First aid in school physical education

RODRIGUES, Higor Gramon [1]

RODRUIGUES, Elaine Aparecida Fernandes [2]

RODRIGUES, Higor Gramon; RODRIGUES, Elaine Aparecida Fernandes. First aid in school physical education. Multidisciplinary Core scientific journal of knowledge. Year 1. Vol. 9. pp. 215-234, October/November 2016. ISSN. 2448-0959

SUMMARY

By ignorance of large portion of the population about first aid, many lives are lost in accidents that could be resolved immediately, are not. This article aims to make an approach about accidents and first aid in the school environment. The methodology used in the study was a review of the literature. The survey was conducted on online as Google Scholar and in repositories of Brazilian universities, in addition to extensive research in digital magazines. The school physical education is a proposed activity geared towards the overall development of the students, in their physical, psychological, emotional and cognitive. The first aid training should be included in the curriculum of physical education professional training, since it is of fundamental importance that knowledge to minimize damage. A great barrier faced in the Brazilian educational system is the lack of professional preparation for the provision of first aid. The ignorance of the basics of ER is unacceptable, because knowing how to provide assistance to a rugged effectively and immediately can save him from death.

Keywords: School. Ready service. Child. Teenager.

INTRODUCTION

Any person is subject, in many environments, the variety of situations that may result in an accident, or even the occurrence of a sudden illness. (1)

The occurrence of accidents is as old as the appearance of the man himself and can occur on the street, in a shopping mall, and even indoors. If we talk of situations in which physical activity is practiced in gyms, in parks and, mainly, in school, the risk of accidents increases even more. (2)

By ignorance of large portion of the population about first aid, many lives are lost and accidents that could be resolved immediately, are not. The lapse in time between the occurrence of the accident and the arrival of specialist medical team can mean saving or not a human being. "The first steps that can be taken until we reach medical assistance, are crucial in order to save a life. ” (2)

Schools and teachers play an important role in health promotion and prevention of diseases and accidents among children and adolescents in schools. In many situations, the lack of knowledge leads to numerous problems, such as State of panic when he saw the victim, the victim's incorrect handling and unnecessary request specialized in emergency aid. It is in this context that becomes important knowledge about first aid among physical education teachers of public schools. (3)

In the educational environment, especially during the exercises of physical education classes, are commonplace situations that demand the necessary role of the teacher in the provision of the first calls. Occurrences that require emergency care, in General, are: wounds and bleeding, foreign bodies, animal bites, gagging and burns. (1)

Knowing that the physical education in his speech Pro, works with various bodily practices and manifestations, it can be affirmed that the teacher of that discipline this susceptible to experience during your lessons, situations in which students require emergency care, as a result of injuries caused by the movement of the body. (4)

The Physical education teacher knowledge about first aid should not stick only to the professional. Such knowledge must be shared with everyone, students and other educational agents, as they may carry out, if necessary, the pre-hospital care, thus helping the nuclear family, as well as the whole society. (1)

However, spreading just theoretical, in isolation and by a few times, it's not what you crave. The topic first aid kit must be attached to the school curriculum, in order to be assimilated by the teachers and students, creating good habits and attitudes. Health, in General, is a cross-cutting issue, characterized by interdisciplinarity.

[…] the level of knowledge of teachers in first aid and the implementation of emergency plans within the scope is of great importance, thus allowing the immediate relief to students, the promotion of health, prevention of illnesses, accidents among children and adolescents. Therefore, it is evident the importance of resource persons, whether in schools or in any other place, having the exact science to correct conduct when in emergency situation. (5)

"First aid in school physical education" was chosen as the object of research on the need to outline new strategies of preventive interaction concerning accidents within schools. The study seeks to warn about the need of knowledge about first aid, leading to effective training teachers, preventing and ensuring the physical safety of the student.

Thus, the problem of the study is: how knowledge about first aid can help the teacher of physical education in your work performance?

This article aims to make an approach about accidents and first aid in the school environment. Specific objectives: to find out what are the main causes of accidents in the school environment; check what are the main procedures adopted by the Physical education teacher and the school front of accidents in school; expose what the guidance that the trader had in his training course regarding the aid of urgency; analyze what the perception of the professional about the importance of knowledge and procedures of ready attendance in schools.

