The youngest link may be the strongest

Silvio Refalo's distressing account of his son's tragic death after choking on food in a restaurant is a worrying occurrence as it confirms my belief that the current level of community basic life support and cardiopulmonary resuscitation (CPR) knowledge is low.

I personally second their appeal that restaurants should ensure that their staff should be proficient in basic life support. However, this is not enough. It should be joint health and education policy to ensure that the teaching of basic life support (BLS) and resuscitation should be incorporated in the national school curriculum.

It is a well established fact the irreversible brain damage will occur after approximately four minutes of cardiac arrest from any primary cause, be it a cardiac factor or, as in this incident, following lack of oxygen, unless proper basic life support measures are initiated on site.

Regardless of how advanced and sophisticated the country's emergency response set up is, unless CPR is initiated by a bystander within the first platinum four minutes, the outcome of the collapse remains gloomy indeed.

To improve on this situation it is imperative to ensure that training in BLS is widespread with as large a percentage of the population receiving some form of formal education in resuscitation as is possible. Thus, health and education policy makers must identify and confirm the need to increase the country's capacity to provide effective life support.

Cardiopulmonary resuscitation is a basic life support procedure combining artificial respiration and artificial circulation by external cardiac compressions carried out on a person who is in cardiac arrest. Basic life support training teaches the bystander to recognise the state of cardiac arrest, places priority on calling for more professional help and initiates and maintains basic life support until advanced life support measures can be applied by more specialised medical personnel.

The first four minutes are the initial steps in the chain of survival, a four stage intervention process which if carried out quickly and efficiently can help save the lives of the near and dear ones within the family circle.

I have always supported the idea that training in basic life support should commence at an early age. From personal experiences I find it easier to train younger individuals, some even as young as nine and 10 years of age, than adults. Young individuals are more easily motivated to learn these skills. They are also more able to retain these skills for longer periods of time. BLS skills performance has been shown through studies to decline rapidly following initial training unless proper retraining facilities are in place. Thus, proper BLS training involves clear, simple instructions with sustained and repetitive practice. Young children are often as capable as teenagers and adults in carrying out BLS.

It is with this viewpoint in mind that there is no better place to teach these skills than through the education system by introducing BLS training in the national school curriculum. Investing in the country's young people will eventually reap a rich harvest as they will remain life savers for a much longer time than us more mature adults.

The financial input in carrying out such a project should be minimal but the gain in the number of lives saved priceless!

Dr Joslin serves at the Accident & Emergency Department, St Luke's Hospital.