INTRODUCTION

In a situation of Cardiorespiratory Arrest (CRA), the maneuvers of Cardiopulmonary Resuscitation (CPR) are presented as the pillar of survival, in which the understandings and insufflations applied, allow to compensate for the sudden interruption of heart beats and the absence of spontaneous ventilation of CRA ⁽¹⁾.

Worldwide, CRA is one of the main causes of death, in which in the last 50 years, there has been a significant increase in the practice of CPR in an extra-hospital environment ⁽²⁾. In the United States of America (USA) it has an incidence of 76/100,000 inhabitants per year and in Europe of 84/100,000 ⁽²⁾. In Portugal, there is also a high mortality rate, which is a serious public health problem ⁽²⁾.

Data from the National Institute of Medical Emergency (NIME) show that there was an increase in occurrences of CRA, in the year 2021 with the registration of 21603 cases per day and in the year 2022 with 21692 cases (3). These data allow us to verify that most CRA events that occur are not witnessed by pre-hospital emergency teams, which always depends on the performance of third parties. Thus, the citizen becomes the first intervener on site to apply CPR maneuvers using the basic life support algorithm (BLS) ⁽²⁾.

There are emergency situations in the school context ranging from traumatology, hemorrhage, asthma, diabetes mellitus, convulsive crisis, anaphylactic shock, among others, which trigger moments of stress and condition the activity of the school community. Require early recognition of signs of risk of death and immediate and effective intervention in the maintenance and support of the victim, the performance of BLS includes a set of standardized interventions aimed at saving time, until the arrival of differentiated help, thus promoting a better prognosis and an increased probability of survival ⁽⁴⁾.

Research ^(5-6) affirm that education in first aid, especially in the BLS, provides an improvement in the knowledge and skills of teachers and students in providing relief to the victim. They also emphasize that a regular and systematized training offer increases agility and effectiveness in the care of the victim.

Health promotion in a school context is a conducive means to promote the adoption of healthy behaviors, based on the principles of Health Promoting Schools, contributing to the increase of health literacy in the educational community. Portugal, in collaboration with other countries, has introduced mandatory BLS training for 3^rd cycle students ⁽⁷⁾. The strategies of the National School Health Program contribute to the improvement of the health of the educational community, with the provision of educational activities in first aid, being a mediator between education and health ⁽⁵⁾. The responsibility of encouraging education among students and knowing how to deal with situations that positively impact educational success, as well as students' health literacy. Thus, the knowledge about CPR maneuvers, assumes a preponderant role in education and health literacy in schools, because its result, in addition to providing and stimulating better attention and learning capacity ⁽⁸⁾. Interventions implemented in the school environment to improve knowledge and modify behaviors tend to be successful in promoting student empowerment. As a result, these interventions can play a crucial role in improving their education and promoting the health of future generations. Having the potential to reduce the current disparities, it is essential that health literacy interventions in BLS are directed to secondary school students, where health education focuses on a partnership between teachers, teachers and students and trainers in this knowledge sector ⁽⁹⁾.

It is intended with this scoping review protocol to detail the criteria that researchers used to include and exclude studies, extract, synthesize and present the relevant data for understanding the phenomenon under study ⁽¹⁰⁾.

Thus, after a preliminary search in the various databases, no recorded protocols or studies related to the proposed objective were identified. Thus, the design of this scoping protocol aims to fill a gap in the body of knowledge related to CPR in secondary school students. This review aims to answer the following research question: "What is the knowledge of secondary school students about CPR?".

This study aimed to map the available scientific evidence on the knowledge of secondary school students in cardiopulmonary resuscitation.

METHODOLOGY

Study design

A scoping review protocol was conducted, according to the methodology of the Joanna Briggs Institute^® (JBI) following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using the extension for scoping reviews (PRISMA-ScR^®) ⁽¹¹⁾. The protocol is registered on the Open Science Framework platform and can be consulted via the link: https://doi.org/10.17605/OSF.IO/V9X5N.

Inclusion criteria

Following the recommendations of the JBI, the eligibility criteria were defined according to the mnemonic PCC (Participants, Concept, Context) ⁽⁹⁾, according to Table 1.

Regarding the type of study, primary, qualitative, quantitative or mixed studies were included, as well as reviews of literature and gray literature, excluding articles inherent to other contexts or other groups of participants.

Board 1. Eligibility criteria of the scoping review protocol

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Search strategy

The research strategy was conducted in three stages. In the initial stage, a general research was conducted in the databases CINAHL^®; Medline Complete^®; Nursing & Allied Health Collection: Comprehensive^®; MedicLatina^® (via EBSCO) to analyze the keywords of interest contained in the titles, abstracts and the indexing terms of the studies. In a second phase, we proceeded to a broader search in the search engines using the operators AND and OR, being AND to identify studies and OR for synonym, according to the combinations between the descriptors. The following Boolean phrase was created: (“Secondary School” [All fields] AND “Students” [All fields] AND “Knowledge” [All fields] AND “Cardiopulmonary Resuscitation” [All fields]) as shown in board 2. Studies were included written in Portuguese, English and Spanish, without time limit, published in peer-reviewed journals and/or available in the gray literature in free full text.

Board 2. Records of searches conducted in the different sources of information

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Selection of studies

We included studies with quantitative, qualitative or mixed approaches written in Portuguese, English and Spanish, without time limit, published in journals with peer review and/or available in the gray literature in free full text.

