Introduction: A low proportion of bystanders in Slovenia are willing to provide resuscitation to people experiencing cardiac arrest. We measured knowledge acquired after cardiopulmonary resuscitation training among Slovenian children in the final three grades of primary school. Methods: This pre- and post-test cohort study included 566 schoolchildren aged 12–15 years. From April to May 2018, we administered a 15-item questionnaire to children in 15 primary schools, to assess the effects of theoretical and practical cardiopulmonary resuscitation training on their knowledge of cardiopulmonary resuscitation at 1–2 months after training. Data were processed using univariate, bivariate, and multivariate analyses. Results: A significantly greater level of post-training knowledge was noted in all three equally sized school grade groups (p=0.001). The youngest group (mean age 12.5 years) exhibited the greatest increase in knowledge, with test scores increasing by an average 2.65 (range 0–15) points. Age (p=0.001), body mass index (p=0.037), female sex (p=0.006), and previous resuscitation training (p=0.024) were significant independent predictors of pre-training knowledge level. Sex was the only predictor significantly influencing knowledge levels after training (p=0.002); girls scored up to 0.7 points higher than boys, both before and after training. Conclusions: Among Slovenian schoolchildren aged 12–15 years, a significantly improved level of theoretical knowledge was demonstrated after cardiopulmonary resuscitation training. The introduction of cardiopulmonary training may be most effective in children aged 12.5 years (seventh graders). Early, compulsory resuscitation training might reduce social barriers to performing resuscitation, which may eventually translate into better post-cardiac arrest outcomes.

Background: Pulmonary aspiration during induction of anaesthesia may lead to rapidly progressive, life-threatening hypoxaemic respiratory failure. This poses a particular challenge when urgent surgery cannot be deferred. Case Presentation: A 33-year-old man required urgent relaparotomy for mesenteric venous thrombosis and multifocal bowel gangrene after blunt abdominal trauma. During rapid-sequence induction, he aspirated approximately 230 mL of mixed liquid gastric contents and solid food particles. Despite immediate suctioning, three therapeutic bronchoscopies, volume-controlled ventilation with FiO₂ 1.0 and PEEP 10 cmH₂O, stepwise PEEP titration, and inhaled nitric oxide, hypoxaemia progressed. At the final pre-ECMO assessment, SpO₂ was 68%, pH 7.329, PaO₂ 5.1 kPa, PaCO₂ 6.66 kPa, and the PaO₂/FiO₂ ratio approximately 38 mmHg. Tidal volume was 590 mL (8.0 mL/kg of predicted body weight). Plateau pressure was not measured; driving pressure and pre-ECMO static compliance were therefore unavailable. Severe refractory hypoxaemia persisted for approximately 60 min. The decision to initiate VV-ECMO was made 45 min after aspiration; as a result, full femoro-jugular flow was achieved at 105 min after aspiration, and surgical incision followed 45 min later. The operation lasted 165 min. The estimated blood loss was 500 mL, and three units of packed red blood cells were transfused without uncontrolled surgical haemorrhage. The ECMO course was complicated by excessive advancement of the right internal jugular return cannula with clinically suspected recirculation and by marked transient thrombocytopenia. VV-ECMO was discontinued on ICU day 7, and final extubation occurred on ICU day 21. The patient was discharged home after regaining independence in basic activities of daily living, with an end-ileostomy and end-descending colostomy. Intestinal continuity was successfully restored at approximately 18 months. No formal pulmonary-function or neurocognitive testing was performed during follow-up. Conclusions: In this patient, rescue VV-ECMO provided gas-exchange support, enabling non-deferrable abdominal surgery to proceed. However, a single case cannot establish general feasibility, safety, effectiveness, optimal timing, or patient-selection criteria.