The physical education professional, as well as several other professionals in the field of education, faced in their daily lives with emergency situations in which must act with precision to reverse accidental framework. The practice of first aid is essential to prevent, control and prevent students, as well as the other people who are in school, suffer accidents, and if they suffer, evil led be kept as small as possible.

The study of the practice of first aid has great relevance. It is evident the need of professionals able to provide help efficiently, specific to the case. The emergency medical relief is routinely omitted, being usual nothing doing between the time of the occurrence and the arrival of the rescue team. The action during the time lapse between the accident and the arrival of specialized emergency can mean saving a life.

As above, the first aid training should be included in the curriculum of physical education professional training, since it is of fundamental importance that knowledge to minimize damage.

METHODOLOGY

The methodology used in the study was a review of the literature. The survey was conducted on online as Google Scholar and in repositories of Brazilian universities, in addition to extensive research in digital magazines.

The keywords used were: first aid, accidents, preventive methods and physical education. The research will be guided by articles published between 2006 and 2015; the data were collected between February and September 2016.

The importance of preventive methods and knowledge of first aid actions to prevent accidents during the school sports practices will be the theme considered as a criterion for the selection of articles and studies.

There will be an analysis of the materials to achieve expected results through the research proposal, confronting what is already held in the school environment with suggestions of new methods.

1. THE SCHOOL ENVIRONMENT

The school environment is a place that has high incidence of accidents, since children and adolescents are clusters within a common space, interacting through numerous motor and sports activities. Global development-related characteristics of the individual, such as your physical, psychic, cognitive aspects, chronological age and social relationship, can define the kinds of accidents that occur within that school environment. (6)

Accidents are a constant concern within the educational space, being essential for the educational agents know how to act in the face of these events, giving first aid effectively, thus avoiding complications resulting from inappropriate procedures. (7)

[…] the child shows interest in exploring new situations, for which not always is prepared, which facilitates the occurrence of accidents. Becomes important, knowledge of the most common accidents in each age group, for the targeting of the measures to be adopted for their prevention. (6)

Children and adolescents are victims of accidents because society in General doesn't care about the safety of this group, providing them an environment that is really protected. This could be accomplished through an effective legislation focused on the aspect of security; as well as through the proactivity of the community in control of accidents and violence. (7)

1.1. The legislation and accidents at school: rights and duties

Article 5 of the Federal Constitution sets out: "all are equal before the law, without distinction of any kind, ensuring to Brazilians and foreigners residing in the country the inviolability of the right to life[…]. ” (8)

In article 196, the same legal instrument, is determined:

Health is everyone's right and duty of the State, guaranteed by social and economic policies aimed at reducing the risk of disease and other aggravations and universal access and equal to the actions and services for its promotion, protection and recovery. (8)

In the criminal context, the Criminal Code asserts in his article 135:

Fail to provide assistance when possible to do so without personal risk[…], lost or injured person, helplessness or in serious and imminent danger; or doesn't, in such cases, the public authority assistance: – detention of 1 to 6 months, or a fine. Sole paragraph-the penalty is increased by half if the omission results in injury of serious nature, and tripled if death results. (9)

The Physical education teacher is directly responsible for their students. The welfare, the safety and health of students are of its competence. The Civil Code of 2002 (Law 10,406/2002^{) (10}), in its article 186, establishes that the individual, either by voluntary action/omission, negligence or if you violate the law and cause damage to others, still exclusively, makes moral tort. People during sport practices are subject to accidents and injuries, but on the occasion of this legal determination, the professor has liability, being compensated the victim subject to sports training suffer any injury. (6)

The responsibility to students and beneficiaries of physical activities pertain to the constitutional, civil, criminal rights and, above all, professional ethics. Therefore, it is of the utmost importance that the physical education professionals are trained, up to date and ready for accidents and fatalities that may happen in your job and create a service routine of an emergency involving the entire team. (11)

On the other hand, the help provider should be aware that the victim can refuse service for any religious belief or lack of trust in the person who performs the service. The victim cannot be forced, and the service provider help make sure that the specialized care was named, leaving the victim helpless, monitoring it and trying to earn your trust through dialogue. The victim can demonstrate their negative receive care through a simple negative is made with the head or pushing the hand of the person who tries to help her. If the service provider help insist on playing the victim, this may be considered violations of her rights, generating further damages. In this way, it is important that witnesses be called to make it clear the refusal of first aid. (12)

