Everyone needs to know CPR, but not everyone has an equal opportunity to learn. This is especially true for the deaf and hearing impaired, blind and visually impaired, seniors (who may have compounding needs) and those with physical and cognitive disabilities.
Emergency responders from Falck San Diego are addressing the challenge by bringing accessible, hands-only CPR and AED training to persons with Access and Functional Needs (AFN) in their community.
“Having heard from most attendees that they had never had the opportunity to learn or practice CPR demonstrates the unfounded assumption that communities with disabilities cannot be involved in saving lives,” said Falck EMT Julia Goebel, who helps teach these roughly 30-minute non-certification lessons in compression only CPR/AED. “Empowering all communities and making CPR training accessible and tailored to ability is a logical step forward improved survival.”
Empowering Training for People of All Abilities
While CPR instruction geared toward those with AFN is not new, it’s still not widely available. One trailblazer in training, the National Organization of Nurses with Disabilities, partnered with the American Heart Association in 2020 to create a BLS advisor course designed for persons who can pass the cognitive portion of the course but can’t physically perform CPR. The course empowers students to recognize signs and symptoms of sudden cardiac arrest, access 911, and instruct others to perform compressions.
In San Diego, one student in a recent course said she wanted to take a CPR class when she was young but was told that blind people can’t learn CPR. After some hands-on instruction and practice, she demonstrated competence rivaling her seeing counterparts and was very excited to learn.
Feedback from other students has been equally positive. “Participating in the CPR class was an enriching and empowering experience,” said Hermes Castro, program manager at Access to Independence of San Diego, a center for independent living. “The hands-on training, delivered with clarity and enthusiasm, ensured that every participant left with the confidence and skills needed to save lives.”
Access to Independence serves a clientele with conditions such as blindness or visual impairments, cognitive and physical disabilities and mental health challenges.
Anyone Can Deliver CPR
Another valuable partner for Falck has been the San Diego Center for the Blind (SDCB). Each semester, Falck paramedics and EMTs teach a new group of students who come to the center to learn skills for living successfully with blindless and vision loss.
“In providing rehabilitation services for individuals with visual impairments, our goal is to help each individual to their highest level of independence,” said Kim Taylor, interim CEO of SDCB. “Although they may not have vision or their vision has changed, many of our clients are still physically capable of providing CPR. With adaptive instruction, any hesitation these individuals may have to step in can be eliminated. When told we would be providing accessible CPR training, clients expressed gratitude and relief, and our staff with visual impairments asked to participate too.”
Teaching CPR to persons with AFN can be extremely rewarding. Empowering someone with CPR skills can be especially impactful to someone who may already feel vulnerable at times because of their disability. To learn this lifesaving new skill to act in an emergency and learn it in an environment friendly to everyone’s needs touches the hearts of students and instructors alike.
Tips for Planning and Hosting Accessible CPR Training
Establish partnerships with organizations that already serve the AFN community.
These organizations are invaluable as they can more easily reach and advertise classes, provide venues and contribute their expertise. Such organizations include non-profits, regional centers, senior centers and centers for independent living.
Prepare for accommodations.
Find out in advance the various access and functional needs of your audience. If partnering with an organization that serves the AFN community, they will have this information. Do a site visit beforehand to see the venue. Arrange for adequate space and AV capability and make sure that the building is ADA-accessible.
Additionally, as students arrive for class, carefully observe (or ask respectfully) if there any special considerations. Knowing in advance that a person can’t use one of their limbs or can’t get on the ground, for example, is helpful before starting. You can also do a run-through or “test” class with one or two individuals beforehand to get comfortable as an instructor.
For students in wheelchairs or with other mobility issues:
Prepare to have manikins on tables of varying height and cushions or floor mats on the ground. For example, someone in a wheelchair may prefer to practice compressions on a standard height table, others on a coffee or end-table, and others may prefer to get on the ground.
Also, create virtual experiences for those who cannot fully participate in certain aspects of the event. For example, Falck includes an ambulance tour as part of its CPR classes and filmed a “virtual ambulance tour” for any who cannot participate.
For students who are blind and visually-impaired:
Don’t assume everyone has zero vision—many students may still have limited vision and groups also might include seniors who had sight most of their lives. You can still utilize video when teaching the blind and visually impaired. Many of the short hands-only CPR videos easily accessible online have great descriptive language that clearly explains CPR and AEDs.
Also, videos that demonstrate agonal respirations help students recognize the sounds of SCA. Audible metronomes or music can assist with teaching proper compression rate.
To assist with proper hand placement, use manikins with arms if available and get tactile—before class, encourage students to feel the manikins to get oriented. After obtaining permission, students may appreciate you guiding their hands over the manikin’s head and torso to identify landmarks and ensure they are in proper position.
Teaching AED pad placement may be very challenging as pads are not currently labeled with braille and some pads are not interchangeable.
In that instance, you may instruct blind and visually-impaired persons to elicit the help of someone on scene to help find and apply an AED. Demonstrating and discussing AEDs is still very valuable, even if someone would have difficulty applying it in an emergency.
For students who are deaf or hearing-impaired:
Use ASL interpreters and videos with subtitles. Remember that students may be looking at the interpreter instead of directly at you during the lesson. Use light-flashing or vibrating metronomes to help teach proper CPR rate. These tools are available online.
If you have someone in your first responder organization who knows ASL, bring them along, and learning a few signs (including your name in ASL) also goes far.
Set a comfortable learning environment from the start.
Explain clearly at the outset that students are welcome to participate to their comfort level. Almost all will fully participate but respect it if someone only wants to participate in part of the activities or just observe. There are no requirements such as there are in certification training, so this is fine.
Be mindful if any of your students start to look fatigued or uncomfortable and encourage them to take a break when needed.
Welcome family members and caretakers to participate.
They commonly accompany students to classes and can provide additional assistance while learning themselves.
Communicate using clear, simple, direct language that can be translated easily if needed.
Speak clearly and encourage students to ask questions. Speak loudly or use microphones. AFN students may have additional questions or request additional explanation for concepts. Work in extra time for questions.
Start with yourself.
If you feel nervous or intimidated about teaching accessible CPR, remember that AFN communities are used to adapting. They do it every day and it’s not a big deal to them, even though it may be for you.
Remember that you get to teach someone who probably has never been given the opportunity in their life to learn CPR. Also, there will probably be fewer accommodations needed than you might think. Keep a sense of humor because you might say or do something awkward at first.
Get feedback.
After the class, survey students and any sponsors and solicit suggestions. If possible, do a pre- and post-survey to gauge how much people learned and how confident they are in applying their new CPR skills.
Loralee Olejnik is the Community Education Specialist for Falck San Diego. She can be reached at Loralee.Olejnik@falck.com.
