In the United States, approximately 38 people have an out-of-hospital cardiac arrest every hour.1 We know that for victims of a witnessed cardiac arrest each minute without CPR decreases their chance of survival by 7-10%. Therefore, during these first critical moments prior to EMS arrival, a bystander who identifies an unresponsive, apneic patient can more than double the chance of survival by initiating high-quality chest compressions.2
Students as Teachers
The rate of bystander-initiated CPR in Alameda County, Calif., historically only reached approximately 28%. In order to increase bystander participation and decrease the time to lifesaving interventions, Alameda County EMS developed CPR-7, an innovative and aggressive community outreach program launched in seventh-grade public school classrooms in 2010. Funding for the CPR-7 project comes from California Senate Bill 12 and is independent of public school funding.
After a pilot study in 2007-2008 demonstrated that the hands-only CPR technique was better adopted by students in the seventh grade vs. 10th grade, the CPR-7 program was implemented countywide.
Throughout Alameda’s 18 public school districts, teachers of seventh-grade science, health and physical education teachers were provided with Laerdal CPR Anytime kits to train their students in CPR. CPR Anytime is an all-in-one training kit that teaches basic CPR skills in about 20 minutes. The “practice while watching” DVD in each kit focuses on identifying cardiac arrest victims, stresses the importance of calling 9-1-1, and teaches students how to initiate hands-only CPR.
Over five years, Alameda County seventh-graders have taught hands-only CPR to over 120,000 members of their community.
In the 2014-2015 school year alone, more than 32,000 seventh-grade students and community members were trained to deliver hands-only CPR. A survey documenting signatures from those trained outside of school is used to identify the number of community members reached, now totaling more than 120,000.The Laerdal Mini Anne manikin and instructional DVD in each kit is then given to students to take home and train as many family members and friends over 12 years of age as possible.
At the Sunol Glen School in Sunol, Calif., seventh-grade teacher Suzette Takaei has been participating in the CPR-7 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 hands-only CPR to 102 people through her local church, and Ellie trained 120 members of her community at a nearby park. Although the CPR-7 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 reflects on the CPR-7 program, “The greatest benefit to my students is the opportunity to practice civic responsibility. It’s 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 when approached are amazed they are being asked to learn the skill set 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.”
Sunol Glen School seventh-graders Neidy Jimenez and Ellie Chan collectively trained 222 people in CPR as a part of the CPR-7 program.
Although there are more than 500,000 cardiac arrests each year, less than 15% of victims survive, according to the American Heart Association (AHA). 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 in mind, the CPR-7 program in Alameda County hoped to significantly impact the survival of cardiac arrest victims through community outreach and education. Although California doesn’t yet require CPR training in public school curriculums, the dedicated seventh-grade students of Alameda County are already doing their part to save lives.
Since the implementation of CPR-7, 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.
It takes innovative strategies to develop a system of care to battle out-of-hospital cardiac arrest and Alameda County EMS recognizes CPR-7 is an important one: the community helping the community.
1. CPR in schools. (2015.) American Heart Association. Retrieved April 26, 2016, 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(24):2307-2315.
3. Meaney PA, Bobrow BJ, Mancini ME, et al. CPR quality: Improving cardiac resuscitation outcomes both inside and outside the hospital: A consensus statement from the American Heart Association. Circulation. 2013;128(4):417-435.
For more information on the Alameda County CPR-7 project, visit www.acphd.org/CPR-7.aspx.