In the U.S., approximately 38 people have an out-of-hospital cardiac arrest every hour.1 We know that for victims with a witnessed event, each minute without CPR decreases their chance of survival by 7–10%. Therefore, during the critical moments prior to EMS arrival, a bystander who identifies an unresponsive, non-breathing patient, can more than double the chance of survival by initiating high quality chest compressions.2
In Alameda County, Calif., the rate of bystander-initiated CPR historically only reached approximately 28%. In order to increase bystander participation and decrease the time to life-saving interventions, Alameda County Emergency Medical Services developed an innovative and aggressive community outreach program, CPR7, which was launched in public school 7th grade classrooms in 2010. After a 2007–2008 pilot study demonstrated that the hands-only CPR technique was better adopted by students in 7th grade rather than 10th grade, the CPR7 program was implemented countywide.
Throughout the county’s 18 public school districts, 7th grade science, health, and P.E. teachers were provided with Laerdal CPR Anytime kits to train their classrooms in CPR. The “watch and learn” video in each kit focuses on identifying cardiac arrest victims, stresses the importance of calling 9-1-1 and provides instruction on how to initiate hands-only CPR. The Laerdal Mini Anne manikin and instructional DVD were given to the students, who then trained as many family members and friends (over the age of 12) as possible.
In the 2014–15 school year alone, more than 32,000 7th graders and community members were trained. A survey documenting signatures from those trained outside of school was used to identify the number of community members reached, which totals more than 120,000 to date.
At Sunol Glen School, 7th grade teacher Suzette Takaei has been participating in the CPR7 program for the past five years. Last year, two of her students, Neidy Jimenez and Ellie Chan, far exceeded the expectations set forth by the program. Neidy taught handsonly CPR to 102 participants through her local church, and Ellie trained 120 members of her community at a nearby park. While the CPR7 project aims for each student to teach CPR to at least six people, these two students showed the potential community impact of the initiative to be far greater.
Sunol Glen Unified School District Superintendent Molly Barnes says, “The greatest benefit to my students is the opportunity to practice civic responsibility. It is not just learning the skill set of CPR, but sharing their abilities with others. Our students have reported a sense of pride and empowerment. The community members are amazed they are being asked to learn the skillset from a 12- or 13-year-old. The students have reported how receptive people are and are happy to learn from them. It has been an incredible opportunity for our students.”
While there are more than 500,000 cardiac arrests each year, less than 15% of victims survive, according to the American Heart Association.3 Evidence shows that early, high quality CPR can significantly decrease patient mortality, however the AHA is currently only able to train approximately 3% of the U.S. population annually.
With this goal in mind, the CPR7 program in Alameda County hoped to significantly impact the survival of cardiac arrest victims through community outreach and education. Although California does not yet require CPR training in public school curriculums, the dedicated 7th grade students of Alameda County are already doing their part to save lives using bystander-initiated CPR.
Over the past five years, since the implementation of CPR7, the bystander CPR rate has increased to nearly 50% at peak, with a concurrent increase in return of spontaneous circulation with EMS resuscitation and survival to hospital discharge with favorable neurologic function. Funding for the CPR-7 project comes from California Senate Bill 12 and is independent of public school funding.
It takes innovative strategies to develop a system of care to battle out-of-hospital cardiac arrest, and Alameda County EMS recognizes CPR7 as an important example of the community helping the community.
1. CPR & First Aid Emergency Cardiovascular Care (n.d.) CPR in schools. Retrieved on Nov. 16, 2015, from http://cpr.heart.org/AHAECC/CPRAndECC/Programs/CPRInSchools/UCM_473194_CPR-In-Schools.jsp.
2. Hasselqvist-Ax I, Riva G, Herlitz J, et al. Early cardiopulmonary resuscitation in out-of-hospital cardiac arrest. N Engl J Med 2015;372:2307–15.
3. Meaney, P, Bobrow, B, Mancini, M, et al. (July 23, 2013) CPR quality: improving cardiac resuscitation outcomes both inside and outside the hospital. A consensus statement from the American Heart Association. Retrieved on Nov. 16, 2015, from http://circ.ahajournals.org/content/early/2013/06/25/CIR.0b013e31829d8654.full.pdf.