1.2. The main causes of accidents in school context

It is said that the accident "is an unintentional event which can cause injury and may be avoidable under school or in other social environments; sometimes can feature a set of harms to health. ” ⁽⁵⁾. Similarly accident is regarded as "unintentional event capable of causing physical or emotional injury, depending on its severity and may occur in any environments, including at school. "(13)

Despite being characterized as unintentional, it is erroneous to say that the accident is unpredictable, sudden or unexpected, because it has cause, origin and epidemiological determinants, being possible to be prevented and controlled. This recognition is essential for the abandonment of the culture that claims to be the accident something normal in the process of child development. (7)

Within the school environment, at any time, the student is exposed to a number of risks. Places such as the classroom, the hallways, the courtyard, stairs, bathrooms, laboratories, library, recreation and sports areas, can be instrumental in the accident arise suddenly and in a sudden way, despite being almost always predictable. The predictability of accidents may be linked to the high concentration of children and young people in these locations in conducting meetings, interactions and practicing the various motor and sports activities. (6)

The event of accidents is as old as the appearance of mankind, and can occur in any location. ⁽²) the large number of children and adolescents interacting and developing in various motor and sports activities can lead to accidents that cause physical sequelae, can achieve the emotional aspect, leading the student to school failure. (6)

The educational environment is a place where a large number of children in the process of interaction and development, which should be worked on several sports activities. Because of this, the environment becomes conducive to accidents. […] educational spaces must provide a physical education facing the motor development, cognitive and social development of children and adolescents, but the thinking and doing safety should be observed at all times of the permanence of children in school. (5)

Children and adolescents suffer accidents because the society in which they are inserted not gives a protective environment. It must be recognized that the immaturity and/or lack of knowledge are own the world. Thus it is necessary to combat the misinformation and lack of care, promoting within the community a new concept about security. (7)

Children's accidents are an alarming public health problem due to the high incidence and impact. National and international statistics of mortality would be reduced if preventive educational actions were adopted. Unintentional injuries cause numerous sequels in motor function, sensory, cognitive and behavioral. Most of the sequels is the child with motor difficulty of locomotion and limited to perform their daily activities such as bathing and dressing alone. (13)

Accidents are increasing cause of mortality and disability in childhood and adolescence and important source of concern, for they are the predominant group of causes of death from one year of age, reaching percentages greater than 70% in adolescents 10 to 14 years of, when you analyze the deaths caused by external causes (accidents and violence). Accidents cause, every year, the group under the age of 14 years, nearly 6,000 deaths and more than 140,000 hospital admissions, only in the public health network. (7)

For example, the following search terms:

Harada (2003) references a survey conducted in the United States, which points out that, every year, 3,700,000 children suffering accidents in schools. Other research carried out in 20 schools participating in the project Unimed, Life in the city of Blumenau, in 2000, reveals that, of the 287 accidents recorded in the period of one year, it was found that 117 (41%) of them occurred on the Court. The higher incidence of accidents (55%) happened during school. Colucci (2006) presents data of a research conducted in 23 public and private schools of São Paulo: 78% of children who are victims of accidents were hurt with adults around. (2)

The accident has caused a foreign agent that, in addition to individual factors and the environment, allows a certain amount of energy is passed on to the individual environment. In this way, the energy transferred can be mechanical (falls and hits), thermal (Burns), electric (electric shocks) or chemical (poisoning). The accident is the result of the inadequacy of the environment, and can be avoided if they are implemented measures of fitness. ⁽⁶⁾. The most common occurrences are: wounds and bleeding, foreign bodies, animal bites, gagging and burns. For students of early childhood education, mouth lesions, especially in the teeth, and head and neck, are the most common and dermal bone level. (1)

Inside the school, accidents occur taking into account as a criterion for classifying the age group of the students. So, in the initial series, a striking feature of the students is the need of exploration, always looking for the new, the unknown. For another perspective, the aggressive between older students is latent, another situation that causes physical and emotional injuries, called bullying. (7)

