The “chain of survival” in cardiac arrest includes early detection, prompt activation of emergency services, early cardiopulmonary resuscitation (CPR), and early defibrillation.

A survey was distributed to teachers in an urban public school district to assess their impressions of the effectiveness of CPR and of automated external defibrillators (AEDs), CPR training, willingness to perform CPR on students or co-workers, and support for AEDs in school and required CPR training.  Of the group (n=259), 77% returned surveys distributed by principals during a staff meeting.  The respondents taught in elementary (32%), middle (37%), or high school (31%). Most believed a patient would survive if CPR (83%) or CPR and AED use (92.6%) occurred until an ambulance arrived.

Nearly all (84.5%) believed at least one staff member should have CPR training. Only 44% believed training should be required for teacher certification.  Half (52%) had ever taken a CPR class.  Just 16% had training within the past two years.

Most had concerns about giving CPR to a co-worker (76%) or a student (87%). Those who had ever been trained were much more likely to attempt CPR than those not trained (71% vs. 23%). Most (92%) were willing to take a free CPR and AED course if offered.  Over 70% thought the school should have an AED and over 60% felt school AEDs should be bought with public funds.  Only 17% could call “911” directly from the classroom.

In a commentary, the director of a children’s hospital emergency services drew other conclusions.  Higher survival rates occur in communities with high rates of residents trained in CPR and prompt ambulance response.  The sample’s (75% female, mean age of 46 years) replies were consistent with middle-aged to older women’s views.  CPR training stresses motor skills but should address concerns about exposure to bodily fluids (with an option to perform only chest compressions) and motivate people to take action. Since most (94%) believed that each school should have a trained staff and an AED, perhaps interested staff could organize CPR training for volunteer teachers.

(Quan L. Am J Health Educ 2003;34(4):193-196)

Comment:  The survey did not distinguish between public education or other public funding. There was no indication of the availability or opinion that the school nurse should be the trained staff – another limitation of the survey questions. More schools will be stocked with AEDs so school nurses can take a leadership role to plan appropriate training and response plans in the event of need -- likely for a staff or visitor.  --J.O.