Importance and Implementation of Training in Cardiopulmonary Resuscitation and Automated External Defibrillation in Schools

Abstract

In 2003, the International Liaison Committee on Resuscitation published a consensus document on education in resuscitation that strongly recommended that “…instruction in CPR [cardiopulmonary resuscitation] be incorporated as a standard part of the school curriculum.”1 The next year the American Heart Association (AHA) recommended that schools “…establish a goal to train every teacher in CPR and first aid and train all students in CPR” as part of their preparation for a response to medical emergencies on campus.2 Since that time, there has been an increased interest in legislation that would mandate that school curricula include training in CPR or CPR and automated external defibrillation. Laws or curriculum content standards in 36 states (as of the 2009–2010 school year) now encourage the inclusion of CPR training programs in school curricula. The language in those laws and standards varies greatly, ranging from a suggestion that students “recognize” the steps of CPR to a requirement for certification in CPR. Not surprisingly, then, implementation is not uniform among states, even those whose laws or standards encourage CPR training in schools in the strongest language. This statement recommends that training in CPR and familiarization with automated external defibrillators (AEDs) should be required elements of secondary school curricula and provides the rationale for implementation of CPR training, as well as guidance in overcoming barriers to implementation. Sudden cardiac arrest is a leading cause of death in the United States and Canada. It is estimated that each year emergency medical services (EMS) personnel assess 294 851 (quasi-confidence intervals, 236 063 to 325 007) out-of-hospital cardiac arrests (OHCAs) in the United States. Survival, which is defined as being discharged alive from the hospital, varies widely by region (3.0% to 16.3%; median, 8.4%), but the overall average rate of survival to discharge from the hospital is estimated …