The Board of accidents and violence in school is a serious public health problem. Several institutions, privatized or not, have been adopting various pipelines to ensure the rights of children and adolescents to have a safe environment. An accident that occurs, brings many negative consequences for the school. The right of children and adolescents to remain in a safe environment must be widely protected, mainly because these people spend approximately one-third of the day in the educational centre or on the way toward him. (2)

2. THE PHYSICAL EDUCATION CLASSES

In the years 60 and 70, the school physical education was working way, because it was conceived just erroneous as sports training that answer to social and political concerns of the time. (5)

Currently, the physical education classes seek to promote growth, development of body culture, sociability, physical skills and civic training. (14)

As above, during sports practices students are subject to various types of accidents. The following were exposed the main procedures performed if incidents happen.

2.1 main procedures adopted in the face of accidents

Accidents that occur can include trivial contusions, abrasions and from cramps to abundant bleeding or head trauma. (11)

The phases of relief, so synthesized: (12)

• The assessment of the scene is the first action to be made at the crash site, looking into the risks that may jeopardize the relief provider. If you check any potential danger, you must wait for the arrival of relief electricians. At this stage, the service provider should know what happened with tranquility and efficiency; check the risks for themselves, for others and for the victim; create an action plan to provide human and material resources in order to provide swift assistance; protect the victim from danger by keeping local security; don't try to do it alone more than possible; call for help;
• In this second phase, the provider will verify and correct relief life-threatening problems in the short term, such as airway obstruction and circulation;
• In the third stage, the help provider checks with the victim, through a quick interview, if possible, the signs and symptoms, allergies, medications, past medical, food and fluid intake, previous events related to trauma or disease; If later a cursory examination and measurement of vital signs;
• The detailed physical evaluation, which is the fourth phase, examine the feet and the head of the victim, looking for injuries;
• In the fifth phase, terminates the examination, assessing the dorsal region, preventing the shock and preparing transportation;
• Finally, in the sixth phase check periodically the vitals, keeping a constant observation of the general appearance of the victim.

Through a survey (2) with re^spect to accidents that occur within the educational institutions, there is a major disagreement about the student service. Often, the municipal secretariats of Education determine that only local asepsis and application of ice in case and scratches and cuts. However, the authors suggest that the school is preparing with a first aid kit suitable and available. Materials such as splints and bandages are and great value in cases of fracture where the detention is necessary. It is forbidden also medicate students who are under the responsibility of the school, which is seen as positive by the authors, because there is no individual control of drugs that can be used. Besides, the procedure adopted in the face of accidents in school is driving the victim to the emergency room, letting you know what happened to the parents or guardians by the student. (6)

2.2. Prevention of accidents in physical education classes

The school environment is safe? The United Nations was based the concept of human security is based on the development of the human being, covering the security of all citizens in their daily lives: public roads, work, leisure, school and home environment.  When referring to school, there's always an idea of safe environment, but many places within of the colleges are stages of numerous accidents. (2)

In this same context, it is stated that the school must be a protagonist in the actions of protection of children's health and welfare, responsible for creation and maintenance of security plans, with the aim of reducing the number of accidents, which generates suffering of parents and children; ensuring, in this way, a protected place for games and school activities. (13)

Most injuries occur during sports and recreation not in organized competitions. This is a consequence of the intense contact of people who often are not physically prepared for the execution of a particular activity. It's a risk activity, but the environment and the equipment used are additional risks to a greater or lesser degree. (2)

Over time and due to jackpots, railings and fencing off wire ends and, therefore, do the sports courts a place of risk. Equipment and facilities must be appropriate to the maturity of the participants. Children should be taught about the rules of the games and reminded that many rules are there for your safety. (2)

During sports practices, it is essential to respect the rules of the game, thus avoiding injuries. Safety equipment, shoes and appropriate clothing help preventive security practices. In the physical environment, avoid gaps in the blocks, preferring that the surface is made with materials that absorb the impact at the moment of the falls, also protecting columns and architectural structures. The case of the other AIDS in protection of all, and teach children such conduct, as well as stimulate teamwork. (7)

