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Current landscape in US schools for bystander CPR training and AED requirements

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Out-of-hospital cardiac arrest is a public health crisis affecting about 356,000 adults and 23,000 children annually in the US with 90% fatality. Early bystander CPR and AED application improve survival. Less than 3% of the US population is CPR trained annually. Since 20% of the US population is at school daily, these represent ideal places to target CPR training. Having standardized state school CPR and AED laws will help with training.

Methods

We performed a systemic search of the state-specific laws for school AED and CPR requirements within the US. We used PubMed and Google search using keywords: school CPR mandates, US laws for CPR in schools, US state laws for AED implementation, and gaps in US school CPR and AED. We searched for mandates for schools in other countries for comparison.

Results

The state laws for CPR training for high school graduation and AED requirements in US. schools are highly variable, and funding for AEDs is inadequate, especially in schools in lower socio-economic zip codes. Recent AED legislative efforts focus mainly on athletic areas and don’t adequately address school size, number of buildings, non-athletic areas, and engagement of student-led advocacy efforts.

Conclusion

To improve OHCA survival, we identified potential solutions to consolidate efforts and overcome the barriers—standardize state laws, involve student bodies, increase funding, and allocate appropriate resources. The CPR/AED education needs to start earlier in schools and be part of the standard curriculum rather than implemented as a stopgap check-box mandate.

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Data Availability

The data that support the findings of this review are available from the corresponding author, N.K.M., upon reasonable request.

Abbreviations

AED:

Automated External Defibrillator

AHA:

American Heart Association

CPR:

Cardiopulmonary Resuscitation

EAP:

Emergency Action Plan

OHCA:

Out-of-hospital Cardiac Arrests

SCA:

Sudden Cardiac Arrest

References

  1. American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2000;102:2135–302.

    Google Scholar 

  2. Public Access Defibrillation Trial Investigators. Public-access defibrillation and survival after out-of-hospital cardiac arrest. N Engl J Med. 2004;351(7):637–46.

    Article  Google Scholar 

  3. Yan S, Gan Y, Jiang N, et al. The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis. Crit Care. 2020;24:61. https://doi.org/10.1186/s13054-020-2773-2.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Anderson ML, Cox M, Al-Khatib SM, et al. Rates of cardiopulmonary resuscitation training in the United States. JAMA Intern Med. 2014;174(2):194–201.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Sherrid M, Aagaard P, Serrato S, et al. State Requirements for Automated External Defibrillators in American Schools. J Am Coll Cardiol. 2017;69(13):1735–43.

    Article  PubMed  Google Scholar 

  6. Maron BJ, Haas TS, Duncanson ER, et al. Comparison of the frequency of sudden cardiovascular deaths in young competitive athletes versus nonathletes: should we really screen only athletes? Am J Cardiol. 2016;117(8):1339–41.

    Article  PubMed  Google Scholar 

  7. Vetter V, Griffis H, Dalldorf K, et al. Impact of State Laws. J Am Coll Cardiol. 2022;79(21):2140–3.

    Article  PubMed  Google Scholar 

  8. Mitani Y, Ohta K, Yodoya N, et al. Public access defibrillation improved the outcome after out-of-hospital cardiac arrest in school-age children: a nationwide, population-based, Utstein registry study in Japan. Europace. 2013;15(9):1259–66.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Brown, Lorrel E., Halperin. CPR Training in the United States: The Need for a New Gold Standard (and the Gold to Create It) CPR Training in the US. Circ Res. 2018;123.8:950–952.

  10. Einspruch EL, Lynch B, Aufderheide TP, et al. Retention of CPR skills learned in a traditional AHA Heartsaver course versus 30-min video self-training: a controlled randomized study. Resuscitation. 2007;74(3):476–86.

    Article  PubMed  Google Scholar 

  11. Rose K, Martin M, Berger S, et al. Cardiac emergency response planning for schools: a policy statement. NASN Sch Nurse. 2016;31(5):263–70.

    Article  PubMed  Google Scholar 

  12. Garcia RA, Spertus JA, Girotra S, et al. Racial and Ethnic Differences in Bystander CPR for Witnessed Cardiac Arrest. N Engl J Med. 2022;387(17):1569–78.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Naim MY, Griffis HM, Burke RV, et al. Race/Ethnicity and Neighborhood Characteristics Are Associated with Bystander Cardiopulmonary Resuscitation in Pediatric Out-of-Hospital Cardiac Arrest in the United States: A Study From CARES. J Am Heart Assoc. 2019;8(14):e012637.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Caroll Independent School District, Southlake, TX, USA

    Ketan Tamirisa

  2. Division of Cardiovascular Medicine, St. Louis University School of Medicine, St. Louis, MO, USA

    Hiren Patel

  3. Heart and Vascular Institute, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA

    Saima Karim

  4. Department of Cardiovascular Medicine, Corewell William Beaumont University Hospital, Royal Oak, MI, USA

    Nishaki Kiran Mehta

Authors
  1. Ketan Tamirisa
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  2. Hiren Patel
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  3. Saima Karim
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  4. Nishaki Kiran Mehta
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Corresponding author

Correspondence to Nishaki Kiran Mehta.

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Tamirisa, K., Patel, H., Karim, S. et al. Current landscape in US schools for bystander CPR training and AED requirements. J Interv Card Electrophysiol 66, 2177–2182 (2023). https://doi.org/10.1007/s10840-023-01579-9

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  • DOI: https://doi.org/10.1007/s10840-023-01579-9

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