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Push hard, push fast: quasi-experimental study on the capacity of elementary schoolchildren to perform cardiopulmonary resuscitation

Simon Berthelot1*, Miville Plourde2, Isabelle Bertrand1, Amélie Bourassa3, Marie-Maud Couture2, Élyse Berger-Pelletier4, Maude St-Onge1, Renaud Leroux1, Natalie Le Sage5 and Stéphanie Camden5

Author Affiliations

1 Department of Emergency Medicine, CHU de Québec – CHUL, 2705 Boul. Laurier, Québec, Qc G1V 4G2, Canada

2 CHU de Québec - HSFA, Québec, Qc, Canada

3 CHU de Québec – HSS, Québec, Qc, Canada

4 CHAUQ - Hôtel-Dieu de Lévis, Québec, Qc, Canada

5 Centre de recherche du CHU de Québec, Québec, Qc, Canada

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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2013, 21:41  doi:10.1186/1757-7241-21-41

Published: 21 May 2013



The optimal age to begin CPR training is a matter of debate. This study aims to determine if elementary schoolchildren have the capacity to administer CPR efficiently.


This quasi-experimental study took place in a Quebec City school. Eighty-two children 10 to 12 years old received a 6-hour CPR course based on the American Heart Association (AHA) Guidelines. A comparison group of 20 adults who had taken the same CPR course was recruited. After training, participants’ performance was evaluated using a Skillreporter manikin. The primary outcome was depth of compressions. The secondary outcomes were compression rate, insufflation volume and adherence to the CPR sequence. Children’s performance was primarily evaluated based on the 2005 AHA standards and secondarily compared to the adults’ performance.


Schoolchildren did not reach the lower thresholds for depth (28.1 +/− 5.9 vs 38 mm; one-sided p = 1.0). The volume of the recorded insufflations was sufficient (558.6 +/222.8 vs 500 ml; one-sided p = 0.02), but there were a significant number of unsuccessful insufflation attempts not captured by the Skillreporter. The children reached the minimal threshold for rate (113.9 +/−18.3 vs 90/min; one-sided p < 0.001). They did not perform as well as the adults regarding compression depth (p < 0.001), but were comparable for insufflation volume (p = 0.83) and CPR sequence.


In this study, schoolchildren aged 10–12 years old did not achieve the standards for compression depth, but achieved adequate compression rate and CPR sequence. When attempts were successful at generating airflow in the Skillreporter, insufflation volume was also adequate.

Child; Cardiopulmonary resuscitation/standards; Cardiopulmonary resuscitation/methods; Education; School health services; Age factors