Even if the other employees take care of the cleaning and maintenance of the sports environment, it is the duty of the teacher to check the Security site. That way, he should be aware of the slippery floors, broken beams, floor gaps, among other problems that can cause injury to the students. Primarily, the professional of physical education must be trained and prepared for, in emergency cases, act safely and effectively, since, as will be treated further, the teacher must have full knowledge, as their practice cannot be marked by trial and error. The error, in this case, could mean serious consequences or even death. (2)

Prevention measures are guided by principles that respect the personal individuality and prolong life, sticking to actions intended to contribute to the health and prevention of sports injuries. Prevention measures can be grouped into three steps: (6)

• Primary prevention: heating, clothing and appropriate footwear, healthy feeding habit, hydration, sports and other accommodations;
• Secondary prevention: medical advice before beginning the practice of physical activity and early prognosis of predisposition to sports injuries;
• Tertiary prevention: evaluation and rehabilitation of the changes in the body as a result of the practice of physical activity.

In the studies was examined a given peculiar. Teachers stated that many accidents occur due to lack of ability of the student. In this way, teachers of the research conducted by these authors state that, although the Court or of the place where the classes are the biggest cause of accidents, the indiscipline, disability and student's own jokes are causes of several accidents. (2)

This is reaffirmed by Costa (6). The author points out six causes of accidents in physical education practices and the conduct of preventive main held by professor, exposed below:

• Novice: disability begins with simple exercises and, from the development of engine elements, more complex exercises are added. The class must be always supervised, not allowing potentially dangerous activities
• Body inequality and/or technical: to propose the activities, the educator must match the size of the students, dividing them by size, physical maturity, experience and technical skill;
• Age: must observe the student's age, in order to assess their psychological and physiological development;
• Contempt of the danger: the teacher should require students to use the appropriate safety equipment, causing also a preview survey to find out if the equipment is in good condition. The teacher should also find out if students are using safety materials properly;
• Causes unpredictable: are circumstances in which you can't protect or guard, where the cause can never be totally eliminated;
• Supertreinamento: everyone has a functional limit and this must be respected.

3 the ROLE of the TEACHER

The teacher, as well as all the teaching Center, has important role in the development of health and prevention of accidents among children and adolescents within school. The lack of knowledge on the part of professionals can bring numerous problems, such as incorrect handling of the victim or lack of psychological preparation to meet efficiently the rugged. The knowledge about first aid for teachers of physical education is essential, and can avoid unnecessary distress call from the specialized to maintain a life. (3)

3.1. The teacher is ready?

Even with the historic process of modification of the physical education, in its essence, she still works with the body and its movements. Thus, we can affirm that the teacher, during his work, is exposed to numerous situations requiring urgent/emergent care. Being the nearest of the injured person, the teacher is responsible for the first installment. (15)

The Physical education teacher should possess basic first aid notions within the educational framework to act properly when necessary. A survey exposes the teachers, on average 30%, do not feel prepared for the right action at the time. (3)

The level of knowledge of teachers in first aid and the implementation of emergency plans within the scope is of great importance, thus allowing the immediate relief of the students, the promotion of health, prevention of illnesses, accidents among children and adolescents. Therefore, it is evident the importance of resource persons, whether in schools or in any other place, having the exact science to correct conduct when in emergency situation. (5)

Generally, the professionals who have little knowledge about how to act when faced with emergency situations, usually, do nothing. In this way, the Physical education teacher should always be aware, do you know what time you will be required to provide help.

The Brazil and the world have witnessed several fatalities that occurred in the Middle, showing the care that we should have to submit a person to practice sport activity, being her child, teenager or elderly. After these events the clubs and professionals of the health area, has been involved and prepared more in relation to the first aid care. (1)

The professional can get an amplification of their knowledge through retraining. You have to adjust periodically, through studies and training, to be able to make an immediate relief. Everyone should have the conscience to act in these situations can be complicated and very difficult. (5)

The lack of knowledge of the physical education teachers in first aid can cause several problems to students, as incorrect handling of the victim or even sometimes unnecessary request specialized emergency aid. […] much of the physical education teachers do not have the necessary knowledge to cope with and to help before an emergency situation involving attitudes related to first aid practice. The responsibility of the teacher to attend a bumpy at school is very important, because this service can do emerge several aggravating, generating several disorders to the institution. (5)