The search result was exported to a reference manager platform Rayyan^® – Intelligent Systematic Review ⁽¹⁰⁾. The screening of the studies was conducted through the reading of the title and abstract, later the reading was made in full by two independent reviewers who will extract and synthesize the data. A third reviewer shall be used in case of disagreement. Finally, the bibliographical references of the identified articles were analyzed to assess the need to include additional studies. The selection process is explained in the PRISMA flow diagram⁽¹²⁾.

Data Extraction

Data extraction will occur through an evidence table built by the authors based on the recommendations of the JBI Manual for Evidence Synthesis ⁽⁹⁾. The extracted data will be Author/year/country, title, objective, type of study, methodology and main results, as shown in Table 2. Any divergences that arise between reviewers in data extraction and analysis will be resolved by consensus or using a third reviewer as mentioned above. The results will be presented in a descriptive and narrative way.

Data Presentation

Eight articles were included that will be presented in a descriptive and narrative way, according to the table of evidence built by the researchers for a better interpretation of the results. The presentation and interpretation of the data will be conducted through the recommendations of the JBI^®(13) for review of scoping review using Table 3.

Board 3. Study Data Extraction Tool.

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FINAL THOUGHTS

Studies in the specific field of cardiopulmonary resuscitation are extremely important to ensure the quality of care for the critically ill. It is expected with the accomplishment of this study that the identification and mapping of the scientific evidence related to the knowledge of the contribute to a practice of care based on scientific evidence contributing to increase students' knowledge about CPR procedures.

REFERENCES

1. Duarte HMS, Dixe M dos ACR. Conhecimentos dos estudantes de enfermagem sobre suporte básico de vida. Rev. Enf. Ref [Internet]. 30 de Julho de 2021 [citado 19 de Janeiro de 2024];5(7):1-8. Available from: https://revistas.rcaap.pt/referencia/article/view/26379

2. Mourão C, Martins C, Vicente L, Cartaxo V. O impacto da formação comunitária em SBV-DAE na sobrevivência à PCR. O que sabemos do mundo e de Portugal? Life Saving: Separata Cientifica [Internet]. 2021 Feb 1;8(19):42–9. Available from: https://sapientia.ualg.pt/handle/10400.1/17145

3. Portugal. Plano de Atividades do INEM, I.P. Instituto Nacional de Emergência Médica. (Agosto 2022). Diário da República Eletrónico nº 07715656. Available from: https://www.inem.pt/wp-content/uploads/2023/07/Plano-de-Atividades-INEM-2023_homologado.pdf

4. Carolina A, Izabela Meneghesso, de L, Isadora Freitas Marcatto, Amanda Adabo Gastaldi, Fernanda Berchelli Girão. Prática deliberada e prática deliberada em ciclos rápidos para suporte básico de vida: scoping review. Escola Anna Nery. 2023 Jan 1;27.

5. Tony ACC, Carbogim FC, Motta DS, Santos KB, Dias AA, Paiva ACPC. Teaching Basic Life Support to schoolchildren: quasi-experimental study. Rev. Latino-Am. Enfermagem. 2020;28:e3340. [Access 20 02 2024]; Available from: https://www.scielo.br/j/rlae/a/FKQd7s9sRcdmrJHwD8QpRjp/?lang=pt&format=pdf. DOI: http://dx.doi.org/10.1590/1518-8345.4078.3340

6. Fan M, Leung LP, Leung R, Hon S, Fan KL. Prontidão dos professores do ensino secundário de Hong Kong para o ensino da ressuscitação cardiopulmonar nas escolas: uma pesquisa por questionário. Hong Kong J Emerg Med. 2019; 26 (3):174–178. doi: 10.1177/1024907918797532

7. Diário da República n.º 53/2013, Série I de 2013-03-15. Resolução da Assembleia da República 33/2013, de 15 de Março. Available from: https://dre.tretas.org/dre/307692/resolucao-da-assembleia-da-republica-33-2013-de-15-de-marco

8. Vajda de Albuquerque J, Chen Y, Moir F, Henning M. School-based interventions to improve health literacy of senior high school students. JBI Evidence Synthesis. 2022 Feb 3;Publish Ahead of Print.

9. Peters M, Godfrey C, McInerney P, Munn Z, Trico A, Khalil H. Chapter 11: Scoping Reviews. JBI Manual for Evidence Synthesis [Internet]. 2020; Available from: https://jbi-global-wiki.refined.site/space/MANUAL/4687342/Chapter+11%3A+Scoping+reviews

10. Amendoeira J, Silva M & Ferreira R, Dias H. Revisão Sistemática de Literatura A Scoping Review. Instituto Politécnico de Santarém – UMIS- ESSS. 2022. ISBN 978-989-33-2553-7. Available from: https://repositorio.ipsantarem.pt/bitstream/10400.15/3784/3/TUTORIAL_SCOPING%20REVIEW_mai_2022%20PT.pdf

11. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews. Systematic Reviews. 2016. Available from: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-016-0384-4#citeas. Available from: https://doi.org/10.1186/s13643-016-0384-4

12. Tricco AC, Lille E, Zarin W, Obrien KK, Colquhoun H, Levac Dea. PRISMA Extension for Scoping Reviews (PRISMAScR): Checklist and explanation. Ann Intern Med. 2018: p. 467-473. Available from: https://doi.org/10.7326/M18-0850

13. Pollock D, Peters MDJ, Khalil H, McInerney P, Alexander L, Tricco AC, et al. Recommendations for the extraction, analysis, and presentation of results in scoping reviews. JBI Evidence Synthesis. 2023. Available from: https://doi.org/10.11124/JBIES-22-00123

Información adicional

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