Submitted by SCAFoundation on Thu, 07/17/2014 - 7:16pm

Representatives from several national nonprofit organizations recently collaborated to develop an overview of the status of CPR/AED education in America’s K-12 schools for the Emergency Cardiovascular Care Update, a biennial conference of the Citizen CPR Foundation. The group is part of a task force on sudden cardiac arrest in youth, led by Stuart Berger, MD, of the Medical College of Wisconsin. Members include M. Kathleen Murphy, DNP, RN, of the National Association of School Nurses, Mary Newman, MS, of the Sudden Cardiac Arrest Foundation, Donna Siegfried of the National Safety Council, Merrilee Sweet of the American Heart Association, and Vicki Vetter, MD, of the Children’s Hospital of Philadelphia. Murphy and Newman chaired the subcommittee and presented the information that follows. (See attached slide set.)

CDC School Health Policies and Programs Studies

SHPPSThe Centers for Disease Control and Prevention (CDC)’s School Health Policies and Programs Studies, which were published most recently in 2000, 2006 and 2012, reveal the following:

  • In 2000, 10 states required elementary schools to teach CPR, 16 states required middle/ junior schools to teach CPR, and 20 states required senior high schools to teach CPR.
  • In 2006, the number of states requiring student instruction in CPR was not reported. However, 23 states reported providing funding for staff development in CPR.
  • In 2012, the number of states requiring student instruction in CPR again was not reported. However, the study listed 15 key educational topics including alcohol/drug use prevention, nutrition and dietary behavior, and STD prevention. CPR/AED instruction was conspicuously absent from the list of national education priorities.
A Poll of School Nurses

NASNThe subcommittee submitted a question to the National Association of School Nurses for its weekly online poll, asking, “Does your school have a CPR/AED training program for students?” The March 20-26 poll was not scientific, but it did provide some telling information. Of the 539 respondents:

  • 17% said CPR/AED education is required in their school
  • 16% said CPR/AED education is optional in their school
  • 67% said CPR/AED education is not required in their school.
 
States Where CPR/AED Education is Required Before Graduation from High School

States Where CPR/AED Training is Required in SchoolsWhile recent CDC School Health Policies and Programs Reports and the National Association of School Nurses poll are disappointing, there are promising indications that CPR/AED education in schools is a concept that is gaining traction. In 2011, the American Heart Association issued a statement urging state legislatures to make CPR education a requirement for all students before high school graduation and to provide the necessary funds to make this feasible. At that time, 36 states had legislation that “encouraged” CPR training.[1]

A compilation of reports from the American Heart Association, the Sudden Cardiac Arrest Foundation, and other sources now indicates there are 18 states that require quality CPR/AED education that includes psychomotor skills training before high school graduation. In Utah, CPR/AED training is not only required, but funding is available to schools to provide such training.

Other states have CPR/AED education requirements for schools, but there are limitations. For example: In Illinois, schools are required to offer CPR/AED training, but students are not required to undergo training (HB 3724). In Indiana, CPR/AED training is a requirement for graduation from high school, but schools can get waivers to opt out of the training requirement (HEA 1290). In Nevada, students must undergo CPR/AED training...as long as funds are available.

Still other states recommend CPR/AED training, but do not require it. In Wisconsin, for example, schools have been required to offer CPR/AED instruction since the 2011-2012 school year, however it not a requirement for high school graduation. In Connecticut, school boards will be required to make CPR/AED training available (Public Act 12-198) beginning in school year 2015-16. In South Dakota, CPR/AED training is recommended, but it is not a requirement that all students undergo such training (AB 414).

Other states considering legislation related to CPR/AED training in schools include Maine (LD 709, LD 1366), Massachusetts (SB 266), Michigan (HB 4272), New Jersey (AB 2072, SB 235), and New York (S 6410, A 8232).

Model Legislation

For states interested in making CPR/AED education mandatory in schools, the American Heart Association has put forth model legislation. (See attachment.) It would require all public, charter and private schools with grades 7-12 to:

  • Make CPR/AED education a requirement for graduation from high school
  • Provide CPR instruction and awareness about AED use
  • Use nationally recognized curricula based on current AHA/ECC guidelines
  • Include psychomotor skills training.

The model legislation would not require licensed teachers to be authorized CPR/AED instructors, however if course completion cards are offered, instruction would have to be provided by authorized CPR/AED instructors. It calls on state boards of education to be responsible for monitoring adherence to the program and adjusting state grant/ shared revenue amounts based on failure to comply.

Model School Programs

Three model programs were highlighted during the presentation: Milwaukee WI public schools, San Diego CA schools, and Georgia schools.

Murphy, previously associated with Milwaukee Public Schools, described the MPS CPR/AED program which is targeted to 9th graders, many of whom are from underserved populations (56% are African Americans; 80% are eligible for free or reduced cost lunches). She emphasized the importance of a three-pronged approach that features staff CPR/AED training, student CPR/AED training, and emergency response protocols. During the 2013-2014 school year, 150 youth in middle schools were trained through the AHA Family and Friends CPR Anytime program. In addition, infant and child CPR courses were offered to pregnant and parenting youth.

Alison EllisonThe San Diego Project Heart Beat program was also highlighted. The mantra of its champion, Maureen O’Connor, is to “Make it fun!” More… Project Save in Atlanta, an affiliate of Project Adam, was also showcased. Thanks to champion Alison Ellison and her colleagues, 2,246 schools with 1,633,596 students have been reached to date, and 39% of Georgia schools have been deemed “Heart Safe.” Since the program began, 40 of 70 SCA victims in Georgia schools have become survivors.

The session ended with an appeal to conference participants to help make CPR/AED education in schools universal. An article in PARADE magazine, which advocated for CPR education in schools 28 years ago (see attached) begged the question, “Isn’t it about time?” The audience seemed to agree that, whether or not CPR/AED education is required, all schools should make it available.

For more information on CPR/AED training and AED placement in schools, download a copy of You Can Save a Life at School here.

-Mary Newman, SCA Foundation


[1] Circulation. 2011; 123: 691-706 Published online before print January 10, 2011, doi: 10.1161/ CIR.0b013e31820b5328