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RES CPR 7 Expand CPR Training for K-12

Key area

CPR Rescue

Expand cardiopulmonary rescusitation (CPR) training in schools with age-appropriate content for grades K-12.

Spectrum level: Changing Organizational Practices Strengthening Individual Knowledge and Skills

Evidence level: Medium

Implementation levels: Community County National State

Rationale:

Evidence has shown that increased rates of bystander CPR reduce the morbidity and mortality of out-of-hospital cardiac arrest in the context of drowning, as with other forms of cardiac arrest. CPR training should start with elementary school-aged children and progress until high school graduation.

Anticipated Impact:

After implementing this recommendation, you can expect to experience the following outcomes.

  • Increased rates of bystander CPR leads to a reduction of morbidity and mortality in the context of drowning as with other forms of cardiac arrest.
  • CPR education and training through public schools leads to an increase in the number of people who can perform bystander CPR.
  • Reviewing and practicing CPR at regular intervals throughout education leads to significant enhancements in students’ memory and comfort in providing this intervention.

Evidence:

CPR skills can be taught at age appropriate levels and bystander CPR can reduce morbidity and mortality of out of hospital cardiac arrest.

Evidence Sources:

Panchal AR, Fishman J, Camp-Rogers T, Starodub R, Merchant RM. An "Intention-Focused" paradigm for improving bystander CPR performance. Resuscitation. 2015 Mar;88:48-51. doi: 10.1016/j.resuscitation.2014.12.006. Epub 2014 Dec 19. PMID: 25534077; PMCID: PMC4426863.

Lim GB. Cardiac resuscitation: Benefit of bystander CPR and defibrillation. Nat Rev Cardiol. 2017 Jul;14(7):382. doi: 10.1038/nrcardio.2017.81. Epub 2017 May 18. PMID: 28518174.

Leong BS. Bystander CPR and survival. Singapore Med J. 2011 Aug;52(8):573-5. PMID: 21879214.

High Risk Populations Addressed:

All populations can benefit from implementation of this recommendation.

Evaluation Metrics:

Indicators of long-term impact:

  • Morbidity and mortality due to out-of-hospital cardiac arrest are significantly reduced

Indicators of intermediate impact:

  • Increase in the number of interventions performed by students

Indicators of initial impact:

  • Increase in the number of students trained in CPR per year

Implementation:

Consider the following to ensure successful implementation:

  • Ensure training curriculum is age and developmentally appropriate. For example, it could start with general awareness of situations where CPR is needed at the elementary school level, start teaching compressions only at the middle school level, and require CPR certification at the high school level.
  • Find ways to attain administrative or legislative approval for changes to school curricula.
  • Consider effective ways to train educators, and, or community members as instructors.
  • Consider funding needed to develop and implement the CPR curriculum.
  • Consider how to ensure access to educational material and time for non-core content within low-resource school districts.
  • Consider advocating for national or state legislation or local ordinances requiring CPR education to support adherence to this recommendation.
  • Consider ways to develop State Department of Education "buy-in".

Challenges to Implementation:

When implementing this recommendation, you might encounter challenges related to the following factors.

  • Administrative or legislative approval may be required to changes school curricula.
  • Educators, and, or community members would need to be trained as instructors.
  • Developing and implementing the CPR curriculum may have many financial considerations.
  • Access to educational material and time for non-core content may be limited in low-resource districts.

Potential Facilitators:

The following factors might facilitate the implementation of this recommendation.

  • National or state legislative requirements or local ordinances requiring CPR education will support implementation.
  • State Department of Education "buy-in".

GAP Recommendation:

The cost/benefit of implementing such programs needs further studying.

Research is needed to determine age-appropriate content for CPR training with respect to physical and cognitive capabilities.

Research is needed to better understand the impact of compression-only CPR on cardiac and non-cardiac etiologies.

Research is needed on retention of CPR skills once leaving school

Research is needed on the long-term changes in career paths or CPR recertification once out of school