How to Save a Life: The Importance of First Aid and CPR Training in High School Students

Alex Norwood never thought his lifeguard training would come into play on the baseball field, but when his umpire’s heart stopped, Norwood was able to use cardiopulmonary resuscitation (CPR) training to save him (Stump). Breanna Sudano was just as lucky when she collapsed during a field hockey game, and was saved by a CPR trained bystander. As a result, “Breanna’s Law” is set to make successful completion of a CPR training course mandatory, in conjunction with an SEL curriculum, for all Maryland high school graduates. It is one of several laws just like it being passed in the United States (Silverberg). The truth, however, is not everyone is so lucky. Studies show that an individual who suffers cardiac arrest outside of a hospital has a less than percent chance of survival (Mitchell 52). Making it a requirement to graduate high school with the ability to perform CPR will increase survival rates of individuals that may require CPR. It is especially important that the students trained are done so properly, to ensure the likelihood of an individual coming to a victim’s aid and doing so correctly. With proper education and training, high school seniors may graduate from school with the very real ability to save lives. What constitutes proper education, however, is not currently standardized.

Many people believe that CPR is used to restart the heart of an individual who is in cardiac arrest. In actuality, its main purpose is to maintain blood-flow to the brain of the victim until medical professionals are able to return the heart to its natural function. Successful CPR requires manually applying pressure to the chest at a certain pressure and rhythm over a certain period of time. CPR must be delivered correctly if it is to be effective in saving a victim’s life. This is why adequate training is so important. It is equally important, however, that those trained in CPR are willing to attempt it if they are even in a situation in which they are needed to do so.

The effectiveness of CPR response has a lot to do with the level of CPR training an individual receives. When people feel confident in their CPR skills, CPR does save lives. In fact, according to Christian Vallaincourt’s “Understanding and Improving Low Bystander CPR Rates,” an individual who receives CPR administered by a bystander is four times more likely to survive cardiac arrest (52). However, many people, even though they are trained in CPR, do not rush to the aid of individuals who need it. According to “Teaching Resuscitation in Schools: Annual Tuition by Trained Teachers is Effective Starting at Age 10. A Four-year Prospective Cohort Study,” even though fifty-six percent of bystanders are CPR trained, only thirty percent attempt to perform CPR on victims of cardiac arrest (Bohn et al. 619). One reason for this, according to many experts, is a lack of confidence in ability. An individual who feels that they will not be able to perform CPR correctly is less likely to try in the first place.

There are several factors that cause a CPR-trained individual to hesitate performing CPR when they witness a victim of cardiac arrest. Dr. Trudy Dwyer’s 2008 study reports that confidence—and lack thereof—plays a large role in an individual’s decision not to attempt CPR. Dwyer explains, "Even among those with CPR training, the desire to ‘get it right’ and fear of failing impair confidence” (157). A solution to this issue would be more comprehensive training over a longer period of time, with chances for individuals to practice their skills.

While it is possible for an individual to elect to take part in CPR training outside of a schoolroom setting, there are reasons that this often proves to be less effective than classroom education at the high school or elementary school level. Issues with CPR training outside of schools include the fact that it is not so closely regulated, training occurs as a one-time isolated event, and it does not allow for follow-up practice and training. Vallaincourt’s study explains that CPR training outside of the classroom does not allow for enough individualized, long-term instruction (Vallaincourt, et al.). The obvious solution to this is to provide CPR trainees with opportunities to practice and hone their skills over a longer period of time. The recent study conducted by Susan Oerman, et al., “Effects of Practice on Competency in Single-Rescuer Cardiopulmonary Resuscitation” explains that:

“With practice, [students] learn to perform the skill consistently and more quickly than during their initial learning. As they continue to practice, they gain proficiency and eventually can perform the skill without thinking about each step; performance in this phase becomes automatic.” (Oerman, et al. 22)

The best way to increase an individual’s confidence is to increase their skill level. Someone who knows that they are fully trained and capable will be much less likely to hesitate because they know that if they do attempt CPR, they are likely to be successful.