The current situation of education in Brazil and the problems related to it come from higher education because there is no specific training for teachers. The universities must seek improvements in the process of qualification of its professionals, going over everything that is necessary for the performance of the physical education teacher. There is a growing concern of the municipal departments of Health to reduce the accident rates in public schools. For this reason, employees are undergoing training, orientation and notions of saving in case of accidents. (5)

On the other hand, it is insufficient that only the teacher knows how to deal with emergency situations. The technical knowledge should be shared, going beyond the school environment and the student's family. The teacher must not only work the procedural dimension, but also bring the theory and correlate the contents. The proposal should be guided by the self-knowledge and self-care, individual and collective dimension. Education is a strong ally in the prevention of accidents; as well as to the formation of citizens who know how to use first aid effectively in situations that require this practice. (1)

To support the above includes results of a survey (3), held in a town southwest of Goiás:

• Most of the teachers had the discipline of first aid during his graduation, but the content was considered inadequate administered; later, the vast majority of teachers held training courses.
• It is important that in addition to the physical education professionals, the other teachers to participate in training in er, improving psychological, emotional and technical aspects to provide security to all persons within the school. After all, accidents can happen at all times, whether in time or in/out of school.

In other research carried out, the favorite theoretical content seen by students within the discipline of physical education were the first aid kit. This preference is backed by the applicability and utility throughout life. The student can so highly noticeable, extrapolate the knowledge acquired in the context of schools, being very important in situations of danger. (1)

3.2. The importance of knowledge and ER procedures in schools
"First aid is the first care provided to a victim who is injured or falls ill instant power, whether temporarily or immediacy. ” (3)

First aid is the immediate care provided to a person, whose physical, psychic or emotional cause in danger to the integrity of your health or your life. This care are carried out outside the hospital environment, and have the goal of keeping the vital functions of the victim, avoiding the aggravation of your static frame, until the specialist medical assistance arrives. (12)

The help provider that acts during pre-hospital care, i.e., first aid, should pay attention, primarily for their own safety. The person shall not, on impulse, if put at risk, taking deliberate and reckless attitudes. Besides, the seriousness and respect are very important for a good provision of first aid. The victim should not be exposed unnecessarily and the secrecy about the personal information that the service provider help becomes aware during the relief action must be maintained. (12)

In physical education are worked numerous bodily practices and its manifestations, being professor susceptible to, during his lessons, experience situations in which your students require emergency care. The teacher, therefore, must have enough knowledge to act in these situations, because the service performed by first responders can take to arrive, bringing irreparable trauma or even causing death. (15) "several studies show that the chance to revive a patient with cardiopulmonary arrest decreases of 7 to 10 percent per minute, so, without proper care, the victim might die in a few minutes. "(11)

It would be interesting that within the school planning were added classes geared to the provision of first aid and accident prevention, empowering the students themselves to this type of occurrence. (2)

4 FINAL CONSIDERATIONS

The school physical education is a proposed activity geared towards the overall development of the students, in their physical, psychological, emotional and cognitive. Society in General has to be concerned with the practitioners of sports activities, since most of the accidents occur during the exercise.

Is for student's own factors, such as lack of ability or disconnected from your age group/body size unsuitable for the activity; either by environmental factors (inadequate sports court), accidents do happen and it is the duty of all educational actors to prevent them, creating a protective environment for the students.

Accidents can cause small abrasions or even a head trauma and the physical education professional, as well as others, because accidents can occur at any time and place, be prepared to provide first aid, always respecting the rights of the victim.

A great barrier faced in the Brazilian educational system is the lack of professional preparation for the provision of first aid. The ignorance of the basics of ER is unacceptable, because knowing how to provide assistance to a rugged effectively and immediately can save him from death. The problem of poor University education must be fixed with educational policies towards subjects relating to emergency calls because the same far beyond the scope and are the basis for situations routinely faced anywhere.

Is valid to note that articles aimed at the theme of this work are scarce, being very important to production of other studies geared to business so that the academic community and the physical education professionals have a greater knowledge on attendance of urgency, especially so practical.

REFERENCES

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[1] Student in physical education of College Patos de Minas (FPM) forming in the year 2016.

[2]Professor of the course of physical education of the Faculty of Patos de Minas. Master of science from the University of São Paulo (USP).