchildren as lifesavers in Europe—training in cardiopulmonary resuscitation for children. Best Pract Res Clin Anaesthesiol 2013; 27: 387–96.
BSIP/Contributor
have been a clinically significant contributing factor in the first livebirth.1 All of these pregnancies had other pre-eclampsia risk factors of aged uterus, immunosuppression, and in-vitro fertilisation.
Who will implement WHO’s statement on public disclosure of trial results? WHO’s statement 1 issued in April, 2015, calling for public disclosure of all interventional trials—whether they have positive or negative findings and irrespective of date (present or past)—is laudable. By calling for the public disclosure of past trials, WHO’s statement goes further than existing policies or laws. Ben Goldacre’s commentary2 then effectively outlines how an audit system could serve as a powerful and practical means to put this statement1 into practice. Although the need to establish what should be disclosed and how disclosure should be encouraged are crucial issues, identification of who should be responsible for enforcing the various facets of public disclosure is essential. WHO’s statement and Goldacre’s commentary are both vague on this important point. WHO officials have named many actors— including research ethics committees, regulatory authorities, professional
For Kids Save Lives see http://www.wfsahq.org/latestnews
2353
We declare no competing interests.
*Mats Brännström, Cesar Diaz-Garcia, Liza Johannesson, Pernilla Dahm-Kähler, Hans Bokström [email protected] Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden (MB, CD-G, LJ, PD-K, HB); and Stockholm IVF, Stockholm, Sweden (MB) 1
2
3
4
5
6
7
Brännström M, Johannesson L, Bokström H, et al. Livebirth after uterus transplantation. Lancet 2015; 385: 607–16. Oppelt P, Renner SP, Kellermann A, et al. Clinical aspects of Mayer-Rokitansky-KuesterHauser syndrome: recommendations for clinical diagnosis and staging. Hum Reprod 2006; 21: 792–97. Heinonen PK. Gestational hypertension and preeclampsia associated with unilateral agenesis in women with uterine malformations. Eur J Obstet Gynecol Reprod Biol 2004; 114: 39–43. Reisaeter AV, Roislien J, Henriksen T, Irgens LM, Hartmann A. Pregnancy and birth after kidney donation: the Norwegian experience. Am J Transplant 2009; 9: 820–24. Christensen M, Kronborg CJ, Knudsen UB. Preeclampsia and arterial stiffness—a 10-year follow up of previous preeclamptic women. Pregnancy Hypertens 2015; 5: 72–73. Balayla J, Edwards M, Lefkowitz A. Uterine artery as an arterial conduit for coronary bypass graft (CABG) surgery in women: a role for the estrogen-receptor alpha (ER-a) in the prevention of post-CABG accelerated atherosclerosis and graft disease. Med Hypotheses 2013; 80: 162–66. Brännström M, Johannesson L, Dahm-Kähler P, et al. First clinical uterus transplantation trial: a six-month report. Fertil Steril 2014; 101: 1228–36.
Training children in cardiopulmonary resuscitation worldwide In Europe and the USA, 700 000 people die after out-of-hospital cardiac arrest and unsuccessful cardiopulmonary resuscitation (CPR) every year,1 about 2000 deaths per day. These estimates apply to many other parts of the world. This cause of death is probably the third most common cause of death in www.thelancet.com Vol 385 June 13, 2015
developed countries, after all cancers combined and other cardiovascular causes.1 When professional emergency medical services arrive after cardiac arrest—which can be after 8–12 min or more—the brain has already started to die. Thus, a time window for lay resuscitation exists.2 In 60–80% of cases, a lay bystander witnesses the cardiac arrest, and 60–70% of cases occur at home.3 Lay resuscitation can fill the gap between cardiac arrest and arrival of emergency medical services in most cases. In fact, initiation of resuscitation by a lay bystander is associated with a two to four times increase in neurologically intact survival.3 Perhaps more than 100 000 deaths per year could be prevented if members of the public, beginning with school children, were educated about how to do CPR.4,5 In countries where educating school children in CPR is mandatory, lay resuscitation is done in 60–75% of cases, and survival after out-ofhospital cardiac arrest can be tripled.2 Inspired by, and on the basis of this information, the European Patient Safety Foundation, the European Resuscitation Council, the International Liaison Committee on Resuscitation, and the World Federation of Societies of Anesthesiologists developed their joint “Kids Save Lives” statement for training of school children worldwide in CPR. We asked WHO to lend support to this statement. On Jan 13, 2015, we received a letter from WHO stating that “…approval has been granted for the WHO to endorse the statement on Kids Save Lives”. We recommend in this statement that school children be educated in CPR from the age of 12 years or younger for 2 hours per year. This endorsement will help to save thousands of lives worldwide, thanks to many individuals, colleagues, organisations, initiatives, and the WHO. We declare no competing interests.
*Bernd W Böttiger, Hugo Van Aken [email protected]
Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany (BWB); Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Münster, Germany (HVA) 1
2
3
4
5
Taniguchi D, Baernstein A, Nichol G. Cardiac arrest: a public health perspective. Emerg Med Clin North Am 2012; 30: 1–12. Wissenberg M, Lippert FK, Folke F, et al. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA 2013; 310: 1377–84. Böttiger BW, Bode C, Kern S, et al. Efficacy and safety of thrombolytic therapy after initially unsuccessful cardiopulmonary resuscitation: a prospective clinical trial. Lancet 2001; 357: 1583–85. Plant N, Taylor K. How best to teach CPR to schoolchildren: a systematic review. Resuscitation 2013; 84: 415–21. Bohn A, Van Aken H, Lukas RP, Weber T, Breckwoldt J. Schoolchildren as lifesavers in Europe—training in cardiopulmonary resuscitation for children. Best Pract Res Clin Anaesthesiol 2013; 27: 387–96.
BSIP/Contributor
have been a clinically significant contributing factor in the first livebirth.1 All of these pregnancies had other pre-eclampsia risk factors of aged uterus, immunosuppression, and in-vitro fertilisation.
Who will implement WHO’s statement on public disclosure of trial results? WHO’s statement 1 issued in April, 2015, calling for public disclosure of all interventional trials—whether they have positive or negative findings and irrespective of date (present or past)—is laudable. By calling for the public disclosure of past trials, WHO’s statement goes further than existing policies or laws. Ben Goldacre’s commentary2 then effectively outlines how an audit system could serve as a powerful and practical means to put this statement1 into practice. Although the need to establish what should be disclosed and how disclosure should be encouraged are crucial issues, identification of who should be responsible for enforcing the various facets of public disclosure is essential. WHO’s statement and Goldacre’s commentary are both vague on this important point. WHO officials have named many actors— including research ethics committees, regulatory authorities, professional
For Kids Save Lives see http://www.wfsahq.org/latestnews
2353