CPR Teaching in secondary schools, a national project in Luxembourg
M.Majerus1 ,J.Beissel2 ,C.Clarens3 ,P. Stammet4 , J. Uhrig5 , P. Welter6

Introduction
Sudden cardiac arrest without successful cardiopulmonary resuscitation (CPR) is the third leading cause of death in industrialized nations. Every year about 350,000 people die in Europe after such an event.1
Many people in cardiac arrest could be saved if more lay people started immediately with resuscitation procedures before the arrival of the  emergency services ( 8 minutes and often longer) as the brain starts to die after 3-5 minutes, the ”Time window for lay resuscitation”.3
As early initiation of CPR can increase survival rate significantly we have to raise the number and the quality of bystander resuscitation substantially.
The Luxembourg Resuscitation Council (LRC) decided in 2013 to promote the education of lay people in cardiac arrest and we started the project “reagis” (“react”) in different municipalities and private companies all over the country.
In 2015-16 the LRC launched the pilot project “Réagis au Lycée” in 4 secondary schools (SS) : Train the trainer - teachers teach the students CPR. As a consequence of the very positive feedback from teachers and students, the Minister of Education decided that CPR training will become compulsory in all public secondary schools (SS).
 
Objective
The Luxembourg Resuscitation Council aspires to increase the number of lay people performing resuscitation in out of hospital cardiac arrest. By teaching students of all secondary schools we aim to train the live savers of tomorrow.

Materials and Methods

In 2015-16 the LRC launched the pilot project “Réagis au Lycée” in 4 secondary schools : Train the trainer -teachers teach the students CPR.
As a consequence of the very positive feedback from teachers and students, the Minister of Education decided that CPR training will become compulsory starting September 2017, in all public secondary schools (SS) at three levels during their school curriculum.
The Ministry of Education provided 30 Mini-Anne TM mannequins and 2 AED Trainers for each school and organized 22 BLS-AED provider courses of 4 hours  for 10 teachers of the 35 schools as a train the trainer program. A 2 hours session with instructions how organizing a CPR course for students was provided to the teachers, as well as the instruction slides with the CPR algorithm intended for the students.
Each school organizes the courses which must simply comply to the following: 50 minutes theoretical teaching followed by 50 minutes of hands on exercises with instructions how to perform hands only CPR combined with an AED.
The LRC has been mandated to supervise this project.
Results
The teacher BLS-AED P courses
-	Number of teachers trained : 350, out of all 35 public SS
-	Overall satisfaction of the teachers:  90%
-	Formal assessments of the teachers: 100% positive results
-	Motivation for teaching the BLS skills: >90%
-	Difficulties for realizing the project
-	Proposals for improving the project
The results of the courses in the secondary schools
   - Number of students participating in the project: +-3000 with feedback;        aged from 12 to 23 years
   - Number of teachers participating in the project: 80;      teaching different branches
   - Teachers' overall satisfaction:95%
    - Students' overall satisfaction: 91% 
  -  Performance of the students: 86%
  - Difficulties in realizing the project:  organization of  the courses like    planification and finding the adequate locations
  - Suggestions for improving the project:
      improve the organization of the courses
      implicate more teachers in the training in some SS
      inform the parents of the CPR project
Conclusions
Trained teachers in CPR-AED consider the Reagis Project as a very important project at school
Students easily acquire CPR AED skills and are very motivated and satisfied with this training
Some schools have more facilities for organizing the courses and including them in the school curriculum.

BIBLIOGRAPHY1. Taniguchi, D, Baernstein , A, and Nichol, G. Cardiac arrest: A public health perspective. Emerg Med Clin North Am. 2012; 30: 1-12     
2. 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;310:1377-1384;   
3. 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: 1583-1585   
4. European Resuscitation Council comments on compression-only CPR study in the Lancet 2007; 369:920-26; 5. Bohn A, Lukas RP, Breckwoldt J, Böttiger BW , Van Aken H, «Kids save lives: Why school children should train in CPResuscitation”, Critical Care 2015; 06, vol.21, nr 3,221

1.Head Nurse LRC; 2.Cardiologist, INCCI; 3.Head Nurse LRC; 4.Anesthesiologist-CGDIS; 5. Anesthesiologist-CHEM; 6.Anesthesiologist-HRS
This poster was supported by the Ministries of Health and Education and by all the secondary schools

4 - CPR Teaching in secondary schools, an national project in Luxembourg