Making successful completion of a CPR training course mandatory for all high school graduates would help combat the issues related to current training programs. High school training programs could be long-term. They could allow for multiple training sessions over the course of four years. In fact, there is no reason that CPR training could not start even sooner. Bohn’s 2012 study explains that students have the capability to learn and perform CPR at as young as ten years of age. In fact, students who were provided yearly training at a the age of ten retained more of the skill and were less anxious about performing it than those who received training twice a year starting at thirteen years old (Bohn 619). Not only does longer-term training lead to better results, but it also calls for less classroom time in the long run. The younger a student is when they start training, the more easily acquired and retained the skill is, which means that yearly maintenance training could be used to ensure quality of CPR skills over time. Allowing students yearly opportunities to revisit their CPR training would give students a chance to practice and improve their skills over enough time that they would be adequately learned, retained, and regularly practiced. They would eventually feel confident enough in their skills to know that if someone needed CPR they could administer it safely and effectively.

A less obvious benefit of mandatory CPR training for high school graduates is in the sheer number of individuals that would be add to the population of CPR trained individuals. Bohn study reported that only thirty percent of CPR trained individuals help in the event of cardiac arrest (619). While, as previously discussed, high school CPR training would help increase this percentage, so would simply having more individuals trained in the first place. The Western Interstate Commission for Higher Education reports that more than three million students are set to graduate high school in 2014. This would add three million more people to the pool of CPR trained individuals. Having this many appropriately trained people will be absolutely beneficial in saving lives of individuals with coronary artery disease who suffer cardiac arrest.

Breanna’s Law, and other laws like it, are being passed in various states. The country is slowly learning that CPR training in high school is important. It needs to learn that it is necessary. High school across America need to institute a CPR training program that not only allows for training, but also provides opportunities for practice and follow-up training to ensure that students graduating from high school are confident in their abilities to use cardiopulmonary resuscitation in the event that they are there at the time a victim suffers cardiac arrest. Passing a law that would make CPR training mandatory for all high school graduates is the best way to increase the likelihood that an individual with CPR training will be there when they are needed.

Works Cited

Bohn, A., H.k. Van Aken, T. Möllhoff, H. Wienzek, P. Kimmeyer, E. Wild, S. Döpker, R.p. Lukas, and T.p. Weber."Teaching resuscitation in schools: annual tuition by trained teachers is effective starting at age 10. A four-year prospective cohort study." Resuscitation 83.5 (2012): 619-625.

Dwyer, Trudy. "Psychological Factors Inhibit Family Members' Confidence to Initiate CPR."Prehospital Emergency Care 12.2 (2008): 157-161.

"Knocking at the College Door." The Western Interstate Commission for Higher Education. WICHE, n.d. Web. 7 Apr. 2014. http://knocking.wiche.edu/explore?state_id=U.

Mitchell, Anthony. "A Heart-to-Heart Talk." Techniques 1 May 2013: 5.

Oermann, Marilyn, Suzan E. Kardong-Edgren, Tamara Maryon-Odom, and Caleb J. Roberts. "Effects of Practice on Competency In Single-Rescuer Cardiopulmonary Resuscitation."MedSurg Nursing 23.1 (2014): 22-8.

Silverberg, Hank. "Push to train students in CPR region wide." USA 9. Gannett Satellite Information Network (CBS), 6 Feb. 2014. <http://www.wusa9.com/story/news/local/2014/02/06/students-learning-cpr/5266639/>.

Stump, Scott. "'I wasn't nervous': Teen baseball player helps save umpire with CPR." TODAY News. NBC News, 28 Mar. 2014. http://www.today.com/news/i-wasnt-nervous-teen-baseball-player-helps-save-umpire-cpr-2D79448003.

Vaillancourt, Christian, Ian Stiell, and George Wells. "Understanding and improving low bystander CPR rates: a systematic review of the literature." Canadian Journal of Emergency Medicine 10.1 (2008): 51-65. EbscoHost.

Ornato, Joseph P., and Mary Ann Peberty. Cardiopulmonary Resuscitation. Totowa: Humana Press, 2005.